• Title/Summary/Keyword: aged 35 years and older

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Efficacy and Safety of Daclatasvir and Asunaprevir Combination Therapy in Elderly Chronic Hepatitis C Patients (고령의 만성 C형 간염 환자에서 Daclatasvir와 Asunaprevir 병용 요법의 유효성 및 안전성 평가)

  • Park, You Kyung;Shin, Su Jin;Choi, You Ock;Choi, Hye Jung;Kang, Jin Suk;Hwangbo, Shin-Yi
    • Journal of Korean Society of Health-System Pharmacists
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    • v.35 no.4
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    • pp.453-462
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    • 2018
  • Background : The prevalence of chronic hepatitis C virus (HCV) tends to be higher in the elderly. Pegylated interferon and ribavirin therapy (Peg-IFN/RBV) was recommended as the first-line treatment in the past decades, but this regimen showed unsatisfactory results in terms of safety and efficacy especially in elderly patients. Recently, it was demonstrated that dual therapy with daclatasvir and asunaprevir was well tolerated and led to high sustained virological response (SVR) rates, irrespective of age. We conducted a study to evaluate the efficacy and safety of daclatasvir plus asunaprevir by involving elderly patients aged above 65 years. Methods : We retrospectively analyzed clinical data from chronic hepatitis C virus (HCV) genotype 1b patients treated with daclatasvir plus asunaprevir from September 2015 to December 2016 at Seoul St. Mary's hospital. The patients were divided into two groups as elderly patients (older than 65 years) and non-elderly patients (younger than 65 years) and compared the efficacy and safety. Results : A total of 112 patients were treated with daclatasvir plus asunaprevir for chronic hepatitis C. Among them, 101 patients completed the whole treatment, and in 88 patients the amount of HCV RNA was measured after 12 weeks of treatment. There was no significant difference in SVR at 12 weeks between both the groups (p=0.68). Typically, 91.4%(32/35) of elderly patients and 94.3%(50/53) of non-elderly patients achieved SVR12. Common adverse events included elevation in transaminase level, headache, and gastrointestinal disorders. There was no statistical difference in the symptoms between the two groups. Conclusions : The combination therapy with daclatasvir plus asunaprevir exhibited similar rates of SVR12 in HCV elderly patients without leading to further adverse events compared to non-elderly patients. Therefore, it is proposed that daclatasvir plus asunaprevir therapy could be considered as an effective and safe treatment, even in patients aged over 65 years.

Children's Awareness of Racial Features, Racial In-Group Classification and Racial Preference According to Visual and Language Features (유아의 인종적 신체 특징 인식, 외모와 언어 단서에 따른 내집단 범주화 및 선호도)

  • Lee, Jungmin;Lee, Kangyi
    • Korean Journal of Child Studies
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    • v.35 no.2
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    • pp.85-102
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    • 2014
  • The purpose of this study was to examine the awareness of racial features, racial in-group classification and preference by Korean children. The study participants comprised 89 children aged 3-5 years. The children performed photograph description and choice tasks. The major findings were as follows: First, older children were significantly more likely than younger children to use racial feature and less likely to use general physical feature to describe the stimuli. Second, children tended to select the South-Asian person speaking in Korean language as a Korean, rather than the Korean person speaking in English. Third, children tended to select the person of Korean appearance speaking in English as a playmate. The result revealed the developmental features of racial awareness. Furthermore the correspondence of language plays an important role on the children's in-group classification whereas the correspondence of appearance plays an important role on the children's preference.

A computed tomography-based analysis of the structure of the mandible according to age and sex

