• Title/Summary/Keyword: prospective cohort

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Whole pelvic intensity-modulated radiotherapy for high-risk prostate cancer: a preliminary report

  • Joo, Ji Hyeon;Kim, Yeon Joo;Kim, Young Seok;Choi, Eun Kyung;Kim, Jong Hoon;Lee, Sang-Wook;Song, Si Yeol;Yoon, Sang Min;Kim, Su Ssan;Park, Jin-Hong;Jeong, Yuri;Ahn, Hanjong;Kim, Choung-Soo;Lee, Jae-Lyun;Ahn, Seung Do
    • Radiation Oncology Journal
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    • v.31 no.4
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    • pp.199-205
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    • 2013
  • Purpose: To assess the clinical efficacy and toxicity of whole pelvic intensity-modulated radiotherapy (WP-IMRT) for high-risk prostate cancer. Materials and Methods: Patients with high-risk prostate cancer treated between 2008 and 2013 were reviewed. The study included patients who had undergone WP-IMRT with image guidance using electronic portal imaging devices and/or cone-beam computed tomography. The endorectal balloon was used in 93% of patients. Patients received either 46 Gy to the whole pelvis plus a boost of up to 76 Gy to the prostate in 2 Gy daily fractions, or 44 Gy to the whole pelvis plus a boost of up to 72.6 Gy to the prostate in 2.2 Gy fractions. Results: The study cohort included 70 patients, of whom 55 (78%) had a Gleason score of 8 to 10 and 50 (71%) had a prostate-specific antigen level > 20 ng/mL. The androgen deprivation therapy was combined in 62 patients. The biochemical failure-free survival rate was 86.7% at 2 years. Acute any grade gastrointestinal (GI) and genitourinary (GU) toxicity rates were 47% and 73%, respectively. The actuarial rate of late grade 2 or worse toxicity at 2 years was 12.9% for GI, and 5.7% for GU with no late grade 4 toxicity. Conclusion: WP-IMRT was well tolerated with no severe acute or late toxicities, resulting in at least similar biochemical control to that of the historic control group with a small field. The long-term efficacy and toxicity will be assessed in the future, and a prospective randomized trial is needed to verify these findings.

Vitamin D and Depression (비타민 D와 우울증)

  • Cho, Su Kyung;Koo, Sle;Park, Kyong
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.43 no.10
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    • pp.1467-1476
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    • 2014
  • Recent studies have shown that insufficient or deficient vitamin D status may be linked to increased risk of depressive conditions or depression. The aim of this study was to review all available evidence on vitamin D, depression, and any association between them. Cross-sectional, case-control, and cohort studies have reported contradictory results. Some have reported that low levels of vitamin D may be associated with higher risk of depression or depressive symptoms while others reported that vitamin D status may not be related to depression. Recent clinical trials examining the effects of vitamin D supplementation on depression have also showed discrepant results. However, meta-analysis study results are consistent regarding the beneficial effects of vitamin D. Several mechanisms that account for these beneficial effects of vitamin D on depression have been reported but remain largely speculative. Vitamin D deficiency is very common, and prevalence of depression is increasing in the Asian population, especially females. However, limited literature is available on this population. Considering research results of a potential inverse association between vitamin D level and prevalence of depression, it is important to advance our understanding of the role of vitamin D in depression and conduct well-designed prospective trials in the Asian population.

A Public-Private Collaboration Model for Treatment Intervention to Improve Outcomes in Patients with Tuberculosis in the Private Sector

