• 제목/요약/키워드: standardized mortality

검색결과 188건 처리시간 0.026초

노인환자에게 제공하는 개국약국 약료서비스의 경제적 가치 (Economic Value of Pharmaceutical Care for the Elderly Patients in Community Pharmacies)

  • 손현순;신현택
    • 약학회지
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    • 제51권5호
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    • pp.327-335
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    • 2007
  • This study was to evaluate economic impact of a comprehensive pharmaceutical care intervention provided by community pharmacists on drug-related morbidity and mortality in the elderly population, in a societal perspective. Clinical outcomes of pharmaceutical care included compliance increase, inappropriate medication discontinuation, and subsequent drug-related morbidity and mortality reduction. Economic outcomes included cost savings from direct medical costs reduction such as medication and healthcare resource utilization. Input costs for pharmaceutical care included pharmacist time and computerized prescription review supporting program costs. Model parameters of outcomes were derived from published literatures, and costs were from literatures and health insurance statistical data in Korea. Annual costs and benefits were estimated in the year 2005. Current usual care and standardized pharmaceutical care required 0.3 and 2.0 hours per year respectively, for elderly outpatient using average 4.4 prescription drugs per visit and average annual frequency of 17.8 pharmacy visits. Comprehensive pharmaceutical care provided to overall elderly outpatients at community pharmacies would have cost of \74,994 mil. and benefit of \357,002 mil. per year. Benefit:cost ratio was 4.8:1 and net benefit was \282,008 mil/year. It was corresponded to net benefit of \73,816/year for individual elderly patient. In addition, pharmaceutical care was estimated to reduce 1,531 drug-related deaths/year. Conclusively this study, a first attempt in Korea to evaluate an economic value of pharmaceutical care at community pharmacies, proved that it was a cost-effective intervention having significant economic benefit.

Some Epidemiological Measures of Cancer in Kuwait: National Cancer Registry Data from 2000-2009

  • El-Basmy, A.;Al-Mohannadi, S.;Al-Awadi, A.
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권7호
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    • pp.3113-3118
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    • 2012
  • Introduction: Cancer is the second cause of death in Kuwaiti people after cardiovascular diseases. This study is the first in the country to describe epidemiological measures related to cancer in this population. Methods: Data obtained from the Kuwait cancer registry included all Kuwaiti patients between years 2000-2009. Analyses were conducted using age-specific rates, the age-standardization-direct method, 95% confidence intervals (95% CI), cumulative risk by the age of 74 years, limited-duration prevalence, mortality and forecasting to year 2029. Results: It was noted that the commonest cancer sites were colorectal with an age standardized incidence rate (ASIR) of 16.1/100,000 in males and breast (49.4/100,000) in the female population. The trend of cancer incidence (1974-2009) showed no statistically significant change. First causes of death due to cancer were female breast 8(6.4-9.6)/100,000 and lung (males) 8.1/100,000 (6.6-10.0). The risk of developing cancer by the age of 74 was 13.4% (1/8) and 14.3% (1/7) in males and females respectively, and the risk of dying from cancer in the same age group was 1/17 and 1/23. By the end of 2009, prevalent cases represented 0.52% of the Kuwaiti population. In the year 2029, the total number of cancer cases is expected to reach 1200 cases compared to 889 cases in 2009. Conclusions and recommendations: The most common cancers in Kuwait (breast, colorectal and lung) are largely preventable. Prompt and effective interventional prevention programs that vigorously involve diet, anti-smoking and physical activity for both sexes are urgently required.

손상으로 인한 사망자의 지역별 차이에 대한 HGLM을 이용한 연구 (A study using HGLM on regional difference of the dead due to injuries)

  • 김길훈;노맹석;하일도
    • Journal of the Korean Data and Information Science Society
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    • 제22권2호
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    • pp.137-148
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    • 2011
  • 본 논문에서는 최근 중요한 문제로 대두되고 있는 손상으로 인한 사망 중 운수사고, 자살, 낙상사고에 의한 사망률에 대한 시 군 구 별 차이를 체계적으로 파악하고자 한다. 2008년 사망원인통계 원시 자료 중 19세 이상이면서, 국제사인분류에 따른 사인이 운수사고, 자살, 낙상사고에 의한 자료만을 추출하여 분석대상으로 고려하였다. 분석모형으로 성별, 연령, 1인당 주민세를 고정효과로 보정하고, 사망자수가 포아송분포를 따른다는 가정 하에 지역효과를 변량효과로 둔 포아송 HGLM 모형을 고려하여 시 군 구 소지역별 효과의 차이를 질병지도로 나타내었다. 분석결과 운수사고, 자살사고로 인한 사망률은 시 군 구 소지역별로 유의한 차이가 나타났지만, 낙상사고로 인한 사망률은 시 군 구 지역별로 유의한 차이가 없는 것으로 나타났다.

