RESUMO
A Gram-negative, aerobic, non-motile, ovoid bacterium, designated strain MF3-039T, was isolated from tidal mudflat sediment sampled in Gunsan, Republic of Korea. The strain formed yellow-pigmented colonies on marine agar and was positive for catalase and oxidase. It grew at temperatures ranging from 10 to 37 °C (optimum, 25 °C), pH levels from 6.0 to 9.0 (optimum, 7.0), and 0 to 7.0% (w/v) NaCl (optimum, 2.0%). Phylogenetic analysis of 16S rRNA gene sequences revealed that strain MF3-039T clustered within the genus Altererythrobacter (family Erythrobacteraceae), with closest sequence similarity to Altererythrobacter insulae KCTC 63421T (97.9%), Altererythrobacter ishigakiensis ATCC BAA-2084T (97.9%), Altererythrobacter rubellus NBRC 112769T (97.2%), and Tsuneonella suprasediminis KCTC 62388T (97.1%). The draft genome was 2.9 Mbp with a G + C content of 60%. Genomic comparisons indicated average nucleotide identity and digital DNA-DNA hybridisation values below 95% and 70%, respectively, with related Altererythrobacter species. Chemotaxonomic analysis revealed ubiquinone-10 as the primary respiratory quinone, C17:1 ω6c and summed feature 8 (comprising C18:1 ω7c/C18:1 ω6c), and summed feature 3 (C16:1 ω7c/C16:1 ω6c) as predominant fatty acids, and diphosphatidylglycerol, phosphatidylethanolamine, phosphatidylglycerol, phosphatidylcholine, a sphingoglycolipid, an unidentified glycolipid, and an unidentified lipid as major polar lipids. The combination of phenotypic, chemotaxonomic, genomic, and phylogenetic features clearly distinguishes strain MF3-039T from existing genera within the family Erythrobacteraceae. On the basis of these polyphasic analyses, strain MF3-039T represents a novel genus and species, for which the name Litorerythrobacter xanthomarinus gen. nov., sp. nov. is proposed. The type strain is MF3-039T (= KEMB 23948T = KCTC 8705T = TBRC 19385T).
Assuntos
Alphaproteobacteria , Sedimentos Geológicos , Água do Mar , Filogenia , Sedimentos Geológicos/microbiologia , RNA Ribossômico 16S/genética , Composição de Bases , Ácidos Graxos/análise , DNA Bacteriano/genética , DNA Bacteriano/química , República da Coreia , Técnicas de Tipagem Bacteriana , Fenótipo , Fosfolipídeos/análise , Água do Mar/microbiologia , Alphaproteobacteria/classificação , Alphaproteobacteria/genética , Alphaproteobacteria/isolamento & purificação , Hibridização de Ácido Nucleico , Análise de Sequência de DNARESUMO
PURPOSE: As breast cancer survival rates improve, attention is shifting toward long-term health outcomes, including oral health. This study evaluated the dental prosthesis needs of breast cancer survivors using a nationally representative sample and examined variations by menopausal status at diagnosis. METHODS: This nationwide cross-sectional study analyzed data from 14,886 Korean women aged ≥ 19 years who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) from 2016 to 2021. Among these, 214 participants reported a history of breast cancer. Multivariable logistic regression was used to compare prosthetic needs and dental care utilization between breast cancer survivors and non-cancer controls, with subgroup analyses stratified by menopausal status at diagnosis. RESULTS: Breast cancer survivors had significantly greater needs for fixed prostheses than the non-breast cancer controls (OR 1.102, 95% CI 1.018-1.194). Postmenopausal survivors were more likely to require fixed prostheses (OR 1.56, p < 0.001), while premenopausal survivors had greater partial denture needs (OR 5.549, p = 0.009) than the non-breast cancer controls. No significant differences in dental visit frequency or self-perceived oral health were observed between groups. CONCLUSION: Breast cancer diagnosis was significantly associated with higher prosthetic needs, though survivors did not perceive their oral health as worse and demonstrated dental care behaviors comparable to non-cancer individuals. These findings highlight a potential gap in survivor awareness and underscore the need for integrating oral health assessment into survivorship care planning. Targeted dental interventions and awareness programs may improve quality of life for breast cancer survivors.
Assuntos
Neoplasias da Mama , Sobreviventes de Câncer , Prótese Dentária , Menopausa , Humanos , Feminino , Estudos Transversais , República da Coreia , Pessoa de Meia-Idade , Sobreviventes de Câncer/estatística & dados numéricos , Adulto , Prótese Dentária/estatística & dados numéricos , Inquéritos Nutricionais , Idoso , Assistência Odontológica/estatística & dados numéricos , Saúde BucalRESUMO
BACKGROUND: Despite significant morbidity and mortality, obstructive sleep apnea (OSA) remains underdiagnosed. In 2018, the South Korean National Health Insurance (NHI) expanded its coverage for polysomnography (PSG) to enhance diagnostic access for suspected OSA. This study evaluated the influence of expanded NHI coverage on PSG utilization, patient demographics, and OSA diagnosis rates in a single tertiary center. METHODS: A retrospective analysis was conducted on 1,821 adult patients who underwent in-laboratory PSG between 2015 and 2023. Demographic and clinical data, including comorbidities and PSG parameters, were collected before (pre-NHI, n = 477) and after (post-NHI, n = 1,344) coverage implementation. Patient characteristics, OSA diagnosis rates, and PSG parameters were compared between the two periods. RESULTS: Post-NHI, annual PSG utilization increased by 1.8-fold compared to the pre-NHI period (2015-mid-2018), with OSA diagnosis rates rising by 9.3%, reaching 84.8%, including a 7.7% increase in severe OSA cases. The mean patient age increased by 4.3 years, with a significant increase in patients aged ≥ 60 years (33.1%) and females (22.1%). Despite a stable body mass index, OSA severity metrics and comorbidities were higher post-NHI. Referral sources expanded beyond otorhinolaryngology and comprised 31.5% of the total requests post-NHI. CONCLUSION: Expanded NHI coverage positively affected OSA detection and patient management, providing valuable insights into the potential for policy-driven improvements in the management of sleep disorders. The expanded PSG coverage effectively improved OSA detection in the underserved and high-risk populations.
