• 제목/요약/키워드: Multiple chronic diseases

검색결과 265건 처리시간 0.028초

Severe dapsone hypersensitivity syndrome in a child

  • Choi, So Yoon;Hwang, Ho Yeon;Lee, Jung Hyun;Park, Jae Sun;Jang, Min Soo
    • Clinical and Experimental Pediatrics
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    • 제56권6호
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    • pp.260-264
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    • 2013
  • Dapsone (4,4'-diaminodiphenylsulfone, DDS), a potent anti-inflammatory agent, is widely used in the treatment of leprosy and several chronic inflammatory skin diseases. Dapsone therapy rarely results in development of dapsone hypersensitivity syndrome, which is characterized by fever, hepatitis, generalized exfoliative dermatitis, and lymphadenopathy. Here, we describe the case of an 11-year-old Korean boy who initially presented with high fever, a morbilliform skin rash, generalized lymphadenopathy, hepatosplenomegaly, and leukopenia after 6 weeks of dapsone intake. Subsequently, he exhibited cholecystitis, gingivitis, colitis, sepsis, aseptic meningitis, disseminated intravascular coagulation, syndrome of inappropriate antidiuretic hormone secretion, pneumonia, pleural effusions, peritonitis, bronchiectatic changes, exfoliative dermatitis, and acute renal failure. After 2 months of supportive therapy, and prednisolone and antibiotic administration, most of the systemic symptoms resolved, with the exception of exfoliative dermatitis and erythema, which ameliorated over the following 4 months. Agranulocytosis, atypical lymphocytosis, aseptic meningitis, and bronchiectatic changes along with prolonged systemic symptoms with exfoliative dermatitis were the most peculiar features of the present case.

Adolescent nutrition: what do pediatricians do?

  • Ryoo, Eell
    • Clinical and Experimental Pediatrics
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    • 제54권7호
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    • pp.287-291
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    • 2011
  • Multiple psychosocial problems and many chronic diseases of adulthood can be influenced by adolescent nutritional problems. In Korea, adolescent obesity and obesity related health risks have been increased and insufficient intakes of nutrients, such as calcium, iron and potassium, and distorted thinking about obesity are also common. However there are no comprehensive countermeasure because of the excessive burden of studies and the lack of community interest. And the nutrition guidelines that is suitable for Korean adolescent leaves something to be desired, and the pediatrician's concern is lacking yet. In the Korean dietary reference intakes 2010 that was revised according to the 2007 Korean National Growth Chart and 2007 Korean National Health and Nutrition Examination Survey, the range for adolescents is changed to the age 12-18 and dietary reference intakes of some nutrients mainly with vitamin D is changed. Recently several researches, about how school nutrition policies and media effect on eating habits and the weight concerns, and influences of public nutrition policies and fast food commercials have been actively studied to improve adolescent nutritive conditions. In this review, I summarize the dietary reference intakes for Korean adolescents that were revised in 2010, and current studies about the adolescent nutrition.

Type 1 diabetes genetic susceptibility markers and their functional implications

  • Park, Yongsoo
    • Journal of Genetic Medicine
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    • 제11권1호
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    • pp.1-10
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    • 2014
  • Type 1 diabetes (T1D) is a chronic autoimmune disease characterized by selective destruction of pancreatic ${\beta}$-cells resulting in insulin deficiency. The genetic determinants of T1D susceptibility have been linked to several loci, in particular to the human leukocyte antigen (HLA) region, which accounts for 50% of the genetic risk of developing T1D. Multiple genes in the HLA region, which are in strong linkage disequilibrium, are thought to be involved. Another important locus, with a smaller effect on genetic predisposition to T1D, is the insulin gene. The advent of numerous single nucleotide polymorphism markers and genome screening has enabled the identification of dozens of new T1D susceptibility loci. Some of them appear to predispose to T1D independently of the HLA and may be important in families with T1D who lack strong HLA susceptibility. Other loci may interact with each other to cause susceptibility. The autoimmune response against ${\beta}$-cells can also be triggered by environmental factors in the presence of a predisposing genetic background. Deciphering the environmental and genetic factors involved should help to understand the origin of T1D and aid in the design of individualized prevention programs.

