• Title/Summary/Keyword: Low risk

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Evaluation of Proper Use of NSAIDs to Prevent Gastrointestinal and Cardiovascular Problems in Elderly Patients (노인환자에서 위장관계 및 심혈관계 부작용 발생 예방을 위한 NSAIDs 사용의 적절성 평가)

  • Joo, Sung-Lak;Bang, Joon Seok
    • Korean Journal of Clinical Pharmacy
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    • v.24 no.1
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    • pp.15-25
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    • 2014
  • Background: Elderly patients with gastrointestinal (GI) and cardiovascular (CV) risk factors may be more easily exposed to NSAID-related side effects (SEs). Based on the ACG guideline of year 2009, the aim of the study is to evaluate proper use of NSAIDs and gastroprotective drugs according to the degree of GI and CV risk strengths in the patients. Methods: Retrospectively surveyed 410 elderly patients with NSAIDs for more than 30 days at a general hospital in Korea. GI risk factor includes age, ulcer history, high-dose NSIADs, concurrent aspirin use, steroids or anticoagulants. CV risk factor includes angina, myocardial infarction, cerebral infarction, atrial fibrillation or coronary intervention requiring low-dose aspirin. These factors were classified as high/low cardiovascular groups and high/moderate/low GI groups. Results: There were 14 patients in high CV risk group and high GI risk group. The group was recommended not to use NSAIDs as it is not adequate. There were 101 patients in high CV risk group and moderate GI risk group. This group was recommended to use naproxen and PPI/misoprostol. But all patients except one were not adequate. There were 9 patients in low CV risk group and high GI risk group. This group was recommended to use selective COX-2 inhibitor and PPI/misoprostol. 5 cases were proper while 4 cases did not. There were 285 patients in low CV risk and moderate GI risk group who were recommended to use non selective NSAIDs and PPI/misoprostol or selective COX-2 inhibitor only. 103 patients were proper while 182 patients not adequate. Overall, the SEs were higher in those cases for inadequate use of drugs comparing to the adequate. CV SEs were statistically significant. However, SEs for each risk groups were different. For the case of low CV risk group and high/moderate GI risk group, the inadequate use of drugs makes the SE high and the other groups are not. Also, it was not statistically significant. Conclusions: In elderly patients, the inappropriate use of NSAIDs can increase the risk of the disease. Therefore, GI and CV risk must be considered simultaneously, and the proper use of NSAIDs and gastroprotective drugs for each risk groups should be reconsidered.

Importance of Target Blood Pressure Management in Diabetic Kidney Disease (당뇨병성 신장질환 환자에서 적정 혈압 관리의 중요성)

  • Kim, Hee Sung
    • The Journal of the Korea Contents Association
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    • v.19 no.6
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    • pp.461-470
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    • 2019
  • In diabetes mellitus, renal disease is a common complication, characterized by increased urinary albumin excretion and reduced eGFR. According to KDIGO CKD stage classification, Korean characteristics were analyzed according to urinary albumin and eGFR using the National Health and Nutrition Examination Survey VI raw data. According to KDIGO classification, diabetic patients were classified as Low risk 72.0%, Moderate risk 19.3%, High risk 5.6% and Very high risk 3.0%. Low risk decreased from 74.7% to 52.2%, and moderate to very high risk increased from 25.4% to 47.8% as the duration of diabetes mellitus was prolonged. The risk factors were CKD stage 1 (HR 2.064) to stage 4 (HR 11.049), the highest risk of hypertension. The incidence of renal disease was elevated according to duration of hypertension and HR 0.42 of kidney disease was decreased in the group maintaining proper blood pressure. In the hypertensive patients, the group administered with target blood pressure had a reduction of the kidney disease by 42% than the group with the hypertension. Therefore, controlling and managing hypertension to target blood pressure is important for the prevention of kidney disease.