  • Kim, Hee Jin;Bai, Gill-Han;Kang, Mi Kyung;Kim, Sang Jae;Lee, Jong Koo;Cho, Sung-Il;Lew, Woo Jin
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.5
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    • pp.349-357
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    • 2009
  • Background: The treatment success rates in patients with tuberculosis are known to be lower in the private sector compared to the public sector. To improve treatment outcomes in the private sector we developed a public-private collaboration model for strengthening health education and case holding activities with public health nursing in the private sector. Methods: We performed a prospective cohort study in new smear positive pulmonary tuberculosis patients treated at private hospitals, selected by non-randomization, with an intervention consisting of health education and case holding activities by specially trained public health nurses (intervention group) results were compared with cases treated without the intervention (conventional group). Physicians were asked to treat both groups routinely. The treatment outcomes of patients under treatment by the National Tuberculosis Programme were also analyzed for comparison. Results: There were 172 cases each in the intervention and conventional groups. The mean age was 48.9${\pm}$19.0 and 48.2${\pm}$19.7 in the respective groups (p=0.66). The PHN interacted with the cases in the intervention group by initial face to face interview and telephone calls an average of 7.1${\pm}$9.2 times during the initial six months. The intervention group showed a significantly higher treatment success rate, 91.6%, (Rate Ratio [RR]; 1.23, 95% Confidence Interval [CI]; 1.12-1.36), lower default, 3.6%, (RR; 0.31, 95% CI; 0.13-0.75) and transfer-out rate, 3.0%, (RR; 0.32, 95% CI; 0.12-0.86) than the conventional group where they were: 75.0%, 11.6%, 9.3%, respectively. The success rate was even higher than the rate (80.5%) of 1,027 cases treated in health centers (RR; 1.11, 95% CI; 1.05-1.17). Of the completed cases in the intervention group, 82.2% regarded the role of the public health nurse as very helpful. Conclusion: The treatment success rate, of tuberculosis patients in the private sector, was significantly improved by an intervention using a public-private collaboration model.

Correlation Between Nitrogen Dioxide as an Air Pollution Indicator and Breast Cancer: a Systematic Review and Meta-Analysis

  • Keramatinia, Aliasghar;Hassanipour, Soheil;Nazarzadeh, Milad;Wurtz, Morten;Monfared, Ayad Bahadori;Khayyamzadeh, Maryam;Bidel, Zeinab;Mhrvar, Narges;Mosavi-Jarrahi, Alireza
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.1
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    • pp.419-424
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    • 2016
  • Background: The aim of this systematic review was to study the relationship between exposure to nitrogen dioxide ($NO_2$) in the ambient air and breast cancer incidence. Materials and Methods: A systematic review was performed based on the MOOSE guideline for review of observational studies. We searched five online databases (PubMed, Science Direct, Google Scholar, EBSCO, and Scopus) from their conception to June 2014. A pooled estimate of the correlation between $NO_2$ exposure and breast cancer incidence was calculated using Pearson's correlation coefficient. Results: A total of 654 titles were retrieved in the initial search of the databases. Further refinement and screening of the retrieved studies produced a total of five studies from four countries. The studies included three ecological studies (aggregate level) and two individual based studies (one prospective cohort and the other one a case-control study). The ecological studies were pooled and the meta-analysis of correlation coefficient without z transformation showed a pooled estimate of r = 0.89 with 95% CI of 0.84 to 0.95. Using z transformation, the pooled r was 1.38 with 95%CI of 1.11 to 1.59. No significant heterogeneity between studies was observed. Following a sensitivity analysis and the removal of each study from pooled analysis we did not see any significant change in the pooled estimate. Conclusions: It was concluded that there is a tendency toward a weak association between exposure to $NO_2$ in ambient air and breast cancer at the individual level and a significant association at the aggregate level.

Reproducibility and Validity of a Self-Administered Semiquantitative Food Frequency Questionnaire (자기기록식 반정량 식이섭취 빈도조사의 신뢰도 및 타당도 연구)

