Sodium intake trend and current intake level by meal provision place among the citizens of Seoul

BACKGROUND/OBJECTIVES@#The diversity of meal provision places has increased in recent years and sodium intake can vary depending on where meals are eaten, particularly in large cities. In this study, an analysis of the recent trends in sodium intake was performed and a comparison of sodium intake level according to meal provision place among citizens of Seoul was performed. @*SUBJECTS/METHODS@#Data from a 24-h recall dietary intake survey from the 2010–2019 Korea National Health and Nutrition Examination Survey (KNHANES) were used in order to determine the trends in sodium intake among citizens of Seoul, aged 3–74 years old. (n = 11,811). The trend of daily sodium intake was presented in absolute amount and proportion compared to the chronic disease risk reduction intake (CDRR) for each selected characteristic. A comparison of sodium intake level according to meal provision place by sex and age groups as a total amount per meal (mg), density per meal (mg/1,000 kcal), and proportion of the daily sodium intake was performed using the 2016–2019 KNHANES. @*RESULTS@#Sodium intake levels showed a downward trend from 2010–2019. The highest level of sodium intake was observed for subjects aged 30–49, and the level for males aged 30–49 was 202.8% higher than the CDRR. Results of the analysis of sodium intake per meal according to meal provision place showed that the highest sodium intake was in the order of restaurant meal (RM) > institutional foodservice (IF) > home meal (HM) > convenience food (CF). A higher sodium density (mg/1,000 kcal) was observed for IF compared with RM in most adults. Adults aged over 50 years old consumed more than half of the daily sodium in HM. @*CONCLUSION@#Significant variation in the level of sodium intake was observed according to sex and age groups, therefore, different approaches and nutrition policies based on meal provision place are needed.

Changes in dietary habits and chronic diseases before and after COVID-19 by regions using data from the 2018-2020 Korea Community Health Survey and Consumer Behavior Survey for Foods: a cross-sectional study / 대한지역사회영양학회지

Objectives@# This study examined the changes in dietary habits, the prevalence of chronic diseases, and mental health problems in the regional areas of the Republic of Korea before and after the COVID-19 pandemic to provide evidence of the status of regional health inequalities. @*Methods@# This study analyzed Korean adults aged 19 or older who participated in the Korea Community Health Survey (n = 686,708) and Consumer Behavior Survey for Foods (n = 19,109) from 2018 to 2020. The participants were classified according to their residence area (Seoul metropolitan area, Metropolitan cities, Provinces); 2018-2019 were defined as before COVID-19, and 2020 as after COVID-19. The dietary behaviors, chronic diseases, and mental health problems were measured using a self-report questionnaire. @*Results@# After COVID-19, the eating-out usage rate in the Seoul metropolitan area and Provinces decreased compared to before COVID-19 (P < 0.001), and when responding that they eat out, the frequency of eating out with household members in the Seoul metropolitan area increased (P = 0.024). The deliveries/takeout usage rate in the Provinces decreased after COVID-19 compared to before (P < 0.001). After COVID-19, the prevalence of obesity decreased in all regions (P < 0.001), and the prevalence of hypertension increased significantly in the Provinces (P = 0.015). The prevalence of diabetes mellitus increased continuously before and after COVID-19 in all regions (P < 0.002). High-risk subjective stress levels increased significantly in the Seoul metropolitan area (P < 0.001), and sleep duration significantly increased in all regions (P < 0.001). Major depressive disorder was reduced significantly in Metropolitan cities (P = 0.042) and Provinces (P < 0.001). @*Conclusions@# After the COVID-19 pandemic, the prevalence of chronic diseases and mental health problems showed regional differences along with changes in dietary habits. It is necessary to reflect the regional differences in dietary habits in future policies resolving regional health inequalities.

Effect of Verbal Violence on the Turnover Intention among Operating Room Nurses: Focusing on the Moderating Effects of Social Support and Coping / 간호행정학회지

Purpose@#This descriptive correlation study explored the moderating effect of social support and coping in the correlation between experiences of verbal violence and turnover intention among operating room nurses. @*Methods@#The data collection for this study was conducted from July 22 to August 2, 2019, covering 213 operating room nurses working at six general hospitals. Data were analyzed using descriptive statistics, independent t-test, one-way analysis of variance, Pearson’s correlation coefficient, and multiple regression with the SPSS/WIN 25.0 program. @*Results@#The mean scores on the experiences of verbal violence by doctors and nurses, social support, coping and turnover intention were 2.52, 2.33, 3.42, 2.61 and 3.90, respectively. Experiences of verbal violence by doctors (r=.21, p=.002) and nurses (r=.25, p<.001) showed a statistically significant positive correlation with turnover intention. In the relationship between the experiences of verbal violence and turnover intention, social support from coworkers (β=.80, p=.018) and coping (β=-.87, p=.005) had a moderating effect. @*Conclusion@#The experience of verbal violence among operating room nurses affects turnover intention; therefore, there is a need to reduce verbal violence at medical sites, support programs to encourage social support from coworkers, and an effective system to cope with verbal violence.

