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Background@#Pharmacogenomics is the study of how genetic mutations in patients affect their response to drugs. Pharmacogenomic studies aim to maximize drug effects and minimize adverse drug events. The Food and Drug Administration and the European Medicine Agency published guidelines for pharmacogenetics in 2005 and 2006, respectively; the Korean Ministry of Food and Drug Safety followed suit in 2015. @*Methods@#This study analyzed pharmacogenomic information in the Korean Ministry of Food and Drug Safety’s integrated drug information system to evaluate whether domestic pharmaceutical products reflect the current research on pharmacogenomic differences. @*Results@#In June 2020, the Korean pharmacogenomic database contained genomic data on 90 compounds. Of these, 45 compounds were classified as “Antineoplastic and immunomodulating agents.” The other 45 nonantineoplastic agents were in the following categories: Anti-infectives, Mental & behavior disorder, Hormone & metabolism related diseases, Cardiovascular system, Skin & subcutaneous tissue disease, Genito-urinary system and sex hormones, Blood and blood forming organs, Nervous system, Alimentary tract and metabolism, Musculo-skeletal system, and Other conditions including the respiratory system. In addition, 30 additives unrelated to the main ingredient were associated with genetic precautions. @*Conclusion@#This study showed that antineoplastic and immunomodulating agents accounted for half the drugs associated with pharmacogenetic information. For antitumor and immunomodulatory drugs, genomic tests were recommended depending on the indication; this was in contrast to genomic testing recommendations for non-antineoplastic medications. Genomic tests were rarely requested or recommended for non-antineoplastic medications because the relationships between genotype and efficacy among those drugs were relatively weak.
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Background@#Pharmacogenomics is the study of how genetic mutations in patients affect their response to drugs. Pharmacogenomic studies aim to maximize drug effects and minimize adverse drug events. The Food and Drug Administration and the European Medicine Agency published guidelines for pharmacogenetics in 2005 and 2006, respectively; the Korean Ministry of Food and Drug Safety followed suit in 2015. @*Methods@#This study analyzed pharmacogenomic information in the Korean Ministry of Food and Drug Safety’s integrated drug information system to evaluate whether domestic pharmaceutical products reflect the current research on pharmacogenomic differences. @*Results@#In June 2020, the Korean pharmacogenomic database contained genomic data on 90 compounds. Of these, 45 compounds were classified as “Antineoplastic and immunomodulating agents.” The other 45 nonantineoplastic agents were in the following categories: Anti-infectives, Mental & behavior disorder, Hormone & metabolism related diseases, Cardiovascular system, Skin & subcutaneous tissue disease, Genito-urinary system and sex hormones, Blood and blood forming organs, Nervous system, Alimentary tract and metabolism, Musculo-skeletal system, and Other conditions including the respiratory system. In addition, 30 additives unrelated to the main ingredient were associated with genetic precautions. @*Conclusion@#This study showed that antineoplastic and immunomodulating agents accounted for half the drugs associated with pharmacogenetic information. For antitumor and immunomodulatory drugs, genomic tests were recommended depending on the indication; this was in contrast to genomic testing recommendations for non-antineoplastic medications. Genomic tests were rarely requested or recommended for non-antineoplastic medications because the relationships between genotype and efficacy among those drugs were relatively weak.
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Purpose@#Although imatinib-induced hepatotoxicity may aggravate the patient’s clinical condition and alter the treatment plan, the underlying mechanism of and factors influencing imatinibinduced hepatotoxicity have rarely been investigated. The purpose of this study was to investigate factors affecting on the incidence of hepatotoxicity within 90 days after starting imatinib treatment and time to onset of imatinib-induced hepatotoxicity. @*Materials and Methods@#We retrospectively evaluated the records of 177 patients receiving imatinib from October 2012 to September 2017. The analyzed factors included sex, age, body weight, body surface area, underlying disease, and concomitant drugs. @*Results@#The proportion of patients with hepatotoxicity within 90 days after imatinib administration was 33.9%. Proton pump inhibitors (PPIs) increased the incidence of hepatotoxicity approximately 3.8-fold and doubled the hazard of time to reach hepatotoxicity. Patients with liver disease or hepatitis B virus (HBV) carriers had a more than 8-fold higher risk of hepatotoxicity and a 5.2-fold increased hazard of hepatotoxicity compared to those without liver disease or HBV. Patients with body weight under 55 kg had a 2.2-fold higher risk for occurrence of hepatotoxicity. Patients with an imatinib dose > 400 mg had a 2.3-fold increased hazard of time to reach hepatotoxicity compared to those with an imatinib dose ≤ 400 mg. @*Conclusion@#The findings of this study suggest that the use of PPIs and presence of liver disease or HBV were associated with imatinib-induced hepatotoxicity. Thus, close liver function monitoring is recommended, especially in patients with liver impairment or using PPIs.
