• Title/Summary/Keyword: Risk Risk stratification

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Suspecting Intussusception and Recurrence Risk Stratification Using Clinical Data and Plain Abdominal Radiographs

  • Oh, Ye Rim;Je, Bo Kyung;Oh, Chaeyoun;Cha, Jae Hyung;Lee, Jee Hyun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.2
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    • pp.135-144
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    • 2021
  • Purpose: Although ultrasonography is the gold standard of diagnosing intussusception, plain abdomen radiograph (AXR) is often used to make differential diagnosis for pediatric patients with abdominal pain. In intussusception patients, we aimed to analyze the AXR and clinical data to determine the characteristics of early AXR findings associated with diagnosis of intussusception and recurrence after reduction. Methods: Between January 2011 and June 2018, 446 patients diagnosed with intussusception based on International Classification of Diseases-10 code of K56.1 were admitted. We retrospectively reviewed medical records of 398 patients who received air reduction; 51 of them have recurred after initial reduction. We evaluated six AXR features including absent ascending colon gas, absent transverse colon gas, target sign, meniscus sign, mass, and ileus. Clinical data and AXR features were compared between single episode and recurrence groups. Results: Two groups did not show significant differences regarding clinical data. Mean time to recurrence from air reduction was 3.4±3.2 days. Absent ascending colon gas (63.9%) was the most common feature in intussusception, followed by mass (29.1%). All of six AXR features were observed more frequently in the recurrence group. Absent transverse colon gas was the most closely associated AXR finding for recurrence (odds ratio, 2.964; 95% confidence interval, 1.327-6.618; p=0.008). Conclusion: In our study, absence of ascending colon gas was the most frequently seen AXR factor in intussusception patients. Extended and careful observation after reduction may be beneficial if such finding on AXR is found in intussusception patients.

The Association Between Long Working Hours and Infertility

  • Ahn, Joonho;Lee, Sang Ha;Park, Min Young;Oh, Soo Hyun;Lee, Wanhyung
    • Safety and Health at Work
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    • v.12 no.4
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    • pp.517-521
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    • 2021
  • Background: This study aimed to investigate whether working long hours was related to infertility among female Korean workers, while taking age into consideration. Methods: We used data from the 2018 National Survey on Fertility and Family Health and Welfare in Korea that is a cross-sectional, nationally representative, and population-based survey. Infertility was defined as women who were not pregnant after regular unprotected intercourse for a year. Working long hours was classified as ≥52 hours, and subgroups as per age were classified on the basis of being younger or older than 40 years of age. Differences in infertility risk between the long working hour group and none were estimated in crude and fully adjusted logistic regression models with age-group stratification. Results: Of 5,909 Korean female workers, the crude and adjusted odds ratios (95% confidence intervals) of infertility for working long hours were 1.295 (0.948-1.737) and 1.303 (0.921-1.809), respectively. In the subgroup of patients below 40 years of age, the crude and adjusted odds ratios (95% confidence interval) were 1.957 (1.216-3.039) and 1.921 (1.144-3.120), whereas those aged 40 years or older had 0.994 (0.647-1.471) and 0.939 (0.560-1.501), respectively. The weighted prevalence of infertility increased as weekly working hours increased only for the younger than 40-year subgroup. Conclusions: Infertility is associated with working long hours, especially in young-aged workers. Thus, the working schedule must be structured to better suit young female workers.

Beyond Coronary CT Angiography: CT Fractional Flow Reserve and Perfusion (전산화단층촬영 관상동맥조영술: 분획혈류예비력과 심근관류 영상)

  • Moon Young Kim;Dong Hyun Yang;Ki Seok Choo;Whal Lee
    • Journal of the Korean Society of Radiology
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    • v.83 no.1
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    • pp.3-27
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    • 2022
  • Cardiac CT has been proven to provide diagnostic and prognostic evaluation of coronary artery disease for cardiovascular risk stratification and treatment decision-making based on rapid technological development and various research evidence. Coronary CT angiography has emerged as a gateway test for coronary artery disease that can reduce invasive angiography due to its high negative predictive value, but the diagnostic specificity is relatively low. However, coronary CT angiography is likely to overcome its limitations through functional evaluation to identify the hemodynamic significance of coronary artery disease by analyzing myocardial perfusion and fractional flow reserve through cardiac CT. Recently, studies have been actively conducted to incorporate artificial intelligence to make this more objective and reproducible. In this review, functional imaging techniques of cardiac computerized tomography are explored.

