Leisure Time Physical Activity to Reduce Metabolic Syndrome Risk: A 10-Year Community-Based Prospective Study in Korea

PURPOSE: Metabolic syndrome (MetS) is a major public health problem related to increased risks of cardiovascular disease and type 2 diabetes. We investigated whether recommended levels of leisure time physical activity (LTPA) decrease the risk of MetS in a community-based prospective cohort study (Ansung and Ansan cohort).MATERIALS AND METHODS: A total of 3910 adults (1890 men, 2020 women) without MetS examined in 2001–2002 (baseline) were included in this study and followed up from 2013 to 2014. We measured LTPA energy expenditure using the standard metabolic equivalent value [metabolic equivalent of task (MET)-h/wk]. Individuals were categorized into five groups (physically inactive, 0.1 to <7.5, 7.5 to <15.0, 15.0 to <22.5, 22.5 to <40.0, and ≥40.0 MET-h/wk).RESULTS: The mean follow-up period was 11.8 years. Among the cohort, 482 men (25.5%) and 541 women (26.8%) were diagnosed with newly developed MetS. Multivariate logistic analysis revealed a 4.4% lower MetS risk among those performing two to three times the recommended minimum of 7.5 MET-h/wk [multivariate relative risk (RR), 0.956; 95% confidence interval (CI), 0.654–1.398] and a 21.9% lower risk among those performing three to four times the physical activity minimum (multivariate RR, 0.781; 95% CI, 0.574–1.063). This association was only significant in females performing three to four times the minimum (crude RR, 0.655; 95% CI, 0.432–0.994).CONCLUSION: We noted that physical activity at more than 2 times the recommended minimum prevents MetS. Healthcare professionals should encourage inactive adults to be physically active during their leisure time to take advantage of its health benefits.

Comparison of the risks of combustible cigarettes, e-cigarettes, and heated tobacco products

E-cigarettes (ECs) and heated tobacco products (HTPs) have become popular in Korea; hence, it is important to determine whether ECs and HTPs are less hazardous than combustible cigarettes (CCs). In general, the levels of harmful and potentially harmful constituents (HPHCs) are lower in ECs and HTPs than in CCs, although the levels of some heavy metals and HPHCs are higher in ECs and HTPs than in CCs. ECs and HTPs showed possible adverse effects on respiratory and cardiovascular system function, which could result in chronic respiratory and cardiovascular system diseases in animals. An analysis of biomarkers showed that ECs had possible adverse health effects on the respiratory and cardiovascular systems, in addition the effects of HTP on respiratory and cardiovascular systems were not significantly different than those of CC. Epidemiological studies identified positive associations between EC use and asthma, chronic obstructive pulmonary disease, and myocardial infarction. Only one epidemiologic study reported a positive association between ever using HTPs and asthma, allergic rhinitis, and atopic dermatitis among adolescents. Modelling studies of ECs did not show consistent findings regarding the health effects compared with those of CCs. A modeling study of HTPs, performed by tobacco industry, has been criticized for many unfounded assumptions. Lower levels of HPHCs in ECs and HTPs, compared with those in CCs, cannot be directly translated into health benefits because the relationship between exposure and effects is non-linear for cardiovascular diseases and because the duration of exposure is more important than the level of exposure in determining lung cancer mortality. In summary, there is no definite health benefit in using ECs or HTPs instead of CCs, for the individual or the population; hence, tobacco control measures should be the same for ECs, HTPs, and CCs. ECs and HTPs have become popular in Korea; hence, it is important to determine whether ECs and HTPs are less hazardous than CCs.

Correlation between Accelerometer and Questionnaire-Based Assessment of Physical Activity in Patients with Cerebral Palsy

