• Title/Summary/Keyword: Standardized Mortality

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Interstitial Lung Abnormality in Asian Population

  • Gong Yong Jin
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.2
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    • pp.134-144
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    • 2024
  • Interstitial lung abnormalities (ILAs) are radiologic abnormalities found incidentally on chest computed tomography (CT) that can be show a wide range of diseases, from subclinical lung fibrosis to early pulmonary fibrosis including definitive usual interstitial pneumonia. To clear up confusion about ILA, the Fleischner society published a position paper on the definition, clinical symptoms, increased mortality, radiologic progression, and management of ILAs based on several Western cohorts and articles. Recently, studies on long-term outcome, risk factors, and quantification of ILA to address the confusion have been published in Asia. The incidence of ILA was 7% to 10% for Westerners, while the prevalence of ILA was about 4% for Asians. ILA is closely related to various respiratory symptoms or increased rate of treatment-related complication in lung cancer. There is little difference between Westerners and Asians regarding the clinical importance of ILA. Although the role of quantitative CT as a screening tool for ILA requires further validation and standardized imaging protocols, using a threshold of 5% in at least one zone demonstrated 67.6% sensitivity, 93.3% specificity, and 90.5% accuracy, and a 1.8% area threshold showed 100% sensitivity and 99% specificity in South Korea. Based on the position paper released by the Fleischner society, I would like to report how much ILA occurs in the Asian population, what the prognosis is, and review what management strategies should be pursued in the future.

Evaluation of the Trends of Stomach Cancer Incidence in Districts of Iran from 2000-2010: Application of a Random Effects Markov Model

  • Zayeri, Farid;mansouri, Anita;Sheidaei, Ali;Rahimzadeh, Shadi;Rezaei, Nazila;Modirian, Mitra;khademioureh, Sara;Baghestani, Ahmad Reza;Farzadfar, Farshad
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.2
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    • pp.661-665
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    • 2016
  • Background: Stomach cancer is the fifth most common cancer and the third leading cause of death among cancers throughout the world. Therefore, stomach cancer outcomes can affect health systems at the national and international levels. Although stomach cancer mortality and incidence rates have decreased in developed countries, these indicators have a raising trend in East Asian developing countries, particularity in Iran. In this study, we aimed to determine the time trend of age-standardized rates of stomach cancer in different districts of Iran from 2000 to 2010. Materials and Methods: Cases of cancer were registered using a pathology-based system during 2000-2007 and with a population-based system since 2008 in Iran. In this study, we collected information about the incidence of stomach cancer during a 10 year period for 31 provinces and 376 districts, with a total of 49,917 cases. We employed two statistical approaches (a random effects and a random effects Markov model) for modeling the incidence of stomach cancer in different districts of Iran during the studied period. Results: The random effects model showed that the incidence rate of stomach cancer among males and females had an increasing trend and it increased by 2.38 and 0.87 persons every year, respectively. However, after adjusting for previous responses, the random effects Markov model showed an increasing rate of 1.53 and 0.75 for males and females, respectively. Conclusions: This study revealed that there are significant differences between different areas of Iran in terms of age-standardized incidence rates of stomach cancer. Our study suggests that a random effects Markov model can adjust for effects of previous responses.

Breast Cancer Clustering in Kanagawa, Japan: A Geographic Analysis

  • Katayama, Kayoko;Yokoyama, Kazuhito;Yako-Suketomo, Hiroko;Okamoto, Naoyuki;Tango, Toshiro;Inaba, Yutaka
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.455-460
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    • 2014
  • Background: The purpose of the present study was to determine geographic clustering of breast cancer incidence in Kanagawa Prefecture, using cancer registry data. The study also aimed at examining the association between socio-economic factors and any identified cluster. Materials and Methods: Incidence data were collected for women who were first diagnosed with breast cancer during the period from January to December 2006 in Kanagawa. The data consisted of 2,326 incidence cases extracted from the total of 34,323 Kanagawa Cancer Registration data issued in 2011. To adjust for differences in age distribution, the standardized mortality ratio (SMR) and the standardized incidence ratio (SIR) of breast cancer were calculated for each of 56 municipalities (e.g., city, special ward, town, and village) in Kanagawa by an indirect method using Kanagawa female population data. Spatial scan statistics were used to detect any area of elevated risk as a cluster for breast cancer deaths and/or incidences. The Student t-test was performed to examine differences in socio-economic variables, viz, persons per household, total fertility rate, age at first marriage for women, and marriage rate, between cluster and other regions. Results: There was a statistically significant cluster of breast cancer incidence (p=0.001) composed of 11 municipalities in southeastern area of Kanagawa Prefecture, whose SIR was 35 percent higher than that of the remainder of Kanagawa Prefecture. In this cluster, average value of age at first-marriage for women was significantly higher than in the rest of Kanagawa (p=0.017). No statistically significant clusters of breast cancer deaths were detected (p=0.53). Conclusions: There was a statistically significant cluster of high breast cancer incidence in southeastern area of Kanagawa Prefecture. It was suggested that the cluster region was related to the tendency to marry later. This study methodology will be helpful in the analysis of geographical disparities in cancer deaths and incidence.

