Background/Aims: The Gachon Regional Occupational Cohort Study (GROCS) is a large-scale longitudinal study of occupational safety and health data (covering Work Environment Monitoring, Workers' Health Surveillance, and Occupational Health Service) conducted by the Gachon University Gil Medical Center (GUGMC) in Incheon, Republic of Korea. We conducted GROCS to identify the health effects of workers' occupational risks, behavior, socioeconomic status, and life style. Methods: The GROCS includes data from Work Environment Monitoring, Workers' Health Surveillance, and Occupational Health Service. The baseline year for all data collection was 2018. Work Environment Monitoring was conducted in 240 companies located in Incheon. General Health Examination and Special Health Examination were performed on 32,725 and 9,504 workers, respectively. Occupational Health Services were provided to 16,883 workers in 171 companies. These data have been collected and operated at an external data management institution and were provided as a retrospective cohort after removing personal identification information. Results: In 2018, the total number of companies was 2,854, among which which 488 special Health Examination, 171 Work Environment Monitoring, and 240 Occupational Health Service. The proportion of companies undergoing Special Health Examination was 17.1%, the proportion of companies undergoing Work Environment Monitoring was 8.4%, and the proportion of Companies undergoing Occupational Health Service was 6.0%. Conclusion: GROCS expects researchers to utilize its useful and reliable resource for occupational health and surveillance with for academic or political purposes to lead to improved workers' health and working environment.
Objectives: There are no studies which have investigated the health related quality of life(HRQOL) about stroke patients according to the medical care utilization behavior by longitudinal analysis. The purpose of this study is to analyze the quality of life(QOL) and quality adjusted life years(QALYs) of stroke patients of western and combined treatment group by longitudinal analysis. Methods: A retrospective cohort study was conducted among 37 new patients who initiated diagnosis with stroke in 2009 from Korea Health Panel Data. We analyzed the HRQOL of stroke patients and calculated the QALYs after medical use initiation for up to 3 years according to the medical care utilization behavior. Results: Overall, the quality of life of stroke patients was lowered somewhat from 0.8431 to 0.7864 in 2009~2012. Western treatment group was appeared slightly declined in from 0.8527 to 0.8231 and combined treatment group was shown to be falling from 0.8173 to 0.6875. The QALYs of total patients were calculated 2.3654 and western treatment group were 2.4436, combined treatment group were 2.1542 during the 4 year period. The difference of QALYs between two groups was 0.2894 QALYs. Conclusions: Although there was a small difference in QALYs of the two groups, it is not certain that the difference is come from medical care utilization behavior. Further studies should be needed to confirm the relation of the medical care utilization behavior and quality of life by considering severity of the stroke.
An, Seungheon;Jee, Youngju;Lee, Donggeon;Song, Sunhae;Lee, Gyuchang
Physical Therapy Rehabilitation Science
/
제5권1호
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pp.1-8
/
2016
Objective: The present study was to investigate the discrimination capacity of the Performance Oriented Mobility Assessment-Gait Scale (POMA-GS), for predicting falls in stroke survivors. Design: Retrospective cohort study. Methods: Data including the characteristics and number of falls of 52 chronic stroke patients from a rehabilitation center were collected. The number of falls each subject had experienced in the previous year were investigated through interviews. The subjects were divided into two groups depending on the number of falls: if falls occurred twice or more on the basis of the time of study after stroke, they were defined as the falls group and if there was no fall experience or one fall, they were defined as the non-falls group. The subjects were examined with the POMA-GS, and physical functions were examined using by the One Leg Stand Test (OLST), Sit to Stand Test (SST), 10-m Walk Test, Lower Extremity in Fugl-Meyer assessment (FM-LE), and Trunk Impairment Scale (TIS). The validity of POMA-GS for falls prediction was analyzed. Results: In the POMA-GS, which predicts falls in stroke survivors, the cut-off value was 8.5 (sensitivity 72%; specificity 65%) and the area under the curve was 0.75 (95% confidence interval: 0.60-0.90, p<0.007). There was a significant difference in the OLST, SST, FM-LE, and TIS between the subjects with POMA-GS >8.5 and the subjects with POMA-GS ${\leq}8.5$. Conclusions: The POMA-GS could be a useful tool in predicting falls in stroke survivors, as its discrimination capacity and predictive validity is proven satisfactory.
