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Using Quality of Life Scales with Nutritional Relevance after Gastrectomy: a Challenge for Providing Personalized Treatment

  • Lee, Seung Soo;Yu, Wansik;Chung, Ho Young;Kwon, Oh Kyoung;Lee, Won Kee
    • Journal of Gastric Cancer
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    • v.17 no.4
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    • pp.342-353
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    • 2017
  • Purpose: This study evaluated the changes in nutritional status based on quality of life (QoL) item-level analysis to determine whether individual QoL responses might facilitate personal clinical impact. Materials and Methods: This study retrospectively evaluated QoL data obtained by the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) and Quality of Life Questionnaire-Stomach (QLQ-STO22) as well as metabolic-nutritional data obtained by bioelectrical impedance analysis and blood tests. Patients were assessed preoperatively and at the 5-year follow-up. QoL was analyzed at the level of the constituent items. The patients were categorized into vulnerable and non-vulnerable QoL groups for each scale based on their responses to the QoL items and changes in the metabolic-nutritional indices were compared. Results: Multiple shortcomings in the metabolic-nutritional indices were observed in the vulnerable groups for nausea/vomiting (waist-hip ratio, degree of obesity), dyspnea (hemoglobin, iron), constipation (body fat mass, percent body fat), dysphagia (body fat mass, percent body fat), reflux (body weight, hemoglobin), dry mouth (percent body fat, waist-hip ratio), and taste (body weight, total body water, soft lean mass, body fat mass). The shortcomings in a single index were observed in the vulnerable groups for emotional functioning and pain (EORTC QLQ-C30) and for eating restrictions (EORTC QLQ-STO22). Conclusions: Long-term postoperative QoL deterioration in emotional functioning, nausea/vomiting, pain, dyspnea, constipation, dysphagia, reflux, eating restrictions, dry mouth, and taste were associated with nutritional shortcomings. QoL item-level analysis, instead of scale-level analysis, may help to facilitate personalized treatment for individual QoL respondents.

A Survey on General Characteristics and Feeding Methods of the Premature Infants (미숙아의 일반적인 특성과 수유방법에 관한 조사)

  • Lee, Seung-Lim
    • Journal of the Korean Dietetic Association
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    • v.14 no.4
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    • pp.361-370
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    • 2008
  • The purpose of this study is to provide basic data for the medical nutrition therapy of premature infants. The general characteristics, presence of metabolic disorders, hematological profile and feeding methods were compared between the premature infant group (<37 weeks, n=61) and the full-term infant group (37$\sim$42 weeks, n=165). Birth weight (p<0.0001), birth length (p<0.005), head circumference (p<0.0001), chest circumference (p<0.0001), and Apgar scores (p<0.0001) of the neonates were all statistically lower in the premature infant group. Jaundice cases (p<0.0001) were statistically higher in the premature infant group. White blood cell counts (WBC: p<0.005), mean corpuscular volume (MCV: p<0001), mean corpuscular hemoglobin (MCH: p<0.005), mean corpuscular hemoglobin concentration (MCHC: p<0.005), and mean platelet volume (MPV: p<0.05) were statistically lower in the premature infant group. The premature infant group were fed a higher rate of premature formula than breast milk and the full-term infant group were fed a high rate of human milk at a higher rate, showing differences in kinds of feeding methods (p<0.0001) between the two groups. An infant's birth weight showed a significantly positive correlation with the infant's birth length (p<0.0001), head circumference (p<0.0001), chest circumference (p<0.0001), and Apgar scores(p<0.0001). The birth length also showed a significantly positive correlation with both head circumference (p<0.05) and chest circumference (p<0.05). Head circumference showed a significantly positive correlation with chest circumference (p<0.0001) and Apgar scores (p<0.0001). Chest circumference showed a significantly positive correlation with Apgar scores (p<0.0001). In addition, the Apgar Score at of 1 minute after birth showed a significantly positive correlation with the Apgar score at of 5 minute after birth (p<0.0001).

