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1.
Artículo en Inglés | MEDLINE | ID: mdl-33028002

RESUMEN

This study examined the difficulties of running online physical education classes in the context of coronavirus disease 2019 (COVID-19) and used the findings to develop an efficient operation plan to address these difficulties. Six middle and high school physical education teachers participated; three were experts in online physical education and active in the Korea Council School Physical Education Promotion, and three were recommended teachers making efforts to improve the online classes offered by the Korea Ministry of Education. A qualitative case study method employing phenomenological procedures to collect and analyze the data was used. The difficulties of operating middle and high school online physical education classes for the first time included (1) the monotony of the classes within their limited environmental conditions and limited educational content that did not adequately convey the value of physical education, (2) trial-and-error methods applied nationwide, resulting from a lack of expertise in operating online physical education classes, and (3) very limited evaluation guidelines proposed by the Korea Ministry of Education, which made systematic evaluation with online methods impossible. To address the identified problems and facilitate the efficient operation of online physical education classes, changes in strategic learning methods are needed to understand online physical education characteristics and thereby better communicate the value of physical education. It is also necessary to cultivate teaching expertise through sharing online physical education classes, where collaboration among physical education teachers is central. In addition, evaluation processes should be less formal to encourage active student participation.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Educación a Distancia/organización & administración , Pandemias/prevención & control , Educación y Entrenamiento Físico/métodos , Neumonía Viral/prevención & control , Infecciones por Coronavirus/epidemiología , Eficiencia Organizacional , Humanos , Neumonía Viral/epidemiología , República de Corea/epidemiología , Instituciones Académicas , Estudiantes/psicología
2.
Nat Commun ; 11(1): 5009, 2020 10 06.
Artículo en Inglés | MEDLINE | ID: mdl-33024121

RESUMEN

Comorbid conditions appear to be common among individuals hospitalised with coronavirus disease 2019 (COVID-19) but estimates of prevalence vary and little is known about the prior medication use of patients. Here, we describe the characteristics of adults hospitalised with COVID-19 and compare them with influenza patients. We include 34,128 (US: 8362, South Korea: 7341, Spain: 18,425) COVID-19 patients, summarising between 4811 and 11,643 unique aggregate characteristics. COVID-19 patients have been majority male in the US and Spain, but predominantly female in South Korea. Age profiles vary across data sources. Compared to 84,585 individuals hospitalised with influenza in 2014-19, COVID-19 patients have more typically been male, younger, and with fewer comorbidities and lower medication use. While protecting groups vulnerable to influenza is likely a useful starting point in the response to COVID-19, strategies will likely need to be broadened to reflect the particular characteristics of individuals being hospitalised with COVID-19.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Hospitalización , Gripe Humana/epidemiología , Pandemias , Neumonía Viral/epidemiología , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Comorbilidad , Infecciones por Coronavirus/tratamiento farmacológico , Femenino , Humanos , Gripe Humana/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Neumonía Viral/tratamiento farmacológico , Prevalencia , República de Corea/epidemiología , Factores Sexuales , España/epidemiología , Estados Unidos/epidemiología , Adulto Joven
3.
Artículo en Inglés | MEDLINE | ID: mdl-33066581

RESUMEN

The outbreak of the novel coronavirus disease 2019 (COVID-19) occurred all over the world between 2019 and 2020. The first case of COVID-19 was reported in December 2019 in Wuhan, China. Since then, there have been more than 21 million incidences and 761 thousand casualties worldwide as of 16 August 2020. One of the epidemiological characteristics of COVID-19 is that its symptoms and fatality rates vary with the ages of the infected individuals. This study aims at assessing the impact of social distancing on the reduction of COVID-19 infected cases by constructing a mathematical model and using epidemiological data of incidences in Korea. We developed an age-structured mathematical model for describing the age-dependent dynamics of the spread of COVID-19 in Korea. We estimated the model parameters and computed the reproduction number using the actual epidemiological data reported from 1 February to 15 June 2020. We then divided the data into seven distinct periods depending on the intensity of social distancing implemented by the Korean government. By using a contact matrix to describe the contact patterns between ages, we investigated the potential effect of social distancing under various scenarios. We discovered that when the intensity of social distancing is reduced, the number of COVID-19 cases increases; the number of incidences among the age groups of people 60 and above increases significantly more than that of the age groups below the age of 60. This significant increase among the elderly groups poses a severe threat to public health because the incidence of severe cases and fatality rates of the elderly group are much higher than those of the younger groups. Therefore, it is necessary to maintain strict social distancing rules to reduce infected cases.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Distancia Social , Distribución por Edad , Anciano , Infecciones por Coronavirus/epidemiología , Humanos , Persona de Mediana Edad , Modelos Teóricos , Neumonía Viral/epidemiología , República de Corea/epidemiología
4.
Medicine (Baltimore) ; 99(40): e22514, 2020 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-33019453

