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1.
Prog Orthod ; 21(1): 44, 2020 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-33283252

RESUMO

BACKGROUND: The purpose of this study is to investigate the heritability of total rotation, matrix rotation, and intramatrix rotation of the mandible in Korean monozygotic (MZ) twins, dizygotic (DZ) twins, and their siblings. MATERIALS AND METHODS: The samples consisted of 75 pairs of Korean twins (39.7 + 9.26 years; MZ group, 36 pairs; DZ group, 13 pairs; sibling group, 26 pairs). Lateral cephalograms were taken, and 13 variables related to internal and external mandible rotation were measured. Three types of occlusal planes (bisected occlusal plane, functional occlusal plane, and the MM bisector occlusal plane) were used to evaluate genetic influence on the occlusal plane. Heritability (h2) was calculated by using the intraclass correlation coefficient (ICC) and Falconer's method. RESULTS: With regard to mandibular rotation, the MZ twin group showed significantly higher ICC values compared to the DZ twin and sibling groups. The ICC mean values for 13 cephalometric measurements were 0.85 (MZ), 0.62 (DZ), and 0.52 (siblings) respectively. The heritability of the total rotation (0.48) and matrix rotation (0.5) between the MZ and DZ groups was higher than that of the intramatrix rotation (- 0.14). All of the three types of occlusal plane showed high heritability, and among the three types, the functional occlusal plane showed the highest heritability (h2 = 0.76). CONCLUSION: Based on these findings that showed a strong genetic effect on total rotation and matrix rotation, maintaining these rotations should be carefully considered in the orthodontic treatment plan, while the lower border of the mandible may be responsive to various treatments. Occlusal plane change, especially with regard to the functional occlusal plane, may not be stable due to strong genetic influences.

2.
Int J Cancer ; 2020 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-33197272

RESUMO

Mammograms contain information that predicts breast cancer risk. We developed two novel mammogram-based breast cancer risk measures based on image brightness (Cirrocumulus) and texture (Cirrus). Their risk prediction when fitted together, and with an established measure of conventional mammographic density (Cumulus), is not known. We used three studies consisting of: 168 interval cases and 498 matched controls; 422 screen-detected cases and 1197 matched controls; and 354 younger-diagnosis cases and 944 controls frequency-matched for age at mammogram. We conducted conditional and unconditional logistic regression analyses of individually- and frequency-matched studies, respectively. We estimated measure-specific risk gradients as the change in odds per standard deviation of controls after adjusting for age and body mass index (OPERA) and calculated the area under the receiver operating characteristic curve (AUC). For interval, screen-detected and younger-diagnosis cancer risks, the best fitting models (OPERAs [95% confidence intervals]) involved: Cumulus (1.81 [1.41-2.31]) and Cirrus (1.72 [1.38-2.14]); Cirrus (1.49 [1.32-1.67]) and Cirrocumulus (1.16 [1.03 to 1.31]); and Cirrus (1.70 [1.48 to 1.94]) and Cirrocumulus (1.46 [1.27-1.68]), respectively. The AUCs were: 0.73 [0.68-0.77], 0.63 [0.60-0.66], and 0.72 [0.69-0.75], respectively. Combined, our new mammogram-based measures have twice the risk gradient for screen-detected and younger-diagnosis breast cancer (P ≤ 10-12 ), have at least the same discriminatory power as the current polygenic risk score, and are more correlated with causal factors than conventional mammographic density. Discovering more information about breast cancer risk from mammograms could help enable risk-based personalised breast screening.

