• Title/Summary/Keyword: Prospective cohort study

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Vitamin D and Depression (비타민 D와 우울증)

  • Cho, Su Kyung;Koo, Sle;Park, Kyong
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.43 no.10
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    • pp.1467-1476
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    • 2014
  • Recent studies have shown that insufficient or deficient vitamin D status may be linked to increased risk of depressive conditions or depression. The aim of this study was to review all available evidence on vitamin D, depression, and any association between them. Cross-sectional, case-control, and cohort studies have reported contradictory results. Some have reported that low levels of vitamin D may be associated with higher risk of depression or depressive symptoms while others reported that vitamin D status may not be related to depression. Recent clinical trials examining the effects of vitamin D supplementation on depression have also showed discrepant results. However, meta-analysis study results are consistent regarding the beneficial effects of vitamin D. Several mechanisms that account for these beneficial effects of vitamin D on depression have been reported but remain largely speculative. Vitamin D deficiency is very common, and prevalence of depression is increasing in the Asian population, especially females. However, limited literature is available on this population. Considering research results of a potential inverse association between vitamin D level and prevalence of depression, it is important to advance our understanding of the role of vitamin D in depression and conduct well-designed prospective trials in the Asian population.

Reproducibility and Validity of a Self-Administered Semiquantitative Food Frequency Questionnaire (자기기록식 반정량 식이섭취 빈도조사의 신뢰도 및 타당도 연구)

  • 김미경;이상선;안윤옥
    • Korean Journal of Community Nutrition
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    • v.1 no.3
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    • pp.376-394
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    • 1996
  • This study evaluated the reproducibility and validity of the self-administered semiquantitative food frequency questionnaire used in a large prospective cohort study(Korean Cancer Research Survey) in middle-aged men. The questionnaire was administered twice at an interval of approximately two years(December, 1992-January, 1995), and four or five 24-hour recalls for each subject were collected at intervals of approximately three months. The results were as follows; 1) Although the distributions of the data estimated by the questionnaire were somewhat wider, the mean nutrient intakes of group estimated by our questionnaires and the multiple 24-hour recalls were roughly comparable. 2) The reproducibility determined by correlation of absolute(unadjusted nutrient intake) and calorie adjusted nutrient intakes from two semiquantitative food frequency questionnaires were more than 0.5, and the weighted kappa values were more than 0.4. 3) The Pearson correlation coefficients between unadjusted nutrient intakes values were average 0.40 on the average(Ca, 0.13-Carbohydrate, 0.58) at the first questionnaire vs. 24-hour recalls, and 0.28 at the second questionnaire vs. 24-hour recalls. The spearman rank order correlation coefficients were similar. When energy intake was adjusted, there was a slight reduction : 0.28 at the second questionnaire, 0.25 average on the second. In order to correct the measurement error of 24-hour recall data, the deattenuated correlation coefficient was calculated. It averaged 0.53 on the first questionnaire, 0.37 on the second questionnaire for unadjusted nutrient intake. for calorie-adjusted nutrient intake, it averaged 0.44 on the first questionnaire, 0.37 on the second questionnarie. 4) There was lower agreement(k<0.4) between the questionnaries and the 24-hour recalls. And the subjects classified in the same quartile by 24-hour recalls and first questionnaire were average 37$\%$(energy-adjusted values) and 40$\%$(unadjusted values) on the average. More than k10$\%$(average) of subjects were in the extreme quartile of the questionnarie and 24-hour recall method. But 8.2$\%$(average) of subjects classified in the lowest quartile of unadjusted nutrient intake level by the 24-hour recalls were in the highest quartile by the first questionnaire. These data indicate that our self-administered semiquantitative food frequency questionnarie is reproducible. Correlation coefficients comparing nutrient intakes measured by two different dietary assessment methods were less than 0.5. The validity of our questionnarie is not high enough.

