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1.
Cost Eff Resour Alloc ; 22(1): 19, 2024 Mar 02.
Artículo en Inglés | MEDLINE | ID: mdl-38431579

RESUMEN

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is associated with a high readmission rate and poses a significant disease burden. South Korea initiated pilot projects on transitional care services (TCS) to reduce readmissions. However, evidence from cost-effectiveness analyses remains undiscovered. This study aimed to evaluate the cost-effectiveness of TCS in patients with COPD from the healthcare system' perspective. METHOD: A cost-utility analysis was conducted using a Markov model containing six components of possible medical use after discharge. Transition probabilities and medical costs were extracted from the National Health Insurance Service Senior Cohort (NHIS-SC), and utility data were obtained from published literature. Sensitivity analyses were performed to test the robustness of the results. RESULTS: Conducting TCS produced an incremental quality-adjusted life years gain of 0.231, 0.275, 0.296 for those in their 60s, 70s, and 80s, respectively, and cost savings of $225.16, $1668, and $2251.64 for those in their 60s, 70s, and 80s, respectively, per patient over a 10-year time horizon. The deterministic sensitivity analysis indicated that the TCS cost and the cost of readmission by other diseases immensely impact the results. The probabilistic sensitivity analyses showed that the probability that the incremental cost-effectiveness ratio is below $23,050 was over 85%, 93%, and 97% for those in the 60s, 70s, and 80s, respectively. CONCLUSIONS: TCS was the dominant option compared to usual care. However, it is advantageous to the healthcare budget preferentially consider patients aged over 70 years with severe TCS symptoms. In addition, it is essential to include the management of underlying comorbidities in TCS intervention. TRIAL REGISTRATION: Clinical Research Information Service (CRIS), KCT0007937. Registered on 24 November 2022.

2.
BMC Health Serv Res ; 24(1): 240, 2024 Feb 23.
Artículo en Inglés | MEDLINE | ID: mdl-38395843

RESUMEN

BACKGROUND: Transitional care is an integrated service to ensure coordination and continuity of patients' healthcare. Many models are being developed and implemented for this care. This study aims to identify the facilitators and obstacles of project performance through the experiences of the coordinator in charge of the Community Linkage Program for Discharge Patients (CLDP), a representative transitional care program in Korea. METHOD: Forty-one coordinators (nurses and social workers) from 21 hospitals were interviewed using a semi-structured questionnaire, and thematic analysis was performed. RESULT: Three themes were found as factors that facilitate or hinder CLDP: Formation and maintenance of cooperative relationships; Communication and information sharing system for patient care; and interaction among program, regional, and individual capabilities. These themes were similar regardless of the size of the hospitals. CONCLUSION: A well-implemented transitional care model requires a program to prevent duplication and form a cooperative relationship, common computing platform to share patient information between institutions, and institutional assistance to set long-term directions focused on patient needs and support coordinators' capabilities.


Asunto(s)
Cuidado de Transición , Humanos , Atención a la Salud , Hospitales , Investigación Cualitativa , República de Corea
3.
Fitoterapia ; 174: 105859, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38354819

RESUMEN

In this study, we examined physiological functions as a key material to develop cosmeceuticals using extracts of Lagerstroemia macrocarpa Wall. Ex Kurz (L. macrocarpa). Initially, the L. macrocarpa extract was treated by different concentration and antioxidant assay (DPPH and ABTS) were performed to measure free radical scavenging ability. In the cytotoxicity experiment, the extract was treated into human epidermal keratinocytes with different concentrations to measure cytotoxicity. We found that the extract induces differentiation markers such as keratin (KRT)1, KRT2, KRT9, KRT10 in keratinocytes. Furthermore, the extract significantly induces involucrin (IVL), loricrin (LOR), claudin1 (CLDN1), and filaggrin (FLG) expression, suggesting that it may enhance skin barrier functions. Especially, the extract restored FLG expression inhibited by interleukin (IL)-4/IL-13 in in vitro atopic dermatitis-like model. Therefore, we expect L. macrocarpa extract will be an effective material to develop the therapeutic and cosmeceutical of atopic dermatitis.