3.
J Prev Med Public Health ; 53(5): 342-352, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33070506

RESUMO

OBJECTIVES: The aim of this retrospective cohort study was to investigate whether non-alcoholic fatty liver disease (NAFLD) was associated with incident bone mineral density (BMD) decrease. METHODS: This study included 4536 subjects with normal BMD at baseline. NAFLD was defined as the presence of fatty liver on abdominal ultrasonography without significant alcohol consumption or other causes. Decreased BMD was defined as a diagnosis of osteopenia, osteoporosis, or BMD below the expected range for the patient's age based on dual-energy X-ray absorptiometry. Cox proportional hazards models were used to estimate the hazard ratio of incident BMD decrease in subjects with or without NAFLD. Subgroup analyses were conducted according to the relevant factors. RESULTS: Across 13 354 person-years of total follow-up, decreased BMD was observed in 606 subjects, corresponding to an incidence of 45.4 cases per 1000 person-years (median follow-up duration, 2.1 years). In the model adjusted for age and sex, the hazard ratio was 0.65 (95% confidence interval, 0.51 to 0.82), and statistical significance disappeared after adjustment for body mass index (BMI) and cardiometabolic factors. In the subgroup analyses, NAFLD was associated with a lower risk of incident BMD decrease in females even after adjustment for confounders. The direction of the effect of NAFLD on the risk of BMD decrease changed depending on BMI category and body fat percentage, although the impact was statistically insignificant. CONCLUSIONS: NAFLD had a significant protective effect on BMD in females. However, the effects may vary depending on BMI category or body fat percentage.

4.
Artigo em Inglês | MEDLINE | ID: mdl-33121386

RESUMO

Background: It is unclear whether sedentary behavior is associated with metabolic risk, being independent of physical activity and other possible confounders. This study aimed to evaluate an association between sedentary behaviors and metabolic syndrome (MetS). Methods: A community-based cross-sectional study was conducted in a total of 987 Korean adults aged 40 years or older. Information on study variables, including physical activity, awake and sitting time, and components of MetS, was collected by a self-administered questionnaire, physical measurement, and laboratory test. MetS was defined according to the modified National Cholesterol Education Program's Adult Treatment Panel III and Korean Society for the Study of Obesity. Multiple logistic regression analysis was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for MetS associated with absolute sitting time, high sedentary ratio (>0.5), and other selected covariates, including age, sex, smoking, alcohol intake, educational attainment, daily meal times, regular exercise, intensity of physical activities, and sleep and nap duration. Results: After considering other selected variables, the risk of MetS was found to be higher by about 54% among subjects who had a higher sedentary ratio (OR: 1.54, 95% CI: 1.04-2.28). Every hour increase in sitting time was associated with increased risk of MetS (OR: 1.05, 95% CI: 0.99-1.11) with borderline significance (P = 0.119). Conclusions: Sedentary behavior was independently associated with an increased risk of MetS, suggesting that efforts to reduce the sedentary time might be also important for metabolic health in addition to encouraging adequate physical exercise. Clinical trial number is not applicable to this study.

5.
Nutr Metab Cardiovasc Dis ; 30(12): 2271-2278, 2020 11 27.
Artigo em Inglês | MEDLINE | ID: mdl-32980247

RESUMO

BACKGROUND AND AIMS: To compare the cross-sectional and longitudinal associations between appendicular lean mass (ALM) and cardiometabolic risk factors according to body-size adjustment methods and the contributions of genetic and/or environmental factors to the correlations between those traits. METHODS AND RESULTS: Regression coefficients per sex-specific 1 standard deviation in bodyweight (wt), body mass index (BMI), or height-squared (ht2) adjusted ALM (assessed using a dual-energy X-ray absorptiometer (DXA) and a bioelectrical impedance analyzer (BIA) at baseline)/changes in these indices (assessed using BIA) were compared in terms of their associations with blood pressure (BP), lipid profiles, and insulin resistance profiles in 2655 participants for cross-sectional analysis and 332 participants for longitudinal analysis (follow-up time, 32.2 ± 7.9 months). A bivariate genetic analysis of the genetic/environmental cross-trait correlations was conducted to determine their cross-sectional relationships. After adjusting for sociodemographic factors, health behaviors, and BMI in the analysis for ALM/ht2, ALM/wt and ALM/BMI had favorable associations with all cardiometabolic risk factors, while ALM/ht2 had favorable associations with some risk factors. In longitudinal associations, changes in ALM/wt and ALM/BMI had inverse associations with increments of lipid profiles, insulin, and homeostasis model assessment of insulin resistance (HOMA), while change in ALM/ht2 did not have associations with increments of cardiometabolic risk factors. ALM/ht2 had genetic correlations with seven of nine risk factors; ALM/wt and ALM/BMI had correlations with three and one risk factors, respectively. CONCLUSION: ALM/wt and ALM/BMI are better indicators for cardiometabolic risk factors; genetic factors may contribute more to the correlations between ALM/ht2 and those traits.