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Study of depression risk factors in simple labor occupation group (단순노무종사자 직업군에서의 우울증 위험요인 연구)

  • Lee, Bum Ju
    • The Journal of the Convergence on Culture Technology
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    • v.6 no.4
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    • pp.253-258
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    • 2020
  • Depression is a disease with an increasing prevalence worldwide, and is highly associated with mortality as well as several diseases such as hypertension. The aim of this study is to discover clinical risk indicators associated with depression in the occupational group of simple labor workers. This study used the Seventh Korean National Health and Nutrition Examination Survey (2016-2018) conducted by the Korea Centers for Disease Control and Prevention. In association between depression and demographic information, age, sex, degree of stress perception, and stress perception ratio indices had a very high statistical association with depression, and education level and marital status were also associated with depression. Obesity indices such as abdominal circumference and body mass index were not associated with depression. Among the blood information, hemoglobin and hematocrit were highly associated with depression, and statistical significance was maintained even in the analysis adjusted for sex and age. The results of this study can be used as information for the prevention and treatment of depression in the occupational group of simple labor workers in the future.

Iron Nutritional Status by ALAD Genotype and Intervention Study for Rural Area Residents (농촌 여성들의 ALAD 유전형질별 철분영양상태와 철분제 섭취에 따른 영양상태의 변화)

  • Kim, Hee-Seon;Kim, Min-Kyung;Kim, So-Hee;Lee, Sung-Soo;Lee, Byung-Kook
    • Korean Journal of Community Nutrition
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    • v.11 no.6
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    • pp.771-778
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    • 2006
  • Previous studies have suggested that delta-aminolevulinic acid dehydratase (ALAD) phenotype differently affect mineral metabolism. The objective of this study was to determine the effectiveness of 6-month iron supplementation as syrup of NaFeEDTA in improvement of iron status according to ALAD genotype. One hundred thirty adult women living in rural areas of Asan were provided NaFeEDTA syrup once a week for 6 months at the dose of 64mg Fe/week. Three hundred control subjects were observed during the study period. Fasting blood was obtained for analyzing hemoglobin (Hb) and zinc protophorphyrin (ZPP) and serum was analyzed for ferritin, iron and total iron capacity (TIBC) levels before and after iron supplementation. Ninety percent of ALAD 1-1 (ALAD1) and 10% of ALAD 1-2 (ALAD2) genotype were observed in the control group. However in the intervention group, 98% showed ALAD1 while only 2% was ALAD2, which is significantly lower proportions of ALAD2 compared to the control group (p<0.01). The iron status of Intervention group significantly improved except for ferritin and TIBC regardless or ALAD genotype, while the control group did not show any changes in iron status except for ZPP. ZPP concentration of the control group significantly increased in both ALAD1 and 2 while the intervention group showed significantly decreased ZPP after supplementation in ALAD1. Iron supplementation in the form of NaFeEDTA seems to be effective in reduction of ZPP levels although ALAD2 did not show significant changes due to the small number. However, it is difficult to make a conclusion from these results, and more specified further investigation is needed with more participants.

Nutritional Status and Dietary Change after Gastrectomy of Gastric Cancer Patients (위암환자의 위절제술 후 영양상태 및 섭취량 변화)

  • Park, Young-Ok;Yoon, So-Yoon;Kang, Shin-Sook;Han, Sang-Mi;Kang, Eun-Hee
    • Korean Journal of Community Nutrition
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    • v.17 no.1
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    • pp.101-108
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    • 2012
  • The purpose of this survey is to investigate the nutritional status and dietary intake of gastrectomized cancer patients in Asan Medical Center. The subjects were 98 patients, who underwent a gastrectomy due to gastric cancer and were admitted to the General Surgery Department during March 2007 to December 2007. We examined general characteristics (sex, age, clinicopathological stage, type of operation), anthropometric data (height, weight change), biochemical data (red blood cell RBC, hemoglobin HGB, hematocrit HCT, mean corpuscular volume MCV, total lymphocyte count TLC, albumin, total cholesterol), dietary intake and dietary intake related symptoms. Weight loss of gastrectomized patients was $9.0{\pm}4.3$% from preillness weight to visiting out-patient department (OPD) weight. Biochemical data (RBC, HGB, HCT, MCV, TLC, albumin, total cholesterol) significantly deteriorated after gastrectomy. However, outpatient visits were all restored to the normal range. Postoperative energy intake was $785.0{\pm}164.2$ kcal, which corresponds to $41.6{\pm}9.6$% of daily energy requirement. The cause of poor oral intake is mostly fear, abdominal pain and abdominal discomfort. Therefore, to control pre-or post-operative weight change in the future requires, focusing on the body weight to maintain a normal or usual nutrition by interventions and increased caloric intake during hospitalization for the development of nutrient-dense meals. In addition, as the main reason of the lack of intake of meals after the gastrectomy was fear, the patients should be actively encouraged to consider the importance of eating proper meals.