Asunto(s)
Dermatitis Atópica , Lagerstroemia , Humanos , Lagerstroemia/metabolismo , Dermatitis Atópica/tratamiento farmacológico , Dermatitis Atópica/metabolismo , Proteínas de Filamentos Intermediarios/metabolismo , Proteínas de Filamentos Intermediarios/farmacología , Proteínas de Filamentos Intermediarios/uso terapéutico , Estructura Molecular , Queratinocitos , Extractos Vegetales/metabolismo , Transducción de Señal , Factor de Transcripción STAT6/metabolismo , Factor de Transcripción STAT6/farmacología
4.
Pharmaceuticals (Basel) ; 16(10)2023 Sep 27.
Artículo en Inglés | MEDLINE | ID: mdl-37895834

RESUMEN

Allium hookeri (AH) has been used as a nutritional and medicinal food in Asia for many years. Our previous studies have described its anti-diabetic, anti-obesity, and anti-inflammatory activities in animal models and prediabetes. This study investigated whether AH could improve glycemia by modulating insulin secretion in prediabetic subjects through an in-depth study. Eighty prediabetic subjects (100 ≤ fasting plasma glucose < 140 mg/dL) were randomly assigned to a placebo (n = 40) group or an ethanol AH extract (500 mg/day, n = 40) group for 12 weeks. Dietary intake and physical activity, blood glucose (an oral glucose tolerance test for 120 min), insulin (insulin response to oral glucose for 120 min), area under the curve (AUC) of glucose or insulin after oral glucose intake, insulin sensitivity markers, C-peptide, adiponectin, glycated hemoglobin A1c (HbA1c) levels, hematological tests (WBC, RBC, hemoglobin, hematocrit, and platelet count), blood biochemical parameters (ALP, AST, total bilirubin, total protein, albumin, gamma-GT, BUN, creatinine, LD, CK, and hs-CRP), and urine parameters (specific gravity and pH) were examined at both baseline and 12 weeks after supplementation with placebo or AH capsules. Fifty-eight participants (placebo group: 20 men and 10 women; AH group: 13 men and 15 women) completed the study. AH supplementation moderately reduced postprandial blood glucose at 60 min (-6.14 mg/dL, p = 0.061), postprandial insulin levels at 90 min (-16.69 µU/mL, p = 0.017), the glucose AUC at 90 min (-412.52 mg*min/dL, p = 0.021), as well as the insulin AUC at 90 min (-978.77 µU*min/mL, p = 0.021) and 120 min (-1426.41 µU*min/mL, p = 0.015) when compared with the placebo group. However, there were no effects of AH on dietary intake and physical activity; HOMA index; HbAlc; C-peptide; or adiponectin, hematological-, blood biochemical-, and urinary markers. To confirm the effects of AH extract on blood glucose insulin sensitivity, C57BL/6J or C57BL/KsJ-db/db mice were used (n = 8/group). Body weight, fasting plasma glucose level, lipid profiles, liver and renal function, pancreatic histology, and insulin immunoreactivity were assessed. In the diabetic db/db mice, hyperglycemia, which was accompanied by an increase in insulin secretion in diabetic mice, was significantly reduced by AH treatment, resulting in the alleviation of ß-cell overcompensation and insulin resistance. We confirmed that AH supplementation can effectively control blood glucose and insulin levels by improving insulin sensitivity and may be a potential agent for glycemic control in subjects with prediabetes and type 2 diabetes mellitus.