6.
Nutrition ; 79-80: 110939, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32810757

RESUMO

OBJECTIVES: The aims of this study were to investigate the association between initial insulin resistance (IR), weight status, and precedent weight change (PWC) and future weight change and the genetic and environmental contributions affecting these relationships in a prospective cohort of Korean twins and their family members. METHODS: The PWC (weight change from 20 y of age), baseline body mass index (BMI), baseline homeostasis model assessment of IR (HOMA-IR) score, and future weight change (follow-up interval 3.28 ± 1.32 y) of 1565 adults were assessed. The mixed linear model was applied after adjusting for intrafamilial relationship, age, education, health behaviors, chronic diseases, dietary intake, eating restraint, and menopausal status of women at baseline. A bivariate genetic analysis was performed after adjusting for age and sex. RESULTS: In the model that simultaneously included all predictors and confounding factors, inverse associations were observed between PWC and baseline HOMA-IR score and future weight change in men, and only baseline BMI was inversely associated with future weight change in women. Men and women with BMI ≥25 kg/m2, HOMA-IR score ≥2.5, and PWC greater than or the same as the sex-specific median of PWC were more likely to lose weight than those with the combination of the counterparts. Approximately 63.6% of the correlation between the baseline HOMA-IR score and future weight change was attributed to genetic effects, and 68.4% to 91.3% of the correlations between weight-related traits and future weight change were correlated to environmental effects. CONCLUSION: An inverse association was observed between the initial IR, weight status, and PWC and future weight change, and genetic or environmental factors contributed to these relationships.

7.
J Cancer Surviv ; 2020 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-32779103

RESUMO

PURPOSE: This study aimed to evaluate factors associated with pneumococcal vaccination uptake (PVU) of cancer survivors. METHODS: A total of 2032 Korean adult cancer survivors diagnosed between June of 1975 and February of 2018 have participated. Information on PVU status and selected variables were collected through self-administered questionnaires and medical record review. Factors associated PVU were investigated using multiple logistic regression analysis. RESULTS: PVU rate markedly differed by age strata and cancer sites: 73.9% for elderly (≥ 65 years) survivors and 34.6% for younger (< 65 years) survivors and 73.4% for lung cancer survivors and 42.1% for non-lung cancer survivors. Regular physical exercise was associated with higher PVU in both age groups: Odds ratio (OR) and 95% confidence interval (CI) were 1.52 (1.20, 1.94) for younger and 1.78 (1.09, 2.90) for elderly survivors. Complementary medication use was positively associated with PVU with borderline significance in both age groups. However, the association of PVU with other factors differed between the two age groups. In younger survivors, a positive association with PVU was evident for longer time lapse after cancer diagnosis, chronic disease, and living with spouse/or partner, while cancer stage, educational achievement, and alcohol use were inversely associated PVU. On the other hand, multi-modality (≥ 3) cancer treatment was inversely associated with PVU only in elderly survivors. CONCLUSIONS: PVU of Korean cancer survivors was suboptimal in younger survivors and non-lung cancer survivors. Factors associated with PVU differed between younger and elderly survivors, and more diverse factors were identified for younger survivors. IMPLICATIONS FOR CANCER SURVIVORS: In order to promote adherence to PVU in cancer survivors, careful consideration of high-risk factors for non-immunization within cancer survivorship context would be necessary together with free-of-charge vaccination policy.

8.
Br J Ophthalmol ; 2020 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-32788326

RESUMO

PURPOSE: To evaluate genetic influence on macular ganglion cell inner plexiform layer (GCIPL) thickness. METHODS: Macular GCIPL thickness was measured with optical coherence tomography in nine macular subfields defined by the E TDRS. Intraclass correlation coefficients (ICC) of GCIPL thickness by different types of family relationships were estimated to assess intrafamilial resemblance. Then, heritability of GCIPL thickness was estimated. RESULTS: Three hundred and sixty-one Korean adults from 89 families with normal healthy eyes were included. GCIPL thickness was highest in inner subfields and lowest in fovea. Monozygotic twin pairs showed significantly higher ICCs of GCIPL thickness in all subfields compared to those in parent-offspring pairs and sibling pairs. GCIPL thickness was highly heritable in the centre (0.71) and outer subfields but moderate to highly heritable in inner subfields. Heritability of GCIPL thickness in outer subfields was 0.69, 0.67, 0.72 and 0.68 for superior, inferior, temporal and nasal fields, respectively. Heritability of GCIPL thickness in inner subfields was 0.55, 0.56, 0.75 and 050 for superior, inferior, temporal and nasal subfields, respectively. CONCLUSION: Macular GCIPL thickness is significantly influenced by genetic factors. It varies according to subfields with moderate to high heritability in all subfields.