Effect of Different Spray Dried Plasmas on Growth, Ileal Digestibility, Nutrient Deposition, Immunity and Health of Early-Weaned Pigs Challenged with E. coli K88

  • Bosi, P.;Han, In K.;Jung, H.J.;Heo, K.N.;Perini, S.;Castellazzi, A.M.;Casini, L.;Creston, D.;Gremokolini, C.
    • Asian-Australasian Journal of Animal Sciences
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    • v.14 no.8
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    • pp.1138-1143
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    • 2001
  • A total of 96 piglets were weaned at 19 and 13 days in Exp. 1 and 2, respectively, and allotted to one of four diets: three with different spray dried plasmas (SPs) and one with hydrolysed casein (HC). SPs were from pigs (SPP), mixed origin (SMP), and mixed origin with standardized level of immunoglobulins (SMPIG). All the diets contained 1.7% total lysine, 25% of the test protein source, 45% corn starch, 15% lactose, 2% sucrose, 7% soybean oil. At d 4 and d 2 in Exp. 1 and 2, respectively, piglets were perorally challenged with $10^{10}$ CFU E. coli K88. Growth performance, immunity, and health condition were measured for 15 days and 14 days in Exp. 1 and 2, respectively. To investigate apparent ileal digestibility and nutrient deposition, all piglets were sacrificed at d 14 in Exp. 2. In 1. 3 piglets died in HC diet and 1 in SPP diet. HC diet showed higher mortality (p<0.01) than other diets. In Exp. 2, no clinical sign of infection was detected, no difference for the content of E. coli K88 was found in feces at 4 and 6 days after the infection, and no E. coli K88 was found in the jejunum at the end of experiment. In both experiments, feed intake was lower for HC diet and ADG was 96, 106, 122 and 155 for HC, SPP, SMP and SMPIG diet, respectively (HC vs others, p<0.05; SMPIG vs other SP, p<0.01). Heal apparent digestibility of nitrogen in sacrificed piglets was higher for HC diet (p<0.05). After the challenge, K88-specific titers in saliva (Exp. 1) and in plasma (Exp. 2) were reduced in SMP and SMPIG. The piglets positive to the adhesion of the used E. coli strain to the intestinal brush borders had a significantly reduced growth (p<0.01) and a higher K88-specific IgA titer in plasma, in comparison with negative ones. This effect was independent of the diet. The data show the relevance of spray dried plasma sources and particularly of SP with standardized level of immunoglobulins for the feeding of early-weaned at the risk of infection by enterotoxigenic bacteria.

Incidences of Lower Extremity Injuries in Korea (국내 하지손상의 발생현황에 대한 분석)

  • Kim, Chang Sun;Choi, Hyuk Joong;Kim, Jai Yong;Shin, Sang Do;Koh, Sang Baek;Lee, Kug Jong;Im, Tai Ho
    • Journal of Trauma and Injury
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    • v.21 no.1
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    • pp.36-45
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    • 2008
  • Purpose: We conducted this retrospective epidemiological study to assess the incidence and severity of lower extremity injuries in Korea Methods: For this study, we retrospectively reviewed nationwide lower-extremity injury data compiled from 2001 to 2003 based on the National Injury Database, what included National Health Insurance Corporation (NHIC), Car Insurance, and Industry Insurance data. Data were standardized in terms of demographic characteristics, region, and socioeconomic status by using NHIC data. To assess the degree of the injuries, we used the Modified Abbreviated Injury Scale (MoAIS), what has been changed from the International Classification of Disease-10 (ICD-10) code. By using the Excess Mortality Ratio-adjusted Injury Severity Score (EMR-ISS), we classified the degree of severity into four categories: mild, moderate, severe and critical. Results: From 2001 to 2003, lower extremity injuries increased slightly, with a yearly average of 2,437,335. Insurance data should that lower-extremity injuries were the most common, followed by upper-extremity injuries. Significant difference were seen in the numbers of lower extremity injuries based on gender and age. As for provinces, Seoul and Gyeongi provinces had the highest numbers of cases. Junlabukdo had the highest rate of 55,282 cases per 1 million people for standardized gender and population. The annual incidence of the insured patients with lower extrimity injuries was higher than the employer's medical insurance contributions to the medical insurance program. Daily cases occur most often in May and June, with the lowest occurrences being in January and February. Conclusion: The result of this study shows that lower extremity injuries comprised common cause of all injuries. In addition, differences associated with gender, location and socioeconomic status were observed. Further studies are needed to find reasons and then this knowledge will allow strategies to prevent the lower extremity injuries.