5.
Molecules ; 28(16)2023 Aug 18.
Artículo en Inglés | MEDLINE | ID: mdl-37630370

RESUMEN

Atopic dermatitis (AD) is a common inflammatory skin disease characterized by pruritic lesions and skin barrier dysfunction. In this study, we evaluated the effect of a quinazoline derivative, SH-340, on TSLP expression and signaling in human primary keratinocytes. Our results demonstrated that SH-340 significantly increased factors for differentiation and skin barrier function including KRT1, KRT2, KRT10, IVL, LOR, CLDN1, OVOL1, and FLG, whereas it inhibited TSLP expression in a dose-dependent manner, both at the mRNA and protein levels. Furthermore, SH-340 was found to inhibit the phosphorylation of STAT6, a downstream signaling molecule of IL-4 and IL-13, in keratinocytes. These findings suggest that SH-340 may suppress TSLP expression by inhibiting the IL-4/IL-13-STAT6 signaling pathway. Finally, SH-340 may potentially contribute to both the alleviation of inflammation and the restoration of skin barrier function.


Asunto(s)
Dermatitis Atópica , Interleucina-13 , Humanos , Interleucina-4 , Dermatitis Atópica/tratamiento farmacológico , Queratinocitos , Quinazolinas/farmacología
6.
Artículo en Inglés | MEDLINE | ID: mdl-37569047

RESUMEN

Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition characterized by persistent inflammation in the airways, resulting in narrowing and obstruction of the air passages. The development of COPD is primarily attributed to long-term exposure to irritants, such as cigarette smoke and environmental pollutants. Among individuals hospitalized for exacerbations of COPD, approximately one in five is readmitted within 30 days of discharge or encounters immediate post-discharge complications, highlighting a lack of adequate preparedness for self-management. To address this inadequate preparedness, transitional care services (TCS) have emerged as a promising approach. Therefore, this study primarily aims to present a detailed protocol for a multi-site, single-blind, randomized, controlled trial (RCT) aimed at enhancing self-management competency and overall quality of life for patients with COPD through the provision of TCS, facilitated by a proficient Clinical Research Coordinator. The RCT intervention commenced in September 2022 and is set to conclude in December 2024, with a total of 362 COPD patients anticipated to be enrolled in the study. The intervention program encompasses various components, including an initial assessment during hospitalization, comprehensive self-management education, facilitation of social welfare connections, post-discharge home visits, and regular telephone monitoring. Furthermore, follow-up evaluations are conducted at both one month and three months after discharge to assess the effectiveness of the intervention in terms of preventing re-hospitalization, reducing acute exacerbations, and enhancing disease awareness among participants. The results of this study are expected to provide a basis for the development of TCS fee payment policies for future health insurance.


Asunto(s)
Enfermedad Pulmonar Obstructiva Crónica , Cuidado de Transición , Humanos , Anciano , Enfermedad Pulmonar Obstructiva Crónica/terapia , Hospitalización , Terapia Conductista , Hospitales , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto
8.
Artículo en Inglés | MEDLINE | ID: mdl-37297657

RESUMEN

This study aimed to systematically review the effects of transitional care programs on healthcare use and quality of life in patients with chronic obstructive pulmonary disease (COPD). Several databases were searched for randomized controlled trials conducted over the past five years, and their quality was evaluated using the Cochrane Risk of Bias 2.0 tool. For indicators with available statistical information, a meta-analysis was performed using RevMan 5.4, and a narrative review was performed for the rest of the results. In the meta-analysis, no statistically significant difference was observed between the intervention and control groups in the number of readmissions and emergency room visits due to COPD. The relative risk (RR) of readmission for COPD was lower in the intervention group. Respiratory-related quality of life tended to be better in the intervention group, though not significantly. Physical capacity was improved in the intervention group. Considering the characteristics of the complex intervention, the context and factors of cases where the expected results could be obtained and cases where the expected results could not be obtained were reviewed and discussed. Based on the results of the analysis, implications for the development of better protocols were presented.


