Kim, So-Mi;Hwang, Tae-Yoon;Nah, Min-Ah;Lee, Kyeong-Soo;Yeom, Seog-Heon
Journal of agricultural medicine and community health
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v.42
no.4
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pp.226-233
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2017
Objective: The purpose of this study was to describe and understand self-care status of the aged diabetic patients with noncompliance after hospital discharge. Methods: A qualitative research method was used for the study design. The participants were 15 diabetic patients aged 65 or older who had been admitted more than two times for hyperglycemia in the past 1 year in a general hospital in Daegu. Data were collected from November 1 2015 to March 1 2016 through in-depth personal interview. Results: Patients' knowledge level on causes and symptoms of diabetes was low. Most participants rarely and irregularly checked blood sugar at home. They were under a lot of stress from their family. Due to old age and illness they did not have sufficient physical activity and they have had rarely regular meals. They considered the self-care education program unnecessary and there was limitations of accessibility for education. Conclusions: The aged diabetic patients who had the repeat admission did not perform self-care activities properly and had problems especially in blood glucose check, support from their family, and health education after returning home. More personalized and community-based self-management education programs will be necessary.
Background : Primary multidrug-resistant tuberculosis is defined as Mycobacterium tuberculosis isolates that are resistant to at least isoniazid and rifampin in never-been-treated tuberculosis patients, and this malady is caused by the transmission of a resistant strain from one patient, who is infected with a resistant Mycobacterium tuberculosis strain, to another patient. The prevalence of primary multidrug-resistant tuberculosis could be a good indicator of the performance of tuberculosis control programs in recent years. We conducted a case-control study to identify the risk factors for primary multidrug-resistant tuberculosis. Methods : From January 1, 2001 to, June 30, 2003, by conducting prospective laboratory-based surveillance, we identified 29 hospitalized patients with P-MDRTB and these patients constituted a case group in this study. The controls were represented by all the patients with culture-confirmed drug susceptible tuberculosis who were admitted to National Masan Hospital during the same study period. The odds ratios for the patients with primary multidrug-resistant tuberculosis, as compared with those of the patients with drug susceptible tuberculosis, were calculated for each categorical variable with 95% confidence intervals. Results : Multivariate logistic regression showed that the presence of diabetes mellitus (odds ratio 2.68; 95% confidence interval, 1.05-6.86) was independently associated with having primary multidrug-resistant tuberculosis. Conclusion : This study has shown that diabetes mellitus might be one of the risk factors for primary multidrug-resistant tuberculosis.
This study aims to identify geographical variations and factors that affect smoking rates. The data are collected from the Community Health Survey conducted between 2009 and 2011 by Korea Centers for Disease Control and Prevention and other government organizations. Correlation and multiple regression analysis were used to examine the factors influencing smoking rates. For the purpose of investigating regional variations, we employed a decision tree model. The study has found that the significant factors associated with geographical variations in the smoking rates were the rate of hazardous drinking, the completion rate of hypertension education, the experience rate of anti-smoking campaigns, stress awareness rate, hypertension prevalence, health insurance cost, diabetes prevalence, obesity rate, and strength training rate. Convergence-based analysis on geographical variations of the smoking rates is highly important when the regionally customized healthcare programs is implemented. In the future, it is necessary to develop effective program and customized approach for the regions of high smoking rates. Our study is expected to be used as meaningful data for the design of effective health care programs and assessments to lead effective non-smoking program.
Objective: We investigated the clinical characteristics of men with testosterone replacement therapy (TRT)-induced hypogonadism and its effect on assisted reproductive technology (ART) in infertile couples. Methods: This study examined the records of 20 consecutive male patients diagnosed with azoospermia or severe oligozoospermia (< 5 × 106/mL) who visited a single infertility center from January 2008 to July 2018. All patients were treated at a primary clinic for erectile dysfunction or androgen deficiency symptoms combined with low serum testosterone. All men received a phosphodiesterase 5 inhibitor and TRT with testosterone undecanoate (Nebido®) or testosterone enanthate (Jenasteron®). Patients older than 50 years or with a chronic medical disease such as diabetes were excluded. Results: The mean age of patients was 37 years and the mean duration of infertility was 16.3 ± 11.6 months. At the initial presentation, eight patients had azoospermia, nine had cryptozoospermia, and three had severe oligozoospermia. Serum follicle-stimulating hormone levels were below 1.0 mIU/mL in most patients. Three ongoing ART programs with female factor infertility were cancelled due to male spermatogenic dysfunction; two of these men had normal semen parameters in the previous cycle. After withholding TRT, serum hormone levels and sperm concentrations returned to normal range after a median duration of 8 months. Conclusion: TRT with high-dose testosterone can cause spermatogenic dysfunction due to suppression of the hypothalamic-pituitary-testicular axis, with adverse effects on infertility treatment programs. TRT is therefore contraindicated for infertile couples attempting to conceive, and the patient's desire for fertility must be considered before initiation of TRT in a hypogonadal man.
