• Title/Summary/Keyword: Disease Activity Score 28

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Validation of the Short Form Bobath Memorial Hospital Fall Risk Assessment Scale at a Specialized Geriatric Hospital in Korea (단축형 노인 낙상위험 사정도구의 타당도)

  • Sohng, Kyeong-Yae;Park, Mi Hwa;Chaung, Seung Kyo;Park, Hye Ja
    • Journal of Korean Public Health Nursing
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    • v.28 no.3
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    • pp.495-508
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    • 2014
  • Purpose: This study was conducted in order to evaluate the reliability, validity, sensitivity, and specificity of the Short Form of Bobath Memorial Hospital Fall Risk Assessment Scale (BMFRAS-SF). Methods: A validation study was conducted on 207 elderly patients aged over 65 who were admitted to Bobath Memorial Hospital. Fall risk scores of BMFRAS, composed of eight subscales (age, fall history, physical activity, consciousness level, communication, fall risk factors, underlying disease, and medications) were assessed from the electronic medical record. BMFRAS-SF was derived from eight subscales of the BMFRAS representing the significance between fallers and non-fallers (fall history, physical activity, fall risk factors, underlying disease, and medications). Internal consistency reliability and interrater reliability were assessed by Cronbach's alpha and kappa coefficient. Validity was assessed by Spearman correlation analysis, factor analysis. Sensitivity, specificity, positive predictive and negative predictive values, and a receiver-operating characteristic curve (ROC) were generated. Results: Fallers had significantly higher risk scores than non-fallers in fall history, physical activity, fall risk factors, underlying disease, and medication scales. The BMFRAS-SF demonstrated acceptable Cronbach's alpha (.706) and kappa coefficients of .95. The BMFRAS-SF subscales showed good convergent validity and construct validity. The BMFRAS-SF presented good sensitivity(86.7%), specificity(67.9%), positive predictive value(42.9%) and good negative predictive value(94.8%) at a cut-off score of 5. Areas under the ROC curves were .860 for the BMFRAS and .861 for the BMFRAS-SF. Conclusion: The BMFRAS-SF was proved to be reliable and valid. It could be used for time-saving assessment and evaluation of the high risks for falls in clinical practice settings.

The Probiotic Effects of the Saccharomyces cerevisiae 28-7 Strain Isolated from Nuruk in a DSS-Induced Colitis Mouse Model

  • Lee, Jang Eun;Lee, Eunjung
    • Journal of Microbiology and Biotechnology
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    • v.32 no.7
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    • pp.877-884
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    • 2022
  • Probiotics are microorganisms that can benefit host health when ingested in a live state, and lactic acid bacteria are the most common type. Among fungi, Saccharomyces boulardii (SB) is the only strain known to have a probiotic function with beneficial effects on colitis; however, information on other probiotic yeast strains is limited. Therefore, this study aimed to discover yeast strains expressing intestinal anti-inflammatory activities by exhibiting probiotic properties in dextran sodium sulfate (DSS)-induced colitis mice model. Nuruk (Korean traditional fermentation starter) containing various microbial strains was used as a source for yeast strains, and S. cerevisiae 28-7 (SC28-7) strain was selected with in vitro and in vivo characteristics to enable survival in the intestines. After 14 days of pretreatment with the yeast strains, DSS was co-administered for six days to induce colitis in mice. The results revealed that the disease activity index score was lowered by SC28-7 treatment compared to the DSS group, and the colon length and weight/length ratio were recovered in a pattern similar to that of the normal group. SC28-7 administration significantly reduced the secretion of pro-inflammatory cytokines in the serum and modified the mRNA expression of inflammatory cytokines (interleukin-1β, transforming growth factor-β, and interferon-γ) and proteins involved in gut barrier functions (mucin 2, mucin 3, zonula occludens-1, and occludin) in colon tissues. These results indicate that SC28-7 attenuates DSS-induced colon damage and inflammation, supporting its future use as a probiotic yeast for treating and preventing intestinal inflammatory diseases such as inflammatory bowel disease.

