• 제목/요약/키워드: Risk Severity

검색결과 795건 처리시간 0.026초

Risk factors of medication-related osteonecrosis of the jaw: a retrospective study in a Turkish subpopulation

  • Sahin, Onur;Odabasi, Onur;Aliyev, Toghrul;Tatar, Birkan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제45권2호
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    • pp.108-115
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    • 2019
  • Objectives: Medication-related osteonecrosis of the jaw (MRONJ) is a well-known side effect of certain drugs that are used to influence bone metabolism to treat osteometabolic disease or cancers. The purpose of our study was to investigate how high-concentration and low-concentration bisphosphonate (BP) intake affects the disease severity. Materials and Methods: Data collected from the medical records of 52 patients treated with BPs, antiresorptive, antiangiogenic drugs and diagnosed with MRONJ were included in this study. Age, sex, type of systemic disease, type of drug, duration of drug treatment, jaw area with MRONJ, drug administration protocol, and MRONJ clinical and radiological findings were obtained. Patients were divided into two groups: anti-neoplastic (Group I, n=23) and anti-osteoporotic (Group II, n=29). Statistical evaluations were performed using the IBM SPSS ver. 21.0 program. Results: In both groups, more females had MRONJ. MRONJ was found in the mandibles of 30 patients (Group I, n=14; Group II, n=16). When we classified patients according to the American Association of Oral and Maxillofacial Surgeons staging system, significant differences were seen between groups (${\chi}^2=12.23$, P<0.01). More patients with advanced stage (stage 2-3) MRONJ were found in Group I (60.9%). Conclusion: According to our results, high-concentration BP intake, age and duration of drug intake increased disease severity.

독사 교상 후 발생하는 횡문근 융해증 (Rhabdomyolysis induced by venomous snake bite)

  • 이정호;문정미;전병조
    • 대한임상독성학회지
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    • 제20권2호
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    • pp.51-57
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    • 2022
  • Purpose: Despite previous studies reporting the development of rhabdomyolysis (RM), this affliction tends to be neglected as an envenomation sign in South Korea. The current retrospective study investigates the prevalence and prognosis of RM after a snakebite. We further searched for predictors of snakebite-induced RM, which can be observed at presentation. Methods: This study included 231 patients who presented to the ED within 24 hours after a snakebite. The patients were classified according to the severity of RM, and the data, comprising baseline characteristics and clinical course including the level of creatine kinase (CK), were collected and compared according to the severity of RM. Results: The prevalence of RM and severe RM were determined to be 39% and 18.5%, respectively. Compared to the group without RM or with mild RM, the group with severe RM had a higher grade of local swelling, a higher frequency of acute kidney injury and neurotoxicity, and a greater need for renal replacement therapy and vasopressor administration. However, the incidence of acute renal injury in the RM group was 7.7%, with two patients needing renal replacement therapy. No mortalities were reported at discharge. Results of the multinomial logistic regression model revealed that the WBC levels are significantly associated with the risk of severe RM. Conclusion: RM should be considered the primary clinical sign of snake envenomation in South Korea, although it does not seem to worsen the clinical course. In particular, physicians should pay attention to patients who present with leukocytosis after a snakebite, which indicates the risk of developing RM, regardless of the CK level at presentation.

청소년 폭음과 흡연, 신체활동 부족, 부적절한 체중조절, 성 행태와의 관련성: 2015 청소년건강행태온라인조사를 중심으로 (Smoking, physical inactivity, inappropriate weight control, sexual activity and binge drinking among adolescents: Using Korea Youth Risk Behavior web-based Survey in 2015)