Cysteine antagonism of captafol induced toxicities in rats 1. Effects on hematological and serum biochemical values (랫트에 있어서 captafol의 독성에 대한 cysteine의 방어 작용 1. 혈액학 및 혈청 생화학적 성상에 미치는 영향)

  • Kim, Sung-hoon
    • Korean Journal of Veterinary Research
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    • v.35 no.3
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    • pp.437-445
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    • 1995
  • This experiment was carried out to study the preventive effect of cysteine on the toxicities of captafol to the hematological and serum biochemical values. A single dose of captafol(5mg/kg BW, ip) was given to male Sprague-Dawley rats and its toxicities were evalutated by body weitht changes, autopsy findings, absolute organ weight, and hematological and serum biochemical parameters. The single dose of captafol caused significant decreases in body weitht, and absolute liver weight, as-cites, fibrin clot in abdominal cavity, adhesion of liver lobes significant elevation of number of RBC, hemoglobin concentration and serum AST activity, and decreased of serum phospholipid level. Where as cysteine(over 58mg/kg BW) given immediately after captafol appeared to prevent the ascites, fibrin clot in abdominal cavity and liver lobe adhesion. It also prevented the liver and blood, especially RBC toxicites. The results suggest that cysteine and other compounds containing sulfhydryl groups may protect the subjects from captafol-induced toxicity.

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Treatment Costs and Factors Associated with Glycemic Control among Patients with Diabetes in the United Arab Emirates

  • Lee, Seung-Mi;Song, Inmyung;Suh, David;Chang, Chongwon;Suh, Dong-Churl
    • Journal of Obesity & Metabolic Syndrome
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    • v.27 no.4
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    • pp.238-247
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    • 2018
  • Background: We aimed to estimate the proportion of patients with diabetes who achieved target glycemic control, to estimate diabetes-related costs attributable to poor control, and to identify factors associated with them in the United Arab Emirates. Methods: This retrospective cohort study used administrative claims data handled by Abu Dhabi Health Authority (January 2010 to June 2012) to determine glycemic control and diabetes-related treatment costs. A total of 4,058 patients were matched using propensity scores to eliminate selection bias between patients with glycosylated hemoglobin (HbA1c) <7% and HbA1c ${\geq}7%$. Diabetes-related costs attributable to poor control were estimated using a recycled prediction method. Factors associated with glycemic control were investigated using logistic regression and factors associated with these costs were identified using a generalized linear model. Results: During the 1-year follow-up period, 46.6% of the patients achieved HbA1c <7%. Older age, female sex, better insurance coverage, non-use of insulin in the index diagnosis month, and non-use of antidiabetic medications during the follow-up period were significantly associated with improved glycemic control. The mean diabetes-related annual costs were $2,282 and $2,667 for patients with and without glycemic control, respectively, and the cost attributable to poor glycemic control was $172 (95% confidence interval [CI], $164-180). The diabetes-related costs were lower with mean HbA1c levels <7% (cost ratio, 0.94; 95% CI, 0.88-0.99). The costs were significantly higher in patients aged ${\geq}65$ years than those aged ${\leq}44$ years (cost ratio, 1.45; 95% CI, 1.25-1.70). Conclusion: More than 50% of patients with diabetes had poorly controlled HbA1c. Poor glycemic control may increase diabetes-related costs.

Factors associated with anemia among female adult vegetarians in Malaysia

  • Chai, Zi Fei;Gan, Wan Ying;Chin, Yit Siew;Ching, Yuan Kei;Appukutty, Mahenderan
    • Nutrition Research and Practice
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    • v.13 no.1
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    • pp.23-31
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    • 2019
  • BACKGROUND/OBJECTIVES: A large number of studies on anemia have focused mostly on pregnant women or children. The vegetarian population, which is another potential risk group for anemia, remains largely unexplored. Therefore, this cross-sectional study examined the associations of the sociodemographic, lifestyle, nutritional, and psychological factors with the anemia status among female adult vegetarians. SUBJECTS/METHODS: A total of 177 female vegetarians were recruited from a Buddhist and Hindu organization in Selangor, Malaysia. The participants completed a self-administered questionnaire, which analyzed their sociodemographic characteristics, physical activity level, sleep quality, depression, anxiety, and stress. The body weight, height, waist circumference, and body fat percentage of the participants were also measured. A 3-day dietary recall was conducted to assess their dietary intake. Blood samples (3 ml) were withdrawn by a nurse from each participant to determine the hemoglobin (Hb) level. RESULTS: The findings revealed 28.2% of the participants to be anemic. The age group (AOR = 2.46, 95% CI = 1.19-5.05), marital status (AOR = 2.69, 95% CI = 1.27-5.71), and percentage of energy from protein (AOR = 5.52, 95% CI = 1.41-21.65) were the significant predictors of anemia. CONCLUSIONS: Anemia is a public health problem among female vegetarians in this study. Health promotion programs that target female adult vegetarians should be conducted to manage and prevent anemia, particularly among those who are married, aged 50 and below, and with an inadequate protein intake.