Computed Tomography Assessment of Severity of Acute Pancreatitis in Bangladeshi Children

  • Kaniz Fathema;Bazlul Karim;Salahuddin Al-Azad;Md. Rukunuzzaman;Mizu Ahmed;Tasfia Jannat Rifah;Dipanwita Saha;Md. Benzamin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.27 no.3
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    • pp.176-185
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    • 2024
  • Purpose: Acute pancreatitis (AP) is common among children in Bangladesh. Its management depends mainly on risk stratification. This study aimed to assess the severity of pediatric AP using computed tomography (CT). Methods: This cross-sectional, descriptive study was conducted in pediatric patients with AP at the Department of Pediatric Gastroenterology and Nutrition, BSMMU, Dhaka, Bangladesh. Results: Altogether, 25 patients with AP were included, of whom 18 (mean age, 10.27±4.0 years) were diagnosed with mild AP, and 7 (mean age, 10.54±4.0 years) with severe AP. Abdominal pain was present in all the patients, and vomiting was present in 88% of the patients. Etiology was not determined. No significant differences in serum lipase, serum amylase, BUN, and CRP levels were observed between the mild and severe AP groups. Total and platelet counts as well as hemoglobin, hematocrit, serum creatinine, random blood sugar, and serum alanine aminotransferase levels (p>0.05) were significantly higher in the mild AP group than in the severe AP group (p=0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of CT severity index (CTSI) were 71.4%, 72.2%, 50%, and 86.7%, respectively. In addition, significant differences in pancreatic appearance and necrosis were observed between the two groups on CT. Conclusion: CT can be used to assess the severity of AP. In the present study, the CTSI effectively assessed the severity of AP in pediatric patients.

Remote Cardiac Rehabilitation With Wearable Devices

  • Atsuko Nakayama;Noriko Ishii;Mami Mantani;Kazumi Samukawa;Rieko Tsuneta;Megumi Marukawa;Kayoko Ohno;Azusa Yoshida;Emiko Hasegawa;Junko Sakamoto;Kentaro Hori;Shinya Takahashi;Kaoruko Komuro;Takashi Hiruma;Ryo Abe;Togo Norimatsu;Mai Shimbo;Miyu Tajima;Mika Nagasaki;Takuya Kawahara;Mamoru Nanasato;Toshimi Ikemage;Mitsuaki Isobe
    • Korean Circulation Journal
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    • v.53 no.11
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    • pp.727-743
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    • 2023
  • Although cardiac rehabilitation (CR) has been shown to improve exercise tolerance and prognosis in patients with cardiovascular diseases, there remains low participation in outpatient CR. This may be attributed to the patients' busy schedules and difficulty in visiting the hospital due to distance, cost, avoidance of exercise, and severity of coronary disease. To overcome these challenges, many countries are exploring the possibility of remote CR. Specifically, there is increasing attention on the development of remote CR devices, which allow transmission of vital information to the hospital via a remote CR application linked to a wearable device for telemonitoring by dedicated hospital staff. In addition, remote CR programs can support return to work after hospitalization. Previous studies have demonstrated the effects of remote CR on exercise tolerance. However, the preventive effects of remote CR on cardiac events and mortality remain controversial. Thus, safe and effective remote CR requires exercise risk stratification for each patient, telenursing by skilled staff, and multidisciplinary interventions. Therefore, quality assurance of telenursing and multi-disciplinary interventions will be essential for remote CR. Remote CR may become an important part of cardiac management in the future. However, issues such as cost-effectiveness and insurance coverage still persist.

Association between presenteeism and mental health among logistic center workers

  • Hyoungseob Yoo;Ji-hun Song;Hyoung-Ryoul Kim
    • Annals of Occupational and Environmental Medicine
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    • v.34
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    • pp.39.1-39.11
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    • 2022
  • Background: Workers in logistics centers are always pressed for time to collect and pack products. They also participate in high-intensity manual labor in which various musculoskeletal hazards exist. In the case of logistic center labor, it is estimated that there is a high risk of presenteeism due to the above characteristics which can cause deterioration of workers' mental health. However, there is insufficient research on this topic. Methods: Workers in a logistic center were surveyed using an Internet questionnaire. The survey items included demographic characteristics, labor intensity and work-related factors, and mental health aspects such as depression and anxiety. The survey was conducted for about a month from July 26, 2021 and a total of 353 people were analyzed. Through the χ2 test and t-test, the characteristics of workers who experienced presenteeism were examined and the prevalence ratios (PRs) of depression and anxiety experiences were calculated by multivariable Poisson regression. Afterwards, stratification analysis considering gender, the type of contract, and labor intensity was implemented. Results: In the group that experienced presenteeism, the number of working days per week was higher and fixed-term workers, high labor intensity, and sleep deprivation were more common. In the multi-Poisson regression analysis conducted by adjusting the demographic characteristics, working hours, and work-related factors, the PRs of depression and anxiety were 1.98 (95% confidence interval: 1.24-3.18) and 1.81 (1.22-2.68), respectively. In particular, the p-value for interactions was significant when stratified with the type of contract. Conclusions: As a result of the study, presenteeism and mental health were associated in logistic center workers. To prevent mental health issues of logistic center workers, management of presenteeism is necessary and a prospective study is needed.