Journal of the Korea Academia-Industrial cooperation Society
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v.12
no.2
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pp.765-774
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2011
The purpose of this study is to provide informative statistics which can be used for effective Diabetes Management Programs. We collected and analyzed the data of 666 diabetic people who had participated in Korean National Health and Nutrition Examination Survey in 2007 and 2008. Group classification on management behavior of Diabetic Mellitus is based on the K-means clustering method. The Decision Tree method and Multiple Regression Analysis were used to study factors of the management behavior of Diabetic Mellitus. Diabetic people were largely classified into three categories: Health Behavior Program Group, Focused Management Program Group, and Complication Test Program Group. First, Health Behavior Program Group means that even though drug therapy and complication test are being well performed, people should still need to improve their health behavior such as exercising regularly and avoid drinking and smoking. Second, Focused Management Program Group means that they show an uncooperative attitude about treatment and complication test and also take a passive action to improve their health behavior. Third, Complication Test Program Group means that they take a positive attitude about treatment and improving their health behavior but they pay no attention to complication test to detect acute and chronic disease early. The main factor for group classification was to prove whether they have hyperlipidemia or not. This varied widely with an individual's gender, income, age, occupation, and self rated health. To improve the rate of diabetic management, specialized diabetic management programs should be applied depending on each group's character.
Journal of Korean Academy of Fundamentals of Nursing
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v.10
no.2
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pp.171-180
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2003
Purpose: The purpose of this study was to investigate the relationship of self-efficacy, knowledge about the disease, and self-care behavior to the metabolic level in patients with NIDDM. Method: Data were collected from March 15 to April 15, 2001. Participants in the study were 48 patients with NIDDM who were seen regularly at the endocrinology out-patient department of Gwangju Christian Hospital. The data were collected through individual interviews and patient blood samples. The data were analyzed with SPSS/PC+, using t-test, ANOVA, Pearson correlation coefficients and Cronbach's Alpha. Result: 1. The mean score for self-efficacy was $71.37{\pm}15.56$, knowledge $15.00{\pm}2.84$, self-care behavior $63.18{\pm}13.10$. The mean score for HbAlc level was $7.66{\pm}1.77%$, HDL cholesterol level, $46.22{\pm}13.04 mg/dl$ and total cholesterol level, $187.93{\pm}41.45 mg/dl$. 2. There was a significant difference between patients with a spouse and those without one (t=-2.08, p=0.042), in knowledge according to level of obesity (t=5.14, p=0.010), duration of illness (t=3.22, p=0.031) and presence of complications related to diabetes (t=-2.58, p= 0.013). There were no significant differences in self-care behavior, but there were significant differences in sugar metabolic level according to sex (t=-2.02, p=0.050). 3. The correlation between diabetic patients' self-efficacy, knowledge and self-care behaviour and metabolic control was significantly related only to self-efficacy and self-care behavior (r=.692, p=0.000). Conclusion: It is necessary to improve self-efficacy, knowledge, and self-care behavior for patients with NIDDM by using nursing intervention programs to promote and maintain metabolic control.
The purpose of this study was to identify the association between health-related behaviors including smoking, alcohol intake, and the practice of a low-salt diet using data from a Community Health Survey conducted in 2008. The study subjects were 129,151 persons (19 years and older) without cardiovascular diseases or diabetes mellitus diagnosis history. An index for evaluating low salinity was created by summing three low salinity-related questions (range: 0~3), and a low-salt diet was defined if the index of low salinity was 3. We examined the levels of smoking and alcohol intake according to the index of low salinity, and conducted multiple logistic regression analysis to examine the odds ratios of low-salt diet practice in relation to smoking and drinking behavior, adjusting for general characteristics. The smoking and drinking status significantly improved as the level of low salinity index increase. Adjusting for general characteristics, those with smoking, alcohol intake, or a combined habit of the two behaviors had significantly lower odds ratios for practice of a low-salt diet. In conclusion, smoking and drinking behavior were negatively associated with the practice of a low-salt diet. Based on these findings, it may be necessary to have comprehensive nutritional education programs that consider the multiple effects of smoking, drinking, and a low-salt diet.
