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High Prevalence of Helicobacter pylori Resistance to Clarithromycin: a Hospital-Based Cross-Sectional Study in Nakhon Ratchasima Province, Northeast of Thailand

  • Tongtawee, Taweesak;Dechsukhum, Chavaboon;Matrakool, Likit;Panpimanmas, Sukij;Loyd, Ryan A;Kaewpitoon, Soraya J;Kaewpitoon, Natthawut
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8281-8285
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    • 2016
  • Background: Helicobacter pylori is a cause of chronic gastritis, peptic ulcer disease, and gastric malignancy, infection being a serious health problem in Thailand. Recently, clarithromycin resistant H. pylori strains represent the main cause of treatment failure. Therefore this study aimed to determine the prevalence and pattern of H. pylori resistance to clarithromycin in Suranaree University of Technology Hospital, Suranree University of Technology, Nakhon Ratchasima, Northeastern Thailand, Nakhon Ratchasima province, northeast of Thailand. Materials and Methods: This hospital-based cross-sectional study was carried out between June 2014 and February 2015 with 300 infected patients interviewed and from whom gastric mucosa specimens were collected and proven positive by histology. The gastric mucosa specimens were tested for H. pylori and clarithromycin resistance by 23S ribosomal RNA point mutations analysis using real-time polymerase chain reactions. Correlation of eradication rates with patterns of mutation were analyzed by chi-square test. Results: Of 300 infected patients, the majority were aged between 47-61 years (31.6%), female (52.3%), with monthly income between 10,000-15,000 Baht (57%), and had a history of alcohol drinking (59.3%). Patient symptoms were abdominal pain (48.6%), followed by iron deficiency anemia (35.3%). Papaya salad consumption (40.3%) was a possible risk factor for H. pylori infection. The prevalence of H. pylori strains resistant to clarithromycin was 76.2%. Among clarithromycin-resistant strains tested, all were due to the A2144G point mutation in the 23S rRNA gene. Among mutations group, wild type genotype, mutant strain mixed wild type and mutant genotype were 23.8%, 35.7% and 40.5% respectively. With the clarithromycin-based triple therapy regimen, the efficacy decreased by 70% for H. pylori eradication (P<0.01). Conclusions: Recent results indicate a high rate of H. pylori resistance to clarithromycin. Mixed of wild type and mutant genotype is the most common mutant genotype in Nakhon Ratchasima province, therefore the use of clarithromycin-based triple therapy an not advisable as an empiric first-line regimen for H. pylori eradication in northeast region of Thailand.

Clinical, Laboratory Biomarkers and Imaging Findings of Pancreatic Adenocarcinoma in Iran

  • Hadizadeh, Mohammad;Padashi, Maryam;Alizadeh, Amir Houshang Mohammad;Zali, Mohammad Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.10
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    • pp.4349-4352
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    • 2014
  • Background: Pancreatic cancer has a high mortality rate because it is usually diagnosed late. Since little is known about this cancer in Iran, with the aim of improving this knowledge deficiency, we evaluated clinical, laboratory biomarkers, imaging findings and treatment modalities in Iranian patients with pancreatic adenocarcinoma. Materials and Methods: 131 cases of pancreatic adenocarcinoma in 2010-2013 were obtained from the Taleghani Hospital Record Department. Cases confirmed by histopathology from CT-guided biopsy, EUS-FNA and surgery examination were included. We excluded those with incomplete medical records. Results: The study included 131 subjects between 24 and 97 years of age and a mean age of $63{\pm}13.4$ years. Eighty (61.1%) were male and 51 (38.9%) female. Previous history included diabetes mellitus in 36 (27.5%), alcohol drinking in 5 (3.9%), smoker in 28 (21.4%) and opium addiction in 13 (10%). The common presenting history included weight loss in 79 (60.3%), abdominal pain in 77 (58.8%), fever in 11 (8.4%), nausea in 30 (22.9%), jaundice in 72 (55%), pruritus in 52 (39.7) and anemia in 33 (25.2%). CA19-9 levels with cut offs of 50, 100 and 200 U/ml were increased in 81%, 72% and 66% of patients, respectively. Tumor staging was: stage I, 3 (2.3%); stage II, 10 (7.6%); stage III, 58 (44.3%); and stage IV, 60 (45.8%). From 45 patients, 17 received ERCP inserted metallic stents and 22 plastic stents, the remaining 6 failed that PTC was done. Whipple surgery and chemotherapy were conducted for 10 and 29 patients, respectively. Conclusions: This disease affected older people and there was a male preponderance. The commonest risk factors were diabetes mellitus, smoking and cholelithiasis. The majority of patients presented with loss of appetite, loss of weight, jaundice, abdominal pain and discomfort. Almost all presented at late stages of the disease so that curative surgery was impossible. Also chemotherapy was only performed in a few patients as a neoadjuant treatment.