Seasonal distribution of phytoplankton and environmental factors in the offshore waters of Dokdo: Comparison between 2018 and 2019 (독도 연안 식물플랑크톤의 계절적 분포 특성과 환경요인: 2018년과 2019년 비교)

  • Lee, Minji;Kim, Yun-Bae;Kang, Jung Hoon;Park, Chan Hong;Baek, Seung Ho
    • Korean Journal of Environmental Biology
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    • v.38 no.1
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    • pp.47-60
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    • 2020
  • To assess the characteristics of phytoplankton community structures related to environmental factors, seasonal surveys were conducted in the vicinity of Dokdo. In 2019, phytoplankton of four phyla and 69 species were observed. During winter, unidentified nanoflagellates dominated, with an average of 3.19×104 cells L-1. In spring, unidentified nanoflagellates occupied about 50% of the composition and a variety of dinoflagellates appeared. The summer phytoplankton population showed very low abundance. In autumn, various species of Chaetoceros appeared, along with diatoms, such as Bacteriastrum spp., Guinardia striata, and Pseudo-nitzschia spp. In addition, tropical species Amphisolenia sp. and Ornithocercus sp. were observed in both 2018 and 2019. The diversity was high in the summer of 2018 and the winter of 2019 and the characteristics of each index varied. Cluster analysis was divided into four groups according to species and population characteristics regardless of the season. The stratification of spring was particularly weak. In the autumn of 2018, the water mass was stabilized in the same way as in the summer, which is considered a suitable condition for phytoplankton growth. However, in 2019, the water masses were mixed, resulting in a low population. In a phytoplankton comparison, the dominant group showed seasonal differences, except for summer when the population was low, and the difference was most pronounced in autumn. Therefore, the waters surrounding Dokdo have different environmental and ecological characteristics from the East Sea, but the seasonal characteristics of each year are considered to be different depending on the topography, various currents, the island effect, and other factors.

Effects of Job Strains on Absenteeism from Work (직업성 긴장과 근로자 결근)

  • Cha, Bong-Suk;Chang, Sei-Jin;Choi, Hong-Ryul;Kim, Hyong-Sik;Koh, Sang-Baek
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.4
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    • pp.505-512
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    • 1999
  • Objectives : The purpose of this study was to assess the relationship between job strains and absenteeism from work. Methods : The study design was cross-sectional, and the study subjects consisted of 1,166 workers who were employed in the small-sized industries. A self administered questionnaire was used to measure the general characteristics, job characteristics(job demand, job control), and social support(coworker support, supervisor support) at work. The Job Content Questionnaire(JCQ) was used to assess job demand(2 items) and decision lattitude(10 items). Social support at work (10 items) was measured using JCQ. Sick absence was collected using self-report and were rechecked by the attendance record of their company. Odds ratios and 95% confidence intervals for the association between job strain and sick absence were estimated. The modifying effect of social support was evaluated by stratification. Logistic regression was used to estimate the relationship between job strain and sick absence. Results : In the bivariate analysis, the variables related to sick absence were age, marital status, occupation, job demand. Four distinctly different kinds of level of job strain were generated by the combination of job demand and job control: low strain group, high strain group, active group, and passive group. The crude odds ratio of high job strain was 1.78(95% CI: 1.26-2.53), and those of active group and passive group were 1.33(95% CI: 1.07-1.66) and 1.13 (95% CI: 0.88-1.47), respectively. The odds ratio of high job strain after adjusting for age and occupation were still significant The odds ratio of high job strain in low social support was 5.96(95% CI: 2.45-14.51), but that in high social support was 0.73(95% CI: 0.26-2.01). Conclusions : Job strain was associated with increased risk of absenteeism from work, and social support at work modified the association between job strain and sick absence.

