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2.
PLoS One ; 16(8): e0255020, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34351955

RESUMO

BACKGROUND: Hemodialysis is a life-saving renal replacement treatment for patients with chronic kidney disease, but various complications occur during hemodialysis and associated procedures. This study was conducted to analyze the specific characteristics of hemodialysis-related complications and malpractice that have led to legal disputes. METHODS: Judgments from cases litigated between 1991 and 2019 due to complications related to hemodialysis or vascular access were analyzed using the database of the Korean Supreme Court Judgment System. RESULTS: Of 32 dialysis-related litigation cases, 14 cases were dismissed and malpractice was recognized in 18 cases. Among all cases and those in which malpractice was recognized, the most common clinical complication was associated with central venous catheter (CVC) insertion (25.0% and 42.9%, respectively). In 22 of 32 (68.8%) cases, complications occurred before or after (not during) dialysis, and performance error was the most common clinical error leading to legal disputes (58.3%). Complications resulted in death in 59.4% of cases, and CVC-related complications were associated with the largest proportion (63.2%) of deaths. CONCLUSIONS: Hemodialysis was implicated in various medical disputes, and CVC-related complications were the most common and serious adverse events. Clinicians' awareness of the incidence and severity of possible complications of hemodialysis procedures should be increased.

4.
Int J Mol Sci ; 22(9)2021 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-33922983

RESUMO

Proper regulation of sebum production is important for maintaining skin homeostasis in humans. However, little is known about the role of epigenetic regulation in sebocyte lipogenesis. We investigated histone acetylation changes and their role in key lipogenic gene regulation during sebocyte lipogenesis using the human sebaceous gland cell line SZ95. Sebocyte lipogenesis is associated with a significant increase in histone acetylation. Treatment with anacardic acid (AA), a p300 histone acetyltransferase inhibitor, significantly decreased the lipid droplet number and the expression of key lipogenic genes, including sterol regulatory-binding protein 1 (SREBP1), fatty acid synthase (FAS), and acetyl-CoA carboxylase (ACC). In contrast, treatment with trichostatin A (TSA), a histone deacetylase (HDAC) inhibitor, increased the expression of these genes. Global HDAC enzyme activity was decreased, and HDAC1 and HDAC2 expression was downregulated during sebaceous lipogenesis. Interestingly, HDAC1 knockdown increased lipogenesis through SREBP1 induction, whereas HDAC1 overexpression decreased lipogenesis and significantly suppressed SREBP1 promoter activity. HDAC1 and SREBP1 levels were inversely correlated in human skin sebaceous glands as demonstrated in immunofluorescence images. In conclusion, HDAC1 plays a critical role in reducing SREBP1 transcription, leading to decreased sebaceous lipogenesis. Therefore, HDAC1 activation could be an effective therapeutic strategy for skin diseases related to excessive sebum production.


Assuntos
Histona Desacetilase 1/metabolismo , Lipogênese/fisiologia , Glândulas Sebáceas/citologia , Proteína de Ligação a Elemento Regulador de Esterol 1/genética , Linhagem Celular , Epigênese Genética , Regulação da Expressão Gênica , Histona Desacetilase 1/genética , Histona Desacetilase 2/metabolismo , Histonas/metabolismo , Humanos , Hidrocarbonetos Fluorados/farmacologia , Insulina/metabolismo , Insulina/farmacologia , Metabolismo dos Lipídeos/efeitos dos fármacos , Lipogênese/efeitos dos fármacos , Lipogênese/genética , Receptores X do Fígado/agonistas , Glândulas Sebáceas/metabolismo , Pele/citologia , Proteína de Ligação a Elemento Regulador de Esterol 1/metabolismo , Sulfonamidas/farmacologia
5.
Sci Rep ; 11(1): 6375, 2021 03 18.
Artigo em Inglês | MEDLINE | ID: mdl-33737679

RESUMO

We aimed to investigate the impact of comorbidity burden on mortality in patients with coronavirus disease (COVID-19). We analyzed the COVID-19 data from the nationwide health insurance claims of South Korea. Data on demographic characteristics, comorbidities, and mortality records of patients with COVID-19 were extracted from the database. The odds ratios of mortality according to comorbidities in these patients with and without adjustment for age and sex were calculated. The predictive value of the original Charlson comorbidity index (CCI) and the age-adjusted CCI (ACCI) for mortality in these patients were investigated using the receiver operating characteristic (ROC) curve analysis. Among 7590 patients, 227 (3.0%) had died. After age and sex adjustment, hypertension, diabetes mellitus, congestive heart failure, dementia, chronic pulmonary disease, liver disease, renal disease, and cancer were significant risk factors for mortality. The ROC curve analysis showed that an ACCI threshold > 3.5 yielded the best cut-off point for predicting mortality (area under the ROC 0.92; 95% confidence interval 0.91-0.94). Our study revealed multiple risk factors for mortality in patients with COVID-19. The high predictive power of the ACCI for mortality in our results can support the importance of old age and comorbidities in the severity of COVID-19.


