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Background@#Sleep duration is associated with various health conditions, including chronic kidney disease. However, the association between sleep duration and decline in kidney function in the South Korean population remains unclear. We aimed to investigate the impact of sleep duration on kidney function decline in adult patients with hypertension. @*Methods@#This cohort study was performed using data obtained from the Korean Genome and Epidemiology Study; 2,837 patients with hypertension who initially had normal kidney function were included. Glomerular filtration rates (GFRs) were estimated at baseline and throughout the 16 years of follow-up. A person was considered to have a decline in kidney function if they had a GFR <60 mL/min/1.73 m2. Sleep duration data were obtained through interviewer-assisted questionnaires. Sleep durations were classified as short (<6 hours), normal (≥6 hours but <9 hours), and long (≥9 hours). The Cox proportional hazards model was applied, with adjustments for covariates. @*Results@#After adjusting for covariates, sleep duration was not associated with a decline in kidney function. However, among men with poorly controlled hypertension at baseline, compared to men with normal sleep durations, men with sleep durations <6 hours had a significantly higher risk of kidney function decline (hazard ratio, 1.56; 95% confidence interval, 1.02–2.36). @*Conclusion@#Short sleep duration did not seem to be associated with an increased risk of decline in kidney function; however, it may be a risk factor for the decline in kidney function in men with poorly controlled hypertension.
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Background@#Since the era of “thyroid cancer epidemic,” many Korean academic societies discouraged the use of ultrasonography in healthy individuals and revised the Korean Thyroid Imaging Reporting and Data System to address the overscreening and overdiagnosis issues. This study aimed to evaluate the change in the diagnostic effectiveness of thyroid cancer screening over the last decade. @*Methods@#This single-center, retrospective observational study analyzed the data of 125,962 thyroid nodules obtained during cancer screening at the health promotion center of Seoul National University Bundang Hospital from 2010 to 2019. Only 327 thyroid cancer cases pathologically confirmed by fine-needle aspiration (FNA) were included in the study. The strength of the association between the number of FNA and (1) the number of thyroid cancer diagnoses, (2) the positive predictive values (PPVs), and (3) the difference in PPV from the previous year were evaluated using Pearson’s correlation analysis. @*Results@#The number of thyroid FNA biopsies as well as the thyroid cancer diagnoses decreased from 2010 to 2019 (166 to 48 [-71.1%] vs. 43 to 22 [-48.8%]). The PPV of FNA biopsies increased from 25.9% to 45.8% (+76.8%) and was negatively correlated with the number of FNA biopsies performed (R=-0.87, P<0.001). The difference in PPV from the previous year increased similarly but without statistical significance (R=-0.59, P=0.09). @*Conclusion@#The diagnostic efficiency of thyroid cancer screening has increased over the last decade, as evidenced by the increasing PPV of FNA biopsies.
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Background@#This study aimed to explore the relationship between fruit intake, changes in fruit intake, and changes in cardiometabolic factors in people with obesity. @*Methods@#A total of 21,270 subjects (8,718 men, 12,552 women) aged 40 years and over, from the Korean-based Genome and Epidemiology Study, were followed up for an average of 4.4 years. Fruit intake was assessed using a food frequency questionnaire at baseline and the second follow-up. The beta coefficient and confidence intervals for changes in cardiometabolic risk factors according to fruit consumption were calculated using a linear regression model. @*Results@#In men, the abdominal circumference decreased with changes in fruit intake (P=0.029). Fruit intake and increased fruit intake in men were associated with a lower systolic blood pressure (P=0.012 and P=0.02, respectively) and lower triglyceride levels (P=0.002 and P<0.001, respectively). In women, abdominal circumference decreased with both fruit intake and increased fruit intake (P<0.001 and P=0.013, respectively). Systolic blood pressure and triglycerides tended to decrease only with fruit intake (P=0.048 and P<0.001, respectively). Unlike in men, fasting blood glucose tended to decrease in women with both fruit intake and increased fruit intake (P=0.011 and P=0.005, respectively). @*Conclusion@#Fruit intake and increased fruit intake may have beneficial effects on cardiometabolic risk factors among individuals who are obese.