노인의 사회계층간 질병부담격차 (Differences in the burden of disease of the elderly by socioeconomic status)

  • 이채은;권순만
    • 보건행정학회지
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    • 제18권4호
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    • pp.1-22
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    • 2008
  • Burden of disease analysis provides a unique perspective on health by integrating fatal and non-fatal outcomes, yet allows the outcome of two classes to be examined separately. Although many studies have shown the inequality in health outcomes across socioeconomic status (SES), an analysis and comparison of Disability Adjusted Life Year (DALY) between different socioeconomic groups has been rare. This paper calculates the DALY and analyzes the distribution of DALYs for different SES. This study draws from 3,278 cases from the survey on "The Livelihood and Welfare Needs of the Elderly (2004)". It first provides a comprehensive assessment of the burden of 10 chronic diseases of the elderly based on DALY. Then this paper analyzes inequalities in the burden of disease by the levels of SES such as education, income, family size, occupation, and subjective economic conditions. For the elderly, the burden of disease is the highest for hypertension, arthritis and cancer. DALY rate per 1,000 people for the most socio-economically disadvantaged group is expressed as a multiple of the standardized rate for the least disadvantaged group (Rate Ratios). Family size is strongly related to. the difference in the burden of disease between SES groups, and the elderly Who live alone have higher DALY rate than those who live with their family. Other significant variables related to SES groups include subjective economic conditions, occupation, elderly income, and household income.

장애인의 건강검진 미수검에 영향을 미치는 요인 (Factors Associated with Non-Participation in Health Screening for People with Disabilities)

  • 김석영;이정찬;안병기;김양균
    • 보건의료산업학회지
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    • 제11권4호
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    • pp.89-104
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    • 2017
  • Objectives : The purpose of this study was to find the determinants for non-participation in health screenings among the disabled. Methods : We used 2014-15 Korea Health Panel data and analyzed 1,073 people with disabilities older than 19 years to investigate the two-year health screening participation rates. Multiple logistic regression analyses were conducted to analyze the factors affecting non-participation in health screenings. Results : Of the 1,073 people with disabilities who were analyzed, 29.8% and 27.1% participated in NHI mass screenings and cancer screenings, respectively. In both screenings, non-participation rates were higher in people aged 19-49 and lower in people aged 50 -69 than those aged 70 or older; higher in people with lower education, higher in people with private health insurance; higher in people with fewer chronic diseases; and higher in people with severe disability ratings. Conclusions : People with disabilities should be provided with more appropriate preventive care services according to their disability types and severity compared to people without disabilities.

류마티스 관절염 진단자의 치석제거 경험과 관련요인 (Scaling experience and related factors in people diagnosed with rheumatoid arthritis)

  • 김지현;김민영
    • 한국치위생학회지
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    • 제16권6호
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    • pp.1105-1114
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    • 2016
  • Objectives: The purpose of this study was to examine the scaling experience and related factors of people diagnosed with rheumatoid arthritis. Methods: The subjects were 30,680 people diagnosed with rheumatoid arthritis from the 2014 community health survey who were $${\geq_-}19$$ years old. Data were analyzed by chi-square test and multiple logistic regression analysis. Results: Those having regular scaling included well educated people, drinkers, more than three times tooth brushing practice, and regular dental checkup. The respondents were in the higher quartile of income And the respondents who were in the higher quartile of income were less likely to have scaling experience (p<0.05). Conclusions: The scaling experience was closely related with the age, educational level, residential area, income, drinking, tooth brushing practice, and regular dental checkup. It is necessary to investigate the influencing factors of rheumatoid arthritis and periodontal diseases in the further studies.

Actinomycosis and Sialolithiasis in Submandibular Gland

  • Kang, Jin Seok;Choi, Hwan Jun;Tak, Min Sung
    • 대한두개안면성형외과학회지
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    • 제16권1호
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    • pp.39-42
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    • 2015
  • Actinomycosis is a subacute or chronic suppurative infection caused by Actinomyces species, which are anaerobic Gram-positive bacteria that normally colonize the human mouth and digestive and urogenital tracts. Cervicofacial actinomycosis is the most frequent clinical form of actinomycosis, and is associated with odontogenic infection. Characterized by an abscess and mandibular involvement with or without fistula, but the cervicofacial form of actinomycosis is often misdiagnosed because the presentation is not specific and because it can mimic numerous infectious and non-infectious diseases, including malignant tumors. We report a rare case of actinomycosis infection with coexisting submandibular sialolithiasis. The patient presented with a $1{\times}1cm$ abscess-like lesion below the lower lip. Punch biopsy of the lesion revealed atypical squamous cell proliferation with infiltrative growth, suggestive of squamous cell carcinoma. The patient underwent wide excision of this lesion, where the lesion was found to be an abscess formation with multiple submandibular sialolithiases. The surgical specimen was found to contain Actinomyces without any evidence of a malignant process. We assumed that associated predisposing factors such as poor oral hygiene may have caused a dehydrated condition of the oral cavity, leading to coexistence of actinomycosis and sialolithiasis.

