Background: Drugs should be evaluated in appropriate subjects representing potential population to take the drugs. This study focuses on gender factor and aims to make known the appropriateness of considering gender difference on clinical evaluation of drug with domestic data related to drug use. Methods: To understand gender difference shown in drug use, three types of domestic statistical data (prevalence of chronic disease, number of outpatient with major concerning disease, and consumption of medicine) were analyzed and compared according to gender. Results: Three of fifteen chronic diseases which were analyzed, showed significantly higher prevalence in women than in men, and three were vice versa. Meanwhile, the sex ratio of outpatients was significantly different in 22 major concerning diseases. Among the drug groups coded by Anatomical Therapeutic Chemical (ATC) Classification System, the consumption of most drug groups was generally higher in women than in men except for one group coded G (genito-urinary system and sex hormones). Conclusion: Gender difference should be considered in domestic clinical evaluation of drug and domestic guidance for reflecting gender difference should be established.
Three hundred sixty-two(male 131, female 231) elderly aged over 65 in Chungb- uk area were interviewed to determine the disease states and drug usage patterns. The prebalence of disease was 78% and women reported more chronic diseases(83%) than men(71%). Elderly who live with spouse and have an occupation have a lower rate of disease. Average number of diseases of the elderly was $1.8\pm{1.1}$, and women$(2.1\pm{1.3)}$ have significantly higher average number of diseases than that of men$(1.4\pm{0.7)}$. Also the elderly in urban areas$(2.1\pm{1.4)}$ have significantly higher number of diseases than that of the elderly in rural areas$(1.6\pm{0.9)}$. Arthritis, hypertension, cardiovascular and gastric diseases were the most frequently listed chronic diseases in order for both men and women. Anemia and fracture of bone were relatively higher in women than in men. Particularly, the arthritis of the urban elderly have a rate of 1.5 times higher than that of the rural elderly. Fifty-two percent of the elderly were currently using drugs ; among drug users 71.2% used prescription drugs and 20.5% used nonprescription drugs. The average number taken per person was 2.1$\pm$1.4 and there was no sex or age difference. However, the elderly in rural areas $(2.7\pm{1.7)}$ consumed a significantly higher number of drugs than those in urban areas$(1.7\pm{0.7)}$. The average number of prescripti- on drugs taken was 2.0$\pm$1.4 while the average of nonprescription drugs taken was $(1.3\pm{0.6)}$. Analgesics and antihypertensive drugs were most commonly used. Vitamin and analgesics were the most frequently used self-prescribed drugs. It was noted that potential adverse drug interaction by concominant drug consumption for arthritis and antihypensive drug, abuse of digestants and antiacid without treatment of the underlying disease, and misuse of quick-acting bowel medications were problematic for the elderly. In addition drugs used for the elderly have some adverse effect on the digestive system. The types and composition of drugs used by the elderly were identified and presented. Medication compliance was poor and 13.5% reported adverse reactions such as edema, heartburn, nausea, and difficulty with eating. Seventeen percent of the elderly obtained drugs arranged by those other than medical staff. Also, even among those elderly who obtained drugs prescribed by a doctor, 69.1% of subjects had not receive instruction about potential adverse reactions. These results suggest that nutritional problems related to drug usage might exist and so dietitians, either individually or as members of health teams, need to have a better understanding of drug-nutrient interaction and closer supervision, and drug information/education service should therefore be provided to prevent or minimize adverse drug reaction in elderly users of medication.
Non-alcoholic fatty liver disease (NAFLD) is a complex disorder characterized by the accumulation of fat in the liver in the absence of excessive alcohol consumption. It is one of the most common liver diseases worldwide, affecting approximately 25% of the global population. It is closely associated with obesity, type 2 diabetes, and metabolic syndrome. Moreover, NAFLD can progress to non-alcoholic steatohepatitis, which can cause liver cirrhosis, liver failure, and hepatocellular carcinoma. Currently, there are no approved drugs for the treatment of NAFLD. Therefore, the development of effective drugs is essential for NAFLD treatment. In this article, we discuss the experimental models and novel therapeutic targets for NAFLD. Additionally, we propose new strategies for the development of drugs for NAFLD.
