• Title/Summary/Keyword: metabolic patients

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Clinical outcomes of adjuvant radiation therapy and prognostic factors in early stage uterine cervical cancer

  • Kim, Hyun Ju;Rhee, Woo Joong;Choi, Seo Hee;Nam, Eun Ji;Kim, Sang Wun;Kim, Sunghoon;Kim, Young Tae;Kim, Gwi Eon;Kim, Yong Bae
    • Radiation Oncology Journal
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    • v.33 no.2
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    • pp.126-133
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    • 2015
  • Purpose: To evaluate the outcomes of adjuvant radiotherapy (RT) and to analyze prognostic factors of survival in the International Federation of Gynecology and Obstetrics (FIGO) IB-IIA uterine cervical cancer. Materials and Methods: We retrospectively reviewed the medical records of 148 patients with FIGO IB-IIA uterine cervical cancer who underwent surgery followed by adjuvant RT at the Yonsei Cancer Center between June 1997 and December 2011. Adjuvant radiotherapy was delivered to the whole pelvis or an extended field with or without brachytherapy. Among all patients, 57 (38.5%) received adjuvant chemotherapy either concurrently or sequentially. To analyze prognostic factors, we assessed clinicopathologic variables and metabolic parameters measured on preoperative 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). To evaluate the predictive performance of metabolic parameters, receiver operating characteristic curve analysis was used. Overall survival (OS) and disease-free survival (DFS) were analyzed by the Kaplan-Meier method. Results: The median follow-up period was 63.2 months (range, 2.7 to 206.8 months). Locoregional recurrence alone occurred in 6 patients, while distant metastasis was present in 16 patients, including 2 patients with simultaneous regional failure. The 5-year and 10-year OSs were 87.0% and 85.4%, respectively. The 5-year and 10-year DFSs were 83.8% and 82.5%, respectively. In multivariate analysis, pathologic type and tumor size were shown to be significant prognostic factors associated with both DFS and OS. In subset analysis of 40 patients who underwent preoperative PET/CT, total lesion glycolysis was shown to be the most significant prognostic factor among the clinicopathologic variables and metabolic parameters for DFS. Conclusion: Our results demonstrated that adjuvant RT following hysterectomy effectively improves local control. From the subset analysis of preoperative PET/CT, we can consider that metabolic parameters may hold prognostic significance in early uterine cervical cancer patients. More effective systemic treatments might be needed to reduce distant metastasis in these patients.

Self-management levels of diet and metabolic risk factors according to disease duration in patients with type 2 diabetes

  • Cho, Sukyung;Kim, Minkyeong;Park, Kyong
    • Nutrition Research and Practice
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    • v.12 no.1
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    • pp.69-77
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    • 2018
  • BACKGROUND/OBJECTIVES: Metabolic risk factors should be managed effectively in patients with type 2 diabetes mellitus (T2DM) to prevent or delay diabetic complications. This study aimed to compare the self-management levels of diet and metabolic risk factors in patients with T2DM, according to the duration of illness, and to examine the trends in self-management levels during the recent decades. SUBJECTS/METHODS: Data were collected from the Korea National Health and Nutrition Examination Surveys (KNHANES, 1998-2014). In our analysis, 4,148 patients with T2DM, aged ${\geq}30years$, were categorized according to the duration of their illness (< 5 years, 5-9 years, and ${\geq}10years$). Demographic and lifestyle information was assessed through self-administered questionnaires, and biomarker levels (e.g., fasting glucose level, blood pressure, or lipid level) were obtained from a health examination. Dietary intake was assessed by a 24-recall, and adherence level to dietary guidelines (meal patterns and intake levels of calories, carbohydrates, vegetable/seaweed, sodium, and alcohol) were assessed. Multivariable generalized linear regression and unconditional logistic regression models were used to compare the prevalence rates of hyperglycemia, dyslipidemia, and hypertension according to the duration of patients' illness, accounting for the complex survey design of the KNHANES. RESULTS: In the multivariable adjusted models, patients with a longer duration (${\geq}10years$) of T2DM had a higher prevalence of hyperglycemia than those with a shorter duration of T2DM (< 5 years) (odds ratio 2.20, 95% confidence interval 1.61-3.01, P for trend < 0.001). We did not observe any associations of disease duration with the prevalence of hypertension and dyslipidemia. In addition, the adherence levels to dietary recommendations did not significantly differ according to disease duration, except adherence to moderate alcohol consumption. There were significant decreasing trends in the prevalence of hyperglycemia in patients with a duration of illness ${\geq}10years$ (P for trend = 0.004). CONCLUSION: Although the proportion of patients with adequate control of glucose levels has improved in recent decades, poorer self-management has been found in those with a longer disease duration. These findings suggest the need for well-planned and individualized patient education programs to improve self-management levels and quality of life by preventing or delaying diabetic complications.

