• Asian Pacific Journal of Cancer Prevention
• /
• 제17권7호
• /
• pp.3489-3494
• /
• 2016

Background: A major problem with cervical cancer screening in countries which have no organized national screening program for cervical cancer is sub-optimal participation. Implementation of self-sampling method may increase the coverage. Objective: We determined the agreement of cytological diagnoses made on samples collected by women themselves (self-sampling) versus samples collected by physicians (Physician sampling). Materials and Methods: We invited women volunteers to undergo two procedures; cervical self-sampling using the Evalyn brush and physician sampling using a Cervex brush. The women were shown a video presentation on how to take their own cervical samples before the procedure. The samples taken by physicians were taken as per routine testing (Gold Standard). All samples were subjected to Thin Prep monolayer smears. The diagnoses made were according to the Bethesda classification. The results from these two sampling methods were analysed and compared. Results: A total of 367 women were recruited into the study, ranging from 22 to 65 years age. There was a significant good agreement of the cytological diagnoses made on the samples from the two sampling methods with the Kappa value of 0.568 (p=0.040). Using the cytological smears taken by physicians as the gold standard, the sensitivity of self-sampling was 71.9% (95% CI:70.9-72.8), the specificity was 86.6% (95% CI:85.7-87.5), the positive predictive value was 74.2% (95% CI:73.3-75.1) and the negative predictive value was 85.1% (95% CI: 84.2-86.0). Self-sampling smears (22.9%) allowed detection of micro-organisms better than physicians samples (18.5%). Conclusions: This study shows that samples taken by women themselves (self-sampling) and physicians have good diagnostic agreement. Self-sampling could be the method of choice in countries in which the coverage of women attending clinics for screening for cervical cancer is poor.

• Clinical and Experimental Pediatrics
• /
• 제60권11호
• /
• pp.353-358
• /
• 2017

Purpose: To develop and evaluate a simple screening tool to assess hearing loss in newborns. A derived score was compared with the standard clinical practice tool. Methods: This cohort study was designed to screen the hearing of newborns using transiently evoked otoacoustic emission and auditory brain stem response, and to determine the risk factors associated with hearing loss of newborns in 3 tertiary hospitals in Northern Thailand. Data were prospectively collected from November 1, 2010 to May 31, 2012. To develop the risk score, clinical-risk indicators were measured by Poisson risk regression. The regression coefficients were transformed into item scores dividing each regression-coefficient with the smallest coefficient in the model, rounding the number to its nearest integer, and adding up to a total score. Results: Five clinical risk factors (Craniofacial anomaly, Ototoxicity, Birth weight, family history [Relative] of congenital sensorineural hearing loss, and Apgar score) were included in our COBRA score. The screening tool detected, by area under the receiver operating characteristic curve, more than 80% of existing hearing loss. The positive-likelihood ratio of hearing loss in patients with scores of 4, 6, and 8 were 25.21 (95% confidence interval [CI], 14.69-43.26), 58.52 (95% CI, 36.26-94.44), and 51.56 (95% CI, 33.74-78.82), respectively. This result was similar to the standard tool (The Joint Committee on Infant Hearing) of 26.72 (95% CI, 20.59-34.66). Conclusion: A simple screening tool of five predictors provides good prediction indices for newborn hearing loss, which may motivate parents to bring children for further appropriate testing and investigations.