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Background@#Although the identification of clinical and laboratory features in pediatric COVID-19 patients is essential in establishing an appropriate treatment plan, a systematic review and meta-analysis on the topic has yet to be reported. @*Methods@#We searched MEDLINE, Embase, and Web of Science to access clinical and laboratory characteristics as well as clinical outcomes of children with COVID-19 infection. A meta-analysis using random-effect model was performed to estimate pooled prevalence and 95% confidence intervals. @*Results@#Among the 532 studies initially collected, 12 articles were finally included in the meta-analysis. Among the investigated 320 pediatric patients with COVID-19, fever (48.2%) and cough (39.3%) were the most common symptoms.Almost one third of patients (30.4%) were asymptomatic. In laboratory findings, only 11.4% of pediatric patients experienced lymphocytopenia. Increased inflammatory markers including c-reactive protein (18.6%) and procalcitonin (32.4%) were observed.Only a few patients needed mechanical ventilation and intensive care support, and only one death was reported. @*Conclusion@#Pediatric patients with COVID-19 infection exhibited milder symptoms and more favorable outcomes compared to adults. However, considering the high rate of asymptomatic pediatric patients, close monitoring is required to prevent community infection in asymptomatic conditions and hidden disease progression.
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Background@#Although the identification of clinical and laboratory features in pediatric COVID-19 patients is essential in establishing an appropriate treatment plan, a systematic review and meta-analysis on the topic has yet to be reported. @*Methods@#We searched MEDLINE, Embase, and Web of Science to access clinical and laboratory characteristics as well as clinical outcomes of children with COVID-19 infection. A meta-analysis using random-effect model was performed to estimate pooled prevalence and 95% confidence intervals. @*Results@#Among the 532 studies initially collected, 12 articles were finally included in the meta-analysis. Among the investigated 320 pediatric patients with COVID-19, fever (48.2%) and cough (39.3%) were the most common symptoms.Almost one third of patients (30.4%) were asymptomatic. In laboratory findings, only 11.4% of pediatric patients experienced lymphocytopenia. Increased inflammatory markers including c-reactive protein (18.6%) and procalcitonin (32.4%) were observed.Only a few patients needed mechanical ventilation and intensive care support, and only one death was reported. @*Conclusion@#Pediatric patients with COVID-19 infection exhibited milder symptoms and more favorable outcomes compared to adults. However, considering the high rate of asymptomatic pediatric patients, close monitoring is required to prevent community infection in asymptomatic conditions and hidden disease progression.
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Nonprescription drugs have become increasingly important in Korean healthcare. By leveraging lower-cost drugs and reducing expenditure associated with fewer physician visits, the nonprescription segment can deliver tremendous value to individual consumers and the Korean healthcare system. Many countries have provided simpler and more rapid routes to market entry for qualifying nonprescription drug products, using the established data on drug safety and efficacy, as well as public and professional opinion. In US, the FDA waived the pre-approval process for over-the-counter (OTC) drugs marketed through the OTC Monograph Process. In Australia and Canada, different OTC product application levels are defined, with a reduced level of assessment required when the risks to consumers are considered low. Japan established a new OTC evaluation system in 2014 to facilitate the Rx-to-OTC switch process. The legislative framework for medicinal products in the European Union allows for drugs to be approved with reference to appropriate bibliographic data for old active substances with well-established uses. Through a comparison of the regulatory framework and the requirements for nonprescription approval process in different countries, several ways to improve regulatory practice for the evaluation of nonprescription drugs in Korea have been suggested.