Asunto(s)
Enfermedad Pulmonar Obstructiva Crónica , Cuidado de Transición , Humanos , Calidad de Vida , Enfermedad Pulmonar Obstructiva Crónica/terapia , Alta del Paciente , Hospitales
9.
Metabolites ; 12(8)2022 Aug 03.
Artículo en Inglés | MEDLINE | ID: mdl-36005589

RESUMEN

Skin has heterogenous identities on different body sites despite similar cellular compositions. There are two types of skin, volar (palmoplantar) and non-volar (dorsal), which are characterized by epidermal thickness, pigmentation, and presence of hair follicles. However, the mechanisms underlying the development of these different skin types remain unclear. To investigate these, we profiled the cellular metabolites of volar and non-volar skin in mice using gas chromatography-time-of-flight/mass spectrometry (GC-TOF/MS), and further assessed the metabolic differences between them. In total, 96 metabolites from both volar and non-volar skin of mice were identified using the BinBase database system. Metabolomics analysis revealed important differences associated with amino acid metabolism (phenylalanine, tyrosine, and tryptophan biosynthesis; aspartate and glutamate metabolism), sugar metabolism (pentose phosphate pathway), and nucleotide metabolism (pyrimidine metabolism) in volar skin. Fifty metabolites were identified as potential biomarkers differentiating the physiological characteristics of these skin types. Of these, nine were highly increased whereas 41 were significantly decreased in volar skin compared with those in non-volar skin. Overall, these results provide valuable information for understanding the metabolic differences between volar and non-volar skin.

10.
PLoS One ; 17(5): e0267645, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35507600

RESUMEN

OBJECTIVES: To assess efficacy and safety of the combined treatment of antibiotics (3rd-generation cephalosporin and azithromycin) and antiviral agents (lopinavir/ritonavir or hydroxychloroquine) on moderate COVID-19 patients in South Korea. METHODS: A retrospective cohort study of the 358 laboratory-confirmed SARS-CoV-2 (COVID-19) patients was conducted. 299 patients met inclusion criteria for analysis. Propensity score matching (PSM) and Cox regression method were used to control and adjust for confounding factors. Mild to moderate COVID-19 patients were managed with either CA/LoP (cephalosporin, azithromycin, and lopinavir/ritonavir) (n = 57), CA/HQ (cephalosporin, azithromycin, and hydroxychloroquine) (n = 25) or standard supportive care (n = 217). We analyzed the association between treatment group and standard supportive group in terms of three endpoints: time to symptom resolution, time to viral clearance, and hospital stay duration. Using propensity-score matching analysis, three rounds of propensity-matching analysis were performed to balance baseline characteristics among three cohorts. RESULTS: Kaplan-Meier curves fitted using propensity score-matched data revealed no significant differences on time to symptom resolution, time to viral clearance, hospital stay duration among the three treatment arms (CA/LoP vs Standard, log-rank p-value = 0.2, 0.58, and 0.74 respectively for the three endpoints) (CA/HQ vs Standard, log-rank p-value = 0.46, 0.99, and 0.75 respectively). Similarly, Cox regression analysis on matched cohorts of CA/LoP and standard supportive group showed that hazard ratios of time to symptom resolution (HR: 1.447 [95%-CI: 0.813-2.577]), time to viral clearance(HR: 0.861, [95%-CI: 0.485-1.527]), and hospital stay duration (HR: 0.902, [95%-CI: 0.510-1.595]) were not significant. For CA/HQ and standard supportive group, hazard ratios of the three endpoints all showed no statistical significance (HR: 1.331 [95%-CI:0.631-2.809], 1.005 [95%-CI:0.480-2.105], and 0.887, [95%-CI:0.422-1.862] respectively). No severe adverse event or death was observed in all groups. CONCLUSIONS: Combined treatment of 3rd cephalosporin, azithromycin and either low-dose lopinavir/ritonavir or hydroxychloroquine was not associated with better clinical outcomes in terms of time to symptom resolution, time to viral clearance, and hospital stay duration compared to standard supportive treatment alone. Microbiological evidence should be closely monitored when treating SARS-CoV-2 patients with antibiotics to prevent indiscreet administration of empirical antimicrobial treatments.