BACKGROUND: Precise measuring and monitoring of physical activity (PA) in patients with cerebral palsy (CP) are critical for assessing their PA participation and its potential health benefits. Accelerometer-based assessment of PA has been considered valid, reliable, and practical in children with CP. Therefore, we investigated the correlation between accelerometer- and questionnaire-based assessment of PA in CP patients.METHODS: Nineteen patients with CP who were classified as Gross Motor Function Classification System level I–III and 84 normally developed participants were included in the study. Study participants wore an accelerometer for seven days, after which they visited the hospital and completed the International Physical Activity Questionnaire (IPAQ). CP patients and their caregivers completed the Pediatric Outcomes Data Collection Instrument (PODCI) and the Caregiver Priorities and Child Health Index of Life with Disabilities, respectively. The concurrent validity of the questionnaires was assessed.RESULTS: In the accelerometer-based assessment, time spent in PA was significantly shorter at every intensity level in CP patients than in normally developed participants. However, PA assessed by the IPAQ was significantly higher in patients with CP, indicating that they tend to exaggerate their participation in PA. On the correlation of the assessment by the accelerometer and by the PODCI, transfer/basic mobility, sports/physical function, and happiness increased significantly as the number of steps taken and the distance travelled increased.CONCLUSIONS: In patients with CP, happiness and quality of life are associated with higher levels of PA. Thus, programs for patients with CP should focus on improving their PA.

Neuroprotective effects of urolithin A on H₂O₂-induced oxidative stress-mediated apoptosis in SK-N-MC cells

Método Pilates: benefí­cios e aplicabilidade para melhorar a qualidade de vida / Pilates method: benefits and applicability to improve the quality of life

O método Pilates de condicionamento corporal foi criado por Joseph H. Pilates, que transmitiu os benefícios de um equilíbrio perfeito entre corpo e mente, e chamou de Contrologia, coordenação completa do corpo, da mente e do espírito. Utilizando princípios específicos para promover a integração entre eles, que são a concentração, centro de força (power house), fluidez, precisão, respiração e controle dos movimentos. Como o número de praticantes do método Pilates tem aumentado muito nas últimas décadas demonstra a necessidade de evidências científicas sobre os benefícios desse método. Sendo assim, este artigo teve como objetivo geral verificar através de um levantamento bibliográfico no qual foram realizadas buscas sistematizadas em três bases de dados eletrônicas (Lilacs, Scielo e Google Acadêmico). Os termos de busca utilizados nas bases foram Pilates, método Pilates, indicações do método Pilates e contraindicações do método Pilates. Dentre os resultados, verificou-se que o método Pilates é utilizado como recurso para condicionamento físico e mental em diversas áreas da saúde, e os estudos analisados evidenciaram a eficácia do método Pilates como ferramenta na prevenção, promoção, reabilitação e melhora da qualidade de vida das pessoas que o praticam. (AU)

The Pilates method of body conditioning was created by Joseph H. Pilates, who conveyed the benefits of a perfect balance between body and mind, and called Contrology, complete coordination of body, mind and spirit. Using specific principles to promote integration between them, they are concentration, power house, fluidity, precision, breathing and movement control. Since the number of Pilates practitioners has increased greatly in the last decades, scientific evidence on the benefits of the Pilates method is needed. Therefore, this article had as general objective to verify through a bibliographic survey carried out in three electronic databases (Lilacs, Scielo and Academic Google). The search terms used in the bases were Pilates, Pilates method, Pilates method indications and contraindications of the Pilates method. Among the results it was verified that the Pilates method is used as a resource for physical and mental conditioning in several areas of health and the studies analyzed demonstrated the effectiveness of the Pilates method as a tool in prevention, promotion, rehabilitation and improvement of people's quality of life who practice it. (AU)

Anti-melanogenic effects of Hordeum vulgare L. barely sprout extract in murine B16F10 melanoma cells / 한국영양학회지

PURPOSE: Barely sprout is a well-known oriental herbal medicine with a wide range of health benefits. Recent studies have provided scientific evidence of its therapeutic effects with expanded application. This study investigated anti-melanogenic effect of barley sprout water extract (BSE) in murine melanocyte B16F10. METHODS: Various concentrations (0, 50, 125, and 250 µg/mL) of BSE and arbutin (150 ppm) were applied to B16F10 stimulated with or without alpha-melanocyte stimulating hormone (100 nM) for 72 hours. The whitening potency of BSE was determined altered cellular melanin contents. Activity and expression of tyrosinase and microphthalmia-associated transcription factor (MITF) were also assayed. RESULTS: Experimental results revealed that treatment with BSE reduced cellular melanin production by approximately 40% compared to the control. Molecular findings supported that suppressed activity and expression of tyrosinase and MITF proteins by BSE were associated with declined cellular melanogenesis. Furthermore, anti-melanogenic effect of BSE (250 µg/mL) was similar to that of arbutin, a commonly used whitening agent. Lastly, polyphenols including p-coumaric, ferulic, and vanillic acids were identified in BSE using HPLC analyses. They might be potential active ingredients showing such melanogenesis-reducing effect. CONCLUSION: BSE was evident to possess favorable anti-melanogenic potency in an in vitro model. As a natural food sourced material, BSE could be an effective depigmentation agent with potential application in pharmaceutical and cosmetic industries.

