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1.
Ann Lab Med ; 42(1): 36-46, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34374347

RESUMO

Background: The emergence of carbapenemase-producing Enterobacteriaceae (CPE) represents a major clinical problem. Recently, the occurrence of CPE has increased globally, but epidemiological patterns vary across region. We report the trends in the genotypic distribution and antimicrobial susceptibility of CPE isolated from rectal and clinical samples during a four-year period. Methods: Between January 2016 and December 2019, 1,254 nonduplicated CPE isolates were obtained from four university hospitals in Korea. Carbapenemase genotypes were determined by multiplex real-time PCR. Antimicrobial susceptibility was profiled using the Vitek 2 system (bioMérieux, Hazelwood, MO, USA) or MicroScan Walkaway-96 system (Siemens West Sacramento, CA, USA). The proportions of carbapenemase genotypes and nonsusceptibility were analyzed using Pearson's chi-square test. Results: Among the 1,254 CPE isolates, 486 (38.8%), 371 (29.6%), 357 (28.5%), 8 (0.6%), 8 (0.6%), and 24 (1.9%) were Klebsiella pneumoniae carbapenemase (KPC), oxacillinase (OXA)-48-like, New Delhi metallo-ß-lactamase (NDM), imipenemase (IMP), Verona integron-encoded metallo-ß-lactamase (VIM), and multiple producers, respectively. The predominant species was K. pneumoniae (72.6%), followed by Escherichia coli (6.5%). More than 90% of the isolates harboring KPC, NDM, and OXA-48-like were nonsusceptible to cephalosporins, aztreonam, and carbapenems. Conclusions: The impact of CPE is primarily due to KPC-, NDM-, and OXA-48-like-producing K. pneumoniae isolates. Isolates carrying these carbapenemase are mostly multidrug-resistant. Control strategies based on these genotypic distributions and antimicrobial susceptibilities of CPE isolates are required.


Assuntos
Anti-Infecciosos , Enterobacteriáceas Resistentes a Carbapenêmicos , Infecções por Enterobacteriaceae , Antibacterianos/farmacologia , Proteínas de Bactérias/genética , Infecções por Enterobacteriaceae/epidemiologia , Genótipo , Hospitais Universitários , Humanos , Klebsiella pneumoniae , Testes de Sensibilidade Microbiana , República da Coreia , beta-Lactamases/genética
2.
Ann Lab Med ; 42(1): 24-35, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34374346

RESUMO

Background: Laboratory parameter abnormalities are commonly observed in COVID-19 patients; however, their clinical significance remains controversial. We assessed the prevalence, characteristics, and clinical impact of laboratory parameters in COVID-19 patients hospitalized in Daegu, Korea. Methods: We investigated the clinical and laboratory parameters of 1,952 COVID-19 patients on admission in nine hospitals in Daegu, Korea. The average patient age was 58.1 years, and 700 (35.9%) patients were men. The patients were classified into mild (N=1,612), moderate (N=294), and severe (N=46) disease groups based on clinical severity scores. We used chi-square test, multiple comparison analysis, and multinomial logistic regression to evaluate the correlation between laboratory parameters and disease severity. Results: Laboratory parameters on admission in the three disease groups were significantly different in terms of hematologic (Hb, Hct, white blood cell count, lymphocyte%, and platelet count), coagulation (prothrombin time and activated partial thromboplastin time), biochemical (albumin, aspartate aminotransferase, alanine aminotransferase, lactate, blood urea nitrogen, creatinine, and electrolytes), inflammatory (C-reactive protein and procalcitonin), cardiac (creatinine kinase MB isoenzyme and troponin I), and molecular virologic (Ct value of SARS-CoV-2 RdRP gene) parameters. Relative lymphopenia, prothrombin time prolongation, and hypoalbuminemia were significant indicators of COVID-19 severity. Patients with both hypoalbuminemia and lymphopenia had a higher risk of severe COVID-19. Conclusions: Laboratory parameter abnormalities on admission are common, are significantly associated with clinical severity, and can serve as independent predictors of COVID-19 severity. Monitoring the laboratory parameters, including albumin and lymphocyte count, is crucial for timely treatment of COVID-19.