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A Classification Method of Delirium Patients Using Local Covering-Based Rule Acquisition Approach with Rough Lower Approximation (러프 하한 근사를 갖는 로컬 커버링 기반 규칙 획득 기법을 이용한 섬망 환자의 분류 방법)

  • Son, Chang Sik;Kang, Won Seok;Lee, Jong Ha;Moon, Kyoung Ja
    • KIPS Transactions on Software and Data Engineering
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    • v.9 no.4
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    • pp.137-144
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    • 2020
  • Delirium is among the most common mental disorders encountered in patients with a temporary cognitive impairment such as consciousness disorder, attention disorder, and poor speech, particularly among those who are older. Delirium is distressing for patients and families, can interfere with the management of symptoms such as pain, and is associated with increased elderly mortality. The purpose of this paper is to generate useful clinical knowledge that can be used to distinguish the outcomes of patients with delirium in long-term care facilities. For this purpose, we extracted the clinical classification knowledge associated with delirium using a local covering rule acquisition approach with the rough lower approximation region. The clinical applicability of the proposed method was verified using data collected from a prospective cohort study. From the results of this study, we found six useful clinical pieces of evidence that the duration of delirium could more than 12 days. Also, we confirmed eight factors such as BMI, Charlson Comorbidity Index, hospitalization path, nutrition deficiency, infection, sleep disturbance, bed scores, and diaper use are important in distinguishing the outcomes of delirium patients. The classification performance of the proposed method was verified by comparison with three benchmarking models, ANN, SVM with RBF kernel, and Random Forest, using a statistical five-fold cross-validation method. The proposed method showed an improved average performance of 0.6% and 2.7% in both accuracy and AUC criteria when compared with the SVM model with the highest classification performance of the three models respectively.

Birth Weight and the Development of Functional Gastrointestinal Disorders in Infants

  • Baldassarre, Maria Elisabetta;Di Mauro, Antonio;Salvatore, Silvia;Tafuri, Silvio;Bianchi, Francesco Paolo;Dattoli, Enzo;Morando, Lucia;Pensabene, Licia;Meneghin, Fabio;Dilillo, Dario;Mancini, Valentina;Talarico, Valentina;Tandoi, Francesco;Zuccotti, Gianvincenzo;Agosti, Massimo;Laforgia, Nicola
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.4
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    • pp.366-376
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    • 2020
  • Purpose: To assess the association between birth weight and the development of functional gastrointestinal disorders (FGIDs) in the first year of life. Methods: This is a secondary analysis of a prospective cohort multicenter study including neonates, consecutively enrolled at birth, and followed up for one year. At birth all infants were classified by birth weight as extremely low (ELBW), very low, or low when <1,000, <1,500, and <2,500 g, respectively, and by birth weight for gestational age as appropriate (AGA, weight in the 10-90th percentile), small (SGA, weight <10th percentile), and large (LGA, weight >90th percentile) for gestational age. FGIDs were classified according to the Rome III criteria and assessed at 1, 3, 6, and 12 months of life. Results: Among 1,152 newborns enrolled, 934 (81.1%) completed the study: 302 (32.3%) were preterm, 35 (3.7%) were ELBW, 104 (11.1%) were SGA, 782 (83.7%) were AGA, and 48 (5.1%) were LGA infants. Overall, throughout the first year of life, 718 (76.9%) reported at least one FGID. The proportion of infants presenting with at least one FGID was significantly higher in ELBW (97%) compared to LBW (74%) (p=0.01) and in LGA (85.4%) and SGA (85.6%) compared to AGA (75.2%) (p=0.0001). On multivariate analysis, SGA was significantly associated with infantile colic. Conclusion: We observed an increased risk of FGIDs in ELBW, SGA, and LGA neonates. Our results suggest that prenatal factors determining birth weight may influence the development of FGIDs in infants. Understanding the role of all potential risk factors may provide new insights and targeted approaches for FGIDs.

Change in Palliative Performance Scale (PPS) Predicts Survival in Patients with Terminal Cancer

  • Oh, Jee Hye;Lee, Yong Joo;Seo, Min Seok;Yoon, Jo Hi;Kim, Chul Min;Kang, Chung
    • Journal of Hospice and Palliative Care
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    • v.20 no.4
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    • pp.235-241
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    • 2017
  • Purpose: The Palliative Performance Scale (PPS) is a widely used prognostic tool in patients with advanced cancer. This study examines the association between changes in PPS score and survival in patients with advanced cancer. Methods: We identified a cohort of 606 inpatients who died at a Korean university hospital's hospice/palliative care center. For each patient, the PPS score was measured twice according to a standard procedure: 1) upon admission, and 2) three days after admission (D3). "Change on D3" was defined as a difference between initial PPS and PPS on D3. We used a Cox regression modeling approach to explore the association between this score change and survival. Results: The changes in scores were associated with survival. A score change of >30% yielded a hazard ratio for death of 2.66 (95% CI 2.19~3.22), compared to a score change of ${\leq}30%$. PPS of ${\leq}30$ on D3 also independently predicted survival, with a hazard ratio of 1.67 (95% CI 1.38~2.02) compared to PPS of >30. Conclusion: A change of over 30% in PPS appears to predict survival in hospitalized patients with terminal cancer, even after adjustment for confounders. Changes in PPS may be a more sensitive indicator of impending death than a single PPS measured on the day of admission in terminal cancer patients. Further prospective study is needed to examine this important finding in other populations.