Assuntos
COVID-19/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Estudos de Coortes , Comorbidade , Bases de Dados como Assunto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Adulto Jovem
7.
J Drugs Dermatol ; 20(1): 49-54, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33400411

RESUMO

BACKGROUND: Intradermal injections of botulinum toxin have been reported to improve sebum secretion, facial skin laxity, and facial pores. However, the effects of Incobotulinumtoxin-A for these indications have not been reported. OBJECTIVE: To evaluate the efficacy of Incobotulinumtoxin-A for the improvement of sebum secretion, face laxity, and facial pores. MATERIALS AND METHODS: This single-center retrospective study included patients treated with Incobotulinumtoxin-A to improve facial skin laxity, sebum secretion, and facial pores. The microdroplet injection protocol included injection points on the lateral face, anterior medial cheek, mandibular line, depressor anguli oris points, mid-glabella area, and chin. Outcomes were measured using a Sebumeter and three-dimensional scanner and were evaluated by facial laxity ratings and the Global Aesthetic Improvement Scale. RESULTS: Twenty patients were included in the analysis. Sebum secretion, mandibular length, facial pores, and facial laxity ratings were improved at 1 week and results were sustained through 12 weeks. All outcomes showed maximum improvement after 4 weeks. Evaluation using the Global Aesthetic Improvement Scale showed that all subjects reported at least a score of 2 (improved) after 4 weeks. CONCLUSION: This study showed that intradermal injection with Incobotulinumtoxin-A could be effective for face lifting, reduced sebum production, and improved facial pores. J Drugs Dermatol. 2021;20(1):49-54. doi:10.36849/JDD.5616.


Assuntos
Toxinas Botulínicas Tipo A/administração & dosagem , Ritidoplastia/métodos , Glândulas Sebáceas/efeitos dos fármacos , Pele/efeitos dos fármacos , Adulto , Estética , Face , Feminino , Humanos , Injeções Intradérmicas/métodos , Masculino , Estudos Retrospectivos , Glândulas Sebáceas/metabolismo , Sebo/metabolismo , Pele/anatomia & histologia , Resultado do Tratamento
9.
J Dermatolog Treat ; 32(3): 297-301, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-31424962

RESUMO

BACKGROUND: Herbal extracts with fewer adverse effects can be an alternative to these drugs because they can target various molecular pathways of acne pathogenesis. OBJECTIVES: To evaluate the clinical efficacy of herbal extracts (mangosteen, Lithospermum officinale, Tribulus terrestris L., Houttuynia cordata Thunb) for the treatment of mild to moderate acne vulgaris. METHODS: Sixty patients were randomized in a 1:1 ratio to receive blinded treatment with herbal extracts or vehicle for 8 weeks. Inflammatory and non-inflammatory acne lesion counts, Investigator's Global Assessment, patient's satisfaction and safety profiles were assessed. We also performed skin biopsy at baseline and week 8 to confirm immunological changes with immunohistochemistry staining. RESULTS: By the end of the study period, both inflammatory and non-inflammatory acne lesion counts were significantly decreased in herbal extracts group (p< .05). In immunohistochemistry staining, expressions of IL-1α, IL-8, and keratin 16 were significantly decreased in herbal extracts group compared to vehicle group from baseline to week 8. There was no serious adverse events in both groups. CONCLUSIONS: This herbal extracts can be a new therapeutic option for patients with mild to moderate acne vulgaris who are reluctant to use drugs.


Assuntos
Acne Vulgar/tratamento farmacológico , Extratos Vegetais/uso terapêutico , Acne Vulgar/patologia , Administração Cutânea , Adulto , Método Duplo-Cego , Esquema de Medicação , Feminino , Garcinia mangostana/química , Garcinia mangostana/metabolismo , Humanos , Interleucina-1alfa/metabolismo , Lithospermum/química , Lithospermum/metabolismo , Masculino , Satisfação do Paciente , Extratos Vegetais/química , Índice de Gravidade de Doença , Pele/metabolismo , Pele/patologia , Resultado do Tratamento , Adulto Jovem
10.
J Dermatol ; 48(1): 42-48, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33180351