Objectives : The purpose of this study is to analyze the oriental medical treatments of burning mouth syndrome, understand the tendency of treatment, and apply it to clinical settings. Methods : We collected case reports, retrospective cohort studies and RCT studies related to oriental medical treatments of burning mouth syndrome using domestic and Chinese databases(CNKI, KISS, RISS, OASIS, KCI). Search terms include 'Burning Mouth Syndrome', 'BMS', 'Burning Tongue', '灼口综合征', and 'oriental medicine', 'oriental medical treatment', 'Korean medicine' and '中医'. A search was conducted by appropriately combining keywords. Results : A total of 27 papers were included in the analysis. Among them, 9 are case studies, 1 is a retrospective cohort study, 1 is a before and after study and 16 are RCT studies. Treatments for burning mouth syndrome included herbal medicine, acupuncture, electro-acupuncture, acupoint injection, auricular acupuncture treatment, external use herbal medicine and gargling. In all studies, symptoms of burning mouth syndrome were alleviated after oriental medical treatments. In 14 RCT studies comparing western medical treatments, the results of the treatment group that included oriental medical treatments were found to be more significant, except for one. Conclusions : As a result of the study, oriental medical treatments are effective in treating burning mouth syndrome. In the future, we hope that clinical research related to oriental medical treatments of burning mouth syndrome will be actively conducted so that evidence-based treatment can be implemented.
Backgrounds/Aims: Prehabilitation aims for preoperative optimisation to reduce postoperative complications. However, there is a paucity of data on its use in patients undergoing pancreaticoduodenectomy (PD). Thus, this study aims to evaluate the outcomes of a home-based outpatient prehabilitation program (PP) versus no-PP in patients undergoing PD. Methods: This retrospective cohort study compared patients who underwent PP versus no-PP before elective PD from January 2016 to December 2020. Inclusion criteria for PP were < 65 years or 65-74 years with FRAIL score < 3. No-PP included dietician, case manager and anesthesia review. PP included additional physiotherapy sessions, caregiver training and interim phone consultation. Univariate and multivariate analysis were used to evaluate length of stay (LOS), morbidity, 30-day readmission, and 90-day mortality. Results: Seventy-one patients (PP: n = 50 [70.4%]; no-PP: n = 21 [29.6%]) were included in this study. Median age was 65 years (interquartile range [IQR]: 58-72 years). Majority (n = 58 [81.7%]) of patients underwent open surgery. Ductal adenocarcinoma was the most common histology (49.3%). Patient demographics were comparable between both groups. Overall median LOS was 11.0 days (IQR: 8.0-17.0 days). Compared to no-PP, PP was not independently associated with reduced intra-abdominal collections (odds ratio [OR]: 0.43; 95% confidence interval [CI]: 0.03-6.11, p = 0.532), major morbidity (OR: 1.31; 95% CI: 0.09-19.47; p = 0.845) or 30-day readmission (OR: 3.16; 95% CI: 0.26-38.27; p = 0.365). There was one (1.4%) 30-day mortality. Conclusions: Our outpatient PP with unsupervised exercise regimes did not improve postoperative outcomes following elective PD.
The objective of the study is to measure the changes in measles infection and measles vaccination rates for the past 10 years in a rural area, Kang Wha. The study population were the entire children who were born between 1971 and 1950 in three townships (Sunwon, Naegae, Buleun) in Kangwha County. Two interview surveys were carried out during the 10 years of period, one in 1977 and the other in 1981. The data were collected by Family Health Workers through interview with structured questionnaires. The diagnosis of measles was mainly based on histories, symptoms and sighs of the disease. If a mother had reported measles history of her child, a public physician reviewed and decided the final diagnosis of the reported case. A retrospective cohort observation was done in order to see the trends of measles infections and measles vaccinations. The major findings were as follows; 1. The 5 year prevalence rate of measles vaccinations was 51.3% between 1971 and 1975 and 71.9% between 1976 and 1980 respectively. The difference between two periods was statistically significant (P<0.05). The secular trend of measles vaccinations showed increasing tendency from 1971 to 1978 and since then kept maintained. 2. In the birth cohort analysis of measles vaccinations, the vaccination rates, in general, were higher in the later cohort groups than that of earlier cohort groups. 9. The 5-year experience rates for measles infections were 24.3% between 1971 and 1975 and 17.2% between 1976 and 1980 respectively. This difference was statistically significant(P<0.05). The secular trend of experience rates for measles infections showed decreasing tendency from 1971 to 1980 except an outbreak in 1976. 4. The birth cohort analysis of experience rates for measles infections showed that the rate was higher in the later cohort groups than that of the earlier cohort groups. This decreasing tendency was prominent between $1973{\sim}1974$ and $1976{\sim}1977$. 5. The distribution of age specific incidence rates for measles infections showed unimodal curve with the peak at the age of 12 to 18 months. This findings were same in both two surveys. 6. Seasonal variations of the measles infections showed two peaks, one major peak in March through May and the another minor peak in September through December. 7. The 5-year reduction rate for measles infections among those vaccinated was 90.4% between 1971 and 1975 and 88% between 1976 and 1980.