Testicular Cancer and Testicular Self-Examination; Knowledge, Attitudes and Practice in Final Year Medical Students in Nigeria

  • Ugwumba, Fred O;Ekwueme, Osa Eloka C;Okoh, Agharighom D
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.11
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    • pp.4999-5003
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    • 2016
  • The testicular cancer (TCa) incidence is increasing in many countries, with age-standardized incidence rates up to 7.8/100,000 men in the Western world, although reductions in mortality and increasingly high cure rates are being witnessed at the same time. In Africa, where rates are lower, presentation is often late and morbidity and mortality high. Given this scenario, awareness of testicular cancer and practice of testicular self-examination among future first response doctors is very important. This study was conducted to determine knowledge and attitude to testicular cancer, and practice of testicular self-examination (TSE) among final (6th) year medical students. In addition, the effect of an intervention in the form of a single PowerPoint(R) lecture, lasting 40 minutes with image content on testicular cancer and testicular self examination was assessed. Pre and post intervention administration of a self-administered structured pre tested questionnaire was performed on 151 medical students, 101 of whom returned answers (response rate of 66.8%). In the TC domain, there was a high level of awareness of testicular cancer, but poor knowledge of the age group most affected, with significant improvement post intervention (p<0.001). Notable also was the poor awareness of the potential curability of TC, this also being improved following the intervention (p<0.001). A poor level of awareness and practice of testicular self-examination pre-intervention was found considering the nature of the study group..Respondents had surprisingly weak/poor responses to the question "How important to men's health is regular testicular self-examination?" Answers to the questions "Do you think it is worthwhile to examine your testis regularly?" and "Would you be interested in more information on testicular cancer and testicular self-examination?" were also suboptimal, but improved post intervention p<0.001, p<0.001 and p=0.037. Age, gender and marital status were without specific influence. In conclusion, this study showed poor levels of knowledge regarding epidemiology of TCa and its potential curability when detected early. There was also a poor awareness of, practice of, and poor attitudes to TSE. The significant improvement in these parameters post intervention indicates value in educational intervention. We recommend inclusion of TCa coverage and TSE teaching in the secondary school curriculum (targeting adolescents). Greater emphasis should also be given to testicular cancer in the curricula of medical schools and other training institutions for health care personnel.

The study for the Epidemiologic Characteristics of Cancer Patients in Jeju Special Self-governing Province (제주특별자치도 암 환자의 역학적인 특성에 관한 연구)

  • Chang, Weon-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.2
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    • pp.1292-1303
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    • 2015
  • Jeju province is the highest area about obesity(1st), alcohol consumption(2nd) and male smoking(2nd) among sixteen Korean provinces by the report of Statistics Korea: 2013 community health survey. Therefore, it is assumed that the incidence rate of colon, liver, lung and breast cancer can be high. The purpose of this study is to test these cancer's incidence and mortality trends and compare comparability with national average. The Joinpoint regression model and permutation tests for identifying changes and parallelism in trend were used to test registered data at Jeju Regional Cancer Registry from 1999 to 2012. In male colorectal cancer, Average Age Percent Change(AAPC) of Age-Standardized incidence Rate(ASR) was 8.4% per year(p-value<.000) and the hypothesis of parallelism with Korean male average was rejected because of steep increasing of Jeju male patients' AAPC(p-value=.047). In male liver cancer, AAPC of ASR was -2.98 % per year(p-value<.000) and parallelism with Korean male average was rejected because of sluggish decreasing of Jeju(p-value=.026). In male lung cancer, the ASR parallelism with Korean male average was rejected(p-value=.009) because Jeju patients APC(4.37% per year) was increased during 2006~2012. This study demonstrates that AAPC and Trends of male colon, male lung and male liver were difference from national average. Further studies are needed to understand its causes.