  • 서수인;오진경;임민경
    • 보건교육건강증진학회지
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    • 제34권1호
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    • pp.1-12
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    • 2017
  • Objectives: The aim of this study was to verify relationships between light- and heavy alcohol drinking and health-risk behaviors such as smoking, inappropriate weight control, physical inactivity, and sexual activity among adolescents. Methods: The data of 68,043 adolescents in middle- and high school collected from the Korea Youth Risk Behavior Web-based Survey in 2015 were analyzed. For statistical analysis, logistic regression model was used. Results: The rate of heavy alcohol drinking increased with increasing age up to 21.5% among boys and 13.9% among girls. Among boys, heavy alcohol drinkers were at a higher risk of smoking (adjusted odds ratios [OR]=3.3, 95% confidence interval [CI]=2.8-3.8), inappropriate weight control (OR=1.7; 95% CI=1.4-2.1), having sexual intercourse (OR=3.6; 95% CI=3.0-4.2) than light drinkers. Multiple health-risk behaviors of smoking, inappropriate weight control and sexual intercourse also increased in accordance with the severity of drinking alcohol beverage compared to non-drinker. Physical inactivity was decreased among heavy drinkers compared to light drinkers (OR=0.8; 95% CI=0.7-0.9 for inactivity of moderate exercise). Similar results were observed among girls. Conclusions: Alcohol drinking especially heavy alcohol drinking among adolescents is related to other risky behaviors including smoking, inappropriate weight control, and sexual activity. To prevent health problems in adolescents, it is necessary to adopt a combined approach regarding heavy drinking and health-risk behaviors.

국적일반화물선 초기안전성평가(High-level FSA) 연구(2) (A Study on High-level FSA for Korean-flagged General Cargo Ships)

  • 이종갑;나성;김홍태;박재홍
    • 한국항해항만학회지
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    • 제35권1호
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    • pp.23-30
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    • 2011
  • 본 논문은, 국적일반화물선 공식안전성평가(Formal Safety Assessment, 이하 FSA) 연구의 1, 2 단계에 해당하는 위험요소 식별(Hazard identification) 및 식별된 사고 시나리오에 대한 위험도 분석(Risk analysis) 결과를 소개한 "국적일반화물선 초기안전성평가 연구(1)"에 이어 FSA 연구의 3, 4 그리고 5단계를 수행한 내용으로, 국적일반화물선의 운용 중 발생 가능한 위험을 저감할 수 있는 위험도제어방안들(Risk Control Options)을 식별하는 단계(Step 3)와 식별된 위험도제어방안들 중 전문가 의견수렴을 통하여 선별된 위험도제어방안들을 대상으로 한 비용-효과 평가 단계(Step 4: Cost-Benefit Assessment) 그리고 비용-효과 평가의 결과를 정리하여 국적일반화물선의 안전성 제고를 위한 구체적인 방안을 제안하는 단계(Step 5: Recommendation for Decision Making)의 결과를 소개하였다.

일부 대학생의 식사 장애 위험 정도에 따른 체중 조절 방법 (Weight Control History according to Risk of Eating Disorder)

  • 남희정;김영순
    • 한국식품영양학회지
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    • 제19권2호
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    • pp.111-125
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    • 2006
  • This quantitative study was conducted to examine the relationship between weight control behaviors and disordered eating patterns in some university students. This study used a cross-sectional study design. A total of 347 students from three universities participated in this study (88 male and 259 female) Eating disorders were assessed using the Eating Attitudes Test (EAT-26); a score of =20 identifies individuals who likely have an eating disorder, including anorexia nervosa and bulimia nervosa. A score for healthy dietary behaviors was obtained by self-assessment on a healthy diet scale (20-item questionnaire), and the severity of any state-trait anxiety was calculated by the state-trait anxiety inventory (40-item questionnaire). In the analyzed results, the percentage of participants with experience of weight control was 58% in male and 73% in female. The subjects with a high risk of an eating disorder (score of =20 of EAT-26) were 44.3% ($mean{\pm}S.D;\;18.9{\pm}13.4$) of the males, and 57.9% ($mean{\pm}S.D;\;23.2{\pm}11.6$) of the females. Higher Body Mass Index (BMI) was significantly related with an increased risk for an eating disorder in females, but not in males. In the group who had attempted weight control of all types, there was a severe risk of an eating disorder. Increased eating disorder risk was significantly related with weight control behaviors such as a higher number of attempts at weight control, having used medication, having experienced side effects, and having experienced disease for both sexes. Therefore, the results of this paper showed that detrimental behaviors of weight control are connected to an increased risk of eating disorders. Consequently, education regarding the correct, behaviors of weight control is necessary to prevent eating disorders in adolescents.