• 한국임상약학회지
• /
• 제20권1호
• /
• pp.78-84
• /
• 2010

Background: Clostridium difficile is the primary reason of the nosocomial diarrhea. The antimicrobial therapy plays a central role in the pathogenesis of Clostridium difficile associated diarrhea (CDAD). Although nearly all classes of antimicrobial agents have been associated with CDAD, clindamycin and the third-generation cephalosporins have traditionally been considered to the greatest risk factor. Recent studies have also implicated fluoroquinolones as high-risk agents due to increasing use of the agents. This study was to determine the incidence and the risk factors of CDAD related to the administered antibiotics and to assess the therapeutic regimen of metronidazole or vancomycin based on the C. difficile toxin assay Methods: A retrospective study was performed in patients with Clostridium difficile toxin assay at I Hospital (Incheon, South Korea) during the period from January 2007 through December 2007. Administrative, laboratory, and pharmacy data were collected from Electronic Medical Databases. Results: The analysis included 129 reported C.difficile toxin assay results, with 42 positive cases and 87 negative cases. Significant antibiotic risk factors for CDAD included the use of the fourth-generation cephalosporinse (OR=5.97, 95% CI 1.37-25.98, P=0.017). Administration of metronidazole was protective against CDAD (OR=0.30, 95% CI 0.12-0.74, P=0.009). Prolonged antimicrobial therapy has been associated with an increased risk of CDAD. The third-generation cephalosporins (OR=3.81, 95% CI 1.08-13.41, P=0.037) and aminoglycoside (OR=5.50, 95% CI 1.43-21.10, P=0.013) demonstrated greater risk for CDAD over 15 days than 8days or less days of treatment duration. Conclusions: The fourth and third generation cephalosporin, aminglycoside were the significant risk factors compared with other antibiotics, whereas metronidazole appears to be protective. The longer duration of antiobiotic use increased CDAD.

• Gut and Liver
• /
• 제12권6호
• /
• pp.633-640
• /
• 2018

Background/Aims: Obesity is a risk factor for gastroesophageal reflux disease (GERD), with several studies demonstrating positive associations between body mass index (BMI) and GERD symptoms. However, little is known about the effect of BMI changes on erosive esophagitis (EE). In this study, we investigated whether BMI reduction could resolve EE. Methods: A retrospective cohort study was performed to assess the natural course of EE according to changes in BMI. Participants undergoing health check-ups from 2006 to 2012 were enrolled, and 1,126 subjects with EE were included. The degree of esophagitis was measured by upper endoscopy and serially checked over a 5-year follow-up. Logistic regression and Cox proportional hazards models were used to investigate the association between BMI reduction and EE resolution. Results: Substantial weight loss is associated with EE resolution. The adjusted odds ratio for EE resolution was 1.44 (95% confidence interval [CI], 1.09 to 1.92) among participants with a decrease in BMI compared to those with no decrease in BMI. The EE resolution rate was related to the degree of BMI reduction. The effect of weight loss on EE resolution was higher among subjects who lost more weight. Compared with subjects with no decrease in BMI, the hazard ratios for EE resolution were 1.09 (95% CI, 0.89 to 1.35), 1.31 (95% CI, 1.01 to 1.72) and 2.12 (95% CI, 1.44 to 3.12) in subjects with BMI reductions of ${\leq}1$, 1-2, and >$2kg/m^2$, respectively. Conclusions: EE resolution is associated with a decrease in BMI, and weight loss is potentially an effective GERD treatment.

• Journal of Korean Medical Science
• /
• 제33권48호
• /
• pp.295.1-295.7
• /
• 2018

Background: Vancomycin-resistant enterococci (VRE) infections have become a major healthcare-associated pathogen problem worldwide. Nosocomial VRE infections could be effectively controlled by screening patients at high risk of harboring VRE and thereby lowering the influx of VRE into healthcare centers. In this study, we evaluated factors associated with VRE colonization in patients transferred to emergency departments, to detect patients at risk for VRE carriage. Methods: This study was conducted in the emergency department of a medical college-affiliated hospital in Korea. Every patient transferred to the emergency department and admitted to the hospital from January to December 2016 was screened for VRE using rectal cultures. In this cross-sectional study, the dependent variable was VRE colonization and the independent variables were demographic and clinical factors of the patients and factors related to the transferring hospital. Patients were divided into two groups, VRE and non-VRE, and previously collected patient data were analyzed. Then we performed logistic regression analyses of characteristics that differed significantly between groups. Results: Out of 650 patients, 106 (16.3%) had positive VRE culture results. Significant variables in the logistic analysis were transfer from geriatric long-term care hospital (adjusted odds ration [aOR]: 8.017; 95% confidence interval [CI]: 1.378-46.651), hospital days (4-7 days; aOR: 7.246; 95% CI: 3.229-16.261), duration of antimicrobial exposure (1-3 days; aOR: 1.976; 95% CI: 1.137-3.436), and age (aOR: 1.025; 95% CI: 1.007-1.043). Conclusion: VRE colonization in patients transferred to the emergency department is associated primarily with factors related to the transferred hospitals rather than demographic and clinical characteristics.

