Kim, Min-Soo;Park, Joong-Min;Choi, Yoo-Shin;Cha, Sung-Jae;Kim, Beom-Gyu;Chi, Kyong-Choun
Journal of Gastric Cancer
/
v.10
no.3
/
pp.118-125
/
2010
Purpose: Operative morbidity and mortality from gastric cancer have decreased in recent years, but many studies have demonstrated that its prevalence is still high. Therefore, we investigated the risk factors for morbidity and mortality considering the type of complication in patients with gastric cancer. Materials and Methods: A total of 259 gastrectomies between 2004 and 2008 were retrospectively reviewed. Results: Overall morbidity and mortality rates were 26.6% and 1.9%, respectively. A major risk factor for morbidity was combined resection (especially more than two organs) (P=0.005). The risk factors for major complications in which a re-operation or intervention were required were type of gastrectomy, upper location of lesion, combined resection, and respiratory comorbidity (P=0.042, P=0.002, P=0.031). Mortality was associated with preexisting neurologic disease such as cerebral stroke (P=0.016). In the analysis of differen complication's risk factors, a wound complication was not associated with any risk factor, but combined resection was associated with bleeding (P=0.007). Combined resection was an independent risk factor for a major complication, surgical complication, and anastomotic leakage (P=0.01, P=0.003, P=0.011, respectively). Palliative resection was an independent risk factor for major complications and a previous surgery for malignant disease was significantly related to anastomosis site leakage (P=0.033, P=0.007, respectively). Conclusions: The risk factors for gastrectomy complications of gastric cancer were combined resection, palliative resection, and a previous surgery for a malignant disease. To decrease post-gastrectomy complications, we should make an effort to minimize the range of combined resection, if a palliative gastrectomy is needed for advanced gastric cancer.
Patients with gastrointestinal disease (GI) are at risk for osteopenia or osteoporosis, which can lead to fractures. Although these patients may be at risk from a young age, gastroenterologists often overlook this fact in practice. There are well-known GI diseases associated with osteopenia and osteoporosis, such as the post-gastrectomy state, inflammatory bowel disease (IBD), and celiac disease. As there is an increase in the prevalence of IBD patients, newly diagnosed celiac disease in adulthood, and gastric cancer survivors following gastrectomy, bone disease in these patients becomes an important issue. Here, we have discussed osteoporosis and fractures in GI disease, especially in the postgastrectomy state, IBD, and celiac disease. Although the pathogenesis of bone loss in each disease has not been fully identified, we have confirmed that the prevalence of osteoporosis and fractures in each of these diseases is high. There are scarce studies comparing the prevalence of osteoporosis or osteoporotic fractures in GI disease patients with studies in postmenopausal women, and specific guidelines for their management in each disease have not been established. Intensive surveillance and management are needed to ensure that these patients attain peak bone mass for age and sex to prevent fractures.
Meng, Lu;Wolff, Marilyn B.;Mattick, Kelly A.;DeJoy, David M.;Wilson, Mark G.;Smith, Matthew Lee
Safety and Health at Work
/
v.8
no.2
/
pp.117-129
/
2017
Chronic disease rates have become more prevalent in the modern American workforce, which has negative implications for workplace productivity and healthcare costs. Offering workplace health interventions is recognized as an effective strategy to reduce chronic disease progression, absenteeism, and healthcare costs as well as improve population health. This review documents intervention and evaluation strategies used for health promotion programs delivered in workplaces. Using predetermined search terms in five online databases, we identified 1,131 published items from 1995 to 2014. Of these items, 27 peer-reviewed articles met the inclusion criteria; reporting data from completed United States-based workplace interventions that recruited at-risk employees based on their disease or disease-related risk factors. A content rubric was developed and used to catalogue these 27 published field studies. Selected workplace interventions targeted obesity (n = 13), cardiovascular diseases (n = 8), and diabetes (n = 6). Intervention strategies included instructional education/counseling (n = 20), workplace environmental change (n = 6), physical activity (n = 10), use of technology (n = 10), and incentives (n = 13). Self-reported data (n = 21), anthropometric measurements (n = 17), and laboratory tests (n = 14) were used most often in studies with outcome evaluation. This is the first literature review to focus on interventions for employees with elevated risk for chronic diseases. The review has the potential to inform future workplace health interventions by presenting strategies related to implementation and evaluation strategies in workplace settings. These strategies can help determine optimal worksite health programs based on the unique characteristics of work settings and the health risk factors of their employee populations.
