Survival Analysis for Prognostic Factors of Occupational Low Back Pain

PURPOSE: The goals of this research are to find out factors influencing the duration of work-related disability and to present implications for policies to prevent delayed recovery. METHOD: The subjects of this study were 238 workers who had been proved to be industrial disaster victims for occupational low back pain between January 1 2000 and December 31 2003. Kaplan-Meier method was used to estimate the proportion of duration of disability associated with low back pain, and Cox proportional hazards analysis was used to identify factors predicting it. The model distinguished main symptom variables affecting acute(90 days). RESULT: Fifty percent of the workers had not recovered in 408 days. The results of Cox regression show that delayed duration of disability was predicted by diagnosis, pain radiation (in chronic phase), sex, the size and labor union of the workplace, scheduled rest, compensation from the company, and operation. CONCLUSION: Duration of disability associated with compensated low back pain is influenced not only by factors related to the company and compensation system but also by individual factors. Thus, future efforts to reduce duration of disability may need to take into account all these factors.

Relationships of Smoking, Stress and Social Support of High School Students / 예방의학회지

OBJECTIVES: The purpose of the present study was to explore a possible interaction effect of stress and social support on the smoking status and identify smoking related factors of high school students. METHODS: A cross-sectional design was used for this study. A total of 1, 251 high school students from Gyeonggi-do were selected using stratified-proportional random cluster sampling methods. The participants completed a set of questionnaires to measure their smoking status, stress, social support and sociodemographic information. The obtained data were analyzed using descriptive statistics, x2-tests and hierarchical logistic regressions. RESULTS: The interaction effect of stress and social support on smoking status was not supported. However, stress, sex, types of school, parent's smoking and friends' smoking were significantly predicted the smoking status of the high school students. CONCLUSIONS: In relation to the prevention of adolescents' smoking, it is recommended to decrease the stress levels of students, to make adolescents' parents cease smoking, and to educate adolescents on how to refuse the temptation to smoke or pressure from their smoking friend.

Comparison of Urea Kinetic Modeling, Standardized Creatinine Clearance and Indices of Nutrition in Continuous Ambulatory Peritoneal Dialysis (CAPD) Patients / 대한내과학회지

OBJECTIVES: Protein-calorie malnutrition has been shown to be prevalent among patients on chronic dialysis, And assessment of nutritional status of continuous ambulatory peritoneal dialysis(CAPD) patients has assumed greater importance because of the association of protein-calorie malnutrition with increasing morbidity and mortality. So we observed the incidence and clinical effect of protein-calorie malnutrition, and we compared the indices of nutrition with dialysis adequacy utilizing urea kinetic modeling and cretinine clearance in CAPD patients. METHODS: We performed a cross-sectional study in which eight parameters, based on anthropometry, blood chemistry and subjective symptoms, were scored according to the degree of abnormalities in 82CAPD patients. A malnutrition index was derived from these scores. We also performed comparative analysis to identify significant correlations of the indices of urea kinetic modeling and creatinine clearance with the other parameters of nutritional status. RESULTS: The malnutrition index classified 47(57%) patients as normal, 30(37%) intermediately malnourished, and 5(6%) as severely malnourished. Malnutrition index showed a significant correlation with the body mass index(BMI), triceps skinfold thickness(TSF), mid-arm circumference(MAC), mid-arm muscle area (MAMA), duration of CAPD, subjective symptoms, serum albumin, transferrin, cholesterol, and triglyceride. The malnutrition index also showed a significant correlation with residual renal function(RRF), and standardized creatinine clearance(SCCr). The TWR-Kt/V(total Kt/Vurea per week with consideration of residual renal urea clearance) was significantly lower in the severely malnourished group than in the normal group. Serum alkaline phosphatase and BUN levels were higher in the severely malnourished group than in the normal and inter-mediate groups. CONCLUSION: In assessing the nutrition status of CAPD patients, body weight, TSF, MAC, MAMA, subjective symptoms, serum albumin, transferrin, cholesterol, triglyceride, urea nitrogen, and alkaline phosphatase were considered useful parameters. There was a trend of increased BUN and decreased TWR-Kt/V in severely malnourished patients, and the value of SCCr was significantly lower in malnourished patients. However, no meaningful relationships between TW-Kt/V and malnutrition index or between NPCR(normalized protein catabolic rate) and malnutrition index were found m this cross-sectional study. As the number of patients with longer duration of CAPD or negligible RRF has increased in the malnourished patients, regular monitoring of these parameters, especially TWR-Kt/V and SCCr, may be helpful to assess dialysis adequacy to keep good nutritional status of each CAPD patient.

Severe hypophosphatemia in hospitalized patients / 대한신장학회잡지

No abstract available.