Relationship between Metabolic Syndrome and Cataract in a Middle-Aged Men over the Age of 40's -Based on the 5th Korean National Health and Nutrition Examination Survey- (40세 이상 중장년의 대사증후군과 백내장과의 관련성 -제5기 국민건강영양조사 자료중심으로-)

  • Hwang, Hye-Kyung;Park, Chun Man
    • The Journal of Korean Society for School & Community Health Education
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    • v.16 no.2
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    • pp.17-31
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    • 2015
  • Objectives: This study aimed to analyze the relationship between metabolic syndrome and cataract in a middle-aged men over the age of 40's by using the data from the 5th Korean National Health and Nutrition Examination Survey(2010~2012). Methods: The subjects for the analysis were comprised of 5,808 patients who were at least 40 years or more with metabolic syndrome and cataract. The comparison between the metabolic syndrome and ophthalmic diseases according to the health demographic characteristics, health behavior and health conditions was analyzed with ${\chi}^2-test$. The complex samples logistic regression analysis was used to calculate the odds ratio of cataract according to the health demographic characteristics, health behavior and health conditions and the combination of the comprising factors of the metabolic syndrome. Results: After controlling the confounding factors, the odds ratio of cataract in the metabolic syndrome group was OR 1.30, which was significantly high (p<0.01). Furthermore, the odds ratio of cataract was significantly high in the case of males, as the age increased, educational level decreased, with exercising habits of less than 3 days a week, sun exposure of at least 5 hours, with hypertension and diabetes (p<0.01). The results of analyzing the odds ratio for the occurrence of cataract with the components of metabolic syndrome were OR 1.36 (concurrent high fasting blood glucose, high triglycerides, low HDL cholesterol), OR 1.63 (concurrent high fasting blood glucose, high triglycerides, high waist circumference) and OR 1.33 (high triglycerides, low HDL cholesterol, high waist circumference), which showed significantly high odds ratio for cataract occurrence (p<0.05). Conclusions: We come to know that the relation between metabolic syndrome and components are associate with cataract. Therefore the thorough management of metabolic syndrome and components is needed to prevent cataract.

10-year Analysis of Inherited Metabolic Diseases Diagnosed with Tandem Mass Spectrometry (탠덤 매스 검사(Tandem Mass Spectrometry)를 이용한 선천성 대사이상 선별검사 10년간의 분석)

  • Lee, Bomi;Lee, Jiyun;Lee, Jeongho;Kim, Suk Young;Kim, Jong Won;Min, Won-Ki;Song, Woon Heung;Song, Jung Han;Woo, Hang Jae;Yoon, Hye Ran;Lee, Yong-Wha;Choi, Koue Young;Choi, Tae Youn;Lee, Dong Hwan
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.17 no.3
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    • pp.77-84
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    • 2017
  • Purpose: From the early 1990's, use of Tandem mass spectrometry in neonatal screening test, made early stage detection of disorders that was not detectable by the previous methods of inspection. This research aims to evaluate the frequency of positive results in national neonatal screening test by Tandem mass spectrometry and its usefulness. Methods: A designated organization for inherited metabolic disorder executed neonatal screening test on newborns using Tandem mass spectrometry from January 2006 to December 2015, followed by the investigation of these data by the Planned Population Federation of Korea (PPFK), and this research analyzed those inspected data from the PPFK. Results: Among total childbirth of 4,590,606, from January 2006 to December 2015, 3,445,238 were selected for MS/MS and conduction rate was 75.1%. 261 out of the selected 3,445,238 were confirmed patients and for last decade, detection rate of total metabolic disorder was 1/13,205. In 261 confirmed patients, 120 had an amino acid metabolic disorder and its detection rate was 1/28,710 and 110 had an organic acid metabolic disorder and detection rate was 1/31,320. Also, 31 had a fatty acid metabolic disorder and detection rate was 1/13,205. Conclusion: Inherited metabolic disorder is very rare. Until now, it was difficult to precisely grasp an understanding on the national incidence of inherited metabolic disorder, due to lack of overall data and inconsistent and incomplete long-term result analysis. However, this research attempted to comprehensively approach the domestic incidence, by analyzing previous 10 years of data.