Assuntos
Programas Nacionais de Saúde , Apneia Obstrutiva do Sono , Humanos , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/patologia , Feminino , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Polissonografia , República da Coreia/epidemiologia , Adulto , Idoso , ComorbidadeRESUMO
BACKGROUND: Hip fractures in older adults are associated with high rates of mortality, functional decline, and secondary fractures. Although Fracture Liaison Services (FLSs) have shown clinical benefits in many countries, a comprehensive, coordinator-based FLS model has not been widely implemented in Korea. This study aimed to evaluate the clinical impact of a newly introduced coordinator-based FLS in elderly hip fracture patients. METHODS: This prospective cohort study included patients aged 65 and older who were admitted with a hip fracture to a single tertiary hospital between June 2022 and February 2024. Patients were divided into two groups: those who received FLS after July 2023 (n = 105) and those who did not (n = 168). Clinical data were collected during hospitalization and at 6 weeks, 3 months, 6 months, and 1 year postoperatively. Variables included time to surgery, length of hospital stay, mortality, refracture rate, osteoporosis treatment rates, functional and nutritional outcomes, and patient satisfaction. RESULTS: The FLS group had significantly shorter time to surgery (2.5 ± 2.3 vs. 4.4 ± 5.5 days, P < 0.001) and hospital stay (20.0 ± 11.3 vs. 24.7 ± 18.0 days, P = 0.010). In-hospital mortality (1.0% vs. 4.2%), 6-month (4.8% vs. 6.5%), and 1-year mortality (8.6% vs. 12.5%) were all lower in the FLS group (P < 0.05). Refracture rates at 6 months (2.8% vs. 7.1%) and 1 year (5.7% vs. 10.7%) were also significantly lower in the FLS group (P < 0.05). Osteoporosis medication prescription (68.6% vs. 48.8%) and calcium/vitamin D supplementation (63.8% vs. 15.9%) were significantly higher in the FLS group (P < 0.001). Although no significant differences were observed in functional recovery, the FLS group showed a significant increase in serum albumin over 1 year (P = 0.022). Patient satisfaction exceeded 90% at all follow-up intervals. CONCLUSION: The coordinator-based FLS service reduced the length of hospital stay and time from admission to surgery in elderly hip fracture patients, while also lowering the risk of postoperative mortality and refracture. It increased the prescription rate of osteoporosis medications and can improve patients' nutritional status. However, further research is needed to assess functional improvement.
Assuntos
Fraturas do Quadril , Humanos , Fraturas do Quadril/mortalidade , Fraturas do Quadril/cirurgia , Feminino , Masculino , Idoso , República da Coreia , Idoso de 80 Anos ou mais , Estudos Prospectivos , Tempo de Internação , Resultado do Tratamento , Osteoporose/tratamento farmacológico , Osteoporose/complicações , Satisfação do PacienteRESUMO
BACKGROUND: Hepatocellular carcinoma (HCC) management requires complex decision-making considering tumor burden, liver function, and patient's functional performance status. Large language models (LLMs) show promise in clinical applications, but their utility in HCC treatment recommendations remains unexplored. We evaluated the clinical relevance of LLM-generated treatment recommendations by comparing concordance with real-world physician decisions and survival outcomes. METHODS AND FINDINGS: We analyzed 13,614 treatment-naive HCC patients diagnosed between 2008 and 2020 in the Korean Primary Liver Cancer Registry. Treatment recommendations were generated using ChatGPT 4o, Gemini 2.0, and Claude 3.5 with standardized prompts referencing the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver guidelines. Patients were classified as "matched" when LLM recommendations corresponded to actual treatments received. Overall survival (OS) was compared between matched and mismatched groups, stratified by the Barcelona Clinic Liver Cancer (BCLC) stage. Decision tree analysis identified factors influencing treatment selection patterns. Concordance rates between LLM recommendations and physician decisions were 31.1% (ChatGPT 4o), 32.7% (Gemini 2.0), and 26.8% (Claude 3.5). In BCLC-A patients, treatment concordance with LLM recommendations was associated with significantly improved survival (ChatGPT 4o HR: 0.743, 95% CI [0.665, 0.831], P < 0.001). Conversely, in BCLC-C patients, concordance was associated with worse survival outcomes (ChatGPT 4o HR: 1.650, 95% CI [1.523, 1.787], P < 0.001; Gemini 2.0 HR: 1.586, 95% CI [1.470, 1.711], P < 0.001; Claude 3.5 HR 1.483, 95% CI [1.366, 1.610], P < 0.001). In BCLC-B, concordance showed only modest or nonsignificant associations with survival across models. Decision tree analysis revealed that physicians prioritized liver function parameters, while LLMs emphasized tumor characteristics. In early-stage HCC, physicians avoided curative treatments when hepatic reserve was limited, whereas in advanced-stage HCC, physicians preferred locoregional therapies in patients with preserved liver function despite guideline recommendations for systemic therapy. This study is limited by its retrospective design, reliance on registry data without imaging information, and focus on guideline-era treatments, warranting future prospective validation. CONCLUSIONS: Concordance between LLM-generated and physician treatment decisions was associated with improved survival in early-stage HCC, whereas this association was not observed in advanced-stage disease. While LLMs may serve as adjunctive tools for guideline-concordant decisions in straightforward scenarios, their recommendations may reflect limited contextual awareness in complex clinical situations requiring individualized care. LLM recommendations should be interpreted cautiously alongside clinical judgment.