Asunto(s)
Tratamiento Farmacológico de COVID-19 , SARS-CoV-2 , Antibacterianos/uso terapéutico , Antivirales/uso terapéutico , Azitromicina/uso terapéutico , Cefalosporinas/uso terapéutico , Humanos , Hidroxicloroquina/uso terapéutico , Lopinavir/uso terapéutico , Estudios Retrospectivos , Ritonavir/uso terapéutico , Resultado del Tratamiento
12.
Nutrients ; 13(8)2021 Jul 28.
Artículo en Inglés | MEDLINE | ID: mdl-34444766

RESUMEN

The goal of treatment for mild cognitive impairment (MCI) is to reduce the existing clinical symptoms, delay the progression of cognitive impairment and prevent the progression to Alzheimer's disease (AD). At present, there is no effective drug therapy for AD treatment. However, early intake of dietary supplements may be effective in alleviating and delaying the MCI. This study aims to evaluate the effects of sesame oil cake extract (SOCE) supplementation on cognitive function in aged 60 years or older adults with memory impairment. A total of 70 subjects received either SOCE (n = 35) or placebo (n = 35) for 12 weeks based on random 1:1 assignment to these two groups. Cognitive function was evaluated by a computerized neurocognitive function test (CNT), and changes in the concentrations of plasma amyloid ß (Aß) proteins and urine 8-OHdG (8-hydroxy-2'-deoxyguanosine) were investigated before and after the experiment. Verbal learning test index items of the CNT improved markedly in the SOCE group compared to the placebo group (p < 0.05). Furthermore, plasma amyloid-ß (1-40) and amyloid-ß (1-42) levels in the SOCE group decreased significantly compared to that in the placebo group (p < 0.05). There was no statistically significant difference in urine 8-OHdG between the two groups (p > 0.05). Collectively, intake of SOCE for 12 weeks appears to have a beneficial effect on the verbal memory abilities and plasma ß-amyloid levels of older adults with memory impairment.


Asunto(s)
Suplementos Dietéticos , Memoria/efectos de los fármacos , Extractos Vegetales/farmacología , Aceite de Sésamo/farmacología , Anciano , Enfermedad de Alzheimer/tratamiento farmacológico , Péptidos beta-Amiloides/sangre , Péptidos beta-Amiloides/metabolismo , Cognición/efectos de los fármacos , Disfunción Cognitiva/tratamiento farmacológico , Dioxoles , Método Doble Ciego , Ingestión de Alimentos , Femenino , Furanos , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto
13.
J Cell Mol Med ; 25(17): 8300-8311, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34318593

RESUMEN

Dasatinib is an inhibitor of Src that has anti-tumour effects on many haematological and solid cancers. However, the anti-tumour effects of dasatinib on human oral cancers remain unclear. In this study, we investigated the effects of dasatinib on different types of human oral cancer cells: the non-tumorigenic YD-8 and YD-38 and the tumorigenic YD-10B and HSC-3 cells. Strikingly, dasatinib at 10 µM strongly suppressed the growth and induced apoptosis of YD-38 cells and inhibited the phosphorylation of Src, EGFR, STAT-3, STAT-5, PKB and ERK-1/2. In contrast, knockdown of Src blocked the phosphorylation of EGFR, STAT-5, PKB and ERK-1/2, but not STAT-3, in YD-38 cells. Dasatinib induced activation of the intrinsic caspase pathway, which was inhibited by z-VAD-fmk, a pan-caspase inhibitor. Dasatinib also decreased Mcl-1 expression and S6 phosphorylation while increased GRP78 expression and eIF-2α phosphorylation in YD-38 cells. In addition, to its direct effects on YD-38 cells, dasatinib also exhibited anti-angiogenic properties. Dasatinib-treated YD-38 or HUVEC showed reduced HIF-1α expression and stability. Dasatinib alone or conditioned media from dasatinib-treated YD-38 cells inhibited HUVEC tube formation on Matrigel without affecting HUVEC viability. Importantly, dasatinib's anti-growth, anti-angiogenic and pro-apoptotic effects were additionally seen in tumorigenic HSC-3 cells. Together, these results demonstrate that dasatinib has strong anti-growth, anti-angiogenic and pro-apoptotic effects on human oral cancer cells, which are mediated through the regulation of multiple targets, including Src, EGFR, STAT-3, STAT-5, PKB, ERK-1/2, S6, eIF-2α, GRP78, caspase-9/3, Mcl-1 and HIF-1α.


