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1.
J Korean Med Sci ; 36(5): e44, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33527786

RESUMO

BACKGROUND: Understanding the changes in emergency department (ED) visit patterns during the coronavirus disease 2019 (COVID-19) outbreak is important for effectively operating EDs during the pandemic. We aimed to analyze the changes in pediatric ED visits during the COVID-19 pandemic and examine the relationship between the number of ED visits and the stringency of government social distancing measures. METHODS: This multicenter retrospective study used data of pediatric (age < 18 years) ED visits in Seoul metropolitan area from June 1, 2018, to May 31, 2020. Patient demographics, ED results, and diagnoses were compared during the COVID-19 period and the previous year. To evaluate the effect of the stringency of social distancing measures on the number of ED visits, a Poisson regression model was developed with month, year, and the average monthly Government Response Stringency Index (GRSI) as fixed effects. RESULTS: In total, 190,732 patients were included. The number of pediatric ED visits during the COVID-19 period was 58.1% lower than in the previous year. There were disproportionate decreases in the numbers of ED visits for children in early childhood (66.5%), low-acuity children (55.2-63.8%), those who did not use an ambulance (59.0%), and those visiting the ED for noninjury complaints (64.9%). The proportion of admissions increased from 11.9% to 16.6%. For every 10-point increase in the GRSI, there was a 15.1% decrease in monthly ED visits. CONCLUSION: A striking decrease in pediatric ED visits was observed during the COVID-19 outbreak, the scale which was associated with the stringency of government policies. Changes in the number and characteristics of children visiting the ED should be considered to facilitate the effective operation of EDs during the pandemic.


Assuntos
/epidemiologia , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Pediatria/organização & administração , Adolescente , Criança , Pré-Escolar , Surtos de Doenças , Feminino , Hospitalização , Humanos , Lactente , Recém-Nascido , Masculino , Distribuição de Poisson , República da Coreia/epidemiologia , Estudos Retrospectivos , Seul/epidemiologia , Centros de Atenção Terciária
2.
J Korean Med Sci ; 36(5): e45, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33527787

RESUMO

Considering the mild degree of coronavirus disease 2019 (COVID-19) in children and the enormous stress caused by isolation in unfamiliar places, policies requiring mandatory isolation at medical facilities should be reevaluated especially given the impact of the pandemic on the availability of hospital beds. In this study, we assessed the usefulness of facility isolation and the transmissibility of severe acute respiratory syndrome coronavirus 2 by infected children to uninfected caregivers in isolation units at a hospital and a residential treatment center in Seoul during August-November 2020. Fifty-three children were included and median age was 4 years (range, 0-18). All were mildly ill or asymptomatic and isolated for a median duration of 12 days. Thirty percent stayed home longer than 2 days before entering isolation units from symptom onset. Among 15 uninfected caregivers, none became infected when they used facemasks and practiced hand hygiene. The results suggest children with mild COVID-19 may be cared safely at home by a caregiver in conditions with adherence to the preventive measures of wearing facemasks and practicing hand hygiene.


Assuntos
/prevenção & controle , Assistência Domiciliar , Isolamento de Pacientes/métodos , Adolescente , Cuidadores , Criança , Pré-Escolar , Feminino , Higiene das Mãos , Hospitalização , Humanos , Lactente , Recém-Nascido , Masculino , Cooperação do Paciente , Seul/epidemiologia
3.
Nutr Metab Cardiovasc Dis ; 31(1): 76-84, 2021 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-33500111

RESUMO

BACKGROUND AND AIMS: Studies have reported that nut consumption is potentially beneficial in preventing cardiovascular disease. However, data are insufficient regarding the association between nut consumption and left ventricular hypertrophy (LVH). METHODS AND RESULTS: In the Kangbuk Samsung Health Study, the participants were 34,617 men and 12,257 women who completed a food-frequency questionnaire for nut consumption and received echocardiography. Nut consumption was evaluated only for peanuts, pine nuts, and almonds defining 15 g as one serving/servings dose. Multivariable adjusted odds ratio (OR) and 95% confidence interval (CI) for LVH were evaluated according to the consumption frequency of one serving dose of nut. The frequency of nut consumption was categorized into five groups (<1/month, 1/month-1/week, 1-2/week, 2-4/week, and ≥4/week). The subgroup analysis was conducted by dividing the participants into the following two groups: the nonhypertensive/nondiabetic group and hypertensive or diabetic group. In women, nut consumption ≥2/week had the lower multivariable adjusted OR and 95% CI for LVH (2-4/week: 0.46 [0.26-0.81] and ≥4/week: 0.48 [0.25-0.92]) when compared with nut consumption <1/month. This association was identically observed in the subgroup analysis for women without hypertension and diabetes mellitus (DM) and women with hypertension or DM. However, men did not show the significant association. CONCLUSION: In women, nut consumption ≥2/week was associated with the decreased probability of LVH. Further research studies should investigate whether the beneficial effect of nut consumption on LV structure results in better cardiovascular prognosis.