Assuntos
COVID-19 , Análise de Dados , Humanos , Laboratórios , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Estudos Retrospectivos , SARS-CoV-2
3.
Ann Lab Med ; 42(1): 54-62, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34374349

RESUMO

Background: Associations between IgA nephropathy (IgAN) and HLA-DRB1 and -DQB1 alleles have been reported in several ethnic groups. We investigated the association of HLA-DRB1 and -DQB1 alleles with the predisposition for IgAN and disease progression to end-stage kidney disease (ESKD) in Korean patients. Methods: We analyzed HLA-DRB1 and -DQB1 genotypes in 399 IgAN patients between January 2000 and January 2019 using a LIFECODES sequence-specific oligonucleotide (SSO) typing kit (Immucor, Stamford, CT, USA) or a LABType SSO Typing Test (One Lambda, Canoga Park, CA, USA). Alleles with a significant difference in two-digit resolution were further analyzed using in-house sequence-based typing and sequence-specific primer PCR. As controls, 613 healthy hematopoietic stem cell donors were included. Kidney survival was analyzed in 281 IgAN patients with available clinical and laboratory data using Cox regression analysis. Where needed, P-values were adjusted using Bonferroni correction. Results: The allele frequencies of HLA-DRB1*04:05 (corrected P [Pc]<0.001), -DQB1 *04:01 (Pc=0.048), and -DQB1*03:02 (Pc=0.021) were significantly higher in IgAN patients than in controls, whereas those of HLA-DRB1*07:01, -DRB1*15:01, -DQB1*02:02, and -DQB1*06:02 (Pc<0.001 for all) were significantly lower in IgAN patients than in controls. The allele frequency of HLA-DQB1*05:03 (Pc=0.016) was significantly lower in the ESKD group than in the non-ESKD group; however, there was no significant difference for ESKD progression between these groups. Conclusions: We report novel associations of HLA-DRB1*15:01, DQB1*02:02, -DQB1*03:02, and -DQB1*04:01 with IgAN. Further studies of HLA alleles associated with IgAN progression in a larger cohort and in various ethnic groups are needed.


Assuntos
Glomerulonefrite por IGA , Alelos , Predisposição Genética para Doença , Glomerulonefrite por IGA/diagnóstico , Glomerulonefrite por IGA/genética , Cadeias HLA-DRB1/genética , Teste de Histocompatibilidade , Humanos , República da Coreia
4.
Ann Lab Med ; 42(1): 96-99, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34374354

RESUMO

The sensitivity of molecular diagnostics could be affected by nucleotide variants in pathogen genes, and the sites affected by such variants should be monitored. We report a single-nucleotide variant (SNV) in the nucleocapsid (N) gene of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), i.e., G29179T, which impairs the diagnostic sensitivity of the Xpert Xpress SARS-CoV-2 assay (Cepheid, Sunnyvale, CA, USA). We observed significant differences between the threshold cycle (Ct) values for envelope (E) and N genes and confirmed the SNV as the cause of the differences using Sanger sequencing. This SNV, G29179T, is the most prevalent in Korea and is associated with the B.1.497 virus lineage, which is dominant in Korea. Clinical laboratories should be aware of the various SNVs in the SARS-CoV-2 genome and consider their potential effects on the diagnosis of coronavirus disease 2019.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , Técnicas de Diagnóstico Molecular , Nasofaringe , Nucleotídeos , Prevalência , República da Coreia , Sensibilidade e Especificidade
5.
Ann Lab Med ; 42(1): 105-109, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34374356

RESUMO

The number of ABO-incompatible solid organ transplantations (ABOi SOTs) has markedly increased worldwide since the early 2000s. We investigated the choice of ABO group for blood component transfusion in ABOi SOT. We conducted a survey by e-mailing a questionnaire to blood bank specialists at 77 major hospitals in Korea, among whom 34 responded to the survey. In major ABOi SOT, for red blood cells (RBCs), the recipient's type (70.6%) was the most common choice, followed by group O (29.4%); for platelets, group AB (50.0%) was the most common choice, followed by the donor type (38.2%); for plasma, group AB (55.9%) was the most common choice, followed by the donor type (32.4%). In bidirectional ABOi SOT, for RBCs, the recipient's type (55.9%) was the most common choice, followed by group O (44.1%); for platelets and plasma, group AB was the most common choice (94.1% and 97.1%, respectively). The policies for transfusion in ABOi SOT were diverse. We suggest a guideline on the choice of ABO group for transfusion in ABOi SOT to secure patient health and enable an efficient use of blood components.