Assuntos
Carcinoma Hepatocelular , Linguagem , Neoplasias Hepáticas , Humanos , Carcinoma Hepatocelular/terapia , Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/patologia , Carcinoma Hepatocelular/diagnóstico , Neoplasias Hepáticas/terapia , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/diagnóstico , Feminino , Masculino , Sistema de Registros , Pessoa de Meia-Idade , Estudos Retrospectivos , Idoso , República da Coreia/epidemiologia , Tomada de Decisão Clínica , Modelos de Linguagem de Grande EscalaRESUMO
BACKGROUND/AIMS: We examined the association between diabetes duration and hyperuricemia in Korean subjects based on data from the Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: This cross-sectional study included 4,575 subjects aged 30 years and older with type 2 diabetes mellitus based on data from the KNHANES from 2016 to 2021. Hyperuricemia was defined as a serum uric acid level ≥ 7.0 mg/dL. Univariable and multivariable logistic regression models were used calculate adjusted odds ratios (ORs) and their 95% confidence intervals (CIs). RESULTS: The mean age of subjects was 61.0 years, 56.5% were male, and the mean body mass index (BMI) was 25.6 kg/m2. Compared to those with diabetes duration 5 to < 10 years, those with shorter or longer diabetes duration had higher serum uric acid levels and higher prevalence of hyperuricemia. In multivariable logistic regression models, a U-shaped association between diabetes duration and hyperuricemia was observed after adjusting for age, sex, income, smoking status, alcohol consumption, regular exercise, and presence of hypertension, dyslipidemia, or chronic kidney disease. Compared to those with new-onset diabetes mellitus, the adjusted OR (95% CI) for hyperuricemia was 0.55 (0.38-0.82) in those with diabetes duration 5 to < 10 years. The results were consistent in subgroup analysis according to age, sex, BMI, and chronic kidney disease. CONCLUSION: The U-shaped association between diabetes duration and hyperuricemia was observed in a representative sample of Korean adults.
Assuntos
Diabetes Mellitus Tipo 2 , Hiperuricemia , Ácido Úrico , Humanos , Hiperuricemia/epidemiologia , Hiperuricemia/sangue , Hiperuricemia/diagnóstico , Masculino , Pessoa de Meia-Idade , Feminino , República da Coreia/epidemiologia , Estudos Transversais , Inquéritos Nutricionais , Idoso , Ácido Úrico/sangue , Fatores de Tempo , Adulto , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/sangue , Prevalência , Fatores de Risco , Biomarcadores/sangue , Medição de RiscoRESUMO
BACKGRUOUND: A new diagnostic framework for clinical obesity, proposed by the Lancet Commission, defines obesity as excess adiposity with organ dysfunction, offering a more functional assessment than traditional body mass index (BMI)-based classification. However, it has not been applied to Asian populations, where obesity-related complications arise at lower BMI thresholds. METHODS: We analyzed 57,863 Korean adults aged ≥20 years from the 2014 to 2023 Korea National Health and Nutrition Examination Survey (KNHANES), a nationally representative, cross-sectional dataset. Clinical obesity was defined as excess adiposity with ≥1 obesity-related complication or functional limitation; preclinical obesity was defined as excess adiposity without complications. Age, sex, and temporal trends were examined and compared with BMI-based classifications using complex sampling weights and age-standardization. RESULTS: The prevalence of clinical obesity and preclinical obesity was 31.2% and 8.1%, respectively. Among those with BMI-defined obesity (≥25.0 kg/m²), 20.1% had no complications, while 19.4% of overweight individuals (BMI 23.0-24.9 kg/m²) met clinical obesity criteria. Clinical obesity increased with age despite stable BMI, driven by metabolic and functional decline. Cancer prevalence was highest among individuals with clinical obesity (1.77%). Applying Western waist circumference cutoffs drastically reduced the estimated prevalence of clinical obesity to 13.1%. Longitudinal analyses showed a rising trend in clinical obesity over ime. CONCLUSION: This is the first large-scale study to apply the clinical obesity framework in an Asian population. The framework identifies high-risk individuals missed by BMI al.
