Identifying Adverse Events Using International Classification of Diseases, Tenth Revision Y Codes in Korea: A Cross-sectional Study / 예방의학회지

OBJECTIVES: The use of administrative data is an affordable alternative to conducting a difficult large-scale medical-record review to estimate the scale of adverse events. We identified adverse events from 2002 to 2013 on the national level in Korea, using International Classification of Diseases, tenth revision (ICD-10) Y codes. METHODS: We used data from the National Health Insurance Service-National Sample Cohort (NHIS-NSC). We relied on medical treatment databases to extract information on ICD-10 Y codes from each participant in the NHIS-NSC. We classified adverse events in the ICD-10 Y codes into 6 types: those related to drugs, transfusions, and fluids; those related to vaccines and immunoglobulin; those related to surgery and procedures; those related to infections; those related to devices; and others. RESULTS: Over 12 years, a total of 20 817 adverse events were identified using ICD-10 Y codes, and the estimated total adverse event rate was 0.20%. Between 2002 and 2013, the total number of such events increased by 131.3%, from 1366 in 2002 to 3159 in 2013. The total rate increased by 103.9%, from 0.17% in 2002 to 0.35% in 2013. Events related to drugs, transfusions, and fluids were the most common (19 446, 93.4%), followed by those related to surgery and procedures (1209, 5.8%) and those related to vaccines and immunoglobulin (72, 0.3%). CONCLUSIONS: Based on a comparison with the results of other studies, the total adverse event rate in this study was significantly underestimated. Improving coding practices for ICD-10 Y codes is necessary to precisely monitor the scale of adverse events in Korea.

Identifying Adverse Events Using International Classification of Diseases, Tenth Revision Y Codes in Korea: A Cross-sectional Study / 예방의학회지

OBJECTIVES@#The use of administrative data is an affordable alternative to conducting a difficult large-scale medical-record review to estimate the scale of adverse events. We identified adverse events from 2002 to 2013 on the national level in Korea, using International Classification of Diseases, tenth revision (ICD-10) Y codes.@*METHODS@#We used data from the National Health Insurance Service-National Sample Cohort (NHIS-NSC). We relied on medical treatment databases to extract information on ICD-10 Y codes from each participant in the NHIS-NSC. We classified adverse events in the ICD-10 Y codes into 6 types: those related to drugs, transfusions, and fluids; those related to vaccines and immunoglobulin; those related to surgery and procedures; those related to infections; those related to devices; and others.@*RESULTS@#Over 12 years, a total of 20 817 adverse events were identified using ICD-10 Y codes, and the estimated total adverse event rate was 0.20%. Between 2002 and 2013, the total number of such events increased by 131.3%, from 1366 in 2002 to 3159 in 2013. The total rate increased by 103.9%, from 0.17% in 2002 to 0.35% in 2013. Events related to drugs, transfusions, and fluids were the most common (19 446, 93.4%), followed by those related to surgery and procedures (1209, 5.8%) and those related to vaccines and immunoglobulin (72, 0.3%).@*CONCLUSIONS@#Based on a comparison with the results of other studies, the total adverse event rate in this study was significantly underestimated. Improving coding practices for ICD-10 Y codes is necessary to precisely monitor the scale of adverse events in Korea.

Evaluation of the learning curve for external cephalic version using cumulative sum analysis

OBJECTIVE: We evaluated the learning curve for external cephalic version (ECV) using learning curve-cumulative sum (LC-CUSUM) analysis. METHODS: This was a retrospective study involving 290 consecutive cases between October 2013 and March 2017. We evaluated the learning curve for ECV on nulli and over para 1 group using LC-CUSUM analysis on the assumption that 50% and 70% of ECV procedures succeeded by description a trend-line of quadratic function with reliable R² values. RESULTS: The overall success rate for ECV was 64.8% (188/290), while the success rate for nullipara and over para 1 groups was 56.2% (100/178) and 78.6% (88/112), respectively. ‘H’ value, that the actual failure rate does not differ from the acceptable failure rate, was −3.27 and −1.635 when considering ECV success rates of 50% and 70%, respectively. Consequently, in order to obtain a consistent 50% success rate, we would require 57 nullipara cases, and in order to obtain a consistent 70% success rate, we would require 130 nullipara cases. In contrast, 8 to 10 over para 1 cases would be required for an expected success rate of 50% and 70% on over para 1 group. CONCLUSION: Even a relatively inexperienced physician can experience success with multipara and after accumulating experience, they will manage nullipara cases. Further research is required for LC-CUSUM involving several practitioners instead of a single practitioner. This will lead to the gradual implementation of standard learning curve guidelines for ECV.