  • Jung, Soyeon;Yun, Hyunjong;Chung, Chul Hoon;Kim, Kuylhee;Chang, Yongjoon
    • Archives of Craniofacial Surgery
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    • v.23 no.3
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    • pp.103-110
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    • 2022
  • Background: The primary objectives of mandibular surgery are to achieve optimal occlusion, low sensory disturbance, and adequate fixation with early movement. In-depth knowledge of the mandibular structure is required to achieve these goals. This study used computed tomography (CT) to evaluate the mandibular cortical thickness and cancellous space according to age and sex. Methods: We enrolled 230 consecutive patients, aged 20 to 50 years, who underwent CT scanning. The cortex and cancellous space centered around the inferior alveolar nerve (IAN) canal were measured at two specific locations: the lingula and second molar region. Statistical analysis of differences according to increasing age and sex was performed. Results: The t-test revealed that the cancellous space and cortical thickness differed significantly with respect to the threshold of 35 years of age. Both cortical thickness and cancellous space in the molar region were negatively correlated with age. Meanwhile, both cortical thickness and cancellous space in the lingula region showed a positive correlation with age. With respect to sex, significant differences in the cancellous space at the molar region and the cortical thickness at the lingula were observed. However, no further statistically significant differences were observed in other variables with respect to sex. The sum of each measurement on the mandibular body reflected the safe distance from the surface of the outer cortex to the IAN canal. The safe distances also showed statistically significant differences between those above and below 35 years of age. Conclusion: Knowledge of the anatomical structure of the mandible and of changes in bone structure is crucial to ensure optimal surgical outcomes and avoid damage to the IAN. CT examination is useful to identify changes in the bone structure, and these should be taken into account in the planning of surgery for older patients.

Sleep problems in children and adolescents at pediatric clinics

  • Kim, Dong Soon;Lee, Cho Long;Ahn, Young Min
    • Clinical and Experimental Pediatrics
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    • v.60 no.5
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    • pp.158-165
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    • 2017
  • Purpose: To investigate the frequency of childhood sleep problems at pediatric clinics in Seoul and Gyeonggi provinces. Methods: Children (n=936) and their parents who visited 5 primary and 1 secondary pediatric outpatient clinics were invited to complete a Pediatric Sleep Questionnaire. Results: Among patients, 901 (96.3%) answered questionnaires in sufficient detail for evaluation. The participant's mean age was $4.35{\pm}3.02years$ (range, 0-18 years). The male to female ratio was 1:0.93 (466 boys, 435 girls). Habitual snoring (>3 day/week) was reported in 16.9% of the participants. The prevalence of habitual snoring in children <2 years and those between 2-5 years was 9% and 18%, respectively. Sleep disordered breathing was found in 15.1% (106 of 700) of children >2 years. Insomnia was reported in 13.2% of children. The prevalence of sleepwalking, night terrors, and bruxism, is 1.6%, 19%, and 21.1%, respectively. Snoring was associated with increased incidence of sleepwalking, night terrors, and bruxism. Age was associated with insomnia and habitual snoring (P<0.05). Insomnia was more prevalent in younger (21%) than in older children (6%). Snoring was more frequent in both preschool (34%) and school-aged children (33%). The frequency of sleep disordered breathing and insomnia did not vary significantly with gender. However, snoring was more prevalent in boys. Conclusion: Sleep problems are frequent among children in Korea. Children with snoring have an increased risk of sleepwalking, night terror, and bruxism. Primary clinicians should consider children's sleep habits to improve their health.

한국인의 평균 유배우여명에 관한 연구

  • 윤병준
    • Korea journal of population studies
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    • v.11 no.2
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    • pp.22-32
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    • 1988
  • This study was conducted in order to compare the sequential changes of marital partnership and average marital life expectancy in Korea using Korean marriage life table for 1970, 1980, and 1985. The marriage life table was constructed by the Wolfbein-Wool method of constructing a working life table. Data used in this study was obtained from the Population Census Reports of Korea and the Korean Abridged life Tables. Some of the finding may be summarized as follows : 1. The marital partnership findings showed that males in the 40-44 age group in 1970 and in 1980 and those in the 45-49 bracket in 1985 have the highest rates of any other age interval, the percentages were 97.5% 97.3% and 96.9% respectively. The highest marital partnership rates for females were those aged 30-34 in 1970 and in 1980 and 35-39 in 1985:these were 94.6% 94.3% and 93.30% respectively. 2. The marital rate of the youngest age group has decreased due to the increasing amount of people marrying at older ages. On the other hand, the marital rates of the elderly has increased slightly due to the decreasing mortality rate. 3. The enterance rate of marriage at the 15-19 female age group ad the 20-24 male age group has decreased. 4. The secession rate of marriage has gradually decreased due to the decrease in the mortality rate. The main reason of secession for males is his own death. For females, the main reasons are divorce and the death of her spouse. 5. Korean average marital life expectancy has improved in general. In 1985 the average marital life expectancy for males was higher by 4-5 years than for females. The average difference of marital expectancy and life expectancy is about 1.4 - 1.5 years for males and about 11-14 years at the age groups below 60 years for females.