Assuntos
Arachis , Dieta Saudável , Hipertrofia Ventricular Esquerda/prevenção & controle , Nozes , Pinus , Prunus dulcis , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Inquéritos sobre Dietas , Comportamento Alimentar , Feminino , Humanos , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Hipertrofia Ventricular Esquerda/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Proteção , Medição de Risco , Fatores de Risco , Seul/epidemiologia , Tamanho da Porção de Referência , Fatores de Tempo , Adulto Jovem
4.
J Korean Med Sci ; 36(4): e38, 2021 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-33496089

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) outbreaks emerged at two university-affiliated hospitals in Seoul (hospital A) and Uijeongbu City (hospital S) in the metropolitan Seoul area in March 2020. The aim of this study was to investigate epidemiological links between the outbreaks using whole genome sequencing (WGS) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: Fifteen patients were enrolled in the study, including four non-outbreak (A1-A4) and three outbreak cases (A5-A7) in hospital A and eight cases (S1-S8) in hospital S. Patients' hospital stays, COVID-19 symptoms, and transfer history were reviewed. RNA samples were submitted for WGS and genome-wide single nucleotide variants and phylogenetic relationships were analyzed. RESULTS: The index patient (A5) in hospital A was transferred from hospital S on 26 March. Patients A6 and A7 were the family caregiver and sister, respectively, of the patient who shared a room with A5 for 4 days. Prior to transfer, A5 was at the next bed to S8 in the emergency room on 25 March. Patient S6, a professional caregiver, took care of the patient in the room next to S8's room for 5 days until 22 March and then S5 for another 3 days. WGS revealed that SARS-CoV-2 in A2, A3, and A4 belong to clades V/B.2, S/A, and G/B.1, respectively, whereas that of A5-A7 and S1-S5 are of the V/B.2.1 clade and closely clustered. In particular, SARS-CoV-2 in patients A5 and S5 showed perfect identity. CONCLUSION: WGS is a useful tool to understand epidemiology of SARS-CoV-2. It is the first study to elucidate the role of patient transfer and caregivers as links of nosocomial outbreaks of COVID-19 in multiple hospitals.


Assuntos
/epidemiologia , Infecção Hospitalar/epidemiologia , Surtos de Doenças , Hospitais Universitários , /genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Busca de Comunicante , Infecção Hospitalar/virologia , DNA Viral/genética , Registros Eletrônicos de Saúde , Feminino , Genoma Viral , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Seul/epidemiologia , Sequenciamento Completo do Genoma , Adulto Jovem
5.
Artigo em Inglês | MEDLINE | ID: mdl-33401562

RESUMO

We measured PM2.5 in 41 underground shopping districts (USDs) in the Seoul metropolitan area from June to November 2017, and associated 18 trace elements to determine the sources and assess the respiratory risks. The PM2.5 concentrations were 18.0 ± 8.0 µg/m3 inside USDs, which were lower than 25.2 ± 10.6 µg/m3 outside. We identified five sources such as indoor miscellanea, soil dust, vehicle exhaust/cooking, coal combustion, and road/subway dust, using factor analysis. Almost 67% of the total trace element concentration resulted from soil dust. Soil dust contribution increased with the number of stores because of fugitive dust emissions due to an increase in passers-by. Vehicle exhaust/cooking contribution was higher when the entrances of the USDs were closed, whereas coal combustion contribution was higher when the entrances of the USDs were open. Although miscellanea and coal combustion contributions were 3.4% and 0.7%, respectively, among five elements with cancer risk, Cr and Ni were included in miscellanea, and Pb, Cd, and As were included in coal combustion. The excess cancer risk (ECR) was the highest at 67 × 10-6 for Cr, and the ECR for Pb was lower than 10-6, a goal of the United States Environmental Protection Agency for hazardous air pollutants.


Assuntos
Poluentes Atmosféricos , Material Particulado , Oligoelementos , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Humanos , Material Particulado/efeitos adversos , Material Particulado/análise , Transtornos Respiratórios/induzido quimicamente , Transtornos Respiratórios/epidemiologia , Medição de Risco , Seul/epidemiologia , Oligoelementos/efeitos adversos , Oligoelementos/análise
6.
J Korean Med Sci ; 35(40): e367, 2020 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-33075858