Perceptions of Healthcare Workers of Health Risks of Electromagnetic Fields

BACKGROUND: This study assessed the perceptions of healthcare staff of the health risks of exposure to electromagnetic fields (EMF). METHODS: In total, 328 healthcare workers (e.g., physicians, nurses, medical students, and paramedics) completed a self-administered questionnaire. The questionnaire assessed the following: risk perceptions of 17 environmental factors as potential health threats; EMF sources; information for the potential risks of EMF; and thoughts on how to protect the public from potential EMF-related health risks. RESULTS: Of the included environmental factors, high-tension power lines and mobile phone handsets were ranked as the second and fourth lowest perceived risk, respectively. Approximately 60% of respondents were concerned about the potential health risks of EMF and dissatisfied with the information they received. The main reason for dissatisfaction was insufficient information. The most frequently cited action was that the government should review the available scientific evidence on potential EMF-related health risks. CONCLUSIONS: Having scientific basis through well-designed researches and providing accurate information to the public on the potential health risks of EMF will be important in the future.

The effect of cavity wall property on the shear bond strength test using iris method / 대한치과보존학회지

OBJECTIVES: In the unique metal iris method, the developing interfacial gap at the cavity floor resulting from the cavity wall property during polymerizing composite resin might affect the nominal shear bond strength values. The aim of this study is to evaluate that the iris method reduces the cohesive failure in the substrates and the cavity wall property effects on the shear bond strength tests using iris method. MATERIALS AND METHODS: The occlusal dentin of 64 extracted human molars were randomly divided into 4 groups to simulate two different levels of cavity wall property (metal and dentin iris) and two different materials (ONE-STEP(R) and ALL-BOND(R) 2) for each wall property. After positioning the iris on the dentin surface, composite resin was packed and light-cured. After 24 hours the shear bond strength was measured at a crosshead speed of 0.5 mm/min. Fracture analysis was performed using a microscope and SEM. The data was analyzed statistically by a two-way ANOVA and t-test. RESULTS: The shear bond strength with metal iris was significant higher than those with dentin iris (p = 0.034). Using ONE-STEP(R), the shear bond strength with metal iris was significant higher than those with dentin iris (p = 0.005), but not in ALL-BOND(R) 2 (p = 0.774). The incidence of cohesive failure was very lower than other shear bond strength tests that did not use iris method. CONCLUSIONS: The iris method may significantly reduce the cohesive failures in the substrates. According to the bonding agent systems, the shear bond strength was affected by the cavity wall property.

Midtrimester pregnancy termination with prostaglandin E1 Misoprostol compared with physician-chosen combination method; A prospective randomized trial / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to determine the effectiveness and safety of misoprostol in termination of pregnancy. MATERIALS & METHODS: 38 women who presented with indication for termination of pregnancy were assigned randomly to receive either 200 microgram of misoprostol orally every 4 hours as needed, or medication according to the our established protocol (physician-chosen combinations of Sulprostone infusion every 6 hours with vaginal PGE2 or Laminaria). Exclusion criteria were history of asthma, glaucoma, cardiac or hepatic disease, or chorioamnionitis. Unless delivery had occurred or was imminent after 24 hours with medication, the case was considered to have failed. The induction to delivery time and influencing factors were analyzed in both group using t-test, chi-square test or Fisher`s exact test, Kaplan-Meier and Cox regression. RESULTS: The success rate of termination of pregnancy within 12 hours and 24 hours were 67% and 93% with misoprostol (n=15) versus 5% and 43% with physician-chosen combination (n=21) (p<0.05). Among 3 cases failed with misoprostol within 24 hours, two cases crossed to the alternative method after 24 hours of misoprostol, so, the 2 cases were excluded. The mean dosage and frequency of misoprostol was 540 microgram and 2.8 times. The mean induction to delivery time ( mean +/- standard deviation) with oral misoprostol (n=15) was 640+/-590 minutes versus 1670+/-750 minutes with physician-chosen combination (n=21) (p<0.001). Reanalyzed in selected cases of Bishop score

Prediction of preterm delivery by measurement of cervical length / 대한산부인과학회잡지

No abstract available.

Multivariate Analysis of Adverse Pregnancy Outcome by Multiprediction Factors / 대한산부인과학회잡지

PURPOSE: To evaluate a role as over 35 years, maternal serum markers, and a false positive screen for Down syndrome were the predictor of adverse pregnancy outcome. Materials and METHODS: From Mar.1994, through Feb.1996, 5284 women were screened triple test to detect Down syndrome in the second trimester and were delivered Samsung Cheil hospital. The values of each maternal serum markers were measured with radioimmunoassay. And then, the screen positive of Down syndrome was calculated using alpha-software Version 4.0. The adverse outcome of the fetus and the mother included low birth weight(LBW) ( 2.0 MoM) associated with IUFD, LBW, PIH, prematurity, and PPROM , elevated MS-hCG (>3.0 MoM) associated with IUFD, LBW, PIH, prematurity, and placenta previa, lowered uE3 (0.05) CONCLUSIONS: Some predictors such as over 35 year, elevated hCG, lowered uE3, a false positive screen for Down syndrome were significantly associated with adverse pregnancy outcome. Also in multivariate analysis, we identified especially elevated AFP to be the most reliable predictor for adverse pregnancy outcome.