Park, Sohyun;Lee, Jounghee;Kwon, Kwang-Il;Kim, Jong-Wook;Byun, Jae-Eon;Kang, Baeg-Won;Choi, Bo Youl;Park, Hye-Kyung
Nutrition Research and Practice
/
v.8
no.6
/
pp.719-723
/
2014
BACKGROUND/OBJECTIVES: South Korean's sodium consumption level is more than twice the upper limit level suggested by the WHO. Steep increases in the prevalence of hypertension and cardiovascular disease in Korea necessitate more effective sodium reduction programs. This study was conducted in order to compare sodium intake-related eating behaviors and key psychosocial factors according to age group and gender. SUBJECTS/METHODS: Using an online survey, a total of 1,564 adults (20-59 years old) considered to be geographically representative of South Korea were recruited and surveyed. The major outcomes were perceived behaviors, knowledge, intentions, and self-efficacy related to sodium intake. RESULTS: The results show that perceived behavior and level of self-efficacy related to low sodium consumption differed by age and gender. Female participants showed better behavior and intention towards low sodium intake than male counterparts. Young participants in their 20s showed the lowest intention to change their current sodium intake as well as lowest self-efficacy measures. CONCLUSIONS: Future sodium reduction interventions should be developed with tailored messages targeting different age and gender groups. Specifically, interventions can be planned and implemented at the college level or for workers in their early career to increase their intention and self-efficacy as a means of preventing future health complications associated with high sodium intake.
Fabry disease is an X-linked lysosomal storage disorder caused by a deficiency of the enzyme ${\alpha}-galactosidase$ A, resulting in the accumulation of glycosphingolipids within the lysosomes of various cell types. It has a wide spectrum of clinical phenotypes, and renal failure is a serious complication. Fabry disease is confirmed either by measurement of ${\alpha}-galactosidase$ A activity or by genetic testing for GLA mutations. Renal biopsy findings on light microscopy, specifically enlarged podocytes with foamy cytoplasm, and osmiophilic inclusion bodies in the cytoplasm in all types of renal cells on electron microscopy, are characteristic of this disease. The predominant differential diagnosis is iatrogenic phospholipidosis in association with certain drugs that can cause cellular injuries indistinguishable from Fabry disease. Here, we report the case of a 10-year-old boy with microscopic hematuria who underwent a renal biopsy that showed morphological findings consistent with Fabry disease, although the patient had neither a GLA mutation nor a history of drug consumption. Six years later, spontaneous regression of this renal pathology was observed in a second renal biopsy examination.
The objective of this study was to evaluate the efficacy and the pattern of regimens prescribed for the treatment of peptic ulcer disease in a regional community hospital. 226 patients were treated as an outpatient and followed for one year. 88 patients $(38.9\%)$ had gastric ulcer (GU) alone, 6 patients $(2.7\%)$ had duodenal ulcer (DV) alone, 5 patients $(2.2\%)$ had gastroesophageal reflux disease (GERD) alone, 25 patients $(11.1\%)$ had both GU and DU, 88 patients $(38.9\%)$ had both GU and GERD, and 14 patients $(6.2\%)$ had both DU and GERD. During this study period no one was treated for Zollinger-Ellison Syndrome. The disease showed higher occurrence in male population (139 patients, $61.5\%$) and among the ages of 30 and 40 $(62.4\%)$. The average age of these patients was 41.3 years and there was no difference between the genders. $81.4\%$ of these patients underwent CLO test to check for the existence of Helicobacter and $66.3\%$ of these Patients showed the positive response. $65.6\%$ of patients with GU and $80\%$ of patients with DU showed the positive response and there was no difference between the genders $(65.4\%\;vs.\;67.6\%)$. 184 patients $(81.4\%)$ were deemed to be cured based on the disappearance of their symptoms after completing the regimens. Compliance rate did not differ for gender or different diseases, while showing a difference in age. Patients between the ages of 20 to 30 years old showed the worst compliance rate. In addition, the compliance was lower among the patients who had previous occurrence of the disease, and this was more evident among female patients. Although 184 patients out of the total 226 patients were deemed to be cured, 36 patients $(20.65\%)$ of these returned to the hospital for relapsed diseases within one year. The factors that affected for patients to relapse were the diseases accompanied by ulcer and social environments, such as smoking, alcohol consumption, and previous history of the diseases (smoking P<0.001, alcohol consumption P<0.02, previous history of disease P<0.05). The regimen using $H_2$ receptor antagonists+tripotassium dicitrato bismuthate+clarithromycin showed the lower rate of relapse, and the regimens of omeprazole (OMP)+amoxicillin+tripotassium dicitrato bismuthate and OMP+amoxicillin+metronidazole showed better compliance rate. Patient education by pharmacists on the importance of compliance to regimens and the risk factors fer relapse can provide a better patient care. This would ultimately result in more cost-effective treatments by preventing additional cost for treating relapsed symptoms in approximately $20\%$ of patients.
Recently, attention for health promotion is rising. Alcohol is widely consumed among adults. About 1/3 of people 15 years of older enjoy drinking alcohol. Some 80% of them drink a half or more bottle of soju each time. Regular excessive drinking of alcohol may cause various problems. WHO(1990) reported that social problems such as divorce, unemployment, and financial difficulties ; psychological problems such as melancholy, suicide, and drug abuse ; physical problems such as cirrhosis, lung cancer, high blood pressure, stroke, and sterilization. The patients with liver disease are estimated to be 628,000. Approximately, 12,000 persons are dying by chronic liver disease and cirrhosis each year. Among the people of 15 years or older, persons dependent on alcohol are estimated to be 1,480,000. This study suggests policies to reduce the consumption of alcohol for planning for health promotion. Limitations of sites and times of sales and designation of sellers, designation of sites prohibiting drinking, limitation of alcohol sales promotion, and restrictions on advertisement can be inaugurated. Increase of price through the raise of tax and taxation of promotion cost. Education of high risk groups such as soldiers, pregnant women, and the youth can be introduced. Provision of alternative socialization programs instead of drinking. Some approaches on target groups were suggested.