Emodin exerts protective effect against palmitic acid-induced endoplasmic reticulum stress in HepG2 cells / 한국영양학회지

PURPOSE: Protein overloading in the endoplasmic reticulum (ER) leads to endoplasmic reticulum stress, which exacerbates various disease conditions. Emodin, an anthraquinone compound, is known to have several health benefits. The effect of emodin against palmitic acid (PA) - induced ER stress in HepG2 cells was investigated. METHODS: HepG2 cells were treated with varying concentrations of palmitic acid to determine the working concentration that induced ER stress. ER stress associated genes such as ATF4, XBP1s, CHOP and GRP78 were checked using RT- PCR. In addition, the expression levels of unfolded protein response (UPR) associated proteins such as IRE1α, eIF2α and CHOP were checked using immunoblotting to confirm the induction of ER stress. The effect of emodin on ER stress was analyzed by treating HepG2 cells with 750 µM palmitic acid and varying concentrations of emodin, then analyzing the expression of UPR associated genes. RESULTS: It was evident from the mRNA and protein expression results that palmitic acid significantly increased the expression of UPR associated genes and thereby induced ER stress. Subsequent treatment with emodin reduced the mRNA expression of ATF4, GRP78, and XBP1s. Furthermore, the protein levels of p-IRE1α, p-elF2α and CHOP were also reduced by the treatment of emodin. Analysis of sirtuin mRNA expression showed that emodin increased the levels of SIRT4 and SIRT7, indicating a possible role in decreasing the expression of UPR-related genes. CONCLUSION: Altogether, the results suggest that emodin could exert a protective effect against fatty acid-induced ER stress and could be an agent for the management of various ER stress related diseases.

Clinical Practice Guideline for Cardiac Rehabilitation in Korea / 대한흉부외과학회지

BACKGROUND: Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. METHODS: This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors—primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. RESULTS: CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. CONCLUSION: Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.

The socioeconomic impact of Korean dental health insurance policy on the elderly: a nationwide cohort study in South Korea

PURPOSE: The purpose of this retrospective study was to investigate the relationships of types of dental insurance coverage in Korea with sociodemographic characteristics and the prevalence of systemic and oral diseases, as well as to evaluate the socioeconomic impact of Korean dental insurance policies. METHODS: Sample cohort data from 2006 to 2015 were obtained from the National Health Insurance Service. Patients were divided into 2 groups. The exposed group comprised patients who received insurance benefits for complete dentures, removable partial dentures, and implant care, while the control group comprised patients who did not receive these benefits. The type of insurance coverage and the prevalence of systemic and oral diseases were compared between the 2 groups. RESULTS: Patients who received benefits in the form of complete dentures, removable partial dentures, and implants had similar sociodemographic characteristics in terms of sex, age, income quintile, and type of insurance coverage to the control group. The prevalence of hypertension, anemia, renal disease, rheumatoid arthritis, osteoporosis, asthma, and cerebral infarction was higher in the exposed group than in the control group (P<0.05). The prevalence of periodontal diseases and dental caries was also higher in the exposed group. CONCLUSIONS: Korean dental health insurance policy has been beneficial for the medical expenses of low-income and elderly people suffering from a cost burden due to systemic diseases. However, since there is a tendency to avoid invasive interventions in older patients due to the high risk of systemic diseases, insurance coverage of dentures may be more helpful from a socioeconomic perspective than coverage of dental implant treatments.

