• Title/Summary/Keyword: Excess mortality

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Apixaban versus Warfarin in Patients with Chronic Kidney Disease; A Systematic Review and Meta-analysis (만성신장병환자에서 apixaban과 warfarin의 안전성 비교: 체계적 문헌고찰 및 메타분석)

  • Nam, Jae Hyun;Kim, Chae Young;Lee, Yoo Kyung;Jung, Da Woom;Gwak, Hye Young;Chung, Jee Eun
    • Korean Journal of Clinical Pharmacy
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    • v.31 no.2
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    • pp.87-95
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    • 2021
  • Background: Patients with chronic kidney disease (CKD) are at a high risk of stroke-related morbidity, mortality, and bleeding. However, the overall risk/benefit of anticoagulant therapy among patients with CKD remains unclear. Methods: The MEDLINE, EMBASE, and CENTRAL databases were comprehensively searched until July 31, 2020, to investigate the safety and efficacy of apixaban in patients with stage 4 or 5 CKD, as compared with warfarin. The primary outcome was an incidence of major bleeding. Secondary outcomes included composite bleeding (major, clinically relevant, and minor bleeding), venous thromboembolism (VTE), stroke, and death. Results: In total, seven studies consisting of 10,816 patients were included. Compared with warfarin, apixaban was associated with a reduced risk of major bleeding (OR 0.49, 95% CI 0.41-0.58). In terms of composite bleeding, apixaban tended to pose a significantly lower risk than warfarin (OR 0.51, 95% CI 0.37-0.71). There was no difference between apixaban and warfarin with respect to the risk of stroke or death (stroke: OR 1.23, 95% CI 0.49-3.12; death: OR 0.73, 95% CI 0.45-1.18). Conclusion: Among patients with stage 4 or 5 CKD, the use of apixaban was associated with a lower risk of bleeding compared to warfarin and was also found to pose no excess risk of thromboembolic events.

Characteristics of injuries associated with electric personal mobility devices: a nationwide cross-sectional study in South Korea

  • Kim, Maro;Suh, Dongbum;Lee, Jin Hee;Kwon, Hyuksool;Choi, Yujin;Jeong, Joo;Kim, Sola;Hwang, Soyun;Park, Joong Wan;Jo, You Hwan
    • Journal of Trauma and Injury
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    • v.35 no.1
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    • pp.3-11
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    • 2022
  • Purpose: The increasing use of electric personal mobility devices (ePMDs) has been accompanied by an increasing incidence of associated accidents. This study aimed to investigate the characteristics of ePMD-related injuries and their associated factors. Methods: This cross-sectional study was conducted using data from the Emergency Department-based Injury In-depth Surveillance database from 2014 to 2018. All patients who were injured while operating an ePMD were eligible. The primary outcome was the rate of severe injury, defined as an excess mortality ratio-adjusted Injury Severity Score of ≥25. We calculated the adjusted odds ratios (AORs) of outcomes associated with ePMD-related injuries. Results: Of 1,391,980 injured patients, 684 (0.05%) were eligible for inclusion in this study. Their median age was 28 years old, and most injuries were sustained by men (68.0%). The rate of ePMD-related injuries increased from 3.1 injuries per 100,000 population in 2014 to 100.3 per 100,000 population in 2018. A majority of the injuries occurred on the street (32.7%). The most commonly injured area was the head and face (49.6%), and the most common diagnosis was superficial injuries or contusions (32.9%). Being aged 55 years or older (AOR, 3.88; 95% confidence interval, 1.33-11.36) and operating an ePMD while intoxicated (AOR, 2.78; 95% confidence interval, 1.52-5.08) were associated with severe injuries. Conclusions: The number of emergency room visits due to ePMD-related injuries is increasing. Old age and drunk driving are both associated with serious injuries. Active traffic enforcement and safety regulations regarding ePMDs should be implemented to prevent severe injuries caused by ePMD-related accidents.

Exposure Characteristics of Indoor Air Pollutants in Some Local Pubic Buses (IoT 기반 시내버스 실내공기질 노출 특성)

  • Kim, Ho-Hyun
    • Journal of Environmental Health Sciences
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    • v.48 no.1
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    • pp.44-51
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    • 2022
  • Background: Air pollution is increasing together with industrialization and urbanization. In order to reduce air pollution, public transportation is recommended rather than private cars, and the number of passengers using public transportation is increasing accordingly. This study observes the concentration of indoor pollutants in city buses over time. Through this means, we intend to suggest a plan to manage the indoor air quality in city buses. Objectives: The concentration of indoor pollution in public transportation was investigated from April 2021 to January 2022. Based on this, we evaluated the exposure to indoor pollutants. Methods: Six city bus lines in an industrial city were selected for the research, and indoor pollution was measured through IoT (Internet of Things)-based sensor-type measuring devices. The concentration of pollutants was measured every minute, and statistical data were constructed based on the measurement results. Results: In all the city buses studied, the average concentration of pollutants were below the guidelines. However, some measurement results showed cases of exceeding the guidelines. As a result of the analysis by time zone, there were more cases in which pollutants exceeded the standard value during rush hour compared to at other times. A risk assessment for PM10 was performed by evaluating the excess mortality risk from exposure and the risk from inhalation exposure. Conclusions: All measured indoor pollutants in the city buses did not exceed the guidelines. Also, the risk assessment results were found to be within the level of safety. However, if a city bus is used for a long time, there is a possibility that there may be an impact on the human body due to inhalation exposure, so additional management is required.