  • 김미경;이상선;안윤옥
    • Korean Journal of Community Nutrition
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    • v.1 no.3
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    • pp.376-394
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    • 1996
  • This study evaluated the reproducibility and validity of the self-administered semiquantitative food frequency questionnaire used in a large prospective cohort study(Korean Cancer Research Survey) in middle-aged men. The questionnaire was administered twice at an interval of approximately two years(December, 1992-January, 1995), and four or five 24-hour recalls for each subject were collected at intervals of approximately three months. The results were as follows; 1) Although the distributions of the data estimated by the questionnaire were somewhat wider, the mean nutrient intakes of group estimated by our questionnaires and the multiple 24-hour recalls were roughly comparable. 2) The reproducibility determined by correlation of absolute(unadjusted nutrient intake) and calorie adjusted nutrient intakes from two semiquantitative food frequency questionnaires were more than 0.5, and the weighted kappa values were more than 0.4. 3) The Pearson correlation coefficients between unadjusted nutrient intakes values were average 0.40 on the average(Ca, 0.13-Carbohydrate, 0.58) at the first questionnaire vs. 24-hour recalls, and 0.28 at the second questionnaire vs. 24-hour recalls. The spearman rank order correlation coefficients were similar. When energy intake was adjusted, there was a slight reduction : 0.28 at the second questionnaire, 0.25 average on the second. In order to correct the measurement error of 24-hour recall data, the deattenuated correlation coefficient was calculated. It averaged 0.53 on the first questionnaire, 0.37 on the second questionnaire for unadjusted nutrient intake. for calorie-adjusted nutrient intake, it averaged 0.44 on the first questionnaire, 0.37 on the second questionnarie. 4) There was lower agreement(k<0.4) between the questionnaries and the 24-hour recalls. And the subjects classified in the same quartile by 24-hour recalls and first questionnaire were average 37$\%$(energy-adjusted values) and 40$\%$(unadjusted values) on the average. More than k10$\%$(average) of subjects were in the extreme quartile of the questionnarie and 24-hour recall method. But 8.2$\%$(average) of subjects classified in the lowest quartile of unadjusted nutrient intake level by the 24-hour recalls were in the highest quartile by the first questionnaire. These data indicate that our self-administered semiquantitative food frequency questionnarie is reproducible. Correlation coefficients comparing nutrient intakes measured by two different dietary assessment methods were less than 0.5. The validity of our questionnarie is not high enough.

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The relationship of dietary sodium, potassium, fruits, and vegetables intake with blood pressure among Korean adults aged 40 and older

  • Kim, Mi Kyung;Kim, Kirang;Shin, Min-Ho;Shin, Dong Hoon;Lee, Young-Hoon;Chun, Byung-Yeol;Choi, Bo Youl
    • Nutrition Research and Practice
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    • v.8 no.4
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    • pp.453-462
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    • 2014
  • BACKGROUND/OBJECTIVES: The inverse relationships of combined fruits and vegetables intake with blood pressure have been reported. However, whether there are such relationships with salty vegetables has rarely been investigated in epidemiologic studies. We evaluated the relation of combined and separate intake of fruits, vegetable intakes, and salty vegetables, as well as sodium and potassium, with blood pressure among the middle-aged and elderly populations. SUBJECTS/METHODS: The present cross-sectional analysis of a prospective cohort baseline survey was performed with 6,283 subjects (2,443 men and 3,840 women) and free of hypertension, diabetes, cardiovascular diseases, and cancer. Dietary data were collected by trained interviewers using food frequency questionnaire. RESULTS: The significantly inverse linear trend of diastolic blood pressure (DBP) was found in fruits and non-pickled vegetables (81.2 mmHg in the lowest quintile vs 79.0 mmHg in the highest quintile, P for trend = 0.0040) and fruits only (80.9 mmHg in the lowest quintile vs 79.4 mmHg in the highest quintile, P for trend = 0.0430) among men. In contrast, sodium and sodium to potassium ratio were positively related with blood pressure among men (DBP, 78.8 mmHg in the lowest quintile vs 80.6 mmHg in the highest quintile, P for trend = 0.0079 for sodium; DBP, 79.0 mmHg in the lowest quintile vs 80.7 mmHg in the highest quintile, P for trend = 0.0199 and SBP, 123.8 mmHg in the lowest quintile vs 125.9 mmHg in the highest quintile for sodium/potassium). Kimchies consumption was positively related to DBP for men (78.2 mmHg in the lowest quintile vs 80.9 mmHg in the highest quintile for DBP, P for trend = 0.0003). Among women, these relations were not found. CONCLUSION: Fruits and/or non-pickled vegetables may be inversely, but sodium, sodium to potassium, and Kimchies may be positively related to blood pressure among men.