9.
Cancer Res Treat ; 52(4): 1251-1261, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32599975

RESUMO

PURPOSE: Neuroblastoma (NB) is the most common extracranial solid tumor found in children. To identify significant genetic factors for the risk of NB, several genetic studies was conducted mainly for Caucasians and Europeans. However, considering racial differences, there is a possibility that genetic predispositions that contribute to the development of NB are different, and genome-wide association study has not yet been conducted on Korean NB patients. Materials and Methods: To identify the genetic variations associated with the risk of pediatric NB in Korean children, we performed a genome-wide association analysis with 296 NB patients and 1000 unaffected controls (total n = 1,296) after data cleaning and filtering as well as imputation of non-genotyped SNPs using IMPUTE v2.3.2. RESULTS: After adjusting for multiple comparisons, we found 21 statistically significant SNPs associated with the risk of NB (Pcorr < 0.05) within 12 genes (RPTN, MRPS18B, LRRC45, KANSL1L, ARHGEF40, IL15RA, L1TD1, ANO7, LAMA5, OR7G2, SALL4, and NEUROG2). Interestingly, out of these, 12 markers were nonsynonymous SNPs. The SNP rs76015112 was most significantly associated with the risk of NB (p = 8.1E-23, Pcorr = 2.3E-17) and was located in the RPTN gene. In addition, significant nonsynonymous SNPs in ADGRE1 were found in patients with MYCN amplification (rs7256147, p = 2.6E-05). In high-risk group, rs7256147 was observed as a significant SNP (p = 5.9E-06). CONCLUSION: Our findings might facilitate improved understanding of the mechanism of pediatric NB pathogenesis. However, functional evaluation and replication of these results in other populations are still needed.

10.
Korean J Fam Med ; 2020 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-32521989

RESUMO

Background: We aimed to evaluate the association between metabolic syndrome (MetS) and hearing loss (HL) in light of noise exposure in Korean middle-aged adults. Methods: Subjects were 10,356 adults (4,509 males, 5,847 females) aged 40-80 years, who completed audiometric tests and laboratory examinations as part of the Korea National Health and Nutrition Examination Survey between 2010 and 2012. MetS was defined according to the National Cholesterol Education Program-Third Adult Treatment Panel (NCEP III) and International Diabetes Federation (IDF). Low-frequency HL was defined as pure tone averages >25 decibels (dB) at low frequencies (0.5, 1, and 2 kilohertz [kHz]). High-frequency HL was defined as pure tone averages >25 dB at high frequencies (3, 4, and 6 kHz). Odd ratios (OR) and 95% confidence intervals (CI) of MetS associated with each HL type were estimated using multiple logistic regression analysis after adjusting for covariates and taking into consideration sampling weight. Results: 38.1% and 28.6% met the MetS by NCEP III and IDF criteria, respectively. Prevalence of HL was 29.3% and 63.9% for low- and high-frequency HL, respectively. MetS defined by NCEP III was associated with higher risk of high-frequency HL (OR, 1.35; 95% CI, 1.05-1.73), while MetS by IDF criteria was not. The interaction by the noise exposure on the MetS and high-frequency HL was not significant (P-interaction=0.100). There was no association between MetS and low-frequency HL, regardless of applied diagnostic criteria for MetS. Conclusion: Our findings suggest MetS is associated with high-frequency HL in people with exposure to noise.