RESUMEN

Despite the controversy surrounding electronic cigarette (e-cigarette) safety, global consumption has been rapidly increasing. We investigated the relationship between e-cigarette use and mental health conditions in adults of various ages.We conducted a secondary data analysis of adults aged 19 to 80 who participated in the first year of the 7th Korea National Health and Nutrition Examination Survey (2016). The total number of participants was 5469, including 3398 non-smokers, 1700 smokers who had never used e-cigarettes, and 371 smokers who had previously used e-cigarettes, selected based on self-report questionnaires. Mental health factors including stress status, depressive mood, suicide plan, and suicide attempt were assessed by self-reported questionnaire. The Patient Health Questionnaire (PHQ-9) was used to assess depressive mood, with a cut-off value of 10. The relationship between e-cigarette use and stress status with depressive mood were analyzed with adjustment for potential confounders.Both male and female smokers who previously used e-cigarettes showed higher levels of stress than non-smokers or smokers who had never used e-cigarettes. The average PHQ-9 score was higher among previous e-cigarette-using smokers relative to non-smokers and smokers who had never used e-cigarettes, regardless of gender. The number of participants with depressive mood was significantly higher in the group of smokers who previously used e-cigarettes. In multivariable-adjusted logistic regression analyses, there was a significantly higher odds ratio for higher stress in male smokers who had previously used e-cigarettes and for depressive mood in female smokers who had previously used e-cigarettes, compared with non-smokers.This study analyzed the association between adult e-cigarette use and mental health conditions, including stress and depressive mood, and showed that e-cigarette use was significantly related to both conditions in men and women.


Asunto(s)
Depresión/epidemiología , Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Salud Mental/estadística & datos numéricos , Estrés Psicológico/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas Nutricionales , República de Corea/epidemiología , Intento de Suicidio/estadística & datos numéricos , Adulto Joven
5.
Artículo en Inglés | MEDLINE | ID: mdl-33081367

RESUMEN

BACKGROUND: The COVID-19 pandemic has swept the world like a gigantic tsunami, turning social and economic activities upside down. METHODS: This paper presents some of the innovative response strategies implemented by the public health system, healthcare facilities, and government in South Korea, which has been hailed as the model country for its success in containing COVID-19. Korea reinvented its public health infrastructure with a sense of urgency. RESULTS: Korea's success rests on its readiness, with the capacity for massive testing and obtaining prompt test results, effective contact tracing based on its world-leading mobile technologies, timely provision of personal protective equipment (PPE) to first responders, effective treatment of infected patients, and invoking citizens' community and civic conscience for the shared goal of defeating the pandemic. The lessons learned from Korea's response in countering the onslaught of COVID-19 provide unique implications for public healthcare administrators and operations management practitioners. CONCLUSION: Since many epidemic experts warn of a second wave of COVID-19, the lessons learned from the first wave will be a valuable resource for responding to the resurgence of the virus.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Infecciones por Coronavirus/epidemiología , Difusión de Innovaciones , Gobierno , Administración de Instituciones de Salud , Humanos , Neumonía Viral/epidemiología , Administración en Salud Pública , República de Corea/epidemiología
6.
BMC Med ; 18(1): 321, 2020 10 09.
Artículo en Inglés | MEDLINE | ID: mdl-33032601

RESUMEN

BACKGROUND: After experiencing a sharp growth in COVID-19 cases early in the pandemic, South Korea rapidly controlled transmission while implementing less stringent national social distancing measures than countries in Europe and the USA. This has led to substantial interest in their "test, trace, isolate" strategy. However, it is important to understand the epidemiological peculiarities of South Korea's outbreak and characterise their response before attempting to emulate these measures elsewhere. METHODS: We systematically extracted numbers of suspected cases tested, PCR-confirmed cases, deaths, isolated confirmed cases, and numbers of confirmed cases with an identified epidemiological link from publicly available data. We estimated the time-varying reproduction number, Rt, using an established Bayesian framework, and reviewed the package of interventions implemented by South Korea using our extracted data, plus published literature and government sources. RESULTS: We estimated that after the initial rapid growth in cases, Rt dropped below one in early April before increasing to a maximum of 1.94 (95%CrI, 1.64-2.27) in May following outbreaks in Seoul Metropolitan Region. By mid-June, Rt was back below one where it remained until the end of our study (July 13th). Despite less stringent "lockdown" measures, strong social distancing measures were implemented in high-incidence areas and studies measured a considerable national decrease in movement in late February. Testing the capacity was swiftly increased, and protocols were in place to isolate suspected and confirmed cases quickly; however, we could not estimate the delay to isolation using our data. Accounting for just 10% of cases, individual case-based contact tracing picked up a relatively minor proportion of total cases, with cluster investigations accounting for 66%. CONCLUSIONS: Whilst early adoption of testing and contact tracing is likely to be important for South Korea's successful outbreak control, other factors including regional implementation of strong social distancing measures likely also contributed. The high volume of testing and the low number of deaths suggest that South Korea experienced a small epidemic relative to other countries. Caution is needed in attempting to replicate the South Korean response in populations with larger more geographically widespread epidemics where finding, testing, and isolating cases that are linked to clusters may be more difficult.