Factors affecting preference of vegetable in elementary school students: based on social cognitive theory / 한국영양학회지

PURPOSE: This study was conducted to identify the factors affecting vegetable preferences of children based on the social cognitive theory to reduce imbalances in vegetable consumption. METHODS: The survey investigated 177 elementary school students in Yangsan, Gyeongsangnam-do, in June of 2018. The subjects consisted of 44 fifth graders (27.7%) and 128 (72.3%) sixth graders. RESULTS: Among personal factors of the Social Cognitive Theory, positive outcome expectation and self-efficacy of the vegetable preference group were significantly higher than those of the non-preference group. Negative barrier scores of the non-preference group were significantly higher than those of the preference group, and the biggest barrier was that vegetables were tasteless. Among behavioral factors, the nutritional knowledge of vegetables was high, but the degree of practice was low. Practice score of the vegetable preference group was significantly higher than that of the non-preference group. Among environmental factors, the vegetable preference group was more likely to accept advice from people around them than the non-preference group and the most influential people were doctors and parents. In the vegetable intake environment, children in the vegetable preference group had high accessibility to vegetables. Correlation analysis and regression analysis of the social cognitive factors and vegetable preferences revealed all factors except nutritional knowledge showed significant correlation with vegetable preference. And surrounding people (p < 0.01), practice (p < 0.01), and self-efficacy (p < 0.05) had positive effects on vegetable preference. CONCLUSION: These results suggest that providing the health benefits from eating vegetables and educating children for improving their self-confidence are necessary for increasing the preference for vegetables and their intake by children.

The Impact of Weekend Admission and Patient Safety Indicator on 30-Day Mortality among Korean Long-Term Care Insurance Beneficiaries / 보건행정학회지

BACKGROUND: This study investigates the impact of weekend admission with a patient safety indicator (PSI) on 30-day mortality among long-term insurance beneficiaries. METHODS: Data were obtained from the National Health Insurance Service-Senior claim database from 2002 to 2013. To obtain unbiased estimates of odds ratio, we used a nested case-control study design. The cases were individuals who had a 30-day mortality event after their last medical utilization, while controls were selected by incidence density sampling based on age and sex. We examined the interaction between the main independent variables of weekend admission and PSI by categorizing cases into four groups: weekend admission/PSI, weekend admission/non-PSI, weekday admission/PSI, and weekday admission/non-PSI. RESULTS: Of the 83,400 individuals in the database, there were 20,854 cases (25.0%) and 62,546 controls (75.0%). After adjusting for socioeconomic, health status, seasonality, and hospital-level factors, the odds ratios (ORs) of 30-day mortality for weekend admission/PSI (OR, 1.484; 95% confidence interval [CI], 1.371–1.606) and weekday admission/PSI (OR, 1.357; 95% CI, 1.298–1.419) were greater than for patients with weekday admission/non-PSI. CONCLUSION: This study indicated that there is an increased risk of mortality after weekend admission among patients with PSI as compared with patients admitted during the weekday without a PSI. Therefore, our findings suggest that recognizing these different patterns is important to identify at-risk diagnosis to minimize the excess mortality associated with weekend admission in those with PSI.

Clinical Practice Guideline for Cardiac Rehabilitation in Korea Online only

OBJECTIVE: Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and three additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. METHODS: This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors—primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and two general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, three rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. PRINCIPAL CONCLUSIONS: CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.

Genistein improve nicotine toxicity on male mice pancreas / 대한해부학회지

Nicotine is the most toxic factor of tobacco. Genistein is a phytoestrogen and antioxidant that has numerous health benefits. The aim of this study is to evaluate the effects of genistein against toxic properties of nicotine to the pancreas of mice. For this purpose, 48 male mice were randomly assigned into six groups (n=8): normal control, nicotine control (2.5 mg/kg), genistein (25 and 50 mg/kg), and nicotine+genistein (25 and 50 mg/kg) treated groups. Various doses of genistein and genistein+nicotine were administered intraperitoneally to animals for 4 weeks. The weight of pancreas, total antioxidant capacity and nitrite oxide of serum, insulin levels, and the number and diameter of islets of Langerhans were investigated. Nicotine administration reduced significantly total antioxidant capacity, insulin, pancreas weight, and the number and diameter of islets of Langerhans and increased nitrite oxide in serum compared to the control normal group (P<0.05). Conversely, genistein and genistein+nicotine increased significantly insulin, total antioxidant capacity, and the number and diameter islets of Langerhans and decreased serum nitrite oxide compared to the nicotine control group. It seems that the genistein can improve pancreas damage following the nicotine administration.

