Purpose: Undernutrition during hospitalization increases the risk of nosocomial infection and lengthens the disease courses. The aim of this study was to evaluate the risk factors of weight loss during hospitalization in children. Methods: All the patients who were admitted in general wards between April and May 2014 were enrolled. Patients aged >18 years and discharged within 2 days were excluded. Weight loss during hospitalization was defined as a decrease in body weight of >2% in 8 hospital days or on the day of discharge. Patients who lost body weight during hospitalization were compared with patients who maintained their body weights. Significant parameters were evaluated by using the multivariate logistic regression analysis. Results: We enrolled 602 patients, of whom 149 (24.8%) lost >2% of their body weight. Complaint of pain (p=0.004), admission to the surgical department (p=0.001), undergoing surgery (p=0.044), undergoing abdominal surgery (p=0.034), and nil per os (NPO) durations (p=0.003) were related to weight loss during hospitalization. The patients who had high weight-for-age tended to lose more body weight (p=0.001). Admission to the surgical department (odds ratio [OR], 1.668; 95% confidence interval [CI], 1.054-2.637; p=0.029) and long NPO durations (OR, 1.496; 95% CI, 1.102-2.031; p=0.010) were independent risk factors of weight loss during hospitalization. The patients with high weight-for-age tended to lose more weight during hospitalization (OR, 1.188; 95% CI, 1.029-1.371; p=0.019). Conclusion: Greater care in terms of nutrition should be taken for patients who are admitted in the surgical department and have prolonged duration of nothing by mouth.
Objectives: We developed the predictive model for the incidence of colon cancer by utilizing the health screening data of the National Health Insurance in Korea. We also explored the characteristics of the high risk group for colon cancer. Methods: The predictive model was used to determine those people who have a high risk for colon cancer within 2 years of their NHI health screening, and we excluded the people who had already been treated for cancer or who were cancer patient. The study population is the insured of the NHI, aged 40 or over and they had undergone health screening from the year 2000 to 2004, according to NHI health screening formula. We performed logistic regression analysis and used SAS Enterprise Miner 4.1. Results: This study shows that there exists a higher rate of colon cancer in males than females. Also, for the population in their 60s, the incidence rate of colon cancer is much higher by 5.36 times than that for those people in their 40s. Amongst the behavioral factors, heavy drinking is the most important determinant of the colon cancer incidence (7.39 times in males and 21.51 times in females). Conclusions: Our study confirms that the major influencing factors for the incidence of colon cancer are drinking, lack of exercise, a medical history of colon polypus and a family history of colon cancer. As a result, we can choose the group that is at a high risk for colon cancer and provide customized medical information and selective management services according to their characteristics.
George, Mathew;Asab, Nihad Abu;Varughese, Elizabeth;Irwin, Matthew;Oldmeadow, Christopher;Hollebone, Keith;Apen, Kenneth;Renner, Stefan
Asian Pacific Journal of Cancer Prevention
/
v.15
no.23
/
pp.10251-10254
/
2015
Uterine cancer is the most common invasive gynaecological cancer in Australia. Early detection is a key predictive factor achieved by increasing public awareness and participation in screening. This observational study measures awareness of gynaecological malignancies, particularly uterine, among women in two rural areas of New South Wales, Australia. Patients presenting to gynaecology clinics in January to March 2014 were invited to complete a structured questionnaire. Women with a history of cancer and incomplete questionnaires were excluded. Of the 382 patients invited to participate, 329 (86%) responded with complete feedback. Most respondents were younger than than 50 years (66%) and married with at least 2 children (74%). The majority (94%) of participants had no awareness of uterine cancer and many (46%) were unable to identify common risk factors including obesity, diabetes and hypertension. The ability to identify risk factors was correlated to age, marital status and obesity. The study identifies poor awareness on uterine malignancies in two typical areas of rural Australia. Although external validity is limited by sociological factors, poor awareness of uterine cancer among rural patients in this study represents a valid public health concern. It is imperative to improve awareness of uterine cancer and available screening programs to facilitate early detection and cure.