Background: Differentiated thyroid cancer is the most common endocrine malignancy with a generally good prognosis. Knowing long-term outcomes of each patient helps management planning. The study was conducted to develop and validate a clinical prognostic score for predicting disease remission in patients with differentiated thyroid cancer based on patient, tumor and treatment factors. Materials and Methods: A retrospective cohort study of 1,217 differentiated thyroid cancer patients from two tertiary-care hospitals in the Northeast of Thailand was performed. Associations between potential clinical prognostic factors and remission were tested by Cox proportional-hazards analysis in 852 patients (development cohort). The prediction score was created by summation of score points weighted from regression coefficients of independent prognostic factors. Risks of disease remission were estimated and the derived score was then validated in the remaining 365 patients (validation cohort). Results: During the median follow-up time of 58 months, 648 (76.1%) patients in the development cohort had disease remission. Five independent prognostic factors were identified with corresponding score points: duration from thyroid surgery to $^{131}I$ treatment (0.721), distant metastasis at initial diagnosis (0.801), postoperative serum thyroglobulin level (0.535), anti-thyroglobulin antibodies positivity (0.546), and adequacy of serum TSH suppression (0.293). The total risk score for each patient was calculated and three categories of remission probability were proposed: ${\leq}1.628$ points (low risk, 83% remission), 1.629-1.816 points (intermediate risk, 87% remission), and ${\geq}1.817$ points (high risk, 93% remission). The concordance (C-index) was 0.761 (95% CI 0.754-0.767). Conclusions: The clinical prognostic scoring model developed to quantify the probability of disease remission can serve as a useful tool in personalized decision making regarding treatment in differentiated thyroid cancer patients.
Roh, Simon;Iannettoni, Mark D.;Keech, John;Arshava, Evgeny V.;Swatek, Anthony;Zimmerman, Miriam B.;Weigel, Ronald J.;Parekh, Kalpaj R.
Journal of Chest Surgery
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제52권1호
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pp.1-8
/
2019
Background: Neoadjuvant chemoradiation therapy (nCRT) has become the standard of care for esophageal cancer patients prior to esophagectomy. However, the optimal timing for surgery after completion of nCRT remains unclear. Methods: A retrospective review was performed of patients who underwent esophagectomy with cervical anastomosis for esophageal cancer at a single institution between January 2000 and June 2015. Patients were categorized into 3 cohorts: those who did not receive nCRT prior to esophagectomy (no nCRT), those who underwent esophagectomy within 35 days after nCRT (${\leq}35d$), and those who underwent esophagectomy more than 35 days after nCRT (>35d). Results: A total of 366 esophagectomies were performed during the study period, and 348 patients met the inclusion criteria. Anastomotic leaks occurred in 11.8% of all patients included in the study (41 of 348). Within each cohort, anastomotic leaks were detected in 14.7% of patients (17 of 116) in the no nCRT cohort, 7.3% (13 of 177) in the ${\leq}35d$ cohort, and 20.0% (11 of 55) in the >35d cohort (p=0.020). Significant differences in the occurrence of anastomotic leaks were observed between the no nCRT and ${\leq}35d$ cohorts (p=0.044), and between the ${\leq}35d$ and >35d cohorts (p=0.007). Conclusion: Esophagectomy with cervical anastomosis within 35 days of nCRT resulted in a lower percentage of anastomotic leaks.
Hwang, Young-Jae;Kim, Nayoung;Yun, Chang Yong;Yoon, Hyuk;Shin, Cheol Min;Park, Young Soo;Son, Il Tae;Oh, Heung-Kwon;Kim, Duck-Woo;Kang, Sung-Bum;Lee, Hye Seung;Park, Seon Mee;Lee, Dong Ho
Journal of Cancer Prevention
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제23권4호
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pp.183-190
/
2018
Background: As the number of big-cohort studies increases, validation becomes increasingly more important. We aimed to validate administrative database categorized as colorectal cancer (CRC) by the International Classification of Disease (ICD) 10th code. Methods: Big-cohort was collected from Clinical Data Warehouse using ICD 10th codes from May 1, 2003 to November 30, 2016 at Seoul National University Bundang Hospital. The patients in the study group had been diagnosed with cancer and were recorded in the ICD 10th code of CRC by the National Health Insurance Service. Subjects with codes of inflammatory bowel disease or tuberculosis colitis were selected for the control group. For the accuracy of registered CRC codes (C18-21), the chart, imaging results, and pathologic findings were examined by two reviewers. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for CRC were calculated. Results: A total of 6,780 subjects with CRC and 1,899 control subjects were enrolled. Of these patients, 22 subjects did not have evidence of CRC by colonoscopy, computed tomography, magnetic resonance imaging, or positron emission tomography. The sensitivity and specificity of hospitalization data for identifying CRC were 100.00% and 98.86%, respectively. PPV and NPV were 99.68% and 100.00%, respectively. Conclusions: The big-cohort database using the ICD 10th code for CRC appears to be accurate.
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