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Comparison of Health-related Quality of Life Influencing Factors between Metabolic Syndrome and Osteoporotic Metabolic Syndrome in Korean Elderly People (대사증후군 노인과 골다공증을 동반한 대사증후군 노인의 건강관련 삶의 질 영향 요인 비교)

  • Kim, Eun-Sook
    • Journal of Convergence for Information Technology
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    • v.11 no.3
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    • pp.54-67
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    • 2021
  • This study is a secondary data study that analyzes the factors affecting the quality of life of the elderly with metabolic syndrome and the elderly with metabolic syndrome with osteoporosis using data from the 7th year of the National Health and Nutrition Survey (2018). The subjects of this study were 639 patients with metabolic syndrome and 161 patients with metabolic syndrome with osteoporosis. For data analysis, the composite sample Rao-Scott χ2 test, general linear model t-test, and regression model were used. As a result of the study, the factors that lowered the quality of life of metabolic syndrome were age, cohabitation, strength training, subjective health status, activity restriction, body mass index and depression, and the explanatory power was 50.4% (F=515.96, p<.001). In metabolic syndrome with osteoporosis, age, subjective health status, activity restriction, and stress were the factors that lowered the quality of life, and the explanatory power was 48.6% (F=10.42, p<.001). Based on these results, it is necessary to develop and provide an intensive multidisciplinary program for the elderly with metabolic syndrome accompanied by osteoporosis to solve the problem of activity restrictions and manage stress reduction through positive acceptance of health status, instrumental and social support, and caring support.

Negative myoclonus associated with tramadol use

  • Bae, Seong Yoon;Lee, Se-Jin
    • Journal of Yeungnam Medical Science
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    • v.37 no.4
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    • pp.329-331
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    • 2020
  • Negative myoclonus (NM) is a shock-like jerky involuntary movement caused by a sudden, brief interruption of tonic muscle contraction. NM is observed in patients diagnosed with epilepsy, metabolic encephalopathy, and drug toxicity and in patients with brain lesions. A 55-year-old man presented with NM in both his arms and neck. He has taken medications containing tramadol at a dose of 80-140 mg/day for 5 days due to common cold. He had no history of seizures. Acute lesions were not observed during magnetic resonance imaging, and abnormal findings in his laboratory tests were not noted. His NM resolved completely after the discontinuation of tramadol and the oral administration of clonazepam. Our case report suggests that tramadol can cause NM in patients without seizure history or metabolic disorders, even within its therapeutic dose.

Longterm Benefit and Unmet Needs in Enzyme Replacement Therapy of Gaucher (고셔병 환자에서 효소대체치료의 장기적 효과와 한계)

  • Kim, Yoo-Mi
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.14 no.1
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    • pp.42-47
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    • 2014
  • Gaucher disease is a multisystemic disorder arising from a deficient activity of the lysosomal enzyme glucocerebrosidase, which leads to accumulation of glycosylceraide and other glycolipids in the regiculoendothelial system. The characteristics of Gaucher disease are anemia, thrombocytopenia, hepatosplenomegaly, and skeletal disease. Enzyme replacement therapy (ERT) has been proven to prevent progressive manifestations of Gaucher disease and effective in improving anemia, thrombocytopenia, bone markers and biomarkers. However, some patient needs still remain unmet because of the inaccessibility of certain sites including brain, bone and various organs. ERT could not Improve the irreversible lesion such as liver fibrosis, hepatopulmonary syndrome, and necrosis or infarction of bone and other organs. Adult patients with Gaucher disease should be screened for longterm complication such as bone disease, pulmonary hypertension, gallstone, and cancer, especially in patients with splenectomy. Parkinsonism and polyneuropathy was also reported among patients with type 1 Gaucher disease, but ERT does not improve neurological function. We need to review the benefits and unmet needs of ERT in Gaucher disease.