Assuntos
Obesidade , Humanos , Masculino , Feminino , Obesidade/epidemiologia , Obesidade/complicações , Obesidade/diagnóstico , República da Coreia/epidemiologia , Adulto , Pessoa de Meia-Idade , Estudos Transversais , Índice de Massa Corporal , Inquéritos Nutricionais , Prevalência , Idoso , Adulto JovemRESUMO
Background The documentation of clinically significant incidental findings (S modifiers) in low-dose CT lung cancer screening varies among radiologists. Although the Korean National Lung Cancer Screening Program adopted structured reporting for seven standardized S modifiers, the prognostic value of standardized S modifiers has not been evaluated comprehensively. Purpose To evaluate the implementation of structured reporting for prespecified S modifiers by analyzing their prevalence, mortality associations, and co-occurrence patterns. Materials and Methods This retrospective study included baseline screening participants from the Korean National Lung Cancer Screening Program between August 2019 and December 2020. The prevalence of seven S modifiers was calculated, and their prognostic value for all-cause mortality was assessed using multivariable Cox regression. Latent class analysis (LCA) was performed to identify co-occurrence patterns, which were analyzed for mortality risk stratification. Results Among 125 600 participants (mean age ± SD, 62 years ± 5.3; 123 331 men), 2.69% (n = 3380) died over a median follow-up of 3.7 years. Coronary artery calcification was most prevalent (15.07% [18 892 of 125 366 participants]), followed by emphysema (13.77% [17 300 of 125 600 participants]), interstitial lung abnormalities (ILAs) (2.65% [3324 of 125 600 participants]), and pulmonary infection (0.90% [1123 of 124 477 participants]). Extrapulmonary malignancy (74 of 125 257 participants), aortic aneurysm (78 of 125 256 participants), and pleural and/or pericardial effusion (75 of 125 253 participants) were each observed in less than 0.1% of participants. All S modifiers were associated with increased all-cause mortality, with adjusted hazard ratios (HRs) of 8.28 (95% CI: 5.48, 12.51) for pleural and/or pericardial effusion, 3.58 (95% CI: 1.97, 6.49) for extrapulmonary malignancy, 3.28 (95% CI: 1.71, 6.32) for aortic aneurysm, 2.16 (95% CI: 1.89, 2.47) for ILAs, 1.41 (95% CI: 1.30, 1.53) for coronary artery calcification, and 1.15 (95% CI: 1.05, 1.25) for emphysema (P < .001 for all except for emphysema, with P = .002). LCA helped identify four distinct classes with a stepwise increase in mortality from isolated emphysema (adjusted HR, 1.22; 95% CI: 1.10, 1.36; P < .001) to high-risk modifiers (adjusted HR, 5.35; 95% CI: 3.40, 8.41; P < .001). Conclusion In a nationwide lung cancer screening group, structured reporting using seven standardized S modifiers revealed both their prevalence and associations with all-cause mortality, validating their clinical utility in identifying clinically significant abnormalities. © RSNA, 2026 Supplemental material is available for this article. See also the editorial by White and Gierada in this issue.
Assuntos
Detecção Precoce de Câncer , Achados Incidentais , Neoplasias Pulmonares , Tomografia Computadorizada por Raios X , Humanos , Masculino , Feminino , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/epidemiologia , República da Coreia/epidemiologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Prevalência , Detecção Precoce de Câncer/métodos , Prognóstico , Tomografia Computadorizada por Raios X/métodos , IdosoRESUMO
BACKGROUND: The epidemiology of native valve infective endocarditis (IE) has shifted toward older adults with substantial comorbidity burdens, yet contemporary nationwide data on outcomes and surgical impact remain limited. METHODS: We conducted an 18-year nationwide cohort study of adults hospitalised with native valve IE in Korea (2006-2023). Outcomes included in-hospital and 5-year all-cause mortality, IE relapse and a composite of death or relapse. Temporal trends, mortality predictors and surgical associations across age strata were evaluated using multivariable Cox models and stratified survival analyses. RESULTS: Among 18 402 patients (mean age 63.7 years), incidence declined in individuals <45 years but increased in those ≥65 years. In-hospital mortality was 25.5%, and 5-year mortality exceeded 50% overall. Advanced age, dialysis dependence, cancer and major complications predicted mortality. Valve surgery, performed in 29.1% of patients, was consistently associated with lower short- and long-term mortality across age groups, with no evidence of age-by-treatment interaction. Both early (≤7 days) and late (>7 days) surgery showed reduced mortality versus medical therapy. IE relapse was more frequent in older adults, and surgery was associated with a lower relapse risk. In the composite outcome of death or relapse, older adults had a higher event burden, whereas surgery remained associated with fewer composite events. CONCLUSIONS: Native valve IE in Korea has shifted toward an elderly, multimorbid population with persistently high mortality. Despite declining utilisation, the survival benefit of surgery was preserved across the age spectrum, supporting operative consideration in appropriately selected older adults.
Assuntos
Procedimentos Cirúrgicos Cardíacos , Endocardite , Doenças das Valvas Cardíacas , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , Idoso , República da Coreia/epidemiologia , Incidência , Fatores de Risco , Endocardite/epidemiologia , Endocardite/mortalidade , Endocardite/diagnóstico , Endocardite/cirurgia , Mortalidade Hospitalar/tendências , Estudos Retrospectivos , Taxa de Sobrevida/tendências , Adulto , Fatores de Tempo , Seguimentos , Medição de Risco , Doenças das Valvas Cardíacas/epidemiologia , Doenças das Valvas Cardíacas/mortalidade , Doenças das Valvas Cardíacas/diagnóstico , Fatores EtáriosRESUMO
PURPOSE: This study evaluated long-term trends in gastric cancer epidemiology and survival with a focus on conditional relative survival (CRS). MATERIALS AND METHODS: Using the Korea Central Cancer Registry, we analyzed 665,184 patients who were newly diagnosed with gastric cancer between 1999 and 2022. The study period was divided into four intervals: Period I (1999-2005), Period II (2006-2011), Period III (2012-2017), and Period IV (2018-2022). Temporal trends in the incidence and mortality were assessed using crude and age-standardized rates. Relative survival was estimated using the Ederer II method, and the 5-year CRS was calculated according to the survival duration after diagnosis. RESULTS: The incidence of gastric cancer increased until 2011 and subsequently declined, with a marked decrease observed in 2020. Individuals aged ≥70 years consistently had the highest incidence rates. Mortality rates showed a sustained decline throughout the study period. The overall 5-year relative survival improved from 69.8% in Period II to 78.4% in Period IV. The 5-year CRS increased from 86.1% at 1 year after diagnosis to 96.3% at 5 years. Patients with localized stage maintained a 5-year CRS above 95% at 1 year after diagnosis, whereas those with regional and distant stages showed 5-year CRS that consistently remained below 95%. CONCLUSIONS: The incidence and mortality rates of gastric cancer in Korea have declined over the past two decades, accompanied by improved survival outcomes. The CRS analysis suggests that long-term follow-up is warranted, with the optimal duration varying according to patient characteristics.