RESUMO

Various evaluation methods for acne severity have been used without standardization, and the diversity of acne outcome measures is an obstacle to the integrated analysis of various acne studies. In this study, we sought to investigate physician-based evaluation methods used in clinical studies of acne vulgaris and to determine differences according to time, region and study design. PubMed was searched for articles on acne published from January 2000 to June 2019 in five dermatology journals: Journal of the American Academy of Dermatology, JAMA Dermatology, British Journal of Dermatology, Journal of the European Academy of Dermatology and Venereology and Acta Dermato-Venereologica. A total of 186 articles with acne evaluation methods were selected. Among the selected studies, region, study design, type of intervention and the number of subjects were identified and analyzed. Articles from 2010 to 2019 used Investigator Global Assessment (IGA; odds ratio [OR], 5.808; 95% CI, 1.894-17.811) more often and the Leeds technique (OR, 0.282; 95% CI, 0.098-0.812) less often compared with articles from 2000 to 2009. Controlled experimental studies preferred lesion counting (OR, 238.637; 95% CI, 46.795-1216.954), IGA (OR, 9.177; 95% CI, 3.053-27.586) and Leeds Revised Acne Grading System (LRAGS; OR, 10.844; 95% CI, 3.050-38.559) compared with observational studies. North American studies applied lesion counting (OR, 4.573; 95% CI, 1.173-17.836) and IGA (OR, 11.330; 95% CI, 3.487-36.818) more often and LRAGS (OR, 0.171; 95% CI, 0.039-0.758) less often compared with European studies. This study demonstrated the diversity and heterogeneity of acne outcome measures even in highly influential dermatology journals. This is due to the limitations of current methods and suggests the importance of developing a core outcome measure.


Assuntos
Acne Vulgar , Médicos , Acne Vulgar/diagnóstico , Acne Vulgar/terapia , Humanos
12.
Dermatology ; : 1-5, 2020 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-33091912

RESUMO

BACKGROUND: Granulomatous rosacea (GR) is a rare inflammatory skin disease, which is considered a variant of rosacea, apart from other types of rosacea. OBJECTIVE: This study aimed to summarize the characteristics of Korean patients diagnosed with GR by combining clinical and histological findings. METHODS: Fifteen cases, both clinically and histologically consistent with GR, were selected and were subsequently analyzed to describe clinical and histological characteristics. RESULTS: A total of 20 patients showed granulomatous infiltration in skin biopsies, but only 15 of them were clinically consistent with GR. Five patients who showed granulomatous inflammation were clinically consistent with erythematotelangiectatic or papulopustular rosacea. Among 15 patients, 13 (86.7%) were female and 2 (13.3%) were male. The most frequently involved area was the cheek, and none of the patients showed extrafacial lesions. There seems to be a possibility that treatment duration may be associated with the treatment response. CONCLUSIONS: This study confirms clinical characteristics of GR based on the diagnosis combining both clinical and histological findings.

14.
Medicine (Baltimore) ; 99(21): e19936, 2020 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-32481257

RESUMO

Rapid growth of cutaneous melanoma is associated with aggressive histopathologic features and poor prognosis. However, the impact of growth rate (GR) in acral melanoma (AM) remains largely unknown.We performed this study to identify the impact of GR on lymph node metastasis and survival in AM.We analyzed cases of invasive AM diagnosed at our institution between 1998 and 2017. We investigated the impact of GR on the prognosis of AM.A total of 126 cases of invasive AM were included. Log (GR) was significant associated with lymph node metastasis in the univariate logistic regression analysis (P = .005). The log-rank test revealed statistically significant differences in disease-free survival (DFS) and disease-specific survival (DSS) among the GR quartiles. In the Cox regression analysis, log (GR) was an independent predictor for DFS (P = .041), but not for DSS in multivariate analysis. In the subgroup analysis, log (GR) was an independent predictor for early-stage (≤2A) AM (DFS, P = .002; DSS, P = .004).The limitations of this study include the retrospective design of the study and possible recall bias.Our results suggest that GR is an important prognostic factor for DFS and DSS in AM patients and an independent predictor for early-stage AM.


Assuntos
Doenças do Pé/mortalidade , Doenças do Pé/patologia , Mãos , Melanoma/mortalidade , Melanoma/patologia , Neoplasias Cutâneas/mortalidade , Neoplasias Cutâneas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Metástase Linfática , Masculino , Melanoma/secundário , Pessoa de Meia-Idade , Prognóstico , República da Coreia , Estudos Retrospectivos , Taxa de Sobrevida
15.
Reg Anesth Pain Med ; 45(5): 337-343, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32114483