Factors Influencing Glycemic Control by gender in Workers with Diabetes Mellitus / 재활간호학회지

PURPOSE: This study aimed to identify glycemic control status and factors influencing glycemic control by gender in workers with diabetes mellitus. METHODS: Using data from the Korean National Health and Nutrition Examination Survey (KNHANES) from 2013 to 2016, 763 workers with Type II diabetes mellitus who were≥30 years of age were included. Data were analyzed by χ² test and multiple logistic regression using SPSS/WIN 23.0 program. RESULTS: Glycemic control rates were lower in patients who had diabetes mellitus for 10~20 years than in those who had diabetes mellitus for 5 years or less, and this factor affected glycemic control in both men and women. In men, the odds ratio of good glycemic control was higher in insulin treatment, no hyperlipidemia, eat breakfast more than 3 times/week, eating out 3~4 times/week than other group. In women, the odds ratio of good glycemic control was higher in women who were not married and did not drink alcohol than other group. CONCLUSION: Factors influencing glycemic control differed in men and women. Therefore, it is necessary to provide individualized education by gender for patients with diabetes mellitus in hospitals and to prepare a detailed management plan for diabetes mellitus in work places and throughout society.

Adaptation and Effects of the Evidence-based IPC Nursing Protocol on Prevention of Postoperative Venous Thromboembolism / 간호행정학회지

PURPOSE: This study was conducted to adapt the standardized evidence-based nursing protocol using the IPC (intermittent pneumatic compression) intervention to prevent venous thromboembolism in surgical patients. Further, an investigation was done to measure knowledge on prevention of venous thromboembolism, surrogate incidence of venous thromboembolism and to assess IPC compliance in the study patients compared with those in surgical patients who underwent IPC intervention due to previous clinical experience. METHODS: An analysis was done of the nine modules suggested by National Evidence-based Healthcare Collaborating Agency (NECA) in the adaptation manual of the clinical practice guideline for protocol adaptation. A nonequivalent control group post test design as a quasi-experiment was used to verify the effect of the IPC protocol. RESULTS: There was a significant difference in knowledge of prevention of venous thromboembolism, IPC application time after intervention and the number of IPC applications between the experimental group (n=50) using the IPC nursing protocol and the control group (n=49). However, the symptoms of deep vein thrombosis and pulmonary thromboembolism were not observed in either the experimental group or the control group after the intervention. CONCLUSION: Results confirm that the standardized IPC nursing protocol provides effective intervention to prevent venous thromboembolism in surgical patients.

Type 4 dual left anterior descending coronary artery

No abstract available.

Job Satisfaction Level and Related Factors among Korean Hospital Dietitians

The objective of this study was to examine job satisfaction status and its related factors among dietitians working in hospitals. A survey questionnaire was sent to dietitians working in tertiary, general, and convalescent hospitals in Korea. The study sample hospitals included all tertiary hospitals (n=43), and the sample of general hospitals (n=114) and convalescent hospitals (n=240) was randomly selected using a stratified sampling method. A total of 665 dietitians completed the survey questionnaire. The questionnaire included 27 job satisfaction questions on task, stability.vision, working conditions, and relationship areas, and the questions on task improvement need. The job satisfaction scores in all four areas ranged from 2.53/5.00 to 3.89/5.00, implying generally low job satisfaction level in hospital dietitians. The job satisfaction levels in the convalescent hospital group were significantly lower compared to those in the tertiary and general hospital groups. Whereas job satisfaction levels of tertiary and convalescent hospital groups did not differ by number of beds, those of the general hospital group increased significantly with the number of beds for all four areas. Multivariate regression analysis results showed that hospital type was a significant predictor of job satisfaction level for all four areas. Job satisfaction of relationship area was also significantly affected by the number of beds, whereas that of working conditions was influenced by annual income and working experience. The study findings provide useful information in planning clinical dietitians' optimal supply outlook for the improvement of clinical nutrition services.

