This study was conducted to investigate the association between socio-demographic factors and attitudes toward antibiotic resistance and consumer's knowledge on antibiotic use for common cold. Telephone survey was conducted between June 24 and July 2, 2009, among 1,015 adults who were randomly stratified by age, sex and area. A total of 921 respondents were included in the analysis. Logistic regression was used to analyze the influence of socio-demographic factors on knowledge and attitudes. A total of 452 respondents(49.1%) recognised that they knew about antibiotic resistance and 769 respondents(83.5%) worried that antibiotic resistance is a serious problem in Korea. A total of 577 respondents(62.7%) had adequate knowledge on antibiotic use and resistance. Multiple logistic regression showed that younger age and higher education level were associated with adequate knowledge. The odds ratio of appropriate knowledge among persons with college degrees was 5.25(95% CI, 2.78-9.90) compared to those with elementary or less education. Sex and income variable were not predictors of adequate knowledge on antibiotic use and resistance. This study showed that consumers with less education had inadequate knowledge on antibiotic use for common cold. Even though consumers in their 40s and 50s thought they knew about antibiotic resistance, there is a need to improve their knowledge. Education campaigns for appropriate antibiotic use have to be differentiated among consumers with different socio-demographic characteristics.
Objectives: This study investigated the association between perceived ethnic discrimination and depressive symptoms among biethnic adolescents in South Korea. Methods: We performed a cross-sectional study of 4141 biethnic adolescents using data from the 2012 National Survey of Multicultural Families. Perceived ethnic discrimination was measured using the question "Have you ever been discriminated against or ignored because either of your parents is not a Korean?" with an assessment of depressive symptoms over the past 12 months. Logistic regression was applied to examine potential associations between perceived ethnic discrimination and depressive symptoms. Results: Among 4141 biethnic adolescents, 558 (13.5%) reported having experienced ethnic discrimination. The most common discriminatory perpetrators were friends (n=241, 5.8%), followed by strangers (n=67, 1.6%). Depressive symptoms were related to experience of ethnic discrimination (odds ratio [OR], 3.80; 95% confidence interval [CI], 2.89 to 4.98) after adjusting for potential confounders. In an analysis focusing on the perpetrators of discrimination, depressive symptoms were found to be associated with perceived ethnic discrimination from friends (OR, 3.95; 95% CI, 2.75 to 5.68), teachers (OR, 4.53; 95% CI, 2.16 to 9.51), family members and relatives (OR, 3.89; 95% CI, 1.59 to 9.48), neighbors (OR, 2.48; 95% CI, 1.14 to 5.38), and strangers (OR, 2.49; 95% CI, 1.30 to 4.79). Furthermore, the OR for depressive symptoms among those exposed to 1, 2, or 3 or more discriminatory perpetrators were 3.61 (95% CI, 2.49 to 5.24), 3.61 (95% CI, 1.68 to 7.74), and 6.69 (95% CI, 2.94 to 15.22), respectively. Conclusions: According to our findings, friends were the most common perpetrators of discrimination and the experience of ethnic discrimination was associated with depressive symptoms among biethnic adolescents in South Korea.
Intestinal parasitic infections remain a major public health problem in many parts of Thailand, particularly in rural areas. This study aimed to determine the prevalence of intestinal parasitic infections and associated risk factors among the people living in Huai Sai sub-district, Bang Khla district, Chachoengsao Province, central Thailand. A cross-sectional survey was carried out from June 2017 to August 2017 which included a total of 224 participants. Stool samples were examined using a simple direct smear and formalin ethyl acetate concentration technique. Association between risk factors and intestinal parasitic infections was assessed using multivariate logistic regression analysis. The overall prevalence of intestinal parasitic infections was 16.1%. Soil-transmitted helminth infections (14.3%) were more common than protozoan infections (1.8%). The most common intestinal parasites were hookworms (6.7%) followed by Strongyloides stercoralis, (5.0%), Ascaris lumbricoides (1.3%) and Trichuris trichiura (1.3%). Entamoeba histolytica/dispar (1.0%), Giardia intestinalis (0.4%), and Blastocystis hominis (0.4%) were the protozoans identified. A high prevalence of infections was found in male participants of ${\geq}40years$ who raised dogs in the households and did not wear boots while working fields. Multivariate analysis showed a significant association of intestinal parasitic infections with gender with the adjusted odds ratio (OR) of 2.4 and 95% confidence interval (CI) of 1.1-5.2 (P=0.020). The results showed a high prevalence of soil-transmitted helminth infections among adults in rural communities which were particularly apparent regarding the skin-penetrating species of nematodes. A greater focus on intervention is required by improving sanitation and personal hygiene to prevent the spread of intestinal parasitic infections.
