• Title/Summary/Keyword: Systemic risk

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Health Education for Disease-Prevention by the Insurer (보험자가 질병예방차원에서 실시하는 건강교육 개선방안)

  • 유승흠;노지영;이해종;이명선;정상혁
    • Korean Journal of Health Education and Promotion
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    • v.6 no.1
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    • pp.11-21
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    • 1989
  • Among disease prevention methods, health education is an excellent and effective method low cost. However, enforcing health education has the following limitations: there is little health education for the supported, health education disregards the characteristics of those educated, education materials are not specified and published satistactorily, and so on. This study suggests systemic health education planning to the Korea Medical Insurance Corporation. The special methods are as follows: 1. Health education for primary prevention a. We educate the insured who are judged to be normal by the results of health screening, dividing them into three groups:completely healthy status, emotionally disturbed status, and early pathologic status. b. We educate the insured characteristically according to occupational disease. c. In an advanced sense, we educate the insured according to their health condition and occupational status. 2. Health education for secondary and tertiary prevention We educate the insured who are judged to be inn a risk group or to be disease group according to the results of health screening. a. Health education for the risk group By health education on elimination of the risk factors, the risk group can be prevented from the disease. b. Health education for the disease group By health education on the therapeutic process and the method of rehabilitation, the disease group can return to the previous state. We conclude that: 1). Reimbursement for preventive activities{health interview, health education) must be realized. 2) A special organization for health education must be established. 3) All of the insured must be educated and managed during their lifetime by a new special organization.

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Risk Factors for the Prevalence of Periodontal Diseases among Adult Workers (성인 근로자의 치주질환 유병 관련 위험요인)

  • Hong, Min-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.6
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    • pp.3706-3713
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    • 2014
  • This study examined the demographic and oral behavioral risk factors for periodontal disease in adult workers. The research subjects and method were conducted targeting 1,650 Korean adult workers aged 20-64 utilizing the data from the fifth Korea National Health and Nutrition Examination Survey (KNHANES V-3). As a result of this study, the periodontal tissue patients showed the risk factors for gender, age, income level, educational level, systemic disease, sleep hours, oral health level, biting trouble, and chewing difficulty. In terms of the greatest influence, the workers with problems with biting and chewing had a more than 3.5 times higher likelihood of being affected by periodontal disease. The findings of this study show that there are a variety of risk factors for periodontal diseases in Korean workers. To reduce the prevalence rate of periodontal disease, regular checkups including dental checkups and sufficient sleeping will be necessary, and the level of stress should be decreased. In addition, the government should take the required measures to remove the socioeconomic inequality, such as income gap or educational divide.

Association of Serum HE4 with Primary Tumor Diameter and Depth of Myometrial Invasion in Endometrial Cancer Patients at Rajavithi Hospital

  • Prueksaritanond, Nisa;Cheanpracha, Patchara;Yanaranop, Marut
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1489-1492
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    • 2016
  • Background: Although there are no biomarkers that are routinely used in endometrial cancer (EC) management, many studies have found that serum human epididymis protein 4 (HE4) is superior to cancer antigen 125 (CA125) in the detection of EC. The correlation of HE4 with two prognostic factors for EC, primary tumor diameter (PTD) and depth of myometrial invasion (DMI) may be useful in identifying EC patients at high risk of lymphatic dissemination. Objective: To evaluate the correlation of serum HE4 with PTD and DMI in patients with EC. Materials and Methods: A cross-sectional study was conducted on 70 EC patients who were scheduled for elective surgery at Rajavithi Hospital between 1st September 2013 and 30th May 2014. Preoperative serum levels of HE4 and CA125 were investigated, and then gross measurement of PTD was taken and postoperative pathologic slides were reviewed for DMI including histologic types, grading and staging. Results: Preoperative serum HE4 levels were strongly correlated with PTD (r=0.65, p<0.001) and moderately correlated with DMI (r=0.46, p<0.001). Moreover, serum HE4 levels were significantly elevated in EC patients with PTD >2 cm (p<0.001) and DMI > 50% (p=0.004). The performance of serum HE4 in identifying EC patients at low risk and high risk of lymph node metastasis was significantly better than that of CA125 (AUC 0.88 vs. 0.65, p=0.003). At an optimal cut-off value of 70 pM/L, serum HE4 had a sensitivity of 83.3% and a specificity of 80.0%. Conclusions: In EC patients, preoperative serum HE4 is significantly correlated with PTD and DMI. Serum HE4 levels could be useful in identifying endometrial cancer patients at high risk of lymphatic spread who would benefit from systemic lymphadenectomy at the cut-off value of 70 pM/L.