• 한국융합학회논문지
• /
• 제10권1호
• /
• pp.239-244
• /
• 2019

본 연구의 목적은 우리나라 30세이상 성인의 혈청지질분포와 치주질환간의 관련성을 파악하고자 하였다. 본 연구자료는 2013년, 2014년 국민건강영양조사 자료를 병합하여 이용하였으며, 최종분석대상자는 8,854명이었다. 치주질환은 지역사회치주지수를 이용하였으며, 혈청지질분포와 치주질환간의 관련성을 파악하기 위해 로지스틱회귀분석을 이용하였다. 연구결과 HDL 이 ${\leq}40mg/dL$ 인 경우에서 치주질환 교차비가 1.39배(95% CI=1.16-1.66)증가하였으며, Triglyceride가 ${\geq}200mg/dL$ 인 경우에서 치주질환 교차비가 1.14배(95% CI=1.02-1.27) 유의하게 증가하였다. HDL과 Triglyceride가 치주질환과 유의한 관련성이 있음을 확인하였다. 따라서, 향후 연구에서는 혈청지질분포와 치주질환간의 실질적 관련성을 파악하고 인과관계와 직접적인 연관성을 파악해야 할 것이다.

• 한국치위생학회지
• /
• 제19권2호
• /
• pp.265-275
• /
• 2019

Objectives: The aim of this study was to investigate trends of oral health behaviors in Korean adolescents. Methods: From the 2005 to 2017 Korea Youth Risk Behavior web-based Survey (KYRBS) Secondary Data (study to 748,461). Independent variables were the year, gender, grade, and living area. Dependent variables were the rate of tooth-brushing after lunch, scaling, use of sealant, and oral health education within 1 year. Chi-squire tests were used to estimate the rate of oral health behaviors and trends. In addition, multiple logistic regression analysis was used to estimate the association between socio-economic characteristics and oral health behaviors. The analyses were conducted using IBM SPSS statistics 21 (version 21.0, IBM Corporation, New York, NY, USA). Results: The rate of tooth-brushing after lunch and use of sealant have significantly increased every year. Oral health behaviors were significantly associated with socio-economic characteristics. The rate of oral health education was higher among males than females, which was in contrast to other oral health behaviors. The scores for tooth-brushing after lunch, use of sealant, and scaling in females were 2.33 (95% CI; 2.27-2.40), 1.31 (95% CI; 1.29-1.33), and 1.20 (95% CI; 1.18-1.22), which were higher than those in males. The score for use of sealant in the highest household economy group was 1.13 (95% CI; 1.10-1.17), which was higher than the lowest economy group. Conclusions: We found positive trends of oral health behaviors in Korean adolescents.

