ABSTRACT
Background@#Upper gastrointestinal endoscopy is becoming a common technique used by primary care physicians, so appropriate education using adummy is beneficial for the trainees. However, because dummies are expensive, only a few hospitals have dummies. In this study, we investigatedwhether a simplified upper gastrointestinal endoscopic simulator created using recycled materials can be useful in endoscopic education. @*Methods@#The simplified upper gastrointestinal endoscopic simulator was prepared using materials that were readily available around us. Focus groupinterviews were conducted with five family medicine trainees for 60 minutes using a semi-structured questionnaire. All conversations were recordedand transcribed after they provided informed consent. Data were analyzed using qualitative analysis methods. @*Results@#Family medicine trainees believe that upper gastrointestinal endoscopic training is essential for primary care physicians and can be helpful intheir job after training. However, they were concerned about the possibility of endoscopic complications and difficulty in endoscopy operation. Allof them said that the simplified upper gastrointestinal endoscopic simulator helped reduce their fear and also helped them become familiar withanatomic positions. The simplified upper gastrointestinal endoscopic simulator also aroused their interest and motivated them to learn. @*Conclusion@#Overall, the simplified upper gastrointestinal endoscopy simulator seemed helpful for trainees of upper gastrointestinal endoscopy. Theuse of a simplified upper gastrointestinal endoscopy simulator could be considered in training hospitals that do not have enough financial resources.Further quantitative studies are needed to generate further evidence.
ABSTRACT
Background@#Previous studies suggested the correlation between thyroid and kidney functions, especially the high prevalence of hypothyroidism in chronic kidney disease. This study aimed to evaluate the influence of hypothyroidism on kidney function in Korean adults by using data from a representative nationwide survey. @*Methods@#This was a cross-sectional study composed of 5,250 individuals aged ≥19 years who were enrolled in the sixth Korea National Health and Nutrition Examination Survey. The participants were classified into three groups of patients with euthyroidism, subclinical hypothyroidism, and overt hypothyroidism according to thyroid function. Chronic kidney disease was defined as having a decreased estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2. Univariate and multivariate logistic regression analyses were used to evaluate the prevalence and adjusted odds ratio (aOR) of chronic kidney disease. @*Results@#Compared with the euthyroidism group, the subclinical and overt hypothyroidism groups showed higher prevalence rates of chronic kidney disease in both sexes. This tendency was significant in the elderly people aged ≥65 years. In the multivariate logistic regression analysis, the subclinical hypothyroidism group did not show a significant difference (adjusted odds ratio [aOR], 1.78; 95% confidence interval [CI], 0.82–3.87) from the euthyroidism group. In the overt hypothyroidism group, the aOR of chronic kidney disease was significantly higher (aOR, 5.90; 95% CI, 1.73– 20.15) than that in the euthyroidism group. @*Conclusion@#Overt hypothyroidism was associated with decreased eGFR and may be considered as an independent risk factor of chronic kidney disease.