The association Between Occupational Exposure to silica and Risk of Developing Rheumatoid Arthritis: A Meta-Analysis

  • Mehri, Fereshteh;Jenabi, Ensiyeh;Bashirian, Saeed;Shahna, Farshid Ghorbani;Khazaei, Salman
    • Safety and Health at Work
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    • v.11 no.2
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    • pp.136-142
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    • 2020
  • Background: Rheumatoid arthritis (RA) is an autoimmune disease with systemic inflammatory arthritis. This meta-analysis was conducted to examine the association between occupational exposure to silica and the risk of developing RA among different workers. Methods: In this meta-analysis, we searched relevant published studies using major electronic databases including Scopus, PubMed, ISI Web of Science, and Google Scholar search engine up to October 2019, and the references of retrieved articles were also checked for further possible sources. A random-effects model was used to account for heterogeneity among the results of the studies using the pooled odds ratios (ORs) and their 95% confidence intervals (CIs). The Q-statistic and I2 tests were calculated to assess heterogeneity between the studies. Results: The pooled calculation of OR indicated a significant association between occupational exposure to silica and risk of developing RA among different workers (OR = 2.59, 95% CI = 1.73 to 3.45). In addition, the pooled estimates of OR in smokers were statistically significant (OR = 2.49, 95% CI = 1.13 to 3.86). Conclusions: The findings of the present study reveal that occupational exposure to silica may be associated with increased risk of developing RA.

Metastasis Risk Reduction Related with Beta-Blocker Treatment in Mexican Women with Breast Cancer

  • Parada-Huerta, E;Alvarez-Dominguez, TP;Uribe-Escamilla, R;Rodriguez-Joya, JF;Ponce-Medrano, JA Diaz;Padron-Lucio, S;Alfaro-Rodriguez, A;Bandala, C
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2953-2957
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    • 2016
  • Background: Breast Cancer (BCa) is the most common malignant tumour in Mexican women. In BCa, several studies have linked ${\beta}2-adrenergic$ receptor activation with increased tumour growth and progression as related with Epinephrine-NorEpinephrine (E-NE) stimulation. The aim of this study was to describe Beta-Blocker (BB) treatment related with reduction of the risk of metastasis in Mexican patients with BCa. Materials and Methods: We collected data of 120 patients seen at the High-Specialty Naval General Hospital in Mexico City (HOSGENAES), all of these with a histopathological diagnosis of BCa. Four groups of patients were divided as follows: without Systemic Arterial Hypertension (SAH); with SAH treatment with non-selective BB; with SAH treatment with selective BB, and with SAH treatment with other antihypertensive drugs. Chi-square, Mantel-Haenszel, Student t, and ANOVA tests were performed for data analysis. Results: On average, patients were $54.8{\pm}11.8$ years of age. Risk factors such as smoking and consuming alcohol exhibited a frequency of 33 and 36.5% respectively. Clinical stages III- IV were found in 50% of patients, while, 30% of patients had arterial hypertension (n=29 and N=96, respectively) and 17.5% used BB. One hundred percent of patients with arterial hypertension treated with BB for ${\beta}1$ - and ${\beta}2$ -adrenergic-receptors did not present metastasis globally, but patients treated with ${\beta}1$ BB presented 30% of metastasis while patients treated with no BB or without SAH had around 70% of metastasis. Conclusions: In Mexican patients with BCa and SAH treated with non-selective (${\beta}1$- and ${\beta}2-adrenergic$ receptors) BB, a decrease in the risk for metastasis was observed at the time of diagnosis.