Asunto(s)
Antineoplásicos/farmacología , Biomarcadores de Tumor/metabolismo , Carcinoma de Células Escamosas/tratamiento farmacológico , Dasatinib/farmacología , Neoplasias de la Boca/tratamiento farmacológico , Inhibidores de Proteínas Quinasas/farmacología , Línea Celular Tumoral , Humanos
14.
J Prev Med Public Health ; 54(1): 1-7, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33618493

RESUMEN

The Korean government's strategy to combat coronavirus disease 2019 (COVID-19) has focused on non-pharmaceutical interventions, such as social distancing and wearing masks, along with testing, tracing, and treatment; overall, its performance has been relatively good compared to that of many other countries heavily affected by COVID-19. However, little attention has been paid to health equity in measures to control the COVID-19 pandemic. The study aimed to examine the unequal impacts of COVID-19 across socioeconomic groups and to suggest potential solutions to tackle these inequalities. The pathways linking social determinants and health could be entry points to tackle the unequal consequences of this public health emergency. It is crucial for infectious disease policy to consider social determinants of health including poor housing, precarious working conditions, disrupted healthcare services, and suspension of social services. Moreover, the high levels of uncertainty and complexity inherent in this public health emergency, as well as the health and socioeconomic inequalities caused by the pandemic, underscore the need for good governance other than top-down measures by the government. We emphasize that a people-centered perspective is a key approach during the pandemic era. Mutual trust between the state and civil society, strong accountability of the government, and civic participation are essential components of cooperative disaster governance.


Asunto(s)
COVID-19/prevención & control , Equidad en Salud/normas , Política de Salud , Infectología/legislación & jurisprudencia , COVID-19/fisiopatología , Programas de Gobierno/legislación & jurisprudencia , Programas de Gobierno/métodos , Equidad en Salud/estadística & datos numéricos , Humanos , Infectología/métodos , Infectología/tendencias , Pandemias/prevención & control , Pandemias/estadística & datos numéricos , Salud Pública/legislación & jurisprudencia , Salud Pública/métodos , Salud Pública/tendencias , República de Corea
15.
J Korean Med Sci ; 35(30): e280, 2020 Aug 03.
Artículo en Inglés | MEDLINE | ID: mdl-32743995

RESUMEN

BACKGROUND: The fatality rate of patients with coronavirus disease 2019 (COVID-19) varies among countries owing to demographics, patient comorbidities, surge capacity of healthcare systems, and the quality of medical care. We assessed the clinical outcomes of patients with COVID-19 during the first wave of the epidemic in Korea. METHODS: Using a modified World Health Organization clinical record form, we obtained clinical data for 3,060 patients with COVID-19 treated at 55 hospitals in Korea. Disease severity scores were defined as: 1) no limitation of daily activities; 2) limitation of daily activities but no need for supplemental oxygen; 3) supplemental oxygen via nasal cannula; 4) supplemental oxygen via facial mask; 5) non-invasive mechanical ventilation; 6) invasive mechanical ventilation; 7) multi-organ failure or extracorporeal membrane oxygenation therapy; and 8) death. Recovery was defined as a severity score of 1 or 2, or discharge and release from isolation. RESULTS: The median age of the patients was 43 years of age; 43.6% were male. The median time from illness onset to admission was 5 days. Of the patients with a disease severity score of 3-4 on admission, 65 (71.5%) of the 91 patients recovered, and 7 (7.7%) died due to illness by day 28. Of the patients with disease severity scores of 5-7, 7 (19.5%) of the 36 patients recovered, and 8 (22.2%) died due to illness by day 28. None of the 1,324 patients who were < 50 years of age died; in contrast, the fatality rate due to illness by day 28 was 0.5% (2/375), 0.9% (2/215), 5.8% (6/104), and 14.0% (7/50) for the patients aged 50-59, 60-69, 70-79, and ≥ 80 years of age, respectively. CONCLUSION: In Korea, almost all patients of < 50 years of age with COVID-19 recovered without supplemental oxygen. In patients of ≥ 50 years of age, the fatality rate increased with age, reaching 14% in patients of ≥ 80 years of age.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/terapia , Neumonía Viral/epidemiología , Neumonía Viral/terapia , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , COVID-19 , Niño , Preescolar , Infecciones por Coronavirus/diagnóstico , Recolección de Datos , Progresión de la Enfermedad , Femenino , Geografía , Hospitalización , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Mortalidad , Evaluación de Resultado en la Atención de Salud , Pandemias , Aislamiento de Pacientes , Neumonía Viral/diagnóstico , República de Corea/epidemiología , Respiración Artificial , Índice de Severidad de la Enfermedad , Capacidad de Reacción , Resultado del Tratamiento , Organización Mundial de la Salud , Adulto Joven
16.
Int J Infect Dis ; 99: 279-285, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32763446