Chloride and lactate as prognostic indicators of calf diarrhea from eighty-nine cases

  • Gencay Ekinci;Emre Tufekci;Youssouf Cisse;Ilknur Karaca Bekdik;Ali Cesur Onmaz;Oznur Aslan;Vehbi Gunes;Mehmet Citil;Ihsan Keles
    • Journal of Veterinary Science
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    • v.25 no.3
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    • pp.38.1-38.16
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    • 2024
  • Importance: Deaths due to neonatal calf diarrhea are still one of the most critical problems of cattle breeding worldwide. Determining the parameters that can predict diarrhea-related deaths in calves is especially important in terms of prognosis and treatment strategies for the disease. Objective: The primary purpose of this study was to determine mortality rates and durations, survival status, and predictive prognosis parameters based on vital signs, hematology, and blood gas analyses in neonatal diarrheic calves. Methods: The hospital automation system retrospectively obtained data from 89 neonatal diarrheic calves. Results: It was found that 42.7% (38/89) of the calves brought with the complaint of diarrhea died during hospitalization or after discharge. Short-term and long-term fatalities were a median of 9.25 hours and a median of 51.50 hours, respectively. When the data obtained from this study is evaluated, body temperature (℃), pH, base excess (mmol/L), and sodium bicarbonate (mmol/L) parameters were found to be lower, and hemoglobin (g/dL), hematocrit (%), lactate (mmol/L), chloride (mmol/L), sodium (mmol/L) and anion gap (mmol/L) parameters were found to be higher in dead calves compared to survivors. Accordingly, hypothermia, metabolic acidosis, and dehydration findings were seen as clinical conditions that should be considered. Logistic regression analysis showed that lactate (odds ratio, 1.429) and CI- (odds ratio, 1.232) concentration were significant risk factors associated with death in calves with diarrhea. Conclusions and Relevance: According to the findings obtained from this study, the determination of lactate and Cl- levels can be used as an adjunctive supplementary test in distinguishing calves with diarrhea with a good prognosis.

Influence of Energy Restriction and Pre-incubation Holding Period of Eggs on Fertility and Hatchability in Aged Broiler Breeders

  • Shyam Sunder, G.;Vijaya Kumar, Ch.;Panda, A.K.;Rama Rao, S.V.;Raju, M.V.L.N.
    • Asian-Australasian Journal of Animal Sciences
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    • v.23 no.2
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    • pp.240-245
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    • 2010
  • The effects of controlled energy restriction and duration of pre-incubation egg holding on fertility, hatchability and hatch losses were evaluated in aged broiler breeders (64 wk). The energy (ME) required for maintenance, activity, growth and anticipated egg production was calculated and offered to a control group (283-471 kcal/kg) from 21-64 weeks of age. In three other groups, ME was quantitatively reduced either by 20% (SER; severe energy restriction) or 10% (MER; moderate energy restriction) and increased by10% (EEF; excess energy feeding) over the control group (CER; controlled energy restriction). Each diet was offered to 130 pullets in individual cages, and the quantity of ME increased with age. At the end of 64 weeks, fertile eggs were collected from each dietary group for 11 consecutive days and grouped under 4 holding periods based on the length of storage (2, 5, 8 or 11 d). The influence of energy regimes, egg holding intervals and their interaction was evaluated on fertility, hatch losses and hatchability. Broiler breeders maintained on SER regime (231-419 kcal/d) produced maximum number of eggs (993) followed by MER (819), CER (624) and EEF (438) during the 11-day period. The percent fertility and hatchability was significantly (p$\leq$0.05) higher in SER and MER groups compared to CER and EEF. However, energy regimes did not influence the loss in egg weight during pre-incubation storage, shell weight, shell thickness or hatch losses as dead germs and dead in shell. The improvement in hatchability in SER and MER groups appeared to be closely related to higher fertility and lower embryonic mortality. Holding of eggs for 11 days showed a linear loss in egg weight with the length of storage, but did not influence the fertility and hatch losses. The percent hatchability on eggs set was maximum when storage period was restricted to 5 days. The interaction between energy regimes and egg holding periods exhibited better hatchability results with SER regime when eggs were held for 5 days. Response to MER was not different from SER. It was obvious that energy restriction during production period had a positive influence on egg number, fertility and hatchability in aged breeders. At 64 weeks of age, holding of fertile eggs for 5 days prior to incubation was adequate for optimum hatchability in breeders.