노인층에서 Clostridium difficile 감염 약물사용평가 및 비호전군에 대한 영향인자 (Drug Use Evaluation of Clostridium difficile Infection in Elderly Patients and Risk Factors of Non-improving Group)

  • 노현정;함정연;이자균;이정연
    • 한국임상약학회지
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    • 제28권3호
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    • pp.174-180
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    • 2018
  • Objective: Clostridium difficile Infection (CDI) is one of the common nosocomial infections. As elderly population increases, the proper treatment has been emphasized. We investigated the risk factors associated with CDI unimprovement in elderly patients. Furthermore, we performed drug use evaluation of old CDI patients and oldest-old CDI patients. Methods: It was a retrospective study using electronic medical record at Kangbuk Samsung Medical Center (KBSMC) from January 2016 to December 2017. Seventy three patients aged 65 years or older, diagnosed with CDI by Clostridium difficile Toxin B Gene [Xpert] were screened and they were assessed for risk factors regarding unimprovement status. We also evaluated drug use evaluation in old patients ($65{\leq}age$<80) and oldest-old patients ($80{\leq}age$) by assessing the use of initial therapy, severity, dose, route, treatment course, days of use, total days of use and treatment outcome of initial therapy. Results: Out of 73 patients aged over 65 years, four patients were excluded because they did not receive any treatment. There were 31 improved patients and 38 unimproved patients after initial therapy. We were able to find out patients with surgical comorbidity or endocrine comorbidity (especially, diabetes mellitus) had 2.885 more risk of becoming unimproved than those patients without surgical comorbidity or endocrine comorbidity. Drug use evaluation for CDI was generally fair, but vancomycin as initial therapy is more recommended than metronidazole. Conclusion: Although age, antibiotics exposure, use of antacids are all important risk factors for CDI, our result did not show statistical significance for these risk factors. However, the study is meaningful because the number of elderly population keeps increasing and recently updated guideline suggests the use of vancomycin as drug of choice for CDI.

40대 유방암 생존자의 우울·불안 위험요인 (Risk Factors for Depression and Anxiety among Breast Cancer Survivors in Their 40s)

  • 황숙연
    • 한국콘텐츠학회논문지
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    • 제15권2호
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    • pp.313-323
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    • 2015
  • 본 연구는 우리나라에서 가장 유방암 발생률이 높은 40대 유방암 생존자들의 우울과 불안의 정도를 파악하고 그 위험요인들을 검토하기 위해 수행되었다. 자료 수집은 유방암으로 진단 받은 40-49세 유방암 생존자 중 연구에 동의하고 설문지를 완성한 609명을 대상으로 이루어졌다. CES-D와 GAD-7을 사용하여 측정된 우울과 불안의 평균점수는 각각 16.35(SD=9.24), 4.25(SD=4.17)였으며, 절단점을 기준으로 우울군은 전체의 47.7%, 불안군은 10.3%로 나타났다. BPI-K로 측정된 통증강도 평균은 1.91(SD=1.60)이었으며, 전체의 82.8%가 통증을 호소하였고 10.9%가 중증도 이상의 통증을 보고하였다. 위계적 회귀분석결과 최종모델에서 통증 일상생활방해정도, 직업 없음, 동거가족유형과 과거 정신과 질환이 우울의 유의미한 위험요인으로 나타났고, 불안의 위험요인은 통증 일상생활방해정도, 직업 없음 및 과거 정신과질환으로 나타났다. 이러한 결과는 우리나라 40대 유방암 생존자의 우울과 불안 유병률이 높으며, 우울과 불안의 위험요인에 초점을 두어 위험군에 대한 적절한 심리사회적 개입이 제공되어야 함을 지적해주고 있다.