Risk Assessment of Triclosan, a Cosmetic Preservative

  • Lee, Jung Dae;Lee, Joo Young;Kwack, Seung Jun;Shin, Chan Young;Jang, Hyun-Jun;Kim, Hyang Yeon;Kim, Min Kook;Seo, Dong-Wan;Lee, Byung-Mu;Kim, Kyu-Bong
    • Toxicological Research
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    • v.35 no.2
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    • pp.137-154
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    • 2019
  • Triclosan (TCS) is an antimicrobial compound used in consumer products. The purpose of current study was to examine toxicology and risk assessment of TCS based on available data. Acute toxicities of oral, transdermal and inhalation routes were low, and phototoxicity and neurotoxicity were not observed. Topical treatment of TCS to animal caused mild irritation. TCS did not induce reproductive and developmental toxicity in rodents. In addition, genotoxicity was not considered based on in vitro and in vivo tests of TCS. It is not classified as a carcinogen in international authorities such as International Agency for Research on Cancer (IARC). No-observed-adverse-effect level (NOAEL) was determined 12 mg/kg bw/day for TCS, based on haematoxicity and reduction of absolute and relative spleen weights in a 104-week oral toxicity study in rats. Percutaneous absorption rate was set as 14%, which was human skin absorption study reported by National Industrial Chemicals Notification and Assessment Scheme (NICNAS) (2009). The systemic exposure dosage (SED) of TCS has been derived by two scenarios depending on the cosmetics usage of Koreans. The first scenario is the combined use of representative cosmetics and oral care products. The second scenario is the combined use of rinse-off products of cleansing, deodorants, coloring products, and oral care products. SEDs have been calculated as 0.14337 mg/kg bw/day for the first scenario and 0.04733 mg/kg bw/day for the second scenario. As a result, margin of safety (MOS) for the first and second scenarios was estimated to 84 and 253.5, respectively. Based on these results, exposure of TCS contained in rinse-off products, deodorants, and coloring products would not pose a significant health risk when it is used up to 0.3%.

Risk Assessment of Ethylhexyl Dimethyl PABA in Cosmetics

  • Sung, Chi Rim;Kim, Kyu-Bong;Lee, Joo Young;Lee, Byung-Mu;Kwack, Seung Jun
    • Toxicological Research
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    • v.35 no.2
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    • pp.131-136
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    • 2019
  • Ethylhexyl dimethyl para-aminobenzoic acid (PABA) is an oily yellow liquid derivative of water-soluble PABA commonly used in sunscreen. Ethylhexyl dimethyl PABA is widely used as an ingredient in many cosmetics at an average concentration of 1.25% (0.5-2.0%) in Korea. Previous studies, including those involving animals, have demonstrated that ethylhexyl dimethyl PABA is toxic to the following four organs: testis, epididymis, spleen, and liver. In addition, experiments using human keratinocytes found that ethylhexyl dimethyl PABA inhibits cell growth and DNA synthesis at low concentrations, and halted the cell cycle of MM96L cells (human melanoma cell line) at the G1 phase. Despite limited clinical data in humans, many studies have confirmed increased mutagenicity of ethylhexyl dimethyl PABA following exposure to sunlight, which suggests that this molecule is likely to contribute to onset of sun-induced cancer despite protecting the skin through absorption of UVB. For risk assessment, the no observed adverse effect level (NOAEL) chosen was 100 mg/kg bw/day in a 4 weeks oral toxicity study. Systemic exposure dosage (SED) was 0.588 mg/kg bw/day for maximum use of ethylhexyl dimethyl PABA in cosmetics. Based on the risk assessment and exposure scenarios conducted in this study, the margin of safety (MOS) was calculated to be 180.18 for a sunscreen containing 8% ethylhexyl dimethyl PABA, which is the maximum level allowed by the relevant domestic authorities.

Evaluation of failed implants and reimplantation at sites of previous dental implant failure: survival rates and risk factors

  • Park, Yu-Seon;Lee, Bo-Ah;Choi, Seong-Ho;Kim, Young-Taek
    • Journal of Periodontal and Implant Science
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    • v.52 no.3
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    • pp.230-241
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    • 2022
  • Purpose: The purpose of this study was to evaluate failed implants and reimplantation survival and to identify the relative risk factors for implant re-failure. Methods: Ninety-one dental implants were extracted between 2006 and 2020 at the National Health Insurance Service Ilsan Hospital, including 56 implants in the maxilla and 35 implants in the mandible that were removed from 77 patients. Patient information (e.g., age, sex, and systemic diseases) and surgical information (e.g., the date of surgery and location of the implants and bone grafts) were recorded. If an implant prosthesis was used, prosthesis information was also recorded. Results: In total, 91 first-time failed dental implants in 77 patients were analyzed. Of them, 69 implants in 61 patients received reimplantation after failure. Sixteen patients (22 implants) refused reimplantation or received reimplantation at a different site. Eight of the 69 reimplants failed again. The 1-year survival rate of the 69 reimplants was 89.4%. Age at reimplantation and smoking significantly increased the risk of reimplantation failure. However, a history of taking anti-thrombotic agents showed a statistically significant negative association with reimplantation failure. Of the failed implants, 66% showed early failure and 34% showed late failure of the initial implantation. All 8 re-failed implants showed early failure. Only 3 of these 8 failed reimplants were re-tried and the second reimplants all survived. Conclusions: The total survival rate of implants, which included reimplants and second reimplants was 99.2%, although the survival rate of the initial implantations was 96.3%. Previous failure did not affect the success of the next trial. Reimplantation failure was more strongly affected by patient factors than by implant factors. Therefore, each patient's specific factors need to be meticulously controlled to achieve successful reimplantation.