Rapid onset of efficacy predicts response to therapy with certolizumab plus methotrexate in patients with active rheumatoid arthritis

  • Kang, Young Mo;Park, Young-Eun;Park, Won;Choe, Jung-Yoon;Cho, Chul-Soo;Shim, Seung-Cheol;Bae, Sang Cheol;Suh, Chang-Hee;Cha, Hoon-Suk;Koh, Eun Mi;Song, Yeong-Wook;Yoo, Bin;Lee, Shin-Seok;Park, Min-Chan;Lee, Sang-Heon;Arendt, Catherine;Koetse, Willem;Lee, Soo-Kon
    • The Korean journal of internal medicine
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    • v.33 no.6
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    • pp.1224-1233
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    • 2018
  • Background/Aims: The objective of this study was to determine the efficacy and safety of add-on therapy with certolizumab pegol (CZP) in active rheumatoid arthritis (RA) patients of a single ethnicity. Methods: In this 24-week, phase 3, randomized, double-blind, placebo-controlled trial, eligible patients (n = 127) were randomized 2:1 to subcutaneous CZP + methotrexate (MTX; 400 mg at week 0, 2, and 4 followed by 200 mg every 2 weeks) or placebo + MTX. Results: At week 24, the American College of Rheumatology criteria for 20% (ACR20) response rate was significantly greater with CZP + MTX than with placebo (66.7% vs. 27.5%, p < 0.001). Differences in ACR20 response rates for CZP vs. placebo were significant from week 1 (p < 0.05) and remained significant through week 24. The CZP group reported significant improvement in physical function and disability compared to the placebo group (p < 0.001) at week 24, as assessed by Korean Health Assessment Questionnaire-Disability Index (KHAQ-DI). Post hoc analysis indicated that the proportion of patients who had ACR70 responses, Disease Activity Score 28 (DAS28) low disease activity, and DAS28 remission at week 24 was greater in CZP + MTX-treated patients who achieved a decrease in DAS28 ${\geq}1.2$ (43.8%) at week 4 than in nonresponders. Among 18 (22.2%) and 14 patients (35.0%) in CZP and placebo groups who had latent tuberculosis (TB), none developed active TB. Most adverse events were mild or moderate. Conclusions: CZP treatment combined with MTX in active RA patients with moderate to severe disease activity and an inadequate response to MTX resulted in rapid onset of efficacy, which is associated with better clinical outcome at week 24 and has an acceptable safety profile, especially in an intermediate TB-burden population.

Low Serum Potassium Levels Associated with Disease Severity in Children with Nonalcoholic Fatty Liver Disease

  • Tabbaa, Adam;Shaker, Mina;Lopez, Rocio;Hoshemand, Kazem;Nobili, Valerio;Alkhouri, Naim
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.3
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    • pp.168-174
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    • 2015
  • Purpose: Recent studies have suggested that decreased serum potassium level may contribute to various metabolic disorders in adult patients including nonalcoholic fatty liver disease (NAFLD). We aimed to study the correlation between serum potassium levels and the histologic severity of NAFLD in children. Methods: Pediatric patients with biopsy-proven NAFLD were included in this study. Demographic, clinical, and histopathological data were obtained. Multivariable logistic regression analysis was used to assess whether potassium levels are associated with the presence of nonalcoholic steatohepatitis (NASH) or fibrosis after adjusting for possible confounders. A p-value <0.05 was considered statistically significant. Results: Among 125 biopsies, 49.6% (62) had evidence of NASH while 66.4% (83) had some degree of fibrosis (stage 1-3). Mean serum potassium was significantly lower in NASH group as compared to non-NASH group ($4.4{\pm}0.42mmoL/L$ vs. $4.8{\pm}0.21$, p<0.001). Higher potassium level had negative correlation with presence of steatosis, ballooning, lobular inflammation, fibrosis and NAFLD activity score (p<0.05). On multivariable analysis and after adjusting for the metabolic syndrome and insulin resistance, higher potassium level was significantly associated with lower likelihood of having a histological diagnosis of NASH on biopsy (odds ratio [OR], 0.12; 95% confidence interval [95% CI], 0.05-0.28; p<0.001). Similarly, the likelihood of having fibrosis decreases by 76% for every 0.5 mmoL/L increase in potassium (OR, 0.24; 95% CI, 0.11-0.54; p<0.001). Conclusion: Our study shows an inverse relationship between serum potassium levels and the presence of aggressive disease (NASH and fibrosis) in children with NAFLD.

