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Meta-analysis of factors predicting resistance to intravenous immunoglobulin treatment in patients with Kawasaki disease

  • Baek, Jin-Young;Song, Min Seob
    • Clinical and Experimental Pediatrics
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    • v.59 no.2
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    • pp.80-90
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    • 2016
  • Purpose: Studies have been conducted to identify predictive factors of resistance to intravenous immunoglobulin (IVIG) for Kawasaki disease (KD). However, the results are conflicting. This study aimed to identify laboratory factors predictive of resistance to high-dose IVIG for KD by performing meta-analysis of available studies using statistical techniques. Methods: All relevant scientific publications from 2006 to 2014 were identified through PubMed searches. For studies in English on KD and IVIG resistance, predictive factors were included. A meta-analysis was performed that calculated the effect size of various laboratory parameters as predictive factors for IVIG-resistant KD. Results: Twelve studies comprising 2,745 patients were included. Meta-analysis demonstrated significant effect sizes for several laboratory parameters: polymorphonuclear leukocytes (PMNs) 0.698 (95% confidence interval [CI], 0.469-0.926), C-reactive protein (CRP) 0.375 (95% CI, 0.086-0.663), pro-brain natriuretic peptide (pro-BNP) 0.561 (95% CI, 0.261-0.861), total bilirubin 0.859 (95% CI, 0.582-1.136), alanine aminotransferase (AST) 0.503 (95% CI, 0.313-0.693), aspartate aminotransferase (ALT) 0.436 (95% CI, 0.275-0.597), albumin 0.427 (95% CI, -0.657 to -0.198), and sodium 0.604 (95% CI, -0.839 to -0.370). Particularly, total bilirubin, PMN, sodium, pro-BNP, and AST, in descending numerical order, demonstrated more than a medium effect size. Conclusion: Based on the results of this study, laboratory predictive factors for IVIG-resistant KD included higher total bilirubin, PMN, pro-BNP, AST, ALT, and CRP, and lower sodium and albumin. The presence of several of these predictive factors should alert clinicians to the increased likelihood that the patient may not respond adequately to initial IVIG therapy.

Effect of Stress and Serotonin-Transporter-Linked Polymorphic Region Variants on Internet Gaming Disorder in Korean Adults (한국 성인남녀에서 스트레스와 세로토닌 전달체(5-HTTLPR) 유전자 변이가 인터넷 게임장애(IGD)에 미치는 영향)

  • Hong, Hyung-Sook;Jeong, Jo-Eun;Cho, Hyun;Kwak, Su-Min;Choi, Mi Ran;Choi, Jung-Seok;Choi, Sam-Wook;Kim, Dai-Jin
    • Korean Journal of Biological Psychiatry
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    • v.25 no.3
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    • pp.79-87
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    • 2018
  • Objectives Internet gaming disorder (IGD) is known to be related to stress and the serotonin-transporter-linked polymorphic region (5-HTTLPR) that is known to be associated with stress and has been studied to affect various psychiatric illness outbreaks. We tried to examine the relationship between stress, 5-HTTLPR and IGD. Methods A total of 59 participants with IGD, diagnosed according to the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria and 67 normal controls (NC) were enrolled. The IGD group and the NC were compared using chisquare test and independent sample t-test, and logistic regression analysis was used to examine the relationship between stress, the 5-HTTLPR, and IGD. Results The mean scores for anxiety, impulsivity and stress were significantly higher in the IGD group than in the NC. In addition, there was a significant association between stress and IGD [odds ratio (OR) = 1.172, 95% confidence interval (CI) = 1.008-1.362]. Conclusions This study showed that stress would affect IGD. Therefore, the evaluation and management of stress should be included in the diagnosis and treatment of IGD.