Inhaled Corticosteroids in Asthma and the Risk of Pneumonia

PURPOSE: Asthma is a common disease that is expensive and burdensome for patients. Inhaled corticosteroids (ICS) are the most important drugs for asthma treatment and are often prescribed long-term. However, the use of ICS has been reported to increase pneumonia, though this remains controversial. We evaluated whether the use of ICS increases the risk of pneumonia in asthmatic patients using the Health Insurance Review and Assessment Service (HIRA) database in Korea. METHODS: The Asthma Management Adequacy Assessment was performed by the HIRA in Korea. Patients with claimed insurance benefits for asthma disease codes and who were prescribed asthma medications more than 2 times were enrolled. Patient demographics, asthma medications, healthcare use, and complications were analyzed. RESULTS: The total number of asthma patients was 831,613. Patients using ICS were older and had more comorbidities than those not using ICS; they also visited outpatient clinics and emergency departments, and were more often hospitalized. Pneumonia and other complications occurred more often in patients using ICS, and they used more respiratory medications, except for theophylline. Multiple logistic regression analysis showed that ICS prescription was associated with pneumonia (odds ratio, 1.38; 95% confidence interval, 1.36-1.41). Age, sex, medical care, use of secondary and tertiary hospitals, and hospitalization due to asthma in the previous year were also associated with pneumonia. CONCLUSIONS: ICS use was associated with increasing pneumonia in asthmatic patients in Korea. Therefore, it is critical to acknowledge that the use of ICS may increase the risk of pneumonia and should be meticulously monitored in asthmatics.

A Systematic Review of Outcomes Research in the Hospital Pharmacists' Interventions in South Korea

BACKGROUND AND OBJECTIVE: Since the introduction of hospital pharmacy residency programs in 1983, hospital pharmacists in South Korea have been expected to expand their roles. However, their services and the outcomes have not been fully understood. In this study, we conducted a systematic review of Korean hospital pharmacist-provided interventions with regard to intervention type, intervention consequences, and target patient groups. METHODS: A literature search of the following databases was performed: Embase, PubMed, Medline, KoreaMed, RISS, KMbase, KISS, NDSL, and KISTI. The search words were “hospital pharmacist”, “clinical pharmacist”, and “Korea”. Articles reporting clinical or economic outcome measures that resulted from hospital pharmacist interventions were considered. Numeric measures for the acceptance rate of pharmacist recommendations were subjected to meta-analysis. RESULTS: Of the 1,683 articles searched, 44 met the inclusion selection criteria. Most articles were published after 2000 (81.8%) and focused on clinical outcomes. Economic outcomes had been published since 2011. The interventions were classified as patient education, multidisciplinary team work, medication assessment, and guideline development. The outcome measures were physicians’ prescription changes, clinical outcomes, patient adherence, economic outcomes, and quality of life. The acceptance rate was 80.5% (p < 0.005). CONCLUSION: Studies on pharmacist interventions have increased and showed increased patient health benefits and reduced medical costs at Korean hospital sites. Because pharmacists' professional competency would be recognized if the economic outcomes of their work were confirmed and justified, studies on their clinical performance should also include their economic impact.

Clinical Practice Guideline for Cardiac Rehabilitation in Korea: Recommendations for Cardiac Rehabilitation and Secondary Prevention after Acute Coronary Syndrome

Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular (CV) disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of thirty-three authors—primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers CV mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.

The Role of Two Human Milk Oligosaccharides, 2′-Fucosyllactose and Lacto-N-Neotetraose, in Infant Nutrition / 대한소아소화기영양학회지

Human breast milk contains numerous biomolecules. Human milk oligosaccharides (HMOs) are the third most abundant component of breast milk, after lactose and lipids. Amongst the synthetized HMOs, 2′-fucosyllactose (2′-FL) and lacto-N-neotetraose (LNnT) are widely studied and are considered safe for infant nutrition. Several studies have reported the health benefits of HMOs, which include modulation of the intestinal microbiota, anti-adhesive effect against pathogens, modulation of the intestinal epithelial cell response, and development of the immune system. The amount and diversity of HMOs are determined by the genetic background of the mothers (HMO secretors or non-secretors). The non-secretor mothers secrete lower HMOs than secretor mothers. The breastfed infants of secretor mothers gain more health benefit than those of non-secretor mothers. In conclusion, supplementation of infant formula with 2′-FL and LNnT is a promising innovation for infant nutrition.