Associations of serum levels of vitamins A, C, and E with the risk of cognitive impairment among elderly Koreans

  • Kim, Sung Hee;Park, Yeong Mi;Choi, Bo Youl;Kim, Mi Kyung;Roh, Sungwon;Kim, Kyunga;Yang, Yoon Jung
    • Nutrition Research and Practice
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    • v.12 no.2
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    • pp.160-165
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    • 2018
  • BACKGROUND/OBJECTIVES: Korea is quickly becoming an aged society. Dementia is also becoming a vital public health problem in Korea. Cognitive impairment as a pre-stage of dementia shares most risk factors for dementia. The aim of the present study was to determine associations of serum levels of vitamins A, C, and E with the risk of cognitive impairment among elderly Koreans. SUBJECTS/METHODS: In this cross-sectional study, a total of 230 participants aged 60-79 years from Yangpyeong cohort were included. Cognitive function was assessed by the Korean version of the Mini-Mental State Examination for Dementia Screening. The logistic multivariable regression model was applied to determine the effect of serum vitamins A, C, and E on the risk of cognitive impairment. RESULTS: There was no significant association between the risk of cognitive impairment and serum levels of vitamin A and vitamin C. There was a significant odd ratio when the second tertile group of beta-gamma tocopherol level was compared to the first tertile group [odds ratio (OR) = 0.37, 95% confidence interval (CI) = 0.14-0.98, P for trend = 0.051]. In subgroup analyses, there were significant negative associations between beta-gamma tocopherol level and the risk of cognitive impairment in men (OR = 0.17, 95% CI = 0.03-0.87, P for trend = 0.028), non-drinkers or former drinkers (OR = 0.13, 95% CI = 0.02-0.66, P for trend = 0.025), and non-smokers or former smokers (OR = 0.27, 95% CI = 0.09-0.82, P for trend = 0.017). CONCLUSION: Serum beta-gamma tocopherol levels tended to be inversely associated with the risk of cognitive impairment. Further prospective large-scaled studies are needed to examine this association.

Use of radiotherapy in patients with palliative double bypass for locally advanced pancreatic adenocarcinoma

  • Glinka, Juan;Diaz, Federico;Alva, Augusto;Mazza, Oscar;Claria, Rodrigo Sanchez;Ardiles, Victoria;Santibanes, Eduardo de;Pekolj, Juan;Santibanes, Martin de
    • Radiation Oncology Journal
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    • v.36 no.3
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    • pp.210-217
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    • 2018
  • Purpose: Pancreatic cancer (PC) has not changed overall survival in recent years despite therapeutic efforts. Surgery with curative intent has shown the best long-term oncological results. However, 80%-85% of patients with these tumors are unresectable at the time of diagnosis. In those patients, first therapeutic attempts are minimally invasive or surgical procedures to alleviate symptoms. The addition of radiotherapy (RT) to standard chemotherapy, ergo chemoradiation, in patients with locally advanced pancreatic cancer (LAPC) is still controversial. The study aims to compare outcomes in patients with a double bypass surgery due to LAPC treated or not with RT. Materials and Methods: A retrospective cohort study of patients with double bypass for LAPC were registered and divided into two groups: treated or not with postoperative RT. Baseline characteristics, postoperative complications, those related to RT and their relation to the main event (mortality) were compared. Results: Seventy-four patients were included. Surgical complications between the groups did not offer significant differences. Complications related to RT were mostly mild, and 86% of patients completed the treatment. Overall survival at 1 and 2 years for patients in the exposed group was 64% and 35% vs. 50% and 28% in the non-exposed group, respectively (p = 0.11; power 72%; hazard ratio = 0.53; 95% confidence interval, 0.24-1.18). Conclusion: We observed a tendency for survival improvement in patients with postoperative RT. However, we've not had enough power to demonstrate this difference, possibly due to the small sample size. It is indispensable to develop randomized and prospective trials to guide more specific treatment lines in this patients.

