• Title/Summary/Keyword: Disease burden

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Association between High Diffusion-Weighted Imaging-Derived Functional Tumor Burden of Peritoneal Carcinomatosis and Overall Survival in Patients with Advanced Ovarian Carcinoma

  • He An;Jose AU Perucho;Keith WH Chiu;Edward S Hui;Mandy MY Chu;Siew Fei Ngu;Hextan YS Ngan;Elaine YP Lee
    • Korean Journal of Radiology
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    • v.23 no.5
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    • pp.539-547
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    • 2022
  • Objective: To investigate the association between functional tumor burden of peritoneal carcinomatosis (PC) derived from diffusion-weighted imaging (DWI) and overall survival in patients with advanced ovarian carcinoma (OC). Materials and Methods: This prospective study was approved by the local research ethics committee, and informed consent was obtained. Fifty patients (mean age ± standard deviation, 57 ± 12 years) with stage III-IV OC scheduled for primary or interval debulking surgery (IDS) were recruited between June 2016 and December 2021. DWI (b values: 0, 400, and 800 s/mm2) was acquired with a 16-channel phased-array torso coil. The functional PC burden on DWI was derived based on K-means clustering to discard fat, air, and normal tissue. A score similar to the surgical peritoneal cancer index was assigned to each abdominopelvic region, with additional scores assigned to the involvement of critical sites, denoted as the functional peritoneal cancer index (fPCI). The apparent diffusion coefficient (ADC) of the largest lesion was calculated. Patients were dichotomized by immediate surgical outcome into high- and low-risk groups (with and without residual disease, respectively) with subsequent survival analysis using the Kaplan-Meier curve and log-rank test. Multivariable Cox proportional hazards regression was used to evaluate the association between DWI-derived results and overall survival. Results: Fifteen (30.0%) patients underwent primary debulking surgery, and 35 (70.0%) patients received neoadjuvant chemotherapy followed by IDS. Complete tumor debulking was achieved in 32 patients. Patients with residual disease after debulking surgery had reduced overall survival (p = 0.043). The fPCI/ADC was negatively associated with overall survival when accounted for clinicopathological information with a hazard ratio of 1.254 for high fPCI/ADC (95% confidence interval, 1.007-1.560; p = 0.043). Conclusion: A high DWI-derived functional tumor burden was associated with decreased overall survival in patients with advanced OC.

The Effects of Emerging Infectious Disease Knowledge and Clinical Practice Stress on Nursing Students' Coping with Stress (신종감염병지식과 임상실습스트레스가 간호대학생의 스트레스대처방식에 미치는 영향)

  • So Young Lee;Hey Kyoung Kim
    • Journal of the Korean Applied Science and Technology
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    • v.40 no.3
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    • pp.507-520
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    • 2023
  • The purpose of this study is to inquire into the effect on the coping with stress by the knowledge of Emerging infectious disease, clinical practice stress. A research was held to the nursing students living in Seoul and Chungbuk from September 10 to October 10, 2022, 259copies of the data were used for the final analysis, Pearson's correlation coefficient and Multiple linear regressions was used. As a result of the study, there was a positive correlation between clinical practice stress due to burden of work, practice education environment stress, and active coping with stress. Clinical practice stress due to interpersonal conflicts, conflicts with patients, burden of work, and undesirable role models was positively correlated with passive coping with stress. Satisfaction of clinical practice, practical educational environment stress and gender accounted for 15.0% of the total variance in the active stress coping, and burden of work accounted for 7% of the total variance in the passive stress coping. Consequently, this study could be suggested as a basis for counseling and developing practical education program for active coping with stress.