Are There Standardized Cutoff Values for Neutrophil-Lymphocyte Ratios in Bacteremia or Sepsis?

  • Gurol, Gonul;Ciftci, Ihsan Hakki;Terzi, Huseyin Agah;Atasoy, Ali Riza;Ozbek, Ahmet;Koroglu, Mehmet
    • Journal of Microbiology and Biotechnology
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    • 제25권4호
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    • pp.521-525
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    • 2015
  • Bacteremia and sepsis are common causes of morbidity and mortality worldwide, with incorrect or delayed diagnoses being associated with increased mortality. New tests or markers that allow a more rapid and less costly detection of bacteremia and sepsis have been investigated. The aim of this study was to clarify the cutoff value of the neutrophillymphocyte ratio (NLR) according to procalcitonin (PCT) level in the decision-making processes for bacteremia and sepsis. In addition, other white blood cell subgroup parameters, which are assessed in all hospitals, for bacteremia and sepsis were explored. This retrospective study included 1,468 patients with suspected bacteremia and sepsis. Patients were grouped according to the following PCT criteria: levels <0.05 ng/ml (healthy group), 0.05-0.5 ng/ml (local infection group), 0.5-2 ng/ml (systemic infection group), 2-10 ng/ml (sepsis group), and >10 ng/ml (sepsis shock group). One important finding of this study, which will serve as a baseline to measure future progress, is the presence of many gaps in the information on pathogens that constitute a major health risk. In addition, clinical decisions are generally not coordinated, compromising the ability to assess and monitor a situation. This report represents the first study to determine the limits of the use of NLR in the diagnosis of infection or sepsis using a cutoff value of <5 when sufficient exclusion criteria are used.

부산지역 미세먼지에 대한 건강 취약성 평가 (Health Vulnerability Assessment for PM10 in Busan)

  • 이원정;황미경;김유근
    • 한국환경보건학회지
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    • 제40권5호
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    • pp.355-366
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    • 2014
  • Objectives: This study seeks to evaluate the vulnerability assessment of the human health sector for $PM_{10}$, which is reflected in the regional characteristics and related disease mortality rates for $PM_{10}$ in Busan over the period of 2006-2010. Methods: According to the vulnerability concept suggested by the Intergovernmental Panel on Climate Change (IPCC), vulnerability to $PM_{10}$ is comprised of the categories of exposure, sensitivity, and adaptive capacity. The indexes of the exposure and sensitivity categories indicate positive effects, while the adaptive capacity index indicates a negative effect on vulnerability to $PM_{10}$. Variables of each category were standardized by the rescaling method, and each regional relative vulnerability was computed through the vulnerability index calculation formula. Results: The regions with a high exposure index are Jung-Gu (transportation region) and Saha-Gu (industrial region). Major factors determining the exposure index are the $PM_{10}$ concentration, days of $PM_{10}{\geq}50$, ${\mu}g/m^3$, and $PM_{10}$ emissions. The regions that show a high sensitivity index are urban and rural regions; these commonly have a high mortality rate for related disease and vulnerable populations. The regions that have a high adaptive capacity index are Jung-Gu, Gangseo-Gu, and Busanjin-Gu, all of which have a high level of economic/welfare/health care factors. The high-vulnerability synthesis of the exposure, sensitivity, and adaptive capacity indexes show that Dong-Gu and Seo-Gu have a risk for $PM_{10}$ potential effects and a low adaptive capacity. Conclusions: This study presents the vulnerability index to $PM_{10}$ through a relative comparison using quantitative evaluation to draw regional priorities. Therefore, it provides basic data to reflect environmental health influences in favor of an adaptive policy limiting damage to human health caused by vulnerability to $PM_{10}$.

