• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권4호
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• pp.278-288
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• 2018

Purpose: Dehydration is a paediatric medical emergency but there is no single standard parameter to evaluate it at the emergency department. Our aim was to evaluate the reliability and validity of capillary refilling time as a triage parameter to assess dehydration in children. Methods: This was a prospective pilot cohort study of children who presented to two paediatric emergency departments in Italy, with symptoms of dehydration. Reliability was assessed by comparing the triage nurse's measurements with those obtained by the physician. Validity was demonstrated by using 6 parameters suggestive of dehydration. Comparison between refilling time (RT) and a validated Clinical Dehydration Score (CDS) was also considered. The scale's discriminative ability was evaluated for the outcome of starting intravenous rehydration therapy by using a receiver operating characteristic (ROC) curve. Results: Participants were 242 children. All nurses found easy to elicit the RT after being trained. Interobserver reliability was fair, with a Cohen's kappa of 0.56 (95% confidence interval [CI], 0.41 to 0.70). There was a significant correlation between RT and weight loss percentage (r-squared=-0.27; 95% CI, -0.47 to -0.04). The scale's discriminative ability yielded an area under the ROC curve (AUC) of 0.65 (95% CI, 0.57 to 0.73). We found a similarity between RT AUC and CDS-scale AUC matching the two ROC curves. Conclusion: The study showed that RT represents a fast and handy tool to recognize dehydrated children who need a prompt rehydration and may be introduced in the triage line-up.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.1069-1072
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• 2015

Background: Colorectal cancer (CRC) is an important cause of mortality and morbidity in many communities worldwide. This population based study was conducted to assess determinants of colorectal mortality in Iranian patients. Materials and Methods: A cohort of 1,127 cases of confirmed colorectal cancer registered in a population based registry covering 10 referral hospital in Tehran, Iran, were followed for five years. Information about tumor characteristics, smoking status and family history were collected at base line and survival status were followed every six months by contacting patient or next of kin (if patients died during the follow-up). The cause of death for each case was validated by verbal autopsy and referring to patient medical records at the time of death. The data were analyzed by Stata software using univariate and multivariate analysis (Cox regression). In building the model a p value of less than 5% was considered as significant. Results: The age at diagnosis was $53.5{\pm}14$ years. Sixty one percent were male. Colorectal mortality among the patients was 96.9 person-years among men and 83 person-years among women. Seventy five percent of patients lived for 2.72 years, 50% for 5.83, and 25% for 13 years after the diagnosis of colorectal cancer. The age at diagnosis was significantly different between men and women (p<0.03). Higher tumor grade predicted higher death rate; the adjusted hazard ratios were 1.79 (95%CI, 0.88-3.61), 2.16 (95%CI, 1.07-4.37), and 3.1 (95%CI, 1.51-6.34) for grades II, III, and IV respectively when they were compared with grade I as reference. Ethnicity, marital status, family history of cancer, and smoking were related to survival with different degrees of magnitude. Conclusions: Among many factors related to survival among the colorectal patients, tumor grade and smoking showed the highest magnitudes of association.

• 한국치위생학회지
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• 제11권4호
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• pp.511-522
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• 2011

Objectives : The purpose of this study was to provide some information on the development of oral health care programs geared toward diabetics and ways of promoting their oral health. Methods : The subjects in this study were 586 diabetics who were selected from the 2009 third-year raw data of the 4th(2007~2009) National Health & Nutrition Survey. The data were analyzed with the statistical package SPSS 12.0 to grasp the influence of their sociodemographic characteristics and oral health behaviors on the presence or absence of periodontal diseases and missing tooth. Results : 1. Periodontal diseases were twofold more prevalent among the men than the women(p<0.01). By age, those who were in their 60s had 1.11-fold more periodontal diseases than those who were in their 70s and up(p<0.05). 2. The men and women were similar to each other in the number of missing tooth. By age, the number of missing tooth got smaller in proportion to decrease in age. By income, the number of missing tooth was 1.48-fold larger among the patients who earned an income of one million won or less than those who earned an income of two million won or more(p<0.01). Conclusions : The above-mentioned findings suggest that prospective cohort studies should be implemented to present prediction models of periodontal diseases and diabetes instead of merely sticking to cross-sectional studies. And oral health programs should be developed based on the findings of cohort studies to encourage diabetics to care about their oral health, and in which way they should be helped to promote their oral health should carefully be considered.

