• Annals of Laboratory Medicine
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• v.38 no.6
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• pp.518-523
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• 2018

Background: Lipemia, a significant source of analytical errors in clinical laboratory settings, should be removed prior to measuring biochemical parameters. We investigated whether lipemia in serum/plasma samples can be removed using a method that is easier and more practicable than ultracentrifugation, the current reference method. Methods: Seven hospital laboratories in Spain participated in this study. We first compared the effectiveness of ultracentrifugation ($108,200{\times}g$) and high-speed centrifugation ($10,000{\times}g$ for 15 minutes) in removing lipemia. Second, we compared high-speed centrifugation with two liquid-liquid extraction methods-LipoClear (StatSpin, Norwood, USA), and 1,1,2-trichlorotrifluoroethane (Merck, Darmstadt, Germany). We assessed 14 biochemical parameters: serum/plasma concentrations of sodium ion, potassium ion, chloride ion, glucose, total protein, albumin, creatinine, urea, alkaline phosphatase, gamma-glutamyl transferase, alanine aminotransferase, aspartate-aminotransferase, calcium, and bilirubin. We analyzed whether the differences between lipemia removal methods exceeded the limit for clinically significant interference (LCSI). Results: When ultracentrifugation and high-speed centrifugation were compared, no parameter had a difference that exceeded the LCSI. When high-speed centrifugation was compared with the two liquid-liquid extraction methods, we found differences exceeding the LCSI in protein, calcium, and aspartate aminotransferase in the comparison with 1,1,2-trichlorotrifluoroethane, and in protein, albumin, and calcium in the comparison with LipoClear. Differences in other parameters did not exceed the LCSI. Conclusions: High-speed centrifugation ($10,000{\times}g$ for 15 minutes) can be used instead of ultracentrifugation to remove lipemia in serum/plasma samples. LipoClear and 1,1,2-trichlorotrifluoroethane are unsuitable as they interfere with the measurement of certain parameters.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.5
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• pp.289-294
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• 2019

Background: Pain, limitations in opening, asymmetrical jaw movements, and temporomandibular joint (TMJ) sounds are the most common findings in temporomandibular joint disorders (TMDs), which causes excruciating pain, inflammation of the surrounding muscles, posterior fibers, and synovial fluid. This study aimed to evaluate and compare the effects of ultrasound heat therapy and low-level laser therapy (LLLT) in reducing TMD-related pain. Methods: This prospective study included 42 patients (age range, 25-45 years), who were divided into two groups of 21 patients each. All patients were prescribed a non-steroidal anti-inflammatory drug (NSAID) twice a day for 5 days for temporary relief of pain prior to the commencement of treatment. Patients were kept on a soft diet and asked to restrict mouth opening during the same period. Fifteen sessions of LLLT (Group A) or ultrasound therapy (Group B) were administered to the affected side. Results: Post-therapy, the mean visual analog scale score for group A and group B was 4.81 (2.01) and 6.19 (1.20), respectively; the difference was statistically significant and favoring the LLLT group. Similarly, the mean mouth opening for group A and group B was 3.99 (0.40) and 3.65 (0.41), respectively; the difference was statistically significant and favoring the LLLT group. Conclusion: Our study recommends LLLT for treating TMD-related pain with no underlying bony pathology.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.1
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• pp.1700-1705
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• 2019

