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1.
Sci Total Environ ; 750: 141521, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-32829258

RESUMO

In order to control the spread of COVID-19, social distancing measures were implemented in many countries. This study investigated changes in air pollution during the social distancing after the COVID-19 outbreak in Korea. Ambient PM2.5, PM10, NO2, and CO that are particularly related to industrial activities and traffic were reduced during the social distancing in response to the COVID-19 outbreak. In March 2020, immediately after social distancing, mean levels of PM2.5, PM10, NO2, and CO decreased nationwide from last year's mean levels by 16.98 µg/m3, 21.61 µg/m3, 4.16 ppb, and 0.09 ppm, respectively (p-value for the year-to-year difference <0.001, =0.001, =0.008, <0.001), a decrease by 45.45%, 35.56%, 20.41%, and 17.33%, respectively. Changes in ambient O3 or SO2 were not observed to be attributable to social distancing. Our findings, that such effort for a short period of time resulted in a significant reduction in air pollution, may point toward reducing air pollution as a public health problem in a more sustainable post-COVID-19 world.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Betacoronavirus , Monitoramento Ambiental , Humanos , Material Particulado/efeitos adversos , Material Particulado/análise , República da Coreia/epidemiologia
2.
J Korean Med Sci ; 35(43): e388, 2020 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-33169559

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic caused disruptions to healthcare systems and endangered the control and prevention of tuberculosis (TB). We investigated the nationwide effects of COVID-19 on the national Public-Private Mix (PPM) TB control project in Korea, using monitoring indicators from the Korean PPM monitoring database. METHODS: The Korean PPM monitoring database includes data from patients registered at PPM hospitals throughout the country. Data of six monitoring indicators for active TB cases updated between July 2019 and June 2020 were collected. The data of each cohort throughout the country and in Daegu-Gyeongbuk, Seoul Metropolitan Area, and Jeonnam-Jeonbuk were collated to provide nationwide data. The data were compared using the χ² test for trend to evaluate quarterly trends of each monitoring indicator at the national level and in the prespecified regions. RESULTS: Test coverages of sputum smear (P = 0.622) and culture (P = 0.815), drug susceptibility test (P = 0.750), and adherence rate to initial standard treatment (P = 0.901) at the national level were not significantly different during the study period. The rate of loss to follow-up among TB cases at the national level was not significantly different (P = 0.088); however, the treatment success rate among the smear-positive drug-susceptible pulmonary TB cohort at the national level significantly decreased, from 90.6% to 84.1% (P < 0.001). Treatment success rate in the Seoul metropolitan area also significantly decreased during the study period, from 89.4% to 84.5% (P = 0.006). CONCLUSION: Our study showed that initial TB management during the COVID-19 pandemic was properly administered under the PPM project in Korea. However, our study cannot confirm or conclude a decreased treatment success rate after the COVID-19 pandemic due to limited data.


Assuntos
Infecções por Coronavirus/patologia , Pneumonia Viral/patologia , Tuberculose/prevenção & controle , Antituberculosos/uso terapêutico , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Bases de Dados Factuais , Assistência à Saúde , Resistência Microbiana a Medicamentos , Humanos , Pandemias , Cooperação do Paciente , Pneumonia Viral/epidemiologia , República da Coreia/epidemiologia , Escarro/microbiologia , Tuberculose/diagnóstico , Tuberculose/tratamento farmacológico
3.
J Korean Med Sci ; 35(42): e380, 2020 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-33140592

RESUMO

There were two rallies of medical students and trainee doctors, where 9,000 participants gathered. We performed polymerase chain reaction (PCR)-based universal screening for the participants using pooling at a tertiary care hospital. Around 609 (94%) of 646 participants underwent PCR tests for severe acute respiratory syndrome coronavirus 2; all of them tested negative. Our data suggested low transmission rates in open air mass gatherings when appropriate personal protective practices were followed.


