• Title/Summary/Keyword: Epidemiologic studies

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Phytoestrogen Intake and Risk of Ovarian Cancer: a Meta-Analysis of 10 Observational Studies

  • Qu, Xin-Lan;Fang, Yuan;Zhang, Ming;Zhang, Yuan-Zhen
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.21
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    • pp.9085-9091
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    • 2014
  • Background: Epidemiology studies have shown an inconclusive relationship between phytoestrogen intake and ovarian cancer risk and there have been no relevant meta-analyses directly regarding this topic. The purpose of the present meta-analysis was therefore to investigate any association between phytoestrogen intake and ovarian cancer in detail. Materials and Methods: We conducted a search of PubMed, EMBASE, EBSCO, the Cochrane Library, CNKI and Chinese Biomedical Database (up to April 2014) using common keywords for studies that focused on phytoestrogen and ovarian cancer risk. Study-specific risk estimates (RRs) were pooled using fixed effect or random-effect models. Results: Ten epidemiologic studies were finally included in the meta-analysis. The total results indicated higher phytoestrogen intake was associated with a reduced ovarian cancer risk (RR, 0.70; 95%CI: 0.56-0.87). The association was similar in sensitivity analysis. Meta regression analysis demonstrated sources and possibly types and regions as heterogeneous factors. Subgroup analysis of types, sources and regions showed that isoflavones (RR: 0.63; 95%CI: 0.46, 0.86), soy foods (RR: 0.51; 95%CI: 0.39, 0.68) and an Asian diet (RR: 0.48; 95%CI: 0.37, 0.63) intake could reduce the incidence of ovarian cancer. Conclusions: Our findings show possible protection by phytoestrogens against ovarian cancer. We emphasize specific phytoestrogens from soy foods, but not all could reduce the risk. The habit of plentiful phytoestrogen intake by Asians is worthy to recommendation. However, we still need additional larger well designed observational studies to fully characterize underlying associations.

Is meconium exposure associated with autism spectrum disorders in children?

  • Jenabi, Ensiyeh;Ayubi, Erfan;Khazaei, Salman;Bashirian, Saeid;Khazaei, Mojtaba
    • Clinical and Experimental Pediatrics
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    • v.64 no.7
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    • pp.341-346
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    • 2021
  • Background: The results differ among published studies regarding exposure to meconium and the risk of developing autism spectrum disorders (ASDs). Purpose: The present study pooled all of the epidemiologic studies retrieved from broader databases on the association between meconium exposure and risk of developing ASD in children. Methods: The Web of Science, PubMed, Scopus, and Google Scholar databases were searched without language restrictions for articles published between their inception to February 20, 2020, using relevant keywords. The pooled odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated as random-effect estimates of the associations among studies. A subgroup analysis was conducted to explore any potential sources of heterogeneity among studies. Results: The pooled estimate of OR reported a weakly significant association between meconium exposure and ASD development in children (OR, 1.13; 95% CI, 1.03-1.24). There was low heterogeneity among the articles reporting risk for ASD among children (I2=19.3%; P=0.259). The results of subgroup analysis based on meconium exposure showed a significant association between a meconium-stained neonate and ASD development (OR, 1.18; 95% CI, 1.11-1.24). Couclusion: Meconium exposure was weakly associated with an increased risk of ASD. However, more evidence based on large prospective cohort studies is required to provide conclusive evidence about whether meconium exposure is associated with an increased risk of ASD development.

Clinical Evaluation of Abdominal Stab Wound Patients in the ED (복부 자상환자의 처치에 대한 응급의학에서의 고찰)