Paradoxos nos 'benefícios' aos incapacitados: biopolítica e saúde mental / The paradoxes of government 'benefits' in individual considered incapable: biopolitics and mental health / Las paradojas de los 'beneficios' gubernamentales cedidos a los individuos considerados incapacitados: biopolítica e salud mental

Este ensaio objetiva problematizar os paradoxos dos 'benefícios' governamentais, cedidos aos indivíduos considerados incapacitados ao trabalho, devido algum diagnóstico em saúde mental. Para tanto, utiliza do conceito de Biopolítica, proposto por Michel Foucault, contrapondo a relatos de usuários e usuárias de serviços de saúde mental. Através dessas experiências, analisam-se impasses produzidos entre os princípios da Reforma Psiquiátrica Brasileira e os métodos utilizados pelos programas de seguridade social para garantia dos 'benefícios'. Na discussão, aponta-se que o paradoxo dos direitos se torna ainda mais intenso quando as reivindicações emancipatórias no campo da subjetividade estão localizadas numa sociedade em que os Direitos Sociais, previstos em Constituição, não foram conquistados pela maioria da população brasileira. Assim, se os 'benefícios' se colocam de forma paradoxal é, também, porque boa parte da população não tem direitos garantidos e precisam obter alimentação, moradia, saúde, dentre outros, à custa da manutenção de patologias como justificativa para garantir direitos.

This essay aims to discuss the paradoxes of government 'benefits', given to individuals considered incapable of work, due to some diagnosis in mental health. For this, use the concept of Biopolitics, proposed by Michel Foucault, in opposition to reports of users of mental health services. Through these experiences, analyze impasses produced between the principles of the brazilian Psychiatric Reform and the methods used by the social security programs to guarantee benefits. In the discussion, it is pointed out that the rights paradox becomes even more intense when the emancipatory claims in the field of subjectivity are located in a society in which the Social Rights, foreseen in Constitution, were not won by the majority of the brazilian population. Thus, if the benefits are paradoxical, it is also because a large part of the population does not have guaranteed rights and needs to obtain food, shelter, health, among others, at the expense of maintaining pathologies as justification for ensure rights.

Este ensayo objetiva discutir las paradojas de los 'beneficios' gubernamentales, cedidos a los individuos considerados incapacitados al trabajo, debido a algún diagnóstico en la salud mental. Para ello, se utiliza el concepto de Biopolítica, propuesto por Michel Foucault, en contrapunto a relatos de usuarios de servicios de salud mental. A través de esas experiencias, se analizan impasses producidos entre los principios de la Reforma Psiquiátrica brasileña y los métodos utilizados por los programas de seguridad social para garantizar los beneficios. En la discusión, se apunta que la paradoja de los derechos se vuelve aún más intenso cuando las reivindicaciones emancipatorias en el campo de la subjetividad están localizadas en una sociedad en la que los Derechos Sociales, previstos en la Constitución, no fueron conquistados por la mayoría de la población brasileño. Así, si los beneficios se plantean de forma paradójal es, también, porque buena parte de la población no tiene derechos garantizados y necesitan obtener alimentación, vivienda, salud, entre otros, a costa del mantenimiento de patologías como justificación para asegurar derechos.