RESUMO

BACKGROUND: In response to the disaster of coronavirus disease 2019 (COVID-19) pandemic, Seoul Metropolitan Government (SMG) established a patient facility for mild condition patients other than hospital. This study was conducted to investigate the operation and necessary resources of a community treatment center (CTC) operated in Seoul, a metropolitan city with a population of 10 million. METHODS: To respond COVID-19 epidemic, the SMG designated 5 municipal hospitals as dedicated COVID-19 hospitals and implemented one CTC cooperated with the Boramae Municipal Hospital for COVID-19 patients in Seoul. As a retrospective cross-sectional observational study, retrospective medical records review was conducted for patients admitted to the Seoul CTC. The admission and discharge route of CTC patients were investigated. The patient characteristics were compared according to route of discharge whether the patient was discharged to home or transferred to hospital. To report the operation of CTC, the daily mean number of tests (reverse transcription polymerase chain reaction and chest X-ray) and consultations by medical staffs were calculated per week. The list of frequent used medications and who used medication most frequently were investigated. RESULTS: Until May 27 when the Seoul CTC was closed, 26.5% (n = 213) of total 803 COVID-19 patients in Seoul were admitted to the CTC. It was 35.7% (n = 213) of 597 newly diagnosed patients in Seoul during the 11 weeks of operation. The median length of stay was 21 days (interquartile range, 12-29 days). A total of 191 patients (89.7%) were discharged to home after virologic remission and 22 (10.3%) were transferred to hospital for further treatment. Fifty percent of transferred patients were within a week since CTC admission. Daily 2.5-3.6 consultations by doctors or nurses and 0.4-0.9 tests were provided to one patient. The most frequently prescribed medication was symptomatic medication for COVID-19 (cough/sputum and rhinorrhea). The next ranking was psychiatric medication for sleep problem and depression/anxiety, which was prescribed more than digestive drug. CONCLUSION: In the time of an infectious disease disaster, a metropolitan city can operate a temporary patient facility such as CTC to make a surge capacity and appropriately allocate scarce medical resource.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Hospitalização , Hospitais , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Criança , Pré-Escolar , Cidades , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Pandemias , Alta do Paciente , Transferência de Pacientes , Estudos Retrospectivos , Seul/epidemiologia , Adulto Jovem
7.
Cardiovasc Ther ; 2020: 4354759, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33042223

RESUMO

To investigate whether specific time series patterns for blood pressure (BP), heart rate (HR), and sympathetic tone are associated with metabolic factors and the 10-year risk of atherosclerotic cardiovascular disease (ASCVD). A total of 989 patients who underwent simultaneous 24-hour ambulatory BP and Holter electrocardiogram monitoring were enrolled. The patients were categorized into sixteen groups according to their circadian patterns using the consensus clustering analysis method. Metabolic factors, including cholesterol profiles and apolipoprotein, were compared. The 10-year ASCVD risk was estimated based on the Framingham risk model. Overall, 16 significant associations were found between the clinical variables and cluster groups. Age was commonly associated with all clusters in systolic BP (SBP), diastolic BP (DBP), HR, and sympathetic tone. Metabolic indicators, including diabetes, body mass index, total cholesterol, high-density lipoprotein, and apolipoprotein, were associated with the four sympathetic tone clusters. In the crude analysis, the ASCVD risk increased incrementally from clusters 1 to 4 across SBP, DBP, HR, and sympathetic tone. After adjustment for multiple variables, however, only sympathetic tone clusters 3 and 4 showed a significantly high proportion of patients at high risk (≥7.5%) of 10-year ASCVD (odds ratio (OR) = 5.90, 95% confidential interval (CI) = 1.27-27.46, and P value = 0.024 and OR = 15.28, 95% CI = 3.59-65.11, and P value < 0.001, respectively). Time series patterns of BP, HR, and sympathetic tone can serve as an indicator of aging. Circadian variations in sympathetic tone can provide prognostic information about patient metabolic profiles and indicate future ASCVD risk.


Assuntos
Pressão Sanguínea , Doenças Cardiovasculares/fisiopatologia , Sistema Cardiovascular/inervação , Ritmo Circadiano , Frequência Cardíaca , Adulto , Idoso , Biomarcadores/sangue , Monitorização Ambulatorial da Pressão Arterial , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Análise por Conglomerados , Eletrocardiografia Ambulatorial , Metabolismo Energético , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Seul/epidemiologia , Fatores de Tempo
8.
J Korean Med Sci ; 35(33): e311, 2020 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-32830472

RESUMO

Serosurveillance studies reveal the actual disease burden and herd immunity level in the population. In Seoul, Korea, a cross-sectional investigation showed 0.07% anti-severe acute respiratory syndrome coronavirus-2 antibody seropositivity among 1,500 outpatients of the university hospitals. Low seroprevalence reflects well-implemented social distancing. Serosurveillance should be repeated as the pandemic progresses.