Assuntos
Incompatibilidade de Grupos Sanguíneos , Transplante de Órgãos , Transfusão de Componentes Sanguíneos , Humanos , República da Coreia , Inquéritos e Questionários
7.
World J Gastroenterol ; 27(31): 5126-5151, 2021 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-34497440

RESUMO

Gastric cancer accounts for a significant proportion of worldwide cancer-related morbidity and mortality. The well documented precancerous cascade provides an opportunity for clinicians to detect and treat gastric cancers at an endoscopically curable stage. In high prevalence regions such as Japan and Korea, this has led to the implementation of population screening programs. However, guidelines remain ambiguous in lower prevalence regions. In recent years, there have been many advances in the endoscopic diagnosis and treatment of early gastric cancer and precancerous lesions. More advanced endoscopic imaging has led to improved detection and characterization of gastric lesions as well as superior accuracy for delineation of margins prior to resection. In addition, promising early data on artificial intelligence in gastroscopy suggests a future role for this technology in maximizing the yield of advanced endoscopic imaging. Data on endoscopic resection (ER) are particularly robust in Japan and Korea, with high rates of curative ER and markedly reduced procedural morbidity. However, there is a shortage of data in other regions to support the applicability of protocols from these high prevalence countries. Future advances in endoscopic therapeutics will likely lead to further expansion of the current indications for ER, as both technology and proceduralist expertise continue to grow.


Assuntos
Neoplasias Gástricas , Inteligência Artificial , Dissecação , Gastroscopia , Humanos , República da Coreia/epidemiologia , Neoplasias Gástricas/diagnóstico por imagem , Neoplasias Gástricas/epidemiologia
8.
World J Gastroenterol ; 27(31): 5247-5258, 2021 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-34497448

RESUMO

BACKGROUND: Antibiotic resistance to Helicobacter pylori (H. pylori) infection, which ultimately results in eradication failure, has been an emerging issue in the clinical field. Recently, to overcome this problem, an antibiotic sensitivity-based tailored therapy (TT) for H. pylori infection has received attention. AIM: To investigate the efficacy and safety profiles of TT for H. pylori infection treatment compared to a non-bismuth quadruple therapy, concomitant therapy (CT) regimen. METHODS: We included patients (> 18 years) with an H. pylori infection and without a history of Helicobacter eradication who visited the Gil Medical Center between March 2016 and October 2020. After being randomly assigned to either the TT or CT treatment group in 1 to 1 manner, patient compliance, eradication success rate (ESR), and patient-reported side effects profiles were assessed and compared between the two groups. H. pylori infection was diagnosed using a rapid urease test, Giemsa stain, or dual priming oligonucleotide polymerase chain reaction (DPO-PCR). Tailored eradication strategy based through the presence of a 23S ribosomal RNA point mutation. For the TT group, a DPO-PCR test, which detected A2142G and/or A2143G point mutations, and a clarithromycin resistance test were performed. Patients in the clarithromycin-resistant group were treated with a bismuth-containing quadruple combination therapy, while those with sensitive results were treated with the standard triple regimen. RESULTS: Of the 217 patients with a treatment naive H. pylori infection, 110 patients [mean age: 58.66 ± 13.03, men, n = 55 (50%)] were treated with TT, and 107 patients [mean age: 56.67 ± 10.88, men, n = 52 (48.60%)] were treated with CT. The compliance (TT vs CT, 100% vs 98.13%, P = 0.30), and follow-up loss rates (8.18% vs 9.35%, P = 0.95) were not significantly different between the groups. The ESR after treatment was also not statistically different between the groups (TT vs CT, 82.73% vs 82.24%, P = 0.95). However, the treatment-related and patient-reported side effects were significantly lower in the TT group than in the CT group (22.77% vs 50.52%, P < 0.001). CONCLUSION: The DPO-based TT regimen shows promising results in efficacy and safety profiles as a first-line Helicobacter eradication regimen in Korea, especially when physicians are confronted with increased antibiotic resistance rates.


