Background: Primary idiopathic myelofibrosis (PMF) is a clonal Philadelphia chromosome-negative myeloproliferative neoplasm characterized by extramedullary hematopoiesis and marrow fibrosis. It is an uncommon hematopoietic malignancy which primarily affects elderly individuals. The rational of this study was to determine its clinico-epidemiological profile along with risk stratification in Pakistani patients. Materials and Methods: In this retrospective cross sectional study, 20 patients with idiopathic myelofibrosis were enrolled from January 2011 to December 2014. Data were analyzed with SPSS version 22. Results: The mean age was $57.9{\pm}16.5years$ with 70% of patients aged above 50. The male to female ratio was 3:1. Overall only 10% of patients were asymptomatic and the remainder presented with constitutional symptoms. In symptomatic patients, major complaints were weakness (80%), weight loss (75%), abdominal discomfort (60%), night sweats (13%), pruritus (5%) and cardiovascular accidents (5%). Physical examination revealed splenomegaly as a predominant finding detected in 17 patients (85%) with the mean splenic span of $22.2{\pm}2.04cm$. The mean hemoglobin was $9.16{\pm}2.52g/dl$ with the mean MCV of $88.2{\pm}19.7fl$. The total leukocyte count of $17.6{\pm}19.2{\times}10^9/l$ and platelets count were $346.5{\pm}321.9{\times}10^9/l$. Serum lactate dehydrogenase, serum creatinine and uric acid were $731.0{\pm}154.1$, $0.82{\pm}0.22$ and $4.76{\pm}1.33$ respectively. According to risk stratification, 35% were in high risk, 40% in intermediate risk and 25% in low risk groups. Conclusions: The majority of PMF patients were male and presented with constitutional symptoms in our setting. Risk stratification revealed predominance of advanced disease in our series.
Bleomycin-induced pulmonary toxicity usually occurs in the elderly patients (greater than 70 years old), patients with a cumulative dose above 400 units, previous chest radiotherapy, oxygen therapy, and renal failure. However, there are some reports of severe pneumonitis that developed after administering low bleomycin doses(less than 100 units). In severe bleomycin-induced pneumonitis in non-Hodgkin's lymphoma patients, the response to corticosteroid is poor and the mortality rate is very high, approximately 83%. Therefore, clinicians should have a low threshold for investigating and treating bleomycin-induced pneumonitis. Here, we report a case of severe bleomycin-induced pneumonitis as a complication of a non-Hodgkin's lymphoma treatment.
Kim, Il-Chun;Hur, Jin-Woo;Kwon, Ki-Young;Lee, Jong-Ju;Lee, Jong-Won;Lee, Hyun-Koo
Journal of Korean Neurosurgical Society
/
v.54
no.4
/
pp.323-328
/
2013
Objective : The purpose of this study was to examine the efficacy and perioperative complications associated with lumbar spinal fusion surgery, focusing on geriatric patients in the Republic of Korea. Methods : We retrospectively investigated 485 patients with degenerative spinal diseases who had lumbar spinal fusion surgeries between March 2006 and December 2010 at our institution. Age, sex, comorbidity, American Society of Anesthesiologists (ASA) class, fusion segments, perioperative complications, and outcomes were analyzed in this study. Risk factors for complications and their association with age were analyzed. Results : In this study, 81 patients presented complications (16.7%). The rate of perioperative complications was significantly higher in patients 70 years or older than in other age groups (univariate analysis, p=0.015; multivariate analysis, p=0.024). The perioperative complications were not significantly associated with the other factors tested (sex, comorbidity, ASA class, and fusion segments). Post-operative outcomes of lumbar spinal fusion surgeries for the patients were determined on the basis of MacNab's criteria (average follow up period : 19.7 months), and 412 patients (85.0%) were classified as having "excellent" or "good" results. Conclusion : Increasing age was an important risk factor for perioperative complications in patients undergoing lumbar spinal fusion surgery, whereas other factors were not significant. However, patients' satisfaction or return to daily activities when compared with younger patients did not show much difference. We recommend good clinical judgment as well as careful selection of geriatric patients for lumbar spinal fusion surgery.