RESUMO

BACKGROUND: Although there is a low incidence of complications associated with epidural injections, pain physicians should still remain vigilant for potentially serious adverse outcomes. This study aimed to identify and describe the major complications of epidural injections. METHODS: This retrospective, observational, medicolegal study analyzed closed cases of precedents involving complications of epidural injections from January 1997 to August 2019 using the database of the Supreme Court of Korea's judgement system. Clinical characteristics and judgement statuses were analyzed. RESULTS: Of the 73 potential cases assessed for eligibility, a total of 49 malpractice cases were included in the final analysis. Thirty-three claims resulted in payments to the plaintiffs, with a median payment of US$103 828 (IQR: US$45 291-US$265 341). The most common complication was infection (n=13, 26.5%), followed by worsening pain (n=8, 16.3%). Physician malpractice before, during, and after the procedure was claimed by plaintiffs in 18 (36.7%), 44 (89.8%), and 31 (63.3%) cases, respectively. Of these cases, 6 (33.3%), 19 (43.2%), and 15 (48.4%), respectively, were adjudicated in favor of the plaintiffs by the courts. In cases involving postprocedural physician errors, the majority (13/15) of the plaintiff verdicts were related to delayed management. Violation of the physician's duty of informed consent was claimed by plaintiffs in 31 (63.3%) cases, and 14 (45.2%) of these cases were judged medical malpractice. CONCLUSIONS: Our data will allow pain physicians to become acquainted with the major epidural injection-associated complications that underlie malpractice cases.


Assuntos
Injeções Epidurais/efeitos adversos , Imperícia , Manejo da Dor/efeitos adversos , Humanos , República da Coreia/epidemiologia , Estudos Retrospectivos
17.
J Dermatol ; 47(1): 47-53, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31642113

RESUMO

The incidence of herpes zoster (HZ) is mainly affected by age. Various comorbidities could influence the risk of HZ, but a general guideline for evaluating their effect on HZ is lacking. The purpose of this study was to determine whether the Charlson comorbidity index (CCI) is useful in evaluating the risk of HZ in the general population. This retrospective cohort study analyzed data from 1 016 580 random multistage representative samples in Korea, recorded from 2004 to 2013 in the South Korean National Health Insurance Service-National Sample Cohort database. We calculated the baseline CCI score of comorbidities and compared the hazard ratio (HR) of HZ according to the calculated CCI scores. A total of 340 124 eligible subjects aged 40-79 years and 35 874 HZ patients were identified. After adjustment of age, sex and income, the HR of HZ and odds ratio of postherpetic neuralgia in the CCI score of 1 or more group was found to be significantly higher than that of the CCI score 0 group. Compared with the 60s age group with a CCI score of 0, the 50s age group with a CCI score of 1 had a higher risk of HZ, and the 40s age group with a CCI score of 3 or more had a similar risk of HZ. Scoring systems of comorbidities such as the CCI could be useful in identifying the high-risk group for HZ, especially among the 40-59-year age group. Further studies are required to establish the usage of a HZ-specific comorbidity scoring system in a large multinational population.


Assuntos
Indicadores Básicos de Saúde , Herpes Zoster/epidemiologia , Neuralgia Pós-Herpética/epidemiologia , Adulto , Idoso , Comorbidade , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores de Risco
19.
Eur J Nutr ; 59(7): 3171-3182, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31822988

RESUMO

PURPOSE: Specific food consumption, besides food allergy, may aggravate atopic dermatitis (AD). However, previous reports on the association between AD and food intake in adolescents are scarce. The aim of this study was to determine the relationship between AD and specific food consumption frequency in adolescents. METHODS: A cross-sectional analysis using data from the Korea Youth Risk Behavior Web-based Survey 2017 was performed. The frequency of food consumption in the recent-diagnosed AD group (AD diagnosed within 12 months) compared to those in the previous-diagnosed AD (AD diagnosed more than 12 months ago) or control group were investigated. RESULTS: A total of 53,373 participants were eligible for this study. The weighted prevalence of the recent-diagnosed AD and the previous-diagnosed AD was 7.39% and 18.00%, respectively. When compared with subjects with the previous-diagnosed AD, those with the recent-diagnosed AD were significantly more likely to frequently consume fast foods (odds ratio OR 1.405; 95% CI 1.150-1.717), energy drinks (OR 1.457; 95% CI 1.175-1.807), or convenience food (OR 1.304; 95% CI 1.138-1.495). Patients of the recent-diagnosed AD were significantly more likely to frequently consume fast foods (OR 1.374; 95% CI 1.155-1.634) than the control group. The differences in the frequency of specific food consumption among groups were more pronounced in high school students than in middle school students. CONCLUSIONS: Frequent intake of fast foods, energy drinks, and convenience food was related to the recent-diagnosed AD in adolescents. Prospective cohort and interventional studies are needed to identify causal relationships.


Assuntos
Dermatite Atópica/epidemiologia , Bebidas Energéticas , Fast Foods , Adolescente , Estudos Transversais , Dermatite Atópica/induzido quimicamente , Dermatite Atópica/etiologia , Bebidas Energéticas/efeitos adversos , Fast Foods/efeitos adversos , Feminino , Humanos , Masculino , Razão de Chances , República da Coreia/epidemiologia , Estudantes/estatística & dados numéricos
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