Objective: To summarize the endoscopic screening findings in high-risk population of esophageal and gastric carcinoma and analyze influential factors related to screening. Methods: In seven selected cities and counties with high incidences of esophageal carcinoma, people at age of 40-69 were set as the target population. Those with gastroscopy contradictions were excluded, and all who were voluntary and willing to comply with the medical requirements were subjected to endoscopic screening and histological examination for esophageal, gastric cardia and gastric carcinoma in accordance with national technical manual for early detection and treatment of cancer. Results: In three years, 36,154 people were screened, and 16,847 (46.60%) cases were found to have precancerous lesions. A total of 875 cases were found to have cancers (2.42%), and among them 739 cases had early stage with an early diagnosis rate is 84.5%. Some 715 patients underwent prompt treatment and the success rate was 81.8%. Conclusions: In a high-risk population of esophageal and gastric carcinoma, it is feasible to implement early detection and treatment by endoscopic screening. Screening can identify potential invasive carcinoma, early stage carcinoma and precancerous lesions, improving efficacy through early detection and treatment. The exploratory analysis of related influential factors will help broad implementation of early detection and treatment for esophageal and gastric carcinoma.
Objective: Postoperative delirium (POD) is characterized by an acute change in cognitive function and can result in longer hospital stays, higher morbidity rates, and more frequent discharges to long-term care facilities. In this study, we investigated the incidence and risk factors of POD in 224 patients older than 70 years of age, who had undergone a neurosurgical operation in the last two years. Methods: Data related to preoperative factors (male gender, >70 years, previous dementia or delirium, alcohol abuse, serum levels of sodium, potassium and glucose, and co-morbidities), perioperative factors (type of surgery and anesthesia, and duration of surgery) and postoperative data (length of stay in recovery room, severity of pain and use of opioid analgesics) were retrospectively collected and statistically analyzed. Results: POD appeared in 48 patients (21.4%) by postoperative day 3. When we excluded 26 patients with previous dementia or delirium, 17 spontaneously recovered by postoperative day 14, while 5 patients recovered by postoperative 2 months with medication, among 22 patients with newly developed POD. The univariate risk factors for POD included previously dementic or delirious patients, abnormal preoperative serum glucose level, pre-existent diabetes, the use of local anesthesia for the operation, longer operation time (>3.2 hr) or recovery room stay (>90 mini, and severe pain (VAS>6.8) requiring opioid treatment (p<0.05). Backward regression analysis revealed that previously dementic patients with diabetes, the operation being performed under local anesthesia, and severe postoperative pain treated with opioids were independent risk factors for POD. Conclusion: Our study shows that control of blood glucose levels and management of pain during local anesthesia and in the immediate postoperative period can reduce unexpected POD and help preventing unexpected medicolegal problems and economic burdens.
Single nucleotide polymorphism (SNP) in adiponectin gene has been associated with insulin resistance, diabetes, and cardiovascular disease (CVD). This study was performed to investigate the association of SNP 276G${\rightarrow}$T at adiponectin gene with CVD risk factors in Korean type 2 diabetes mellitus (DM) patients. The subjects were 351 type 2 DM patients visited a DM clinic in Seoul, and the patients with known CVD were excluded. The adiponectin SNP 276G${\rightarrow}$T was analyzed and dietary intakes were assessed by a Food Frequency Questionnaire. The prevalence of G/G, G/T, and T/T genotype was 47.6%, 43.3%, and 9.1%, respectively. Male subjects with T/T genotype showed significantly lower level of adiponectin and HDL-cholesterol and significantly higher C-reactive protein (CRP) level compared to G/G and G/T genotypes. In G/G genotype, protein intake was negatively correlated to body weight, BMI, and waist circumference, and there were positive correlation between carbohydrate intake and BMI, waist-hip ratio, and ApoB/apoA-1 ratio in G/T genotype. However, in T/T genotype, there was no significant association between macronutrient intakes and anthropometric and hematological values. In conclusion, CVD risk would be high in type 2 DM patients with T/T genotype, and the association of macronutrient intakes with anthropometric and hematologic factors was different among the three adiponectin genotypes. These results may imply the need for different dietary management regime according to adiponectin genotype to lower CVD complications in Korean type 2 DM patients.
Purpose: The present study will identify risk factors for aspiration in severe trauma patients by comparing patients who showed a sign of aspiration lung disease on chest computed tomography (CT) and those who did not. Methods: We conducted a retrospective review of the Korean Trauma Data Bank between January 2014 and December 2019 in a single regional trauma center. The inclusion criteria were patients aged ≥18 years with chest CT, and who had an Injury Severity Score ≥16. Patients with Abbreviated Injury Scale (AIS)-chest score ≥1 and lack of medical records were excluded. General characteristics and patient status were analyzed. Results: 425 patients were included in the final analysis. There were 48 patients showing aspiration on CT (11.2%) and 377 patients showing no aspiration (88.7%). Aspiration group showed more endotracheal intubation in the ER (p=0.000) and a significantly higher proportion of severe Glasgow Coma Scale (GCS) (p=0.000) patients than the non-aspiration group. In AIS as well, the median AIS head score was higher in the aspiration group (p=0.046). Median oxygen saturation was significantly lower in the aspiration group (p=0.002). In a logistic regression analysis, relative to the GCS mild group, the moderate group showed an odds ratio (OR) for aspiration of 2.976 (CI, 1.024-8.647), and the severe group showed an OR of 5.073 (CI, 2.442-10.539). Conclusions: Poor mental state and head injury increase the risk of aspiration. To confirm for aspiration, it would be useful to perform chest CT for severe trauma patients with a head injury.
