ABSTRACT
Background@#In 2017, Korea implemented nationwide latent tuberculosis infection (LTBI) project targeting healthcare workers (HCWs). We aimed to assess its performance using the cascade of care model. @*Methods@#We included 45,503 employees of medical institutions with positive interferongamma release assay result who participated between March 2017 and December 2018. We described percentages of LTBI participants completing each step in the cascade of care.Poisson regression model was conducted to assess individual characteristics and factors associated with not-visiting clinics for further care, not-initiating LTBI treatment, and notcompleting treatment. @*Results@#Proportions of visiting clinics and initiating and completing treatment in HCWs were 54.9%, 38.5%, and 32.0%, respectively. Despite of less likelihood of visiting clinics and initiating LTBI treatment, older age ≥ 65 years were more likely to complete treatment (adjusted relative risk [aRR], 0.80; 95% confidence interval [CI], 0.64–0.99), compared to young age < 35 years. Compared to nurses, doctors were less likely to visit clinic; however, were more likely to initiate treatment (aRR, 0.88; 95% CI, 0.81–0.96). Those who visited public health centers were associated with not-initiating treatment (aRR, 1.34; 95% CI, 1.29–1.40). When treated at private hospitals, 9-month isoniazid monotherapy was less likely to complete treatment, compared to 3-month isoniazid and rifampicin combination therapy (aRR, 1.33; 95% CI, 1.16–1.53). @*Conclusion@#Among employees of medical institutions with LTBI, only one third completed treatment. Age, occupation, treatment center, and initial regimen were significantly related to LTBI treatment performance indicators. Rifampicin-based short treatment regimens were effective under standard of care.
ABSTRACT
In 2017, the Korean government launched an unprecedentedly large-scaled latent tuberculosis infection (LTBI) screening project which covered more than a million individuals in congregate settings. A total of 1,047,689 participants of source population (n = 2,336,157) underwent LTBI testing from 2017 to 2018. The overall LTBI test uptake rate during this project was 44.8%. Workers in daycare centers (83.5%) and kindergartens (78.9%) showed high participation rate. A total of 1,012,206 individuals with valid results of interferongamma release assay (IGRA) were selected to constitute the IGRA cohort. Most of the enrolled participants in the IGRA cohort were in their working age. Approximately, threequarters of total enrolled population were female. Investigating the LTBI prevalence, stages of LTBI care cascade, natural history of LTBI, efficacy of LTBI treatment and cost-effectiveness of LTBI screening are feasible within this IGRA cohort.
ABSTRACT
Lipids, which along with carbohydrates and proteins are among the most important nutrients for the living organism, have a variety of biological functions that can be applied widely in biomedicine. A fatty acid, the most fundamental biological lipid, may be classified by length of its aliphatic chain, and the short-, medium-, and long-chain fatty acids and each have distinct biological activities with therapeutic relevance. For example, short-chain fatty acids have immune regulatory activities and could be useful against autoimmune disease; medium-chain fatty acids generate ketogenic metabolites and may be used to control seizure; and some metabolites oxidized from long-chain fatty acids could be used to treat metabolic disorders. Glycerolipids play important roles in pathological environments, such as those of cancers or metabolic disorders, and thus are regarded as a potential therapeutic target. Phospholipids represent the main building unit of the plasma membrane of cells, and play key roles in cellular signaling. Due to their physical properties, glycerophospholipids are frequently used as pharmaceutical ingredients, in addition to being potential novel drug targets for treating disease. Sphingolipids, which comprise another component of the plasma membrane, have their own distinct biological functions and have been investigated in nanotechnological applications such as drug delivery systems. Saccharolipids, which are derived from bacteria, have endotoxin effects that stimulate the immune system. Chemically modified saccharolipids might be useful for cancer immunotherapy or as vaccine adjuvants. This review will address the important biological function of several key lipids and offer critical insights into their potential therapeutic applications.
ABSTRACT
In 2017, the Korean government launched an unprecedentedly large-scaled latent tuberculosis infection (LTBI) screening project which covered more than a million individuals in congregate settings. A total of 1,047,689 participants of source population (n = 2,336,157) underwent LTBI testing from 2017 to 2018. The overall LTBI test uptake rate during this project was 44.8%. Workers in daycare centers (83.5%) and kindergartens (78.9%) showed high participation rate. A total of 1,012,206 individuals with valid results of interferongamma release assay (IGRA) were selected to constitute the IGRA cohort. Most of the enrolled participants in the IGRA cohort were in their working age. Approximately, threequarters of total enrolled population were female. Investigating the LTBI prevalence, stages of LTBI care cascade, natural history of LTBI, efficacy of LTBI treatment and cost-effectiveness of LTBI screening are feasible within this IGRA cohort.