• Nutrition Research and Practice
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• 제11권6호
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• pp.492-499
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• 2017

BACKGROUND/OBJECTIVES: This study aimed to investigate the association of dietary patterns with overweight risk and all-cause mortality in pediatric cancer patients. SUBJECTS/METHODS: Prospective cohort study was undertaken; 83 cancer patients admitted to the pediatric cancer ward at a university hospital in Seoul were included and followed for obesity and death over 24 months. Food consumption data were collected from patients using validated meal order sheets for breakfast, lunch, and dinner at the pediatric cancer ward over 3 days. Using principal component analysis, three dietary patterns were derived from 29 food groups. RESULTS: Eighteen deaths occurred among the patient cohort during the follow-up period. The "spicy & fried meat and fish" dietary pattern was positively associated with overweight risk at both baseline [odds ratio (OR) = 4.396, 95% confidence interval (CI) = 1.111-17.385, P for trend = 0.023] and after 6 months (OR = 4.088, 95% CI = 1.122-14.896, P for trend = 0.025) as well as all-cause mortality (hazard ratios = 5.124, 95% CI = 1.080-24.320, P for trend = 0.042), when comparing the highest and lowest tertiles after adjusting for covariates. The "fish, egg, meat, and fruits & vegetables" dietary pattern was associated with lower overweight risk after 24 months (OR = 0.157, 95% CI = 0.046-0.982, P for trend = 0.084). CONCLUSION: The results imply that dietary patterns might be associated with weight gain and premature death among pediatric cancer patients.

• 지질동맥경화학회지
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• 제7권2호
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• pp.110-121
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• 2018

Objective: We developed a new equation for predicting coronary heart disease (CHD) risk in Korean diabetic patients using a hospital-based cohort and compared it with a UK Prospective Diabetes Study (UKPDS) risk engine. Methods: By considering patients with type 2 diabetes aged ${\geq}30years$ visiting the diabetic center in Boramae hospital in 2006, we developed a multivariable equation for predicting CHD events using the Cox proportional hazard model. Those with CHD were excluded. The predictability of CHD events over 6 years was evaluated using area under the receiver operating characteristic (AUROC) curves, which were compared using the DeLong test. Results: A total of 732 participants (304 males and 428 females; mean age, $60{\pm}10years$; mean duration of diabetes, $10{\pm}7years$) were followed up for 76 months (range, 1-99 month). During the study period, 48 patients (6.6%) experienced CHD events. The AUROC of the proposed equation for predicting 6-year CHD events was 0.721 (95% confidence interval [CI], 0.641-0.800), which is significantly larger than that of the UKPDS risk engine (0.578; 95% CI, 0.482-0.675; p from DeLong test=0.001). Among the subjects with <5% of risk based on the proposed equation, 30.6% (121 out of 396) were classified as ${\geq}10%$ of risk based on the UKPDS risk engine, and their event rate was only 3.3% over 6 years. Conclusion: The UKPDS risk engine overestimated CHD risk in type 2 diabetic patients in this cohort, and the proposed equation has superior predictability for CHD risk compared to the UKPDS risk engine.

• Journal of Gastric Cancer
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• 제21권4호
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• pp.403-417
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• 2021

Purpose: Owing to differences in the general characteristics of gastric cancer (GC) according to histological type, the association of GC risk factors, such as diet, may also differ depending on the histological type. We investigated the associations between individual and combined intake of soy products, vegetables, and dairy products and GC mortality by following up cases of death among Korean GC cases and whether these associations differ according to the histological type. Materials and Methods: A total of 508 GC cases were enrolled from two hospitals between 2002 and 2006. Their survival or death was prospectively followed up until December 31, 2016, through a review of medical records and telephonic surveys. Finally, 300 GC cases classified as intestinal- or diffuse-type GC cases were included. The median follow-up period was 7.1 years. Results: In the fully adjusted model, a high intake of soy products (hazard ratio [HR], 0.43; 95% confidence interval [CI], 0.19-0.96) and the combination of soy products and vegetables (HR, 0.34; 95% CI, 0.12-0.96) or soy products and dairy products (HR, 0.37; 95% CI, 0.14-0.98) decreased the mortality from intestinal-type GC. In particular, patients consuming various potentially protective foods (HR, 0.23; 95% CI, 0.06-0.83) showed a highly significant association with a lower mortality from intestinal-type GC. However, no significant association was found with diffuse-type GC. Conclusions: High intake of potentially protective foods, including soy products, vegetables, and dairy products, may help increase survival in intestinal-type GC.

• Tuberculosis and Respiratory Diseases
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• 제85권4호
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• pp.349-357
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• 2022

Background: The most consistently identified mortality determinants for the new coronavirus 2019 (COVID-19) infection are aging, male sex, cardiovascular/respiratory diseases, and cancer. They were determined from heterogeneous cohorts that included patients with different disease severity and previous conditions. The main goal of this study was to determine if activities of daily living (ADL) dependence measured by Barthel's index could be a predictor for COVID-19 mortality. Methods: A prospective cohort study was performed with a consecutive sample of 340 COVID-19 patients representing patients from all over the northern region of Portugal from October 2020 to March 2021. Mortality risk factors were determined after controlling for demographics, ADL dependence, admission time, comorbidities, clinical manifestations, and delay-time for diagnosis. Central tendency measures were used to analyze continuous variables and absolute numbers (proportions) for categorical variables. For univariable analysis, we used t test, chi-square test, or Fisher exact test as appropriate (α=0.05). Multivariable analysis was performed using logistic regression. IBM SPSS version 27 statistical software was used for data analysis. Results: The cohort included 340 patients (55.3% females) with a mean age of 80.6±11.0 years. The mortality rate was 19.7%. Univariate analysis revealed that aging, ADL dependence, pneumonia, and dementia were associated with mortality and that dyslipidemia and obesity were associated with survival. In multivariable analysis, dyslipidemia (odds ratio [OR], 0.35; 95% confidence interval [CI], 0.17-0.71) was independently associated with survival. Age ≥86 years (pooled OR, 2.239; 95% CI, 1.100-4.559), pneumonia (pooled OR, 3.00; 95% CI, 1.362-6.606), and ADL dependence (pooled OR, 6.296; 95% CI, 1.795-22.088) were significantly related to mortality (receiver operating characteristic area under the curve, 82.1%; p<0.001). Conclusion: ADL dependence, aging, and pneumonia are three main predictors for COVID-19 mortality in an elderly population.