Gene set analysis (GSA) is useful in interpreting a genome-wide association study (GWAS) result in terms of biological mechanism. We compared the performance of two different GSA implementations that accept GWAS p-values of single nucleotide polymorphisms (SNPs) or gene-by-gene summaries thereof, GSA-SNP and i-GSEA4GWAS, under the same settings of inputs and parameters. GSA runs were made with two sets of p-values from a Korean type 2 diabetes mellitus GWAS study: 259,188 and 1,152,947 SNPs of the original and imputed genotype datasets, respectively. When Gene Ontology terms were used as gene sets, i-GSEA4GWAS produced 283 and 1,070 hits for the unimputed and imputed datasets, respectively. On the other hand, GSA-SNP reported 94 and 38 hits, respectively, for both datasets. Similar, but to a lesser degree, trends were observed with Kyoto Encyclopedia of Genes and Genomes (KEGG) gene sets as well. The huge number of hits by i-GSEA4GWAS for the imputed dataset was probably an artifact due to the scaling step in the algorithm. The decrease in hits by GSA-SNP for the imputed dataset may be due to the fact that it relies on Z-statistics, which is sensitive to variations in the background level of associations. Judicious evaluation of the GSA outcomes, perhaps based on multiple programs, is recommended.
Park, Myonghwa;Sung, Mi Ra;Kim, Sun Kyung;Lee, Dong Young
Journal of Korean Academy of Nursing
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v.44
no.4
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pp.351-360
/
2014
Purpose: This study was done to compare demographic characteristics, comorbidity, and health habits of elders with mild cognitive impairment (MCI) and elders with cognitively normal function (CNF). Methods: Secondary data analysis was conducted using data from the Database of the Seoul Dementia Management Project for 5,773 adults age 60 and above. Results: The MCI group showed an older age distribution, but there was no significant education difference between the two groups. Elders with MCI had more diabetes and stroke than elders with CNF. In subgroups, the same findings were observed in women, but not in men. While more men with MCI had hypertension compared to men with CNF, there was no significant difference in hypertension between the two groups for women. Elders with MCI, men in particular, had a lower prevalence of obesity than men with CNF. MCI individuals did less exercise compared to individuals with CNF. While there were no significant differences in alcohol consumption and smoking between MCI and CNF groups, the over 80's subgroup with MCI reported more alcohol consumption. Conclusion: Findings from this study could be helpful in designing community-based dementia prevention programs and health policies to reduce the prevalence of dementia or related cognitive impairments.
Background: The purpose of this study was to investigate the distribution of systemic diseases and medications in patients older than 65 years of age who visited the hospital for implant treatment, as well as to investigate basic information about surgical complications that may occur after insured implant treatment. Method: A total of 126 patients over 65 years of age were treated for implant surgery from October 1, 2013 to October 30, 2016. Electronic chart review was conducted to obtain medical records, which included sex, age, systemic diseases, medication(s) being taken, and control of the medications. Five patients were excluded due to lack of medical records giving information about systemic disease. Results: Of the 126 patients, 112 (88.9%) were taking medication due to systemic disease and 9 patients (7.1%) were not. The sex distribution was 71 women and 55 men and the highest proportion of patients were between 65 and 69 years old. The most common diseases were, from most to least frequent, hypertension, cardiovascular disease, diabetes, and osteoporosis. The drug groups that can cause major complications after dental treatment were classified as hemorrhagic, osteoporotic, and immunosuppressive agents, and were taken by 45 (35.7%), 22 (17.5%) and 4 (3.2%) patients, respectively. Conclusion: Given that 88.9% of the elderly patients who were eligible for insurance implant treatment had systemic disease, it is necessary to carefully evaluate patients' medical histories and their general conditions in order to prevent emergencies during implant surgery.
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