Background: Mild cognitive impairment (MCI) is also called as aging related memory damage. Decreased cognitive function due to aging is known to be associated with the frontal lobe. Alpha wave is generated in the dominance in the frontal lobe or a wide range of regions in the brain, it should be doubted that the brain function might be degraded. Objective: To determine the effect of sensory stimulation type on learning and brain activity pattern of elderly persons with MCI. Design: Randomized Controlled Trial (single blind) Methods: Twenty elderly persons aged more than 65 with MCI were randonmized to simultaneous visual/auditory stimulation group (SVASG) and or auditory stimulation group (ASG). Ten peoples were assigned to each group and lectroencephalogram test was performed to individuals. In the electroencephalogram test, electroencephalography of prior to sensory stimulation, and during sensory stimulation were measured to compare brain activity pattern according to the study groups and measurement period. Results: The relative alpha power due to a sensory stimulation type showed that the SVASG significantly decreased in the left frontal lobe and the left parietal lobe statistically compared to those of the ASG while sensory stimulation was given (p<.05). The relative beta power due to a sensory stimulation type showed that the SVASG significantly increased in the left and right frontal lobes, the left and right parietal lobes, and the left temporal lobe statistically compared to those of the ASG while sensory stimulation was given (p<.05). Conclusions: Electroencephalographic analysis showed that the type of sensory stimulation can affect the brain activity pattern. However, the effects were not studied that which brain activity pattern help to improved cognitive function of elderly persons with mild cognitive impairment.

• Safety and Health at Work
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• v.5 no.4
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• pp.191-197
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• 2014

Background: Disabling fatigue is common in the working age population. It is essential that occupational health (OH) professionals are up-to-date with the management of fatigue in order to reduce the impact of fatigue on workplace productivity. Our aim was to evaluate the impact of one-day workshops on OH professionals' knowledge of fatigue and chronic fatigue syndrome (CFS), and their confidence in diagnosing and managing these in a working population. Methods: Five interactive problem-based workshops were held in the United Kingdom. These workshops were developed and delivered by experts in the field. Questionnaires were self-administered immediately prior to, immediately after, and 4 months following each workshop. Questionnaires included measures of satisfaction, knowledge of fatigue and CFS, and confidence in diagnosing and managing fatigue. Open-ended questions were used to elicit feedback about the workshops. Results: General knowledge of fatigue increased significantly after training (with a 25% increase in the median score). Participants showed significantly higher levels of confidence in diagnosing and managing CFS (with a 62.5% increase in the median score), and high scores were maintained 4 months after the workshops. OH physicians scored higher on knowledge and confidence than nurses. Similarly, thematic analysis revealed that participants had increased knowledge and confidence after attending the workshops. Conclusion: Fatigue can lead to severe functional impairment with adverse workplace outcomes. One-day workshops can be effective in training OH professionals in how to diagnose and manage fatigue and CFS. Training may increase general knowledge of fatigue and confidence in fatigue management in an OH setting.

• Journal of Korean Dental Hygiene Science
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• v.3 no.1
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• pp.15-24
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• 2020

Background: The program aims to enable the participants to receive oral health care with sustainability and give them the choice and prior autonomy of dental practitioners while enhancing the benefits of sustainability. The purpose of this study is to investigate the necessity, awareness, and satisfaction of the implementation of the registered dentist program for children and adolescents, and to promote the introduction of RDPCA. Methods: The survey targeted adult residents in their 20s or older who live in Seoul, an area that continuously implements the RDPCA system, especially in the cities of Cheonan and Asan Results: 79.7% were the most unaware. However, RDPCA participants were significantly more aware than non-participants. When surveying the desire to participate in RDPCA, 96.6% of the respondents said they would 'participate' in the non-RDPCA participate group. The analysis of the satisfaction level of the RDPCA received by their children indicated that 48.6% expressed their satisfaction, and 47.3% said they were healthy. There was a high percentage of people who said they would recommend RDPCA to others as well as a high rate of those who said they would continue to use RDPCA. Conclusions: The reality is that the awareness and implementation of RDPCA are low. For the development of oral health care programs for all children and adolescents in Korea, and the improvement of the satisfaction level of the dental care system, there should be an active consideration of high-quality programs and.

