As with humans, overweight or obesity is a major health concern in the companion animal population. A cross-sectional questionnaire-based survey of dog owners attending primary small animal veterinary practices from different areas in Chuncheon, Kangwon province, Korea was undertaken to explore the relationships between socioeconomic and other relevant risk factors associated with canine obesity. In addition, the author was to estimate the prevalence of obesity compared to published literatures for dogs. Owners were asked about dog age, neuter status, feeding habits, dog exercise, household income and owner age. The body condition score (BCS) of the dogs was also assessed. Multivariable binary logistic regression was used to assess the association between BCS and potential risk factors controlling for confounding variables, using odds ratios (OR), 95% confidence intervals (CIs). A total of 275 dogs (136 males and 139 females) aged 1-12 years (mean age $5.6{\pm}3.7$ years) were surveyed in 2013. Of these, 46.9% of dogs (n = 129) were classed as an ideal body shape (BCS = 3), 30.9% (n = 85) were overweight (BCS = 4), 8.4% (n = 23) were obese (BCS = 5) and 13.8% (n = 38) were underweight (BCS = 1 or 2). Neutered males and spayed females had the highest prevalence of obesity (43.4% and 33.9%); intact females had the lowest prevalence of obesity (31.6%). In univariable model, risk factors associated with canine obesity are multifactorial and include owner income, owner age, age of dog, neuter status, frequency of feeding per day, frequency of snacks and consultation with veterinarian on dog's weight. In final multivariable logistic regression model, dogs whose owners reported no consultation with veterinarians for weight management were significantly more likely to be obesity than ideal (OR = 7.6, 95% CI, 4.2-13.8; p < 0.0001). This study showed a high prevalence of obesity in domestic companion dogs. Since this was a cross-sectional study with small samples, the association of canine obesity with risk factors warrants more research. To the author's best knowledge, this is the first Korean study on dog body condition and obesity.
Background: Reported age standardized incidence rates for esophageal cancer in Iran are 0.88 and 6.15 for females and males, at fifth and the eighth ranks, respectively, of cancers overall. The present study aimed to map relative risk using more realistic and less problematic methods than common estimators. Materials and Methods: In this ecological investigation, the studied population consisted of all esophageal cancer patients in Iran from 2005 to 2007. The Bayesian multilevel space-time model with three levels of county, province, and time was used to measure the relative risk of esophageal cancer. Analyses were conducted using R package INLA. Results: The total number of registered patients was 7,160. According to the results, the three-level model with adjustment for risk factors of physical activity and smoking had the best fit among all models. The overall temporal trend was significantly increasing. At county level, Ahar, Marand, Salmas, Bojnoord, Saghez, Sarakhs, Shahroud and Torbatejam had the highest relative risks. Physical activity was found to have significant direct association with risk of developing esophageal cancer. Conclusions: Given to great variation across geographical areas, many different factors affect the incidence of esophageal cancer. Conducting further studies at the individual level in areas with high incidence could provide more detailed information on risk factors of esophageal cancer.
Objectives: Prospective evaluations of the associations between depressive symptoms and suicide deaths have been mainly performed in high-risk populations, such as individuals with psychiatric disorders or histories of self-harm. The purpose of this study was to prospectively examine whether more severe depressive symptoms assessed using the Geriatric Depression Scale (GDS) were associated with a greater risk of death from suicide in a general-risk population. Methods: A total of 113 478 men from the Korean Veterans Health Study (mean age, 58.9 years) who participated in a postal survey in 2004 were followed up for suicide mortality until 2010. Results: Over 6.4 years of follow-up, 400 men died by suicide (56.7 deaths per 100 000 person-years). More severe depressive symptoms were associated with greater risk of suicide death (p for trend <0.001). The unadjusted hazard ratios (HRs) in comparison to the absence of depression were 2.18 for mild depression, 2.13 for moderate depression, 3.33 for severe depression, and 3.67 for extreme depression. After adjusting for potential confounders, men with a potential depressive disorder had an approximate 90% higher mortality from suicide (adjusted HR, 1.92; 95% confidence interval [CI], 1.38 to 2.68; p<0.001) than men without depression. Each five-point increase in the GDS score was associated with a higher risk of death by suicide (adjusted HR, 1.22; p<0.001). The value of the area under the receiver operating characteristics curve of GDS scores for suicide deaths was 0.61 (95% CI, 0.58 to 0.64). Conclusions: Depressive symptoms assessed using the GDS were found to be a strong independent predictor of future suicide. However, the estimate of relative risk was weaker than would be expected based on retrospective psychological autopsy studies.