RESUMEN

OBJECTIVES: The aim of this study was to elucidate patterns of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) clearance in the natural course of asymptomatic coronavirus disease 2019 (COVID-19). METHODS: Consecutive patients with non-severe COVID-19 were included retrospectively. Asymptomatic patients with a normal body temperature and no evidence of pneumonia throughout the disease course were assigned to the asymptomatic group. The reverse transcription PCR (RT-PCR) assay was repeated every two to five days after the first follow-up RT-PCR assay. Negative conversion was defined as two consecutive negative RT-PCR assay results within a 24-h interval. Rebound of the cycle threshold (Ct) value was defined as negative from the single RT-PCR assay and positive from the following assay. RESULTS: Among a total of 396 patients identified (median age 42.5 years (interquartile range (IQR) 25.0-55.0 years), 35.6% male), 68 (17.2%) were assigned to the asymptomatic group and 328 (82.8%) to the symptomatic group. The time until negative conversion was significantly shorter in the asymptomatic group than in the symptomatic group: median 14.5 days (IQR 11.0-21.0 days) and 18.0 days (IQR 15.0-22.0 days), respectively (p = 0.001). Rebound of Ct values was observed in 78 patients (19.7%). CONCLUSIONS: Time until negative conversion is shorter in asymptomatic COVID-19 than in symptomatic COVID-19. Rebound of Ct values is not uncommon.


Asunto(s)
Betacoronavirus/genética , Infecciones por Coronavirus/epidemiología , Pandemias , Neumonía Viral/epidemiología , Adulto , Enfermedades Asintomáticas , COVID-19 , Estudios de Cohortes , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/virología , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neumonía Viral/diagnóstico , Neumonía Viral/virología , República de Corea/epidemiología , Estudios Retrospectivos , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , SARS-CoV-2 , Carga Viral
17.
BMC Infect Dis ; 20(1): 445, 2020 Jun 23.
Artículo en Inglés | MEDLINE | ID: mdl-32576139

RESUMEN

BACKGROUND: Coronavirus disease (COVID-19) is rapidly spreading worldwide. Although 10-20% of patients with COVID-19 have severe symptoms, little is known about the risk factors related to the aggravation of COVID-19 symptoms from asymptomatic or mild to severe disease states. METHODS: This retrospective study included 211 patients who were asymptomatic or with mild presentations of COVID-19. We evaluated the differences in demographic and clinical data between the cured (discharged to home) and transferred (aggravated to severe-stage COVID-19) groups. RESULTS: A multivariate logistic analysis showed that body temperature, chills, initial chest X-ray findings, and the presence of diabetes were significantly associated with predicting the progression to severe stage of COVID-19 (p < 0.05). The odds ratio of transfer in patients with COVID-19 increased by 12.7-fold for abnormal findings such as haziness or consolidation in initial chest X-ray, 6.32-fold for initial symptom of chills, and 64.1-fold for diabetes. CONCLUSIONS: Even if patients are asymptomatic or have mild symptoms, clinicians should closely observe patients with COVID-19 presenting with chills, body temperature > 37.5 °C, findings of pneumonia in chest X-ray, or diabetes.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/fisiopatología , Neumonía Viral/epidemiología , Neumonía Viral/fisiopatología , Betacoronavirus , COVID-19 , Estudios de Cohortes , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico por imagen , Complicaciones de la Diabetes , Progresión de la Enfermedad , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico por imagen , República de Corea , Estudios Retrospectivos , Factores de Riesgo , SARS-CoV-2
18.
Health Educ Behav ; 47(4): 525-530, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32443944