Sex Difference in the Effect of Body Mass Index and Stress on High-Risk Diabetes Mellitus in Korean Adults (한국 성인의 고 위험 당뇨에 대한 스트레스와 체질량 지수의 성별 차이)

  • Lee, Hea Shoon
    • Journal of Korean Biological Nursing Science
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    • v.21 no.3
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    • pp.224-230
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    • 2019
  • Purpose: This study aimed to investigate sex differences in the effect of body mass index (BMI) and stress on high-risk diabetes mellitus (DM). Methods: Secondary analysis of data from 4,271 male and female adults participating in the Sixth Korea National Health and Nutrition Examination Survey 2015 was performed. The participants were evaluated using questionnaires and blood tests. Data were analyzed using descriptive statistics, t-test, ${\chi}^2-test$, and multiple logistic regression analysis (SPSS 24.0). Results: To identify sexspecific effects, interaction variables were included. Hemoglobin A1c (HbA1c) level was higher in men than in women, and the risk of DM decreased 0.31 times in women compared to that in men. As age increased, the odds of risk DM increased 1.03. The risk of DM increased 1.99 times in overweight individuals and 2.79 times for obese individuals compared to that in individuals with normal weight. Stress levels were higher in women than in men, but stress is not an influential factor in high-risk DM. In age-sex interaction, the odds of risk DM increased 1.02 in women compared to that in men as age increased. Conclusion: HbA1c level was affected by age-sex interaction, and age and sex should be considered in the application of HbA1c in the diagnosis of DM.

Impact of Insulin Resistance on Acetylcholine-Induced Coronary Artery Spasm in Non-Diabetic Patients

  • Kang, Kwan Woo;Choi, Byoung Geol;Rha, Seung-Woon
    • Yonsei Medical Journal
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    • v.59 no.9
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    • pp.1057-1063
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    • 2018
  • Purpose: Coronary artery spasm (CAS) and diabetes mellitus (DM) are implicated in endothelial dysfunction, and insulin resistance (IR) is a major etiological cause of type 2 DM. However, the association between CAS and IR in non-diabetic individuals has not been elucidated. The aim of the present study was to evaluate the impact of IR on CAS in patients without DM. Materials and Methods: A total of 330 eligible patients without DM and coronary artery disease who underwent acetylcholine (Ach) provocation test were enrolled in this study. Inclusion criteria included both hemoglobin A1c <6.0% and fasting glucose level <110 mg/dL without type 2 DM. Patients were divided into quartile groups according the level of homeostasis model assessment of insulin resistance (HOMA-IR): 1Q (n=82; HOMA-IR<1.35), 2Q (n=82; $1.35{\leq}HOMA-IR<1.93$), 3Q (n=83; $1.93{\leq}HOMA-IR<2.73$), and 4Q (n=83; $HOMA-IR{\geq}2.73$). Results: In the present study, the higher HOMA-IR group (3Q and 4Q) was older and had higher body mass index, fasting blood glucose, serum insulin, hemoglobin A1c, total cholesterol, and triglyceride levels than the lower HOMA-IR group (1Q). Also, poor IR (3Q and 4Q) was considerably associated with frequent CAS. Compared with Q1, the hazard ratios for Q3 and Q4 were 3.55 (95% CI: 1.79-7.03, p<0.001) and 2.12 (95% CI: 1.07-4.21, p=0.031), respectively, after adjustment of baseline risk confounders. Also, diffuse spasm and accompanying chest pain during Ach test were more strongly associated with IR patients with CAS. Conclusion: HOMA-IR was significantly negatively correlated with reference diameter measured after nitroglycerin and significantly positively correlated with diffuse spasm and chest pain.