• 대한영양사협회학술지
• /
• 제27권1호
• /
• pp.35-44
• /
• 2021

This study analyzed the intake of calories and nutrients based on the consumption of black beans. The survey was conducted on 124 college students (male: 42, female: 82), of whom 63.7% (79 students) were consumers of black beans. The calorie intake of the black bean intake group (1599.81±555.48 kcal) was significantly higher than that of the non-black bean intake group (1259.99±507.58 kcal) (P<0.01). The black bean intake group also showed a significantly higher intake of crude protein (P<0.05), plant protein (P<0.01), animal protein (P<0.05), crude fiber (P<0.001), plant calcium (P<0.001), plant iron (P<0.001), zinc (P<0.01), vitamin B2 (P<0.01), vitamin C (P<0.01), vitamin E (P<0.01) and folic acid (P<0.001) compared to the non-black bean intake group. There was a positive correlation between the frequency of black bean intake and crude fiber (P<0.05), plant calcium (P<0.05), plant iron (P<0.05), and folic acid (P<0.05). Overall, the black bean intake group was more likely to eat black sesame 13.82 times (95% CI=5.37, 35.55), white beans 10.79 times (95% CI=3.53, 33.02), mung beans 7.22 times (95% CI=2.58, 20.23), and brown rice 4.72 times (95% CI=1.88, 11.84), than the non-black bean intake group. In conclusion, we believe that black beans constitute a vital food ingredient that is necessary to provide Korean college students with a well-balanced diet.

• Clinical and Experimental Emergency Medicine
• /
• 제5권4호
• /
• pp.264-271
• /
• 2018

Objective For patients with acute myocardial infarction (AMI), symptoms assessed by emergency medical services (EMS) providers have a critical role in prehospital treatment decisions. The purpose of this study was to evaluate the diagnostic accuracy of EMS provider-assessed cardiac symptoms of AMI. Methods Patients transported by EMS to 4 study hospitals from 2008 to 2012 were included. Using EMS and administrative emergency department databases, patients were stratified according to the presence of EMS-assessed cardiac symptoms and emergency department diagnosis of AMI. Cardiac symptoms were defined as chest pain, dyspnea, palpitations, and syncope. Disproportionate stratified sampling was used, and medical records of sampled patients were reviewed to identify an actual diagnosis of AMI. Using inverse probability weighting, verification bias-corrected diagnostic performance was estimated. Results Overall, 92,353 patients were enrolled in the study. Of these, 13,971 (15.1%) complained of cardiac symptoms to EMS providers. A total of 775 patients were sampled for hospital record review. The sensitivity, specificity, positive predictive value, and negative predictive value of EMS provider-assessed cardiac symptoms for the final diagnosis of AMI was 73.3% (95% confidence interval [CI], 70.8 to 75.7), 85.3% (95% CI, 85.3 to 85.4), 3.9% (95% CI, 3.6 to 4.2), and 99.7% (95% CI, 99.7 to 99.8), respectively. Conclusion We found that EMS provider-assessed cardiac symptoms had moderate sensitivity and high specificity for diagnosis of AMI. EMS policymakers can use these data to evaluate the pertinence of specific prehospital treatment of AMI.

• The Korean Journal of Pain
• /
• 제35권4호
• /
• pp.447-457
• /
• 2022

Background: Ultrasound-guided genicular nerve radiofrequency (RF) procedures are of interest in the management of chronic knee pain. A wide variety of demographic, clinical, and procedural characteristics can affect treatment success. This study aimed to determine predictive factors to provide superior treatment outcomes. Methods: The demographic, clinical, and technical data of patients who received genicular nerve RF for knee pain between September 2016 and September 2021 were evaluated. A positive outcome was defined as at least 50% pain relief on a pain score for at least 6 months. Logistic regression analysis was performed to determine the factors associated with a successful response to genicular RF. Results: Among 206 patients who underwent genicular RF, 62% of the patients reported successful outcomes at 6 months. In the multivariate model, targeting 5 nerves (odds ratio [OR], 6.184; 95% confidence interval [CI], 2.291-16.690; P < 0.001) was the most significant predictor of successful outcomes. Multivariable logistic regression analysis showed that prognostic genicular nerve block with a 50% cut-off value (OR, 2.109; 95% CI, 1.038-4.287; P = 0.039), no opioid use (OR, 2.753; 95% CI, 1.405-5.393; P = 0.003), and depression (OR, 0.297; 95% CI, 0.124-0.713; P = 0.007) were the predictive factors significantly associated with response to genicular RF. Conclusions: Clinical and technical factors associated with better treatment outcomes were ultimately targeting more nerves, performing prognostic block, no opioid use, and no depression. These results are expected to be considered when selecting patients for genicular RF.