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Australia , Canada , Delivery of Health Care , Drug and Narcotic Control , Drug Approval , European Union , Health Expenditures , Japan , Korea , Nonprescription DrugsABSTRACT
BACKGROUND: Cyclosporine is an immunosuppressive agent used to treat and prevent graft versus host reaction (GVHR)-a complication associated with stem cell transplantation. This study aimed to develop a population pharmacokinetic model of cyclosporine and investigate factors affecting cyclosporine clearance in pediatric hematopoietic stem cell transplant patients. METHODS: A total of 650 cyclosporine concentrations recorded in 65 patients who underwent hematopoietic stem cell transplantation were used. Data including age, sex, weight, height, body surface area (BSA), type of disease, chemotherapy before stem cell transplantation, type of donor, serum creatinine levels, total bilirubin concentration, hematocrit value, and type of concomitant antifungal agents and methylprednisolone used were retrospectively collected. Data related to cyclosporine dosage, administration time, and blood concentration were also collected. All data were analyzed using the non-linear mixed effect model; a two-compartment model with first-order elimination was used. RESULTS: The population pharmacokinetic model of cyclosporine using the NONMEM program was as follows: CL (L/h) = 5.9 × (BSA / 1.2)0.9, V2 (L) = 54.5, Q (L/h) = 3.5, V3 (L) = 1080.0, ka (h-1) = 0.000377. BSA was selected as a covariate of cyclosporine clearance, which increased with an increase in BSA. CONCLUSION: A population pharmacokinetic model for Korean pediatric hematopoietic stem cell transplant patients was developed, and the important factor affecting cyclosporine clearance was found to be BSA. The model might contribute to the development of the most appropriate dosing regimen for cyclosporine. Further studies on population pharmacokinetics should be carried out, prospectively targeting pediatric patients.
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In this paper, the current status of adolescent suicide prevention and intervention are addressed, including areas related to medicine, counseling, mental health nursing, social welfare, and education. Many preventive efforts and intervention programs have been developed and implemented, but the results have been mostly minimal or unfruitful and many problems arose. First, there is a lack of epidemiological research and developmentally appropriate data on adolescent suicide. Thus evidence-based research on adolescent suicide necessary to make important decisions regarding prevention strategies and the allocation of budgets and human resources is not available. Second, there are only a handful of experts with an appropriate level of education and training. Current suicide prevention efforts are performed as a part of crisis intervention, but only a few persons know how to do so effectively. Finally, a good networking and referral system among each area of service is needed. One of the most important issues might be balancing the levels of service available to each subject and to provide a proper, systematized intervention and continuous crisis management services. In order to create an effective networking and referral system among several service providers for adolescent suicide prevention, we need robust support from the Korean government and local communities.
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Adolescent , Humans , Budgets , Counseling , Crisis Intervention , Hand , Mental Health , Referral and Consultation , Social Welfare , SuicideABSTRACT
The National Evidence-based Collaborating Agency (NECA) holds the NECA Round-table Conference that not only disseminates objective and systematic information on topics of social concern in public health care but also organizes discussions on core issues under dispute in the literature through panels composed of multidisciplinary experts. Accordingly, the Round-table Conference was composed of multidisciplinary experts including medical specialists in the areas of psychiatry and preventive medicine, psychiatric and mental health nursing, psychologists, social welfare experts, consultation experts, religious leaders, and government officials from the Ministry of Education, Science and Technology, and Ministry of Health and Welfare. The Round-table Conference, tasked with analysis of the actual status and causes of, and search for solutions for suicide in adolescents, has reached consensus on the current status, trend, risk factors and prevention factors, problems and issues in prevention and coping strategies, effective prevention and coping strategies and areas of research needed for the future. The Round-table Conference commented on the actual status and gravity of suicides in adolescents, and came to the agreement that mental health issues including stress from interpersonal relationships and depression are the key risk factors of suicide. It was further agreed that problems in the measures being implemented for each of the areas include lack of manpower and funding, and inadequate organic association and cooperation among relevant institutions. They also agreed that development of a government-initiated suicide prevention program for adolescents, association among relevant experts, and development, and management of practical guidelines that are of broad and practical use are important. Furthermore, the panels were in agreement that the mass media must comply with the recommended level of coverage in reporting of suicide as adolescents are greatly influenced by provocative mass media reports due to their strong impulsive dispositions.