The Influence of Family Support Degree on the Depression of the Elderly in a Rural Area (일부(一部) 농촌노인(農村老人)이 지각한 가족지지(家族支持)가 우울에 미치는 영향(影響))

  • Kim, Mi-Suk;Kim, Ki-Soon;Park, Jong;Cho, Yong-Rae;Kim, Yang-Ok
    • Journal of agricultural medicine and community health
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    • v.24 no.1
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    • pp.115-129
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    • 1999
  • To find the influence of family support degree on the depression of the elderly in a rural area, a questionnaire survey was made toward 163 persons who were more than 65 years old and living in a township at Chollanamdo province from January 1st to February 20th, 1998. The major findings are as follows : 1. By simple analysis significantly associated variables with depression score were residence, adequacy of pocket money, health consciousness, drinking alcohol, smoking, score of activity of daily living(ADL), score of instrumental activities of daily living(IADL), and degree of family support among female respondents(p<0.05). 2. To find the influence of family support on the depression score excluding other associated variables, multiple regression analysis was made and it was found that family support was associated significantly with affective, somatic, psychomotor and psychological domain of depression score among male, and somatic, psychomotor and psychological domain among female(p<0.05). The above finding suggest that family support degree is an important factor to be associated with the depression of the elderly in the rural area. So to deal with the depression of rural elderly, how to make close relation among family members must be considered.

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A Study on the Eating Habits and Its Related Factors of Residents in Urban Area (도시지역주민의 식습관과 연관요인 연구)

  • 남원계;임재은
    • Korean Journal of Health Education and Promotion
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    • v.13 no.2
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    • pp.69-96
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    • 1996
  • This study was conducted to investigate the awareness and practice level of health food intake and use the information for the development of Public Health Policy and Health Education Program in order to help healthy dietary life. The interview was done by trained surveyors on 1, 143 city dwellers who were selected randomly from Oct. 2, to Oct. 21, 1992. The results are summarized as follows: 1) General characteristics of subjects; Among 1, 143 respondents, there were more female(53.8%) than males(46.2%) and the age group of 20-29 account for the hightest portion, 46.7%. As for the education levels, 45.3% of the subjects were college graduates. And 38.9% of the subjects were students. 2) The percentage of subjects who assess themselves ‘Healthy’ was 46.7% and ‘Not Healthy’ was 17.4%. 3) The subjects who have irregular meals(3 times a day) was 48.7%, the rate of females was higher than males. The proportion of unmarried subjects, people with low economic level, high education level, and students was high. 4) As for the amount of 1 meal, 72.4% was ‘moderate’, 16.3% was ‘too much’ amount, which was higher in 19 years old, single, low economic level, elementary school graduate, than other groups. 5) As for the eating speed, 40.2% was fast, which was higher in single(44.3%), in low economic level(50.0%). college graduate(44.9%), student(44.7%) than other groups. 6) As for the level of preference to hot and salty food, 25.7% preferred to have hot and salty food. The difference in the degree of preference to hot and salty food by age and economic level was significant. 7) With regard to the individual food taste, the subjects who prefer to meat and fried food were 12.3%. Which was higher in the group under 19 years old, single, and college graduates. 8) With regard to having a snack, 38.7% have a snack. By characteristics, the subjects who have a snack were higher in female, under 19 years old, single, high economic level, apartment dwellers, college graduate, and student than other groups. 9) As for the coffee intake amount per day, 39.8% of subjects was more than 3 cups daily. 10) With regard to the self-assessment of body weight, the subjects who assess themselves over body weight had late dinner time. 11) As for the correlation among related variables, the age and taking breakfast was positive correlation. And sex and drinking alcohol was positively associated while age had negative correlation.

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Factors affecting HRQOL in Elders with Hearing Impairment : Based on the 2018 KNHNES (청력저하 노인의 건강과 관련된 삶의 질 영향요인: 2018 국민건강영양조사 자료를 이용하여)

  • Ha, Jeongmin;Park, Dahye
    • Journal of the Korea Convergence Society
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    • v.11 no.7
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    • pp.97-104
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    • 2020
  • The Purpose of this paper was to explore the effect of hearing impairment on HRQOL in Korean elders. We carry out a cross-sectional analysis using nationally representative data from the KNHANES, 2018. A total of 528 elders who had hearing impairment were included. Statistical analysis was performed using SPSS 25.0, χ2-test, t-test, correlation, and regression analysis to confirm the quality of life, and the influencing factors. There were significant differences in HRQOL according to gender, age, education, marital status, income, occupation, number of household members, tinnitus, number of comorbidities, smoking status, alcohol drinking status, subjective health status, regular exercise, restriction of activity, depressive mood and perceived stress. The results indicated that age, BMI and number of comorbidities had a significant negative association with HRQOL. In addition, marital status, number of comorbidities, body mass index, subjective health status, regular exercise, restriction of activity and perceived stress were predictors of life quality in elders with Hearing Impairment and the variable in the health-related quality of life was explained by 37.3%. In order to improve the HRQOL of elders with hearing impairment, multidisciplinary efforts and development of educational programs are required.