Assuntos
Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Reação em Cadeia da Polimerase , Infecções por Coronavirus/epidemiologia , Higiene das Mãos , Humanos , Internato e Residência , Máscaras , Programas de Rastreamento , Pandemias , Médicos , Pneumonia Viral/epidemiologia , República da Coreia/epidemiologia , Isolamento Social , Estudantes de Medicina , Centros de Atenção Terciária
4.
PLoS One ; 15(11): e0241466, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33147252

RESUMO

As the number of global coronavirus disease (COVID-19) cases increases, the number of imported cases is gradually rising. Furthermore, there is no reduction in domestic outbreaks. To assess the risks from imported COVID-19 cases in South Korea, we suggest using the daily risk score. Confirmed COVID-19 cases reported by John Hopkins University Center, roaming data collected from Korea Telecom, and the Oxford COVID-19 Government Response Tracker index were included in calculating the risk score. The risk score was highly correlated with imported COVID-19 cases after 12 days. To forecast daily imported COVID-19 cases after 12 days in South Korea, we developed prediction models using simple linear regression and autoregressive integrated moving average, including exogenous variables (ARIMAX). In the validation set, the root mean squared error of the linear regression model using the risk score was 6.2, which was lower than that of the autoregressive integrated moving average (ARIMA; 22.3) without the risk score as a reference. Correlation coefficient of ARIMAX using the risk score (0.925) was higher than that of ARIMA (0.899). A possible reason for this time lag of 12 days between imported cases and the risk score could be the delay that occurs before the effect of government policies such as closure of airports or lockdown of cities. Roaming data could help warn roaming users regarding their COVID-19 risk status and inform the national health agency of possible high-risk areas for domestic outbreaks.


Assuntos
Telefone Celular , Infecções por Coronavirus/epidemiologia , Previsões/métodos , Pandemias , Pneumonia Viral/epidemiologia , Análise de Dados , Coleta de Dados/métodos , Surtos de Doenças/prevenção & controle , Humanos , Modelos Lineares , Modelos Estatísticos , República da Coreia/epidemiologia , Risco
5.
Medicine (Baltimore) ; 99(45): e22881, 2020 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-33157931

RESUMO

The number of femoral fractures is expected to continue to increase as the size of the older population rapidly grows. However, old age is accompanied by various comorbidities and is an important postoperative risk factor in itself, meaning that patients who undergo surgery for a femur fracture may require admission to an ICU. We investigated pulmonary complications in patients over the age of 65 admitted to the ICU after femur fracture surgery.In this single-center retrospective observational study, 289 patients over 65 years who admitted to the ICU after femur fracture surgery between June 2008 and December 2016 were investigated.Pulmonary complications occurred in 97 of these patients (33.6%) after surgery. Mean hospitalization days (34.1 ±â€Š25.7 vs 23.1 ±â€Š15.7, P < .001) and mean ICU length of stay (8.4 ±â€Š16.1 vs 2.5 ±â€Š1.1, P = .001) were significantly longer for patients with pulmonary complications than for patients without pulmonary complications after femur fracture surgery. Patients with pulmonary complications were significantly more likely to have pulmonary disease (19.6% vs 8.9%, P = .009) and exhibit sequelae on preoperative chest X-rays (9.3% vs 3.6%, P = .048) than were patients without pulmonary complications. In addition, significant differences were observed in the right ventricular systolic pressure (RVSP) measured during preoperative echocardiography (37.4 ±â€Š10.9 mm Hg vs 40.7 ±â€Š9.3 mm Hg for patients without and with pulmonary complications, P = .010) and in the proportion of each group that had an RVSP of >35 mm Hg, which is a marker for pulmonary hypertension (55.2% vs 76.3% for patients without and with pulmonary complications, P < .001). In multivariate analysis, an RVSP of >35 mm Hg during preoperative echocardiography was associated with pulmonary complications after femur fracture surgery (OR, 2.6; 95% CI, 1.45-4.53).In conclusion, Pulmonary complications in older patients admitted to the ICU after femur fracture surgery was associated with longer hospitalization and ICU stays. Preoperative RVSP measurement could identify those older patients with a high risk of pulmonary complications following transferal to the ICU after femur fracture surgery.