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Prevalence of Depressive Disorder of Outpatients Visiting Two Primary Care Settings

  • Jo, Sun-Jin;Yim, Hyeon Woo;Jeong, Hyunsuk;Song, Hoo Rim;Ju, Sang Yhun;Kim, Jong Lyul;Jun, Tae-Youn
    • Journal of Preventive Medicine and Public Health
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    • v.48 no.5
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    • pp.257-263
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    • 2015
  • Objectives: Although the prevalence of depressive disorders in South Korea's general population is known, no reports on the prevalence of depression among patients who visit primary care facilities have been published. This preliminary study was conducted to identify the prevalence of depressive disorder in patients that visit two primary care facilities. Methods: Among 231 consecutive eligible patients who visited two primary care settings, 184 patients consented to a diagnostic interview for depression by psychiatrists following the Diagnostic and Statistical Manual of Mental Disorders-IV criteria. There were no significant differences in sociodemographic characteristics such as gender, age, or level of education between the groups that consented and declined the diagnostic examination. The prevalence of depressive disorder and the proportion of newly diagnosed patients among depressive disorder patients were calculated. Results: The prevalence of depressive disorder of patients in the two primary care facilities was 14.1% (95% confidence interval [CI], 9.1 to 19.2), with major depressive disorder 5.4% (95% CI, 2.1 to 8.7), dysthymia 1.1% (95% CI, 0.0 to 2.6), and depressive disorder, not otherwise specified 7.6% (95% CI, 3.7 to 11.5). Among the 26 patients with depressive disorder, 19 patients were newly diagnosed. Conclusions: As compared to the general population, a higher prevalence of depressive disorders was observed among patients at two primary care facilities. Further study is needed with larger samples to inform the development of a primary care setting-based depression screening, management, and referral system to increase the efficiency of limited health care resources.

Determinants of Poor Self-rated Health in Korean Adults With Diabetes

  • Lee, Hwi-Won;Song, Minkyo;Yang, Jae Jeong;Kang, Daehee
    • Journal of Preventive Medicine and Public Health
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    • v.48 no.6
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    • pp.287-300
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    • 2015
  • Objectives: Self-rated health is a measure of perceived health widely used in epidemiological studies. Our study investigated the determinants of poor self-rated health in middle-aged Korean adults with diabetes. Methods: A cross-sectional study was conducted based on the Health Examinees Study. A total of 9759 adults aged 40 to 69 years who reported having physician-diagnosed diabetes were analyzed with regard to a range of health determinants, including sociodemographic, lifestyle, psychosocial, and physical variables, in association with self-rated health status using multivariate logistic regression models. A p-value <0.05 was considered to indicate statistical significance. Results: We found that negative psychosocial conditions, including frequent stress events and severe distress according to the psychosocial well-being index, were most strongly associated with poor self-rated health (odds ratio $[OR]_{\text{Frequent stress events}}$, 5.40; 95% confidence interval [CI], 4.63 to 6.29; $OR_{\text{Severe distress}}$, 11.08; 95% CI, 8.77 to 14.00). Moreover, younger age and being underweight or obese were shown to be associated with poor self-rated health. Physical factors relating to participants' medical history of diabetes, such as a younger age at diagnosis, a longer duration of diabetes, insulin therapy, hemoglobin A1c levels of 6.5% or more, and comorbidities, were other correlates of poor reported health. Conclusions: Our findings suggest that, in addition to medical variables, unfavorable socioeconomic factors, and adverse lifestyle behaviors, younger age, being underweight or obese, and psychosocial stress could be distinc factors in predicting negative perceived health status in Korean adults with diabetes.

CHRNA5 rs16969968 Polymorphism Association with Risk of Lung Cancer - Evidence from 17,962 Lung Cancer Cases and 77,216 Control Subjects

  • Xu, Zhi-Wei;Wang, Guan-Nan;Dong, Zhou-Zhou;Li, Tao-Hong;Cao, Chao;Jin, Yu-Hong
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6685-6690
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    • 2015
  • Background: Genetic studies have shown a possible relationship between the rs16969968 polymorphism in CHRNA5 and the risk of lung cancer. However, the results have been conflicting. Thus we rigorously conducted a meta-analysis to clarify any association. Materials and Methods: A total of 10 case-control studies involving 17,962 lung cancer cases and 77,216 control subjects were analysed. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to measure the strength of the association. Results: We found the CHRNA5 rs16969968 polymorphism to be associated with the risk of lung cancer (AA vs GG: OR=1.60, 95%CI=1.51-1.71). On stratified analysis by smoking status, a statistically significant increased risk was observed in the smoking group (AA vs GG: OR=1.80, 95%CI=1.61-2.01). However, this polymorphism was not associated with lung cancer risk in Asians (AA vs GG: OR=0.95, 95%CI=0.35-2.59), whereas it was linked to increased risk of lung cancer among Caucasians (AA vs GG: OR=1.65, 95%CI=1.55-1.76). Conclusions: Our meta-analysis provided statistical evidence for a strong association between rs16969968 polymorphism and the risk of lung cancer, especially in smokers and Caucasians. Application of this relationship may contribute to identification of individuals at high risk of lung cancer and indicate a chemoprevention target.