The purpose of this preliminary study was to develop a measurement for assessing risk factors for falling in community-dwelling elderly persons. Rasch analysis and principal component analysis were performed to examine whether items on the Activities-Specific Balance Confidence (ABC), assessing self-efficacy, and items on the Berg Balance Scale (BBS), assessing balance function, contribute jointly to a unidimensional construct in the elderly. A total of 35 elderly persons (4 men, 31 women) participated. In this study, each item of ABC (16 items) and BBS (14 items) was scored on a 5-point ordinal rating scale from 0 to 4. The initial Rasch and principal component analysis indicated that 3 of the ABC items and 2 of the BBS items were misfit for this study. These 5 items were excluded from further study. After combining ABC and BBS, Rasch and principal component analyses were examined and finally 23 items selected; 12 items from ABC, 11 items from BBS. The 23 combined ABC-BBC items were arranged in order of difficulty. The hardest item was 'walk outside on icy sidewalks' and the easiest item was 'pivot transfer'. Although structural calibration of each 5 rating scale categories was not ordered, the other three essential criteria of Linacre's optimal rating scale were satisfied. Overall, the ABC-BBS showed sound item psychometric properties. Each of the 5 rating scale categories appeared to distinctly identify subjects at different ability levels. The findings of this study support that the new ABC-BBS scale measure balance function and self-efficacy. It will be a clinically useful assessment of risk factors for falling in the elderly. However, the number of subjects was too small to generalize our results. Further study is needed to develop a new assessment considering more risk factors of falling in elderly.
Recently, since the risk on natural disasters is increasing due to abnormal weather such as the global warming, a need for a system on prior review on the influence of disasters has emerged in order to establish a solution by analyzing elements of disaster in advance. However, since the inherently destroying business namely the quarrying business is excluded from the range of subject business of Prior Review System on the influence of disasters, a correction for this is required. In order to actually explore how much risk it contains, actual outflow of soil and flood in the quarrying block where quarrying is being currently carried out was examined and the required undercurrent facility capacity which is also used as a grit chamber was investigated. In addition, by comparing the soil outflow of industrial complexes and golf courses which are current subject businesses of Prior Review on the Influence of Disasters and that of rock mountains relative risk level was examined. After investigation, it was found that the risk on occurrence of disasters was increased due to increase in outflow of soil and flood because of the change of land condition during and after development thus an adequate solution to decrease is required. In addition, after comparison with other business groups it was found that a significantly higher amount of soil is outflown in case of rock mountains thus it was analyzed that a solution to decrease is required. Therefore, a correction is immediately required in order to include quarrying business in the subject business of Prior Review System on the Influence of Disasters.
Roh, Young-Man;Lee, Cheol Min;Kim, Yoon Shin;Kim, Seok Won;Kim, Chi-Nyon;Kim, Hyun-Wook;Cho, Kee Hong;Choi, Ho Chun;Kim, Jung Man
Journal of Korean Society of Occupational and Environmental Hygiene
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v.16
no.1
/
pp.54-67
/
2006
This study was performed to deduct the extension possibility of the standards establishment for $NO_2$, $O_3$, Asbestos, Radon, total volatile organic compounds (TVOC) excluded in the indoor air part of Industrial Safety Acts in Korea. The air pollutants were sampled for 30 office buildings from August to September, 2005 in the metropolitan area. The airborne concentrations of $NO_2$, $O_3$, Radon and TVOC were 0.0092 ppm, 0.0035 ppm, 0.57 pCi/L and $423{\mu}g/m^3$, respectively. The management plan and reduction methods is required in the aspect of indoor air quality(IAQ) because the emission sources of those also exist in indoor as well as outdoor even though those were not exceeded the standards of the Ministry of Environment in Korea. The standard for TVOC in the new and remodeling office has to be established based on the risk assessment when hazard index exceeded "1" in the worst case scenario. In the state of art, the management of each volatile organic compounds has a difficulty due to not enough data for toxicological reference. Therefore, it is suggested that first of all, the standard for TVOC be established and then expanded to each materials for decision-making of improvement of IAQ in office.
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