Efficiency of MVP ECG Risk Score for Prediction of Long-Term Atrial Fibrillation in Patients With ICD for Heart Failure With Reduced Ejection Fraction

  • Levent Pay;Ahmet Cagdas Yumurtas;Ozan Tezen;Tugba Cetin;Semih Eren;Goksel Cinier;Mert Ilker Hayiroglu;Ahmet Ilker Tekkesin
    • Korean Circulation Journal
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    • v.53 no.9
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    • pp.621-631
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    • 2023
  • Background and Objectives: The morphology-voltage-P-wave duration (MVP) electrocardiography (ECG) risk score is a newly defined scoring system that has recently been used for atrial fibrillation (AF) prediction. The aim of this study was to evaluate the ability of the MVP ECG risk score to predict AF in patients with an implantable cardioverter defibrillator (ICD) and heart failure with reduced ejection fraction in long-term follow-up. Methods: The study used a single-center, and retrospective design. The study included 328 patients who underwent ICD implantation in our hospital between January 2010 and April 2021, diagnosed with heart failure. The patients were divided into low, intermediate and high-risk categories according to the MVP ECG risk scores. The long-term development of atrial fibrillation was compared among these 3 groups. Results: The low-risk group included 191 patients, the intermediate-risk group 114 patients, and the high-risk group 23 patients. The long-term AF development rate was 12.0% in the low-risk group, 21.9% in the intermediate risk group, and 78.3% in the high-risk group. Patients in the high-risk group were found to have 5.2 times higher rates of long-term AF occurrence compared to low-risk group. Conclusions: The MVP ECG risk score, which is an inexpensive, simple and easily accessible tool, was found to be a significant predictor of the development of AF in the long-term follow-up of patients with an ICD with heart failure with reduced ejection fraction. This risk score may be used to identify patients who require close follow-up for development and management of AF.

Evaluation of the Validity of a Simple Screening Test Developed for Identifying Korean Elderly at Risk of Undernutrition (우리 나라 노인의 영양부족위험 진단을 위해 개발된 간이조사표의 타당성 평가)

  • 이정원;김경은;김기남;현태선;현화진;박영숙
    • Journal of Nutrition and Health
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    • v.33 no.8
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    • pp.864-872
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    • 2000
  • This study intended to evaluate the validity of the simple nutrition screening test that had been developed with the elderly living in Cheongju as a subject. Nutrition screening score(NSS) and reference standards for nutritional and health status(nutrient intakes, mean adequacy ratio, perceive health, and serum albumin, hematocrit, and hemoglobin) were estimated by using the date obtained in 1996 from the 174 elderly living in Taejon, Statistical analysis showed significant correlations between mean adequacy ratio(MAR) and NSS(r=0.341) and also between NSS and biological indices such as albumin and hematocrit, Around 65-75% of the elderly with perceive health and low level of serum albumin, hemoglobin and hematocrit had NSS$\leq$ll. Sensitivity, specificity, and positive predictive values(PPV) were calculated from the crosstabulation of the three categories of NSS(high, moderate, and low nutritional risk) and low categories MAR(< 0.75, undernutrition;$\geq$0.75, normal) to validate the cut-off point for high or low nutritional risk by NSS. It was suggested that point l1 was appropriate as a criterion to determine high risk of undernutrition, but point 16 was better than 17 as criterion to determine low nutritional risk in the Taejon elderly. When point ll was used as a criterion of high nutritional risk, sensitivity, specificity, and PPV are 59.5, 60.5 and 82.1 respectively. When point 16 was used as a criterion of low nutritional risk, sensitivity, specificity, and PPV are 25.6, 95.4, and 64.7%, respectively. In conclusion, nutrition screening test that had been developed can be a simple, easy, and proper instrument to classify the high risk group of undernutrition. A further validation study seems to be required among other groups of individuals for the screening test to the finalized as a more valid instrument identifying Korean elderly at nutrition and health risk(Korean J Nutrition 33(8) : 864-872, 2000)

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Association between drinking behaviors and components of metabolic syndrome in subjects in their 20s and 30s: data obtained from the Korea National Health and Nutrition Examination Survey (2016-2018)