Assuntos
Neoplasias Gástricas , Humanos , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/patologia , República da Coreia/epidemiologia , Feminino , Masculino , Idoso , Incidência , Pessoa de Meia-Idade , Sistema de Registros/estatística & dados numéricos , Taxa de Sobrevida , Idoso de 80 Anos ou mais , AdultoRESUMO
Importance: Persistent chemotherapy-induced alopecia (PCIA) is a distressing adverse effect that can have lasting psychosocial consequences. However, racial and ethnic differences in PCIA incidence and associated distress remain unclear, owing to limited multiracial and multiethnic data. Objective: To evaluate racial and ethnic disparities in the incidence of PCIA and alopecia-related psychological distress among women with breast cancer from baseline to 12 months after completion of chemotherapy. Design, Setting, and Participants: This prospective cohort study was conducted at 2 tertiary cancer centers in the US (August 19, 2015, to December 31, 2021) and South Korea (December 20, 2018, to April 27, 2022). Women (aged ≥18 years) with stage I to III breast cancer who received chemotherapy were included. Data analysis was conducted from June 30 to July 15, 2025. Exposures: Standardized trichoscopic assessments were performed and validated distress questionnaires were administered at baseline and 12 months after treatment. Main Outcomes and Measures: The primary outcome was PCIA incidence, which was defined as hair thickness or density at 12 months after completion of chemotherapy that fell more than 2 SDs below the level measured before chemotherapy. Secondary outcomes included changes in hair density, hair shaft thickness, and alopecia-related distress, measured using the Chemotherapy-Induced Alopecia Distress Scale (CADS). Results: The 304 women (mean [SD] age, 50.3 [10.6] years) in this study were Asian (n = 159 [52.3%]), Black (n = 20 [6.6%]), Hispanic or Latino (n = 17 [5.6%]), or White (n = 108 [35.5%]). At baseline, Asian women had the thickest hair shafts (mean [SD], 83.2 [13.4] µm) but the lowest follicular density (mean [SD], 136.2 [27.6] hairs/34.34 mm2 at ×50 magnification; P < .001). At 12 months, PCIA incidence was highest in Asian women (59 [42.1%]), followed by White (24 [22.2%]), Black (2 [10.0%]), and Hispanic or Latino (1 [5.1%]) women (P = .001). Asian women also had the greatest increase in CADS scores compared with White women, particularly in the emotional (adjusted mean difference, 1.88 [95% CI, 0.92-2.95]) and activity-related (1.55 [95% CI, 0.58-2.52]) domains. Conclusions and Relevance: In this prospective multinational cohort study, significant racial and ethnic disparities were observed in the incidence and psychological effects of PCIA. Asian women experienced the greatest burden. These findings underscore the need for personalized counseling, culturally sensitive psychosocial support, and consideration of pharmacogenetic risks in managing chemotherapy-related alopecia.
Assuntos
Alopecia , Antineoplásicos , Neoplasias da Mama , Etnicidade , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Alopecia/induzido quimicamente , Alopecia/etnologia , Alopecia/psicologia , Alopecia/epidemiologia , Antineoplásicos/efeitos adversos , Negro ou Afro-Americano/estatística & dados numéricos , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/etnologia , Etnicidade/estatística & dados numéricos , Hispânico ou Latino/estatística & dados numéricos , Incidência , Estudos Prospectivos , República da Coreia/epidemiologia , Estados Unidos/epidemiologia , Brancos/estatística & dados numéricos , Asiático/estatística & dados numéricosRESUMO
Unhealthy lifestyles are strongly associated with the development of cardiometabolic diseases and the risk of all-cause mortality. We hypothesized that unhealthy lifestyles including poor diet contribute to the development of cardiometabolic diseases. This study aimed to investigate the incidence of metabolic syndrome (MetS) and its clustering components in relation to diet and lifestyle risk factors in Korean population. At baseline, all participants (nâ =â 2000) completed a general health-related questionnaire, provided blood samples, and underwent health examinations. Lifestyle factors were investigated including smoking, alcohol consumption, physical activity, sleep, dietary quality, and weight status. Cox proportional hazard regression was used to estimate the hazard ratio (HR) and 95% confidence intervals (CIs) of primary endpoints: MetS events and their clustering components. A total of 1697 participants (mean age: 43.8â ±â 0.2 years) were included, of whom 72.4% (nâ =â 1228) were women. Compared to the healthy group, unhealthy participants had a significant HR value of abdominal obesity for lifestyle factors (HRs: 1.937, 95% CI: 1.335-2.810). No significant differences were observed between MetS and other clustering components. After adjusting for covariates, the lowest quintile of vitamin C (HRs: 1.553, 95% CI: 1.153-2.091), fiber (HRs: 1.409, 95% CI: 1.035-1.919) and vegetable intake (HRs: 1.300, 95% CI: 1.008-1.678) were significantly associated with abdominal obesity incidence compared with the highest quintile. Adherence to healthy lifestyle factors and dietary factors, such as high intakes of vitamin C and vegetables, were negatively associated with the incidence of abdominal obesity among the MetS components in Korean adults.