Assuntos
Anticorpos Antivirais/sangue , Betacoronavirus/imunologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/imunologia , Estudos Transversais , Feminino , Hospitais Universitários , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/imunologia , Seul/epidemiologia , Estudos Soroepidemiológicos , Adulto Jovem
9.
Cardiovasc Ther ; 2020: 3612607, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32774458

RESUMO

Introduction: Severe hypoglycemia can be life-threatening; therefore, it is important to identify the characteristics of the hypoglycemic patients. The aim of this study is to analyze the type and characteristics of diabetic patients with hypoglycemia who visited an emergency room. Methods: We included diabetic patients with hypoglycemia who visited the emergency room of St. Mary's Hospital in Seoul from January 2009 to August 2018 in the study. Hypo_S group patients visited the emergency room once whereas Hypo_M group patients visited twice or more. We also compared the incidence of cardiovascular disease between the groups within 5 years after hypoglycemia. Results: A total of 843 patients were included in this study, with a mean age of 71 ± 14 years and average glycated hemoglobin (HbA1c) level of 6.7 ± 1.4%. For patients with hypoglycemia, lower body mass index, lower HbA1c, shorter diabetes duration, and lower glomerular filtration rate have a statistically significant relationship with patient characteristics in the emergency room group (all p < 0.001). Hypoglycemia symptoms were most frequently observed between 6:00 and 12:00 am (p < 0.001). Cardiovascular diseases within 5 years after discharge were more frequent in the Hypo_S group than in the Hypo_M group; however, there was no statistical significance. The frequency of aneurysms was significantly higher in patients with hypoglycemia than in other patients in the emergency room (p < 0.05). Conclusion: Relatively thin older patients with a diabetes duration shorter than 10 years and good blood sugar control showed higher frequency of visits to the emergency room due to hypoglycemia. For these patients, medical staff should always be mindful of their susceptibility to hypoglycemia when prescribing insulin or OHA and educate them on the prevention of hypoglycemia.


Assuntos
Glicemia/efeitos dos fármacos , Diabetes Mellitus/tratamento farmacológico , Serviço Hospitalar de Emergência , Hipoglicemia/induzido quimicamente , Hipoglicemiantes/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Glicemia/metabolismo , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/sangue , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Feminino , Hemoglobina A Glicada/metabolismo , Humanos , Hipoglicemia/sangue , Hipoglicemia/diagnóstico , Hipoglicemia/epidemiologia , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Seul/epidemiologia , Índice de Gravidade de Doença , Fatores de Tempo
10.
PLoS One ; 15(8): e0237692, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32797094

RESUMO

BACKGROUND: Our hospital experienced the first healthcare-associated COVID-19 outbreak in Seoul at the time the first COVID-19 cases were confirmed in Korea. The first confirmed COVID-19 patient was a hospital personnel who was in charge of transferring patients inside our hospital. To contain the virus spread, we shutdown our hospital, and tested all inpatients, medical staff members, and employees. METHODS: We retrospectively analyzed the results of SARS-CoV-2 RT-PCR testing according to the contact history, occupation, and presence of respiratory symptoms. Closed-circuit television (CCTV) was reviewed in the presence of an epidemiologist to identify individuals who came into contact with confirmed COVID-19 patients. RESULTS: A total of 3,091 respiratory samples from 2,924 individuals were obtained. Among 2,924 individuals, two inpatients, and one caregiver tested positive (positivity rate, 0.1%). Although all confirmed cases were linked to a general ward designated for pulmonology patients, no medical staff members, medical support personnel, or employees working at the same ward were infected. Contact with confirmed COVID-19 cases was frequent among inpatients and medical support personnel. The most common contact area was the general ward for pulmonology patients and medical support areas, including clinical and imaging examination rooms. Finally, the total number of hospital-associated infections was 14, consisting of four diagnosed at our hospital and ten diagnosed outside the hospital. CONCLUSIONS: The robust control of the COVID-19 outbreak further minimized the transmission of SARS-CoV-2 in the hospital and local communities. However, there was also a debate over the appropriate period of hospital shutdown and testing of all hospital staff and patients. Future studies are required to refine and establish the in-hospital quarantine and de-isolation guidelines based on the epidemiological and clinical settings.


Assuntos
Betacoronavirus/genética , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Transmissão de Doença Infecciosa/prevenção & controle , Hospitais Universitários , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/virologia , Infecção Hospitalar/virologia , Feminino , Pessoal de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Quartos de Pacientes , Pneumonia Viral/diagnóstico , Pneumonia Viral/virologia , Quarentena/métodos , Estudos Retrospectivos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Seul/epidemiologia , Adulto Jovem
11.
Diab Vasc Dis Res ; 17(7): 1479164120945910, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32746630