Assuntos
Pressão Sanguínea/fisiologia , Fraturas do Fêmur/cirurgia , Unidades de Terapia Intensiva , Doenças Respiratórias/epidemiologia , Sístole/fisiologia , Função Ventricular Direita/fisiologia , Idoso , Idoso de 80 Anos ou mais , Ecocardiografia , Feminino , Humanos , Tempo de Internação , Masculino , Admissão do Paciente , Complicações Pós-Operatórias , Cuidados Pré-Operatórios , República da Coreia/epidemiologia , Estudos Retrospectivos
6.
Int J Equity Health ; 19(1): 198, 2020 11 06.
Artigo em Inglês | MEDLINE | ID: mdl-33158449

RESUMO

While the coronavirus disease 2019 (COVID-19) pandemic is an ongoing worldwide, including South Korea (hereinafter Korea), it is impossible to predict the duration of the pandemic. To stop the spread of COVID-19, "social distancing," which included mandatory lockdown, and attention to personal hygiene are being adopted globally as non-pharmaceutical preventive strategies. In Korea, after maintaining strong social distancing rules for a while, the government transitioned to implementing "distancing in daily life" since May 6, 2020. The distancing in daily life was combined with infection prevention activities to stop the COVID-19 pandemic, while guaranteeing one's daily life and economic activities.In this regard, the Ministry of Health and Welfare in Korea disclosed key rules for personal quarantine. The five key rules for individual infection control are as follows: to stay at home for 3-4 days if you feel unwell, keep a distance of two arms' length from others, to wash your hands for 30 s and cough or sneeze into your sleeves, ventilate at least twice a day and disinfect regularly, and stay connected while physically distancing. However, for vulnerable populations, it is very difficult to follow such rules.Thus, we attempted to recommend how the society could support such vulnerable populations who may face difficulties in following these individual infection control rules. Through our recommendations for the weakest part of our society, we expect to strengthen the overall social structure.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Populações Vulneráveis , Infecções por Coronavirus/epidemiologia , Governo , Humanos , Higiene , Pneumonia Viral/epidemiologia , Quarentena/legislação & jurisprudência , República da Coreia/epidemiologia , Distância Social
7.
Artigo em Inglês | MEDLINE | ID: mdl-33202624

RESUMO

Because of the ongoing COVID-19 pandemic, the public is unable to maintain a proper balance between work and leisure, and an increase in community-based infections is causing severe phobic anxiety. Therefore, the present study investigated the differences in phobic anxiety between work and leisure activities according to optimistic bias among 533 South Korean citizens. Frequency analysis, descriptive statistical analysis, t-tests, and a one-way analysis of variance were conducted to examine the data. The results showed that for leisure activities, women showed a higher perception of phobic anxiety. In addition, the group showing high optimistic bias had a higher perception of phobic anxiety in both work and leisure activity situations. Therefore, support measures to lower phobic anxiety among women are needed at the government level, while support and interest from family members are needed at home. Moreover, local governments must ensure active involvement to mitigate phobic anxiety among individuals, and measures are needed to more actively implement infectious disease prevention behaviors.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus/psicologia , Otimismo , Pneumonia Viral/psicologia , Adulto , Idoso , Betacoronavirus , Emprego , Feminino , Humanos , Atividades de Lazer , Masculino , Pessoa de Meia-Idade , Pandemias , República da Coreia/epidemiologia , Adulto Jovem
8.
Diabetes Metab J ; 44(5): 737-746, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33115212

