• Title/Summary/Keyword: Hospital epidemiology

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Diabetes Mellitus and Risk of Colorectal Cancer Mortality in Japan: the Japan Collaborative Cohort Study

  • Tan, Ce;Mori, Mitsuru;Adachi, Yasushi;Wakai, Kenji;Suzuki, Sadao;Suzuki, Koji;Hashimoto, Shuji;Watanabe, Yoshiyuki;Tamakoshi, Akiko
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.10
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    • pp.4681-4688
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    • 2016
  • Objective: Our aim was to estimate whether diabetes mellitus (DM) may be associated with an increased risk of colorectal cancer (CRC) mortality in Japan. Methods: The Japan Collaborative Cohort (JACC) Study is a nationwide prospective study, initiated in 1988, which involves 110,585 subjects (age range: from 40 to 79 years; 46,395 males and 64,190 females). Our present analysis population comprised 96,081 (40,510 men and 55,571 women) who provided details on DM history. The questionnaire also included age, sex, weight, height, family history of CRC, smoking, drinking and exercise habits, and education. Cox proportional-hazard regression was used to estimate the hazard ratio (HR). We used SPSS 21 software to analyze all data. Results: Among the participants with DM, we followed up for 71,174 person-years and 640. deaths from CRC were confirmed; and, among the non-diabetic participants, 785 CRC deaths were identified during 1,499,324 person-years. After adjusting for multivariate confounding factors, such as age, sex, body mass index (BMI), family history of colorectal cancer, smoking habit, drinking habit, physical activity (sports and walking) and education, DM was associated with an increased risk of CRC death (HR 1.4, 95% confidence interval [CI] 1.0-2.0). Diabetic women, but not diabetic men, experienced increased mortality from CRC (HR 1.7, 95% CI 1.0-3.0). Conclusion: The risk of CRC mortality is significantly increased in both sexes and women with diabetes, but no significant increase was seen for diabetic men among Japanese.

CLINICAL CATEGORIES OF ADOLESCENT BORDERLINE STATE (청소년 경계선 상태의 임상적 분류)

  • Hong, Kang-E;Jeon, Seong-Ill;Shin, Min-Sup
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.6 no.1
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    • pp.18-33
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    • 1995
  • The Purpose of this article is to identify the specific characteristics of borderline disorder in adolescence to conceptualize the borderline state as an adolescent process different from borderline personality disorder in adult, and to classify them according to it's unique clinical feature, porcess and outcome. The development of borderline disorder in adolescent, epidemiology, comorbid disorders and differential diagnosis, pre-existing sub-classification systems, and etiology in theories of psychodynamics, biological theories, experimental studies, and follow-up studies are reviewed. The authors conceptualize the adolescent borderline state include all clinical states generated by re-emergence of unresolved rapproachement conflicts in adolescent, and propose that there are four subgroups in adolescent borderline state. (1) Borderline state as an adolescent process. (2) Borderline state associated with psychotic disorders (3) Borderline state as an initial stnge of typical borderline personality disorder (4) Borderline state associated with organic problems. Conceptually, borderline state in adolescence is not a simple continuation of primary failure of separation-individuation but a struggle for mastering unresolved separation-individuation conflicts in adolesance i.e., the second separation-individuation state, and if it fails this time, the struggle might continue into adult life as borderline personality disorder.

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Modification of a Smoking Motivation Questionnaire for Chinese Medical Students

  • Jiang, Chao;Sun, Wen-Jie;Wan, Yan-Chun;Wei, Ming-Wei;Mu, Yong-Ping;Tarver, Siobhan L.;Gao, Yong-Qing;Hu, Tian;Xu, Chao;Gordon, James;Feng, Cindy Xin;Wen, Yu-Feng
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2707-2711
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    • 2014
  • Introduction: Smoking prevalence among the medical students is high in China. Therefore, understanding the smoking motivations of medical students is crucial for smoking control, but currently there are no scales questionnaires customized for probing the smoking motivations of medical students. This aim of study was to test and modify a questionnaire for investigating smoking motivations among medical students. Methods: A cross-sectional survey was conducted among 1,125 medical students at Xuzhou Medical College in China in 2012.The model fit and validity was assessed by confirmatory factor analysis (CFA) and the reliability was tested by single-item reliability, composite reliability, and item-total correlation. Results: The prevalence of smoking was 9.84 % among study population. In the modified scales, the global fit indices identified a CFI value of 0.96, TLI was 0.96, and the RMSEA was 0.063. CFA supported the two dimensional structure of the instrument. The average variance extracted ranged from 0.45 to 0.62. All single-item reliability scores were greater than 0.20, and the composite reliability ranged from 0.74 to 0.91. Conclusion: Modified scales could be the preliminary instrument used in evaluating the smoking motivations of medical students. However, it should be further assessed using other forms and methods of validity and reliability, additional motivations of smoking, and the survey of other medical colleges in China.