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Background@#Many people use both combustible cigarette (CC) and electronic cigarette (EC). We compared nicotine dependence among CC, EC, and dual users using questionnaires and urinary cotinine levels. @*Methods@#Data from the Korea National Health and Nutrition Examination Survey (2014–2017) databases were analyzed; 3,917 CC, EC, and dual users were administered the urinary cotinine test, and 1,045 current CC and dual users completed the Heaviness of Smoking Index (HSI) questionnaires. Weighted geometric means of urine cotinine levels were compared between exclusive CC, exclusive EC, and dual users. The distribution rate, based on time to first cigarette (TTFC), cigarettes per day (CPD), and the HSI was analyzed in two weighted groups, exclusive CC and dual users. @*Results@#Among those who currently use any type of cigarette, 89.4%, 1.4%, and 9.2% were exclusive CC, exclusive EC, and dual users, respectively. Weighted geometric means of urine cotinine were highest in dual users (1,356.4 ng/mL), followed by exclusive CC (1,270.3 ng/mL), and exclusive EC (867.7 ng/mL) with significant differences between all three groups (P<0.05). There were no statistically significant differences in CPD between exclusive CC and dual users (P=0.626). The proportion of TTFC ≤5 minutes was 21.5% and 29.5% in the two groups, respectively (P=0.010); however, HSI differences in the two groups was marginal (P=0.557). @*Conclusion@#In this study, the urinary cotinine value could distinguish the three groups, CC, EC, and dual users, but the questionnaire using HSI could not distinguish the three groups.
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Background@#This study aimed to explore the relationship between fruit intake, changes in fruit intake, and changes in cardiometabolic factors in people with obesity. @*Methods@#A total of 21,270 subjects (8,718 men, 12,552 women) aged 40 years and over, from the Korean-based Genome and Epidemiology Study, were followed up for an average of 4.4 years. Fruit intake was assessed using a food frequency questionnaire at baseline and the second follow-up. The beta coefficient and confidence intervals for changes in cardiometabolic risk factors according to fruit consumption were calculated using a linear regression model. @*Results@#In men, the abdominal circumference decreased with changes in fruit intake (P=0.029). Fruit intake and increased fruit intake in men were associated with a lower systolic blood pressure (P=0.012 and P=0.02, respectively) and lower triglyceride levels (P=0.002 and P<0.001, respectively). In women, abdominal circumference decreased with both fruit intake and increased fruit intake (P<0.001 and P=0.013, respectively). Systolic blood pressure and triglycerides tended to decrease only with fruit intake (P=0.048 and P<0.001, respectively). Unlike in men, fasting blood glucose tended to decrease in women with both fruit intake and increased fruit intake (P=0.011 and P=0.005, respectively). @*Conclusion@#Fruit intake and increased fruit intake may have beneficial effects on cardiometabolic risk factors among individuals who are obese.
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Background@#Many people use both combustible cigarette (CC) and electronic cigarette (EC). We compared nicotine dependence among CC, EC, and dual users using questionnaires and urinary cotinine levels. @*Methods@#Data from the Korea National Health and Nutrition Examination Survey (2014–2017) databases were analyzed; 3,917 CC, EC, and dual users were administered the urinary cotinine test, and 1,045 current CC and dual users completed the Heaviness of Smoking Index (HSI) questionnaires. Weighted geometric means of urine cotinine levels were compared between exclusive CC, exclusive EC, and dual users. The distribution rate, based on time to first cigarette (TTFC), cigarettes per day (CPD), and the HSI was analyzed in two weighted groups, exclusive CC and dual users. @*Results@#Among those who currently use any type of cigarette, 89.4%, 1.4%, and 9.2% were exclusive CC, exclusive EC, and dual users, respectively. Weighted geometric means of urine cotinine were highest in dual users (1,356.4 ng/mL), followed by exclusive CC (1,270.3 ng/mL), and exclusive EC (867.7 ng/mL) with significant differences between all three groups (P<0.05). There were no statistically significant differences in CPD between exclusive CC and dual users (P=0.626). The proportion of TTFC ≤5 minutes was 21.5% and 29.5% in the two groups, respectively (P=0.010); however, HSI differences in the two groups was marginal (P=0.557). @*Conclusion@#In this study, the urinary cotinine value could distinguish the three groups, CC, EC, and dual users, but the questionnaire using HSI could not distinguish the three groups.