11.
Cancers (Basel) ; 12(4)2020 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-32290037

RESUMO

BACKGROUNDS: The relationship between sarcopenia, characterized by loss of muscle mass and strength, and survival outcomes of esophageal cancer is controversial. This study aimed to assess the effect of sarcopenia and skeletal muscle loss on overall survival (OS) and recurrence-free survival (RFS) of esophageal cancer patients. METHODS: We retrospectively collected the medical records of 248 male patients diagnosed with squamous cell esophageal cancer and who underwent neoadjuvant chemoradiotherapy (NACRT) followed by surgery. We measured the cross-sectional area of the skeletal muscle at the L3 vertebra level using computed tomography images and calculated the skeletal muscle index (SMI). Sarcopenia was defined as SMI <52.4 cm2/m2, and excessive muscle loss was defined as SMI change <-10.0%/50 days during NACRT. Moreover, laboratory test results, such as albumin, prognostic nutritional index (PNI), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) before and after NACRT, were collected. RESULTS: In the univariable Cox analysis, pre- (p = 0.689) and post-radiotherapy (RT) sarcopenia (p = 0.669) were not associated with OS. However, excessive muscle loss had a significant association with OS in both the univariable and multivariable analyses (all p = 0.001). Excessive muscle loss was also related to RFS in both the univariable (p = 0.011) and multivariable (p = 0.022) Cox analysis. Patients with excessive muscle loss had significantly lower levels of post-RT albumin (p < 0.001) and PNI (p < 0.001), higher levels of post-RT NLR (p = 0.031) and PLR (p = 0.071), larger decrease in albumin (p < 0.001) and PNI (p < 0.001) after NACRT, and larger increase in NLR (p = 0.051) and PLR (p = 0.088) after NACRT than in those with non-excessive muscle loss. CONCLUSION: Excessive muscle loss rather than pre- and post-RT sarcopenia was a significant prognostic factor for OS and RFS, and it was also related to nutritional and inflammatory markers.

12.
BMC Cancer ; 20(1): 296, 2020 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-32264879

RESUMO

BACKGROUND: Caregiving for childhood cancer survivors may be burdensome for caregivers and affect their physical health and health behaviors. However, studies examining health behaviors in caregivers of childhood cancer survivors are scarce. This study aimed to examine health behaviors of caregivers of childhood cancer survivors by comparing them with those of the general population, and analyze associated factors. METHODS: This study included 326 caregivers of childhood cancer survivors recruited from 3 major hospitals in South Korea and 1304 controls from the Korean National Health and Nutritional Examination Survey matched for age, sex, and education level. We compared health behaviors between the two groups by using conditional logistic regression analyses, and investigated factors associated with unhealthy behaviors in caregivers by using multiple logistic regression analyses. RESULTS: Caregivers were less likely to be physically inactive (aOR: 0.69, 95% CI: 0.51, 0.92) compared to controls, and this was more evident in women (aOR: 0.65, 95% CI: 0.45, 0.94). However, caregivers were more likely to be binge drinkers (aOR: 2.26, 95% CI: 1.73, 2.97), especially if they were men (aOR: 13.59, 95% CI: 8.09, 22.82). Factors associated with unhealthy behaviors in caregivers differed by the type of behavior. Current smoking risk was lower in female caregivers and in those with more comorbidities. Increasing age, female sex, higher education level, and lower household income were associated with lower risk of binge drinking. Higher household income and anxiety were associated with lower risk of physical inactivity, while depression was associated with higher risk of physical inactivity. CONCLUSIONS: Caregivers of childhood cancer survivors were more likely to engage in binge drinking, but less likely to be physically inactive. Strategies to promote adherence to desirable health behaviors in caregivers are needed with consideration of their socioeconomic and clinical factors, such as number of comorbidities.

13.
J Clin Med ; 9(3)2020 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-32110975

RESUMO

This commentary is about predicting a woman's breast cancer risk from her mammogram, building on the work of Wolfe, Boyd and Yaffe on mammographic density. We summarise our efforts at finding new mammogram-based risk predictors, and how they combine with the conventional mammographic density, in predicting risk for interval cancers and screen-detected breast cancers across different ages at diagnosis and for both Caucasian and Asian women. Using the OPERA (odds ratio per adjusted standard deviation) concept, in which the risk gradient is measured on an appropriate scale that takes into account other factors adjusted for by design or analysis, we show that our new mammogram-based measures are the strongest of all currently known breast cancer risk factors in terms of risk discrimination on a population-basis. We summarise our findings graphically using a path diagram in which conventional mammographic density predicts interval cancer due to its role in masking, while the new mammogram-based risk measures could have a causal effect on both interval and screen-detected breast cancer. We discuss attempts by others to pursue this line of investigation, the measurement challenge that allows different measures to be compared in an open and transparent manner on the same datasets, as well as the biological and public health consequences.