RESUMO

Background: Inconsistent results have been observed regarding the independent effect of diabetes on the severity of coronavirus disease 2019 (COVID-19). We conducted a nationwide population-based cohort study to evaluate the relationship between diabetes and COVID-19 severity in South Korea. METHODS: Patients with laboratory-confirmed COVID-19 aged ≥30 years were enrolled and medical claims data were obtained from the Korean Health Insurance Review and Assessment Service. Hospitalization, oxygen treatment, ventilator application, and mortality were assessed as severity outcomes. Multivariate logistic regression analyses were performed after adjusting for age, sex, and comorbidities. RESULTS: Of 5,307 COVID-19 patients, the mean age was 56.0±14.4 years, 2,043 (38.5%) were male, and 770 (14.5%) had diabetes. The number of patients who were hospitalized, who received oxygen, who required ventilator support, and who died was 4,986 (94.0%), 884 (16.7%), 121 (2.3%), and 211 (4.0%), respectively. The proportion of patients with diabetes in the abovementioned outcome groups was 14.7%, 28.1%, 41.3%, 44.6%, showing an increasing trend according to outcome severity. In multivariate analyses, diabetes was associated with worse outcomes, with an adjusted odds ratio (aOR) of 1.349 (95% confidence interval [CI], 1.099 to 1.656; P=0.004) for oxygen treatment, an aOR of 1.930 (95% CI, 1.276 to 2.915; P<0.001) for ventilator use, and an aOR of 2.659 (95% CI, 1.896 to 3.729; P<0.001) for mortality. CONCLUSION: Diabetes was associated with worse clinical outcomes in Korean patients with COVID-19, independent of other comorbidities. Therefore, patients with diabetes and COVID-19 should be treated with caution.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/mortalidade , Diabetes Mellitus/fisiopatologia , Hospitalização/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/mortalidade , Índice de Gravidade de Doença , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Comorbidade , Infecções por Coronavirus/patologia , Infecções por Coronavirus/virologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/patologia , Pneumonia Viral/virologia , Prognóstico , República da Coreia/epidemiologia , Taxa de Sobrevida , Fatores de Tempo
11.
Math Biosci Eng ; 17(5): 5085-5098, 2020 07 27.
Artigo em Inglês | MEDLINE | ID: mdl-33120541

RESUMO

The COVID-19 outbreak, designated a "pandemic" by the World Health Organization (WHO) on 11 March 2020, has spread worldwide rapidly. Each country implemented prevention and control strategies, mainly classified as SARS LCS (SARS-like containment strategy) or PAIN LMS (pandemic influenza-like mitigation strategy). The reasons for variation in each strategy's efficacy in controlling COVID-19 epidemics were unclear and are investigated in this paper. On the basis of the daily number of confirmed local (imported) cases and onset-to-confirmation distributions for local cases, we initially estimated the daily number of local (imported) illness onsets by a deconvolution method for mainland China, South Korea, Japan and Spain, and then estimated the effective reproduction numbers Rt by using a Bayesian method for each of the four countries. China and South Korea adopted a strict SARS LCS, to completely block the spread via lockdown, strict travel restrictions and by detection and isolation of patients, which led to persistent declines in effective reproduction numbers. In contrast, Japan and Spain adopted a typical PAIN LMS to mitigate the spread via maintaining social distance, self-quarantine and isolation etc., which reduced the Rt values but with oscillations around 1. The finding suggests that governments may need to consider multiple factors such as quantities of medical resources, the likely extent of the public's compliance to different intensities of intervention measures, and the economic situation to design the most appropriate policies to fight COVID-19 epidemics.


Assuntos
Número Básico de Reprodução , Controle de Doenças Transmissíveis/legislação & jurisprudência , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Teorema de Bayes , Betacoronavirus , China/epidemiologia , Controle de Doenças Transmissíveis/métodos , Humanos , Japão/epidemiologia , Modelos Teóricos , Pandemias , Distribuição de Poisson , Quarentena , República da Coreia/epidemiologia , Isolamento Social , Espanha/epidemiologia
12.
Epidemiol Psychiatr Sci ; 29: e176, 2020 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-33077022