  • Park, Jong-Hak;Kim, Jung-Youn;Shin, Jun-Hyun;Yoon, Young-Hoon;Cho, Han-Jin;Moon, Sung-Woo;Choi, Sung-Hyuk;Lee, Sung-Woo;Hong, Yun-Sik
    • Journal of Trauma and Injury
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    • v.23 no.1
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    • pp.21-28
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    • 2010
  • Purpose: In Korea, most abdominal penetrating wounds are caused by stab wounds rather than gun-shot wounds. However, not many studies have been performed on stab injuries and their epidemiologic characteristics. Disagreements of opinions of obligatory surgical exploration and conservative treatment exist, and this subject is still being debated. Therefore, the authors studied the epidemiologic characteristics of abdominal stab wound patients visiting the emergency department and reviewed the proportion of patients that received nontherapeutic surgery and conservative treatment. Methods: This study included patients visiting the emergency department with abdominal stab wounds. A retrospective chart review was done on the abdominal stab wound patients. Sex, age, cause of injury, location of wound, initial vital signs, operation results, injured organs and CT & LWE results were reviewed. Results: The median age of the 121 patients was 40.9 years, of these patients, 88 were males, of which 52 (43.0%) were drunken. Of the patients that received non-therapeutic operations, only 3 patients (15.0%) were drunken, significantly lower than the therapeutic operation group. For the location of the wound, most patients were injured in the right and left upper quadrants, 27 patients each. The most common injured organ was the small bowel; 13 patients were injured in the small bowel. With abdominal CT scans and local wound explorations together, the results exhibited a sensitivity of 97%, a specificity of 44%, a positive predictive value of 56%, and a negative predictive value of 95%. Conclusion: In our study, the sensitivity was 97% when CT & LWE were performed together; thus we can conclude that CT and LWE can be used together to select the treatment method. Although in our study, the surgical indications in abdominal stab wound patients is not sufficient, our results showed a higher rate of nontherapeutic surgery compared to previous studies. Therefore, more research is needed to prevent unnecessary laparotomies in hemodynamically-stable patients without symptoms.

Convergent Factors Related to Job Burnout among Hospital Administrative Staff (병원행정직의 직무소진과 관련된 융복합적 요인)

  • Kim, Seung-Hee;Bae, Sang-Yun
    • Journal of Digital Convergence
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    • v.15 no.10
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    • pp.349-356
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    • 2017
  • This study is executed to investigate convergent factors to job burnout(MBI-GS: Maslach Bunout Inventory-General Survey) among hospital administrative staff. The survey was administered to 201 staff from 9 general hospitals located in J area from Jul. 3rd, 2017 to Jul. 29th, 2017. The structured self-administered questionaries were used. The hierarchical multiple regression analysis shows the following results. The MBI-GS of respondents turned out to be significantly higher in following groups: a group in which Organizational Commitment Questionnaire(OCQ) is lower, a group in which Type A Behavior Pattern(TABP) is higher, a group in which depression(CES-D: Center for Epidemiologic Studies Depression scale) are higher. The results show explanatory power of 52.1%. The results of the study indicate that the efforts, to increase OCQ, and to decrease TABP and CES-D, are required to improve the MBI-GS among hospital administrative staff. The results are expected to be useful for the program and human resource management to related to the MBI-GS among HAS. In the following study, the analysis of structural equation modeling about additional factors of the MBI-GS among hospital administrative staff will be needed.

A study on Symptom Experience, Spiritual Well-Being, and Depression in Patients Undergoing Hemodialysis (혈액투석 환자의 증상경험, 영적 안녕 및 우울에 관한 연구)

  • Song, Ju Yeon;Oh, Pok-Ja
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.5
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    • pp.660-670
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    • 2016
  • This cross-sectional descriptive investigation attempted to identify the relationship among the symptoms, spiritual well-being, and depression experienced by patients undergoing hemodialysis. Data were collected from 146 patients at 6 hemodialysis clinics from October 15th, 2014 to January 15th, 2015. The Dialysis Symptom Index (DSI) was used to measure symptom experience, spiritual well-being was measured using the Spiritual Well-being Scale, and depression was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). The data were analyzed using ANOVA, the t-test, Scheffe's test, Pearson correlation, and hierarchical regression analysis. The mean score of the symptom experience was 26.43 (range: 0~85), the mean spiritual well-being score was 47.79 (range: 20~80), and the mean depression score was 10.56 (range: 0~35). It was found that greater existential well-being leads to lower depression (r=-.23, p=.004) and symptom experience (r=-.17, p=.045). Greater physical (B=.09) and emotional (B=.64) symptom experience leads to higher depression and the explanatory power of these factors was 52.1% (F=18.54, p<.001). Therefore, a comprehensive nursing intervention that can help reduce the symptom experience and increase the existential well-being in hemodialysis patients is needed to reduce their depression.