Risk Factors for Progression to Postpartum Diabetes Mellitus and Perinatal Complications in Women with Gestational Diabetes Mellitus / 임상당뇨병

BACKGROUND: Gestational diabetes mellitus (GDM) is a hyperglycemic condition caused by increased insulin resistance and impaired insulin secretion during pregnancy. It is known to be temporary, but it can cause perinatal complications in the mother and baby. Additionally, it may progress to type 2 diabetes mellitus (T2DM). In the present study, we evaluated the risk factors for complications and progression to T2DM in patients with GDM. METHODS: The study included 130 pregnant women who were diagnosed with GDM at gestational weeks 24-28 in 2011. Body mass index and the levels of glucose, total cholesterol, lipoproteins, and coagulation factors (von Willebrand factor and plasminogen activator inhibitor-1) were assessed in all patients. RESULTS: The level of high-density lipoprotein (HDL) was significantly lower and the triglyceride/HDL ratio and coagulation factor levels were significantly higher in the group of patients with perinatal complications compared to those in the group of patients without complications. After delivery, the level of HDL was lower and the value of homeostasis model assessment of insulin resistance (HOMA-IR) was higher in women with impaired glucose metabolism compared to those in women with normal glucose metabolism. In logistic regression analysis, perinatal complications were independently associated with HDL and PAI-1 levels (OR = 0.929 and 1.101, respectively). CONCLUSION: The findings of our study show that the levels of HDL and coagulation factors are notable risk factors of perinatal complications. Additionally, we showed that lower HDL level may influence the progression to T2DM. Large-scale population studies are needed to verify our findings.

A Case of Cholesterol Crystal Embolization presenting as Focal Myositis and Foot Necrosis / 대한내과학회지

Cholesterol crystal embolism caused by showers of cholesterol emboli from an atherosclerotic aorta is a multisystem disorder that affects many organs. Common signs and symptoms on presentation include skin findings and renal failure. However, myositis due to a cholesterol embolism is uncommon. We report a rare case of cholesterol crystal embolism that presented with features of focal and foot necrosis in an 83-year-old woman.

A Meta-analysis of Intervention on Depression in Cancer Patients

PURPOSE: The purpose of this study was to analyze the characteristics and effect size of the intervention study applied to the depression of the cancer patient. METHODS: A total of 749 studies published from 1990 to 2011 were searched through the search databases and among them, 35 examples satisfied the inclusion criteria. Three independent researchers implemented the methodological qualitative evaluation. The data were analyzed using meta-analysis. RESULTS: For the depression of the cancer patient, 19 various interventions were applied. The size of the intervention effect that can be analyzed in terms of effect size came out as OR of the laugh therapy 8.122 (p=.073), OR of the music therapy 4.418 (p=.014), OR of the integrated therapy 4.418 (p=.015). CONCLUSION: This study suggests that the music therapy and integrated therapy is effective to the depression of cancer patients. Furthermore, in order to check the effects of intervention, we should need to include more randomized controlled studies and various intervention studies.

beta-Cell dysfunction and insulin resistance in gestational glucose intolerance

No abstract available.

Relationship between Vitamin D, Parathyroid Hormone, and Bone Mineral Density in Elderly Koreans

There is controversy regarding definition of vitamin D inadequacy. We analyzed threshold 25-hydroxyvitamin D (25[OH]D) below which intact parathyroid hormone (iPTH) increases, and examined age- and sex-specific changes of 25(OH)D and iPTH, and association of 25(OH)D and iPTH with bone mineral density (BMD) in elderly Koreans. Anthropometric parameters, serum 25(OH)D and iPTH, lumbar spine and femur BMD by dual-energy radiography absorptiometry (DXA) were measured in 441 men and 598 postmenopausal women. iPTH increased below serum 25(OH) of 36.7 ng/mL in men, but failed to reach plateau in women. Femur neck BMD above and below threshold differed when threshold 25(OH)D concentrations were set at 15-27.5 ng/mL in men, and 12.5-20 ng/mL in postmenopausal women. Vitamin D-inadequate individuals older than 75 yr had higher iPTH than those aged < or = 65 yr. In winter, age-associated iPTH increase in women was steeper than in summer. In conclusion, vitamin D inadequacy threshold cannot be estimated based on iPTH alone, and but other factors concerning bone health should also be considered. Older people seemingly need higher 25(OH)D levels to offset age-associated hyperparathyroidism. Elderly vitamin D-inadequate women in the winter are most vulnerable to age-associated hyperparathyroidism.