Assuntos
Dieta , Estilo de Vida , Síndrome Metabólica , Obesidade Abdominal , Humanos , Feminino , Masculino , República da Coreia/epidemiologia , Adulto , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/etiologia , Estudos Prospectivos , Incidência , Pessoa de Meia-Idade , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/etiologia , Dieta/efeitos adversos , Fatores de Risco , Exercício Físico , Modelos de Riscos ProporcionaisRESUMO
Urinary tract infections (UTIs) are common among women, with over half experiencing at least one episode during their lifetime. They are often recurrent and impose a considerable health and economic burden. Although air pollution has been shown to impair mucosal immunity and increase susceptibility to infections, evidence on its long-term effects on UTI risk remains limited. We established a nationwide cohort of 4,384,078 Korean women aged ≥30 years using National Health Insurance Service claims data from 2015 to 2023. A subcohort of 2,245,306 women who underwent general health examinations (GHE) provided detailed information on lifestyle and clinical risk factors. Cox regression models with time-varying covariates were used to estimate hazard ratios (HRs) for incident UTIs per 10 µg/m3 increase in long-term PM2.5 exposure, adjusting for demographic, meteorological, and health-related variables. Over a median follow-up of nine years, 1,386,341 UTI events were recorded. Long-term exposure to PM2.5 was associated with an increased risk of UTI (HR 1.032, 95 % CI 1.022-1.042). The association remained robust after adjustment for lifestyle and clinical factors in the GHE subcohort (HR 1.024, 95 % CI 1.011-1.037). The risk was more pronounced among women with lower income and those engaging in high-risk drinking in both cohorts, highlighting disproportionate vulnerability related to socioeconomic and behavioral factors. Although typically mild, UTIs can negatively impact quality of life, underscoring the need to address environmental health inequities affecting women through air pollution policies.
Assuntos
Poluentes Atmosféricos , Poluição do Ar , Exposição Ambiental , Material Particulado , Infecções Urinárias , Humanos , Feminino , Infecções Urinárias/epidemiologia , Infecções Urinárias/induzido quimicamente , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Adulto , Poluição do Ar/efeitos adversos , Estudos de Coortes , Exposição Ambiental/efeitos adversos , Poluentes Atmosféricos/efeitos adversos , Material Particulado/efeitos adversos , Fatores de Risco , IdosoRESUMO
Objective: To identify single nucleotide polymorphisms (SNPs) associated with cardiovascular disease (CVD) and examine the association of genetic and lifestyle factors using data from the Korean Genome and Epidemiology Study (KoGES). Methods: A secondary analysis was conducted using Phase 1 data from the Health Examinee (HEXA) cohort, including 26,546 participants (1,919 with CVD and 24,627 controls). Sex-stratified analyses were performed on 17,390 females and 9,156 males. SNPs associated with CVD were identified using PLINK 1.9, and logistic regression models were used to assess associations between CVD and genetic, demographic, and lifestyle factors in IBM SPSS Statistics 27.0. Results: Three SNPs (rs8086325, rs34233878, rs218463) were significantly associated with CVD in the overall sample. In males, rs79682491, rs2540719, and rs2576541 showed significant associations, while in females, rs76830381, rs6496602, rs8086325, and rs34233878 were identified. In multivariate analyses, age ≥60 (OR = 15.56), BMI ≥30 (OR = 4.74), male sex, smoking, low protein intake, low income, and selected SNPs were significantly associated with CVD risk. Conclusion: This study underscores the multifactorial nature of CVD risk, highlighting the joint association of genetic, behavioral, and demographic factors. The observed sex-specific genetic associations reinforce the need for personalized prevention strategies. Nurses are well-positioned to lead efforts in implementing sex-sensitive, genomics-informed approaches to reduce CVD risk and promote cardiovascular health.
Assuntos
Doenças Cardiovasculares , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Estilo de Vida , Humanos , Doenças Cardiovasculares/genética , Masculino , Feminino , Polimorfismo de Nucleotídeo Único , Pessoa de Meia-Idade , República da Coreia , Idoso , Adulto , Fatores de RiscoRESUMO
Background: Middle-aged adults experience degenerative aging-related changes, often differing by sex. Research identifying sex-specific factors contributing to biological aging among middle-aged adults remains limited. This study aimed to identify sex-specific factors influencing GrimAge acceleration (GrimAA), a DNA methylation-based estimator of biological aging, among middle-aged Korean adults. Methods: Data were derived from the Korean Genome and Epidemiology Study (KoGES) cohort involving 686 middle-aged adults (422 men and 264 women). GrimAA was calculated from DNA methylation data using the GrimAge epigenetic clock. Demographic, lifestyle, clinical, and psychosocial stress variables were assessed, and sex-specific factors influencing GrimAA were identified through hierarchical multiple regression models. Results: In men, higher GrimAA was significantly associated with current smoking, current drinking, physical inactivity, and elevated Hs-CRP or HbA1C levels, whereas among women, early menopause (<50 years) emerged as a notable factor related to increased GrimAA. Hierarchical regression analyses revealed that chronological age, current smoking, and Hs-CRP were robust predictors of GrimAA in men, whereas GrimAA in women was significantly predicted by current smoking and Hs-CRP. Conclusion: Sex differences in GrimAA may result from the interplay of lifestyle behaviors, inflammatory biomarkers, and hormonal factors. Targeted interventions addressing these sex-specific determinants could be effective strategies to mitigate biological aging acceleration among middle-aged adults.
