• Title/Summary/Keyword: Patient risk index

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Plasma Concentrations of Lipid Profiles and Lipoprotein(a) In Type 2 Diabetes Mellitus Patients with Macrovascular Complications (제2형 당뇨병 환자의 대혈관 합병증 유무별 혈중 지질농도와 Lipoprotein(a) 비교)

  • Song Min Sun;Yoo Yang Sook;Kim Hee Seung
    • Journal of Korean Public Health Nursing
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    • v.16 no.1
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    • pp.115-122
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    • 2002
  • The purpose of this study to examine lipid profiles and lipoprotein (a) concentrations and identify the risk factors of type 2 diabetes mellitus patients with macrovascular complications. The subjects were consisted of 618 out patients with type 2 diabetes mellitus from beginning of March through the end of April in 2001, who visited at the endocrinology department at Kangnam St. Mary's Hospital of Catholic University in Seoul. The patient's clinical laboratory data and the occurrence of chronic complications of diabetes were assessed at medical record review. The data were analyzed using for t-test. chi-square test and logistic regression. The results were as follows : 1. There were no significant differences in age. duration of diabetes. body mass index, sex, fasting blood glucose, 2-hour postprandial blood glucose and $HbA_{1}c$ level between macrovascular complication group and non macrovascular complication group. 2. There were significant differences in the level of total cholesterol. triglyceride. HDL(High density lipoprotein) cholesterol, LDL(Low density lipoprotein) cholesterol and lipoprotein(a) between macrovascular complication group and non macrovascular complication group. 3. Significant factor associated with macrovascular complication in the logistic regression best gut model was HDL cholesterol.

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A Study on the Ring Finger Length Analysis of Heart Diseases Patient's by the Testosterone (테스토스테론에 의한 심장 질환자의 무명지 길이 분석 연구)

  • Kim, Bong-Hyun;Cho, Dong-Uk
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.36 no.7B
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    • pp.841-847
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    • 2011
  • Testosterone acts to protect the heart as a male hormone. If it is secreted suitably, health, but too less it will have an bad influence in organs of the body. In particular, when normal levels of testosterone secretion is less, arteriosclerosis will be increased risk of heart diseases. According to the amount of testosterone is influenced difference in the ring finger length of male. Therefore, we organize groups of subjects in heart diseases and normal who measure these groups' length of the ring finger and index finger. With this in mind, we carried out analysis of interrelationship in length of the ring finger and heart diseases through cross-comparison analysis in this paper.

Standardized multi-institutional data analysis of fixed and removable prosthesis: estimation of life expectancy with regards to variable risk factors

  • Hae-In Jeon;Joon-Ho Yoon;Jeong Hoon Kim;Dong-Wook Kim;Namsik Oh;Young-Bum Park
    • The Journal of Advanced Prosthodontics
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    • v.16 no.2
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    • pp.67-76
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    • 2024
  • PURPOSE. This study aims to assess and predict lifespan of dental prostheses using newly developed Korean Association of Prosthodontics (KAP) criteria through a large-scale, multi-institutional survey. MATERIALS AND METHODS. Survey was conducted including 16 institutions. Cox proportional hazards model and principal component analysis (PCA) were used to find out relevant factors and predict life expectancy. RESULTS. 1,703 fixed and 815 removable prostheses data were collected and evaluated. Statistically significant factors in fixed prosthesis failure were plaque index and material type, with a median survival of 10 to 18 years and 14 to 20 years each. In removable prosthesis, factors were national health insurance coverage, antagonist type, and prosthesis type (complete or partial denture), with median survival of 10 to 13 years, 11 to 14 years, and 10 to 15 years each. For still-usable prostheses, PCA analysis predicted an additional 3 years in fixed and 4.8 years in removable prosthesis. CONCLUSION. Life expectancy of a prosthesis differed significantly by factors mostly controllable either by dentist or a patient. Overall life expectancy was shown to be longer than previous research.