The Correlation Between Defense Mechanism and Posttraumatic Stress Disorder in Burn Patients (화상 환자의 방어기제와 외상후 스트레스 장애와의 관련성)

  • Lee, Dowon;Choi, Yanghwan;Kim, Jong Dae;Son, Kyung-Lak;Im, Woo Young;Jun, Jin Yong
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.191-198
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    • 2021
  • Objectives : This study was designed to investigate the correlation between defense mechanism and posttraumatic stress disorder in burn patients. Methods : We recruit 40 burn patients and we evaluate sociodemographic characteristics, characteristics related to burn, korean version of Impact of Event Scale-Revised (IES-R), Korean Version of Center for epidemiologic studies depression scale (CES-D) and Ewha Defense Mechanisms Test (EDMT). Multiple regression analysis was performed to evaluate the correlation between EDMT score and IES-R score. Results : Factor 2 of EDMT which consists of Ego-expansion subjects was significantly correlate with IER-S score. In factor 2, Controlling (β=-0.299, p<0.05), Sublimation (β=-0.276, p<0.05) is significantly correlate with IER-S score. Conclusions : Some subjects of defense mechanism was significantly correlate with IES-R score. it might be helpful to understand defense mechanism for the posttraumatic stress disorder in burn patients.

Application of Cognitive Enhancement Protocol Based on Information & Communication Technology Program to Improve Cognitive Level of Older Adults Residents in Small-Sized City Community: A Pilot Study (중소도시 지역사회 거주 노인의 치매예방을 위한 Information & Communication Technology 프로그램 기반 인지향상 프로토콜 적용: 파일럿(Pilot) 연구)

  • Yun, Sohyeon;Lee, Hamin;Kim, Mi Kyeong;Park, Hae Yean
    • Therapeutic Science for Rehabilitation
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    • v.12 no.2
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    • pp.69-83
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    • 2023
  • Objective : This study, as a preliminary study, applied an Information & Communication Technology (ICT) home-based program to elderly people aged 65 years or older to confirm the effect of the cognitive enhancement program and to find the possibility of remote rehabilitation. Methods : This study from August to October 2022, three subjects were selected and the intervention was conducted for about 2 months. This intervention was conducted using Korean version of Mini-Mental State Examination, Korean version of Montreal Cognitive Assessment (MoCA-K), Computer Cognitive Senior Assessment System, and the Center for Epidemiologic Studies Depression scale to evaluate cognitive improvement before and after the program. The therapist remotely set the level of cognitive training according to the subject's level through weekly feedback. Results : After the intervention, all subjects showed improved scores in most items of the MoCA-K conducted before and after the intervention. In addition, among the items of Cotras-pro, upper cognition, language ability, attention, visual perception, and memory were improved. Conclusion : Cognitive rehabilitation training using an ICT home-based program not only prevented dementia but also made it habitual. Through this study, it was confirmed that remote rehabilitation for the elderly could be possible.

Helicobacter pylori Infection and Risk of Gastric Cancer in Korea: A Quantitative Systematic Review

  • Bae, Jong-Myon;Kim, Eun Hee
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.4
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    • pp.197-204
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    • 2016
  • Objectives: In the context of the global decrease in mortality due to gastric cancer, previous studies have reported that the effect of chronic Helicobacter pylori (H. pylori) infection on the incidence of gastric cancer varies among regions. This systematic review was conducted to investigate H. pylori as a risk factor for gastric cancer in Korea, where the incidence of gastric cancer is among the highest in the world. Methods: A search strategy was established to identify articles published in Korean as well as in English. Ultimately, we included observational studies conducted among Korean patients that designed with an age-matched and sex-matched control group that reported the odds ratio associated with H. pylori. Gastric cancer cases were subdivided into overall (OGC), cardia (CGC), non-cardia (NGC), early (EGC), advanced, intestinal (IGC), and diffuse forms of gastric cancer. Summary odds ratios (SORs) with 95% confidence intervals (CIs) were calculated in the meta-analysis using a random-effect model. Results: Eleven case-control studies were ultimately selected. H. pylori was associated with an SOR of 1.81 (95% CI, 1.29 to 2.54) for OGC. Additionally, statistically significant risks were observed for CGC, NGC, EGC, and IGC. Conclusions: Chronic H. pylori infection was found to raise the risk of gastric cancer among Koreans, with the highest risk observed for CGC and EGC (SOR=2.88 for both). Follow-up clinical epidemiologic studies are needed to assess the effects of current treatments aimed at eradicating H. pylori infections.