Average spectral acceleration: Ground motion duration evaluation

  • Osei, Jack Banahene;Adom-Asamoah, Mark
    • Earthquakes and Structures
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    • 제14권6호
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    • pp.577-587
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    • 2018
  • The quantitative assessment of the seismic collapse risk of a structure requires the usage of an optimal intensity measure (IM) which can adequately characterise the severity of the ground motion. Research suggests that the average spectral acceleration ($Sa_{avg}$) may be an efficient and sufficient alternate IM as compared to the more traditional first mode spectral acceleration, $Sa(T_1)$, particularly during seismic collapse risk estimation. This study primarily presents a comparative evaluation of the sufficiency of the average spectral acceleration with respect to ground motion duration, and secondarily assesses the impact of ground motion duration on collapse risk estimation. By assembling a suite of 100 historical ground motions, incremental dynamic analysis of 60 different inelastic single-degree-of-freedom (SDF) oscillators with varying periods and ductility capacities were analysed, and collapse risk estimates obtained. Linear regression models are used to comparatively quantify the sufficiency of $Sa_{avg}$ and $Sa(T_1)$ using four significant duration metrics. Results suggests that an improved sufficiency may exist for $Sa_{avg}$ when the period of the SDF system increases, particularly beyond 0.5, as compare to $Sa(T_1)$. In reference to the ground motion duration measures, results indicated that the sufficiency of $Sa_{avg}$ is more sensitive to significant duration definitions that consider almost the full wave train of an accelerogram ($SD_{a5-95}$ and $SD_{v5-95}$). In order to obtain a reduced variability of the collapse risk estimate, the 5-95% significant duration metric defined using the Arias integral ($SD_{a5-95}$) should be used for seismic collapse risk estimation in conjunction with $Sa_{avg}$.

Risk factors of chronic subscapularis tendon tear

  • Hyung Bin Park;Ji Yong Gwark;Jae-Boem Na
    • Clinics in Shoulder and Elbow
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    • 제25권4호
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    • pp.257-264
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    • 2022
  • Background: Chronic subscapularis tendon tear (SBT) is a degenerative disease and a common pathologic cause of shoulder pain. Several potential risk factors for chronic SBT have been reported. Although metabolic abnormalities are common risk factors for degenerative disease, their potential etiological roles in chronic SBT remains unclear. The purpose of this study was to investigate potential risk factors for chronic SBT, with particular attention to metabolic factors. Methods: This study evaluated single shoulders of 939 rural residents. Each subject undertook a questionnaire, physical examinations, blood tests, and simple radiographs and magnetic resonance imaging (MRI) evaluations of bilateral shoulders. Subscapularis tendon integrity was determined by MRI findings based on the thickness of the involved tendons. The association strengths of demographic, physical, social, and radiologic factors, comorbidities, severity of rotator cuff tear (RCT), and serologic parameters for SBT were evaluated using logistic regression analyses. The significance of those analyses was set at p<0.05. Results: The prevalence of SBT was 32.2% (302/939). The prevalence of partial- and full-thickness tears was 23.5% (221/939) and 8.6% (81/939), respectively. The prevalence of isolated SBT was 20.2% (190/939), SBT combined with supraspinatus or infraspinatus tendon tear was 11.9% (112/939). In multivariable logistic regression analysis, dominant side involvement (p<0.001), manual labor (p=0.002), diabetes (p<0.001), metabolic syndrome (p<0.001), retraction degree of Patte tendon (p<0.001), posterosuperior RCT (p=0.010), and biceps tendon injury (p<0.001) were significantly associated with SBT. Conclusions: Metabolic syndrome is a potential risk factor for SBT, as are these factors: overuse activity, diabetes, posterosuperior RCT, increased retraction of posterosuperior rotator cuff tendon, and biceps tendon injury.

신생아 괸리의 지역화 및 전원시스템 (Regionalization of neonatal care and neonatal transport system)

  • 신종범
    • Clinical and Experimental Pediatrics
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    • 제50권1호
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    • pp.1-6
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    • 2007
  • In the United States, The concept of designation for hospital facilities that care for newborn infants according to the level of complexity of care provided was first proposed in 1976. The extent of perinatal health care regionalization varies widely from one area to the other. facilities that provide hospital care for newborn are classified into three categories on the basis of functional capabilities; level I-primary or basic care, level II-secondary or specialty care, level III-tertially or subspecialty care. These facilities should be organized within a regionalized system of perinatal care. The transport system of newborn infants should be organized for referral of high risk newborn to centers with the personnel and resources needed for their degree of risk and severity of illness. In Korea, The korean society of neonatology was established and articulated in the 1994. During the past decade, the number of neonatologist has increased and neonatal intensive care units have proliferated in Korea. However, no standard definitions exist for the graded levels of complexity of care that neonatal intensive care units provide and no uniform guideline or recommendation for regionalization and referral system of high risk neonate have been established. With the rapid changing neonatal care system in Korea, the optimal neonatal care demands regionalization of care in utilization of manpower resources and in efficient use of advanced technology and facility.