Asunto(s)
Betacoronavirus , Trazado de Contacto/métodos , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Cuarentena/métodos , Teorema de Bayes , Técnicas de Laboratorio Clínico , Trazado de Contacto/tendencias , Infecciones por Coronavirus/diagnóstico , Brotes de Enfermedades/prevención & control , Humanos , Neumonía Viral/diagnóstico , Cuarentena/tendencias , República de Corea/epidemiología
7.
J Korean Med Sci ; 35(34): e314, 2020 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-32864911

RESUMEN

A 14-day quarantine is implemented in many countries in response to the coronavirus disease pandemic. Korea implemented a mandatory quarantine for those who had close contact with infected patients and those returning from abroad. The present study explored the implications of mandatory coronavirus disease 2019 testing before releasing individuals from the 14-day quarantine in Incheon, Korea. From February 11 to July 5, 2020, 19,296 people were self-quarantined, and 56 (0.3%) of them were confirmed cases of COVID-19. Twenty (35.7%) were identified through the reporting of symptoms during quarantine, and 32 (57.1%) were identified using mandatory pre-release RT-PCR tests. Among the 32, 14 (25%) individuals reported mild symptoms and 18 (32.1%) were asymptomatic. It is suggested that mandatory diagnostic testing prior to release and the symptom-based surveillance after the 14-day quarantine may help control delayed or asymptomatic COVID-19 cases.


Asunto(s)
Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Control de Infecciones/legislación & jurisprudencia , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Salud Pública/legislación & jurisprudencia , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Betacoronavirus/aislamiento & purificación , Trazado de Contacto , Femenino , Humanos , Control de Infecciones/métodos , Masculino , Persona de Mediana Edad , Pandemias , Cuarentena , República de Corea/epidemiología , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/métodos , Adulto Joven
8.
J Korean Med Sci ; 35(34): e317, 2020 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-32864913

RESUMEN

BACKGROUND: The novel coronavirus (coronavirus disease 2019 [COVID-19]) outbreak began in China in December last year, and confirmed cases began occurring in Korea in mid-February 2020. Since the end of February, the rate of infection has increased greatly due to mass (herd) infection within religious groups and nursing homes in the Daegu and Gyeongbuk regions. This mass infection has increased the number of infected people more rapidly than was initially expected; the epidemic model based on existing studies had predicted a much lower infection rate and faster recovery. METHODS: The present study evaluated rapid infection spread by mass infection in Korea and the high mortality rate for the elderly and those with underlying diseases through the Susceptible-Exposed-Infected-Recovered-Dead (SEIRD) model. RESULTS: The present study demonstrated early infection peak occurrence (-6.3 days for Daegu and -5.3 days for Gyeongbuk) and slow recovery trend (= -1,486.6 persons for Daegu and -223.7 persons for Gyeongbuk) between the actual and the epidemic model for a mass infection region compared to a normal infection region. CONCLUSION: The analysis of the time difference between infection and recovery can help predict the epidemic peak due to mass (or normal) infection and can also be used as a time index to prepare medical resources.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Modelos Estadísticos , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Betacoronavirus , Niño , Preescolar , Infecciones por Coronavirus/patología , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Casas de Salud/estadística & datos numéricos , Pandemias , Neumonía Viral/patología , República de Corea/epidemiología , Factores de Tiempo , Adulto Joven
9.
Yonsei Med J ; 61(9): 826-830, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32882767

RESUMEN

We retrospectively reviewed patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections who were admitted to an intensive care unit in Daegu, South Korea. The outcomes of patients who did (cases) or did not (controls) receive darunavir-cobicistat (800-150 mg) therapy were compared. Fourteen patients received darunavir-cobicistat treatment, and 96 received other antiviral therapy (controls). Overall, the darunavir-cobicistat group comprised patients with milder illness, and the crude mortality rate of all patients in the darunavir-cobicistat group was lower than that in the controls [odds ratio (OR) 0.20, 95% confidence interval (CI) 0.04-0.89, p=0.035]. After 1:2 propensity-score matching, there were 14 patients in the darunavir-cobicistat group, and 28 patients in the controls. In propensity score-matched analysis, the darunavir-cobicistat group had lower mortality than the controls (OR 0.07, 95% CI 0.01-0.52, p=0.009). In conclusion, darunavir-cobicistat therapy was found to be associated with a significant survival benefit in critically ill patients with SARS-CoV-2 infection.