Assuntos
Infecções por Helicobacter , Helicobacter pylori , Idoso , Amoxicilina/uso terapêutico , Antibacterianos/efeitos adversos , Claritromicina/efeitos adversos , Quimioterapia Combinada , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Inibidores da Bomba de Prótons/efeitos adversos , República da Coreia
9.
BMC Health Serv Res ; 21(1): 967, 2021 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-34521408

RESUMO

BACKGROUND: New drugs including cancer drugs and orphan drugs are becoming increasingly more expensive. Risk sharing arrangements (RSAs) could manage the risk based on both financial impact and the health outcome of new drugs if reimbursed. To improve patients' access to new drugs under uncertainties, many developed countries have adopted RSAs. In this study, we aimed to understand the effects of RSAs in South Korea on patients' access. METHODS: We reviewed current status of RSA drugs in South Korea. The number of appraisals and time gap between market approval and reimbursement per RSA drug were considered to quantify improvement of patients' access as they showed how rapidly decisions on reimbursement of RSA drugs were derived. Then, we applied a comparative analysis to determine whether the RSA drugs in South Korea were reimbursed in the UK, Italy, and Australia. Most data for this study were obtained from websites of the governmental department/agencies responsible for appraisal of drug reimbursement in each country. And literatures related to RSAs were investigated as well. RESULTS: The eligibility for Korean RSAs had two key components - drugs for cancer and rare diseases and not having other alternative treatments. As of the first half of 2019, there were 39 RSA drugs reimbursed in South Korea, the majority of which were financial-based schemes. Refund and expenditure cap were the representative types (89.7%). After introduction of RSAs, the time gap and number of appraisals were decreased. Based on the indications of RSA drugs, the level of drug coverage in South Korea was found lower than Italy, similar to the UK, and higher than Australia. CONCLUSIONS: RSAs in South Korea significantly enhanced patients' access to new drugs and led to the alleviation of patients' out-of-pocket expenses. The drug coverage of South Korea had a level comparable to that of other countries. This study provides implications for countries that have a dual mission of containing pharmaceutical expenditure and improving access to new drugs.


Assuntos
Antineoplásicos , Neoplasias , Preparações Farmacêuticas , Humanos , Neoplasias/tratamento farmacológico , Produção de Droga sem Interesse Comercial , República da Coreia
10.
Health Qual Life Outcomes ; 19(1): 217, 2021 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-34521426

RESUMO

BACKGROUND: Health-related quality of life (HRQOL) is an important concept to consider both individuals' ability to manage their daily lives and health status across the lifespan. Despite this variable's importance, there is a lack of clarification on the factors associated with HRQOL, especially for military women. The aim of this study was to examine factors associated with HRQOL of military women in the Republic of Korea (ROK) Army. METHODS: This cross-sectional study included 196 participants who were currently within their 5-year service period. HRQOL was measured by the Korean version of the Short-Form 36 Health Survey Questionnaire version 2.0 (SF-36v2), and depression was assessed using the Korean version of the Patient Health Questionnaire-9 (PHQ-9). Differences in HRQOL according to general and occupational factors were analyzed using the independent t-test and analysis of variance (ANOVA). Multiple linear regression analysis was performed to identify factors associated with the HRQOL of women serving as military junior officers. RESULTS: The mean score for the physical component summary (PCS) of SF-36v2 was 56.0 ± 5.8, and that for the mental component summary (MCS) of SF-36v2 was 47.2 ± 10.0. For depression, the mean score was 5.4 ± 5.2, whereas 19.4% of the participants scored more than 10 out of 27 points, which means moderate to severe. No variables showed statistically significant relationships with the PCS. However, military women showed a lower score for MCS when they were officers (adjusted ß = - 3.52; 95% CI = - 5.47, - 1.58), had higher perceived stress (adjusted ß = - 0.62, 95% CI = - 0.83, - 0.41), and a higher score for depression (adjusted ß = - 0.86, 95% CI = - 1.10, - 0.63). CONCLUSIONS: Although depression levels were not severe, it was a significant factor of HRQOL. Stress and depression were found to be significant factors associated with the MCS in military women. Therefore, to improve their HRQOL, the ROK Army should provide early screening, intervention, and management program for high-risk military women. In addition, an appropriate organizational atmosphere within the military must be created to promote such programs.