Epidemiological and Clinicopathological Characteristics of Lung Cancer in a Teaching Hospital in Iran

  • Hajmanoochehri, Fatemeh;Mohammadi, Navid;Zohal, Mohammad Ali;Sodagar, Abolfazl;Ebtehaj, Mehdi
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2495-2500
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    • 2014
  • Background: Lung cancer is one of the most commonly diagnosed cancers and the most frequent cause of cancer-related death worldwide. In Iran, it ranks second and third as the cancer-causing death in men and women, respectively. We carried out this study to find out the demographic, clinical, and histological characteristics and risk factors of lung cancer in a referral tertiary center in Iran. Materials and Methods: A retrospective study was conducted on cases of primary lung cancer based on the results of registered cancer reports of cytological and pathological specimens between March 2001 and March 2012. Demographic variables, clinical manifestations, histology and location of tumors were determined based on the data found in the medical records of each patient. Definite or probable etiologic factors were identified. Data analysis was performed with SPSS version 16 and a p-value ${\leq}0.05$ was considered as significant. Results: A total of 203 patients, with a mean age of 65.7 years (SD=11.2), with primary lung cancer were identified, 81.3% being men. Of the total, 110 cases (54.2%) were living in urban areas. In 53.2% of cases, the site of tumor was on the right side and in 72.9% of cases the lesion was centrally located. The histological types of lung cancer were squamous cell carcinoma (SCC) in 107 cases (52.7%), adenocarcinoma (AC) in 30 cases (14.8%), and small cell carcinoma (SC) in 27 cases (13.3%). Significant correlations between the gender and residence, smoking, and the histological type and location (central or peripheral) of tumor were found. The percentage of smokers was 75.2% in men and 15.8% in women. Conclusions: Smoking was the most important risk factor and squamous cell carcinoma the most common histological type of lung cancer in our study. Male sex and being a smoker was associated with histological types of SCC while being nonsmoker had relationship with adenocarcinoma.

Effect of Arthritis and Comorbid Chronic Conditions on Health-related Quality of Life in Korean Elderly (우리나라 노인에서 관절염과 동반 만성질환에 의한 건강관련 삶의 질 감소 효과)

  • No, Ji-Young;Kim, Soon-Young;Kweon, In-Sun;Nam, Hae-Sung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.6
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    • pp.3751-3758
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    • 2014
  • This study was designed to evaluate the effects of arthritis and comorbid chronic conditions on the health-related quality of life (HRQoL) in the Korean older population. The study subjects were 2,708 Korean adults aged 65 and older from the $3^{rd}$ Korea National Health and Nutrition Examination Surveys data: 1,357 persons with a single chronic condition, such as arthritis, herniations of the intervertebral disc, osteoporosis, asthma, peptic ulcers, stroke, or cataract; 886 persons with arthritis and a second chronic condition described above; and 465 persons with no chronic condition. An analysis of covariance was performed to compare the EQ-5D index among the groups. The effects of arthritis, second chronic condition and their interactions were analyzed by multiple linear regression analysis. The results are as follows. Compared to men with arthritis only, men with stroke only, stroke and arthritis, or cataract and arthritis had a lower age adjusted EQ-5D index. Women with a stroke only, asthma only, cataract only, osteoporosis and arthritis, peptic ulcer and arthritis, stroke and arthritis, or cataract and arthritis had a lower age adjusted EQ-5D index than women with arthritis only. Arthritis and comorbid conditions had additive effects on the HRQol in both genders except for arthritis and stroke in women. In conclusion, comorbid chronic medical conditions in older people with arthritis may reduce the HRQoL in an additive manner.