14.
Thyroid ; 2020 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-32143548

RESUMO

BACKGROUND: The association between smoking, alcohol consumption, and thyroid cancer has been evaluated in observational studies, yet the results remain controversial. In the present investigation, we analyzed a longitudinal cohort study with representative data to determine the association between smoking, alcohol consumption, and thyroid cancer risk, allowing for risk modification due to age and sex. METHODS: From the Korean National Health Insurance database, .subjects aged ≥20 who participated in health screening program in 2009 were identified and followed-up till 2017. The adjusted hazard ratio (aHR) for the risk of thyroid cancer was estimated by Cox proportional hazard model Results: During a mean follow-up period of 8.33 ± 0.57 years, out of 9,699,104 participants, 89,527 (0.9%) were diagnosed with thyroid cancer. In comparison with those who never smoked, current smokers [aHR: 0.74, 95% confidence interval (CI): 0.72-0.76)] had a decreased risk of thyroid cancer even though ex-smokers (aHR: 0.98, 95% CI: 0.96-1.01) did not. There was no dose-response relationship when the participants were examined with regard to the daily amount of smoking, duration of smoking, and pack-years. A decrease in the risk of thyroid cancer was observed according to both the number of drinking episodes per week and the number of glasses per once drinking (HR: 0.81, 95% CI: 0.74-0.88 for drinks consumed 7 times/week and HR: 0.87, 95% CI: 0.82-0.92 for ≥ 15 glasses once drinking vs. nondrinkers). A certain degree of alcohol consumption seemed to provoke a decreased risk of thyroid cancer as compared to those who did not drink (HR: 0.85, 95% CI: 0.81-0.89 for ≥ 40 g/week). The interaction of smoking and alcohol consumption was found to be significant (p-interaction < 0.0001), and sub-multiplicative. CONCLUSIONS: We found that the risk of thyroid cancer incidence was inversely associated with smoking and alcohol consumption. A sub-multiplicative interaction between smoking and alcohol intake on the risk of thyroid cancer was found. Further studies are needed to elucidate exactly how smoking and alcohol are related to the pathogenesis and the modification their effects may have on thyroid cancer development.

15.
Korean J Fam Med ; 41(2): 98-104, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32208401

RESUMO

BACKGROUND: Smartphone usage is indispensably beneficial to people's everyday lives. However, excessive smartphone usage has been associated with physical and mental health problems. This study aimed to evaluate the association of smartphone usage with depressive symptoms, suicidal thoughts, and suicide attempts in Korean adolescents. METHODS: This cross-sectional study was conducted in 54,603 Korean adolescent participants (26,930 male and 27,673 female) in the Korea Youth Risk Behavior Survey in 2017 who reported their smartphone use. We performed multiple logistic regression analysis to evaluate the association of smartphone use with mental health after adjusting for relevant covariates. RESULTS: Among the participants, 25.6% of male students and 38.4% of female students reported using their smartphone for at least 30 hours per week. As time duration of smartphone usage increased, the risk of experiencing depressive symptoms, suicidal thoughts, and suicide attempt tended to increase, with odds ratios (95% confidence interval) of 1.18 (1.10-1.26), 1.18 (1.08-1.29), and 1.34 (1.11-1.60), respectively, for high smartphone usage compared with low smartphone usage. These associations remained significant with only slight change in odds ratios after consideration of problems that may be caused by smartphone usage, such as conflicts with family members or peers, or disturbance in school work. CONCLUSION: Smartphone overuse was independently associated with an increased risk of mental health problems, which did not seem to be mediated by the problems caused by smartphone usage.