Kim, Jong Joo;Jang, Eun Jin;Cho, Junwoo;Sohn, Hyun Soon
Korean Journal of Clinical Pharmacy
/
v.29
no.3
/
pp.147-155
/
2019
Objectives: The purpose of this study was to investigate the association between fracture risk and proton pump inhibitor (PPI) use to establish evidence for defining high-risk groups of fracture among PPI users. Methods: A case-control study was performed using the National Health Insurance Sample Cohort Database from January 2002 to December 2013. The cases included all incidences of major fractures identified from January 2011 to December 2013, and up to four controls were matched to each case by age, gender, osteoporosis, and Charlson comorbidity index. Conditional logistic regression was used to calculate the adjusted odds ratio (aOR) and associated 95% confidence interval (CI). Results: Overall, 14,295 cases were identified, and 63,435 controls were matched to the cases. The aOR of fractures related to the use of PPIs was 1.06 (95% CI: 1.01-1.11). There was a statistically significant association between fracture and PPI use within 3 months of the last dose, and a trend of increasing fracture risk with increasing cumulative PPI dose. The risk of fracture was significantly higher in patients who took PPIs for more than 1 year during the 2-year observation period. Conclusion: Patients who have been using PPIs for more than 1 year should be warned about the risk of fracture during or at least 3 months after discontinuing the PPI.
Objective : Low back pain (LBP) is a global health problem that affects the productivity of the patients. Several factors such as individual, occupational, and psychosocial factors increase the risk of LBP. However, only a few studies investigated those factors, especially in middle adulthood in Indonesia. Indonesia is a country with a young population that has been rapidly developing in recent years. This study was conducted to find out the factors associated with LBP in middle adulthood. Methods : This study is a cross-sectional observational analytic study using a convenience sampling method with a total sample of 3005 respondents. Data were collected using a questionnaire which was then analyzed using the chi-square test, Kolmogorov-smirnov, Spearman's Rank, and logistic regression test. Results : From the result of this study, it was found that the 12-month prevalence of LBP in middle-aged adults was 44,29%. Female (odds ratio [OR], 1.3; 95% confidence interval [Cl], 1.098-1.545; p=0.002), lack of physical exercises (OR, 0.87; 95% Cl, 0.794-0.959; p=0.005), high body mass index (OR, 1.09; 95% Cl, 1.009-1.187; p=0.002), stress level (OR, 1.26; 95% Cl, 1.088-1.458; p=0.002), and years of work experience (OR, 1.1; 95% Cl, 1.001-1.225; p=0.047) were determined as risk factors that significantly associated with LBP. Conclusion : LBP is quite common among middle-aged adults in Indonesia. Female gender, higher body mass index, lack of physical activity, stress level, and years of work experience were all potential risk factors for LBP in middle-aged adults. Middle-aged adults in Indonesia should be aware of LBP and avoid disabilities by identifying risk factors that may worsen LBP in the future.
Breast cancer (BC) is the most common cancer in females (27% of the total) and the main cause of death (16%) due to cancer in women in developed and developing countries. Variations in its incidence rate among geographical areas are due to various contributing factors. Since there have been a lack of studies on this topic in our country, the present spatial analysis of breast cancer incidence in Iran in 2009 was conducted using data from the national cancer registry system. The reported incidences of the disease were standardized according to the World Health Organization population and the direct method. Then data was inserted into the GIS software and finally, using the Hot Spot Analysis (Geties-Ord Gi), high-risk areas were drawn. Provinces with incidences 1.96 SD higher or lower than the national average were considered as hot spots or cold spots, at the significance level of 0.05%. In 2009, a total of 7,582 cases of BC occurred in Iran. The annual incidence was 33.2 per hundred thousand people. Our study showed that the highest incidence of BC in women occurred in the central provinces of the country, Tehran, Isfahan, Yazd, Markazi and Fars. The results of hot spots analysis showed that the distribution of high-risk BC was focused in central parts of Iran, especially Isfahan province (p <0.01). The other provinces were not significantly different from the national average. The higher incidence in central provinces may be due to greater exposure to carcinogens in urban areas, a Western lifestyle and high prevalence of other risk factors. Further epidemiological studies about the etiology and early detection of BC are essential.
The goal of respiratory management in high risk infants is to maintain proper oxygenation by supporting respiration, therefore to minimize the secondary complications and to promote the maximum growth and development. While on artificial ventilator to achieve this goal, the infants require endotracheal suctioning(ETS) to remove lung secretions. However, the negative effects of ETS in neoates have been documented and include hypoxia, bradycardia, mucosal damage, increased intracranial pressure, and death result. The purpose of the study was to investigate how ETS is currently performed in NICU, which would be beneficial to develop the standardized ETS protocol and to apply it to these population. A national-wide survey on clinical protocol of ETS was performed to 149 neonatal nurses with the average of 3 years and 6 months experience in neonatal nursing, 34.2% of whom was bachelor in nursing. The results showed that about 89% of the nurses initiate En primarily based on the need of the subjects. The aseptic regulation on ETS was used in 83.9% of the subjects. There was no regulation on the length of catheter in 32.9% and on ID/OD ratio in 17.4%. Many nurses administered hyperoygenation/hyperinflation/hyperventilation based on personal knowhow, rather than scientific rationals (77.2%, 40.9%, 75.2%, retrospectively). About 41% of the nurse regulate subjectively the suction power, while 73.8% of them rotate the sub ject's head during suctioning and the half of the nurses was favorable in adapting the closed-suctioning protocol. With the findings of the study, the current clinical application of E% in neonates appears to be based on adult care practices, or personal preference, rather than scientific validation of the safety and effectiveness of the procedure. This study support the needs for developing and applying the standardized ETS protocolin conjunction with the consideration given to the physiologic characteristics of the neonates in respiratory distress.