A Classification Method of Delirium Patients Using Local Covering-Based Rule Acquisition Approach with Rough Lower Approximation (러프 하한 근사를 갖는 로컬 커버링 기반 규칙 획득 기법을 이용한 섬망 환자의 분류 방법)

  • Son, Chang Sik;Kang, Won Seok;Lee, Jong Ha;Moon, Kyoung Ja
    • KIPS Transactions on Software and Data Engineering
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    • v.9 no.4
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    • pp.137-144
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    • 2020
  • Delirium is among the most common mental disorders encountered in patients with a temporary cognitive impairment such as consciousness disorder, attention disorder, and poor speech, particularly among those who are older. Delirium is distressing for patients and families, can interfere with the management of symptoms such as pain, and is associated with increased elderly mortality. The purpose of this paper is to generate useful clinical knowledge that can be used to distinguish the outcomes of patients with delirium in long-term care facilities. For this purpose, we extracted the clinical classification knowledge associated with delirium using a local covering rule acquisition approach with the rough lower approximation region. The clinical applicability of the proposed method was verified using data collected from a prospective cohort study. From the results of this study, we found six useful clinical pieces of evidence that the duration of delirium could more than 12 days. Also, we confirmed eight factors such as BMI, Charlson Comorbidity Index, hospitalization path, nutrition deficiency, infection, sleep disturbance, bed scores, and diaper use are important in distinguishing the outcomes of delirium patients. The classification performance of the proposed method was verified by comparison with three benchmarking models, ANN, SVM with RBF kernel, and Random Forest, using a statistical five-fold cross-validation method. The proposed method showed an improved average performance of 0.6% and 2.7% in both accuracy and AUC criteria when compared with the SVM model with the highest classification performance of the three models respectively.

Reproducibility of Nutrient Intake Estimated by Three-Day 24-Hour Dietary Recall of Middle-Aged Subjects for 6 Month Intervals (자기기록식 3일간의 24시간 회상법의 신뢰도 연구 -서울지역 중년 자원자를 대상으로-)

  • 이미숙;우미경;김성애;오세인;곽충실
    • Korean Journal of Community Nutrition
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    • v.8 no.4
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    • pp.603-609
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    • 2003
  • This study examined the reproducibility of nutrient intakes estimated by the 24-hour recall method in a prospective cohort study (Longitudinal study of aging and health monitoring of Korean elderly) of middle-aged volunteer subjects (42 males and 49 females) in the Seoul area. The three-day 24-hour recall was administered twice at an interval of approximately 6 months. The first data were collected and a corrective procedure was performed by interviewing of the subjects and a trained dietitian. The second data were collected by mail from the subjects without the performance of any corrective procedure. The mean age of the subjects was 53.5 $\pm$ 9.6 for the males and 52.2 $\pm$ 8.9 for the females. The subjects who had above college education were 95% in the case of the males and 60% in the case of the females. The characteristics of the male subjects in this study were that they were highly educated and held professional jobs and were from the middle or upper class. Comparing the first and second 24-hour recall data, the second data showed relatively lower intakes of all nutrients, except vitamin A, vitamin Bi and cholesterol. There was no difference in the nutrients of the first and the second data with respect to vitamin A, vitamin B$_1$ and cholesterol in the males and calcium, iron, sodium, vitamin A, vitamin B$_1$, vitamin B$_2$ and cholesterol in the females. This data may indicate that the 24 hour retail method without a dietitian's help may result in lower reporting of the subject's intakes. The men had a tendency to remember less than the women. Pearson's correlation coefficients with unadjusted nutrient intakes values were ranged from 0.24 to 0.66. When energy intake was adjusted, there was a slight increase (from 0.26 to 0.71). Intra-class correlation coefficients with nutrient-unadjusted values ranged from 0.22 to 0.66, and the energy-adjusted values were ranged from 0.23 to 0.69. The weighted Kappa statistical values ranged from 0.10 to 0.40. On the average,46.3% of the subjects who were found in the lowest quartile of the nutrient intake levels based on the first 24-hour recall, were in the lowest quartile based on the second 24-hour recall. Therefore, there was a low reproducibility between the first and the second 24-hour recall. We should examine the factors influencing low reproducibility. Also, strategies should be developed to maximize the reliability of the assessment, with regard to portion-size training and telephone validation. (Korean J Community Nutrition 8(4) : 603∼609, 2003)