Sweet Bee Venom Pharmacopuncture May be Effective for Treating Sexual Dysfunction

  • Lee, Pavel;Yu, Junsang
    • Journal of Pharmacopuncture
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    • v.17 no.3
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    • pp.70-73
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    • 2014
  • Sexual dysfunction (SD) is a health problem which occurs during any phase of the sexual response cycle that keeps the individual or couple from experiencing satisfaction from the sexual activity. SD covers a wide variety of symptoms like in men, erectile dysfunction and premature or delayed ejaculation, in women, spasms of the vagina and pain with sexual intercourse, in both sexes, sexual desire and response. And pharmacopuncture, i.e. injection of subclinical doses of drugs, mostly herb medicine, in acupoints, has been adopted with successful results. This case report showed the effect of bee venom on SD. A 51-year-old male patient with SD, who had a past history of taking Western medication to treat his SD and who had previously undergone surgery on his lower back due to a herniated disc, received treatments using pharmacopuncture of sweet bee venom (SBV) at Gwanwon (CV4), Hoeeum (CV1), Sinsu (BL23), and Gihaesu (BL24) for 20 days. Objectively, the patient showed improvement on most items on the International Index for Erectile Dysfunction (IIEF) like 28 to 29 out of perfect score 30 for erectile function, 10 to 10 out of perfect score 10 for orgasmic function, 6 to 8 out of perfect score 10 for sexual desire, 10 to 13 out of perfect score 15 for satisfaction with intercourse, and 6 to 8 out of perfect score 10 for overall satisfaction; subjectively, his words, the tone of his voice and the look of confidence in his eyes all indicated improvement. Among the variety of effects of SBV pharmacopuncture, urogenital problems such as SD may be health problems that pharmacopuncture can treat effectively.

Treat-to-Target Strategy for Asian Patients with Early Rheumatoid Arthritis: Result of a Multicenter Trial in Korea

  • Song, Jason Jungsik;Song, Yeong Wook;Bae, Sang Cheol;Cha, Hoon-Suk;Choe, Jung-Yoon;Choi, Sung Jae;Kim, Hyun Ah;Kim, Jinseok;Kim, Sung-Soo;Lee, Choong-Ki;Lee, Jisoo;Lee, Sang-Heon;Lee, Shin-Seok;Lee, Soo-Kon;Lee, Sung Won;Park, Sung-Hwan;Park, Won;Shim, Seung Cheol;Suh, Chang-Hee;Yoo, Bin;Yoo, Dae-Hyun;Yoo, Wan-Hee
    • Journal of Korean Medical Science
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    • v.33 no.52
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    • pp.346.1-346.11
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    • 2018
  • Background: To evaluate the therapeutic benefits of the treat-to-target (T2T) strategy for Asian patients with early rheumatoid arthritis (RA) in Korea. Methods: In a 1-year, multicenter, open-label strategy trial, 346 patients with early RA were recruited from 20 institutions across Korea and stratified into 2 groups, depending on whether they were recruited by rheumatologists who have adopted the T2T strategy (T2T group) or by rheumatologists who provided usual care (non-T2T group). Data regarding demographics, rheumatoid factor titer, anti-cyclic citrullinated peptide antibody titer, disease activity score of 28 joints (DAS28), and Korean Health Assessment Questionnaire (KHAQ) score were obtained at baseline and after 1 year of treatment. In the T2T group, the prescription for disease-modifying antirheumatic drugs was tailored to the predefined treatment target in each patient, namely remission (DAS28 < 2.6) or low disease activity (LDA) ($2.6{\leq}DAS28$ < 3.2). Results: Data were available for 163 T2T patients and 162 non-T2T patients. At the end of the study period, clinical outcomes were better in the T2T group than in the non-T2T group (LDA or remission, 59.5% vs. 35.8%; P < 0.001; remission, 43.6% vs. 19.8%; P < 0.001). Compared with non-T2T, T2T was also associated with higher rate of good European League Against Rheumatism response (63.0% vs. 39.8%; P < 0.001), improved KHAQ scores (-0.38 vs. -0.13; P = 0.008), and higher frequency of follow-up visits (5.0 vs. 2.0 visits/year; P < 0.001). Conclusion: In Asian patients with early RA, T2T improves disease activity and physical function. Setting a pre-defined treatment target in terms of DAS28 is recommended.