생활체육에 참여하는 노인의 삶의 만족도의 영향요인 (Effect of Participation in Life Sports on Life Satisfaction of the Elderly)

  • 송민선;양남영
    • 가정간호학회지
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    • 제25권3호
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    • pp.173-181
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    • 2018
  • Purpose: This study examined the effects of physical fitness and aging anxiety on life satisfaction among the elderly. Methods: The participants were 119 elderly. Data collection was conducted from July 1 to 10, 2018. Data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson's correlation coefficients, and multiple linear regression analysis with SPSS software. Results: The mean life satisfaction score was 4.10. Life satisfaction differed significantly according to several general characteristics: education level (p=.014), income (p<.001), living with partner (p=.041), perceived health status (p<.001), and number of chronic diseases (p<.001). Statistically significant positive relationships were observed between life satisfaction with muscle strength (r=.20) and, flexibility (r=.21), and a negative relationship was observed with aging anxiety (r=-.66). A total of 60.0% of life satisfaction was explained by income, perceived health status, muscle strength, flexibility, and aging anxiety. Conclusion: These results can be used to develop life sports programs to improve physical, social, and emotional health promotion with consideration for support to alleviate economic burden. Effect of life sports are evident as a way for healthy and energetic elderly. It should not be a simple exercise program but an integrated plan for improving physical, mental, and social health of the elderly.

Alport syndrome: new advances in the last decade

  • Kim, Ji Hyun
    • Childhood Kidney Diseases
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    • 제26권1호
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    • pp.31-39
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    • 2022
  • Alport syndrome (AS) is a progressive hereditary nephritis that is often accompanied by sensorineural hearing loss and ocular abnormalities. It is inherited in three modes of X-linked AS (XLAS), autosomal recessive AS (ARAS), and autosomal dominant AS (ADAS). XLAS is caused by pathogenic variants in COL4A5, while ARAS and ADAS are caused by those in COL4A3 or COL4A4. There is currently no curative treatment for AS; however, angiotensin-converting enzyme inhibitors (ACEi) can improve the outcome of AS. In the past decade, multiple studies have shown that early intervention with ACEi upon isolated microscopic hematuria or microalbuminuria could delay disease progression, and early diagnosis is crucial for early treatment. Therefore, a new classification of AS based on molecular diagnoses has been proposed, including the paradigm shift of re-classifying female "carriers" to "patients" and "thin basement membrane nephropathy" to "ADAS." In addition, with the detection of COL4A mutations in some patients with biopsy-confirmed IgA nephropathy, focal segmental glomerulosclerosis, and chronic kidney disease of unknown origin, it is suggested that the phenotype of AS should be expanded. In this review, we highlight the landmark studies and guidelines published over the past decade and introduce strategies for early diagnosis and treatment to improve the outcomes of AS.

Magnetic Resonance Imaging of Hidradenitis Suppurativa: A Focus on the Anoperineal Location

  • Sitthipong Srisajjakul;Patcharin Prapaisilp;Sirikan Bangchokdee
    • Korean Journal of Radiology
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    • 제23권8호
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    • pp.785-793
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    • 2022
  • Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease involving apocrine-bearing sites. It is characterized by recurrent painful nodules and abscesses that potentially rupture, resulting in sinus tract formation, fistulas, and scarring. HS tends to be found in the intertriginous areas (i.e., the axillary, inguinal, and perianal areas of the body). HS may be uncommon for radiologists because its diagnosis is usually based on clinical assessment. However, diagnosis based solely on clinical manifestations can underestimate the severity of HS. Ultrasonography and MRI play a critical adjunct role in determining the severity and extent of the disease and greatly aid its management. Given that MRI is an effective imaging tool, its role in the analysis of severe and anogenital HS lesions merits considerable attention. Unfortunately, anoperineal HS imposes diagnostic dilemmas. It has multiple symptoms and presentations and often mimics other diseases in the intertriginous areas. Therefore, a thorough understanding of HS is essential to avoid delayed diagnoses. This review highlights the typical MRI imaging features and staging of HS, emphasizing on the anoperineal location. The review also differentiates the disease from mimics to facilitate the prompt delivery of appropriate treatment and improve patients' quality of life.