Asbestos Exposure and Ovarian Cancer: A Meta-analysis

  • Seo Young Kim;Ha Kyun Chang;Ohwi Kwon;JaeYoung Park;Jun-Pyo Myong
    • Safety and Health at Work
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    • 제15권1호
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    • pp.1-8
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    • 2024
  • Background: The International Agency for Research on Cancer (IARC) Monograph conducted a systematic review of the relationship between asbestos and ovarian cancer. However, there may have been information bias due to the undue weight given to few articles. To address this limitation, the present study performed a meta-analysis integrating studies published both before and after the 2012 IARC Monograph on Asbestos, with the aim of investigating the association between asbestos exposure and ovarian cancer. Methods: A comprehensive search of major journal databases was conducted to identify studies examining the relationship between asbestos exposure and ovarian cancer, including those featured in the 2012 IARC Monograph on Asbestos. A meta-analysis on asbestos exposure and cancer risk was performed. Results: The meta-analysis of studies published after the 2012 IARC Monograph on Asbestos found a summary Standardized Mortality Ratio (SMR) of 2.04 (95% CI: 1.03-4.05; p = 0.0123; 5 studies), with a significant degree of heterogeneity among the studies (I2 = 72.99%). The combined analysis of 15 studies before and after the 2012 IARC Monograph showed an overall summary SMR of 1.72 (95% CI: 1.43-2.06; p = 0.0349; 15 studies), with a moderate degree of heterogeneity (I2 = 42.99%). Conclusion: This meta-analysis provides evidence of a significant association between asbestos exposure and ovarian cancer mortality. While the possibility of misdiagnosis in earlier studies cannot be completely ruled out, recent findings suggest a robust correlation between asbestos exposure and ovarian cancer. This highlights the importance of sustained efforts to minimize asbestos exposure and protect public health.

Incidence, mortality and survival of gallbladder, extrahepatic bile duct, and pancreatic cancer using Korea central cancer registry database: 1999-2019

  • Mee Joo Kang;E Hwa Yun;Kyu-Won Jung;Sang-Jae Park
    • 한국간담췌외과학회지
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    • 제26권3호
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    • pp.220-228
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    • 2022
  • Backgrounds/Aims: In Korea, pancreatic cancer and "gallbladder and extrahepatic bile duct cancer" were ranked the 8th and 9th most frequent cancers in 2019 and the 4th and 6th most common causes of cancer deaths in 2020, respectively. Methods: This review provides national cancer statistics and secular trends of 207,521 patients with gallbladder (n = 44,178), extrahepatic bile duct (n = 61,856), and pancreatic cancer (n = 101,487) between 1999 and 2019 in Korea. Results: The crude incidence rate in both sexes increased in the gallbladder (2.8 to 5.4 per 100,000), extrahepatic bile duct (3.6 to 9.0), and pancreatic cancer (5.5 to 15.8). The age-standardized incidence rate in both sexes significantly increased in the extrahepatic bile duct (3.7 to 4.1) and pancreatic (5.6 to 7.6) cancers but decreased in gallbladder cancer (2.9 to 2.4). The overall 5-year relative survival rate increased in the gallbladder (21.8% to 30.6%), extrahepatic bile duct (23.1% to 27.5%), and pancreatic (8.5% to 13.3%) cancers. Between 2006 and 2019, the proportion of localized or regional stages remained stable. The proportion of surgical treatment within the first 4 months after diagnosis was relatively higher in the gallbladder (42.2%) and extrahepatic bile duct (45.9%) cancers than in pancreatic cancer (22.2%). Conclusions: The crude incidence and mortality rates of the gallbladder, extrahepatic bile duct, and pancreatic cancer are steadily increasing in Korea, and the prognosis remains poor. Early detection, active application of surgical treatment, and minimization of the proportion of untreated patients are required to improve the survival rates of these cancers.