Asunto(s)
Fármacos Anti-VIH/uso terapéutico , Cobicistat/uso terapéutico , Infecciones por Coronavirus/tratamiento farmacológico , Darunavir/uso terapéutico , Inhibidores de la Proteasa del VIH/uso terapéutico , Neumonía Viral/tratamiento farmacológico , Adulto , Fármacos Anti-VIH/administración & dosificación , Fármacos Anti-VIH/efectos adversos , Betacoronavirus , Estudios de Casos y Controles , Cobicistat/administración & dosificación , Cobicistat/efectos adversos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/mortalidad , Enfermedad Crítica , Darunavir/administración & dosificación , Darunavir/efectos adversos , Femenino , Inhibidores de la Proteasa del VIH/administración & dosificación , Inhibidores de la Proteasa del VIH/efectos adversos , Humanos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/mortalidad , República de Corea/epidemiología , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Resultado del Tratamiento
10.
Korean J Parasitol ; 58(4): 413-419, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32871635

RESUMEN

Eosinophilia occurs commonly in many diseases including allergic diseases and helminthic infections. Toxocariasis has been suggested as one cause of eosinophilia. The present study was undertaken to examine the prevalence of toxocariasis in patients with eosinophilia and to identify the risk factors for toxocariasis. This prospective cohort study recruited a total of 81 patients with eosinophilia (34 males and 47 females) who visited the outpatient clinic at Seoul National University Hospital from January 2017 to February 2018 and agreed to participate in this study. The prevalence of toxocariasis was examined by T. canis-specific ELISA, and the various risk factors for toxocariasis were evaluated by a questionnaire survey. Among 81 patients with eosinophilia, 18 were positive for anti-T. canis antibodies (22.2%); 88.9% were male (16/18) and 11.1% were female (2/18). Multivariate statistical analysis revealed that males (OR 21.876, 95% CI: 1.667-287.144) with a history of consuming the raw meat or livers of animals (OR 5.899, 95% CI: 1.004-34.669) and a heavy alcohol-drinking habit (OR 8.767, 95% CI: 1.018-75.497) were at higher risk of toxocariasis in patients with eosinophilia. Toxocariasis should be considered a potential cause of eosinophilia when the patient has a history of eating the raw meat or livers of animals in Korea. A single course of albendazole is recommended to reduce the migration of Toxocara larvae in serologically positive cases with eosinophilia.


Asunto(s)
Eosinofilia/etiología , Toxocariasis/complicaciones , Toxocariasis/epidemiología , Alcoholismo , Animales , Anticuerpos Antihelmínticos/sangre , Biomarcadores/sangre , Estudios de Cohortes , Ensayo de Inmunoadsorción Enzimática , Eosinofilia/epidemiología , Conducta Alimentaria , Femenino , Humanos , Masculino , Carne/efectos adversos , Prevalencia , Estudios Prospectivos , República de Corea/epidemiología , Factores de Riesgo , Encuestas y Cuestionarios , Toxocara canis/inmunología , Toxocariasis/diagnóstico , Toxocariasis/parasitología
11.
J Transl Med ; 18(1): 345, 2020 09 05.
Artículo en Inglés | MEDLINE | ID: mdl-32891155

RESUMEN

BACKGROUND: Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), spreads rapidly and has attracted worldwide attention. METHODS: To improve the forecast accuracy and investigate the spread of SARS-CoV-2, we constructed four mathematical models to numerically estimate the spread of SARS-CoV-2 and the efficacy of eradication strategies. RESULTS: Using the Susceptible-Exposed-Infected-Removed (SEIR) model, and including measures such as city closures and extended leave policies implemented by the Chinese government that effectively reduced the ß value, we estimated that the ß value and basic transmission number, R0, of SARS-CoV-2 was 0.476/6.66 in Wuhan, 0.359/5.03 in Korea, and 0.400/5.60 in Italy. Considering medicine and vaccines, an advanced model demonstrated that the emergence of vaccines would greatly slow the spread of the virus. Our model predicted that 100,000 people would become infected assuming that the isolation rate α in Wuhan was 0.30. If quarantine measures were taken from March 10, 2020, and the quarantine rate of α was also 0.3, then the final number of infected people was predicted to be 11,426 in South Korea and 147,142 in Italy. CONCLUSIONS: Our mathematical models indicate that SARS-CoV-2 eradication depends on systematic planning, effective hospital isolation, and SARS-CoV-2 vaccination, and some measures including city closures and leave policies should be implemented to ensure SARS-CoV-2 eradication.