16.
Bone ; 135: 115306, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32126312

RESUMO

The influence of proton pump inhibitors (PPIs) on the risk of osteoporotic fractures remains to be elucidated, especially in the Asian population. This study evaluated the risk of osteoporotic fractures in elderly female Korean PPI users compared to histamine-2 receptor antagonist (H2RA) users, as well as the relationship between fractures and the duration, dose, and pattern of use of PPI. We screened a nationwide cohort of elderly Korean women who underwent bone mineral density measurements during their 66-year-old life-transition medical examination between 2009 and 2014. Study subjects included 8903 cases diagnosed with new osteoporotic fractures and 44,515 matched controls (1:5 ratio based on cohort entry date, follow-up duration, and baseline osteoporosis status) without fractures. They were followed up until 2015. Information on the exposure to PPI or H2RA, occurrence of fracture, and covariates were obtained from the Korean National Health Insurance Service data. Covariate-adjusted odds ratio (aOR) and 95% confidence interval (CI) were estimated using conditional logistic regression analysis. PPI use was associated with an increased risk of osteoporotic fractures (aOR: 1.13, 95% CI: 1.07, 1.18) compared with H2RA-only use. Increasing duration of PPI use was positively associated with the risk of osteoporotic fracture [aOR (95% CI) of long-term PPI use (≥1 year): 1.3 (1.09, 1.56)]. Recent PPI use within the last year was associated with an increased risk of fracture (aOR: 1.31, 95% CI: 1.23, 1.38), whereas remote PPI use was not (aOR: 0.98, 95% CI: 0.92, 1.04). The risk of fracture did not increase with the increasing cumulative PPI dose. Compared with the use of H2RA alone, PPI use was associated with an increased risk of osteoporotic fractures in elderly Korean women, particularly among those who had used PPI within the last year or for more than one year.

17.
Health Qual Life Outcomes ; 18(1): 21, 2020 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-32019567

RESUMO

BACKGROUND: To determine relationship between cancer survivors' perception of care coordination and their health outcomes. METHODS: Study subjects were 1306 Korean adulthood cancer survivors who were enrolled in two academic hospital and completed a questionnaire consisting of questions asking two aspects of care coordination for cancer treatment they had received: 1) who played a main coordinator role and 2) whether care services had met their necessitated health concerns. We measured health outcomes including new comorbidity, number of clinic visits, health-related quality of life (HRQoL) and fear of cancer recurrence (FCR). Associations between the level of care coordination and health outcomes were evaluated by multiple logistic regression analysis after adjusting for covariates. RESULTS: Survivors with uncoordinated care were more likely to have more new comorbidities after cancer diagnosis, visit clinic more frequently and have worse HRQoL and higher FCR. Females and unmarried survivors were more likely to have received uncoordinated care than males and ever married survivors. Uncoordinated care group had an increased the risk of new comorbidity (odds ratio 1.73, [95% confidence interval] 1.02-2.92), multiple clinic visits (1.69, 1.00-2.88), severe FCR (2.28, 1.33-3.93), low EuroQoL Visual Analogue Scale (1.82, 1.28-2.60), low global health status (1.51, 1.04-2.21), and poor physical (2.00, 1.31-3.04), role (2.46, 1.69-3.56) and emotional function (2.62, 1.81-3.78). CONCLUSIONS: Coordinated care of Korean cancer survivors was associated with their health outcomes, including new comorbidity, clinic visits, HRQoL and FCR. Good care coordination may be reinforced to improve outcomes of survivorship care.


Assuntos
Sobreviventes de Câncer/psicologia , Continuidade da Assistência ao Paciente/normas , Qualidade de Vida , Adulto , Idoso , Sobreviventes de Câncer/estatística & dados numéricos , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/psicologia , Neoplasias/epidemiologia , Neoplasias/psicologia , Neoplasias/terapia , Avaliação de Resultados em Cuidados de Saúde , República da Coreia/epidemiologia , Inquéritos e Questionários
18.
Sci Rep ; 10(1): 3519, 2020 02 26.
Artigo em Inglês | MEDLINE | ID: mdl-32103112

RESUMO

The purpose of the study is to evaluate the heritability of inner retinal layer (IRL) and outer retinal layer (ORL) thicknesses in the healthy Korean population. This was a cross-sectional, twin and family study. We included 374 Korean adults with healthy eyes from 89 families. IRL thickness (from the internal limiting membrane to the external limiting membrane) and ORL thickness (from the external limiting membrane to the outer border of the retinal pigment epithelium layer) were measured in the nine macular subfields as defined by the Early Treatment of Diabetic Retinopathy Study using optical coherence tomography. The heritability on IRL and ORL thicknesses were investigated using a variance decomposition model. The heritability of IRL thickness was 0.87, 0.58, 0.85, 0.89, and 0.74 for the central, inner superior, inner inferior, inner temporal, inner nasal subfields, respectively; and 0.62, 0.83, 0.62, and 0.60 for the outer superior, outer inferior, outer temporal, outer nasal subfields, respectively. The heritability of ORL thickness was 0.56, 0.75, 0.66, 0.72, and 0.56 for the central, inner superior, inner inferior, inner temporal, inner nasal subfields, respectively; and 0.64, 0.63, 0.73, 0.54 for the outer superior, outer inferior, outer temporal, and outer nasal subfields, respectively. The heritability estimates of IRL thickness and ORL thickness ranged from moderate to high. The IRL thickness at the central, inner temporal, and inner inferior subfields had particularly high heritability.