Assuntos
Depressão/psicologia , Militares/psicologia , Estresse Ocupacional/psicologia , Qualidade de Vida/psicologia , Estresse Fisiológico , Adulto , Estudos Transversais , Feminino , Humanos , República da Coreia , Inquéritos e Questionários
11.
BMJ Open ; 11(9): e050037, 2021 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-34479937

RESUMO

OBJECTIVES: This study aimed to determine the cross-sectional association between long working hours and gastritis diagnosed by endoscopy. DESIGN: Cross-sectional study. SETTING: Large university hospitals in Seoul and Suwon, South Korea. PARTICIPANTS: Workers in formal employment who underwent a comprehensive health examination at the Kangbuk Samsung Hospital Total Healthcare Centre clinics in Seoul and Suwon, South Korea, between January 2011 and December 2018. Of the 386 488 participants, 168 391 full-time day workers met the inclusion criteria and were included in the analysis. PRIMARY OUTCOME MEASURE: Endoscopic gastritis. RESULTS: The participants were predominantly college graduates or above (88.9%), male (71.2%) and in their 30s (51.1%), and the median age was 36 (IQR 31-42). Approximately 93.2% of participants had positive endoscopic gastritis, and there was a significant association between working hours and positive findings of endoscopic gastritis. The multivariate fully adjusted prevalence ratio (PR) of endoscopic gastritis for participants working >55 hours per week compared with 35-40 hours per week was 1.011 (95% CI 1.007 to 1.015). Furthermore, endoscopic findings were classified into nine subtypes of gastritis, including superficial gastritis, erosive gastritis, atrophic gastritis, intestinal metaplasia and haemorrhagic gastritis increased with longer working hours (p for trends <0.05). Their PRs for participants working >55 hours per week compared with 35-40 hours per week were 1.019 (95% CI 1.012 to 1.026), 1.025 (95% CI 1.011 to 1.040), 1.017 (95% CI 1.008 to 1.027), 1.066 (95% CI 1.028 to 1.105) and 1.177 (95% CI 1.007 to 1.375), respectively. CONCLUSIONS: Working over 55 hours per week was cross-sectionally associated with positive findings of endoscopic gastritis. The study findings indicated potentially increased risks of superficial gastritis, erosive gastritis, atrophic gastritis, intestinal metaplasia and haemorrhagic gastritis among workers with long working hours (>55 hours per week), supporting the need for further exploration via longitudinal studies.


Assuntos
Gastrite Atrófica , Gastrite , Adulto , Estudos Transversais , Endoscopia , Gastrite/epidemiologia , Humanos , Masculino , República da Coreia/epidemiologia
12.
BMJ Open ; 11(9): e049063, 2021 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-34489281

RESUMO

OBJECTIVES: This study aimed to examine the association between metabolically healthy obesity and all-cause and cardiovascular disease (CVD) mortality in a Korean population. DESIGN: A prospective study. SETTING: This study used data from the Korean Genome and Epidemiology Study. PARTICIPANTS: A total of 140 137 participants were followed up over a median period of 9.2 years. Participants were categorised into four groups according to obesity (obese: body mass index ≥25 kg/m2 or non-obese) and metabolic health (metabolically unhealthy: two or more metabolic abnormalities or metabolically healthy). PRIMARY AND SECONDARY OUTCOME MEASURES: All-cause and CVD mortality of the participants until 31 December 2018 were ascertained by the National Health Insurance Service of beneficiary status of Korea. RESULTS: Metabolically unhealthy non-obese participants were at elevated risk of all-cause mortality (HR, 1.12; 95% CI, 1.04 to 1.21; p=0.0019) and CVD mortality (HR, 1.39; 95% CI, 1.17 to 1.65; p=0.0002), particularly mortality from ischaemic heart disease (IHD) (HR, 1.54; 95% CI, 1.10 to 2.14; p=0.0116) compared with metabolically healthy non-obese participants. Surprisingly, metabolically healthy obese participants were at reduced risk of all-cause mortality (HR, 0.89; 95% CI, 0.81 to 0.98; p=0.0197). Metabolically unhealthy obese participants were at elevated risk of CVD mortality (HR, 1.51; 95% CI, 1.26 to 1.81; p<0.0001) and IHD mortality (HR, 1.88; 95% CI, 1.35 to 2.63; p=0.0002) compared with metabolically healthy non-obese participants. CONCLUSIONS: In a Korean population, metabolically healthy obese participants had reduced risk of all-cause mortality compared with their non-obese counterparts, whereas metabolically unhealthy participants had elevated risk of CVD mortality, in particular mortality from IHD regardless of obesity.


