• Title/Summary/Keyword: retrospective exposure

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Technical and clinical aspects of cortisol as a biochemical marker of chronic stress

  • Lee, Do Yup;Kim, Eosu;Choi, Man Ho
    • BMB Reports
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    • v.48 no.4
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    • pp.209-216
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    • 2015
  • Stress is now recognized as a universal premorbid factor associated with many risk factors of various chronic diseases. Acute stress may induce an individual's adaptive response to environmental demands. However, chronic, excessive stress causes cumulative negative impacts on health outcomes through "allostatic load". Thus, monitoring the quantified levels of long-term stress mediators would provide a timely opportunity for prevention or earlier intervention of stressrelated chronic illnesses. Although either acute or chronic stress could be quantified through measurement of changes in physiological parameters such as heart rate, blood pressure, and levels of various metabolic hormones, it is still elusive to interpret whether the changes in circulating levels of stress mediators such as cortisol can reflect the acute, chronic, or diurnal variations. Both serum and salivary cortisol levels reveal acute changes at a single point in time, but the overall long-term systemic cortisol exposure is difficult to evaluate due to circadian variations and its protein-binding capacity. Scalp hair has a fairy predictable growth rate of approximately 1 cm/month, and the most 1 cm segment approximates the last month's cortisol production as the mean value. The analysis of cortisol in hair is a highly promising technique for the retrospective assessment of chronic stress. [BMB Reports 2015; 48(4): 209-216]

Methodologic Issues in Using Epidemiologic Studies for Quantitative Risk Assessment

  • Stayner Leslie
    • 대한예방의학회:학술대회논문집
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    • 1994.02a
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    • pp.417-425
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    • 1994
  • Although animal studies have been used most often for quantitative risk assessment, it is generally recognized that well-conducted epidemiologic studies would provide the best basis for estimating human risk. However, there are several features related to the design and analysis of epidemiologic studies that frequently limit their usefulness for quantitating risks. The lack of accurate information on exposure in epidemiologic studies is perhaps the most frequently cited limitation of these studies for risk assessment. However. other features of epidemiologic study design, such as statistical power, length of follow-up, confounding, and effect modification, may also limit the inferences that can be drawn from these studies. Furthermore, even when the aforementioned limitations are overcome, substantial uncertainty exists concerning the choice of an appropriate statistical (or biologic) model for extrapolation beyond the range of exposures observed in a particular study. This paper focuses on presenting a review and discussion of the methodologic issues involved in using epidemiologic studies for risk assessment. This review concentrates on the use of retrospective, cohort, mortality studies of occupational groups for assessing cancer risk because this is the most common application of epidemiologic data for quantitative risk assessment (QRA). Epidemiologic data should not be viewed as a panacea for the problems inherent in using animal bioassay data for QRA. Rather, information that can be derived from epidemiologic and toxicologic studies complement one another, and both data sources need to be used to provide the best characterization of human risk.

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Initial Blood Glucose Can Predict the Outcome of OP Poisoning (유기인계 중독환자에서 내원시 혈당과 예후와의 연관성)

  • Lee, Sung Do;Moon, Jeong Mi;Chun, Byeong Jo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.13 no.2
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    • pp.55-61
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    • 2015
  • Purpose: Many studies have examined the mechanisms of impaired glucose homeostasis after organophosphate (OP) exposure, however no study has evaluated the clinical utility of blood glucose measurements in patients with OP poisoning. The current study was conducted to evaluate the initial glucose level at presentation and the glycemic variables during the first 3 days after admission as a predictor of mortality. Methods: This retrospective observational case series included 228 patients with a history of OP poisoning. Among other clinical data, information on the initial glucose level at presentation and mean glucose level, delta glucose level, and the presence of a hypoglycemic event during the first 3 days of admission, was collected. Results: Survivors had lower initial glucose levels at presentation and glucose variability during the first 3 days of admission compared to non-survivors. The frequency of hypoglycemic events was higher in non-survivors. In multivariate analysis, the initial glucose level (> 233 mg/dl) was an independent predictor of mortality, along with age. Conclusion: The initial glucose level at presentation can be helpful in prediction of mortality in cases of OP intoxication at bedside. The physician should pay attention to patients with a glucose level >233 mg/dl at presentation after ingestion of OP.

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The usability of Infraorbital Approach on the patients with Orbito-Zygomatic Fracture (안와-관골골절 환자에서 안와하 접근법의 유용성)

  • Yun, Chi Sun;Kim, Jong Hwan;Yang, Ho Jik
    • Archives of Craniofacial Surgery
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    • v.10 no.1
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    • pp.19-22
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    • 2009
  • Purpose: There are various approaches for open reduction surgery for orbitozygomatic fractures. After the incisions are performed, patients might have various complications. In this point of view, we conducted a retrospective study of the usability of infraorbital incision on elderly patients, generally more vulnerable to scleral show and ectropion. Methods: In this study, 20 patients who are relatively more vulnerable to scleral show and ectropion through snap-back test having infraorbital incision were reviewed. We monitored the duration of the surgery, and complications resulted from the incision. We evaluated the scars with the researcher's observations and with the patient's level of satisfaction on a scale of 1 to 5. Results: On average, 5 minutes was spent between the skin incision and the fracture exposure. No case of scleral show and ectropion occurred. One year follow-up observation revealed 4 cases of visible scars, 9 cases of barely visible scars, and 7 cases of invisible scars. The subjective satisfaction level of the patients' scar is an average of 4.0. Conclusion: Infraorbital incision has many advantages. First, it can reduce the complications such as scleral show and ectropion. Second, it can shorten the operation time. Third, it can diminish incision-related scars.