RESUMO

BACKGROUND: The effect of interarm blood pressure difference on the development of diabetic retinopathy, proteinuria and chronic kidney disease remains unknown. We investigated to determine the impact of interarm blood pressure difference on the prevalence of diabetic retinopathy, proteinuria and chronic kidney disease in patients with type 2 diabetes. METHODS: The study included 563 patients with diabetes, who were evaluated with a simultaneous bilateral blood pressure measurement. The cutoff values for interarm blood pressure difference were 5, 10 and 15 mmHg. Logistic regression analysis was used to explore the relation between interarm blood pressure difference and diabetic retinopathy, proteinuria and chronic kidney disease. RESULTS: Diabetic patients with systolic interarm blood pressure difference ⩾5, ⩾10 and ⩾15 mmHg showed an increased risk of diabetic retinopathy [adjusted odds ratio = 1.48 (95% confidence interval = 1.01-2.18), odds ratio = 1.80 (95% confidence interval = 0.99-3.22), odds ratio = 2.29 (95% confidence interval = 1.00-5.23)] after adjustment. There were significant associations between interarm blood pressure difference ⩾5 and ⩾10 mmHg and proteinuria [odds ratio = 1.68 (95% confidence interval = 1.15-2.44), 1.89 (95% confidence interval = 1.05-3.37)]. CONCLUSION: The association between interarm blood pressure difference and the presence of diabetic retinopathy emerged even for systolic interarm blood pressure difference ⩾5 mmHg without interaction of systolic blood pressure. Systolic interarm blood pressure difference should be considered a surrogate marker for vascular complication in patients with type 2 diabetes.


Assuntos
Pressão Sanguínea , Diabetes Mellitus Tipo 2/fisiopatologia , Retinopatia Diabética/fisiopatologia , Extremidade Superior/irrigação sanguínea , Idoso , Índice Tornozelo-Braço , Estudos Transversais , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Nefropatias Diabéticas/diagnóstico , Nefropatias Diabéticas/epidemiologia , Nefropatias Diabéticas/fisiopatologia , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prevalência , Proteinúria/diagnóstico , Proteinúria/epidemiologia , Proteinúria/fisiopatologia , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/fisiopatologia , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Seul/epidemiologia
12.
Nutr Metab Cardiovasc Dis ; 30(10): 1653-1661, 2020 09 24.
Artigo em Inglês | MEDLINE | ID: mdl-32631703

RESUMO

BACKGROUND AND AIMS: Coffee is known to have a beneficial effect on various liver diseases. The aim of this retrospective longitudinal study was to investigate an association between the amount of coffee consumption and the incidence of fatty liver disease in Korean adults. METHODS AND RESULTS: Data from a total of 91,436 male and female subjects with the mean follow-up period of 2.8 years were analyzed. The incidence of fatty liver was not associated with the amount of coffee consumption at baseline, but it was associated with the change in the amount of coffee consumption at the follow-up period. Multiple linear regression analyses showed that hazard ratios for incidence of fatty liver disease were significantly low in "increase" group comparing with "no change" group in fully adjusted model. When a subgroup analysis by gender was conducted, similar significant results were observed in male subjects, but not in females. CONCLUSIONS: The increment in the amount of coffee consumption is associated with the lower incidence of fatty liver in Korean men and suggests that increasing the coffee consumption may have a protective effect on fatty liver.


Assuntos
Café , Fígado Gorduroso/prevenção & controle , Adulto , Fígado Gorduroso/diagnóstico , Fígado Gorduroso/epidemiologia , Feminino , Humanos , Incidência , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fatores de Proteção , Estudos Retrospectivos , Fatores de Risco , Seul/epidemiologia , Fatores Sexuais
13.
Epidemiol Health ; 42: e2020047, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32660220

RESUMO

OBJECTIVES: To estimate time-variant reproductive number (Rt) of coronavirus disease 19 based on either number of daily confirmed cases or their onset date to monitor effectiveness of quarantine policies. METHODS: Using number of daily confirmed cases from January 23, 2020 to March 22, 2020 and their symptom onset date from the official website of the Seoul Metropolitan Government and the district office, we calculated Rt using program R's package "EpiEstim". For asymptomatic cases, their symptom onset date was considered as -2, -1, 0, +1, and +2 days of confirmed date. RESULTS: Based on the information of 313 confirmed cases, the epidemic curve was shaped like 'propagated epidemic curve'. The daily Rt based on Rt_c peaked to 2.6 on February 20, 2020, then showed decreased trend and became <1.0 from March 3, 2020. Comparing both Rt from Rt_c and from the number of daily onset cases, we found that the pattern of changes was similar, although the variation of Rt was greater when using Rt_c. When we changed assumed onset date for asymptotic cases (-2 days to +2 days of the confirmed date), the results were comparable. CONCLUSIONS: Rt can be estimated based on Rt_c which is available from daily report of the Korea Centers for Disease Control and Prevention. Estimation of Rt would be useful to continuously monitor the effectiveness of the quarantine policy at the city and province levels.