Incidence and Mortality of Female Breast Cancer in Jiangsu, China

  • Wu, Li-Zhu;Han, Ren-Qiang;Zhou, Jin-Yi;Yang, Jie;Dong, Mei-Hua;Qian, Yun;Wu, Ming
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2727-2732
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    • 2014
  • Objectives: The aim of this study was to describe and analyze the incidence and mortality of female breast cancer in Jiangsu Province of China. Methods: Incidence and mortality data for female breast cancer and corresponding population statistics from eligible cancer registries in Jiangsu from 2006 to 2010 were collected and analyzed. Crude rates, age-specific rates and age-standardized rates of incidence and mortality were calculated, and annual present changes (APCs) were estimated to describe the time trends. Results: From 2006 to 2010, 11,013 new cases and 3,068 deaths of female breast cancer were identified in selected cancer registry areas of Jiangsu. The annual average crude incidence and age-standardized incidence by world population (ASW) were 25.2/ and 17.9/100,000 respectively. The annual average crude and ASW for mortality rates were 7.03/ and 4.81/100,000. The incidence was higher in urban areas than that in rural areas, and this was consistent in all age groups. No significant difference was observed in mortality between urban and rural areas. Two peaks were observed when looking at age-specific rates, one at 50-59 years and another at over 85 years. During the 5 years, incidence and mortality increased with APCs of 4.47% and 6.89%, respectively. Compared to the national level, Jiangsu is an area with relatively low risk of female breast cancer. Conclusion: Breast cancer has become a main public health problem among Chinese females. More prevention and control activities should be conducted to reduce the burden of this disease, even in relatively low risk areas like Jiangsu.

Functional Prediction of Hypothetical Proteins from Shigella flexneri and Validation of the Predicted Models by Using ROC Curve Analysis

  • Gazi, Md. Amran;Mahmud, Sultan;Fahim, Shah Mohammad;Kibria, Mohammad Golam;Palit, Parag;Islam, Md. Rezaul;Rashid, Humaira;Das, Subhasish;Mahfuz, Mustafa;Ahmeed, Tahmeed
    • Genomics & Informatics
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    • v.16 no.4
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    • pp.26.1-26.12
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    • 2018
  • Shigella spp. constitutes some of the key pathogens responsible for the global burden of diarrhoeal disease. With over 164 million reported cases per annum, shigellosis accounts for 1.1 million deaths each year. Majority of these cases occur among the children of the developing nations and the emergence of multi-drug resistance Shigella strains in clinical isolates demands the development of better/new drugs against this pathogen. The genome of Shigella flexneri was extensively analyzed and found 4,362 proteins among which the functions of 674 proteins, termed as hypothetical proteins (HPs) had not been previously elucidated. Amino acid sequences of all these 674 HPs were studied and the functions of a total of 39 HPs have been assigned with high level of confidence. Here we have utilized a combination of the latest versions of databases to assign the precise function of HPs for which no experimental information is available. These HPs were found to belong to various classes of proteins such as enzymes, binding proteins, signal transducers, lipoprotein, transporters, virulence and other proteins. Evaluation of the performance of the various computational tools conducted using receiver operating characteristic curve analysis and a resoundingly high average accuracy of 93.6% were obtained. Our comprehensive analysis will help to gain greater understanding for the development of many novel potential therapeutic interventions to defeat Shigella infection.

Cost of Illness of Chronic Disease by Region in Korea (3대 만성질환자의 지역별 의료비 분석)

  • Moon, Jong Youn;Shin, Jaeyong;Kim, Jae-Hyun
    • Health Policy and Management
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    • v.31 no.1
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    • pp.65-73
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    • 2021
  • Background: With the recent aging of the population, the transition to a disease structure centered on chronic diseases is accelerating. Moreover, the socio-economic gap and the polarization of the health gap between regions further increase the burden of disease on the country. Accordingly, this study calculated the disease cost of hypertension, diabetes, and hyperlipidemia, which are the three major chronic diseases, to establish an effective health promotion policy strategy for each region, and analyzed the gap in disease cost within the region to determine health determinants at the individual as well as the regional level. Methods: This study utilized data from the 2015 sample cohort of the National Health Insurance Service and calculated the disease cost of patients (diabetes: I10-I15, hypertension: E10-E14, hyperlipidemia: E78) based on the main diagnosis. Results: Based on our analysis, the case of medical use in cities and provinces was higher than in metropolitan cities, with relatively small medical use in Seoul and Gangwon-do. In terms of the disease cost, the cost of chronic diseases in Seoul and Jeju was the highest, but the difference in disease cost between patients in each region was the largest in Seoul and Gangwon-do. Conclusion: The results of this study provide meaningful data for implementing efficient health promotion policies by analyzing the differences in disease cost and identifying health determinants in different regions. Furthermore, in Korea, where socioeconomic differences are clearly revealed, it can be used as a basis for preparing a strategic plan, from a long-term perspective, to improve the health of patients with chronic diseases in the future.