  • Lee, Soo Jin;Ryu, Ho Kyung
    • Nutrition Research and Practice
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    • v.16 no.3
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    • pp.392-404
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    • 2022
  • BACKGROUND/OBJECTIVES: Numerous studies have examined the relationship between drinking behaviors and metabolic syndrome (MetS) for adults, but these include very few studies for young adults. This study therefore undertook to investigate the association between drinking behaviors and components of MetS among adult drinkers aged 20-30 years. SUBJECTS/METHODS: Using the 2016-2018 Korea National Health and Nutrition Examination Survey data, drinking behaviors of adults in the age group 20-30 years were divided into 4 groups: 1) group A, good drinking habits; 2) group B, frequent binge drinking but not frequent drinking; 3) group C, frequent drinking but not frequent binge drinking; 4) group D, frequent drinking and binge drinking. The association between MetS components and drinking behaviors was analyzed by applying multiple logistic regression analysis. RESULTS: We determined the prevalence risk compared to group A. In men, the prevalence risk of high triglyceride (TG) increased 2.051-fold in group C and 1.965-fold in group D. Moreover, in group D, the prevalence risk of low high density lipoprotein cholesterol (HDL-C) increased 0.668-fold, high blood pressure (BP) increased 2.147-fold, and MetS increased 1.567-fold. In women, there was an increased prevalence risk of low HDL-C (0.353-fold) and MetS (3.438-fold) in group C, whereas group D showed increased prevalence risk of abdominal obesity (2.959-fold), high TG (1.824-fold, and low HDL-C (0.424-fold). CONCLUSIONS: Our study indicates that frequent drinking increases the risk of high TG, whereas frequent and binge drinking increases the risk of high TG, low HDL-C, high BP, and prevalence of MetS in men. In women, frequent drinking without binge drinking increases the risk of low HDL-C and MetS, whereas frequent and binge drinking increases the risk of abdominal obesity, high TG, and low HDL-C. We propose that improvements in the drinking behaviors can reduce the prevalence of MetS.

The Risk Factors of Industrial Low Back Pain among Shipyard Workers (조선업 생산직 근로자의 요통 발생에 영향을 미치는 요인)

  • Hong, Yun-Chul;Ha, Eun-Hee;Park, Hye-Sook
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.1 s.52
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    • pp.91-102
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    • 1996
  • Low back pain patients and controls of shipyard workers were surveyed between June 1995 and September 1995 to identify risk factors of industrial low back pain. The patients were 17 male workers who had got medical treatment for over 3 days because of industrial back pain. Controls were 51 male workers who had not have musculoskeletal disorder for one year before the survey. By univariate analysis, the workers who did overtime work 4 times or more for the last 2 weeks showed odds ratio of 3.67 on low back pain with the workers who did less overtime work. Carrying heavy materials was also associated with the low back pain and the odds ratio increased with the increase of carrying weight. Work space and work posture were not associated with the low back pain significantly. The welder had higher odds ratio than the other workers on low back pain. The duration of employment and job satisfaction did not affect the risk of low back pain. Multiple logistic regression analysis showed that frequency of overtime work for the last 2 weeks and carrying heavy materials among the risk factors were associated significantly with the low back pain. We found that important risk factors of low back pain of shipyard workers are work intensity factors such as overtime work and carrying heavy weight.

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Quantitative Fire Risk Assesment for the Subway Platform Types (지하철 승강장 형식에 따른 정량적 화재 위험성 평가)

  • Rie, Dong-Ho;Kim, Ha-Young
    • Journal of the Korean Society of Safety
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    • v.21 no.6 s.78
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    • pp.1-6
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    • 2006
  • Subway platform is divided into Side-platform type and Center-platform type. In this study does quantitative fire risk assesment of subway platform types in numerical analysis by using CFD model. From the result of this study, 1) All exhaust mode was low-end result it seems most fire risk at Side-platform station. 2) All exhaust mode was low-end result it seems most fire risk at Center-Platform station. 3) When comparing same type exhaust mode of Side-platform and Center-platform that last thing was visible $9.1{\sim}72.34%$ low-end fire risk. Center-platform is more opera-tive than Side-platform that reduce fire risk when that was same dimension and external environment. Designer look upon a fire characteristic of subway platform types when he make smoke control air volume and platform area design.