Assuntos
Retinopatia Diabética , Retina/diagnóstico por imagem , Tomografia de Coerência Óptica , Gêmeos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Retinopatia Diabética/diagnóstico por imagem , Retinopatia Diabética/genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
19.
Br J Ophthalmol ; 104(10): 1448-1452, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31959589

RESUMO

BACKGROUND/AIM: Characterising genetic effect on macular retinal nerve fibre layer (RNFL) is needed to obtain better understanding of various retinopathies and optic neuropathies. The purpose of this study was to evaluate genetic influence on macular RNFL thickness. METHODS: This is a cross-sectional, twin and family study. Three hundred and sixty-two Korean adults with healthy eyes were included in the study from 79 households with two or more family members. Macular RNFL thickness was measured with optical coherence tomography at nine macular subfields defined by the ETDRS. Intraclass correlation coefficients (ICCs) were estimated to assess intrafamilial resemblance of RNFL thickness by different types of family relationship. Heritability of RNFL thickness was evaluated using variance decomposition model. RESULTS: RNFL thickness increased from central subfield to outer subfields. Temporal quadrant RNFL was thinner compared with other quadrants. Monozygotic twin pairs showed the highest ICCs of RNFL thickness, although the ICC level varied across different subfields. Heritability of RNFL thickness was the highest at central subfield (0.81). RNFL thicknesses of outer subfields were moderately to highly heritable: 0.53, 0.71, 0.47 and 0.66 for superior, inferior, temporal and nasal fields, respectively. RNFL thicknesses at inner subfields showed the lowest heritability: 0.21, 0.24, 0.27 and 0.27 for superior, inferior, temporal and nasal subfields, respectively. CONCLUSION: Macular RNFL thickness is significantly influenced by genetic factors. It varies largely by subfields with the highest heritability at the central subfield and a relatively lower heritability at inner subfields.

20.
Sci Rep ; 10(1): 574, 2020 01 17.
Artigo em Inglês | MEDLINE | ID: mdl-31953444

RESUMO

The purpose of the study is to propose choroidal spatial distribution indexes (CSDIs) to represent choroidal topographic features, establish a normative database for CSDIs, and identify factors associated with CSDIs in healthy eyes. Retrospective data analysis of 363 healthy eyes from a single-center, prospective, cross-sectional, non-interventional study. Subjects were evaluated using spectral domain OCT with enhanced depth imaging. Choroidal volume and average thickness were measured with OCT in nine macular subfields defined by the Early Treatment Diabetic Retinopathy Study. Vertical CSDI was defined as the natural logarithm of superior choroidal volume divided by inferior choroidal volume. Horizontal CSDI was defined as the natural logarithm of temporal choroidal volume divided by nasal choroidal volume. The overall distributions of vertical and horizontal CSDIs was analyzed. Linear regression analyses were used to identify ocular and systemic factors associated with vertical and horizontal CSDIs. The average vertical CSDI was 0.062 ± 0.206, and average horizontal CSDI was 0.138 ± 0.226. Both vertical and horizontal CSDIs followed normal distribution. Increasing age was significantly associated with greater vertical CSDI (choroidal volume distribution tilted toward the superior region), and longer axial length and thinner subfoveal choroidal thickness were significantly associated with greater horizontal CSDI (choroidal volume distribution tilted toward the temporal region).


Assuntos
Corioide/anatomia & histologia , Tomografia de Coerência Óptica/métodos , Adulto , Fatores Etários , Corioide/diagnóstico por imagem , Estudos Transversais , Feminino , Voluntários Saudáveis , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Retrospectivos , Gêmeos
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