Assuntos
Doenças Cardiovasculares , Síndrome Metabólica , Obesidade Metabolicamente Benigna , Índice de Massa Corporal , Humanos , Estudos Prospectivos , República da Coreia/epidemiologia , Fatores de Risco
13.
BMC Psychiatry ; 21(1): 445, 2021 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-34496823

RESUMO

BACKGROUND: The risk of depression has risen in the general population during the COVID-19 epidemic. This study was conducted to explore risk and protective factors associated with depression among the general population uninfected by COVID-19. METHODS: A cross-sectional study was conducted with 1,500 representative South Korean citizens aged 19-65 years through an anonymous online survey. Depression was defined as a Patient Health Questionnaire-9 score of 10 or higher. Other questionnaires included one measuring psycho-behavioural and social changes, and stress, due to COVID-19, a six-item version of the Gratitude Questionnaire (GQ-6), and a three-item version of the UCLA loneliness scale. RESULTS: Of the 1492 participants not infected by COVID-19, 312 (20.9%) exhibited depression. Multiple logistic regression analysis revealed that depression was positively associated with COVID-19-related stress and psycho-behavioural variables such as disturbances in eating and sleeping, younger age, smoking, underlying mental illness, and loneliness scale scores. In contrast, exercise three or more times per week and GQ-6 scale scores were inversely associated with depression. CONCLUSION: During the COVID-19 pandemic, maintaining daily routines including eating, sleeping, and regular exercise and focusing on gratitude may be important for the prevention of depression. In addition, more attention should be paid to vulnerable populations, including young people, those with mental illnesses, and smokers, who might be more susceptible to depression.


Assuntos
COVID-19 , Pandemias , Adolescente , Ansiedade , Estudos Transversais , Depressão/epidemiologia , Humanos , Saúde Mental , Fatores de Proteção , República da Coreia/epidemiologia , SARS-CoV-2
14.
Sensors (Basel) ; 21(17)2021 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-34502742

RESUMO

Here, we introduce the current stage and future directions of the wireless infrastructure of the Korea Research Environment Open NETwork (KREONET), a representative national research and education network in Korea. In 2018, ScienceLoRa, a pioneering wireless network infrastructure for scientific applications based on low-power wide-area network technology, was launched. Existing in-service applications in monitoring regions, research facilities, and universities prove the effectiveness of using wireless infrastructure in scientific areas. Furthermore, to support the more stringent requirements of various scientific scenarios, ScienceLoRa is evolving toward ScienceIoT by employing high-performance wireless technology and distributed computing capability. Specifically, by accommodating a private 5G network and an integrated edge computing platform, ScienceIoT is expected to support cutting-edge scientific applications requiring high-throughput and distributed data processing.


Assuntos
Rede Social , Tecnologia sem Fio , República da Coreia
15.
Endocrinol Metab (Seoul) ; 36(4): 769-777, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34474515