Asunto(s)
Betacoronavirus/fisiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/virología , Erradicación de la Enfermedad , Modelos Teóricos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Neumonía Viral/virología , China/epidemiología , Infecciones por Coronavirus/epidemiología , Epidemias/prevención & control , Gobierno , Humanos , Italia/epidemiología , Neumonía Viral/epidemiología , Cuarentena , República de Corea/epidemiología , Vacunación
12.
Math Biosci Eng ; 17(4): 3637-3648, 2020 05 18.
Artículo en Inglés | MEDLINE | ID: mdl-32987548

RESUMEN

Based on the reported data from February 16, 2020 to March 9, 2020 in South Korea including confirmed cases, death cases and recovery cases, the control reproduction number was estimated respectively at different control measure phases using Markov chain Monte Carlo method and presented using the resulting posterior mean and 95% credible interval (CrI). At the early phase from February 16 to February 24, we estimate the basic reproduction number R0 of COVID-19 to be 4.79(95% CrI 4.38 - 5.2). The estimated control reproduction number dropped rapidly to Rc ≈ 0.32(95% CrI 0.19 - 0.47) at the second phase from February 25 to March 2 because of the voluntary lockdown measures. At the third phase from March 3 to March 9, we estimate Rc to be 0.27 (95% CrI 0.14 - 0.42). We predict that the final size of the COVID-19 outbreak in South Korea is 9661 (95% CrI 8660 - 11100) and the whole epidemic will be over by late April. It is found that reducing contact rate and enhancing the testing speed will have the impact on the peak value and the peak time.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Pandemias , Neumonía Viral/epidemiología , Número Básico de Reproducción/estadística & datos numéricos , Simulación por Computador , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Brotes de Enfermedades/prevención & control , Brotes de Enfermedades/estadística & datos numéricos , Humanos , Cadenas de Markov , Conceptos Matemáticos , Modelos Biológicos , Método de Montecarlo , Pandemias/prevención & control , Pandemias/estadística & datos numéricos , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , República de Corea/epidemiología , Factores de Tiempo
13.
Medicine (Baltimore) ; 99(38): e22155, 2020 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-32957338

RESUMEN

To investigate the risk of mortality associated with exposure to codeine, considering various risk groups, using population-based national insurance claims data.National sample cohort data from the National Health Insurance Service of South Korea (2002-2013) was used in this case-control study. Cases were defined as patients with a death record between January 1, 2002 and December 31, 2013. Each case was matched to 10 controls based on age, sex, baseline comorbidities, and year of death. Definition of exposure was codeine prescription in 30 days prior to death and sensitivity analyses were performed for 15 and 60-day exposures. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were estimated using conditional logistic regression adjusting for benzodiazepine, other opioids, anesthetics, hypnotics, CYP2D6 inducer, CYP3A4 inducer, and the Charlson comorbidity index.A total of 19,341 cases and 185,700 matched controls were included. The overall risk associated with codeine use and mortality risk was not significant (aOR 1.08, 95% CI 1.00-1.16). Sensitivity analyses with different exposure time window also presented similar insignificant results. However, in the subgroup analyses, codeine use was associated with an increased risk of mortality in the >85-year-old age group (aOR 2.38, 95% CI 1.26-4.48) and patients with respiratory disease (aOR 1.29, 95% CI 1.17-1.42).Although no statistically significant association was found in codeine exposure and mortality risk between cases and controls, we demonstrated that the elderly over 85 years old and patients with respiratory disease are associated with a higher risk with codeine exposure. Therefore, a more cautious practice of codeine prescription in these groups might be needed.


Asunto(s)
Codeína/efectos adversos , Mortalidad/tendencias , Enfermedades Respiratorias/complicaciones , Anciano de 80 o más Años , Estudios de Casos y Controles , Femenino , Humanos , Masculino , República de Corea/epidemiología , Enfermedades Respiratorias/epidemiología , Estudios Retrospectivos , Riesgo
14.
Medicine (Baltimore) ; 99(38): e22192, 2020 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-32957348