RESUMO

AIMS: To investigate the association between parity and the risk of incident dementia in women. METHODS: We pooled baseline and follow-up data for community-dwelling women aged 60 or older from six population-based, prospective cohort studies from four European and two Asian countries. We investigated the association between parity and incident dementia using Cox proportional hazards regression models adjusted for age, educational level, hypertension, diabetes mellitus and cohort, with additional analysis by dementia subtype (Alzheimer dementia (AD) and non-Alzheimer dementia (NAD)). RESULTS: Of 9756 women dementia-free at baseline, 7010 completed one or more follow-up assessments. The mean follow-up duration was 5.4 ± 3.1 years and dementia developed in 550 participants. The number of parities was associated with the risk of incident dementia (hazard ratio (HR) = 1.07, 95% confidence interval (CI) = 1.02-1.13). Grand multiparity (five or more parities) increased the risk of dementia by 30% compared to 1-4 parities (HR = 1.30, 95% CI = 1.02-1.67). The risk of NAD increased by 12% for every parity (HR = 1.12, 95% CI = 1.02-1.23) and by 60% for grand multiparity (HR = 1.60, 95% CI = 1.00-2.55), but the risk of AD was not significantly associated with parity. CONCLUSIONS: Grand multiparity is a significant risk factor for dementia in women. This may have particularly important implications for women in low and middle-income countries where the fertility rate and prevalence of grand multiparity are high.


Assuntos
Doença de Alzheimer/epidemiologia , Demência/epidemiologia , Paridade/fisiologia , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos de Coortes , Europa (Continente)/epidemiologia , Feminino , Psiquiatria Geriátrica , Humanos , Incidência , Vida Independente , Pessoa de Meia-Idade , Gravidez , Modelos de Riscos Proporcionais , República da Coreia/epidemiologia , Fatores de Risco , Fatores Socioeconômicos
13.
Int J Food Microbiol ; 335: 108893, 2020 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-33007603

RESUMO

Food-producing animals are considered a leading source of human Salmonella infections in Korea. However, there is a lack of comprehensive and up-to-date data regarding the diversity and resistance profiles of Salmonella serotypes in these animals. Therefore, this study aimed to determine the distribution and antimicrobial resistance profiles of Salmonella serotypes isolated from cattle, pigs, and chickens in Korea between 2010 and 2018. A total of 3018 Salmonella isolates were obtained from 16 laboratories/centers participating in the Korean Veterinary Antimicrobial Resistance Monitoring System. Salmonella serotypes were identified from the following isolates: 179 cattle (17 serotypes), 959 pig (45 serotypes), and 1880 chicken (64 serotypes). The most frequent serotypes in cattle (Typhimurium, Salmonella 4,[5],12:i:-, and Schwarzengrund), pigs (Typhimurium, Rissen, and S. 4,[5],12:i:-), and chickens (Enteritidis, Albany, Virchow, and Montevideo) accounted for more than 50% of the total serotypes in the respective animal species. To the best of our knowledge, Salmonella 4,[5],12:i:- has not been identified in cattle in Korea to date. More than 80% of the isolates demonstrated resistance to at least one antimicrobial agent. Multidrug-resistance was found in almost half of the serotypes; the highest proportion in cattle (59.2%), followed by pigs (53.4%), and chickens (45.7%). Significant proportions of the serotypes were resistant to ampicillin, streptomycin, and tetracycline. Ceftiofur and ciprofloxacin resistance rates were the highest in Salmonella isolated from chickens (17.1% and 4.1%, respectively) and cattle (10.1% and 3.9%, respectively) compared to that in pigs. Among the frequent serotypes, Albany demonstrated the highest resistance rate (>90%) to five different antimicrobials. Alarmingly, some Salmonella serotypes that are frequently associated with human infections demonstrated a trend of increasing resistance to critically important antibiotics, including 3rd generation cephalosporins and quinolones. Collectively, the presence of antibiotic-resistant Salmonella in food-producing animals poses a potential risk to public health.


Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana , Salmonelose Animal/microbiologia , Salmonella/classificação , Salmonella/efeitos dos fármacos , Animais , Bovinos , Galinhas , Farmacorresistência Bacteriana/efeitos dos fármacos , Humanos , Testes de Sensibilidade Microbiana , República da Coreia/epidemiologia , Salmonella/isolamento & purificação , Salmonelose Animal/epidemiologia , Sorogrupo , Suínos
14.
Artigo em Inglês | MEDLINE | ID: mdl-33081367

RESUMO

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


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/epidemiologia , Difusão de Inovações , Governo , Administração de Instituições de Saúde , Humanos , Pneumonia Viral/epidemiologia , Administração em Saúde Pública , República da Coreia/epidemiologia
15.
Artigo em Inglês | MEDLINE | ID: mdl-33028002