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Development of prediction model identifying high-risk older persons in need of long-term care (장기요양 필요 발생의 고위험 대상자 발굴을 위한 예측모형 개발)

  • Song, Mi Kyung;Park, Yeongwoo;Han, Eun-Jeong
    • The Korean Journal of Applied Statistics
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    • v.35 no.4
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    • pp.457-468
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    • 2022
  • In aged society, it is important to prevent older people from being disability needing long-term care. The purpose of this study is to develop a prediction model to discover high-risk groups who are likely to be beneficiaries of Long-Term Care Insurance. This study is a retrospective study using database of National Health Insurance Service (NHIS) collected in the past of the study subjects. The study subjects are 7,724,101, the population over 65 years of age registered for medical insurance. To develop the prediction model, we used logistic regression, decision tree, random forest, and multi-layer perceptron neural network. Finally, random forest was selected as the prediction model based on the performances of models obtained through internal and external validation. Random forest could predict about 90% of the older people in need of long-term care using DB without any information from the assessment of eligibility for long-term care. The findings might be useful in evidencebased health management for prevention services and can contribute to preemptively discovering those who need preventive services in older people.

The Development of Physical Functioning Scale for Community-Dwelling Older Persons (지역사회 노인의 신체기능 평가도구 개발)

  • Lee, Kyung-Jong;Han, Geun-Shik;Yoon, Soo-Jin;Lee, Yeon-Kyung;Kim, Chan-Ho;Kim, Jeong-Lim;Lee, Yun-Hwan
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.4
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    • pp.359-374
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    • 2002
  • Objectives : To develop a physical functioning instrument for older adults living in the community. Methods : A representative sample of 979 people aged 65 years or over were interviewed in-person. Of these, 199 people also completed a detailed in-hospital examination. The scale items were selected based on the frequency of endorsement, along with the item-total and inter-item correlations. The associations of the scale with their physical performance and clinical examination were analyzed to evaluate the criterion-related validity. Construct validity was assessed using factor analysis, and internal consistency through Cronbach's alpha and item-total correlations. Test-retest reliability was measured by agreement between the household survey and the repeat survey at the in-hospital examination. Results : Initially, 23 items on the level of difficulty, ranging from no difficulty to an inability to complete a task, with the specific mobility and self-care tasks were included. Those with a high frequency of endorsement and a low inter-item or item-total correlations were excluded, resulting in a 10-item Physical Functioning (PT) scale. Equal weights were given to each item and a summated score was calculated. Significant associations were found between the PF scores and the physical performance, surrey and clinical data. The scale revealed a 2-factor (mobility and self-care) structure. Cronbach's alpha was 0.92 and the item-total correlations were in the 0.63 to 0.78 range. Pearson's correlations for the test-retest ranged between 0.56 and 0.61. Conclusions : The newly developed Physical Functioning (PF) scale showed good psychometric properties in older people. Further work, however, is needed to improve its sensitivity to discriminate higher levels of functioning, in addition to assessing its predictive value in detecting changes in health.

Comparison of Cardiovascular Risk Profile Clusters Among Industrial Workers

  • Hwang, Seon-Young;Lee, Ji-Hyun
    • Journal of Korean Academy of Nursing
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    • v.35 no.8
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    • pp.1500-1507
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    • 2005
  • Purpose. The purpose of this study was to identify subgroups of the physical and behavioral risk profiles for cardiovascular disease among industrial workers, and to examine predicting factors for the subgroups. Sample and Method. Health records of 2,616 male and female workers aged 19-56 years who were employed in an airplane manufacturing industry were analyzed. Data were analyzed using the Latent class cluster analysis. Results. Four different clusters (two high-risk groups, one low-risk group, and one normal group) were found and these clusters were significantly different by age, gender, and work type (p < .05 ). The two high-risk groups had higher chances of drinking alcohol, elevated BMI, FBS, total cholesterol, having hypertension, and were significantly older, and had relatively high chances of being day workers rather than other groups. The low-risk group had higher chances of drinking alcohol, higher BMI and total cholesterols compared to normal group, and highest portions of current smokers and shift workers in the four clusters and their mean BP was within prehypertension criteria. Conclusion. Industrial nurses should guide the lifestyle behaviors and risk factors of the high risk groups for CVD and need to intervene early for behavioral change for the low-risk group who are young and shift workers. Age, and work environment should be considered in planning for targeted preventive interventions for industrial workers.