Diagnostic Accuracy of Lactate Dehydrogenase/Adenosine Deaminase Ratio in Differentiating Tuberculous and Parapneumonic Effusions: A Systematic Review

  • Larry Ellee Nyanti;Muhammad Aklil Abd Rahim;Nai-Chien Huan
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.1
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    • pp.91-99
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    • 2024
  • Background: Tuberculous pleural effusion (TPE) and parapneumonic effusion (PPE) are often difficult to differentiate owing to the overlapping clinical features. Observational studies demonstrate that the ratio of lactate dehydrogenase to adenosine deaminase (LDH/ADA) is lower in TPE compared to PPE, but integrated analysis is warranted. Methods: We conducted a systematic review to evaluate the diagnostic accuracy of the LDH/ADA ratio in differentiating TPE and PPE. We explored the PubMed and Scopus databases for studies evaluating the LDH/ADA ratio in differentiating TPE and PPE. Results: From a yield of 110 studies, five were included for systematic review. The cutoff value for the LDH/ADA ratio in TPE ranged from <14.2 to <25. The studies demonstrated high heterogeneity, precluding meta-analysis. Quality Assessment of Diagnostic Accuracy Studies Tool 2 assessment revealed a high risk of bias in terms of patient selection and index test. Conclusion: LDH/ADA ratio is a potentially useful parameter to differentiate between TPE and PPE. Based on the limited data, we recommend an LDH/ADA ratio cutoff value of <15 in differentiating TPE and PPE. However, more rigorous studies are needed to further validate this recommendation.

Utility of Peripheral Blood Parameters in Predicting Breast Cancer Risk

  • Okuturlar, Yildiz;Gunaldi, Meral;Tiken, Elif Eda;Oztosun, Bugra;Inan, Yesim Ozdem;Ercan, Tarik;Tuna, Savas;Kaya, Ali Osman;Harmankaya, Ozlem;Kumbasar, Abdulbaki
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2409-2412
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    • 2015
  • Purpose: We aimed to study the inflammatory parameters of complete blood count in breast cancer cases. Materials and Methods: This retrospective study covered 178 breast cancer patients and 107 age and body mass index matched healthy women. Complete blood count parameters, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and MPV/platelet were analyzed. Results: The leukocyte, neutrophil and neutrophil/lymphocyte ratio were higher in the patient group (p values 0.001, 0.0001 and 0.0001, respectively) while haemoglobin and hematocrit were higher in the control group (p=0.0001 for both). Logistic regression analysis showed that elevated neutrophils and platelet distribution width (PDW) (OR: 0.627, 95%CI: 0.508-0.774, p=0.001 and OR: 1.191 95%CI: 1.057-1.342 p=0.003) were independent variables for predicting breast cancer. The cut-off value for the neutrophil/lymphocyte ratio was 2.56. Conclusions: According to our study results, neutrophil levels as part of complete blood count may be used as an independent predictor of breast cancer risk.

Pelvic insufficiency fracture after radiotherapy in patients with cervical cancer in the era of PET/CT