RESUMO

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


Assuntos
Infecções por Coronavirus/prevenção & controle , Educação a Distância/organização & administração , Pandemias/prevenção & controle , Educação Física e Treinamento/métodos , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/epidemiologia , Eficiência Organizacional , Humanos , Pneumonia Viral/epidemiologia , República da Coreia/epidemiologia , Instituições Acadêmicas , Estudantes/psicologia
16.
Medicine (Baltimore) ; 99(44): e22897, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33126343

RESUMO

Inflammatory bowel disease (IBD) in Asia has become increasingly prevalent. As a treatment of IBD, many immunomodulators and biological agents were introduced and shown to be effective in inducing and maintaining remission. However, many cases with treatment failure were reported. To overcome the failure, combination therapy of immunomodulatory and biologics have emerged, showing better outcomes by optimizing biologic pharmacokinetics and minimizing immunogenicity. Adversely, rates of tuberculosis (TB) have been increased as a result. The aim of this study is to compare the risk of TB according to the therapy using large population data.We used data from the South Korean Health Insurance and Review Agency over the period 2008-2016 and calculated the hazard ratio (HR) for TB in IBD. We compared the risk of TB according to the medication: infliximab only, azathioprine only (AZA), combination of azathioprine and infliximab (CAI), azathioprine monotherapy and infliximab monotherapy (AIM), and azathioprine and infliximab whether simultaneously or separately (AISS).In IBD patients, a total of 249 patients were identified as active TB. After one-to-one matching with age, sex and disease duration, the risks of TB were significantly higher in AZA group (HR, 2.06; 95% CI, 1.35-3.12, P < .001), AIM group (HR, 3.26; 95% CI, 1.18-9.05, P = .02), AISS group (HR, 3.50; 95% CI, 1.92-6.37, P < .001), and CAI group (HR, 5.67; 95% CI, 2.42-10.21, P < .001), and the HR increased gradually in this order. In UC patients, the results were in similar pattern, but this pattern was not observed in CD patients in our study.Our study shows that Korean IBD patients are at risk of TB, and the risk increases with usage of IBD medication; moreover, the risk is the highest if combination therapy is used. These results highlight the importance of screening for TB in IBD patients, especially in combination therapy.


Assuntos
Azatioprina/uso terapêutico , Quimioterapia Combinada/métodos , Infliximab/uso terapêutico , Tuberculose , Imunidade Adaptativa/efeitos dos fármacos , Produtos Biológicos/uso terapêutico , Estudos de Coortes , Feminino , Humanos , Fatores Imunológicos/uso terapêutico , Doenças Inflamatórias Intestinais/tratamento farmacológico , Doenças Inflamatórias Intestinais/epidemiologia , Doenças Inflamatórias Intestinais/imunologia , Quimioterapia de Manutenção/efeitos adversos , Quimioterapia de Manutenção/métodos , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Medição de Risco , Fatores de Risco , Tuberculose/diagnóstico , Tuberculose/epidemiologia , Tuberculose/prevenção & controle
17.
Medicine (Baltimore) ; 99(44): e22905, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33126345

RESUMO

Coupled with the lowest level of social connectedness, South Korea has the highest suicide rate among the Organization for Economic Co-operation and Development countries. A possible link between community and suicide is social capital imprinted in social connectedness. This study explores whether social capital is protective against suicide ideation in relation to the poverty level of communities, and whether the associations are specific to certain elements of social capital.A total of 908 participants were included to assess cross-sectional association of social capital at individual level with suicide ideation by comparing between poor (government-leased apartments) and non-poor communities (nongovernment-leased apartments). Logistic regression analyses were performed to examine various social capital dimensions in relation to suicide ideation.Suicide ideation was far higher among those living in the poor communities (poor communities 12%; non poor communities 6.3%) and the level of social capital was lower in the poor communities. Nevertheless, the protective effect of social capital, in particular, the cognitive dimension against suicide ideation was demonstrated only in the poor communities (eg, odds ratio = 0.27, 95% confidence interval: 0.12-0.58 for trust in the poor communities). Low income was significantly associated with suicide ideation only in the poor communities, but depression and resilience were associated with suicide ideation both in the poor and non-poor communities.To increase the reliability of the results, established measures based on relevant literature were utilized, but measures on bridging social capital and social network might have relatively low reliability.As to protection against suicide ideation, the extent of reliance on social capital was higher in poor communities than in non-poor communities, in particular, the cognitive dimension was likely to activate in this regard.