RESUMEN

BACKGROUND: Rotavirus is one of the most common causes of infantile enteritis. In common enterocolitis, probiotic organisms, including Lactobacilli, are effective in treating diarrhea. A new species, Lactobacillus plantarum (LRCC5310), which was shown to inhibit the adherence and proliferation of rotavirus in the small intestine through animal experiments, was investigated for the efficacy and safety of patients with rotaviral enteritis. METHODS: LRCC5310 (Group I) and control (Group II) groups consisting of children who were hospitalized for rotaviral enteritis were compared, and the medical records of patients (Group III) who were hospitalized for rotaviral enteritis during the same study period were retrospectively analyzed. Clinical symptoms were compared and stool samples were collected to compare changes in virus multiplication between Groups I and II. RESULTS: Groups I, II, and III comprised 15, 8, and 27 children, respectively. There were no differences in clinical information among the groups at admission. In Group I, a statistically significant improvement was noted in the number of patients with diarrhea, number of defecation events on Day 3, and total diarrhea period as opposed to Group II (P = .033, P = .003, and P = .012, respectively). The improvement of Vesikari score in Group I was greater than that in the other groups (P = .076, P = .061, and P = .036, respectively). Among rotavirus genotypes, 9 (22.5%) strains and 8 (20.0%) strains belonged to the G9P8 and G1P8 genotypes, respectively. The virus reduction effect, as confirmed via stool specimens, was also greater in Group I. No significant side effects were noted in infants. CONCLUSION: LRCC5310 improved clinical symptoms, including diarrhea and Vesikari score, and inhibited viral proliferation in rotaviral gastroenteritis.


Asunto(s)
Enteritis/terapia , Lactobacillus plantarum , Probióticos/uso terapéutico , Infecciones por Rotavirus/terapia , Niño , Preescolar , Enteritis/epidemiología , Enteritis/virología , Heces/virología , Femenino , Humanos , Lactante , Masculino , República de Corea/epidemiología , Estudios Retrospectivos , Infecciones por Rotavirus/epidemiología
15.
Antimicrob Resist Infect Control ; 9(1): 157, 2020 09 23.
Artículo en Inglés | MEDLINE | ID: mdl-32967735

RESUMEN

BACKGROUND: After the Middle East respiratory syndrome coronavirus outbreak in Korea in 2015, the Government established a strategy for infection prevention to encourage infection control activities in hospitals. The new policy was announced in December 2015 and implemented in September 2016. The aim of this study is to evaluate how infection control activities improved within Korean hospitals after the change in government policy. METHODS: Three cross-sectional surveys using the WHO Hand Hygiene Self-Assessment Framework (HHSAF) were conducted in 2013, 2015, and 2017. Using a multivariable linear regression model, we analyzed the change in total HHSAF score according to survey year. RESULTS: A total of 32 hospitals participated in the survey in 2013, 52 in 2015, and 101 in 2017. The number of inpatient beds per infection control professionals decreased from 324 in 2013 to 303 in 2015 and 179 in 2017. Most hospitals were at intermediate or advanced levels of progress (90.6% in 2013, 86.6% in 2015, and 94.1% in 2017). In the multivariable linear regression model, total HHSAF score was significantly associated with hospital teaching status (ß coefficient of major teaching hospital, 52.6; 95% confidence interval [CI], 8.9 to 96.4; P = 0.018), beds size (ß coefficient of 100 beds increase, 5.1; 95% CI, 0.3 to 9.8; P = 0.038), and survey time (ß coefficient of 2017 survey, 45.1; 95% CI, 19.3 to 70.9; P = 0.001). CONCLUSIONS: After the new national policy was implemented, the number of infection control professionals increased, and hand hygiene promotion activities were strengthened across Korean hospitals.


Asunto(s)
Infección Hospitalaria/prevención & control , Higiene de las Manos/métodos , Control de Infecciones/métodos , Infecciones por Coronavirus/epidemiología , Estudios Transversales , Política de Salud , Humanos , República de Corea/epidemiología
16.
PLoS One ; 15(9): e0238684, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32970716

RESUMEN

BACKGROUND: In the Republic of Korea (ROK), social distancing and public behavior changes mitigated COVID-19 spread. However, a second wave of the epidemic is expected in the fall if neither vaccine nor antiviral drugs become available. This study investigated the impact of non-pharmaceutical measures on short- and long-term outbreak dynamics. METHODS: A mathematical model based on Susceptible-Exposed-Infectious-Recovered model is developed considering isolated and behavior-changed groups. Using the least-squares fitting method, transmission and behavior change rates were estimated using cases reported from February 16 to April 20, 2020. FINDINGS: The estimated transmission rate of COVID-19 was 4·6180 and behavior change rate was 2·6044. The model predicted the number of new cases to continuously decrease, with less than one case expected after May 6, 2020. Concurrently, a 25% reduction in behavioral changes during the outbreak would increase the case count by 60,000, resulting in 4,000 cases at maximum, exceeding the medical system's capacity. As behavioral restrictions are eased, local transmission will likely increase, with forecasted second wave peak in October 2020. INTERPRETATION: Social distancing and public behavior changes have curbed the spread of COVID-19 in the ROK. Mathematical modeling demonstrates the importance of these measures in reducing and delaying outbreaks. Nevertheless, non-pharmaceutical interventions cannot eliminate the disease. In the future, vaccines and antiviral treatments combined with social distancing and public behavior changes will be paramount to ending COVID-19 epidemic.