Assuntos
Número Básico de Reprodução/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Epidemias , Pneumonia Viral/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Política Pública , Quarentena , Seul/epidemiologia , Fatores de Tempo , Adulto Jovem
14.
Asia Pac J Public Health ; 32(6-7): 360-362, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32667221

RESUMO

The novel coronavirus disease (COVID-19) outbreak has put the entire world in a pandemic situation. In response, strict screening, quarantine protocols, and contact tracing have been conducted in South Korea. The purpose of this study was to examine effects of social distancing on the Public Bicycle Sharing System (PBSS) during the COVID-19 outbreak. We used the PBSS public dataset of Seoul, South Korea. Difference-in-differences (DID) analysis was used. In the DID approach, the 2 groups are distinguished based on designated year. Cases of PBSS use were observed in 2 time periods: pre- and post-strict social distancing in Seoul, Korea. Average PBSS usage per day doubled during 2019-2020 (30 697 vs 77 996, P < .001). Commuters and weekend users increased during the social distancing period in 2020 compared with the same period in 2019. DID analysis showed statistically significant positive effects of high levels of social distancing on PBSS usage, commuters, weekend users, and new subscribers. In conclusion, social distancing during the COVID-19 outbreak increased outdoor physical activity. Meaningful outdoor physical activity during the COVID-19 pandemic can be safe from infection and psychologically stabilized as long as keeping meticulous physical distancing, such as hand hygiene, wearing facial masks, and surface cleaning of public resources.


Assuntos
Ciclismo/estatística & dados numéricos , Infecções por Coronavirus/prevenção & controle , Surtos de Doenças/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/epidemiologia , Conjuntos de Dados como Assunto , Humanos , Pneumonia Viral/epidemiologia , Seul/epidemiologia
15.
Nutr Metab Cardiovasc Dis ; 30(9): 1484-1491, 2020 08 28.
Artigo em Inglês | MEDLINE | ID: mdl-32600956

RESUMO

BACKGROUNDS AND AIMS: Limited evidence is available on whether serum γ-glutamyltransferase (GGT) has value as a predictor of type 2 diabetes in East Asian populations. We investigated the causal relationship between serum GGT level and incident type 2 diabetes in Korean adults. METHODS AND RESULTS: A total of 7739 nondiabetic adults aged 40-69 years from the Korean Genome and Epidemiology Study were studied. We divided the population into four groups according to sex-specific quartiles by serum GGT levels. Hazard ratios (HRs) with 95% Confidence intervals (CIs) for incident type 2 diabetes were prospectively analyzed using multivariate Cox proportional hazards regression models. A total of 1432 (18.5%) participants developed type 2 diabetes over 12 years of follow-up. The higher the serum GGT group quartile, the higher the cumulative type 2 diabetes incidence over 12 years with significance in both sexes (log-rank test P < 0.001). HRs (95% CIs) for incident type 2 diabetes for the highest quartile versus referent lowest quartile for serum GGT levels were 2.55 (1.86-3.51) for men and 1.90 (1.40-2.58) for women after adjusting for confounding variables. CONCLUSIONS: Higher serum GGT levels preceded and positively associated with incident type 2 diabetes among community-dwelling middle-aged and older Korean adults.


Assuntos
Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/epidemiologia , gama-Glutamiltransferase/sangue , Adulto , Fatores Etários , Idoso , Biomarcadores/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Seul/epidemiologia , Fatores de Tempo
16.
Artigo em Inglês | MEDLINE | ID: mdl-32707971

RESUMO

Both domestic emissions and transported pollutants from neighboring countries affect the ambient fine particulate matter (PM2.5) concentration of Seoul, Korea. Diverse measures to control the coronavirus disease 2019 (COVID-19), such as social distancing and increased telecommuting in Korea and the stringent lockdown measures of China, may reduce domestic emissions and levels of transported pollutants, respectively. In addition, wearing a particulate-filtering respirator may have decreased the absolute PM2.5 exposure level for individuals. Therefore, this study estimated the acute health benefits of PM2.5 reduction and changes in public behavior during the COVID-19 crisis in Seoul, Korea. To calculate the mortality burden attributable to PM2.5, we obtained residents' registration data, mortality data, and air pollution monitoring data for Seoul from publicly available databases. Relative risks were derived from previous time-series studies. We used the attributable fraction to estimate the number of excessive deaths attributable to acute PM2.5 exposure during January to April, yearly, from 2016 to 2020, and the number of mortalities avoided from PM2.5 reduction and respirator use observed in 2020. The average PM2.5 concentration from January to April in 2020 (25.6 µg/m3) was the lowest in the last 5 years. At least -4.1 µg/m3 (95% CI: -7.2, -0.9) change in ambient PM2.5 in Seoul was observed in 2020 compared to the previous 4 years. Overall, 37.6 (95% CI: 32.6, 42.5) non-accidental; 7.0 (95% CI: 5.7, 8.4) cardiovascular; and 4.7 (95% CI: 3.4, 6.1) respiratory mortalities were avoided due to PM2.5 reduction in 2020. By considering the effects of particulate respirator, decreases of 102.5 (95% CI: 89.0, 115.9) non-accidental; 19.1 (95% CI: 15.6, 22.9) cardiovascular; and 12.9 (95% CI: 9.2, 16.5) respiratory mortalities were estimated. We estimated that 37 lives were saved due to the PM2.5 reduction related to COVID-19 in Seoul, Korea. The health benefit may be greater due to the popular use of particulate-filtering respirators during the COVID-19 crisis. Future studies with daily mortality data are needed to verify our study estimates.