A Case Report on Korean Medical Treatment for Induced Remission of Pediatric Crohn's Disease (한방치료로 관해가 유도된 소아 크론병 환자의 증례 보고)

  • Lee, Hyun-Jin;Lee, Hanul;Jeong, Hae In;Cho, Yun-jae;Keum, Chang-Yul;Han, Aram;Ha, Na-yeon;Kim, Jinsung
    • The Journal of Internal Korean Medicine
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    • v.42 no.5
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    • pp.853-862
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    • 2021
  • Objectives: This case study examined the effectiveness of Korean medical treatment for pediatric Crohn's disease. Methods: A 15-year-old female Korean patient with Crohn's disease received acupuncture, electroacupuncture, herbal medicine, moxibustion, and aromatherapy treatment for 1 month in a hospital. Results: Decreases in the Pediatric Crohn's Disease Activity Index score (from 22.5 to 7.5) and the size of two abscesses (from 39.97 mm to 33.36 mm, and from 28.14 mm to 18.71 mm) according to an abdominal CT were observed following treatment. Nausea and vomiting disappeared, stool condition improved, and weight increased (from 30 kg to 33 kg) following treatment. Nausea and vomiting disappeared, stool condition improved, and weight increased (from 30 kg to 33 kg) following treatment. Conclusion: It would be worth examining the long-term effectiveness of Korean medical treatment for pediatric Crohn's disease.

Outcome of Extraarticular Dorsal Closing Wedge Osteotomy for Freiberg's Disease (관절외 배부 폐쇄 쐐기 절골술을 이용한 Freiberg병의 치료 결과)

  • Lee, Jun Young;Kim, Woong Hee;Jung, Sung;Yang, Sung Hun
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.3
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    • pp.126-130
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    • 2016
  • Purpose: The aim of this study was to evaluate the result of extraarticular dorsal closing wedge osteotomy in Freiberg's disease. Materials and Methods: Between February 2012 and July 2014, total 10 patients who underwent dorsal closing wedge osteotomy and followed up more than 1 year were selected for inclusion. Average age was 16.3 years, and average follow-up period was 15.5 months. The diagnosis was made using magnetic resonance imaging of those with a limitation in walking or usual activity due to pain in the metatarsal head. During operation, we removed loose body, and synovectomy was done. Osteotomy at the metatarsal neck and fixation with Kirschner wire were performed. X-ray was taken to check shortening of 2nd metatarsal and bone union. Moreover, we checked the active range of motion of 2nd metatarsophalangeal joint before and after surgery. At the last follow-up, the shortening of metatarsal, American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS), and patient's subjective satisfaction were evaluated. Results: According to the Smillie's stage, there were 3 cases of stage II, 4 cases of stage III, and 3 cases of stage IV. Average bone union time on the osteotomy site was 8 weeks. Average shortening of metatarsal was 2.53 mm. Average AOFAS score improved significantly from 56.9 to 82.8 points at final follow-up (p<0.05), and average VAS score also improved significantly from 6.4 to 1.4 points at final follow-up (p<0.05). Average active range of motion at metatarsophalangeal joint improved from $28.0^{\circ}$ preoperatively to $46.5^{\circ}$ at the final follow-up. Other complications, such as metatarsalgia and arthritis, were not found; however, there was 1 case of delayed union with no symptom. Conclusion: In Freiberg's disease, dorsal closing wedge osteotomy is recommended for the improvement of clinical symptoms and range of motion.

Sexual Life of Husband and Wife after Hysterectomy (자궁절제술을 받은 여성과 배우자의 성생활)