Kim, Sang Uk;Lee, Dong Hoon;Kim, Young Il;Yang, Seung Ho;Sung, Jae Hoon;Cho, Chul Bum
Journal of Korean Neurosurgical Society
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제60권6호
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pp.701-709
/
2017
Objective : Chronic subdural hematoma is a common and relatively benign disease. However, recurrence is common after surgical treatment, and the recurrence rate varies from 5% to 33%. The aim of this study was to investigate the predictive factors for recurrence of chronic subdural hematoma. Methods : We analyzed data from 248 patients with chronic subdural hematoma who were treated by burr-hole craniostomy with a closed drainage system for hematoma evacuation in this five-year retrospective study. Results : Thirty-one (12.6%) patients underwent re-operation for recurrence of chronic subdural hematoma. Univariate analysis revealed that anticoagulation (p=0.0279), headache (p=0.0323), and preoperative midline shifting (p=0.0321) showed significant differences with respect to recurrent chronic subdural hematoma. We performed a multivariate logistic regression analysis and found that diabetes mellitus (odds ratio [OR], 2.618; 95% confidence interval [CI], 1.0899-6.2898; p=0.0314), anticoagulation (OR, 6.739; 95% CI, 1.1287-40.2369; p=0.0364), headache (OR, 2.951; 95% CI, 1.1464-7.5964; p=0.0249), and preoperative midline shifting (OR, 1.0838; 95% CI, 1.0040-1.1699; p=0.0391) were independent predictive factors for recurrence of chronic subdural hematoma. Conclusion : We showed that diabetes mellitus, anticoagulation, headache, and preoperative midline shifting were independent predictors of recurrence of chronic subdural hematoma.
Objective: The PI3K/PTEN/AKT/mTOR signaling pathway has been implicated in resistance to cisplatin. In the current study, we determined whether common genetic variations in this pathway are associated with platinum-based chemotherapy response and clinical outcome in advanced non-small cell lung cancer (NSCLC) patients. Methods: Seven common single nucleotide polymorphisms (SNPs) in core genes of this pathway were genotyped in 199 patients and analyzed for associations with chemotherapy response, progression-free survival (PFS) and overall survival (OS). Results: Logistic regression analysis revealed an association between AKT1 rs2494752 and response to treatment. Patients carrying heterozygous AG had an increased risk of disease progression after two cycles of platinum-based chemotherapy compared to those with AA genotype (Adjusted odds ratio (OR)=2.18, 95% confidence interval (CI): 1.00-4.77, which remained significant in the stratified analyses). However, log-rank test and cox regression detected no association between these polymorphisms in the PI3K pathway genes and survival in advanced NSCLC patients. Conclusions: Our findings suggest that genetic variants in the PI3K/PTEN/AKT/mTOR pathway may predict platinum-based chemotherapy response in advanced NSCLC patients in a Chinese population.