Recent Epidemiologic Features of Carbon Monoxide Poisoning in Korea: A Single Center Retrospective Cohort Study (최근 국내 일산화탄소 중독의 역학적 특징: 일개 응급의료센터의 후향적 코호트 연구)

  • Choi, Byung Ho;Jeon, Jin;Ryoo, Seung Mok;Seo, Dong Woo;Kim, Won Young;Oh, Bum Jin;Lim, Kyoung Soo;Sohn, Chang Hwa
    • Journal of The Korean Society of Clinical Toxicology
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    • v.10 no.2
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    • pp.80-85
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    • 2012
  • Purpose: The aim of this study was to describe the epidemiologic characteristics of adult patients with carbon monoxide poisoning who presented to the emergency department in recent years. Methods: This was a retrospective cohort study on adult consecutive patients with carbon monoxide (CO) poisoning who presented to the emergency department of a tertiary care university-affiliated hospital from January 1, 2008 to December 31, 2011. Results: A total of 91 patients were included in this study; there were 56(61.5%) unintentional and 35(38.5%) intentional poisonings. For the unintentional CO poisonings, the principal sources of exposure to CO were fire (39.3%), charcoal (17.9%), briquette charcoal (7.1%), wood burning boiler (7.1%), gas boiler (5.4%), automobile heater (3.6%), briquette boiler (3.6%), firewood (3.6%), and other items (12.5%). For the intentional CO poisonings, the sources were ignition charcoal (60.0%), briquette (31.4%), charcoal (5.7%) and butane gas (2.9%). For the unintentional CO poisonings, the places of poisoning were the home (58.9%), workplace (10.7%), public accommodation (8.9%), tent (8.9%), automobile (3.6%) and parking place (1.8%). For the intentional CO poisonings, the places of poisoning were the home (77.1%), public accommodation (11.4%) and automobile (11.4%). The proportion of intentional CO poisonings among total poisonings has increased significantly in recent years; 0.0% in 2008, 3.3% in 2009, 5.5% in 2010, and 29.7% in 2011. Conclusion: This study showed that in recent years in Korea, the source of CO has diversified broadly and intentional CO poisonings from burning ignition charcoal or briquettes has increased. Prevention efforts should consider these factors.

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Comparative Analysis : The Patterns of Temporomandibular Disorder among Adolescents (청소년 측두하악장애 환자의 임상적 연구)

  • Ok, Soo-Min;Kim, Chang-Yong;Jeong, Sung-Hee;Ahn, Yong-Woo;Ko, Myung-Yun
    • Journal of Oral Medicine and Pain
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    • v.37 no.1
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    • pp.47-59
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    • 2012
  • A retrospective study was conducted to determine the patterns of Temporomandibular Disorder(TMD) among adolescents (12-19 years) over last ten years. 174 patients who had visited the Oral medicine of Pusan National University Dental Hospital in 2000 and 491 patients in 2008 were found on chart review. The results obtained were as follows : 1. The number of adolescent patients was significantly increased in 2008 than in 2000, especially in male. 2. Bruxing, clenching, holding habits and bad sleep hygiene were highly increased more in 2008 than in 2000. 3. Osteoarthritis was significantly increased in 2008 than in 2000 and anterior disc dislocation without reduction was slightly increased. 4. The ratio of male to female adolescent patients with osteoarthritis was remarkably increased. Among the patients who had holding, bruxing, clenching habits, significantly increased osteoarthritis found to be common. This could imply holding, bruxing, clenching habits are prominently associated with increasing risk of developing osteoarthritis.

Using Implementation Science to Advance Cancer Prevention in India

  • Krishnan, Suneeta;Sivaram, Sudha;Anderson, Benjamin O.;Basu, Partha;Belinson, Jerome L;Bhatla, Neerja;D' Cruz, Anil;Dhillon, Preet K.;Gupta, Prakash C.;Joshi, Niranjan;Jhulka, PK;Kailash, Uma;Kapambwe, Sharon;Katoch, Vishwa Mohan;Kaur, Prabhdeep;Kaur, Tanvir;Mathur, Prashant;Prakash, Anshu;Sankaranarayanan, R;Selvam, Jerard M;Seth, Tulika;Shah, Keerti V;Shastri, Surendra;Siddiqi, Maqsood;Srivastava, Anurag;Trimble, Edward;Rajaraman, Preetha;Mehrotra, Ravi
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3639-3644
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    • 2015
  • Oral, cervical and breast cancers, which are either preventable and/or amenable to early detection and treatment, are the leading causes of cancer-related morbidity and mortality in India. In this paper, we describe implementation science research priorities to catalyze the prevention and control of these cancers in India. Research priorities were organized using a framework based on the implementation science literature and the World Health Organization's definition of health systems. They addressed both community-level as well as health systems-level issues. Community-level or "pull" priorities included the need to identify effective strategies to raise public awareness and understanding of cancer prevention, monitor knowledge levels, and address fear and stigma. Health systems-level or "push" and "infrastructure" priorities included dissemination of evidence-based practices, testing of point-of-care technologies for screening and diagnosis, identification of appropriate service delivery and financing models, and assessment of strategies to enhance the health workforce. Given the extent of available evidence, it is critical that cancer prevention and treatment efforts in India are accelerated. Implementation science research can generate critical insights and evidence to inform this acceleration.