Regional Lymph Node Dissection as an Additional Treatment Option to Endoscopic Resection for Expanded Indications in Gastric Cancer: a Prospective Cohort Study

  • Seo, Ho Seok;Yoo, Han Mo;Jung, Yoon Ju;Lee, Sung Hak;Park, Jae Myung;Song, Kyo Young;Jung, Eun Sun;Choi, Myung-Gyu;Park, Cho Hyun
    • Journal of Gastric Cancer
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    • v.20 no.4
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    • pp.442-453
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    • 2020
  • Purpose: Expanded indications for endoscopic submucosal dissection (ESD) in early gastric cancer (EGC) remain controversial due to the potential risk of undertreatment after adequate lymph node dissection (LND). Regional LND (RLND) is a novel technique used for limited lymphadenectomy to avoid gastrectomy. This study established the safety and effectiveness of RNLD as an additional treatment option after ESD for expanded indications. Materials and Methods: A total of 69 patients who met the expanded indications for ESD were prospectively enrolled from 2014 to 2017. The tumors were localized using intraoperative esophagogastroduodenoscopy (EGD) before RLND. All patients underwent RLND first, followed by conventional radical gastrectomy with LND. The locations of the preoperative and intraoperative EGD were compared. Pathologic findings of the primary lesion and the RLND status were analyzed. Results: The concordance rates of tumor location between the preoperative and intraoperative EGD were 79.7%, 76.8%, and 63.8% according to the longitudinal, circumferential, and regional locations, respectively. Of the 4 patients (5.7%) with metastatic LNs, 3 were pathologically classified as beyond the expanded indication for ESD and 1 had a single LN metastasis in the regional lymph node. Conclusions: RLND is a safe additional option for the treatment of EGC in patients meeting expanded indications after ESD.

Quantitative Research Trends for Critical Care Survivors' Health related Quality of Life after Intensive Care Unit Discharge (중환자실 생존 환자의 퇴원 후 건강관련 삶의 질에 관한 국내·외 양적연구 동향)

  • Son, Youn-Jung;Song, Hyo-Suk
    • Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
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    • v.6 no.12
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    • pp.55-67
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    • 2016
  • Purpose: The aims of this were to analyse the quantitative research trends and describe the factors influencing health related to quality of life (HRQoL) and instruments used to HRQoL after Intensive care units (ICU) discharge. Methods: This study were included 84 published papers regarding HRQoL after ICU discharge from initial data to December 2015. Results: The majority of papers were performed abroad. Only 4 papers with regard to HRQoL of ICU survivors were performed by nurses. 36 studies (42.8%) were used to measure HRQoL ICU survivors using the SF-36. 29 studies (34.5%) were used to measure HRQoL at 3~6 months after ICU discharge. Older age, longer length of stay at ICU, severity of illness, anxiety and depression were main risk factors to lower HRQoL in ICU patients. Conclusions: This study provides a better understanding of quality of life follwing critical illness. Therefore, further stduy is needed to develop patient centered intervention considered patients'health status and recovery phase. Additionally, large prospective multicenter cohort studies should be required.

Cross-sectional Study on Prevalence of Metabolic Syndrome in Stroke Patients (중풍환자의 대사증후군 유병률에 대한 단면조사연구)

  • Park, Seong-Uk;Lee, In-Whan;Jung, Woo-Sang;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Chang-Nam;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.9 no.1
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    • pp.25-32
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    • 2008
  • Objectives : Metabolic syndrome (MetS) is associated with increasing risk of cardiovascular morbidity and mortality but the risk of stroke associated with the MetS is less well established. The objective of this study was to evaluate the prevalence of MetS in stroke patients. Methods : We analyzed the data of 806 patients with acute ischemic stroke from Hanbang Stroke Registry supported by the Ministry of Science and Technology of Korea. Subjects' enrollment was done in the oriental medical hospitals of 4 universities located in the metropolitan region from April 2007 to August 2008. We analyzed all registered data and evaluated the prevalence of MetS and specific components of MetS. Results : The prevalence of MetS in stroke patients according to American Heart Association/National Heart Lung and Blood Institute (AHA/NHLBI) criteria was 59.6%. The prevalence according to the International Diabetes Federation (IDF) criteria was 41.6%. The prevalence of female patients was higher than that of male patients (71.8% vs 51% by AHA/NHLBI criteria; 61.7% vs 27.7% by IDF criteria). The prevalence of central obesity, low HDL cholesterol and hypertension was higher in female patients. There was no significant relationship between MetS and stroke subtype. Conclusions : This work gives us the basic data on the association between MetS and risk of stroke. There should be the prospective cohort studies to evaluate MetS and the risk of stroke.

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