The Apolipoprotein E type 4 allele (ApoE ${\varepsilon}4$) is genetically associated with the common late onset familial and sporadic forms of Alzheimer's disease. The BchE-k variant, which is the common variant of the BchE gene, has been reported to show allelic association with AD in subjects who are also carriers of the ${\varepsilon}4$ allele of the ApoE, especially in subjects over the age of 75. This study was performed to evaluate the distribution of the ApoE and the BchE genotypes in the healthy and AD groups and to evaluate the synergy between the BchE-k variant and the ApoE ${\varepsilon}4$ in AD. The ApoE and the BchE genotypes were determined in DNA samples from 610 healthy people and 60 LOAD patients by using ARMS by standard agarose gel electrophoresis. The effect of the ApoE ${\varepsilon}4$ was closely related to AD(p<0.05). A comparison between the AD patients and the healthy individuals, both with the ${\varepsilon}4$ allele, indicated an interaction between the BchE-k and the ApoE ${\varepsilon}4$(p<0.05). The association of the BchE-k with AD was limited to carriers of the ApoE ${\varepsilon}4$ allele, among whom the presence of the BchE-k gave an odds ratio of AD 3.48 (95% C.I. 1.3-9.2). Therefore, these results suggested that further evidence of an association between the ApoE ${\varepsilon}4$ and LOAD, and the BchE-k acts in synergy with the ApoE ${\varepsilon}4$ as a susceptibility gene for AD.
Kim, Jeong Han;Choe, Won Hyeok;Kwon, So Young;Yoo, Byung-chul
Journal of Korean Medical Science
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제33권52호
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pp.335.1-335.17
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2018
Background: Spontaneous bacterial peritonitis (SBP) is a serious infectious complication in patients with liver cirrhosis. However, information about prognosis of SBP in hepatocellular carcinoma (HCC) patients is limited. We investigated the clinical course of SBP in HCC patients. Methods: This study enrolled patients diagnosed with SBP between 2005 and 2017. Medical records of patients were reviewed and clinical course was compared between the non-HCC and HCC groups. Results: In total, 123 SBP cases including 49 HCC cases were enrolled. Men were predominant (48/74, 64.9% vs. 34/49, 69.4%; P = 0.697); median age was 58 years in both non-HCC and HCC groups (P = 0.887). The most common etiology was alcohol (32/74, 43.2%) in non-HCC group and hepatitis B (30/49, 61.2%) in HCC group (P = 0.009). Antibiotic resistance rate was higher in non-HCC than in HCC group (29.7% vs. 12.2%; P = 0.028); in-hospital mortality did not differ between the groups (25/74, 33.8% vs. 13/49, 26.5%; P = 0.431). Development rate of hepatorenal syndrome did not differ between non-HCC and HCC group (14/74, 18.9% vs. 10/49, 20.4%; P = 1.000), but hepatic encephalopathy was less common in HCC group (26/74, 35.2% vs. 9/49, 18.3%; P = 0.008). The most important predictor of in-hospital mortality in patients with HCC was white blood cell count above $11,570cells/mm^3$ (odds ratio, 6.629; 95% confidence interval, 1.652-26.590; P = 0.008). Conclusion: Prognosis of SBP in HCC patients is relatively less severe. This result may be related with reduced antibiotics resistance and lower development rates of other complications, such as hepatic encephalopathy. Degree of systemic inflammation may be the most important factor for in-hospital mortality.
Kim, Se Jin;Kim, Ga Eun;Park, Jae Hyun;Lee, Sang Lak;Kim, Chun Soo
Clinical and Experimental Pediatrics
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제62권1호
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pp.36-41
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2019
Purpose: In this study, we investigated the clinical features and prognostic factors of early-onset sepsis (EOS) in neonatal intensive care unit (NICU) patients. Methods: A retrospective analysis was conducted on medical records from January 2010 to June 2017 (7.5 years) of a university hospital NICU. Results: There were 45 cases of EOS (1.2%) in 3,862 infants. The most common pathogen responsible for EOS was group B Streptococcus (GBS), implicated in 10 cases (22.2%), followed by Escherichia coli, implicated in 9 cases (20%). The frequency of gram-positive sepsis was higher in term than in preterm infants, whereas the rate of gram-negative infection was higher in preterm than in term infants (P<0.05). The overall mortality was 37.8% (17 of 45), and 47% of deaths occurred within the first 3 days of infection. There were significant differences in terms of gestational age (26.8 weeks vs. 35.1 weeks) and birth weight (957 g vs. 2,520 g) between the death and survival groups. After adjustments based on the difference in gestational age and birth weight between the 2 groups, gram-negative pathogens (odds ratio [OR], 42; 95% confidence interval [CI], 1.4-1,281.8) and some clinical findings, such as neutropenia (OR, 46; 95% CI, 1.3-1,628.7) and decreased activity (OR, 34; 95% CI, 1.8-633.4), were found to be associated with fatality. Conclusion: The common pathogens found to be responsible for EOS in NICU patients are GBS and E. coli. Gram-negative bacterial infections, decreased activity in the early phase of infection, and neutropenia were associated with poor outcomes.