Assuntos
Envelhecimento , Metilação de DNA , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , República da Coreia , Fatores Sexuais , Envelhecimento/genética , Envelhecimento/fisiologiaRESUMO
BACKGROUND: Elevated serum uric acid levels are commonly observed in chronic kidney disease (CKD) and are associated with cardiovascular disease (CVD). Research on the role of serum uric acid in pediatric CKD is limited. This study aims to investigate factors influencing serum uric acid levels and their association with CVD risk factors in children with CKD. METHODS: We used baseline data from the KoreaN cohort study for Outcome in patients with Pediatric Chronic Kidney Disease. Overall, 338 children with CKD were included. RESULTS: The median age of participants was 9.8 years, and their mean estimated glomerular filtration rate (eGFR) was 63.5 mL/min/1.73 m2. The median serum uric acid level was 5.8 mg/dL. Multivariable regression analysis indicated that male sex, older age, and low eGFR were associated with higher serum uric acid levels. In children with CKD stage III or higher, glomerulopathy as the etiology of CKD was also associated with elevated serum uric acid levels. Serum uric acid levels showed a U-shaped relationship with the prevalence of hypertension and left ventricular hypertrophy, with the lowest prevalence occurring at levels between 5.5 and 7.5 mg/dL, even after adjustment for covariates, with the lowest odds ratio in this range. CONCLUSIONS: In pediatric CKD, higher serum uric acid levels were associated with male sex, older age, and lower eGFR, suggesting that these factors should be considered in clinical management. Additionally, the U-shaped relationship between serum uric acid levels and cardiovascular risk of hypertension and left ventricular hypertrophy underscores the importance of maintaining serum uric acid within an optimal range.
Assuntos
Doenças Cardiovasculares , Insuficiência Renal Crônica , Ácido Úrico , Humanos , Masculino , Ácido Úrico/sangue , Feminino , Criança , Insuficiência Renal Crônica/sangue , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/fisiopatologia , Taxa de Filtração Glomerular , Adolescente , República da Coreia/epidemiologia , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/etiologia , Pré-Escolar , Prevalência , Fatores Etários , Fatores Sexuais , Hipertrofia Ventricular Esquerda/epidemiologia , Hipertrofia Ventricular Esquerda/sangue , Hipertrofia Ventricular Esquerda/etiologia , Fatores de Risco , Hipertensão/epidemiologia , Hipertensão/sangue , Hipertensão/etiologia , Fatores de Risco de Doenças CardíacasRESUMO
OBJECTIVE: Evidence regarding the occurrence of fracture in esophageal cancer (EC) survivors remains limited. We aimed to investigate the risk of fractures among EC survivors who received curative-intent surgery. METHODS: We conducted a population-based retrospective cohort study using the Korean National Health Insurance Service database (2009-2022), including patients who underwent surgery for EC (n = 4847) and their 1:3 propensity score matched controls (n = 14,541). We performed competing risk analyses to estimate the risk of fractures. RESULTS: We observed 305 incident fractures among EC survivors (24 [0.50 %], 119 [2.46 %], and 195 [4.02 %] at 1, 3, and 5 years post-surgery, respectively) and 980 fractures among matched controls (118 [0.81 %], 342 [2.35 %], and 557 [3.83 %]) during mean follow-up periods of 5.3 ± 3.7 and 8.1 ± 2.9 years, respectively. EC survivors had a significantly higher fracture risk than controls, with cause-specific hazard ratios of 1.46 (95 % confidence interval [CI] 1.28-1.66) for any fracture, 1.66 (95 % CI 1.31-2.10) for vertebral fracture, and 1.68 (95 % CI 1.28-2.21) for hip fracture, although risk was not significant within the first year after surgery. EC survivors are at a greater risk of fractures than controls regardless of treatment modality, with the highest fracture risk present among those receiving radiation therapy (RT) along with surgery. CONCLUSION: EC survivors had persistently higher risks of any, vertebral, and hip fracture than non-cancer controls, except for during the first year after surgery. The risk of fracture was prominent among EC survivors who received surgery combined with RT.