In vitro diagnostic veterinary medical reagents (IVDVMRs) were diverted the medical devices from medicine by the revision of the pharmaceutical affairs act enforcement regulations in 2015 in Korea. It classified into class I-IV according to risks of individual and public health. However, good manufacturing practices requirements on IVDVMRs were exempted from the current system. The registration of IVDVMRs by the Animal and Plant Quarantine Agency has gradually increased since 2012, and total of 584 products from 68 companies were registered from 1978 to 2017. Most of these items are clinical immunochemistry (infection disease), clinical immunochemistry (non-infection disease), molecular genetics, endocrinology, blood gas analysis, clinical microbiology, toxin, heavy metal and drug of abuse, other etc. The market size of IVDVMRs reported from the Korea Animal Health Products Association was estimated to be approximately 51.9 billion won in 2017. The domestic consumption and the export sales were approximately 31.2 and 20.7 billion won, respectively. They are increasing 23.9% (CAGR) in domestic consumption and 40.4% (CAGR) in export from 2011 to 2017.
Alcoholic liver disease is defined by the development of three types of liver damage following chronic heavy alcohol consumption, namely, alcoholic fatty liver, alcoholic hepatitis, and alcoholic cirrhosis, The clinical features and laboratory tests often do not distinguish among these types of liver injuries. In addition, a considerable number of the patients who have clinical and laboratory features compatible with alcoholic liver disease are diagnosed on liver biopsy to have chronic viral hepatitis or other lesion. Because of these factors, liver biopsy is frequently needed to arrive a definite diagnosis of the disease, its activity, and its chronicity. Fatty liver is usually a benign and reverible condition that disappears on abstinence from alcohol. However, alcoholic hepatitis is usually regarded as a precursor of cirrhosis. The principle factors in the development of alcoholic hepatitis and cirrhosis are the quantity and length of ingestion of alcohol. women are much more susceptible than men to hepatic injuries. Since only 10 - 20% of alcoholics develop cirrhosis, however, it is conceivable that other factors, either genetic, environmental, or nutritional may contribute in the genesis of liver injuries. The most important factor in the treatment of alcoholic liver disease is prolonzed abstinence from alcohol, since abstinence by itself improves clinical status and survival, Nutritional support in patients with nutritional deficiency, and specific drug therapies such as corticosteroid or anabolic steroids for hospitaliged patients with severe alcoholic hepatitis also play an important role in devreasing morbidity and improving survival. Liver transplantation is a newer treatment modality in the patients with advanced cirrhosis, not responsible to medical treatment.
High blood pressure is an important determinant of the incidence of coronary heart disease, stroke, congestive heart failure, renal failure, and peripheral vascular disease. Recommendations for control of high blood pressure emphasize lifestyle modification, including weight control, reduced sodium intake, increased physical activity. Subjects who were normotensive (n=19, $47.2\pm9.0$ y, BP l16/81 mmHg) ,treatment hypertensive (n=33, $54.2\pm6.9$ y, BP 132/85 mmHg) and non-treatment hypertensive (n=14, $50.1\pm11.0$ y, 149/94 mmHg) recruited. Anthropometric assessment (height weight waist circumference, hip circumference, fat$\%$, fat mass, and lean body mass) and dietary assessments (using 3-days food records, daily nutrient intakes were inuysed by CAN PRO 2.0 were carried out. Blood and 24-hour urine were collected). Test of recognition for salt taste threshold were performed. In non-treatment hypertensive male subjects, weight, $\%$IBW, BMI, and waist circumference were significantly higher than those of normotensive and treatment hypertensive subjects (p<0.05) .Food habits were not significantly different among the three groups. Intakes of vitamin A, vitamin B,, and vitamin B, were significantly higher in normotensive group (p<0.05). Intakes of sodium and salt taste recognition threshold were the highest in normotensive group and the lowest in treatment hypertensive group (p<0.05). Blood levels of lipids and minerals were not significantly different among the three groups. Urinary calcium level of normotensive group were significantly higher than that of treatment hypertensive and non-treatment hypertensive groups (p<0.05). These results indicate that continuous management of hypertension by drug and non-drug treatment affects salt taste recognition threshold and reduced the consumption of sodium. However, dietary sodium intake exceed recommended sodium intake to prevent and treat hypertension. It is necessary to develop the lifestyle modification program that may have beneficial effects on hypertension treatment.
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