Background: Acute rhinosinusitis (ARS) is a common condition encountered in ambulatory practice and is one of the most common reasons for antibiotic prescriptions. This study aimed to evaluate the potentially inappropriate antibiotic prescribing for ARS in South Korea and identify influencing factors. Methods: We analyzed Health Insurance Review and Assessment Service-National Patient Samples data. We selected outpatients aged 20 to 64 with ARS, prescribed antibiotics between February and November 2020. Potentially inappropriate antibiotic prescribing was categorized as: 1) inappropriate antibiotic selection and 2) inappropriate antibiotic dosage or duration. Multiple logistic regression was conducted to estimate the impact of various factors on inappropriate antibiotic prescribing. Results: Of 1,210 patients, 80.83% received potentially inappropriate ARS antibiotic prescriptions. Inappropriate antibiotic selection accounted for 43.55%, and inappropriate antibiotic dosage and duration contributed to 37.28%. Otolaryngologists had higher odds ratio (OR) of potentially inappropriate antibiotic prescribing compared to internal medicine practitioners, while dentists had lower OR. Patients aged 20 to 29 years had a higher OR than other age groups, and those who visited primary care clinics had a higher OR than those who visited hospitals. Conclusion: Potentially inappropriate antibiotic prescribing for ARS is prevalent in South Korea. This study identified physician specialty, patient age group, and the level of healthcare facility as factors influencing potentially inappropriate antibiotic prescriptions. Addressing this issue through targeted interventions, such as improved guidelines adherence and patient education, is imperative to mitigate the risks associated with antibiotic misuse and antibiotic resistance.
Purpose: Periprosthetic femoral fracture (PFF) is a common complication after total hip arthroplasty, and open reduction and internal fixation (ORIF) is a common surgical treatment. We conducted a meta-analysis to compare the outcomes of ORIF in patients with different fracture patterns (Vancouver B1 and B2). Materials and Methods: We conducted a systematic search of PubMed, Embase, Cochrane Library and KoreaMed from inception to August 2022. We conducted a pair-wise meta-analysis (with a fixed-effects model) on the 10 comparative studies and a proportional meta-analysis on the data from the 39 articles to determine a consensus. The outcomes were the incidence of reoperations that included osteosynthesis, irrigation/debridement and revision arthroplasty. Results: The pair-wise meta-analysis showed similar outcomes between two groups; the risk of reoperation (odds ratio [OR]=0.82, confidence interval [CI] 0.43-1.55, P=0.542), nonunion (OR=0.49; CI 0.22-1.10, P=0.085) and deep infection (OR=1.89, CI 0.48-7.46, P=0.361). In proportion meta-analysis, pooled prevalence of reoperation was 9% (95% CI, 6-12) in B1 and 8% (95% CI, 2-15) in B2 (heterogeneity between two groups (Q), P=0.772). The pooled prevalence of nonunion was same as of 4% in B1 and B2 (Q, P=0.678), and deep infection was 2% (95% CI, 1-3) in B1 and 4% (95% CI, 2-7) in B2 (Q, P=0.130). Conclusion: ORIF is a feasible treatment for B1 and B2 periprosthetic femoral fractures, with acceptable outcomes in terms of, nonunion and infection. The results of this study would help clinicians and provide baseline data for further studies validating PFF.
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