RESUMO

BACKGROUND: Data on the association between coronavirus disease 2019 (COVID-19) and thyroid have been reported, including overt thyrotoxicosis and suppression of thyroid function. We aimed to evaluate the thyroid hormone profile and its association with the prognosis of COVID-19 in Korean patients. METHODS: The clinical data of 119 patients with COVID-19, admitted in the Myongji Hospital, Goyang, South Korea, were retrospectively evaluated. The thyroid hormone profiles were analyzed and compared based on disease severity (non-severe disease vs. severe to critical disease). Clinical outcomes were analyzed according to the tertiles of thyroid hormones. RESULTS: Of the 119 patients, 76 (63.9%) were euthyroid, and none presented with overt thyroid dysfunction. Non-thyroidal illness syndrome was the most common manifestation (18.5%), followed by subclinical thyrotoxicosis (14.3%) among patients with thyroid dysfunction. Thyroid stimulating hormone (TSH) and triiodothyronine (T3) levels were significantly lower in patients with severe to critical disease than in those with non-severe disease (P<0.05). Patients in the lowest T3 tertile (<0.77 ng/mL) had higher rates of mechanical ventilation, intensive care unit admission, and death than those in the middle and highest (>1.00 ng/mL) T3 tertiles (P<0.05). COVID-19 patients in the lowest T3 tertile were independently associated with mortality (hazard ratio, 5.27; 95% confidence interval, 1.09 to 25.32; P=0.038) compared with those in the highest T3 tertile. CONCLUSION: Thyroid dysfunction is common in COVID-19 patients. Changes in serum TSH and T3 levels may be important markers of disease severity in COVID-19. Decreased T3 levels may have a prognostic significance in COVID-19 related outcome.


Assuntos
COVID-19/sangue , COVID-19/diagnóstico , Tireotropina/sangue , Tri-Iodotironina/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , COVID-19/epidemiologia , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , República da Coreia/epidemiologia , Estudos Retrospectivos
16.
Korean J Med Educ ; 33(3): 163-170, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34474523

RESUMO

It is necessary to reflect on the question, "How to prepare for medical education after coronavirus disease 2019 (COVID-19)?" Although we are preparing for the era of Education 4.0 in line with the 4th industrial revolution of artificial intelligence and big data, most measures are focused on the methodologies of transferring knowledge; essential innovation is not being addressed. What is fundamentally needed in medicine is insightful intelligence that can see the invisible. We should not create doctors who only prescribe antispasmodics for abdominal pain, or antiemetic drugs for vomiting. Good clinical reasoning is not based on knowledge alone. Insightology in medicine is based on experience through Bayesian reasoning and imagination through the theory of mind. This refers to diagnosis of the whole, greater than the sum of its parts, by looking at the invisible using the Gestalt strategy. Identifying the missing process that links symptoms is essential. This missing process can be described in one word: context. An accurate diagnosis is possible only by understanding context, which can be done by standing in someone else's shoes. From the viewpoint of medicine, Education 4.0 is worrisome because people are still clinging to methodology. The subject we should focus on is "human", not "artificial" intelligence. We should first advance the "insightology in medicine" as a new paradigm, which is the "essence" that will never change even when rare "phenomena" such as the COVID-19 outbreak occur. For this reason, we should focus on teaching insightology in medicine, rather than teaching medical knowledge.


Assuntos
COVID-19/epidemiologia , Educação Médica/tendências , Inteligência Artificial , Difusão de Inovações , Humanos , Conhecimento , Pandemias , República da Coreia/epidemiologia , SARS-CoV-2
17.
Korean J Med Educ ; 33(3): 227-232, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34474529

RESUMO

PURPOSE: This study aimed to examine the differences in scores of the Attitude to Patient Safety Questionnaire (APSQ) by medical students before and after the outbreak of COVID-19. METHODS: In total, 97 and 118 medical students completed patient safety courses at Yonsei University Wonju College of Medicine in 2019 and 2020, respectively. In 2019, the course was conducted using traditional learning in the classroom, whereas, in 2020, most of the classes were conducted using non-face-to-face learning methods. RESULTS: In 2019 and 2020, 49 and 53 students responded to the APSQ. Only one item "Patients are not really aware of how safe their care is" had a lower score in 2020 than in 2019. CONCLUSION: Although the total APSQ score did not differ between 2019 and 2020, the students in 2020 might have a poor understanding of the role of patients in medical errors.