Asunto(s)
Control de Enfermedades Transmisibles/métodos , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Conductas Relacionadas con la Salud , Pandemias/prevención & control , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Aislamiento Social , Betacoronavirus , Infecciones por Coronavirus/mortalidad , Predicción , Humanos , Modelos Teóricos , Neumonía Viral/mortalidad , República de Corea/epidemiología
17.
Medicine (Baltimore) ; 99(38): e22036, 2020 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-32957321

RESUMEN

Studies about the effects of metabolically healthy obesity on cardiovascular disease (CVD) have yielded conflicting results. These heterogeneous results could be due to the limited usefulness of BMI in measuring general adiposity, as body mass index (BMI) does not accurately reflect body composition. This study aimed to evaluate the effect of body shape on CVD outcomes across different obesity phenotypes, and to provide an explanation for the heterogeneous effects of metabolically healthy obese (MHO) phenotype on CVD.We analyzed data from the Korean Genome and Epidemiology Study, a population-based cohort study conducted between 2001 and 2012. We divided the participants into 4 groups: metabolically healthy non-obese (MHNO), MHO, metabolically unhealthy non-obese (MUNO), and metabolically unhealthy obese (MUO). To assess body shape, we calculated the z-score of the log-transformed a body shape index (LBSIZ). We computed Pearson correlation coefficients to examine the association of LBSIZ with muscle mass index, percentage of total fat mass (%Total FM), and percentage of abdominal fat mass (%Abdominal FM). We also used Cox proportional hazards regression to evaluate the effect of LBSIZ on CVD events according to the obesity phenotypes.A total of 9460 participants were assessed in this study. The incidence of CVD was 8.53 cases per 1000 person-year. LBSIZ showed strong positive correlation with %Total FM and %Abdominal FM, but negative correlation with muscle mass index. In Cox regression, MHO individuals did not show increased risk of CVD compared with MHNO individuals (hazard ratio [HR], 1.29; 95% confidence interval [CI], 0.96-1.73). However, MHO individuals in the 3rd (HR, 2.40; 95% CI, 1.28-4.51) and 4th (HR, 3.67; 95% CI, 1.99-6.74) quarters of LBSIZ showed significantly higher risk of CVD compared with MHNO individuals in the 1st quarter of LBSIZ. Moreover, LBSIZ showed a linear relationship with CVD among MHO individuals.While the MHO individuals showed similar CVD risk to the MHNO individuals, CVD risk increases with LBSIZ among the MHO individuals. LBSIZ appears to be a useful measure for CVD risk assessment in clinical practice and epidemiologic studies, especially for MHO patients.


Asunto(s)
Composición Corporal/fisiología , Enfermedades Cardiovasculares/epidemiología , Obesidad Metabólica Benigna/epidemiología , Obesidad Metabólica Benigna/patología , Adiposidad , Adulto , Consumo de Bebidas Alcohólicas/epidemiología , Glucemia , Índice de Masa Corporal , Pesos y Medidas Corporales , Fumar Cigarrillos/epidemiología , Femenino , Conductas Relacionadas con la Salud , Estado de Salud , Humanos , Incidencia , Lípidos/sangre , Masculino , Persona de Mediana Edad , Fenotipo , Modelos de Riesgos Proporcionales , República de Corea/epidemiología , Factores de Riesgo , Factores Socioeconómicos
18.
Yonsei Med J ; 61(10): 875-879, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32975062

RESUMEN

PURPOSE: To describe adverse drug reactions (ADRs) to carbamazepine (CBZ) and oxcarbazepine (OXC), including severe cutaneous ADRs, at a tertiary care hospital over a 10-year period. MATERIALS AND METHODS: The frequency and clinical features of ADRs caused by CBZ and OXC were analyzed using the pharmacovigilance database and spontaneous ADR reporting data of Yonsei University Severance Hospital & Dental Hospital (Seoul, Korea) from January 1, 2010 to January 31, 2020. RESULTS: Among 10419 cases prescribed CBZ and OXC, 204 ADR cases were reported. The incidences of ADRs were 1.8% and 2.2% for CBZ and OXC respectively, with no significant difference (p=0.169). The most common clinical presentations were skin disorders. Female patients had relatively more frequent ADRs than male patients. Although mild skin ADRs were more frequent with OXC, nervous system disorders, general disorders, and hepatobiliary disorders occurred more often with CBZ. There were six reports of severe cutaneous adverse reactions to CBZ, while OXC had none. Both CBZ and OXC caused ADRs at daily doses lower than the recommended initial dose. CONCLUSION: Due to lower incidence of severe ADRs with OXC than CBZ, we suggest OXC as a first-line prescription.