Journal of the Korean Society of Food Science and Nutrition
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v.44
no.1
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pp.49-56
/
2015
The present study investigated the risk and prevalence of dysphagia as well as related factors among free-living elders. Subjects were 419 elderly men (116) and women (303) aged 65 years and older ($74.49{\pm}4.70y$) living in Seoul, Gyeonggi-do and Chungcheongbuk-do area in Korea. Data were collected by personal interviews using questionnaires and analyzed by descriptive statistics, t-test, and chi-square test. Prevalence of dysphagia was 53.50% among participants. Risk of dysphagia was significantly different according to age (P<0.001), use of dentures (P<0.05), and activities of daily living (P<0.05). Moreover, dysphagia risk group had significant food intake problems, including poor appetite, smaller portions to reach satiety, frequent meal skipping, as well as poor taste compared to the normal group, accompanied by high risk of weight loss as assessed by simplified nutritional appetite questionnaire (P<0.01). Taken together, risk of dysphagia was more prevalent in older people, affecting the majority of those living independently in the community. This could indicate an association with undernutrition due to factors affecting food intake.
Background: The trend of aging society is occurring globally, and with it, one of the health problems that is emerging is frailty. Efforts are being made to account for the increasing prevalence of frailty, and various modifiable factors are being considered in regards to frailty. Because social contact has shown beneficial effects in terms of health in previous studies, it is increasingly being considered in relation to frailty. The purpose of this study was to assess the association of different types of social contact with frailty status. Methods: A total of 1,200 Korean elders aged 70-84 years old were included in the study. Using Fried's Cardiovascular Health Study index to categorize the frailty status, the relationship between frailty status and frequency of contact (i.e., with family members, friends, or neighbors) was analyzed using multinomial logistic regression accounting for confounders. Results: Adjusting for all covariates, frequency of contact with friends was the most statistically significant. Less frequent contact was associated with a significantly higher odds of pre-frailty: monthly (odds ratio [OR], 2.02; 95% confidence interval [CI], 1.27-3.20), and rarely (OR, 1.87; 95% CI, 1.17-2.99), with daily contact group as reference. Also, those contacting friends monthly (OR, 5.04; 95% CI, 2.29-11.08) or rarely (OR, 3.23; 95% CI, 1.58-6.61) were more likely to be frail compared to the daily group. Conclusion: Frequency of social contact, especially with friends, is strongly associated with frailty.
Park, Cheol-Heum;Choi, Manki;Kang, Chan-Su;Kim, Tae-Gon
Journal of the Korean Burn Society
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v.23
no.1
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pp.20-24
/
2020
Diabetic patients have an increased risk of burn injuries on foot. Because of their diabetic neuropathy, they could contact with hot water or warming device without being aware of it. Split-thickness skin graft (STSG) is successful in treatment of various wound types; however, donor site wounds are sometimes problematic, and complications such as pain and impaired healing often occur. Although, donor site wounds in healthy young individuals can rapidly heal without complications, the wound-healing capacity of elderly patients or those with a comorbidity has been reported to be low. The dermatome is the most commonly used tool because it can harvest a large skin graft in one attempt. However, it is difficult to harvest tissues if the area is not flat. Furthermore, because the harvested skin is usually rectangular, additional skin usually remains after skin grafting. Therefore, use of razor blade and fragmented STSG on a large defect area is advantageous for harvesting a graft with a desired size, shape, and thickness. From January 2018 to July 2018, fragmented STSG was used in 9 patients who suffered from burn induced open wound on foot with diabetic neuropathy. With this approach, healing process was relatively rapid. The mean age of patients was 70 (57~86 years) and all of 9 patients had diabetes mellitus type 2. In all patients, the skin graft on the defect site healed well and did not result in complications such as hematoma or seroma.
This study was attempted to investigate relationship between spousal bereavement and frailty in the Korean older adults using data from the 7th Korea National Health and Nutrition Examination Survey(KNHANES VII-3, 2018). The subjects were 1,609, complex sample frequency, descriptive statistics, cross and logistic regression analysis were performed using SPSS program. As a main result, frailty simultaneously adjusted for general, health behavior and disease characteristics did not show significant relationship between spousal bereavement, but frailty is significantly decreased 65~69, 70~74 years old, better of subjective health perception, no arthritis, significantly increased lower level of income. Finally personal, familiar and social efforts are required to manage the elderly who have lost their spouse.