Birth Weight and the Development of Functional Gastrointestinal Disorders in Infants

  • Baldassarre, Maria Elisabetta;Di Mauro, Antonio;Salvatore, Silvia;Tafuri, Silvio;Bianchi, Francesco Paolo;Dattoli, Enzo;Morando, Lucia;Pensabene, Licia;Meneghin, Fabio;Dilillo, Dario;Mancini, Valentina;Talarico, Valentina;Tandoi, Francesco;Zuccotti, Gianvincenzo;Agosti, Massimo;Laforgia, Nicola
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.4
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    • pp.366-376
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    • 2020
  • Purpose: To assess the association between birth weight and the development of functional gastrointestinal disorders (FGIDs) in the first year of life. Methods: This is a secondary analysis of a prospective cohort multicenter study including neonates, consecutively enrolled at birth, and followed up for one year. At birth all infants were classified by birth weight as extremely low (ELBW), very low, or low when <1,000, <1,500, and <2,500 g, respectively, and by birth weight for gestational age as appropriate (AGA, weight in the 10-90th percentile), small (SGA, weight <10th percentile), and large (LGA, weight >90th percentile) for gestational age. FGIDs were classified according to the Rome III criteria and assessed at 1, 3, 6, and 12 months of life. Results: Among 1,152 newborns enrolled, 934 (81.1%) completed the study: 302 (32.3%) were preterm, 35 (3.7%) were ELBW, 104 (11.1%) were SGA, 782 (83.7%) were AGA, and 48 (5.1%) were LGA infants. Overall, throughout the first year of life, 718 (76.9%) reported at least one FGID. The proportion of infants presenting with at least one FGID was significantly higher in ELBW (97%) compared to LBW (74%) (p=0.01) and in LGA (85.4%) and SGA (85.6%) compared to AGA (75.2%) (p=0.0001). On multivariate analysis, SGA was significantly associated with infantile colic. Conclusion: We observed an increased risk of FGIDs in ELBW, SGA, and LGA neonates. Our results suggest that prenatal factors determining birth weight may influence the development of FGIDs in infants. Understanding the role of all potential risk factors may provide new insights and targeted approaches for FGIDs.

Change in Palliative Performance Scale (PPS) Predicts Survival in Patients with Terminal Cancer

  • Oh, Jee Hye;Lee, Yong Joo;Seo, Min Seok;Yoon, Jo Hi;Kim, Chul Min;Kang, Chung
    • Journal of Hospice and Palliative Care
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    • v.20 no.4
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    • pp.235-241
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    • 2017
  • Purpose: The Palliative Performance Scale (PPS) is a widely used prognostic tool in patients with advanced cancer. This study examines the association between changes in PPS score and survival in patients with advanced cancer. Methods: We identified a cohort of 606 inpatients who died at a Korean university hospital's hospice/palliative care center. For each patient, the PPS score was measured twice according to a standard procedure: 1) upon admission, and 2) three days after admission (D3). "Change on D3" was defined as a difference between initial PPS and PPS on D3. We used a Cox regression modeling approach to explore the association between this score change and survival. Results: The changes in scores were associated with survival. A score change of >30% yielded a hazard ratio for death of 2.66 (95% CI 2.19~3.22), compared to a score change of ${\leq}30%$. PPS of ${\leq}30$ on D3 also independently predicted survival, with a hazard ratio of 1.67 (95% CI 1.38~2.02) compared to PPS of >30. Conclusion: A change of over 30% in PPS appears to predict survival in hospitalized patients with terminal cancer, even after adjustment for confounders. Changes in PPS may be a more sensitive indicator of impending death than a single PPS measured on the day of admission in terminal cancer patients. Further prospective study is needed to examine this important finding in other populations.