The controversy over the mad cow disease in Korea can be understood as a demonstration of complex and skeptical public sentiments toward the government that were all mixed with expectations, demands, hope and mistrust. The governments decision to resume the import of American beef turned such expectations into mistrust and public hope into nationwide resistance expressed in the form of candlelight vigils. This phenomenon can not be simply explained as a fear of risks. Concerns over mad cow disease were a trigger but they were riot sufficient cause to explain the nationwide controversy involving all the Koreans. It was mad cow disease that triggered a sharp confrontation between the government trying to stick to its decision to resume the import of American beef and the opponents who were not convinced by the government. In fact, this is not simply an issue of a disease. It is rather a complex issue of the acceptance of risks, the consistency of the government policy, trust in the government, and the public consensus on the government policy. In this context, this study analyzes the controversy over the mad cow disease from the perspectives of risk management, public policy-making, and public trust and social consensus-building.
Purpose: This study was conducted to examine the effects of individual counseling for bus-drivers on cerebrovascular and cardiovascular disease prevention. Methods: The one-group pretest-posttest design was used. This study presents a secondary analysis of data collected in 'contents of cerebrovascular and cardiovascular disease prevention program for bus-drivers in one workplace in Seoul, Korea. The data were collected from 56 bus drivers, using questionnaires from September 10th to November 20th, 2014. The analysis was conducted with ${\chi}^2$ test and paired samples t-test using SPSS/Win 21.0. Results: After the intervention, the participants showed a significant decrease in the level of systolic blood pressure (p=.003) and a significant increase in the total cholesterol level (p=.030). The distribution of cardiovascular risk groups changed after the intervention: 5.3% decreased in the high risk group, 16.1% decreased in the medium risk group, and 3.5% decreased in the low risk group, while 25.0% increased in the normal group. Conclusion: The comprehensive individual counseling including simple screening, tailored education and counseling is effective to manage their lifestyle risk factors, resulting in better maintenance of their health as well as preventing cerebrovascular and cardiovascular disease.
Clonorchis sinensis is the most common fish-borne intestinal parasite in Korea. The aim of the present investigation was to survey the status of C. sinensis infection and analyze associated risk factors in residents of Haman-gun, Gyeongsangnam-do. A total of 5,114 residents from 10 administrative towns/villages voluntarily agreed to participate in the study, which comprised fecal examination, a questionnaire survey for risk factors, ultrasonography, and enzyme-linked immunosorbent assay for cancer biomarker detection in the blood. We detected C. sinensis eggs in 5.3% of the subjects. By region, Gunbuk-myeon had the highest number of residents with C. sinensis eggs. The infection rate and intensity were higher in male than in female residents. Based on the risk factor questionnaire, infection was highly associated with drinking, a history of C. sinensis infection, and the practice of eating of raw freshwater fish. Extension of the bile duct, infection intensity, and cancer biomarker detection significantly correlated with the presence of eggs in the study population. In conclusion, the development of feasible, long-term control policies and strategies for the elimination of C. sinensis in Korea is still required.
Kim, Hyun Ja;Lee, Yeon-Kyung;Koo, Hoseok;Shin, Min-Jeong
Nutrition Research and Practice
/
v.16
no.sup1
/
pp.70-88
/
2022
Sodium is a physiologically essential nutrient, but excessive intake is linked to the increased risk of various chronic diseases, particularly cardiovascular. It is, therefore, necessary to accomplish an evidence-based approach and establish the Korean Dietary Reference Intakes (KDRIs) index, to identify both the nutritional adequacy and health effects of sodium. This review presents the rationale for and the process of revising the KDRIs for sodium and, more importantly, establishing the sodium Chronic Disease Risk Reduction Intake (CDRR) level, which is a new specific set of values for chronic disease risk reduction. To establish the 2020 KDRIs for dietary sodium, the committee conducted a systematic literature review of the intake-response relationships between the selected indicators for sodium levels and human chronic diseases. In this review, 43 studies published from January 2014 to December 2018, using databases of PubMed and Web of Science, were finally included for evaluating the risk of bias and strength of evidence (SoE). We determined that SoE of the relationship between dietary sodium and cardiovascular diseases, cerebrovascular disease, and hypertension, was moderate to strong. However, due to insufficient scientific evidence, we were unable to establish the estimated average requirement and the recommended nutrient intake for dietary sodium. Therefore, the adequate intake of sodium for adults was established to be 1,500 mg/day, whereas the CDRR for dietary sodium was established at 2,300 mg/day for adults. Intake goal for dietary sodium established in the 2015 KDRIs instead of the tolerable upper intake level was not presented in the 2020 KDRIs. For the next revision of the KDRIs, there is a requirement to pursue further studies on nutritional adequacy and toxicity of dietary sodium, and their associations with chronic disease endpoint in the Korean population.