Influence of Visceral Adiposity on Cardiovascular Autonomic Neuropathy in Patients with Type 2 Diabetes Mellitus

BACKGROUND: The aim of this study was to investigate the influences of visceral adiposity on cardiovascular autonomic neuropathy (CAN) in patients with type 2 diabetes mellitus. METHODS: Two hundred eleven patients with type 2 diabetes participated in this study. Anthropometric and metabolic parameters were measured, and the visceral fat area was assessed using computed tomography. CAN was diagnosed using a cardiovascular reflex test. We analyzed the correlation between the visceral fat area and each parameter in this test. RESULTS: The mean age, body mass index (BMI), and duration of diabetes of the study population were 60+/-14 years (mean+/-standard deviation), 25.1+/-4.2 kg/m2, and 12.3+/-8.9 years, respectively. The visceral fat area showed positive correlations with age, BMI, waist circumference, and subcutaneous fat area. There was no statistically significant difference in the cardiovascular reflex test outcome between genders. Univariate linear regression analysis showed that an increased visceral fat area diminished good heart rate response to a Valsalva maneuver (R2=4.9%, P=0.013 in an unadjusted model), but only in women. This statistical association was preserved after adjusting for age and BMI (R2=9.8%, P=0.0072). CONCLUSION: The results of this study suggest that visceral adiposity contributes to an autonomic imbalance to some degree, as demonstrated by the impaired cardiovascular reflex test among women with type 2 diabetes.

A Case of Salmonella Psoas Abscess Presenting as Low Back Pain and Subacute Renal Failure / 대한내과학회지

Salmonella is a rare cause of psoas abscess and infectious spondylitis. We report a case of a 62-year-old male patient with Salmonella group D psoas abscess and infectious spondylitis as low back pain and subacute renal failure. The patient who had a previous operation history of abdominal aortic aneurysm rupture was admitted to evaluate low back pain and abnormal renal function. Bilateral psoas abscess and infectious spondylitis of lumbar vertebrae was detected by spine MRI and Salmonella group D was isolated in aspirated fluid of psoas abscess. After long term antibiotics treatment (ceftriazxone and ciprofloxacin), psoas abscess and spondylitis was markedly improved, however, his renal function was not recovered to progress to end stage renal disease.

A Case of Acetone Intoxication Misdiagnosed as Diabetic Ketoacidosis / 임상당뇨병

Diabetic ketoacidosis (DKA) is one of the most serious acute metabolic complications of diabetes. The triad of uncontrolled hyperglycemia, metabolic acidosis, and increased total body ketone concentration characterizes DKA. Not all patients with ketoacidosis have DKA, and other situations can result in metabolic acidosis and ketonemia, like starvation ketosis, alcoholic ketoacidosis or ingestion of drugs such as salicylate, methanol, ethylene glycol. We report a case of acetone intoxication that was misdiagnosed as diabetic ketoacidosis.

A Case of Trichosoporon insectorum Peritonitis in a Continous Ambulatory Peritoneal Dialysis Patient / 대한신장학회지

CAPD peritonitis caused by Trichosporon species is uncommon. We report a case of peritonitis due to T. insectorum in a 38-year-old man who had undergone CAPD for about 1 year. He presented with abdominal pain. The clinical signs and analysis of peritoneal fluid were consistent with CAPD peritonitis. Patient deteriorated despite empirical antibiotics therapy. Repeated peritoneal culture revealed Trichosporon species. The peritonitis was treated with CAPD catheter removal and administering amphotericin B and fluconazole. We isolated T. insectorum by DNA sequencing method. We hereby report the first case of T. insectorum CAPD peritonitis.