Breast Lesions in Adolescents and Young Women in Pakistan - a 5 Year Study of Significance of Early Recognition

  • Khurshid, Amna;Faridi, Naveen;Arif, Afreen M.;Naqvi, Hanna;Tahir, Muhammad
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3465-3467
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    • 2013
  • Background: Breast cancer is the most frequent malignant disease amongst young women. If we review local data in Pakistan then breast cancer represents approximately a third of all cancers in females. The age standardized incidence rate (ASR) world per 100,000 is 53.8 and crude incidence rate is 30.9. We have observed during our surgical pathology practice and it is also reported by other Asian studies that breast carcinoma is amongst the leading malignancies in the region and the patients are at least a decade younger than counterparts in developed nations. Age is an important issue in effective screening, diagnosis and management of breast cancer, especially in this geographical region where late presentation and poor prognosis are a hallmark of the disease. Objective: The aim of this study is to determine the frequency of malignant breast lesions in symptomatic young females presenting with breast lumps. Materials and Methods: This is a retrospective study conducted at the Pathology Department, Liaquat National Hospital and Medical College, Karachi. Descriptive and pathology data of malignant breast tumors 1st January 2004 to 31st December 2009 were reviewed, using the departmental archived data. It included both male and female patients up to the age of 25 years. Results: A total of 714 surgical specimens from/of symptomatic breast lesions were received at the pathology department of Liaquat National Medical, in the five years study period, in young females. There were 575 (80%) benign, 119 (16%) inflammatory and 20 (2.8%) malignant lumps. Conclusions: The obtained data for females only up to 25 years of age suggest a massive burden which requires urgent attention. Early assessment of lesions is essential in order to avoid mortality from malignancies.

Epidemiologic study of injury and poisoning occurrence in a rural area (일부 농촌지역 손상 및 중독 발생에 관한 역학적 연구)

  • Yoon, Hi-Seop
    • Research in Community and Public Health Nursing
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    • v.10 no.2
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    • pp.467-479
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    • 1999
  • The mortality and morbidity caused by injury and poisoning has been major public health problem in Korea. This study was carried out to get information indispensable in developing prevention srategies peculiar to korean rural area. In this study 1.499 people of 496 households. who are living in five rural villages of Chooncheon City. Kang-Won Province. were interviewed in accordance with structured questionaire in 1996. The results obtained are summarized as follows: 1. The age-standardized annual incidence rates of injury and poisoning per 100 persons surveyed were 4.2 in males and 1.9 in females. The difference between sex was statistically significant. 2. The places where most of injuries and poisonings occurred were road 66.7% among males. road 31.6% among females. 3. The occurrence of the injuries and poisonings were clustered in intensive farming season in both males and females. 4. The laceration and stab wound were the most frequent nature of injuries in males and the fracture was the most frequent nature of injuries in females. The fracture. sprain were more frequent among males but sprain and contusion were more frequent among females. 5. Incidence rates of injuries and poisoning by cause were higher in traffic accidents among males. though falls among females. The cause specific incidence rate by age was high in traffic accident for 30-59 year age group. and for the aged people older than 60 years. 6. In the management pattern, 78.8% of the injuries and poisoning were received medical care in hospitals and clinics, and the duration of the treatment over 4 weeks in 37.0%. The results obtained indicate that organized community effort is urgently required to prevent injuries and poisonings in rural area.

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The impact of a quality improvement effort in reducing admission hypothermia in preterm infants following delivery

  • Choi, Han Saem;Lee, Soon Min;Eun, Hoseon;Park, Minsoo;Park, Kook-In;Namgung, Ran
    • Clinical and Experimental Pediatrics
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    • v.61 no.8
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    • pp.239-244
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    • 2018
  • Purpose: Hypothermia at admission is associated with increased mortality and morbidity in preterm infants. We performed a quality improvement (QI) effort to determine the impact of a decrease in admission hypothermia in preterm infants. Methods: The study enrolled very low birth weight (VLBW) infants born at Gangnam Severance Hospital between January 2013 and December 2016. This multidisciplinary QI effort included the use of occlusive wraps, warm blankets, and caps; the delivery room temperature was maintained above $23.0^{\circ}C$, and a check-list was used for feedback. Results: Among 259 preterm infants, the incidence of hypothermia (defined as body temperature <$36.0^{\circ}C$) decreased significantly from 68% to 41%, and the mean body temperature on neonatal intensive care unit admission increased significantly from $35.5^{\circ}C$ to $36.0^{\circ}C$. In subgroup analysis of VLBW infants, admission hypothermia and neonatal outcomes were compared between the pre-QI (n=55) and post-QI groups (n=75). Body temperature on admission increased significantly from $35.4^{\circ}C$ to $35.9^{\circ}C$ and the number of infants with hypothermia decreased significantly from 71% to 45%. There were no cases of neonatal hyperthermia. The incidence of pulmonary hemorrhage was significantly decreased (P=0.017). Interaction analysis showed that birth weight and gestational age were not correlated with hypothermia following implementation of the protocol. Conclusion: Our study demonstrated a significant reduction in admission hypothermia following the introduction of a standardized protocol in our QI effort. This resulted in an effective reduction in the incidence of massive pulmonary hemorrhage.