Sub-acute toxicity and effect of Hwangryunhaedok-tang on human drug-metabolizing enzymes

  • Jin, Seong Eun;Lee, Mee-Young;Seo, Chang-Seob;Shin, Hyeun-Kyoo;Cho, Jae-Woo;Ha, Hyekyung
    • The Journal of Korean Medicine
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    • v.38 no.2
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    • pp.15-30
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    • 2017
  • Objectives: Hwangryunhaedok-tang (HHT; Huanglianjiedu-tang, Orengedoku-to), a traditional herbal formula, is used for treating inflammation, hypertension, gastritis, liver dysfunction, cerebrovascular diseases, dermatitis and dementia. The objective of this study was to assess the sub-acute toxicity of HHT in Sprague-Dawley (SD) rats, and its effect on the activities of human microsomal cytochrome P450s (CYP450s) and UDP-glucuronosyltransferases (UGTs). Methods: Male and female SD rats were orally administered HHT once daily at doses of 0, 500, 1000 and 2000 mg/kg for 4 weeks. We analyzed mortality, clinical observations, body weight, food consumption, organ weights, urinalysis, hematology, serum biochemistry, and histopathology. The activities of major human CYP450s (CYP1A2, CYP3A4, CYP2B6, CYP2C9, CYP2C19, CYP2D6, and CYP2E1) and UGTs (UGT1A1, UGT1A4, and UGT2B7) were assessed using in vitro fluorescence- and luminescence-based enzyme assays, respectively. Results: No toxicologically significant changes related to the repeated administration of HHT were observed in both male and female SD rats. The no observed adverse effect level (NOAEL) value was more than 2000 mg/kg/day for both sexes. HHT inhibited the activities of human microsomal CYP1A2, CYP2C19, CYP2D6, and CYP2E1, whereas it weakly inhibited the activities of CYP2B6, CYP2C9, CYP3A4, and UGT1A1. In addition, HHT negligibly inhibited the activities of human microsomal UGT1A4 and UGT2B7 with $IC_{50}$ values in excess of $1000{\mu}g/mL$. Conclusions: Our findings indicate that HHT may be safe for repeated administration up to 4 weeks. In addition, these findings provide information on the safety and effectiveness of HHT when co-administered with conventional drugs.

Analysis of the Prognostic Factors in Trauma Patients with Massive Bleeding (외상으로 인한 대량 출혈 환자에서의 예후인자 분석)

  • Choi, Seok Ho;Suh, Gil Joon;Kim, Yeong Cheol;Kwon, Woon Yong;Han, Kook Nam;Lee, Kyoung Hak;Lee, Soo Eon;Go, Seung Je
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.247-253
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    • 2012
  • Purpose: Hemorrhage is a main cause of death in trauma patients. The goal of this study is to describe the characteristics of trauma patients with massive bleeding and to evaluate the prognostic factors concerning their survival. Methods: This study was performed retrospectively and included trauma patients with massive bleeding who had been treated from March 2007 to August 2012. The inclusion criterion was patients who received more than 10 U of packed red blood cells within the first 24 hours after visiting the emergency department. Based on their medical records, we collected data in terms of demographic findings, mechanisms of injury, initial clinical and laboratory findings, methods for hemostasis (emergency surgery and/or angioembolization), transfusion, injury severity score (ISS), revised trauma score (RTS) and trauma and injury severity score (TRISS). We used the Mann-Whitney U test and Fisher's exact test to compare the variables between the patients that survived and those that did not. We performed a logistic regression analysis with the significant variables from the univariate test. Results: Thirty-two(32) patients were enrolled. The main mechanisms of injury were falls and motor vehicle accidents. The mean transfusion amount of packed red blood cells (PRBC) was 17.4 U. The mean elapsed time for the first hemostasis (surgery or embolization) was 3.5 hours. The initial technical success rates were 83.3%(15/18) in angioembolization and 66.7%(8/12) in surgery. The overall mortality rate was 34.4%(11/32). The causes of death were bleeding, brain swelling and multiple organ failure. The ISS(25.5 vs 46.3, p=0.000), TRISS(73.6 vs 45.1, p=0.034) and base excess(<-12 mmol/L, p=0.020) were significantly different between the patients who survived and those who did not. Conclusion: The ISS was a prognostic factor for trauma patients with massive bleeding.