No Association Between MTHFR A1298C Gene Polymorphism and Head and Neck Cancer Risk: A Meta-analysis Based on 9,952 Subjects

  • Niu, Yu-Ming;Shen, Ming;Li, Hui;Ni, Xiao-Bing;Zhou, Juan;Zeng, Xian-Tao;Leng, Wei-Dong;Wu, Ming-Yue
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3943-3947
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    • 2012
  • Objective: Findings for associations between the methylenetetrahydrofolate reductase (MTHFR) A1298C gene polymorphism and head and neck cancer risk have been conflicting. We therefore performed a meta-analysis to derive a more precise relationship. Methods: Ten published case-control studies were collected and odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the association between MTHFR A1298C polymorphism and head and neck cancer risk. Sensitivity analysis and publication bias assessment also were performed to guarantee the statistical power. Results: Overall, no significant association between MTHFR A1298C polymorphism and head and neck cancer risk was found in this meta-analysis (C vs. A: OR=1.04, 95%CI=0.87-1.25, P=0.668, Pheterogeneity<0.001; CC vs. AA: OR=1.07, 95%CI=0.70-1.65, P=0.748, $P_{heterogeneity}<0.001$; AC vs. AA: OR=1.06, 95%CI=0.88-1.27, P=0.565, $P_{heterogeneity}<0.001$; CC+AC vs. AA: OR=1.06, 95%CI=0.86-1.30, P=0.571, $P_{heterogeneity}<0.001$; CC vs. AA+AC: OR=1.02, 95%CI=0.69-1.52, P=0.910, $P_{heterogeneity}<0.001$). Similar results were also been found in succeeding analysis of HWE and stratified analysis of ethnicity. Conclusion: In conclusion, our meta-analysis demonstrates that MTHFR A1298C polymorphism may not be a risk factor for developing head and neck cancer.

Association between Praziquantel and Cholangiocarcinoma in Patients Infected with Opisthorchis viverrini: A Systematic Review and Meta-Analysis

  • Kamsa-Ard, Supot;Laopaiboon, Malinee;Luvira, Vor;Bhudhisawasdi, Vajarabhongsa
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.7011-7016
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    • 2013
  • Background: The liver fluke, Opisthorchis viverrini, and the associated incidence of subsequent cholangiocarcinoma (CCA) are still a public health problem in Thailand, and praziquantel (PZQ) remains the antihelminthic drug of choice for treatment. Evidence in hamsters shows that repeated infection and PZQ treatments could increase the risk of CCA. However, the existing evidence in humans is inconclusive regarding increased risk of CCA with frequency of PZQ intake. Objectives: To investigate the relationship between number of repeated PZQ treatments and CCA in patients with O viverrini infection. Materials and Methods: The reviewed studies were searched in EMBASE, MEDLINE, ProQuest, PubMed and SCOPUS from inception to October, 2012 using prespecified keywords. The risk of bias (ROB) of included studies was independently assessed by two reviewers using a quality scale from the Newcastle-Ottawa Scale (NOS). Risk effect of PZQ was estimated as a pooled odds ratio (OR) with its 95% confidence interval (95%CI) in the random-effects model using DerSimonian and Laird's estimator. Results: Three studies involving 637 patients were included. Based on the random effects model performed in two included studies of 237 patients, the association between PZQ treatments and CCA was not statistical significant with a pooled OR of 1.8 (95%CI; 0.81 to 4.16). Conclusions: The present systematic review and meta-analysis provides inconclusive evidence of risk effect of PZQ on increasing the risk of CCA and significant methodological limitations. Further research is urgently needed to address the shortcomings found in this review, especially the requirement for histological confirmation.