Asunto(s)
Anticonvulsivantes/efectos adversos , Carbamazepina/efectos adversos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Oxcarbazepina/efectos adversos , Adolescente , Adulto , Anciano , Anticonvulsivantes/uso terapéutico , Trastorno Bipolar , Carbamazepina/uso terapéutico , Epilepsia/tratamiento farmacológico , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Neuralgia , Oxcarbazepina/uso terapéutico , Farmacovigilancia , República de Corea/epidemiología , Centros de Atención Terciaria , Adulto Joven
19.
Epidemiol Health ; 42: e2020064, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32898942

RESUMEN

OBJECTIVES: During the 6 months since the first coronavirus disease 2019 (COVID-19) patient was diagnosed in Korea on January 20, 2020, various prevention and control measures have been implemented according to the COVID-19 epidemic pattern. Therefore, this study aimed to estimate the reproductive numbers (R) for each epidemic stage to analyze the effects of the preventive measures and to predict the COVID-19 transmission trends. METHODS: We estimated the transmission rates for each epidemic stage by fitting a COVID-19 transmission model, based on a deterministic mathematical model, to the data on confirmed cases. The effects of preventive measures such as social distancing by time period were analyzed, and the size and trends of future COVID-19 outbreaks were estimated. RESULTS: The value of R was 3.53 from February18, 2020 to February 28, 2020, and the mean R reduced to 0.45 from March 14, 2020 to April 29, 2020, but it significantly increased to 2.69 from April 30, 2020 to May13, 2020 and it was maintained at 1.03 from May 14, 2020 to July 23, 2020. CONCLUSIONS: According to the estimated R, it had fallen to below 1 and was maintained at that level owing to the isolation of infected persons by the public health authorities and social distancing measures followed by the general public. Then, the estimated R increased rapidly as the contact among individuals increased during the long holiday period from April 30, 2020 to May 5, 2020. Thereafter, the value of R dropped, with the continued use of preventive measures but remained higher than 1.00, indicating that the COVID-19 outbreak can be prolonged and develop into a severe outbreak at any time.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Distancia Social , Número Básico de Reproducción , Infecciones por Coronavirus/epidemiología , Humanos , Modelos Teóricos , Neumonía Viral/epidemiología , República de Corea/epidemiología
20.
BMC Infect Dis ; 20(1): 710, 2020 Sep 29.
Artículo en Inglés | MEDLINE | ID: mdl-32993524

RESUMEN

BACKGROUND: Since pneumonia caused by coronavirus disease 2019 (COVID-19) broke out in Wuhan, Hubei province, China, tremendous infected cases has risen all over the world attributed to its high transmissibility. We aimed to mathematically forecast the inflection point (IFP) of new cases in South Korea, Italy, and Iran, utilizing the transcendental model from China. METHODS: Data from reports released by the National Health Commission of the People's Republic of China (Dec 31, 2019 to Mar 5, 2020) and the World Health Organization (Jan 20, 2020 to Mar 5, 2020) were extracted as the training set and the data from Mar 6 to 9 as the validation set. New close contacts, newly confirmed cases, cumulative confirmed cases, non-severe cases, severe cases, critical cases, cured cases, and death were collected and analyzed. We analyzed the data above through the State Transition Matrix model. RESULTS: The optimistic scenario (non-Hubei model, daily increment rate of - 3.87%), the cautiously optimistic scenario (Hubei model, daily increment rate of - 2.20%), and the relatively pessimistic scenario (adjustment, daily increment rate of - 1.50%) were inferred and modeling from data in China. The IFP of time in South Korea would be Mar 6 to 12, Italy Mar 10 to 24, and Iran Mar 10 to 24. The numbers of cumulative confirmed patients will reach approximately 20 k in South Korea, 209 k in Italy, and 226 k in Iran under fitting scenarios, respectively. However, with the adoption of different diagnosis criteria, the variation of new cases could impose various influences in the predictive model. If that happens, the IFP of increment will be earlier than predicted above. CONCLUSION: The end of the pandemic is still inapproachable, and the number of confirmed cases is still escalating. With the augment of data, the world epidemic trend could be further predicted, and it is imperative to consummate the assignment of global medical resources to curb the development of COVID-19.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Modelos Teóricos , Neumonía Viral/epidemiología , China/epidemiología , Infecciones por Coronavirus/virología , Predicción/métodos , Humanos , Irán/epidemiología , Italia/epidemiología , Pandemias , Neumonía Viral/virología , Pronóstico , República de Corea/epidemiología
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