I. Laboratoy Rearing of the Aphidophagous Ladybeetle, Harmonia axyridis; Yolk Protein Production and Fecundity of the Summer Adult Female (무당벌레(Harmonis axyridis)의 사육 I;여름 성충의 난황단백질 생성 및 산란력)

  • 홍옥기;박용철
    • Korean journal of applied entomology
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    • v.35 no.2
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    • pp.146-152
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    • 1996
  • The adult of the aphidophagous ladybeetle, Harmonia axyridis, was reared by feeding an artificial diet (chicken's 1iver:sugar = 5:2, v/w). The adult ladybeetle used was from pupae collected in the field in midJuly. Yolk protein production, fecundity and longevity of the adult female were checked under 3OoC, 16L:8D. Yolk proteins (Vg3 and Vg4) were detected from the hemolymph of the female 5 days after the emergence. One hundred pairs of female and male were reared separately. First oviposition started from 7 days afier the emergence and laid an average of 163.9k144.0 eggs during lifetime. Seventeen females did not lay eggs at all. Longevity of the female was 60.6k16.9 days. The application of a JH analog, methoprene (2.5 pg), caused the occurrence of yolk proteins in the hemolymph 1 day earlier than that of the control. Weekly application of 2.5 pg of methoprene induced 83.3% from the 30 females to lay eggs within 15 days after the emergence, while the control had 51% only. Methoprene made all females lay eggs, causing the increase in the fecundity. Though the longevity of the female was not effected by the weekly application of methoprene, one time excess dose (12.5 pg) caused high in mortality and low in fecundity.

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Incidences of Lower Extremity Injuries in Korea (국내 하지손상의 발생현황에 대한 분석)

  • Kim, Chang Sun;Choi, Hyuk Joong;Kim, Jai Yong;Shin, Sang Do;Koh, Sang Baek;Lee, Kug Jong;Im, Tai Ho
    • Journal of Trauma and Injury
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    • v.21 no.1
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    • pp.36-45
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    • 2008
  • Purpose: We conducted this retrospective epidemiological study to assess the incidence and severity of lower extremity injuries in Korea Methods: For this study, we retrospectively reviewed nationwide lower-extremity injury data compiled from 2001 to 2003 based on the National Injury Database, what included National Health Insurance Corporation (NHIC), Car Insurance, and Industry Insurance data. Data were standardized in terms of demographic characteristics, region, and socioeconomic status by using NHIC data. To assess the degree of the injuries, we used the Modified Abbreviated Injury Scale (MoAIS), what has been changed from the International Classification of Disease-10 (ICD-10) code. By using the Excess Mortality Ratio-adjusted Injury Severity Score (EMR-ISS), we classified the degree of severity into four categories: mild, moderate, severe and critical. Results: From 2001 to 2003, lower extremity injuries increased slightly, with a yearly average of 2,437,335. Insurance data should that lower-extremity injuries were the most common, followed by upper-extremity injuries. Significant difference were seen in the numbers of lower extremity injuries based on gender and age. As for provinces, Seoul and Gyeongi provinces had the highest numbers of cases. Junlabukdo had the highest rate of 55,282 cases per 1 million people for standardized gender and population. The annual incidence of the insured patients with lower extrimity injuries was higher than the employer's medical insurance contributions to the medical insurance program. Daily cases occur most often in May and June, with the lowest occurrences being in January and February. Conclusion: The result of this study shows that lower extremity injuries comprised common cause of all injuries. In addition, differences associated with gender, location and socioeconomic status were observed. Further studies are needed to find reasons and then this knowledge will allow strategies to prevent the lower extremity injuries.

Experimental Study on Flow Direction of Fire Smoke in DC Electric Fields (DC 전기장 내에서 발생하는 화재연기 진행 방향에 대한 실험적 연구)

  • Park, Juwon;Kim, Youngmin;Seong, Seung Hun;Park, Sanghwan;Kim, Ji Hwan;Chung, Yongho;Yoon, Sung Hwan
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.27 no.5
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    • pp.675-682
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    • 2021
  • Fire accidents on land and at sea can cause serious casualties; specifically, owing to the nature of marine plants and ships, the mortality rate at sea from suffocation in confined spaces is significantly higher than that on land. To prevent such cases of asphyxiation, it is essential to install ventilation fans that can outwardly direct these toxic gases from fires; however, considering the scale of marine fires, the installation of large ventilation fans is not easy owing to the nature of marine structures. Therefore, in this study, we developed a new concept for fire safety technology to control toxic gases generated by fires from applied direct current (DC) electric fields. In the event of a fire, most flames contain large numbers of positive and negative charges from chemi-ionization, which generates an "ionic wind" by Lorentz forces through the applied electric fields. Using these ionic winds, an experimental study was performed to artificially control the fire smoke caused by burning paper and styrofoam, which are commonly used as insulation materials in general buildings and ships. The experiments showed that a fire smoke could be artificially controlled by applying a DC voltage in excess of ±5 kV and that relatively effective control was possible by applying a negative voltage rather than a positive voltage.