RESUMEN

This study aims to analyze South Korea's experience during the COVID-19 outbreak through a gendered lens. We briefly introduce the COVID-19 outbreak in Korea, scrutinize gendered vulnerability in contracting the virus, and then analyze the gendered aspects of the pandemic response in two phases: quarantine policy and mitigation policy. The authors elicit four lessons from the analysis. First, gender needs to be mainstreamed at all stages of a public health emergency response. Second, in addition to medical care, all formal and informal care work should be considered as an essential component of health care systems. Third, a people-centered approach in health governance should be prioritized to make women's voices heard at every level. Fourth, medical technology and resources to cope with pandemic should be produced and distributed in an equitable manner, acknowledging differential vulnerability and susceptibility.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Salud de la Mujer , Betacoronavirus , COVID-19 , Femenino , Política de Salud , Humanos , Masculino , Pandemias , República de Corea/epidemiología , SARS-CoV-2 , Distribución por Sexo , Sexismo
19.
Food Sci Biotechnol ; 29(2): 265-273, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32064135

RESUMEN

Steamed ginger ethanolic extract (SGE) is a product with a high 6-shogaol contents and is thought to be more potent than other ginger products. We conducted a 12-week, randomized, double-blind, placebo-controlled clinical trial to determine the effects of SGE on weight and body fat loss. Eighty healthy obese participants were recruited and randomly divided into the SGE and placebo groups. The outcome measures comprised indicators of efficacy (body weight, body mass index, body composition, and blood markers) and safety. Following the supplementation period, mean body weight, body mass index, and body fat level were significantly lower in the SGE group than in the placebo group. No clinically significant changes were observed for any safety parameter. These results suggest that SGE is a potent anti-obesity agent that does not cause significant side effects. Therefore, SGE supplementation combined with lifestyle modification could be effective in the management of body weight and fat mass.

20.
J Korean Med Sci ; 32(3): 393-400, 2017 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-28145640

RESUMEN

The traditional boundaries between public and private sectors has been blurred, and questions raised regarding how publicness could be conceptualized. The empirical study on the concept of publicness can reveal greatly diversified views on publicness, and help to reduce confusion over publicness. For the content analysis, 750 news articles of 8 national Korean newspapers were retrieved from the Korea Integrated News Database System. The articles were coded by the inductive category for the topic of the paragraph, the concept related to publicness, and the overall tone toward publicness. Publicness was addressed in a number of different issues, and diverse and specific statuses or actions were associated with the realization of publicness. The most frequent concept was "government," which represented the main agent of healthcare provision and the owner of institutions for "the vulnerable." Issues of industrialization of healthcare/healthcare industry and reform of the national healthcare system mentioned publicness in a normative sense, which laid stress on "not-for-profit" service and the right of "universal access" to service for publicness. Articles of health/disease information or global health regarded "the population/public" as the main targets or beneficiaries of healthcare services. Occasionally, publicness was not related to specific concepts, being used unclearly or as a routine. The fulfillment of the specific actions or status may lead to the enhancement of publicness. However, publicness itself could not be reduced to the specific concepts suggested. The use of publicness in healthcare delivered only its normative sense without substantive meaning.


Asunto(s)
Atención a la Salud , Periódicos como Asunto , Personal de Salud , Política de Salud , República de Corea
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