  • Park, Shin-Hyung;Kim, Jae-Chul;Lee, Jeong-Eun;Park, In-Kyu
    • Radiation Oncology Journal
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    • v.29 no.4
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    • pp.269-276
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    • 2011
  • Purpose: To determine the incidence, risk factors, and clinical characteristics of pelvic insufficiency fracture (PIF) in patients with cervical cancer. Materials and Methods: Between July 2004 and August 2009, 235 patients with non-metastatic cervical cancer were treated with definitive chemoradiation or postoperative radiotherapy. Among 235 patients, 117 (49.8%) underwent the first positron emission tomography/computed tomography (PET/CT) within 1 year after radiotherapy. The median radiation dose was 55 Gy (range, 45 to 60 Gy). Medical charts and imaging studies, including PET/CT, magnetic resonance imaging (MRI), CT. bone scintigraphy were reviewed to evaluate the patients with PIF. Results: Among 235 patients, 16 developed PIF. The 5-year detection rate of PIF was 9.5%. The 5-year detection rate of PIF in patients who underwent the first PET/CT within a year was 15.6%. The median time to development of PIF was 12.5 months (range, 5 to 30 months). The sites of fracture included 12 sacroiliac joints, 3 pubic rami, 3 iliac bones, and 1 femoral neck. Eleven of 16 patients having PIF complained of hip pain requiring medications. One patient required hospitalization for pain control. The significant risk factors of PIF were old age, body mass index less than 23, bone mineral density less than -3.5 SD, and the first PET/CT within a year after radiotherapy. Radiation dose and concurrent chemotherapy had no impact on PIF rate. Conclusion: PIFs were not rare after pelvic radiotherapy in cervical cancer patients in the era of PET/CT. Timely diagnosis and management of PIF can improve quality of life in patients with cervical cancer, in addition to reducing unnecessary medical expenses.

Relationship Between Non-alcoholic Fatty Liver Disease and Decreased Bone Mineral Density: A Retrospective Cohort Study in Korea

  • Sung, Jisun;Ryu, Seungho;Song, Yun-Mi;Cheong, Hae-Kwan
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.5
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    • pp.342-352
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    • 2020
  • Objectives: The aim of this retrospective cohort study was to investigate whether non-alcoholic fatty liver disease (NAFLD) was associated with incident bone mineral density (BMD) decrease. Methods: This study included 4536 subjects with normal BMD at baseline. NAFLD was defined as the presence of fatty liver on abdominal ultrasonography without significant alcohol consumption or other causes. Decreased BMD was defined as a diagnosis of osteopenia, osteoporosis, or BMD below the expected range for the patient's age based on dual-energy X-ray absorptiometry. Cox proportional hazards models were used to estimate the hazard ratio of incident BMD decrease in subjects with or without NAFLD. Subgroup analyses were conducted according to the relevant factors. Results: Across 13 354 person-years of total follow-up, decreased BMD was observed in 606 subjects, corresponding to an incidence of 45.4 cases per 1000 person-years (median follow-up duration, 2.1 years). In the model adjusted for age and sex, the hazard ratio was 0.65 (95% confidence interval, 0.51 to 0.82), and statistical significance disappeared after adjustment for body mass index (BMI) and cardiometabolic factors. In the subgroup analyses, NAFLD was associated with a lower risk of incident BMD decrease in females even after adjustment for confounders. The direction of the effect of NAFLD on the risk of BMD decrease changed depending on BMI category and body fat percentage, although the impact was statistically insignificant. Conclusions: NAFLD had a significant protective effect on BMD in females. However, the effects may vary depending on BMI category or body fat percentage.

Clinical features and risk factors for missed stroke team activation in cases of acute ischemic stroke in the emergency department

  • Byun, Young-Hoon;Hong, Sung-Youp;Woo, Seon-Hee;Kim, Hyun-Jeong;Jeong, Si-Kyoung
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.5
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    • pp.437-448
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    • 2018
  • Objective: Acute ischemic stroke (AIS) requires time-dependent reperfusion therapy, and early recognition of AIS is important to patient outcomes. This study was conducted to identify the clinical features and risk factors of AIS patients that are missed during the early stages of diagnosis. Methods: We retrospectively reviewed AIS patients admitted to a hospital through the emergency department. AIS patients were defined as ischemic stroke patients who visited the emergency department within 6 hours of symptom onset. Patients were classified into two groups: an activation group (A group), in which patients were identified as AIS and the stroke team was activated, and a non-activation group (NA group), for whom the stroke team was not activated. Results: The stroke team was activated for 213 of a total of 262 AIS patients (81.3%), while it was not activated for the remaining 49 (18.7%). The NA group was found to be younger, have lower initial National Institutes of Health Stroke Scale scores, lower incidence of previous hypertension, and a greater incidence of cerebellum and cardio-embolic infarcts than the A group. The chief complaints in the A group were traditional stroke symptoms, side weakness (61.0%), and speech disturbance (17.8%), whereas the NA group had non-traditional symptoms, dizziness (32.7%), and decreased levels of consciousness (22.4%). Independent factors associated with missed stroke team activation were nystagmus, nausea/vomiting, dizziness, gait disturbance, and general weakness. Conclusion: A high index of AIS suspicion is required to identify such patients with these findings. Education on focused neurological examinations and the development of clinical decision tools that could differentiate non-stroke and stroke are needed.