Risk Factors for Rectal Cancer and Methylenetetrahydrofolate Reductase Polymorphisms in a Population in Northeast Thailand

  • Promthet, Supannee;Pientong, Chamsai;Ekalaksananan, Tipaya;Songserm, Nopparat;Poomphakwaen, Kirati;Chopjitt, Peechanika;Wiangnon, Surapon;Tokudome, Shinkan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.4017-4023
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    • 2012
  • Background and Aim: Polymorphisms in methylenetetrahydrofolate reductase (MTHFR) are known to be associated with predisposition for certain cancers. This study aimed to evaluate the effects of lifestyle factors, family history and genetic polymorphisms in MTHFR C677T and A1298C on rectal cancer risk and possible interactions with lifestyle factors in Northeast Thailand. Methods: A hospital-based case-control study was conducted during 2002-2006 with recruitment of 112 rectal cancer cases and 242 non-rectal cancer patient controls. Information was collected using a structured-questionnaire. Blood samples were obtained for assay of MTHFR C677T and A1298C genotypes by polymerase chain reaction with restriction fragment length polymorphism (PCR-RFLP) techniques. Associations between lifestyle factors, family history and genetic polymorphisms v.s. rectal cancer risk were assessed using logistic regression analysis. Results: Subjects with frequent and occasional constipation had a higher risk ($OR_{adj.}$=14.64; 95%CI=4.28-50.04 and $OR_{adj.}$=2.15; 95%CI=1.14-4.06), along with those who reported ever having hemorrhoids ($OR_{adj.}$=2.82; 95%CI=1.36-5.84) or a family history of cancer ($OR_{adj.}$=1.90; 95%CI=1.06-3.39). Consumption of a high level of pork was also associated with risk ($OR_{adj.}$=1.82; 95%CI=1.05-3.15). Interactions were not observed between MTHFR and other risk factors. Conclusions: This study suggested that the risk factors for rectal cancer in the Thai population are bowel habits, having had hemorrhoids, a family history of cancer and pork consumption.

Epidemiology of Pesticide Poisoning in Kyungpook (경북지방(慶北地方)의 농약중독(農藥中毒)에 대한 역학적(疫學的) 조사(調査))

  • Chung, Jong-Hak;Cho, Jae-Yeun
    • Journal of agricultural medicine and community health
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    • v.8 no.1
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    • pp.28-34
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    • 1983
  • In spite of the world-wide increase of incidence of pesticide poisoning due to greater use of pesticides, the epidemiological study of pesticide poisoning in Korea has been grossly neglected. The author gained access to the medical records for two year period (1981 through 1982) from local clinics, hospitals and health centers of Kyungpook area to investigate the status of the pesticide poisoning. During these two years, there were 1,618 cases of documented pesticide poisoning, of which in 1981 were 765 and in 1982 were 853. Those in the twenties decade of age was the most frequent and the male(70%) was more liable than the female (30%). In view of manner of poisoning, occupational poisoning was 27.8%, accidental 5.6%, and suicidal 66.6%. There are three distinct groups which make up the large majority of both fatal and nonfatal cases; young children who accidentally ingest pesticides, young to middle age adult who are occupationally poisoned, and middle age to older adults who suicidally ingest pesticides. The seasonal distribution of these poisonings disclosed the peak month to be July, with August next, followed by June and September. Only 11% of cases occurred during the three-month winter season of December to February. Thus pesticide caused poison- ing was primarily a summer and early fall occurrence. During these two years, average of 67 cases of poisoning was observed monthly. Of the pesticide poisoning documented, 49% were treated with poisoning patients from local clinic and 43% from hospital. The case fatality rate of occupational poisoning was 0.9%, accidental 5.6% and suicidal 20.3%. The mean overall case fatality rate was 14.1%. Annual incidence of pesticide poisoning was 25.4 per 100,000 population in the study area. There is a nationwide need for more reliable date on pesticide poisoning. This need can only grow more acute with the passage of time because of the increasing importance of pesticides as a cause of morbidity and mortality.

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