Assuntos
Infecções por Coronavirus/epidemiologia , Exposição Ambiental/análise , Material Particulado/análise , Pneumonia Viral/epidemiologia , Betacoronavirus , Carvão Mineral , Infecções por Coronavirus/virologia , Bases de Dados Factuais , Poeira , Humanos , Pandemias , Material Particulado/toxicidade , Pneumonia Viral/virologia , Seul/epidemiologia
17.
Cardiovasc Diabetol ; 19(1): 82, 2020 06 13.
Artigo em Inglês | MEDLINE | ID: mdl-32534580

RESUMO

BACKGROUND: Reactive hyperemia-peripheral arterial tonometry (RH-PAT) is a noninvasive and simple test for evaluating the endothelial function. There has been sparse evidence on the usefulness of the RH-PAT index (RHI) in predicting future cardiovascular diseases among diabetic patients. METHODS: Asymptomatic diabetic patients with albuminuria were selected; their medical history and laboratory findings were evaluated every 3 to 4 months, respectively. The primary outcome was a composite of three-point major adverse cardiovascular events (3-point MACE): death from cardiovascular causes, acute coronary events, or nonfatal stroke. On the contrary, secondary outcomes included a composite of 3-point MACE, hospitalization for heart failure, or chronic kidney disease (CKD) progression. RHI was measured using the Endo-PAT2000 at the baseline. RHI < 1.67 was considered to indicate peripheral endothelial dysfunction (PED). RESULTS: In total, 149 subjects were included (mean age, 61.8 ± 9.2 years; duration of diabetes was 12 years). During the follow-up period (median, 49.7 months), of the 149 subjects, primary outcomes were detected in 12 (1 [2.3%] and 11 [10.5%] of those without and with PED, respectively). The presence of PED in baseline measurements significantly increased both primary and secondary outcomes, following adjustment for age, sex, hypertension, glycated hemoglobin, low-density lipoprotein cholesterol, triglyceride, systolic blood pressure, baseline estimated glomerular filtration rate, overt proteinuria, duration of diabetes, premedical history of ischemic events, anti-platelet agents, and smoking history (hazard ratio [HR]: 10.95; 95% confidence interval CI 1.00-119.91 for the primary outcome; HR, 4.12; 95% CI 1.37-12.41 for secondary outcome). In addition, PED could predict secondary outcomes independent of the risk score according to the American College of Cardiology/American Heart Association (HR: 3.24; 95% CI 1.14-9.17). CONCLUSIONS: PED can independently predict future cardiovascular events among diabetic patients with albuminuria.


Assuntos
Albuminúria/epidemiologia , Nefropatias Diabéticas/epidemiologia , Endotélio Vascular/fisiopatologia , Doença Arterial Periférica/diagnóstico , Insuficiência Renal Crônica/epidemiologia , Idoso , Albuminúria/diagnóstico , Albuminúria/mortalidade , Albuminúria/terapia , Nefropatias Diabéticas/diagnóstico , Nefropatias Diabéticas/mortalidade , Feminino , Humanos , Hiperemia/fisiopatologia , Masculino , Manometria , Pessoa de Meia-Idade , Doença Arterial Periférica/mortalidade , Doença Arterial Periférica/fisiopatologia , Doença Arterial Periférica/terapia , Valor Preditivo dos Testes , Prevalência , Prognóstico , Estudos Prospectivos , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/mortalidade , Insuficiência Renal Crônica/terapia , Medição de Risco , Fatores de Risco , Seul/epidemiologia , Fatores de Tempo
18.
Cardiovasc Diabetol ; 19(1): 81, 2020 06 13.
Artigo em Inglês | MEDLINE | ID: mdl-32534588

RESUMO

BACKGROUND: There is increasing concern regarding cardiovascular risk in individuals with non-alcoholic fatty liver disease. This study was conducted to evaluate whether hepatic steatosis with or without fibrosis is associated with the progression of carotid atherosclerosis in patients with type 2 diabetes. METHODS: From a longitudinal cohort, we enrolled 1120 patients with type 2 diabetes who underwent repeated carotid artery ultrasonography every 1-2 years. Ultrasonographic findings at baseline and after 6-8 years were compared. Presence of hepatic steatosis was mainly assessed by abdominal ultrasonography; patients with hepatic steatosis were further evaluated for hepatic fibrosis according to fibrosis-4 index. We investigated the association between liver status and atherosclerosis progression. RESULTS: Of 1120 patients, 636 (56.8%) were classified as having hepatic steatosis at baseline. After 6-8 years, 431 (38.5%) showed atherosclerosis progression. Hepatic steatosis was significantly associated with atherosclerosis progression (adjusted odds ratio[AOR]: 1.370, 95% CI 1.025-1.832; p < 0.05). Among patients with hepatic steatosis, only individuals with fibrosis showed significant association with atherosclerosis progression (AOR: 1.615, 95% CI 1.005-2.598; p < 0.05). The association between hepatic fibrosis and atherosclerosis progression was significant in all metabolic subgroups regardless of age, body mass index, presence of metabolic syndrome, or insulin sensitivity (all p < 0.05). Furthermore, subjects with hepatic steatosis & fibrosis and ≥ 4 components of metabolic syndrome criteria showed markedly increased risk of atherosclerosis progression (AOR: 2.430, 95% CI 1.087-5.458; p < 0.05). CONCLUSIONS: Hepatic steatosis with fibrosis is independently associated with the progression of carotid atherosclerosis in patients with type 2 diabetes.