Subject(s)
Adolescent , Humans , Adenosine-5'-(N-ethylcarboxamide) , Cause of Death , Consensus , Depression , Dissent and Disputes , Financial Management , Gravitation , Mass Media , Mental Health , Occupational Groups , Porphyrins , Preventive Medicine , Public Health , Risk Factors , Social Welfare , Specialization , SuicideABSTRACT
The purpose of this study was to examine the urban-rural differences in the prevalence and associated factors with type 2 diabetes mellitus (T2DM) in Korean adults. A total of 1,060 adults >30 yr of age from urban (189 males and 331 females) and rural districts (219 males and 321 females) were recruited. Anthropometric measures, blood pressure, lipid profiles, and fasting and 2-hr after 75-g oral glucose load blood glucose were obtained. The crude- and age-standardized prevalence of T2DM was 15.4% and 14.5%, and 11.7% and 8.6% in urban and rural districts, respectively. Diabetic subjects were older and obese, and had a higher triglyceride level, and systolic blood pressure compared to non-diabetes in both population. Multivariate regression analysis revealed that older age, high triglyceride levels, central obesity, and hypertension were significantly associated with T2DM in both areas. Low monthly incomes were significantly associated with T2DM in urban population, while a family history of T2DM was significantly associated with T2DM in rural area. T2DM is more prevalent in urban than in rural population, and low economic status or genetic factor is differently associated with T2DM in both population, respectively.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Age Factors , Diabetes Mellitus, Type 2/complications , Hypertension/complications , Obesity/complications , Prevalence , Regression Analysis , Republic of Korea/epidemiology , Risk Factors , Rural Population , Socioeconomic Factors , Triglycerides/blood , Urban PopulationABSTRACT
OBJECTIVE: The purpose of this study is to design the web-based dialogue expert system for preventing and managing of habitual substance disorders in adolescents. METHODS: Research process includes the requirement analysis, making of questionnaires, actual survey, and its analysis. Based on the analysis, we designed the web-based dialogue expert system. RESULTS: The habitual substance disorders in adolescents are variable. Our system for managing habitual substance disorders contains the diagnosis of alcoholism, nicotinism, and narcotism. And it analyzes the facts of them based the questionnaires and answer. As the results of the analysis, main reasons in order of the power of influence are belief, will of refusal, personal characteristics, family environment, and psychological personality. Our system suggests the customized solution to conquer that for each adolescent. Moreover, our system also includes the history tracking mechanism to manage the status of each teenager constantly and to make the survey and analysis information. CONCLUSION: With our system, young boys and girls can know their seriousness of alcoholism, nicotinism, and narcotism. And they can get all possible helps through our system. This system will be the interactive and familiar way that anyone all over the world can use for overcoming problems.
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Adolescent , Female , Humans , Alcoholism , Diagnosis , Disulfiram , Expert Systems , Factor Analysis, Statistical , Family CharacteristicsABSTRACT
OBJECTIVE: The purpose of this study was to evaluate the effectiveness of a web-based intervention program for depressive symptoms management among Korean adults. METHODS: After the first author developed a user-centered design website intended to manage the depressive symptoms of the general public, two hundred and seventy two participants were screened and randomly assigned into experimental and control groups. These subjects underwent a 12-week nonequivalent pretest and post.test evaluation program to determine changes in their depression scores, which were measured using the Korean Depression Scale. Subjects' unique IP addresses were used for monitoring their access periods on the website. RESULTS: There were no significant differences in the baseline and outcome characteristics of both experimental and control groups. Moreover, findings revealed that the total depression score of the experimental group (who accessed the developed web-site three times a week with at least an hour per session) showed to have decreased immensely with a mean of 5.57. On the contrary, only a 0.09 point difference resulted between the pre and post tests of the control group (who accessed other depression management websites generally available). CONCLUSIONS: Web-based interventions could be an effective and inexpensive means of managing depressive symptoms of Koreans. Findings from this effectiveness study of an internet-based program could also be used by a variety of audiences including government agencies, educators, and health care professionals concerned with mental health promotion and prevention.
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Adult , Humans , Delivery of Health Care , Depression , Government Agencies , Information Systems , Internet , Management Information Systems , Mental HealthABSTRACT
PURPOSE: A user centered web-based mental health management system may be particularly useful in Korea where there is widespread diffusion of personal computers and internet connectivity. The purpose of this paper was to describe the development of a web-based system for mental health management in adolescents using principals of a user centered design. METHOD: Our design process includes five distinct phases: needs assessment, analysis, design, development/testing/revision, and application release. RESULTS: Web content includes an introduction, information about mental health management in adolescents, self-assessment and guidance, interventions for improving mental health, directory of self-help groups, and counseling and additional community resources. The web site was released using the URL: http://www.baejy.com/youth. CONCLUSION: The end result was a web based mental health management system for adolescents with a high degree of usability. The author believes that web-based mental health interventions in the future have true potential in helping Koreans who are suffering, or at risk, for mental health problems, particularly because of the stigma related to psychiatric therapy in Korea.