Pneumonectomy for Clinical Stage I Non-Small Cell Lung Cancer in Elderly Patients over 70 Years of Age

  • Kim, Tae Ho;Park, Byungjoon;Cho, Jong Ho;Kim, Hong Kwan;Choi, Yong Soo;Kim, Kwhan-Mien;Shim, Young Mog;Zo, Jaeil;Kim, Jhingook
    • Journal of Chest Surgery
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    • v.48 no.4
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    • pp.252-257
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    • 2015
  • Background: Lobectomy is the generally accepted standard treatment for early-stage non-small cell lung cancer (NSCLC). However, especially in elderly patients, it is often necessary to perform pneumonectomy in order to maximize the likelihood of curative treatment, although pneumonectomy is a challenging procedure. Methods: We analysed patients who were clinically diagnosed with stage I NSCLC and underwent pneumonectomy with curative intent from 2004 to 2011. The patients were divided into an elderly group (${\geq}70$ years) and a younger group (<70 years). We retrospectively analysed the outcomes of these groups of patients in order to characterize the role of pneumonectomy as a treatment for elderly patients with clinical stage I NSCLC. Results: Thirty patients younger than 70 years of age (younger group) and fourteen patients 70 years of age or older (elderly group) who underwent pneumonectomy were enrolled in the present study. The median follow-up period was 35 months (range, 0 to 125 months). The perioperative mortality rate (within 90 days after the operation) was 7.1% in the elderly group and 6.7% in the younger group (p=0.73). No significant differences between the two groups were observed regarding the occurrence of pneumonia, acute respiratory distress syndrome, cardiac arrhythmia, bronchopleural fistula, and vocal cord paralysis. The overall five-year survival rate was 79.4% in the younger group and 35.7% in the elderly group, which was a significant difference (p=0.018). The five-year disease-free survival rate was 66.7% in the younger group and 35.7% in the elderly group, but this difference was not statistically significant (p=0.23). Conclusion: Although elderly patients with early stage lung cancer showed a worse long-term survival rate after pneumonectomy than younger patients, the outcomes of elderly patients were similar to those of younger patients in terms of perioperative mortality and postoperative complications. Patients should not be denied pneumonectomy solely due to old age.

Nationwide Incidence Estimation of Uterine Cervix Cancer among Korean Women (한국 여성에서의 자궁경부암 발생률)

  • Park, Byung-Joo;Lee, Moo-Song;Ahn, Yoon-Ok;Choi, Young-Min;Ju, Yeong-Su;Yoo, Keun-Young;Kim, Hun;Yew, Ha-Seung;Park, Tae-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.4 s.55
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    • pp.843-851
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    • 1996
  • To estimate the incidence of uterine cervix cancer among Korean women, we have conducted a study using the claim data on the beneficiaries of Korea Medical Insurance Corporation (KMIC). All medical records of the potential cases with diagnosis of ICD-9 180, 181, 182, 199, 219, 233 in the claims sent by medical care institutions in the whole country to the KMIC from January 1988 to December 1989, were abstracted and Gynecology specialist reviewed the records to identify the new cases of uterine cervix cancer among the potential cases during the corresponding period. Using these data, the incidence of uterine cervix cancer among Korean women was estimated as of July 1, 1988 to June 30, 1989. The crude rate was estimated to be 17.34(95% CI: $16.76\sim17.92$) per 100,000 and the cumulative rates for the ages $0\sim64\;and\;0\sim74$ were 1.7% and 2.2%, respectively. The age-adjusted rate for the world population was 19.93 per 100,000 which was higher than those of other Asian countries including China and Japan in $1983\sim1987$. The truncated rate for ages $35\sim64$ was 52.05 per 100,000 which was one of the highest in the world. With increasing age, the incidence rate increased to 78.11 per 100,000 in women aged $55\sim59$ years, then it decreased in the older groups. This finding suggests that detecting rate of uterine cervix cancer may decrease in women aged 60 years or older due to inadequate medical care seeking behavior. In the geographical area, the SIR of Jeju province was significantly low but it might be due to statistical unstability by small case numbers.

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