  • Kim, Jin-Kyung;Koh, Hyo-Jung
    • Women's Health Nursing
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    • v.7 no.1
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    • pp.18-29
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    • 2001
  • The purpose of this study was to provide basic data from confirming factors that could help nurses tailor counseling program for married couples who were facing the prospect of a hysterectomy. A descriptive design was used to study a total of 81 married couples(total of 162 subjects) between 2 to 18 months after hysterectomy, due to a benign gynecology disease at a University Hospital in Daegu by questionnaires from March, 1999 to June, 2000. This study used Sexual Knowledge Measurement of Koo, Ja-sung(1996), Sexual Attitude Scales of Hudson, Murphy and Nurius(1994), Sexual Attitude Measurement of Jang, Soon-bok(1989), Sexual Activity Questionnaires of Thiriaway, Fallowfield and Cuzick(1996) modified and supplemented by advice of experts in order to measure sexual knowledge, sexual attitude and sexual activity, and Sexual Function Inventory of Derogatis(1979) translated by Jang, Soon-bok(1984) was used to measure sexual satisfaction of the subjects. For data analysis, the study executed $x^2$-test, t-test, ANOVA, Pearson correlation and multiple regression in accordance with the purpose of study by SPSS/PC+ WIN 10.0 program. Also this study obtained Cronbach's alpha for examination of reliability. The results are as follows : 1) The sexual knowledge of the husband was higher than that of the wife after hysterectomy by showing the mean 11.27(${\pm}2.72$) in case of the wife and the mean 11.57(${\pm}2.28$) in case of the husband, but there was no statistically significant difference(t=.681, p=.497). 2)The sexual attitude of the husband was more liberal than that of the wife after hysterectomy by showing the mean 3.25(${\pm}.48$) in case of the wife and the mean 3.42(${\pm}.48$) in case of the husband, and there was statistically significant difference(t=2.399, p=.018). 3)There was no statistically significant difference between the score of sexual activity of wife and husband by period elapsed after hysterectomy. 4)There was no statistically significant difference between the score of sexual satisfaction of wife and husband by period elapsed after hysterectomy. 5)The wife subjects showed positive correlation among sexual knowledge, sexual attitude, sexual activity and sexual satisfaction. The husband subjects showed positive correlation only between sexual knowledge and sexual activity, sexual activity and sexual satisfaction, sexual attitude and sexual satisfaction, sexual knowledge and sexual satisfaction. There was a positive correlation between the sexual knowledge, sexual attitude, sexual activity and sexual satisfaction of the wife and husband. 6)Only the variable of sexual activity among factors of sexual satisfaction of the wife subjects showed the statistical significance(F=52.452, p<0.001), while variables of sexual attitude (F=20.360, p<0.001) and sexual activity (F=14.142, p<0.05) among factors of sexual satisfaction of the husband subjects showed a statistical significance.

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Periodontal pathogens and the association between periodontitis and rheumatoid arthritis in Korean adults

  • Kim, Jin-Hee;Choi, In Ah;Lee, Joo Youn;Kim, Kyoung-Hwa;Kim, Sungtae;Koo, Ki-Tae;Kim, Tae-Il;Seol, Yang-Jo;Ku, Young;Rhyu, In-Chul;Song, Yeong Wook;Lee, Yong-Moo
    • Journal of Periodontal and Implant Science
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    • v.48 no.6
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    • pp.347-359
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    • 2018
  • Purpose: Periodontitis and rheumatoid arthritis (RA) share a similar inflammatory pathogenesis. Porphyromonas gingivalis (Pg) can induce anticyclic-citrullinated peptide autoantibodies (anti-CCP antibodies), a key factor in the development of RA. This study aimed at evaluating the relationships between the 2 diseases and identifying the clinical implications thereof, with a focus on periodontal pathogens in Korean adults. Methods: A total of 260 RA patients and 86 age- and sex-matched control patients without arthritis were enrolled in this prospective cross-sectional study. Periodontal indices and the prevalence and amount of periodontal pathogens were compared between the groups. Correlations between periodontal and RA indices were examined, as were correlations between 9 periodontal pathogens and RA indices. Results: The RA group had significantly higher values than the control group for all investigated periodontal indices (P<0.05) except the number of teeth. The gingival index (GI) was correlated with the disease activity score 28 (DAS28) (r=0.125, P=0.049), RA disease duration (r=0.253, P<0.001), erythrocyte sedimentation rate (ESR) (r=0.162, P=0.010), and anti-CCP antibody titer (r=0.205, P=0.004). Probing pocket depth (PPD) was correlated with ESR (r=0.139, P=0.027) and anti-Pg antibody titer (r=0.203, P=0.001). Bleeding on probing (BOP) was correlated with DAS28 (r=0.137, P=0.030), RA disease duration (r=0.202, P=0.001), ESR (r=0.136, P=0.030), anti-Pg antibody titer (r=0.177, P=0.005), and anti-CCP antibody titer (r=0.188, P=0.007). Clinical attachment level (CAL) and periodontitis severity were correlated with anti-Pg antibody titer (the former r=0.201, P=0.002; the latter r=0.175, P=0.006). The quantity of Pg was positively correlated with the serum anti-Pg antibody titer (r=0.148, P=0.020). Conclusions: The GI, BOP, and PPD showed positive relationships with several RA indices. The anti-Pg antibody titer had positive relationships with PPD, BOP, CAL, and periodontitis severity. Thus, increasing values of periodontal indices could be used as a risk indicator of disease development in RA patients, and an increasing anti-Pg antibody titer could be considered as a warning sign in RA patients suffering with periodontitis.