Correlation between Hair Mercury Concentration and Blood Total Mercury in Several Area Residents (일부 지역 주민들의 모발 수은 농도와 혈중 수은 농도와의 상관성)

  • Kim, Gyeong-Yeon;Seo, Jeong-Wook;Kim, Byoung-Gwon;Kim, Yu-Mi;Kim, Rock-Bum;Kim, Dae-Seon;Kim, Jung-Man;Kim, Choon-Jin;Hong, Young-Seoub
    • Journal of Environmental Health Sciences
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    • v.39 no.2
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    • pp.117-129
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    • 2013
  • Background: This study was carried out for the purpose of comprehensively evaluating the mercury exposure level of residents in several areas and the correlation between hair mercury concentration and blood mercury concentration. Method: One thousand one hundred ninety seven subjects were sampled from 30 sites using random assignment sampling. We performed a questionnaire survey and measured the level of total mercury in hair and blood samples from all subjects. Results: The geometric mean concentrations of hair and blood mercury in all subjects were 1.27 mg/kg [95% confidence interval (CI): 1.23-1.32 mg/kg] and 5.24 ${\mu}g/L$ [95% CI: 5.07-5.41 ${\mu}g/L$], respectively. Male (1.56 mg/kg in hair, 6.00 ${\mu}g/L$ in blood) was significantly higher than that of female (1.03 mg/kg in hair, 4.56 ${\mu}g/L$ in blood), and the concentrations were elevated as age increased up to the 50s. Education, smoking, alcohol drinking, and using of pesticides were also shown to influence mercury concentrations in hair and blood. The ratio of hair/ blood mercury concentration was 261.3. The total mercury concentration in hair was identified to be significantly related with total mercury concentration in blood (r=0.814, p<0.001). Conclusion: The geometric mean concentrations of hair and blood mercury were higher than the levels provided in international recommendations. The total mercury concentration in hair was positively correlated with the concentration in blood. The results of this study suggest that hair mercury be considered as a useful tool for the evaluation of mercury exposure.

A Study on Factors Related to Stroke Patients in Taegu Area (한방병원 내원 뇌졸중 환자에 대한 역학적 조사)

  • 김웅각
    • Biomedical Science Letters
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    • v.4 no.2
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    • pp.153-164
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    • 1998
  • A study on factors related to stroke patients in three oriental medical hospitals in Taegu area was conducted from October 1997 through December 31, 1997. One hundred and sixty three hospitalized and ambulatory patients were interviewed by traind interviewers according to the questionnaires prepared in advance. The results are summarized as follows; male and female ratio of the subjects was 1 to 1.36, and of the subjects 36.8% were 60's of the age and 25.2% were 50's and 19.6% were 70's. 74.7% of the patients were married and 41.5% of them had only six year education. 20% of the subjects became stroke victims while they were engaged in physical activities, 16.2% while in sleep, 15.5% because of psycological shock, and 7.2% while drinking. Of 157 precisely diagnosed cases, cerebral infarction was the most frequent cause (47.7%), cerebral hemorrhage was the second (38.2%), and subarachnoid hemorrhage (5.1%) respectly, Of 161 cases, 64% were normal in body weight, 26.7% were obese and 9.3% were light. Of 163 cases, 65.6% of them did not drink alcohol. Of 162 cases, 63% did not smoke cigarettes.

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Fasting Serum Glucose and Subsequent Liver Cancer Risk in a Korean Prospective Cohort (공복 혈당과 간암 발생 위험에 관한 코호트 연구)