Aspirin Resistance in Patients with End-Stage Renal Disease / 대한신장학회지

PURPOSE: Patients with end-stage renal disease (ESRD) frequently undergo thrombotic cardiovascular events, but the relationship between increased thrombotic events and aspirin resistance is poorly defined in these patients. METHODS: Between December 2008 and November 2009, 59 ESRD patients who had taken aspirin alone or aspirin plus clopidogrel daily for > or =7 consecutive days were included. Aspirin resistance was measured using the VerifyNow Aspirin Assay and compared with that of patients with normal kidney function. Moreover, thrombotic cardiovascular events were examined in the ESRD patients. RESULTS: Aspirin reaction unit was 475+/-58 U in the ESRD patients compared with 443+/-62 U in patients with normal kidney function. Nineteen (11%) of 170 patients were aspirin resistant based on the criterion of aspirin reaction unit (> or =550). The prevalence of aspirin resistance was significantly higher in the ESRD patients than in control patients (20% vs. 6%, p=0.006). ESRD and the use of angiotensin- converting enzyme inhibitors were associated with aspirin resistance in the multivariate logistic regression analysis. After a mean follow-up of 18.6+/-7.5 months, the incidence of thrombotic cardiovascular events in the ESRD patients who had aspirin resistance was significantly higher than in the ESRD patients without aspirin resistance (75% vs. 38%, p=0.023). CONCLUSION: The incidence of aspirin resistance was higher in patients with ESRD than in patients with normal kidney function. In addition, ESRD and the use of angiotensin-converting enzyme inhibitors were significant predictors for aspirin resistance. Aspirin resistance was associated with increased thrombotic cardiovascular events in ESRD patients.

Acute Extensive Ischemic Gastroduodenitis in a Patient with End Stage Renal Disease: A Case Report / 대한신장학회지

Acute extensive ischemic gastroduodenitis is a very rare disease because the stomach and duodenum normally have enough blood supply to the upper gastrointestinal (GI) tract and the submucosal vascular plexus. The major causes of upper GI hemorrhage in end stage renal disease (ESRD) patients include erosive gastritis, erosive esophagitis, esophageal ulcer and peptic ulcer. Ischemic gastritis and duodenitis have been reported to be rare as a cause of upper GI bleeding in ESRD patients. We report a case of acute extensive ischemic gastroduodenitis caused by septic shock with severe mesenteric calcification in a patient with ESRD undergoing maintenance hemodialysis.

A case of back pain caused by Salmonella spondylitis: A case report / 대한마취과학회지

Salmonella spondylitis is a rare illness, and it generally occurs in patients who have already had sickle cell anemia, and it is even rarer in patients who are without sickle cell anemia. A 61-year-old male patient was hospitalized for the evaluation of his renal function and then treatment was started for his back pain. His back pain had developed about 2 months previously without any specific trauma. Only a bulging disc was detected on the initial lumbar MRI. Regarding his fever, it was diagnosed as possible atypical pneumonia, scrub typhus, etc., and multiple antibiotic therapy was administered. At the time of transfer, the leucocytes and hs-CRP were normal and the ESR was elevated. A diagnostic epidural block was performed for his back pain, but his symptoms were not improved. Lumbar MRI was performed again and it showed findings of infective spondylitis. Salmonella D was identified on the abscess culture and so he was diagnosed as suffering from Salmonella spondylitis. After antibiotic treatment, his back pain was improved and the patient was able to walk.

Neutrophil-to-lymphocyte Ratio as a Risk Factor for Severe Acute Kidney Injury / 대한신장학회지

PURPOSE: To evaluate whether neutrophil-to-lymphocyte ratio (NLR) as a marker of inflammation correlates with the severity of ischemic acute kidney injury (AKI). METHODS: Between January 2003 and December 2008, 84 patients were diagnosed with ischemic AKI. Patients were divided into two groups (prerenal azotemia and acute tubular necrosis; ATN) and analyzed. RESULTS: Of 84 ischemic AKI patients studied, 49 (58%) presented with ATN. NLR on admission was significantly greater in patients with ATN than that in those with prerenal azotemia (7.8+/-7.7 vs. 5.1+/- 3.7; p=0.034). There was a significant and positive correlation between NLR and age (r=0.283; p= 0.009), log C-reactive protein (r=0.409; p=0.001), and log initial and peak serum creatinine (SCr) (r= 0.242; p=0.026 and r=0.294; p=0.007, respectively). Body mass index, hemoglobin and serum albumin concentration were negatively correlated with NLR (r=-0.291; p=0.031, r=-0.254; p=0.020, and r= -0.236; p=0.032, respectively). Thirty-four (41%) patients had severe AKI (RIFLE-F, defined as an absolute increase in SCr of either > or = 0.5 mg/dL or a threefold increase from baseline, or a SCr of more than 4 mg/dL) during hospitalization. A high NLR (>7.5) was associated with the development of severe AKI in multivariate logistic regression analysis. CONCLUSION: High levels of inflammation, as demonstrated by a high NLR, are associated with the severity of ischemic AKI.