Assuntos
Sobreviventes de Câncer , Neoplasias Esofágicas , Fraturas Ósseas , Humanos , Neoplasias Esofágicas/cirurgia , Neoplasias Esofágicas/terapia , Feminino , Estudos Retrospectivos , Masculino , Pessoa de Meia-Idade , Idoso , Sobreviventes de Câncer/estatística & dados numéricos , República da Coreia/epidemiologia , Fraturas Ósseas/epidemiologia , Fraturas Ósseas/etiologia , Pontuação de Propensão , Esofagectomia , Fatores de Risco , IncidênciaRESUMO
INTRODUCTION: While esophagectomy remains the standard of care for cT1bN0M0 esophageal squamous cell carcinoma (ESCC), definitive chemoradiotherapy (DCRT) offers a potential organ-preserving alternative. This study aimed to evaluate the equivalence of DCRT and esophagectomy in this patient population. MATERIALS AND METHODS: Medical records of patients with cT1bN0M0 ESCC treated between January 2010 and April 2020 were retrospectively reviewed. Patients were divided into the surgery and DCRT groups. Disease recurrence and overall survival (OS) were compared between two groups. Propensity score matching (PSM) and age-comorbidity subgroup analyses were performed to adjust for baseline differences. RESULTS: A total of 333 and 88 patients who had undergone esophagectomy and DCRT, respectively, were included. Patients in the surgery group were significantly younger and had better performance status than those in the DCRT group. Clinical complete response was achieved in 84 patients (95.5 %) following DCRT. With a median follow-up of 55 months (range, 0.4-134), disease recurrences was observed in 19.2 % (64 patients) and 17.0 % (15 patients) in the surgery and DCRT groups, respectively. Although the surgery group displayed a trend toward improved OS (77.8 % vs. 65.8 %, p = 0.072) in initial analysis, no significant difference in disease-free survival (DFS) was observed between the groups (78.5 % vs. 74.7 %, p = 0.854). After PSM, the survival differences disappeared, demonstrating equivalent OS, locoregional DFS (LRDFS), and DFS. DCRT was associated with significantly better distant DFS (DDFS) (p = 0.011). CONCLUSIONS: DCRT was equivalent to esophagectomy in terms of LRDFS, DFS, and OS rates in patients with cT1bN0M0 ESCC.
Assuntos
Quimiorradioterapia , Neoplasias Esofágicas , Carcinoma de Células Escamosas do Esôfago , Esofagectomia , Humanos , Feminino , Masculino , Estudos Retrospectivos , Neoplasias Esofágicas/terapia , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/mortalidade , Pessoa de Meia-Idade , Idoso , Carcinoma de Células Escamosas do Esôfago/terapia , Carcinoma de Células Escamosas do Esôfago/patologia , Carcinoma de Células Escamosas do Esôfago/mortalidade , Estadiamento de Neoplasias , Taxa de Sobrevida , Pontuação de Propensão , República da Coreia , Recidiva Local de Neoplasia , AdultoRESUMO
Population aging is an increasing challenge for cancer control in rapidly aging societies, yet remains inadequately quantified. We aim to project and illustrate the cancer burden attributable to aging in Korea by utilizing age-period-cohort (APC) models and population attributable fraction (PAF) concepts. From population-based cancer data, incidence and mortality of cancers primarily affected by aging (stomach, colorectal, liver, gallbladder, pancreatic, lung, non-Hodgkin lymphoma, esophagus, prostate, ovarian, male bladder cancers, and female leukemia) and breast cancer were extracted. Aging-attributable fraction, cases, and deaths were estimated for older ages after projection to 2046 by APC models. Future cancer landscapes were projected to evolve due to population aging. While aging-related lung cancer may remain the highest (from 2017-2021: 94,990 cases, 71,726 deaths, PAFmortality 78%; to 2042-2046: 220,251 cases, PAFincidence 78%, 114,476 deaths, PAFmortality 88%), the current high burden of stomach and liver cancers, likely related to infection, will shift to older age with reduced aging-attributable cases but increased PAFincidence. Emerging burden will arise from lifestyle-related cancers, including colorectal cancer mortality (mortality-to-incidence ratio [MIR] of age ≥65 0.41 to 0.46) and prostate and breast cancer incidence (for age ≥65: 60,099 to 228,539 cases, PAFincidence 74% to 86%; and 1316 to 31,874 cases, PAFincidence 1% to 22%, respectively). Our findings highlight the coexistence of traditional and emerging burdens, which should be key priorities for cancer control programs when societies enter the upcoming super-aged decades. Efforts to mitigate forecasted trends are urgently required, including cancer prevention targeting middle-aged adults and cancer care for frail older patients.
Assuntos
Envelhecimento , Neoplasias , Humanos , Masculino , Feminino , Neoplasias/epidemiologia , Neoplasias/mortalidade , Idoso , Pessoa de Meia-Idade , Incidência , República da Coreia/epidemiologia , Idoso de 80 Anos ou mais , Adulto , Efeitos Psicossociais da DoençaRESUMO
BACKGROUND AND AIMS: Although secondhand smoke (SHS) exposure has been linked with metabolic syndrome (MetS) in never-smokers, its effects among individuals who have quit smoking remain unclear. This study investigated the relationship between changes in SHS exposure and incident MetS in a large cohort of Korean former smokers. METHODS AND RESULTS: We analyzed 17,269 Korean former smokers without MetS at baseline from a longitudinal cohort, with a median follow-up of three years. SHS exposure was assessed through structured questionnaires at both baseline and follow-up, categorizing participants into four groups: no exposure, new exposure, former exposure, and sustained exposure. MetS incidence was higher in the new and sustained SHS exposure groups than in the no exposure group (34.1, 42.9, 37.4, and 44.9 per 1000 person-years for no, new, former, and sustained exposure groups, respectively). Multivariable Cox proportional hazards models demonstrated that the new exposure and sustained exposure groups had significantly increased MetS risks compared to the no exposure group (HR [95 % CI], 1.32[1.09-1.60] and 1.43[1.23-1.66], respectively). A dose-response relationship was observed with increasing daily and cumulative SHS exposure. The former exposure group showed no reduction in MetS risk (HR 0.99[0.88-1.11]) but showed favorable trends in individual MetS components including fasting glucose, waist circumference, and blood pressure. CONCLUSION: Continued or newly acquired SHS exposure increases the risk of MetS in former smokers, suggesting the need for complete SHS avoidance even after smoking cessation.