  • Gwack, Jin;Hwang, Seung-Sik;Ko, Kwang-Pil;Jun, Jae-Kwan;Park, Sue-Kyung;Chang, Soung-Hoon;Shin, Hai-Rim;Yoo, Keun-Young
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.1
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    • pp.23-28
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    • 2007
  • Objectives : Chronic infections with hepatitis B or C and alcoholic cirrhosis are three well-known major risk factors for liver cancer. Diabetes has also been suggested as a potential risk factor. However, the findings of previous studies have been controversial in terms of the causal association. Therefore, the aim of this study was to evaluate the association between serum glucose levels and liver cancer development in a Korean cohort. Methods : Thirty-six liver cancer cases were identified in the Korean Multi-Center Cancer Cohort (KMCC). Baseline information on lifestyle characteristics was obtained via questionnaire. Serum glucose levels were measured at the study's enrollment. Relative risks (RRs) were estimated using a Cox proportional hazard regression model. The adjusting variables included age, gender, smoking history, alcohol consumption, body mass index, and hepatitis B surface antigen (HBsAg) seropositivity. Results : The RRs of serum glucose for liver caner were 1.20 (95% CI = 0.48-2.99) for the category of 100 to 125 mg/dL of serum glucose and 2.77 (95% CI = 1.24-6.18) for the >126 mg/dL serum glucose category (both compared to the <100 mg/dL category). In a subgroup analysis, the RR of serum glucose among those who were both HBsAg seronegative and non-drinkers was 4.46 (95% CI = 1.09-18.28) for those with glucose levels >100 mg/dL. Conclusions : The results of this study suggest that a high level of serum glucose can increase liver cancer risk independently of hepatitis infection and drinking history in Koreans. This study implies that glucose intolerance may be an independent risk factor for liver cancer.

Prevalence of Laryngo-pharyngeal Reflux(LPR) Related Symptoms at the Out Patient Department in Korea : One Week Survey (우리나라 이비인후과 외래환자의 인.후두 역류증상 발병빈도 조사(One Week Survey 결과))

  • Choi, Hong-Sik;Kim, Hyung-Tae;Seo, Jang-Soo;Wang, Soo-Gun;Cho, Jae-Sik;Choi, Gun;Hong, Ki-Hwan;Kim, Seok-Il;Lee, Won-Chul
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.11 no.1
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    • pp.87-97
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    • 2000
  • One week survey to investigate the prevalence rate and clinical characteristics of laryngopharyngeal reflux symptoms in Korea. The subject(n=7,704 patients) was newly enrolled patients at the out patient clinic in 90 ENT departments of resident training hospitals and 11 local clinics, which were voluntarily participated in the study 1) Twenty five percent of all enrolled patients has LPR-related symptoms or clinical findings from the examination by ENT specialists. 2) Among e name of LPR-related diagnosis, globus syndrome was e most common, and follows by reflux laryngitis, and chronic laryngitis. 3) Women was more prevalent than men, and it is common in 5th, 6th, and 7th decades, which seems to be related with aging process. 4) Most popular symtoms of LPR. were globus sensation, conic throat clearing, and hoarseness of unknown origin. 5) Aggravating factors of LPR-related symptoms were tiredness, mental stress, drink alcohol, cigarettes smoking, spicy food, and drinking coffee. 6) LPR-related symptoms were more common in professional voice users. 7) In past medical history, diseases of stomach and tonsillitis were most common.

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Dietary Behavior, Health Status, and Perceived Stress of University Students (대학생의 식행동과 건강 상태 및 스트레스에 관한 연구)

  • Cho, Jee-Ye;Song, Jae-Chul
    • The Korean Journal of Food And Nutrition
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    • v.20 no.4
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    • pp.476-486
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    • 2007
  • This study was performed to investigate the dietary behaviors, perceived stress, and health-related factors along with their correlations in University students. The number of subjects was 150(64 males and 86 females), and the results of the study were as follows: Stress was felt by over 80% of the male and female students. The male students were more stressed than the females for economic value, gender difference, professor and drinking-related stress factors, and there was a significant difference between the genders. The female students had more clinical symptoms from stress than the male students in terms of dizziness, indigestion and constipation(p<0.01, p<0.001). The amount of food intake under stress was significantly different by gender. The female students preferred sweet tasting items, whereas the male students preferred hot tasting item when under stress. Also the intake of candy and chocolate when under stress in the male and female students was $2.00{\pm}0.74$ and $2.41{\pm}0.75$, respectively. The female students consumed candy and chocolate more than the male(p<0.01). Furthermore, 62.5% of the male students and 30.2% of the female students exercised to get rid of stress: the use of ball games as exercise in male and female students was $1.59{\pm}0.83$, $1.01{\pm}0.11$, respectively. Many students drank alcohol and smoked while under stress. In particular, the male students smoked more than normal as compared to the females, and there was a significant gender difference(p<0.001). The clinical symptoms positively correlated with the life stress level were degree of nervousness, sweaty, achy neck and shoulders, sore back, dizziness, eye fatigue, headache and indigestion. The amount of food intake under stress was positively correlated to the clinical symptom of headache. These results indicate the effects of life stress on dietary behaviors, food choice, and health status. Stress not only changed dietary behaviors, but was also related to health status. Therefore, education with regard to nutrition is necessary if college students are to practice food eating habits to correctly manage life stresses.