• Health Policy and Management
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• v.31 no.4
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• pp.451-461
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• 2021

Background: Readmissions related to lack of quality care harm both patients and health insurance finances. If the factors affecting readmission are identified, the readmission can be managed by controlling those factors. This paper aims to identify factors that affect readmissions of convalescent rehabilitation patients. Methods: Health Insurance Review and Assessment Service claims data were used to identify readmissions of convalescent patients who were admitted in hospitals and long-term care hospitals nationwide in 2018. Based on prior research, the socio-demographics, clinical, medical institution, and staffing levels characteristics were included in the research model as independent variables. Readmissions for convalescent rehabilitation treatment within 30 days after discharge were analyzed using logistic regression and generalization estimation equation. Results: The average readmission rate of the study subjects was 24.4%, and the risk of readmission decreases as age, length of stay, and the number of patients per physical therapist increase. In the patient group, the risk of readmission is lower in the spinal cord injury group and the musculoskeletal system group than in the brain injury group. The risk of readmission increases as the severity of patients and the number of patients per rehabilitation medicine specialist increases. Besides, the readmission risk is higher in men than women and long-term care hospitals than hospitals. Conclusion: "Reducing the readmission rate" is consistent with the ultimate goal of the convalescent rehabilitation system. Thus, it is necessary to prepare a mechanism for policy management of readmission.

• Clinical and Experimental Pediatrics
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• v.64 no.2
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• pp.80-85
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• 2021

Background: Although identifying cases in large administrative databases may aid future research studies, previous reports demonstrated that the use of the International Classification of Diseases, Tenth Revision (ICD-10) code alone for diagnosis leads to disease misclassification. Purpose: We aimed to assess the value of the ICD-10 diagnostic code for identifying potential children with biliary atresia. Methods: Patients aged <18 years assigned the ICD-10 code of biliary atresia (Q44.2) between January 1996 and December 2016 at a quaternary care teaching hospital were identified. We also reviewed patients with other diagnoses of code-defined cirrhosis to identify more potential cases of biliary atresia. A proposed diagnostic algorithm was used to define ICD-10 code accuracy, sensitivity, and specificity. Results: We reviewed the medical records of 155 patients with ICD-10 code Q44.2 and 69 patients with other codes for biliary cirrhosis (K74.4, K74.5, K74.6). The accuracy for identifying definite/probable/possible biliary atresia cases was 80%, while the sensitivity was 88% (95% confidence interval [CI], 82%-93%). Three independent predictors were associated with algorithm-defined definite/probable/possible cases of biliary atresia: ICD-10 code Q44.2 (odds ratio [OR], 2.90; 95% CI, 1.09-7.71), history of pale stool (OR, 2.78; 95% CI, 1.18-6.60), and a presumed diagnosis of biliary atresia prior to referral to our hospital (OR, 17.49; 95% CI, 7.01-43.64). A significant interaction was noted between ICD-10 code Q44.2 and a history of pale stool (P<0.05). The area under the curve was 0.87 (95% CI, 0.84-0.89). Conclusion: ICD-10 code Q44.2 has an acceptable value for diagnosing biliary atresia. Incorporating clinical data improves the case identification. The use of this proposed diagnostic algorithm to examine data from administrative databases may facilitate appropriate health care allocation and aid future research investigations.

• Tuberculosis and Respiratory Diseases
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• v.84 no.4
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• pp.299-316
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• 2021