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Prognostic significance of minimal residual disease detected by a simplified flow cytometric assay during remission induction chemotherapy in children with acute lymphoblastic leukemia

  • Koh, Kyung-Nam;Park, Mee-Rim;Kim, Bo-Eun;Im, Ho-Joon;Park, Chan-Jeoung;Jang, Seong-Soo;Chi, Hyun-Sook;Seo, Jong-Jin
    • Clinical and Experimental Pediatrics
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    • v.53 no.11
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    • pp.957-964
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    • 2010
  • Purpose: Our study attempted to determine the prognostic significance of minimal residual disease (MRD) detected by a simplified flow cytometric assay during induction chemotherapy in children with B-cell acute lymphoblastic leukemia (B-ALL). Methods: A total of 98 patients were newly diagnosed with precursor B-ALL from June 2004 to December 2008 at the Asan Medical Center (Seoul, Korea). Of those, 37 were eligible for flow cytometric MRD study analysis on day 14 of their induction treatment. The flow cytometric MRD assay was based on the expression intensity of CD19/CD10/CD34 or aberrant expression of myeloid antigens by bone marrow nucleated cells. Results: Thirty-five patients (94.6%) had CD19-positive leukemic cells that also expressed CD10 and/or CD34, and 18 (48.6%) had leukemic cells with aberrant expression of myeloid antigens. Seven patients with ${\geq}1%$ leukemic cells on day 14 had a significantly lower relapse-free survival (RFS) compared to the 30 patients with lower levels (42.9 % [18.7%] vs. 92.0% [5.4%], $P$=0.004). Stratification into 3 MRD groups (${\geq}1%$, 0.1-1%, and <0.1%) also showed a statistically significant difference in RFS (42.9% [18.7%] vs. 86.9% [8.7%] vs. 100%, $P$=0.013). However, the MRD status had no significant influence on overall survival. Multivariate analysis demonstrated that the MRD level on day 14 was an independent prognostic factor with borderline significance. Conclusion: An MRD assay using simplified flow cytometry during induction chemotherapy may help to identify patients with B-ALL who have an excellent outcome and patients who are at higher risk for relapse.

Breast Cancer Association Studies in a Han Chinese Population using 10 European-ancestry-associated Breast Cancer Susceptibility SNPs

  • Guan, Yan-Ping;Yang, Xue-Xi;Yao, Guang-Yu;Qiu, Fei;Chen, Jun;Chen, Lu-Jia;Ye, Chang-Sheng;Li, Ming
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.85-91
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    • 2014
  • Background: Genome-wide association studies (GWAS) have identified various genetic susceptibility loci for breast cancer based mainly on European-ancestry populations. Differing linkage disequilibrium patterns exist between European and Asian populations. Methods: Ten SNPs (rs2075555 in COL1A1, rs12652447 in FBXL17, rs10941679 in 5p12/MRPS30, rs11878583 in ZNF577, rs7166081 in SMAD3, rs16917302 in ZNF365, rs311499 in 20q13.3, rs1045485 in CASP8, rs12964873 in CDH1 and rs8170 in 19p13.1) were here genotyped in 1009 Chinese females (487 patients with breast cancer and 522 control subjects) using the Sequenom MassARRAY iPLEX platform. Association analysis based on unconditional logistic regression was carried out to determine the odds ratio (OR) and 95% confidence interval (95% CI) for each SNP. Stratification analyses were carried out based on the estrogen receptor (ER) and progesterone receptor (PR) status. Results: Among the 10 SNPs, rs10941679 showed significant association with breast cancer when differences between the case and control groups in this Han Chinese population were compared (30.09% GG, 45.4% GA and 23.7% AA; P = 0.012). Four SNPs (rs311499, rs1045485, rs12964873 and rs8170) showed no polymorphisms in our study. The remaining five SNPs showed no association with breast cancer in the present population. Immunohistochemical tests showed that rs2075555 was associated with ER status; the AA genotype showed greater association with ER negative than ER positive (OR = 0.54, 95% CI, 0.29-0.99; P = 0.046). AA of rs7166081 was also associated with ER status, but showed a greater association with ER positive than negative (OR = 1.59, 95% CI = 1.04-2.44; P = 0.031). However, no significant associations were found among the SNPs and PR status. Conclusion: In this study using a Han Chinese population, rs10941679 was the only SNP associated with breast cancer risk, indicating a difference between European and Chinese populations in susceptibility loci. Therefore, confirmation studies are necessary before utilization of these loci in Chinese.