A Study on the Effectiveness of Care of Patients with Alzheimer s Disease According to Residence Arrangement and Types of Services (치매노인의 거주형태 및 서비스유형에 따른 간호관리의 효과분석)

  • 홍여신;박현애;조남옥
    • Journal of Korean Academy of Nursing
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    • v.26 no.4
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    • pp.768-781
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    • 1996
  • The problem of care of patients and families with Alzheimer's disease has become a conscious raising social policy issue in Korea. The government of the Republic of Korea has become cognizant of the situation and has begun searching for ways to remedy it. Thus, there is a need for a comprehensive under-standing of the situation in which patients and their families are struggling and the enormous problems of care. With a realization of the urgent need, this study was done to investigate the situation and the care needs of families with patients with Alzheimer's Disease, and to compare the effectiveness of services utilized by the families in terms of cost and effects on patient's conditions and on family live. The Subjects for the study were 29 families with hospitalized patients, 25 families utilizing hospital outpatient clinics, 14 families utilizing day care facilities, and 16 families with homebound patients. A total of 84 families were interviewed by four trained interviewers using structured and semistructured questionnaires. The data produced from these interviews included : the patient's stage of Alzheimer's disease, patient's bizarre behavior, hours spent on patient care per day, family burden and quality of life, direct and indirect costs encountered in the care of patients, and the families' evaluation of the effectiveness of the services received. The data were analyzed to determine the relationships between family charactersistics, patient's conditions and services utilization. The effectiveness of each of the service entities was assessed through families evaluation and hoped for service and comparisons were made between services in terms of the cost-effectiveness ratios. After initial comparison of cost-effectiveness ratios, further analysis was done to compare between groups for incremental effectiveness for each incremental unit of cost to determine the most cost-effective service entities. The findings of the study are as fellows : 1. The choice of living arrangement and the types of services are a function of the stage of Alzheimer's condition and the economic status of the family. 2. Comparision of the cost of care showed that most expenses were encountered in by families with hospitalization, families using outpatient services, and families using day care services in that order. The least expense was involved in the care of homebound patients. The economic burden felt by families was in the same order as expenses. 3. The average number of hours spent on daily patient care was 9.9 hours for the outpatient clinic users, 9.7 hours for homebound patients, and 5.4 hours for day care users. 4. There were significant differences in the patient's conditions (CDRL), bizarre behaviors and the families's burden by living arrangement and /or types of service. However, no significant difference was found between groups in the family's quality of life. 5. The families rated the services of day care center as most effective for the care of the patients and families, except for a few families who had experienced some improvement in the patient's conditions. The outpatient clinic users expressed psychological comforts mainly in that the patient was being taken care of. For those hospitalized patients, families expressed the comfort of being relieved of the burden of care and that the patient is being professionally cared for. Form the analysis of the costs, hours of patient care, patient's bizarre behaviors, family's quality of life and burdens, and family's evaluation of services, it is concluded that up to the mid stage of Alzheimer's condition, the utilization of day care center services is found to be the most cost-effective, and toward the end stage of the Alzheimer's disease, it is hoped that there will be a establishment of long term or short term in-patient facilities for the protection of patients and preservation of the integrity of families for less cost. Thus. it was concluded that the family centered system of care is the most effective for Korea with systematic support systems developed for the care of patients and their families according to the needs of families as the patient's condition deteriorates.