Kim, Kyungsik;Jeung, Young-Do;Choi, Jeoungbin;Park, Sue K.
Journal of Preventive Medicine and Public Health
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v.55
no.2
/
pp.144-152
/
2022
Objectives: This study aimed to identify the social and policy determinants of coronavirus disease 2019 (COVID-19) infection across 23 countries. Methods: COVID-19 indicators (incidence, mortality, and fatality) for each country were calculated by direct and indirect standardization. Multivariable regression analyses were used to identify the social and policy determinants of COVID-19 infection. Results: A higher number of doctors per population was related to lower incidence, mortality, and fatality rates of COVID-19 in 23 countries (β=-0.672, -0.445, and -0.564, respectively). The number of nurses/midwives per population was associated with lower mortality and fatality rates of COVID-19 in 23 countries (β=-0.215 and -0.372, respectively). Strengthening of policy restriction indicators, such as restrictions of public gatherings, was related to lower COVID-19 incidence (β=-0.423). A national Bacillus Calmette-Guérin vaccination policy conducted among special groups or in the past was associated with a higher incidence of COVID-19 in 23 countries (β=0.341). The proportion of the elderly population (aged over 70 years) was related to higher mortality and fatality rates (β=0.209 and 0.350, respectively), and income support was associated with mortality and fatality rates (β=-0.362 and -0.449, respectively). Conclusions: These findings do not imply causality because this was a country-based correlation study. However, COVID-19 transmission can be influenced by social and policy determinants such as integrated health systems and policy responses to COVID-19. Various social and policy determinants should be considered when planning responses to COVID-19.
The purpose of this study was to investigate older people's planning for estate distribution by examining the factors associated with their will-holding status. This study used data from the 1994 Assets and Health Dynamics among the Oldest Old (AHEAD) Survey, Wave One. The objectives of this study were (a) to establish profiles of older people who have a written will and to compare their financial portfolios across will-holding status; (b) to identify factors that influence the decision to make a will, and (c) to draw implications for family economists, financial educators, planners, and policy makers. The results suggested that a household's financial resources (i.e., liquid and illiquid assets, housing equity, and household income) positively influence the probability of having a will. Older people who resided in a community property state and who were in poor health were less likely to be will-holders than their counterparts, holding financial resources and other variables constant. Demographic characteristics such as age, education, and race, and behavioral characteristic also were significant determinants of the likelihood of having a will. Volunteer participation and charitable contribution, which are proxies for altruism, increased the likelihood of having a will. The probability of having a will also was higher among those who had life insurance and had gwen inter-vivos gifts of more than $\$5,000$ to their children or grandchildren in the past 10 years. On the other hand, the likelihood of having a will declined with increasing number of biological children. From the findings, implications for financial planners and educators were suggested along with directions for future research.
Journal of the Korea Academia-Industrial cooperation Society
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v.18
no.11
/
pp.526-535
/
2017
This study was conducted to identify the effects of a comprehensive health care program for elderly living alone on blood pressure, fasting glucose, body composition, and depression at a senior welfare center in M city. The study employed a one-group, pre-posttest design. The comprehensive health care program lasted for three months, from March to June in 2015, and consisted of open health education, exercise class, health consulting and personal education, nutritional consultation, and a self-support group. The sample elements of this study were individuals over 65-years-old with hypertension or diabetes mellitus, living near a welfare center in M city. A total of 34 participants were initially selected, but five subjects who were attended less than five times were excluded; therefore, a total of 29 individuals were included. The t-test and Pearson's correlation were used to analyze the data. The characteristics of subjects were 19 male(65.52%) and 10 female(34.48%). The most common age was 70 (16 subjects;55.17%). Additionally, 14 subjects were suffering from hypertension and diabetes mellitus (48.27%), which were occupied in the largest number in this study. The average attendance number of health programs was 10.28 times(${\pm}4.17$). In this study of subjects were significantly lower systolic blood pressure(t=3.275, p=0.004), body weight(t=3.878, p=0.001), depression(t=3.308, p=0.004) compared to pre-test. As the elderly population has increased, the number of individuals living alone has also increased. Accordingly, then need for physical and psycho-social health programs targeting the elderly is greater.
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