ABSTRACT
Lipids, which along with carbohydrates and proteins are among the most important nutrients for the living organism, have a variety of biological functions that can be applied widely in biomedicine. A fatty acid, the most fundamental biological lipid, may be classified by length of its aliphatic chain, and the short-, medium-, and long-chain fatty acids and each have distinct biological activities with therapeutic relevance. For example, short-chain fatty acids have immune regulatory activities and could be useful against autoimmune disease; medium-chain fatty acids generate ketogenic metabolites and may be used to control seizure; and some metabolites oxidized from long-chain fatty acids could be used to treat metabolic disorders. Glycerolipids play important roles in pathological environments, such as those of cancers or metabolic disorders, and thus are regarded as a potential therapeutic target. Phospholipids represent the main building unit of the plasma membrane of cells, and play key roles in cellular signaling. Due to their physical properties, glycerophospholipids are frequently used as pharmaceutical ingredients, in addition to being potential novel drug targets for treating disease. Sphingolipids, which comprise another component of the plasma membrane, have their own distinct biological functions and have been investigated in nanotechnological applications such as drug delivery systems. Saccharolipids, which are derived from bacteria, have endotoxin effects that stimulate the immune system. Chemically modified saccharolipids might be useful for cancer immunotherapy or as vaccine adjuvants. This review will address the important biological function of several key lipids and offer critical insights into their potential therapeutic applications.
ABSTRACT
The purpose of this study was to investigate the relationship between hormone replacement therapy (HRT) and periodontal disease in postmenopausal women using data from the 4th and 5th Korea National Health and Nutrition Examination Survey. A total of 5,482 postmenopausal women aged 45~75 years were included as study subjects in the final analysis. The HRT group comprised 1,035 postmenopausal women who had received HRT for at least one month, and the non-HRT group comprised 4,447 postmenopausal women who did not receive HRT. The chi-square test was used to confirm the bivariate relationship between the variables. Multinomial logistic regression analysis was used to adjust for covariance (age, education, family income, body mass index, age of menopause, alcohol, smoking, dental visit < 1 per year, use of oral care products, and frequency of tooth brushing per day). After adjusting for all covariates, HRT was found to be associated with periodontal disease. In particular, the relationship between HRT and periodontal disease was more evident in older women and women younger than 45 years of menopausal age. The relationship between HRT and periodontal disease was stronger in women who brushed their teeth less than 3 times per day, women without regular oral examination, and women who did not use oral hygiene products. The results of this study confirmed the importance of actively considering hormone therapy when determining policy recommendations for postmenopausal women. Especially, health programs such as HRT, regular dental examination, and oral care are needed for older women who have undergone premature menopause.
Subject(s)
Female , Humans , Body Mass Index , Diagnosis, Oral , Education , Hormone Replacement Therapy , Korea , Logistic Models , Menopause , Menopause, Premature , Nutrition Surveys , Oral Hygiene , Periodontal Diseases , Smoke , Smoking , ToothABSTRACT
BACKGROUND/OBJECTIVES: Diet quality scores or indices, based on dietary guidelines, are used to summarize dietary intake into a single numeric variable. The aim of this study was to examine the association between the modified diet quality index for Koreans (DQI-K) and mortality among Health Examinees-Gem (HEXA-G) study participants. SUBJECTS/METHODS: The DQI-K was modified from the original diet quality index. A total of 134,547 participants (45,207 men and 89,340 women) from the HEXA-G study (2004 and 2013) were included. The DQI-K is based on eight components: 1) daily protein intake, 2) percent of energy from fat, 3) percent of energy from saturated fat, 4) daily cholesterol intake, 5) daily whole-grain intake, 6) daily fruit intake, 7) daily vegetable intake, and 8) daily sodium intake. The association between all-cause mortality and the DQI-K was examined using Cox proportional hazard regression models. Hazard ratios and confidence intervals were estimated after adjusting for age, gender, income, smoking status, alcohol drinking, body mass index, and total energy intake. RESULTS: The total DQI-K score was calculated by summing the scores of the eight components (range 0–9). In the multivariable adjusted models, with good diet quality (score 0–4) as a reference, poor diet quality (score 5–9) was associated with an increased risk of all-cause mortality (hazard ratios = 1.23, 95% confidence intervals = 1.06–1.43). Moreover, a one-unit increase in DQI-K score resulted in a 6% higher mortality risk. CONCLUSIONS: A poor diet quality DQI-K score was associated with an increased risk of mortality. The DQI-K in the present study may be used to assess the diet quality of Korean adults.