Dyslipidemia, mainly characterized by high triglyceride (TG) and low high-density lipoprotein cholesterol (HDL-C) levels, is an important etiological factor in the development of cardiovascular disease (CVD). Considering the relationship between childhood obesity and CVD risk, it would be worthwhile to evaluate whether previously identified lipid-related variants in adult subjects are associated with lipid variations in a childhood obesity study (n = 482). In an association analysis for 16 genome-wide association study (GWAS)-based candidate loci, we confirmed significant associations of a genetic predisposition to lipoprotein concentrations in a childhood obesity study. Having two loci (rs10503669 at LPL and rs16940212 at LIPC) that showed the strongest association with blood levels of TG and HDL-C, we calculated a genetic risk score (GRS), representing the sum of the risk alleles. It has been observed that increasing GRS is significantly associated with decreased HDL-C (effect size, $-1.13{\pm}0.07$) compared to single nucleotide polymorphism combinations without two risk variants. In addition, a positive correlation was observed between allelic dosage score and risk allele (rs10503669 at LPL) on high TG levels (effect size, $10.89{\pm}0.84$). These two loci yielded consistent associations in our previous meta-analysis. Taken together, our findings demonstrate that the genetic architecture of circulating lipid levels (TG and HDL-C) overlap to a large extent in childhood as well as in adulthood. Post-GWAS functional characterization of these variants is further required to elucidate their pathophysiological roles and biological mechanisms.
In 2008, baby formula containing melamine was found to be responsible for a large outbreak of renal failure in infants in China. A total of 294,000 infants were hospitalized, and at least 6 babies died due to ingestion of the tainted formula. Melamine contains high levels of nitrogen (>60%), which is used as an indicator of protein content. Therefore, high levels of melamine in infant formula were thought to be the result of deliberate contamination m an attempt to increase its apparent protein content. Following inspections by China's national inspection agency, assorted products from at least 22 dairy manufacturers across China were found to have varied levels of melamine (range: 0.096196.61 mg/kg). Melamine co-exposure with cyanuric acid can induce acute melamine-cyanurate crystal nephropathy, which can lead to renal failure at much lower doses than if either compound were ingested alone. However, currently, there are very few data on melamine analogues other than cyanuric acid. At an expert meeting of the WHO and FAO held to review toxicological aspects of melamine and cyanuric acid on December 14, 2008, a new tolerable daily intake (TDI) of melamine was established that could be applied to the entire population, including infants. Therefore, a risk assessment of the various theoretical melamine contamination levels in infant formula and selected representative foods (other than infant formula and sole-source nutrition products) is urgently needed for Korean babies and children up to 7 years of age. Although the undetectable level regulation for infant formula may be low enough to guarantee the safety of babies under the age of 1 year (including premature babies), the melamine standard of 2.5 ppm for foods other than baby formula could be insufficient to protect the 95th percentile population aged 1~2 years because of this demographic's high consumption of milk, yogurt, and soy milk (hazard index = 1.79). Because TDIs are chronic values intended to protect an individual over his/her lifetime, occasional modest ingestion in excess of the TDI is not likely to be a health concern. However, children aged 1~2 years may have renal systems that are comparatively more sensitive to the crystallization of melamine and its analogues. Therefore, governmental jurisdictions may need to practice more prudent management of food items that could raise the melamine exposure for this population.
We tried to analyze the HPV prevalence and HPV genotypes of sexually high-risk women living in Busan, the biggest seaport of South Korea. Six hundred sixty women engaging in high-risk occupations participated in this study. The prevalence of HPV infection and HPV genotyping were determined with $MyGene^{(R)}$ HPVDNA chip, which consisted of 16 high-risk HPV genotypes (oncogenic genotypes) and 8 low-risk HPV genotypes. The overall prevalence of HPV infection in this study population was 39.1% (258/660) and the 20's showed the highest prevalence of HPV infection (51.5%). The dominant HPV genotypes including single or multiple HPV-infected women were resulted in HPV-16 (15.9%), -53 (10.2%), -58 (7.7%), -18 (5.2%) in case of high-risk HPV genotype and HPV-70 (10.4%), -6 (4.1%), -11 (2.0%) in case of low-risk HPV genotypes. Remarkably, the proportion of women infected with high-risk HPV genotypes (62.0%) was almost four times higher than those of women infected with low-risk HPV genotypes (14.7%) and high/low-risk HPV genotypes (12.0%). Among the 258 HPV-infected women, single infection was 175, double infection 66, triple infection 12, quadruple infection 4, quintuple infection 1, respectively. Our finding suggests that the introduction and development of effective HPV vaccines should consider the current status of HPV genotypic infection in South Korean women.
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