복숭아혹진딧물, Myzus persicae (Sulzer)(Insecta: Hemoptera: Aphididae), 살진딧물 최적 in vitro 살충력 검정 방법 확립 (An Optimal Standardized in vitro Bioassay to Evaluate Susceptibility of Green Peach Aphid, Myzus persicae (Sulzer)(Insecta: Hemoptera: Aphididae), to Aphicides)

  • 조가희;김효정;김영철
    • 한국응용곤충학회지
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    • 제62권3호
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    • pp.139-147
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    • 2023
  • 진딧물 방제제 개발을 위해 In vitro 경엽살포 검정방법이 널리 사용되고 있다. 이러한 신소재 진딧물 방제 제형은 종합방제와 화학농약의 대안으로 많은 연구가 진행되고 있다. 하지만, 경엽살포 검정방법은 환경이 조절되는 실내에서도 진딧물의 증식과 살충에 영향을 받는다. 본 연구에서는 담배를 기주로 하여 솜과 한천방법을 이용하여 진딧물 방제제 검정을 위한 최적 경엽살포 확립하고자 하였다. 진딧물 검정 챔버에 솜과 한천을 넣은 후 담배 잎과 진딧물 3-4령 약충을 접종하였다. Water-sensitive paper를 이용하여 경엽살포 시에 가장 표면 피복이 높은 최적 경엽살포 거리와 살포량을 확립하였다. 대조구로 물을 처리한 구에서 한천 방법이 솜 방법에 비해 살충율이 낮고, 증식율이 높았다. 솜 검정 방법에는 곤충 검정 챔버의 상대습도를 60% 이상 유지시켰을 때 가장 최적 조건이었지만, 한천 검정 방법에서는 한천의 농도에 상대습도 차이가 없었다. 최적화된 조건하에서 대조화학 농약, Sulfoxaflor, 경엽살포 시 솜 방법에서 살충율이 한천방법보다 빨랐지만, 최종 살충율은 통계적으로 유의하지 않았다. 본 연구는 살진딧물 물질을 검정 시 재현성과 활용성이 가능한 최적화된 증식율과 살충율 검정 조건을 제시하였다.

The COX-2 -765 G>C Polymorphism is Associated with Increased Risk of Gastric Carcinogenesis in the Chinese Hui Ethnic Population

  • He, Wen-Ting;Liu, Tao;Tang, Xiao-Fan;Li, Yu-Min
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권9호
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    • pp.4067-4070
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    • 2014
  • Background: The Chinese Hui ethnic group has diverse origins, including Arab, Persian, Central Asian, and Mongol. The standardized mortality rate of gastric cancer in the Hui population is higher than the overall Chinese population. In this study, we investigated whether COX-2-765G>C polymorphism, an extensively studied polymorphism, contributes to gastric cancer and its precursor lesions (GPL) in the Chinese Hui ethnic group. Materials and Methods: COX-2-765G>C polymorphism was determined by pyrosequencing in 100 gastric cancer cases, 102 gastric cancerand its precursor lesions cases and 105 controls. Data were statistically analyzed using Chi-square tests and logistic regression models. Results: Among the Chinese Hui ethnic group COX-2-765 C allele carriers were at increased risk for gastric cancer (OR=1.977, 95%CI=1.104-3.541). We also found an interaction between COX-2 -765 C carriers and Helicobacter pylori infection and eating pickled vegetables. Conclusions: Our findings suggest a multi-step process of gene-environment interaction contributes to gastric carcinogenesis.

중환자의 경관영양 공급 지표로서 위 잔여량의 임상적 효용성: 체계적 문헌고찰 (Clinical Usefulness of Gastric Residual Volume as An Indicator to Provide Approximately Enteral Nutrition for Patients in Intensive Care Units: A Systematic Literature Review)

  • 김현정;장선주
    • Journal of Korean Biological Nursing Science
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    • 제16권4호
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    • pp.267-275
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    • 2014
  • Purpose: The practice of enteral nutrition with gastric residual volumes (GRVs) as a clinical indicator is poorly standardized in intensive care units. This study aims to summarize the results from studies that evaluated the clinical outcomes related to the GRVs. Methods: This systematic review study analyzed 11 studies consisting of four randomized controlled trials, one non-randomized controlled trial, and six observational studies. Results: No consistent relationship between GRV thresholds and clinical outcomes was observed. Higher GRVs were not consistently correlated with clinical outcomes such as higher gastrointestinal complications, aspiration pneumonia, or mortality. Higher GRVs significantly generate complications more often. Findings show that a single GRV more than 200 mL or two consecutive GRVs more than 150 mL should raise concern about negative consequences. Conclusion: Critical care nurses need to monitor GRVs closely during their practice of enteral nutrition. For critically ill patients receiving enteral nutrition, a GRV threshold of 200 ml would be a desirable limit to provide safe and adequate nutrition with a conservative approach.