Subject(s)
Adult , Humans , Male , Alcohol Drinking , Body Mass Index , Cholesterol , Cohort Studies , Diet , Energy Intake , Fruit , Korea , Mortality , Nutrition Policy , Smoke , Smoking , Sodium , VegetablesABSTRACT
PURPOSE: The population of end-stage renal failure patients dependent on hemodialysis continues to expand with an increasing number of patients having an unsuitable cephalic vein or failed radio- and brachio-cephalic fistula. In these patients, the transposed basilic vein to brachial artery arteriovenous fistula (BaVT) provides autologous choice for hemodialysis. The results of basilic vein transposition arteriovenous fistula were assessed. MATERIALS AND METHODS: Three hundred cases of BaVT performed at a single center during the period of January 2005 to December 2011 were reviewed retrospectively. Data including demographics and postoperative complications were collected. Primary and secondary patency rates were determined by using Kaplan-Meier methods. RESULTS: The median age of patients was 57.4±13.1 years, and 154 patients were male. Renal failure was associated with hypertension in 88.7%, and with diabetes in 34.0%. The mean follow-up was 27.4±20.0 (12 to 72) months. There was no operation-related death. Eighteen patients required prosthetic graft interposition because of short vein. Thirty-five postoperative complications developed in 41 patients (148 cases), including thrombosis, stenosis, hematoma, seroma, arm swelling, steal syndrome, infection and aneurysm formation. Primary patency of BaVT was 69%, 60%, 53%, 52%, 44%, and 22% at 1, 2, 3, 4, 5, and 6 years, respectively. Secondary patency was 99%, 97%, 97%, 97%, 95%, and 95%, respectively. CONCLUSION: Chronic renal failure patients with hemodialysis may benefit from BaVT, because of high patency, less radiologic procedure, and less infection rate. The BaVT fistula should be used in preference to polytetrafluoroethylene grafts for secondary access.
Subject(s)
Humans , Male , Aneurysm , Arm , Arteriovenous Fistula , Brachial Artery , Constriction, Pathologic , Demography , Fistula , Follow-Up Studies , Hematoma , Hypertension , Kidney Failure, Chronic , Ocimum basilicum , Polytetrafluoroethylene , Postoperative Complications , Renal Dialysis , Renal Insufficiency , Retrospective Studies , Seroma , Thrombosis , Transplants , VeinsABSTRACT
OBJECTIVES: The purpose of this study was to develop clinical decision support systems (CDSS) that are integrated with hospital information systems for the differential diagnosis of idiopathic pulmonary fibrosis (IPF). METHODS: The integrated CDSS were validated and evaluated by physicians. Knowledge modeling for diagnosing IPF was performed by knowledge working groups, composed of radiologists and respiratory specialists. In order to develop the model for CDSS diagnosis, the clinical cases were collected from 290 cases from Seoul National University Hospital and Sevrance Hospital of Yonsei University. For the evaluation of integrated CDSS, interviews were conducted with respiratory specialists and radiologist 2 weeks after applying CDSSs in clinical settings. The CDSS was integrated with the computer vision system (CVS) and diffuse parenchymal lung diseases (DPLD), CDSS developed in our previous project. RESULTS: Eighteen cases diagnosed as IPF were applied to the collection of diagnostic knowledge and the refined knowledge, the former diagnosed 1 case (6%) and the latter diagnosed 14 cases (78%). Therefore, the refined knowledge performed better than collected knowledge. The validation results of integrated CDSSs showed that 81 cases (74.3%) were diagnosed correctly. CONCLUSIONS: There were 109 cases of IPF diagnosed and initiated on treatment. The significance of this study is in developing integrated CDSS with PACS by acquiring and redefining the knowledge needed for IPF diagnosis. In addition, it is significant for the integration of CDSS to verification and clinical evaluation.