Quantitative and Qualitative Assessment of Dietary Intake in Metabolic Syndrome Patients (대사증후군 환자의 양적 및 질적 식사섭취상태 평가)

  • Kang, Myung-Hwa;Choi, Mi-Kyeong
    • The Korean Journal of Food And Nutrition
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    • v.29 no.4
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    • pp.456-464
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    • 2016
  • The purpose of this study was to compare the quantitative and qualitative assessment of dietary intake between patients with metabolic syndrome (MetS) and healthy subjects and to investigate dietary factors related to MetS. Anthropometric measurements, blood analysis, and dietary intake as assessed by 24-hour recall were conducted in MetS patients (n=15) and healthy subjects (n=25). In order to assess the quantity and quality of dietary intake, daily nutrient intake, nutrient density, nutrient intake to dietary reference intake (DRI), nutrient adequacy ratio (NAR), food intake, dietary diversity score (DDS), and dietary variety score (DVS) were analyzed. The statistical differences between MetS patients and controls were analyzed using the SAS software program. Daily energy intake and food intake were not significantly different between the two groups (2,154.3 kcal vs. 1,872.9 kcal; 1,280.0 g vs. 1,261.6 g). There were also no significant differences in daily nutrient intake, nutrient intake ratio to DRI, NAR, or DVS between the MetS group and the control group. However, daily intake of eggs and milk in MetS patients was significantly lower than in the control group (9.0 g/day vs. 30.3 g/day, p<0.05; 0 g/day vs. 49.7 g/day, p<0.05). These results indicate that low intake of eggs and dairy products may be related to the development of MetS.

A Systematic Review of Traditional Herbal Medicine Treatments for Metabolic Syndrome in Patients Receiving Antipsychotic Drugs (항정신병약물 복용 환자의 대사증후군에 대한 한약치료의 체계적 문헌고찰)

  • Sun-Woo Lim;O-Reun Park;So-Hyeon Park;Sung-Youl Choi;Bo-Kyung Kim;Jung-Hwa Lim
    • Journal of Oriental Neuropsychiatry
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    • v.35 no.1
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    • pp.69-99
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    • 2024
  • Objectives: This study aimed to systematically review the effectiveness and safety of traditional herbal medicine treatments for metabolic syndrome (MS) in patients receiving antipsychotic drugs (APs). Methods: We searched 11 domestic and foreign databases for randomized controlled trials (RCTs) using traditional herbal medicines for MS in patients receiving APs. Results: Twenty RCTs conducted in China were included in the analysis. The most common disease among the participants was schizophrenia. Most studies used the 2004 Chinese Diabetes Society (CDS) standards as the diagnostic criteria for MS. The most used prescription was Yukultang (Liuyu-tang). The most used herbal material was Pinelliae Rhizoma, followed by Poria, Citri Reticulatae Pericarpium, and Glycyrrhizae Radix et Rhizoma. Traditional herbal medicines were mostly reported to improve the symptoms of MS. Conclusions: Traditional herbal medicines may be effective in improving the symptoms of MS in patients receiving APs. However, the quality of the included studies was low, and the studies were heterogeneous. Methodologically rigorous clinical studies on traditional herbal medicine treatments for MS in patients receiving APs are needed.

Early dropout predictive factors in obesity treatment

  • Michelini, Ilaria;Falchi, Anna Giulia;Muggia, Chiara;Grecchi, Ilaria;Montagna, Elisabetta;De Silvestri, Annalisa;Tinelli, Carmine
    • Nutrition Research and Practice
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    • v.8 no.1
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    • pp.94-102
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    • 2014
  • Diet attrition and failure of long term treatment are very frequent in obese patients. This study aimed to identify pre-treatment variables determining dropout and to customise the characteristics of those most likely to abandon the program before treatment, thus making it possible to modify the therapy to increase compliance. A total of 146 outpatients were consecutively enrolled; 73 patients followed a prescriptive diet while 73 followed a novel brief group Cognitive Behavioural Treatment (CBT) in addition to prescriptive diet. The two interventions lasted for six months. Anthropometric, demographic, psychological parameters and feeding behaviour were assessed, the last two with the Italian instrument VCAO Ansisa; than, a semi-structured interview was performed on motivation to lose weight. To identify the baseline dropout risk factors among these parameters, univariate and multivariate logistic models were used. Comparison of the results in the two different treatments showed a higher attrition rate in CBT group, despite no statistically significant difference between the two treatment arms (P = 0.127). Dropout patients did not differ significantly from those who did not dropout with regards to sex, age, Body Mass Index (BMI), history of cycling, education, work and marriage. Regardless of weight loss, the most important factor that determines the dropout appears to be a high level of stress revealed by General Health Questionnaire-28 items (GHQ-28) score within VCAO test. The identification of hindering factors during the assessment is fundamental to reduce the dropout risk. For subjects at risk, it would be useful to dedicate a stress management program before beginning a dietary restriction.