Gastrointestinal Bleeding in Extracorporeal Membrane Oxygenation Patients: A Comprehensive Analysis of Risk Factors and Clinical Outcomes

  • Sahri Kim;Jung Hyun Lim;Ho Hyun Ko;Lyo Min Kwon;Hong Kyu Lee;Yong Joon Ra;Kunil Kim;Hyoung Soo Kim
    • Journal of Chest Surgery
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    • v.57 no.2
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    • pp.195-204
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    • 2024
  • Background: Extracorporeal membrane oxygenation (ECMO) is an intervention for severe heart and lung failure; however, it poses the risk of complications, including gastrointestinal bleeding (GIB). Comprehensive analyses of GIB in patients undergoing ECMO are limited, and its impact on clinical outcomes remains unclear. Methods: This retrospective study included 484 patients who received venovenous and venoarterial ECMO between January 2015 and December 2022. Data collected included patient characteristics, laboratory results, GIB details, and interventions. Statistical analyses were performed to identify risk factors and assess the outcomes. Results: GIB occurred in 44 of 484 patients (9.1%) who received ECMO. Multivariable analysis revealed that older age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.01-1.06; p=0.0130) and need to change the ECMO mode (OR, 3.74; 95% CI, 1.75-7.96; p=0.0006) were significant risk factors for GIB, whereas no association was found with antiplatelet or systemic anticoagulation therapies during ECMO management. Half of the patients with GIB (22/44, 50%) underwent intervention, with endoscopy as the primary modality (19/22, 86.4%). Patients who underwent ECMO and developed GIB had higher rates of mortality (40/44 [90.9%] vs. 262/440 [59.5%]) and ECMO weaning failure (38/44 [86.4%] vs. 208/440 [47.3%]). Conclusion: GIB in patients undergoing ECMO is associated with adverse outcomes, including increased risks of mortality and weaning failure. Even in seemingly uncomplicated cases, it is crucial to avoid underestimating the significance of GIB.

Study on Detection of Oral Bacteria in the Saliva and Risk Factors of Adults (성인의 타액 내 구강세균 검출과 위험요인에 관한 연구)

  • Hong, Min-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.9
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    • pp.5675-5682
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    • 2014
  • As oral diseases are developed by mixed infections, not by any single element, an accurate analysis of the causative microorganisms related to dental caries and periodontal diseases is required. In this study, saliva was collected from selected adults to determine if the bacteria that are well known as the causative microorganisms of dental caries and periodontal diseases would be detected in their saliva. In addition, this study examined whether there would be any differences among adults according to age, smoking, drinking and presence or absence of diseases in the distribution of oral bacteria to determine the risk factors for oral bacteria. The study subjects were 120 adults ranging in age from 20 to 65 years. The experiment data was collected from March 15, to May 2014. The gDNA was collected from the saliva, and the distribution of bacteria for oral diseases was investigated by PCR. The findings of the study were as follows. S. mutans was detected from 72 adults, and P. intermedia was detected from 88 adults. Both bacteria were detected from 54 adults, and no oral bacteria was detected in 14 adults. An analysis of the risk factors of oral bacteria showed that smokers had a 2.8-fold higher risk of S. mutans than nonsmokers, and the former had a 3.5-fold higher risk of P. intermedia than the latter. Drinkers had a 3.3-fold higher risk of S. mutans than nondrinkers. Patients who suffered from systemic diseases had a 4.1-fold higher risk of P. intermedia than those with no diseases. Therefore, smoking, drinking and systemic diseases are factors that increase the likelihood of oral bacteria detection. More periodontal disease bacteria were detected from older adults, and more oral bacteria were found in adults who were in their 20s, as dental caries and periodontal diseases were more common in this age group. The adults in which oral bacteria were detected are more likely to have dental caries or periodontal diseases, and they should try to keep their mouth cavity clean and make regular visits to a dental clinic to prevent possible oral diseases.