Incidence of Hypothermia and Factors Associated with Body Temperature Changes during Surgery in Burned Patients (화상환자의 수술 중 저체온 발생 빈도와 체온변화에 영향을 미치는 요인)

  • Bae, Hye-Young;Kim, Hyunjung
    • Journal of Korean Biological Nursing Science
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    • v.18 no.4
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    • pp.231-238
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    • 2016
  • Purpose: The study aimed to evaluate the changes of body temperature and to identify the factors related to changes during surgery in burned patients. Methods: A retrospective study was conducted by reviewing the medical records of 439 adult burned patients who had a surgery under general anesthesia at the Burn Center of a university hospital. Results: After surgery, body temperature of the burned patients declined from $36.6^{\circ}C$ to $35.2^{\circ}C$; 52.2% were hypothermia. There were significant differences in the changes of body temperature according to the participants' characteristics including American society of anesthesiologists physical status, type of burn injury, total burn surface area, range of exposure, operation time, anesthesia time, amount of fluid, blood transfusion, use of tourniquet, and the method of warming therapy. Factors that influence the temperature changes were total burn surface area (${\beta}=0.26$), operation time (${\beta}=0.25$), amount of fluid (0.20), and warming therapy including 'Room temperature setting + Heated circuit + Hot line'(${\beta}=0.09$) and 'Room temperature setting+one of others'(${\beta}=0.08$). Conclusion: Burned patients experienced a decrease of their body temperature during surgery despite of warming therapy. A nursing protocol is needed to provide an appropriate warming therapy based on their characteristics in burned patients.

Predictive Markers for Screening Renal Damage in Children with Urinary Tract infections and Vesicoureteral Reflux

  • Lee, Hyeonju;Choi, Jae Hong;Kang, Dong-Hyeok;Kim, Seunghyo;Kang, Ki-Soo;Han, Kyoung Hee
    • Childhood Kidney Diseases
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    • v.24 no.1
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    • pp.27-35
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    • 2020
  • Purpose: Urinary tract infections (UTIs) are the most common and serious bacterial infections in children. Therefore, early diagnosis of vesicoureteral reflux (VUR) for treatment planning and the identification of noninvasive markers that can predict renal injury are important in patients with UTIs. We analyzed the clinical features of pediatric UTIs commonly encountered by general practitioners and reinterpreted the blood tests and imaging findings to identify the important clinical predictive markers of VUR in order to selectively perform VCUG. Methods: This retrospective study was performed among 183 children diagnosed with a UTI or acute pyelonephritis. Results: The most significant predictor of high grade and bilateral VUR identified using area under the curve analyses was hydronephrosis on kidney ultrasound images with renal cortical defects on dimercaptosuccinic acid (DMSA) kidney scan simultaneously, followed by hydronephrosis only on kidney ultrasound. Conclusion: The presence of hydronephrosis on kidney ultrasound images or cortical defects or asymmetric kidneys on the DMSA kidney scans can be predictive markers of VUR, reducing the need for VCUG. Our study can thus help minimize the exposure to radiation among patients through selective VCUG.

A Retrospective Study of Patients that Used Herbal Medicine During Pregnancy (임신 중 한약 복용 환자에 대한 후향적 연구)

  • Jung, Eun-Hye;Jang, Sae-Byul;Choi, Kyung-Hee;Yoo, Dong-Youl
    • The Journal of Korean Obstetrics and Gynecology
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    • v.27 no.3
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    • pp.79-93
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    • 2014
  • Objectives: This study was to establish safety and efficacy of using herbal medicine during pregnancy and to investigate patient's satisfaction. Methods: We investigated general pregnancy outcome, birth history, newborn infant's physical condition and patient's satisfaction. Survey respondents were 54 gynecological outpatients who visited Daejeon University Dunsan Oriental hospital from January 1, 2011 through February 28, 2013. Results: A total of fifty one cases maintained pregnancy and 3 cases had miscarriages. Forty seven cases delivered normally, 4 cases gave birth prematurely. There was no congenital malformation due to using herbal medicine and most of newborn babies had on the average weight and height and were healthy condition. The average score of patient's satisfaction was 3.44 point (Excellent=5). Conclusions: This study presents safety and efficacy of using herbal medicine during pregnancy.