Assuntos
Relações Interpessoais , Pobreza/psicologia , Capital Social , Condições Sociais , Ideação Suicida , Suicídio , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Fatores de Proteção , Sistemas de Apoio Psicossocial , Saúde Pública , República da Coreia/epidemiologia , Características de Residência , Resiliência Psicológica , Condições Sociais/economia , Condições Sociais/estatística & dados numéricos , Suicídio/economia , Suicídio/prevenção & controle , Suicídio/psicologia , Suicídio/estatística & dados numéricos
18.
J Korean Med Sci ; 35(41): e372, 2020 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-33107230

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) outbreak has exposed healthcare workers to extreme physical workloads and psychological challenges. Thus, we aimed to assess the immediate correlates of emotional stress and to identify which specific jobs, departments, and exposure types are risk factors for emotional stress in healthcare workers. METHODS: In this cross-sectional study conducted from April 2 to 10, 2020, university hospital workers were administered self-reported questionnaires that covered general characteristics and included the Patient Health Questionnaire, Generalized Anxiety Disorder scale, and a visual analog scale. At-risk groups for depression and anxiety were identified, and the odds ratios for depression and anxiety were analyzed after adjusting for age, gender, education, marital status, and duration of employment. RESULTS: The data of 1,003 participants were analyzed. Of these, 14.2% worked in wards for confirmed COVID-19 cases and 15.2% had had direct contact with these patients. Treating patients with COVID-19 was associated with depression and anxiety, while dealing with COVID-19 test samples was associated with depression. Exposure to random or unspecified patients was also associated with depression. Lastly, social rejection and other negative experiences were associated with depression and anxiety. CONCLUSION: The COVID-19 outbreak is correlated with healthcare workers' emotional stress, and specific types of jobs and duties involving close contact with these patients can be risk factors. Interestingly, even low-exposure groups reported significant depression and anxiety as a result of social stigma and uncertainty. Adequate and timely management measures for emotional stress are required for vulnerable and at-risk groups.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Pessoal de Saúde/psicologia , Estresse Ocupacional , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Adulto , Estudos Transversais , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Pandemias , República da Coreia/epidemiologia , Fatores de Risco , Autorrelato , Distância Social , Carga de Trabalho , Adulto Jovem
20.
PLoS One ; 15(10): e0241472, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33119708

RESUMO

Here we present a discrete-time-evolution model with one day interval to forecast the propagation of Covid-19. The proposed model can be easily implemented with daily updated data sets of the pandemic publicly available by distinct online sources. It has only two adjustable parameters and it predicts the evolution of the total number of infected people in a country for the next 14 days if parameters do not change during the analyzed period. The model incorporates the main aspects of the disease such as the fact that there are asymptomatic and symptomatic phases (both capable of propagating the virus), and that these phases take almost two weeks before the infected person status evolves to the next (asymptomatic becomes symptomatic or symptomatic becomes either recovered or dead). A striking advantage of the model for its implementation by the health sector is that it gives directly the number of total infected people in each day (in thousands, tens of thousands or hundred of thousands). Here, the model is tested with data from Brazil, UK and South Korea, presenting low error rates on the prediction of the evolution of the disease in all analyzed countries. We hope this model may be a useful tool to estimate the propagation of the disease.


Assuntos
Infecções por Coronavirus/epidemiologia , Previsões , Modelos Estatísticos , Pneumonia Viral/epidemiologia , Infecções Assintomáticas , Betacoronavirus , Brasil/epidemiologia , Infecções por Coronavirus/transmissão , Humanos , Pandemias , Pneumonia Viral/transmissão , República da Coreia/epidemiologia , Fatores de Tempo , Reino Unido/epidemiologia
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