Conclusions and Suggestions on Low-Dose and Low-Dose Rate Radiation Risk Estimation Methodology

  • Sakai, Kazuo;Yamada, Yutaka;Yoshida, Kazuo;Yoshinaga, Shinji;Sato, Kaoru;Ogata, Hiromitsu;Iwasaki, Toshiyasu;Kudo, Shin'ichi;Asada, Yasuki;Kawaguchi, Isao;Haeno, Hiroshi;Sasaki, Michiya
    • Journal of Radiation Protection and Research
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    • v.46 no.1
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    • pp.14-23
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    • 2021
  • Background: For radiological protection and control, the International Commission on Radiological Protection (ICRP) provides the nominal risk coefficients related to radiation exposure, which can be extrapolated using the excess relative risk and excess absolute risk obtained from the Life Span Study of atomic bomb survivors in Hiroshima and Nagasaki with the dose and dose-rate effectiveness factor (DDREF). Materials and Methods: Since it is impossible to directly estimate the radiation risk at doses less than approximately 100 mSv only from epidemiological knowledge and data, support from radiation biology is absolutely imperative, and thus, several national and international bodies have advocated the importance of bridging knowledge between biology and epidemiology. Because of the accident at the Tokyo Electric Power Company (TEPCO)'s Fukushima Daiichi Nuclear Power Station in 2011, the exposure of the public to radiation has become a major concern and it was considered that the estimation of radiation risk should be more realistic to cope with the prevailing radiation exposure situation. Results and Discussion: To discuss the issues from wide aspects related to radiological protection, and to realize bridging knowledge between biology and epidemiology, we have established a research group to develop low-dose and low-dose-rate radiation risk estimation methodology, with the permission of the Japan Health Physics Society. Conclusion: The aim of the research group was to clarify the current situation and issues related to the risk estimation of low-dose and low-dose-rate radiation exposure from the viewpoints of different research fields, such as epidemiology, biology, modeling, and dosimetry, to identify a future strategy and roadmap to elucidate a more realistic estimation of risk against low-dose and low-dose-rate radiation exposure.

A Consumer-Oriented Study of Price Increases and Downsizing : Focused on Roles of Competitor's Pricing Strategy and Risk-Aversion (가격인상과 용량감소에 관한 소비자 관점의 비교 연구 : 경쟁사 가격전략과 위험회피성향을 중심으로)

  • Kim, Hye Young;Kang, Yeong Seon
    • Korean Management Science Review
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    • v.32 no.3
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    • pp.55-70
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    • 2015
  • The main objective of this study is to investigate the moderating roles of the competitor's pricing strategy and the degree of consumer's risk-aversion on perceived risk and perceived benefit in responding to price increases and package downsizing. Based on Prospect Theory, several prior researches find that consumers perceive increased price as more loss than package downsizing and perceive package downsizing as more benefit than increased price. We extend these behavioral economics approach using the reference effect of competitor's pricing strategy. We focus on consumer heterogeneity on risk-aversion, measure the degree of consumer's risk-aversion, and divide the consumers into two groups of high levels of risk-aversion vs. low levels of risk-aversion. We find that the firm's pricing strategies of both price increases and package downsizing do not significantly influence the perceived benefit for relatively low risk-aversion consumers. We find that when the firm reduce the package size, relatively high risk-aversion consumers perceived more benefit and had higher purchase intention compared to price increases. We also find that the competitor's pricing strategies do not significantly influence the consumer's response for relatively low risk-aversion consumers. For relatively high risk-aversion consumers, they perceived more loss when the firm has different pricing strategy from the competitor's.

Risk Value Calculation Method for Moderate Risk Concentration Type at Qualitative Risk Analysis Phase (정성적 위험분석 단계에서 중간위험 집중형 위험도 산정 방법)

  • Kim, Seon-Gyoo
    • Korean Journal of Construction Engineering and Management
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    • v.16 no.2
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    • pp.38-45
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    • 2015
  • The risk analysis phase of construction risk management process is subdivided into the qualitative risk analysis that plays a major role, and the quantitative risk analysis acting as a supportive role. The traditional calculation method for quantifying a risk value that has been applied so far is an equation to multiply a probability by an impact simply, but its result shows the low risk value biased distribution. Although another equation that shows the high risk biased distribution as an alternative of traditional method was proposed, both of the low or high risk biased equations do not match with the statistical general knowledge that most natural phenomenons are close to the normal distribution. This study proposes a new risk value calculation method that is concentrated to the moderate risk value. Because the risk value distribution by a new method shows a normal shape similar to natural phenomenon, it helps to choose a middle level not biased to the low or high levels when choosing the level of risk response. Furthermore, it could contribute to improve the flexibility and rationality of risk analysis method by providing additional options for the risk value calculation.