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Treatment of latent tuberculous infection in children and adolescent (소아청소년기 잠복결핵 감염의 치료)

  • Kim, Jong-Hyun
    • Clinical and Experimental Pediatrics
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    • v.52 no.5
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    • pp.519-528
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    • 2009
  • Tuberculosis continues to cause an unacceptably high toll of disease and death among children worldwide. Whereas intense scientific and clinical research efforts into novel diagnostic, therapeutic, and preventive interventions have focused on tuberculosis in adults, childhood tuberculosis has been relatively neglected. However, children are particularly vulnerable to severe disease and death following infection, and those with latent infection become the reservoir for future transmission following disease reactivation in adulthood, fuelling future epidemics. Therefore, it is very important to understand the significance, diagnosis and treatment of latent tuberculous infection to decrease a future disease burden of tuberculosis. Unfortunately, these concept still have not fully implicated in Korean National Tuberculosis Control Program, it should be engaged and enforced as soon as possible.

A Comparative Study of [F-18] Florbetaben (FBB) PET Imaging, Pathology, and Cognition between Normal and Alzheimer Transgenic Mice

  • Thapa, Ngeemasara;Jeong, Young-Jin;Kang, Hyeon;Choi, Go-Eun;Yoon, Hyun-Jin;Kang, Do-Young
    • Biomedical Science Letters
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    • v.25 no.1
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    • pp.7-14
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    • 2019
  • Alzheimer's disease (AD) is highly prevalent in dementia, with no specifically effective treatment having yet been discovered. Amyloid plaques are one of the key hallmarks of AD. Transgenic mouse models exhibiting Alzheimer's disease-like pathology have been widely used to study the pathophysiology of Alzheimer's disease. In this study, we showed an age-dependent correlation between cognitive function, pathological findings, and [F-18] Florbetaben (FBB) PET images. Nineteen transgenic mice (12 with AD, 7 with controls) were used for this study. We observed an increase in ${\beta}$-Amyloid deposition ($A{\beta}$) in brain tissue and [F-18] FBB amyloid PET imaging in the AD group. The [F-18] FBB data showed a mildly negative trend with cognitive function. Pathological findings were negatively correlated with cognitive functions. These finding suggests that amyloid beta deposition can be well-monitored with [F-18] FBB PET and a decline in cognitive function is related to the increase in amyloid plaque burden.

Combination of canagliflozin and puerarin alleviates the lipotoxicity to diabetic kidney in mice

  • Qian Zhu;Qu Zhou;Xiao-li Luo;Xu-jie Zhang;San-yu, Li
    • The Korean Journal of Physiology and Pharmacology
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    • v.27 no.3
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    • pp.221-230
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    • 2023
  • Diabetic kidney disease is one of the most serious complications of diabetes. Although diabetic kidney disease can be effectively controlled through strict blood glucose management and corresponding symptomatic treatment, these therapies cannot reduce its incidence in diabetic patients. The sodium-glucose cotransporter 2 (SGLT2) inhibitors and the traditional Chinese herb "Gegen" have been widely used in diabetes-related therapy. However, it remains unclear whether the combined use of these two kinds of medicines contributes to an increased curative effect on diabetic kidney disease. In this study, we examined this issue by evaluating the efficacy of the combination of puerarin, an active ingredient of Gegen, and canagliflozin, an SGLT2 inhibitor for a 12-week intervention using a mouse model of diabetes. The results indicated that the combination of puerarin and canagliflozin was superior to canagliflozin alone in improving the metabolic and renal function parameters of diabetic mice. Our findings suggested that the renoprotective effect of combined puerarin and canagliflozin in diabetic mice was achieved by reducing renal lipid accumulation. This study provides a new strategy for the clinical prevention and treatment of diabetic kidney disease. The puerarin and SGLT2 inhibitor combination therapy at the initial stage of diabetes may effectively delay the occurrence of diabetic kidney injury, and significantly alleviate the burden of renal lipotoxicity.