Background: The lack of effective medications for coronavirus disease 2019 (COVID-19) has led to a trend of drug repurposing such as the case of azithromycin which shows immunomodulatory and anti-viral effect. Several clinical trials have shown conflicting results. It is currently unclear whether the available evidence is in favor or against the use of azithromycin in COVID-19 patients. Thus, the aim of this study was to investigate the efficacy and safety of azithromycin in COVID-19 patients. Methods: Four independent reviewers selected relevant studies from PubMed, ScienceDirect, EBSCO, and ProQuest published prior to March 2021. The protocol used in this study has been registered in PROSPERO (CRD42020224967). Results: We included 17 studies and found that the mortality rate (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.76-1.19), need of respiratory support (OR, 1.30; 95% CI, 0.98-1.73), hospitalization rate (standardized mean difference, 0.12; 95% CI, -0.02 to 0.27), and intensive care unit transfer (OR, 1.21; 95% CI, 0.79-1.86) of azithromycin-treated group did not differ significantly (p>0.05) from those of the control group. Azithromycin treatment did not significantly increase the risk of getting secondary infection (OR, 1.23; 95% CI, 0.83-1.82), hypoglycemia (OR, 0.73; 95% CI, 0.38-1.40), gastrointestinal problems (OR, 1.03; 95% CI, 0.73-1.45) or electrocardiogram abnormalities (OR, 1.16; 95% CI, 0.94-1.42). The overall quality of evidence ranged from low to very low. Conclusion: Azithromycin did not result in a superior clinical improvement in COVID-19 patients, although it was well-tolerated and safe to use.

• Health Policy and Management
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• v.31 no.3
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• pp.272-279
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• 2021

Background: Korea's health screening program has been faced the need for changes as the population and diseases structure are changing. In addition to Korea, many countries operate state-led health check-up programs to improve the health level of the people, and the operating methods of the program appear in various forms according to each country's health insurance system. This study examines other state-led health screening programs and proposes a direction for the development of Korea's health screening program. Methods: The study was conducted using the literature review method, and the "country" was set as a unit for the case analysis. The operating method of the health screening programs and the financial resources were compared according to the health insurance system. Five countries were selected as Korea, the United States, the United Kingdom, Japan, and Taiwan. Results: The analyzed countries mainly operate the health screening program as a management method for chronic diseases, but there were differences in the operating method, financing, and targeted subjects and examination items. In most countries, a risk assessment was performed prior to the examination (screening), and the subjects who needed the examination were first selected, and a follow-up management service was provided in accordance with the risk each individual exposed. Conclusion: Rather than applying the same screening method to populations with different risk levels, a health screening program will be constructed in consideration of the individual's health level and exposure risk, and the healthcare delivery system will be reorganized so that screening and treatment services can be linked.

• Nutrition Research and Practice
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• v.15 no.5
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• pp.613-627
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• 2021

BACKGROUND/OBJECTIVES: Despite the widespread use of dietary assessment tools, the validity of food records has not been evaluated in Koreans. We assessed the accuracy of estimated food records and the effect of a short education session in young Korean women. SUBJECTS/METHODS: Thirty women (aged 18-23 yrs) each completed 3 food records during a controlled-feeding study. One educational session was provided on day 2 of the study. Food records were analyzed for the accuracy of food items and portion size estimation according to food group (grains; meat, fish, eggs, and beans; vegetables; fruit; dairy; and oils and sugars) and type of dish (rice, kimchi, soup, side dishes, spreads, beverages, and snacks). Reported food items were categorized as exact, close, or far matches, exclusions, or intrusions. Portion sizes were evaluated as accurate, similar, or inaccurate estimates, or missing. The means of days 2 and 3 were used to assess post-education results. Paired t-tests were performed to assess the effects of the education session. RESULTS: The mean percentages of exact matches, close matches, far matches, and exclusions on day 1 were 80.9%, 10.9%, 2.0%, and 6.2%, respectively, and mean intrusions observed were 0.1. The education session slightly increased the accuracy of recorded food items. The percentages of accurate, similar, and inaccurate estimates, and missing portion sizes were 11.7%, 19.8%, 12.2%, and 56.3%, respectively, at baseline. The percentage of missing portion size estimates decreased to 14.0% after the education session, resulting in an increase in the percentages of all other estimates. An increase was observed in the accuracy of reported portion sizes of vegetables, rice, and kimchi. CONCLUSIONS: In young Korean women, estimated food records are highly accurate for food items but not for portion size estimates without prior education. A short education session can improve the accuracy of portion size estimation.