Hepatitis A Outbreak in a Facility for the Disabled, Gyeonggi Province, Korea: An Epidemiological Investigation

  • Chang, Yeonhwa;Kim, Chanhee;Kim, Nayoung;Kim, Joon Jai;Lee, Heeyoung
    • Journal of Preventive Medicine and Public Health
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    • v.54 no.5
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    • pp.370-375
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    • 2021
  • Objectives: The number of cases of hepatitis A virus (HAV) infections has sharply increased in Korea, especially among young adults. In this study, an HAV outbreak in a facility for disabled people was investigated, and we found epidemiological differences both between 2 different generations and between generally abled and disabled groups. Methods: We analyzed the incubation period and attack rate of an HAV outbreak and investigated the prevalence of HAV antibodies among the staff and residents of a facility for the disabled. We performed a retrospective cohort study during the HAV outbreak, which lasted from February 8 to 25, 2019, including examinations of HAV antibody tests and post-exposure HAV vaccination for the staff or residents of the facility. Results: There were 9 confirmed cases in 2 staff members and 7 residents. Among 53 people (30 staff and 23 residents), except for the 9 confirmed cases and 1 staff member with a known history of HAV infection, HAV seroprevalence was seen in 16.7% of the staff under 40 years of age and 95.2% of those over 40 years of age, while the corresponding rates in the residents were 0.0% and 58.8%, respectively. Conclusions: This result implies that it is necessary to prioritize HAV vaccination for vulnerable groups and workers of residential care facilities.

The Effect of Exposure-Risk Behavior toward Endocrine-disrupting Chemicals, Occupational Environments and Daily Habits Related to Endocrine-disrupting Chemicals on Development of Spontaneous Abortion (환경호르몬 노출 위험행위, 직업환경 및 환경호르몬 관련 생활습관이 자연 유산 발생에 미치는 영향)

  • Choe, Myeong-Hui
    • Journal of the Korea Convergence Society
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    • v.11 no.7
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    • pp.377-387
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    • 2020
  • This study is a retrospective and descriptive research to identify the factors affecting development of spontaneous abortion in women of childbearing age. The subjects totaled 198 females aged 20~45 who had experienced childbirth or spontaneous abortion at least once, and data was collected for one month since July 2019 through self-reporting questionnaires. The results showed that the factors affecting development of spontaneous abortion were use of panty liners (daily: reference, 1~2 times a week: B=-1.74, no: B=-0.77) and antimicrobials (often or a lot: reference, small or normal: B=-0.71, no: B=0.79), occupational groups (inoccupation: reference, service industry employee: B=0.73, white collar: B=1.22, professional: B=0.63, manager: B=1.54), and exposure-risk behavior toward endocrine-disrupting chemicals (B=0.81) during pregnancy, and their explanatory power for development of spontaneous abortion was 24.4% (R2=.24). As a result, it is necessary to prevent endocrine-disrupting chemicals exposure and pay attention to the occupational environment during pregnancy in order to reduce the development of spontaneous abortion.

Retrospective Cohort Study on Genetic Susceptibility of Lead Exposure using Stored Blood in Specimen Bank-Focused Newly employed workers (시료보관은행에 저장된 혈액을 이용한 납 노출의 유전적 감수성에 관한 후향성 코호트 조사 연구 - 입사 1년차 대상자 연구)

  • Kim, Nam-Soo;Kim, Jin-Ho;Lee, Kap-Soo;Lee, Sung-Soo;Kim, Hwa-Sung;Ahn, Kyu-Dong;Schwartz, Brian S.;Lee, Byung-Kook
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.16 no.2
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    • pp.152-160
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    • 2006
  • Genotype of ALAD and VDR yields two alleles, respectively and it has been implicated in susceptibility to lead toxicity. Also genotype known to variety by race. To evaluate the genetic susceptibility of ALAD and VDR gene on health effect of lead exposure, this study was done with new workers who entered lead industries from 1992 to 2001. Among database of lead industries of Soonchunhyang University Institute of Industrial Medicine, only new workers were selected for this study. The total of eligible workers for this category was 3,540 workers including non lead exposed workers of same lead industries. Genotype of ALAD and VDR were measured from stored blood in specimen bank of Soonchunhyang University, blood lead and other relevant information were obtained from database of each workers which were gathered at their first year of employment. Among 3,540 new employed study subjects during period of 1992-2001, 3204 workers(90.5%) had ALAD genotype 1-1; whereas 336 workers(9.5%) had variant type of ALAD (1-2 or 2-2). Lead exposed workers, 9.8%(n=243) male and 8.1%(n=16) female were heterozygous for the ALAD allele. Also non lead exposed workers, 8.9%(n=67) male and 9.3%(n=10) female were heterozygous for the ALAD allele. For VDR genotype, 2,903 workers(89.7%) out of total tested 3,238 workers were belonged to type bb and 335 workers(10.3%) were type bB or BB. Lead exposed workers, 10.4%(n=235) male and 12.2%(n=24) female were heterozygous for the VDR allele. Also non lead exposed workers, 9.2%(n=64) male and 12.5%(n=12) female were heterozygous for the VDR allele. No significant differences were seen in mean blood lead levels by ALAD and VDR genotype, nor was significantly associated with blood lead except age in multiple regression analysis.