Assuntos
Doenças das Artérias Carótidas/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Cirrose Hepática/epidemiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Adulto , Idoso , Doenças das Artérias Carótidas/diagnóstico por imagem , Espessura Intima-Media Carotídea , Diabetes Mellitus Tipo 2/diagnóstico , Progressão da Doença , Feminino , Humanos , Cirrose Hepática/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Valor Preditivo dos Testes , Prognóstico , Medição de Risco , Fatores de Risco , Seul/epidemiologia , Fatores de Tempo
19.
BMC Cardiovasc Disord ; 20(1): 227, 2020 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-32414329

RESUMO

BACKGROUND: As a result of advances in pediatric care and diagnostic testing, there is a growing population of adults with congenital heart disease (ACHD). The purpose of this study was to better define the epidemiology and changes in the trend of hospitalizations for ACHD in Korean society. METHODS: We reviewed outpatient and inpatient data from 2005 to 2017 to identify patient ≥18 years of age admitted for acute care with a congenital heart disease (CHD) diagnosis in the pediatric cardiology division. We tried to analyze changes of hospitalization trend for ACHD. RESULTS: The ratio of outpatients with ACHD increased 286.5%, from 11.1% (1748/15,682) in 2005 to 31.8% (7795/24,532) in 2017. The number of ACHD hospitalizations increased 360.7%, from 8.9% (37/414) in 2005 to 32.1% (226/705) in 2017. The average patient age increased from 24.3 years in 2005 to 27.4 in 2017. The main diagnosis for admission of ACHD is heart failure, arrhythmia and Fontan-related complications. The annual ICU admission percentage was around 5% and mean length of intensive care unit (ICU) stay was 8.4 ± 14.6 days. Mean personal hospital charges by admission of ACHD increased to around two times from 2005 to 2017. (from $2578.1 to $3697.0). Total annual hospital charges by ACHD markedly increased ten times (from $95,389.7 to $831,834.2). CONCLUSIONS: The number of hospital cares for ACHD dramatically increased more than five times from 2005 to 2017. We need preparations for efficient healthcare for adults with CHD such as a multi-dimensional approach, effective communication, and professional training.


Assuntos
Serviço Hospitalar de Cardiologia/tendências , Cardiopatias Congênitas/epidemiologia , Cardiopatias Congênitas/terapia , Hospitalização/tendências , Pediatria/tendências , Sobreviventes , Adolescente , Adulto , Serviço Hospitalar de Cardiologia/economia , Feminino , Gastos em Saúde/tendências , Cardiopatias Congênitas/diagnóstico , Cardiopatias Congênitas/economia , Preços Hospitalares/tendências , Custos Hospitalares/tendências , Hospitalização/economia , Humanos , Masculino , Pediatria/economia , Estudos Retrospectivos , Seul/epidemiologia , Fatores de Tempo , Adulto Jovem
20.
Artigo em Inglês | MEDLINE | ID: mdl-32365640

RESUMO

Walking is the most basic movement of humans and the most fundamental mode of transportation. To promote walking, it is necessary to create a safe environment for pedestrians. However, pedestrian-vehicle crashes still remain relatively high in South Korea. This study employs a multilevel model to examine the differences between the lower-level individual characteristics of pedestrian crashes and the upper-level neighborhood environmental characteristics in Seoul, South Korea. The main results of this study are as follows. The individual characteristics of pedestrian-vehicle crashes are better at explaining pedestrian injury severity than built environment characteristics at the neighborhood level. Older pedestrians and drivers suffer more severe pedestrian injuries. Larger vehicles such as trucks and vans are more likely to result in a high severity of pedestrian injuries. Pedestrian injuries increase during inclement weather and at night. The severity of pedestrian injuries is lower at intersections and crosswalks without traffic signals than at crosswalks and intersections with traffic signals. Finally, school zones and silver zones, which are representative policies for pedestrian safety in South Korea, fail to play a significant role in reducing the severity of pedestrian injuries. The results of this study can guide policymakers and planners when making decisions on how to build neighborhoods that are safer for pedestrians.


Assuntos
Acidentes de Trânsito , Ambiente Construído , Pedestres , Ferimentos e Lesões , Feminino , Humanos , Masculino , Modelos Teóricos , Seul/epidemiologia , Caminhada
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