• Clinics in Shoulder and Elbow
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• 제25권1호
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• pp.57-64
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• 2022

Background: There are various conservative treatment options for lateral epicondylitis (LE). The aim is to evaluate pain, daily functioning, and complications after ultrasound-standardized autologous blood injections in patients with LE. Methods: For this prospective cohort study, consecutive patients (>18 years) diagnosed with LE were included. Autologous blood was injected using a medical device containing an injection disposable with 12 small needles (Instant Tennis Elbow Cure [ITEC]) device. Patient-Rated Tennis Elbow Evaluation (PRTEE), subjective elbow score (SES), palpation and provocation pain, satisfaction, and complications of treatment were measured at baseline and two months after treatment. Paired t-tests and Fisher's exact tests were used for calculating the difference between pre- and post-treatment outcomes. Results: Fifty-five elbows were analyzed. Mean time between pre- and post-treatment was 11.1 weeks (standard deviation [SD], 8.9 weeks). The mean PRTEE score decreased from 68.2 (SD, 15.7) before surgery to 53.2 (SD, 25.9; p<0.001) after. The mean SES improved from 36.9 (SD, 20.8) to 51.7 (SD, 27.4; p<0.001). Despite this improvement, only 44.7% of patients showed relevant clinical improvement in PRTEE, and 37.3% showed significant clinical improvement based on SES. Four patients reported a complication and the injection disposable failed three times. Conclusions: Ultrasound-standardized autologous blood injection using the ITEC device is not an effective tool in reducing symptoms related to LE. This study showed that only half of all patients experienced a positive effect. In this heterogeneous cohort of patients, we showed no added value of ultrasound standardization.

• International journal of advanced smart convergence
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• 제11권4호
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• pp.206-215
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• 2022

For a long time, traditional culture has been regarded as one of the sources of the inspiration, method and language of Chinese writing. In this article, we studied the medium- and long-term impact of a traditional Chinese culture seminar attended by college students on the output of creative writing. The seminar included traditional Chinese philosophy, history, literature, art, etc. It spanned three years (22 months) and held lectures lasting for approximately two hours once a week. The subjects of the prospective cohort study included 130 first-year college students who participated in the seminar and 130 controls. From September 2016 to June 2018, 72 lectures were held. We measured the creative writing output from the first lecture (September 2016) to December 2021 (64 months in total), including novels, essays, poems, and plays. Two indicators, the total number of words (TNW) and the quality of yield (QY), were evaluated by a 15-member panel. Although the TNW and QY of the participants and their controls were similar before the seminar, we found that the participants have higher TNW and QY than the controls after participating in the seminar. The difference in TNW became significant after month 51 (p<0.05), and the difference in QY became significant after month 46 (p<0.05). After these dates, the differences stabilized. In addition, text analysis indicates that by month 64, traditional cultural elements in the works of the participating group had a higher frequency (p<0.001). The research shows that the traditional culture seminar not only enhanced the yield of college students' creative writing but also improved the quality of their work. The traditional cultural elements enriched the works of the seminar participants.

• 사상체질의학회지
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• 제36권2호
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• pp.12-26
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• 2024

Objectives We aimed to identify the incidence of metabolic syndrome (MetS) and its clustering components according to constitution type and lifestyle risk factors in Korean adults. Methods This study included 1,978 adults aged 30-55 years from the Korean Medicine Daejeon Citizen Cohort (KDCC) study. We defined lifestyle factors including smoking, alcohol consumption, physical activity, sleep, dietary quality, and weight status. Total lifestyle scores were created based on the six lifestyle factors (ranging from 0 to 5 factors) and classified into two groups: unhealthy (0-2 factors), or healthy (3-5 factors). Cox proportional hazard regression was used to estimate the hazard ratio (HR) and 95% confidence intervals (CIs) of primary endpoints: MetS events and their clustering components. Results During a median follow-up of 2.2 years, we documented 125 new onsets of MetS. Compared with participants with healthy, the HR of unhealthy participants was 2.401 (95% CI: 1.497-3.851) for MetS incidence. After adjusting for covariates, TE type with unhealthy was higher HR values of abdominal obesity (HRs: 1.499, 95%CI: 1.061-2.117) and hypertension (HRs: 1.840, 95%CI: 1.032-3.277), respectively. Conclusion Unfavorable lifestyle factors were highly associated with the prevalence of MetS and its clustering such as abdominal obesity and hypertension in Korean adults with TE. Tailored health management is needed to consider individual traits and healthy lifestyles to prevent cardiometabolic diseases.