Effectiveness Assesment of Bus Signal Priority Systems (버스우선신호시스템 적용 효과 평가)

  • Lee, Ho-Joon;Lee, Sang-Soo;Lee, Choul-Ki;Kim, Nam-Sun
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.11 no.2
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    • pp.57-66
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    • 2012
  • This study intended to evaluate the operational performance change from the introduction of the bus signal priority system using the field data. To complete the objective, travel time and volume data were collected from the before and after study, then the distribution of individual vehicle's travel time and the difference of travel time and traffic volume were compared respectively. Analysis results showed that no significant volume change was observed from both passenger vehicle and bus for the major and cross streets. It was identified that the quality of travel time distributions of passenger vehicle and bus was improved after introducing the bus signal priority system. In terms of average speed, passenger car in a major direction increased by 6.5% and bus increased by 10.5% in general. Statistical tests showed that those speed differences were statistically significant at the 95% of confidence level. The results of this paper will be a good source for further research in the area of bus signal priority control.

Performance Improvement of Human Detection in Thermal Images using Principal Component Analysis and Blob Clustering (주성분 분석과 Blob 군집화를 이용한 열화상 사람 검출 시스템의 성능 향상)

  • Jo, Ahra;Park, Jeong-Sik;Seo, Yong-Ho;Jang, Gil-Jin
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.13 no.2
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    • pp.157-163
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    • 2013
  • In this paper, we propose a human detection technique using thermal imaging camera. The proposed method is useful at night or rainy weather where a visible light imaging cameras is not able to detect human activities. Under the observation that a human is usually brighter than the background in the thermal images, we estimate the preliminary human regions using the statistical confidence measures in the gray-level, brightness histogram. Afterwards, we applied Gaussian filtering and blob labeling techniques to remove the unwanted noise, and gather the scattered of the pixel distributions and the center of gravities of the blobs. In the final step, we exploit the aspect ratio and the area on the unified object region as well as a number of the principal components extracted from the object region images to determine if the detected object is a human. The experimental results show that the proposed method is effective in environments where visible light cameras are not applicable.

Association between Vitamin D Level in Blood and Periodontitis in Korean Elderly

  • Yoon, Na-Na;Lee, Ji-Young;Yu, Byeng-Chul
    • Journal of dental hygiene science
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    • v.17 no.3
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    • pp.233-241
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    • 2017
  • This study identified an effective control method for periodontitis by investigating the association between blood levels of vitamin D and periodontitis in Korean elderly based on raw data from the fifth Korea National Health & Nutrition Examination Survey of 2010 (KNHANES). In this study, 1,021 adults over 65 years of age were evaluated based on data from the KNHANES. Periodontal disease was assessed using community periodontal index (CPI), with CPI codes ${\geq}3$ defined as periodontitis. Blood levels of vitamin D were measured from blood samples and divided into four groups (first quartile: ${\leq}13.23ng/ml$, second quartile: 13.24~16.95 ng/ml, third quartile: 16.96~21.58 ng/ml), and fourth quartile >21.59 ng/ml). Using multiple logistic regression analyses, the variables were adjusted for general characteristics, oral health-related characteristics, health-related characteristics, and bone mineral density. The statistical analysis was performed using the SAS (ver. 9.2). The results of this study are as follows: the prevalence of periodontitis was 42.6% in Korean elderly. After adjusting for general, oral health-related, and health-related, the risk of periodontitis in the first quartile group was 1.74 times (95% confidence interval [CI], 1.02~2.98) higher than that of the fourth quartile group (p=0.041). After adjusting for general, oral health-related, and health-related characteristics as well as bone mineral density, the risk of periodontitis in the first quartile group was 1.73 times (95% CI, 1.02~2.96) higher than that of the four quartile group (p=0.042). There was a significant relationship between blood vitamin D level and periodontitis in Korean elderly. For the prevention of periodontitis, factors related to vitamin D should be considered along with other risk factors.