Assuntos
Atitude do Pessoal de Saúde , COVID-19/epidemiologia , Segurança do Paciente , Estudantes de Medicina/psicologia , Adulto , Feminino , Humanos , Masculino , Pandemias , República da Coreia/epidemiologia , SARS-CoV-2 , Inquéritos e Questionários
18.
Anticancer Res ; 41(9): 4603-4607, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34475088

RESUMO

BACKGROUND/AIM: Niraparib is effective against epithelial ovarian cancer (EOC), but with adverse effects. In this study, we retrospectively investigated niraparib maintenance treatment feasibility in Korean patients newly diagnosed with EOC. PATIENTS AND METHODS: The medical records of 35 patients were reviewed. Data on the baseline clinical characteristics were collected, and adverse effects were described. RESULTS: Sixteen patients underwent treatment suspension or dose reduction. There was no significant difference in adverse effects (A/E) due to the interval between adjuvant chemotherapy conclusion and niraparib initiation. The two groups had similar International Federation of Gynaecology and Obstetrics (FIGO) stages. The number of patients with a history of bevacizumab use was higher in the dose modification group than in the standard dose group. CONCLUSION: Niraparib use must be considered in those previously treated with bevacizumab. There is a need for prospective research on lower dose (<200 mg) treatments in patients with risk factors.


Assuntos
Carcinoma Epitelial do Ovário/tratamento farmacológico , Indazóis/administração & dosagem , Neoplasias Ovarianas/tratamento farmacológico , Piperidinas/administração & dosagem , Inibidores de Poli(ADP-Ribose) Polimerases/administração & dosagem , Quimioterapia Adjuvante , Redução da Medicação , Estudos de Viabilidade , Feminino , Humanos , Indazóis/uso terapêutico , Quimioterapia de Manutenção , Estadiamento de Neoplasias , Piperidinas/uso terapêutico , Inibidores de Poli(ADP-Ribose) Polimerases/uso terapêutico , República da Coreia , Estudos Retrospectivos , Análise de Sobrevida , Resultado do Tratamento
19.
Medicine (Baltimore) ; 100(35): e27115, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34477153

RESUMO

ABSTRACT: Gallbladder polyps (GBPs), especially GBPs ≥5 mm in diameter, are clinically important because they can progress to gallbladder cancer. The known modifiable risk factors for GBP are obesity, metabolic syndrome, and dyslipidemia; however, there is limited evidence regarding specific modifiable risk factors for GBPs ≥5 mm in diameter. Therefore, this study is aimed to investigate the existence of modifiable risk factors affecting the prevalence of GBPs and GBPs ≥5 mm in diameter in a Korean population.A total of 10,119 subjects who visited a single health-screening center at Jeju National University Hospital between January 2009 and December 2019 was included in this study. Binary logistic analyses were performed to identify risk factors affecting the prevalence of GBPs and GBPs ≥5 mm in diameter.The overall prevalence of GBPs and GBPs ≥5 mm in diameter were 9.0% and 4.1%, respectively. Multivariable analysis identified male gender as an independent risk factor affecting the prevalence of GBPs. Moreover, multivariable analysis revealed age and high-density lipoprotein cholesterol levels as independent risk factors for GBPs ≥5 mm in diameter.This study showed that gender was a risk factor affecting the prevalence of GBPs and that age and high-density lipoprotein-cholesterol levels were risk factors for the presence of GBPs ≥5 mm in diameter. High-density lipoprotein cholesterol levels could be a modifiable risk factor affecting the prevalence of large-diameter GBPs.


Assuntos
Doenças da Vesícula Biliar/epidemiologia , Pólipos/epidemiologia , Adulto , Fatores Etários , Idoso , Estudos Transversais , Feminino , Vesícula Biliar/patologia , Doenças da Vesícula Biliar/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Pólipos/patologia , Prevalência , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais
20.
Nurs Open ; 8(3): 1030-1037, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34482659

RESUMO

AIM: This study aimed to examine the sleep pattern of breast cancer survivors and anxiety and depression associated with sleep quality to provide evidence-based information for the development of interventions to improve sleep disorders in these survivors. DESIGN: A cross-sectional study. METHODS: The subjects were 266 breast cancer survivors in South Korea. Structured questionnaires regarding sleep quality, anxiety and depression were used. The data were analysed using t test, ANOVA and multiple regression analysis. RESULTS: Sleep duration and sleep disturbance were found to affect anxiety, whereas sleep latency and subjective sleep quality were found to affect depression. These results suggest that various factors affecting sleep quality should be considered when providing care for anxiety and depression in breast cancer survivors.


Assuntos
Neoplasias da Mama , Sobreviventes de Câncer , Ansiedade/epidemiologia , Neoplasias da Mama/complicações , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , República da Coreia/epidemiologia , Sono , Sobreviventes
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