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Adolescent , Humans , Information Services , Internet , Medical Informatics , Mental Health , Software Design , User-Computer InterfaceABSTRACT
OBJECTIVE: The purpose of this study was to develop a web-based multimedia heath information system for maternal health care using principles of user-centered design. METHODS: Research process includes needs assessment, needs analysis, design, development/testing, and application release. Research methods for needs assessment included literature review, interviews, focus groups, and surveys. RESULTS: Based on the user's needs studies, this information service system contains an introduction, pregnancy test, fetal assessment, maternal and fetal development during pregnancy, maternal self-care methods, complications of pregnancy, complications of postpartum period, information for parenting, father's page, self-help group, FAQ, counseling and hyperlinked on Internet sites of resources pages. The web site was released using the URL: http://www.baejy.com/im. CONCLUSION: Through this health information system, clients can obtain information on maternal and baby care such as maternity care guidelines, daily instructions for families. This system will be a new way of nursing intervention and contribute to the maternal health promotion.
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Female , Humans , Pregnancy , Counseling , Fetal Development , Focus Groups , Health Information Systems , Health Services , Information Services , Information Systems , Internet , Maternal Health Services , Maternal Health , Multimedia , Needs Assessment , Nursing , Parenting , Parents , Postpartum Period , Pregnancy Tests , Self Care , Self-Help Groups , Women's HealthABSTRACT
PURPOSE: It has been suggested that approximately 40% of women between 40 and 64 years of age cease their sexual activity. The aim of this study was to establish the basic data for FSD (female sexual dysfunction) and FSD-related factors in regional urban and rural areas of Korea. METHOD: Three hundred twenty five women over 20 years of age and resident in regional urban and rural areas were analyzed by a visit survey with an organized questionnaire. The female sexual function index (FSFI) for measurement of sexual dysfunction was used. The significance between the degree of sexual dysfunction and characteristics of the participants was analyzed by a t-test and ANOVA test. The relationship between the degree of sexual dysfunction and related factors was analyzed by Pearson's correlation coefficient. RESULTS: All analyzing tools including the FSFI had a high validity for measuring. The FSFI in Korean women was 19.97+/-4.87 and ranged from 2 to 29. Old age, menopause, medication, no contraception usage and longer marital duration were significantly related with a lower FSFI score. Pearson's correlation coefficient revealed the significance in degrees of sexual distress (r=-.469, p=.000), sexual attitude (r=.305, p=.000) and a stressful life event (r=-.141, p=.038) with the sexual function index score. CONCLUSION: Women with sexual dysfunction should be evaluated for these sexual function-related factors in the history taking, and this data can be a basis for study for sexual dysfunction.
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Female , Humans , Contraception , Korea , Menopause , Surveys and Questionnaires , Sexual Behavior , Women's HealthABSTRACT
PURPOSE: The purposes of this study is to develop an educational program to prevent sexual abuse of children and to improve the physical and mental health of children by providing a rape-free environment and safety education. This program will provide parents and children with information on how to prevent sexual abuse in children. Children learn specific methods to avoid being victimized both at home and outside the home through a learning game and simulation, which is based on problem solving. METHOD: This program was developed based on a literature reviews, surveys and negotiation process. School- aged-children, parents, and teachers were interviewed to reveal their educational needs based on their experiences related to sexual abuse. RESULT: This program includes useful subjects such as safety education, early detection of sexual abuse, crisis management, resource persons, and phone numbers of available hospital. Counseling is provided by researcher or by a pediatric psychiatrist if needed. CONCLUSION: This program could be adequately utilized for prevention of sexual abuse of children. It also will provide an intervention strategy for abused children. This educational program was distributed to all of the elementary school through the Ministry of Education and Human Resources Development.
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PURPOSE: The purpose of this study is to develop safety education program to prevent child accident and to improve the health of children by providing a safe environment. This program provide parents and children with information on how to prevent children from accident. Children especially can learn specific methods to avoid accident both at home, school and outside the home through safety education, which is based on problem solving. METHOD: This program was developed based on literature reviews, surveys and negotiation process. School aged children, parents, and teachers were interviewed to identify their educational needs based on their experiences related to child accident. During the 7th Annual Conference of Educational Courses in 1999, the Korean Educational Ministry examined the feasibility and compatibility of integrating the program into the current educational curriculum. RESULT: This program includes useful subjects such as safety education, preventive strategies, crisis management, guide for parent and teacher, resource persons, internet site and phone numbers of available hospital. Counseling is provided by researcher if needed. CONCLUSION: This program could be adequately utilized for prevention of child accident and creation of preventive strategies. It will also suggest an intervention strategy for injured children.