Benefícios por doenças cardiovasculares na cidade do Recife, Pernambuco, no quinquênio 2011­2015 / Benefits granted due to cardiovascular disease in Recife, Pernambuco, Brazil, 2011­2015

Introdução: Os benefícios previdenciários refletem o impacto socioeconômico gerado pela incapacidade ao trabalho por motivo de doença. As doenças cardiovasculares (DCV) são as principais causas de mortalidade e morbidade no mundo. Objetivo: Avaliar, clínica e economicamente, os benefícios previdenciários concedidos por DCVs no Recife, Pernambuco, no quinquênio 2011­2015. Métodos: Estudo descritivo, de corte transversal, com coleta de informações e análise dos benefícios por incapacidade pelas DCVs na gerência executiva do Instituto Nacional do Seguro Social no Recife, por intermédio do Sistema Único de Informações de Benefícios. Resultados: No quinquênio 2011­2015 foram concedidos 186.058 benefícios. Destes, 8.968 (4,8%) foram por DCVs, entre os quais 6.049 (67,5%) foram selecionados por serem as doenças mais frequentes. Dos beneficiários, 78% são masculinos e 63,8% estavam na faixa etária entre 45 e 59 anos. O acidente vascular encefálico (AVE) e a insuficiência cardíaca (IC) foram responsáveis pela maior duração de afastamento ao trabalho (entre 135 e 138 dias) e pelo maior valor do benefício (próximo de R$ 3.900 mensais). Conclusão: Embora a hipertensão arterial sistêmica não acarrete um afastamento tão longo e não seja tão dispendiosa, ela deveria ser prevenida, por ser causa importante de AVE e IC, duas das principais DCVs responsáveis por maior custo e número de dias de absenteísmo. A melhoria da qualidade de vida da população visa à atenuação do impacto na Previdência Social, no mundo do trabalho e na sociedade como um todo.

Background: Social security benefits reflect the socioeconomic impact of work incapacity by disease. Cardiovascular diseases (CVD) are the main cause of mortality and mortality worldwide. Objective: To evaluate benefits granted due to CVD in Recife, Pernambuco, Brazil, from 2011 to 2015, from the clinical and economic perspective. Methods: Cross-sectional and descriptive study which collected and analyzed data on benefits granted for disability caused by CVD by the executive management of the National Social Security Institute in Recife, via the Unified System of Information on Benefits. Results: 186,058 benefits were granted from 2011 to 2015, 8,968 (4.8%) corresponded to CVD, of which 6,049 (67.5%) were selected for analysis because they corresponded to the most frequent diseases. About 78% of the beneficiaries were male and 63.8% were within age range 45 to 59 years old. Stroke and heart failure (HF) accounted for the longest sick leaves (133 to 138 days) and highest benefit amounts (about BRL 3,900.00 per month). Conclusion: While hypertension does not result in as long leaves and costs, it should be prevented for being a significant cause of stroke and HF, both of which account for longer sick leaves and higher social security costs. Improving the quality of life of the population seeks to reduce their impacts on the social security system, the world of work and society at large

The Disease Burden of Lung Cancer Attributable to Residential Radon Exposure in Korean Homes

BACKGROUND: Residential radon exposure is known to be an important risk factor for the development of lung cancer. The objective of this study was to calculate the disease burden of lung cancer attributable to residential radon exposure in Korea. METHODS: We calculated the national exposure level using Korean national radon survey data from 2011 to 2014, and house structure distribution data from each administrative region. Using the exposure-risk function, the population attributable fraction (PAF) was calculated and applied to calculate the disease burden for lung cancer attributable to residential radon exposure. RESULTS: Residential radon exposure levels were the highest, at 116.4 ± 50.4 Bq/m3 (annual mean radon concentration ± standard deviation) in detached houses, followed by 74.1 ± 30.0 Bq/m3 in the multi-family dwellings, and 55.9 ± 21.1 Bq/m3 in apartments. The PAF for lung cancer, due to long-term radon exposure in Korean homes, was 6.6% and 4.7% in men and women, respectively. The total disease burden of lung cancer attributable to residential radon exposure was 14,866 years of life lost (YLL) and 1,586 years lost due to disability (YLD) in 2013. Overall, 1,039 deaths occurred due to residential radon exposure, of which 828 were in men and 211 in women. CONCLUSION: The smoking rate of men in Korea exceeded 70% in the 1990s, and is still near 40%. Although the size of the effect varies depending on the estimation method, it is a critical aspect as a risk factor of lung cancer because of the synergistic relationship between smoking and radon exposure. Because the Korean society is rapidly aging, population who were formerly heavy-smokers are entering a high-risk age of lung cancer. Therefore, it is necessary to inform the public about the health benefits of reduced radon exposure and to strengthen the risk communication.