Purpose. The purpose of this study was to identify subgroups of the physical and behavioral risk profiles for cardiovascular disease among industrial workers, and to examine predicting factors for the subgroups. Sample and Method. Health records of 2,616 male and female workers aged 19-56 years who were employed in an airplane manufacturing industry were analyzed. Data were analyzed using the Latent class cluster analysis. Results. Four different clusters (two high-risk groups, one low-risk group, and one normal group) were found and these clusters were significantly different by age, gender, and work type (p < .05 ). The two high-risk groups had higher chances of drinking alcohol, elevated BMI, FBS, total cholesterol, having hypertension, and were significantly older, and had relatively high chances of being day workers rather than other groups. The low-risk group had higher chances of drinking alcohol, higher BMI and total cholesterols compared to normal group, and highest portions of current smokers and shift workers in the four clusters and their mean BP was within prehypertension criteria. Conclusion. Industrial nurses should guide the lifestyle behaviors and risk factors of the high risk groups for CVD and need to intervene early for behavioral change for the low-risk group who are young and shift workers. Age, and work environment should be considered in planning for targeted preventive interventions for industrial workers.
This study classified subjects aged 30 to 64 into normal group, impaired fasting glucose group, and diabetes mellitus patient group based on data from the 6th period of the National Health and Nutrition Examination Survey (2013-2015). Skipping breakfast, lack of physical activity, inadequate sleep time, inadequate weight, excessive drinking, and current smoking are classified as a low health risk group when three or less items are present, and a high health risk group when three or more items are included. By classification, each item included in the physical measurement and biochemical analysis factors and health risk behavior factors was comparatively analyzed. As a result, in the normal group, impaired fasting glucose group, and diabetes group, the average age was higher in the group with high health risk factors than the group with low risk factors, and the male ratio was higher. Body mass index, waist circumference, blood pressure, triglyceride showed a significantly higher result. In the normal group, the fasting blood glucose level and total cholesterol level were also higher in group 2. Therefore, it is thought that it is necessary to control health risk behaviors through lifestyle changes in the normal group, fasting glucose disorder group, and diabetes group.
Background: Colorectal cancer (CRC) is one of the prime causes of mortality around the globe, with a significantly rising incidence in the Middle East region in recent decades. Since detection of CRC in the early stages is an important issue, and also since to date there are no comprehensive epidemiologic studies depicting the Middle East region with special attention to the average risk group, further investigation is of significant necessity in this regard. Aim: Our aim was to investigate the prevalence of preneoplastic and neoplastic lesions of the colon in an average risk population. Materials and Methods: A total of 1,208 eligible asymptomatic, average- risk adults older than 40 years of age, referred to Firuzgar Hospotal in the years 2008-2012, were enrolled. They underwent colonoscopy screening and all polypoid lesions were removed and examined by an expert gastrointestinal pathologist. The lesions were classified by size, location, numbers and pathologic findings. Size of lesions was measured objectively by endoscopists. Results: The mean age of participants was $56.5{\pm}9.59$ and 51.6% were male. The overall polyp detection rate was 199/1208 (16.5 %), 26 subjects having non-neoplastic polyps, including hyperplastic lesions, and 173/1208 (14.3%) having neoplastic polyps, of which 26 (2.15%) were advanced neoplasms. The prevalence of colorectal neoplasia was more common among the 50-59 age group. Advanced adenoma was more frequent among the 60-69 age group. The majority of adenomas were detected in the distal colon, but a quarter of advanced adenomas were found in the proximal colon; advance age and male gender was associated with the presence of adenoma. Conclusions: It seems that CRC screening among average-risk population might be recommended in countries such as Iran. However, sigmioidoscopy alone would miss many colorectal adenomas. Furthermore, the 50-59 age group could be considered as an appropriate target population for this purpose in Iran.
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