The Infectivity of Pulmonary Tuberculosis in Korean Army Units: Evidence from Outbreak Investigations

  • Yoon, Chang-gyo;Kang, Dong Yoon;Jung, Jaehun;Oh, Soo Yon;Lee, Jin Beom;Kim, Mi-Hyun;Seo, Younsuk;Kim, Hee-Jin
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.4
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    • pp.298-305
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    • 2019
  • Background: Tuberculosis (TB) causes substantial health burden to the Korean military. This study aims to assess the impact of infectious TB cases on close and casual contacts in the Korean Army settings based on contact investigation data. Methods: Six Army units with infectious TB cases from September 2012 to May 2013 were enrolled in the study. We analyzed the clinical data from close and casual contacts screened using the tuberculin skin test (TST) and QuantiFERON-TB Gold In-Tube to identify latent tuberculosis infection (LTBI) cases. For the control group, 286 military conscripts with no reported TB exposure were tested by TST only. Results: Of the 667 contacts of index cases, LTBI cases identified were as follows: 21.8% of close contacts of smearpositive cases (71/326), 8.5% of casual contacts of smear-positive cases (26/305), and 2.8% of close contacts of smearnegative cases (1/36). In the control group, 16.8% showed positivity in TST. In a multivariate analysis, having stayed in the same room or next room with TB patients was identified as a risk factor of LTBI. Conclusion: Using the data from TB contact investigations in the Korean Army units, we found an overall LTBI rate of 14.7% among the contacts screened. This study demonstrates that contacts living in the same building, especially the same room or next room, with TB patients are at a high risk of acquiring LTBI, serving as additional evidence for defining close and casual contacts of a TB patient with regard to Army barrack settings.

Correlation between gray values of cone-beam computed tomograms and Hounsfield units of computed tomograms: A systematic review and meta-analysis

  • Selvaraj, Abirami;Jain, Ravindra Kumar;Nagi, Ravleen;Balasubramaniam, Arthi
    • Imaging Science in Dentistry
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    • v.52 no.2
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    • pp.133-140
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    • 2022
  • Purpose: The aim of this review was to systematically analyze the available literature on the correlation between the gray values (GVs) of cone-beam computed tomography (CBCT) and the Hounsfield units (HUs) of computed tomography (CT) for assessing bone mineral density. Materials and Methods: A literature search was carried out in PubMed, Cochrane Library, Google Scholar, Scopus, and LILACS for studies published through September 2021. In vitro, in vivo, and animal studies that analyzed the correlations GVs of CBCT and HUs of CT were included in this review. The review was prepared according to the PRISMA checklist for systematic reviews, and the risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. A quantitative analysis was performed using a fixed-effects model. Results: The literature search identified a total of 5,955 studies, of which 14 studies were included for the qualitative analysis and 2 studies for the quantitative analysis. A positive correlation was observed between the GVs of CBCT and HUs of CT. Out of the 14 studies, 100% had low risks of bias for the domains of patient selection, index test, and reference standards, while 95% of studies had a low risk of bias for the domain of flow and timing. The fixed-effects meta-analysis performed for Pearson correlation coefficients between CBCT and CT showed a moderate positive correlation (r=0.669; 95% CI, 0.388 to 0.836; P<0.05). Conclusion: The available evidence showed a positive correlation between the GVs of CBCT and HUs of CT.