A Systematic Review on the Causative Medicines for Stevens-Johnson Syndrome (스티븐스-존슨증후군을 유발하는 주요 의약품별 위험도에 대한 체계적 문헌고찰)

  • Kwon, Kyoung-Eun;Jung, Sun-Young;Jung, Hyun-Joo;Kim, Bong Gi;Park, Byung-Joo
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.4
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    • pp.344-364
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    • 2013
  • Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are immune-complex-mediated hypersensitivity reactions that predominantly involve skin and mucous membranes. Despite the low incidence, both are considered medical emergencies as the mortality rate has been estimated at 30-50%. Although as many as half of cases are idiopathic, several drugs have been implicated as main cause of SJS/TEN. This review therefore aimed to identify drugs that were potentially associated with SJS/TEN and compare the relative risk of the medications. Method: A comprehensive search was performed using MEDLINE, EMBASE and 5 Korean databases. We defined study drugs as non-steroidal anti-inflammatory drugs (NSAIDs), antibiotics, antiepileptics, and allopurinol. Only epidemiologic studies investigating associations between the above drugs and drug-induced SJS/TEN were included. Two reviewers independently selected and evaluated candidate papers and extracted odds ratios or incidence rates. Meta-analysis was performed only for drugs that were reported from 4 or more studies. Results: We found 8 case-control studies, 3 cohort studies and 1 RCT. The ranges of adjusted ORs were 0.6-34.0 for NSAIDs, 1.6-302.0 for antiepileptics, 0.3-10.0 for antibiotics and 1.0-187.0 for allopurinol. The drug with the highest incidence of SJS/TEN was carbamazepine (40 persons/1,000 DDD). Conclusion: Finally, the risk was highest in first 8 weeks after onset of treatment in all drugs.

Radiation Exposure and Cancer Mortality Among Nuclear Power Plant Workers: a Meta-analysis (원전종사자의 방사선 노출과 암사망 위험도와의 관련성에 대한 메타분석)

  • Park, Eun-Sook;Moon, Ki-Eun;Kim, Han-Na;Lee, Won-Jin;Jin, Young-Woo
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.2
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    • pp.185-192
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    • 2010
  • Objectives: We conducted a meta-analysis to investigate the relationship between low external doses of ionizing radiation exposure and the risk of cancer mortality among nuclear power plant workers. Methods: We searched MEDLINE using key words related to low dose and cancer risk. The selected articles were restricted to those written in English from 1990 to January 2009. We excluded those studies with no fit to the selection criteria and we included the cited references in published articles to minimize publication bias. Through this process, a total of 11 epidemiologic studies were finally included. A publication bias was tested for using Egger's test. The homogeneity test was performed before the integration of each of the standardized mortality ratios (SMRs) and the result proved that the studies were heterogeneous. Results: We found significant decreased deaths from all cancers (SMR = 0.75, 95% CI = 0.62 - 0.90), all cancers excluding leukemia, solid cancer, mouth and pharynx, esophagus, stomach, rectum, liver and gallbladder, pancreas, lung, prostate, lymphopoietic and hematopoitic cancer. The findings of this meta-analysis were similar with those of the 15 Country Collaborative Study conducted by the International Agency for Research on Cancer. A publication bias was found only for liver and gallbladder cancer (p = 0.015). Heterogeneity was observed for all cancers, all cancers excluding leukemia, solid cancer, esophagus, colon and lung cancer. Conclusions: Our findings of low mortality for stomach, rectum, liver and gallbladder cancers may explained by the health worker effect. Yet further studies are needed to clarify the low SMR of cancers, for which there is no useful screening tool, in nuclear power plant workers.