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Background@#Problem drinking increases the incidence of all-cause mortality and specific cancers, and persistent drinking is associated with cardiovascular disease in certain cancer survivors. This study analyzed the cardiovascular risk factors before and after diagnosis in Korean cancer survivors. @*Methods@#Data for the period between 2002 and 2013 were collected from the National Health Insurance Service Health-Examinee Cohort Database. Among the 27,835 patients included, those with moderate alcohol consumption before and after cancer diagnosis were excluded. Problem drinking was defined as males under 65 years consuming over 14 glasses a week, and males over 65 years or females consuming over seven glasses a week. A t-test, chi-square test, and linear regression analysis were performed for differences in cardiovascular risk factors and differences according to cancer types. @*Results@#There was a difference in the body mass index, systolic and diastolic blood pressure, and total cholesterol among patients who became moderate drinkers after diagnosis, but fasting blood glucose did not show any significant changes. Risk factors for cardiovascular disease were analyzed in patients with liver, stomach, rectal, and breast cancer with improved drinking behavior, and there were significant differences in body mass index, systolic and diastolic blood pressure, fasting blood glucose, and total cholesterol in stomach cancer patients. @*Conclusion@#Moderate drinking can lower cardiovascular risk in cancer survivors, and among the many drinking-related cancers, stomach cancer patients demonstrated significantly reduced cardiovascular risk factors.
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Background@#and Purpose: The aim of this study was to investigate the effects of multicomponent exercise on cognitive function, depression, and quality of life in elderly individuals. @*Methods@#This study prospectively recruited 605 participants, and constructed an exercise pyramid comprising even distributions of daily physical activities, aerobic exercise, musclestrengthening exercise, flexibility exercise, balance exercise, and activities that subjects could perform while sitting down. The exercise program was divided into six stages according to the participant’s level of frailty. The 12-week exercise program intervention was conducted once yearly. @*Results@#The exercise regimen was followed by 402 of the 605 enrolled participants, giving a dropout rate of 33.6%. The 27-month exercise program was completed by 60 participants.The scores for the Mini Mental State Examination for dementia screening (MMSE-DS), short form of the Geriatric Depression Scale, World Health Organization Quality of Life Assessment (WHOQOL-BREF), International Physical Activity Questionnaire (IPAQ), fear of falling, handgrip strength, and walking speed were improved after the exercise intervention. The analysis of frailty revealed that participants in the frail group showed greater improvements for the MMSE-DS, WHOQOL-BREF, IPAQ, fear of falling, handgrip strength, and walking speed. @*Conclusions@#Individually customized, multicomponent exercise programs lead to improved levels of cognitive function, depression, and quality of life, especially among those who are more frail.
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Purpose@#Although smoking has a significant impact on mortality and morbidity of cancer patients, many patients continue to smoke post-diagnosis. The purpose of this study was to investigate prevalence and predictors of sustained smoking among male cancer survivors. @*Materials and Methods@#The Korean National Health Insurance Service-National Health Screening Cohort database was used for this population-based, retrospective study. Study subjects were 15,141 men who were diagnosed with their first incident cancer between 2004 and 2011. Changes in smoking status before and after a cancer diagnosis were investigated. For patients who were current smokers pre-diagnosis, association between post-diagnosis sustained smoking and demographic, socioeconomic, and clinical variables were examined. @*Results@#Of the 4,657 pre-diagnosis smokers, 2,255 (48%) had quit after cancer diagnosis, while 2,402 (51.6%) continued to smoke. In a multivariate logistic regression analysis, younger age at cancer diagnosis (adjusted odds ratio [aOR], 1.37; 95% confidence interval [CI], 1.21 to 1.55; p < 0.001), low socioeconomic status (aOR, 1.29; 95% CI, 1.15 to 1.45; p ≤ 0.001), pre-diagnosis heavy smoking (aOR, 1.24; 95% CI, 1.09 to 1.41; p=0.001), diagnosis of non-smoking– related cancer (aOR, 1.67; 95% CI, 1.42 to 1.96; p < 0.001), and high serum glucose level (aOR, 1.23; 95% CI, 1.03 to 1.46; p=0.019) were associated with sustained smoking after a cancer diagnosis. @*Conclusion@#Almost half of the male smokers continue to smoke after a cancer diagnosis. Targeted interventions for smoking cessation should be considered for patients with younger age, low socioeconomic status, heavy smoking history, non-smoking–related cancer, and high blood glucose levels.
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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.
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BACKGROUND: While various screening tools are available for depression, they are not feasible in clinical practice because of their excessive number of questions. The Patient Health Questionnaire-2 (PHQ-2) consists of two questions gauging the frequency of depressed mood and anhedonia over the past two weeks. This study aimed to assess the usefulness of the PHQ-2 as a brief screening tool for depression.METHODS: This study used Korean National Health and Nutrition Examination Survey data from 2014, and the study population consisted of 4,946 individuals. We analyzed the validity of the PHQ-2 compared with ‘depression by PHQ-9,’ and obtained the optimal cut point for screening depression. The agreement between PHQ-2 and depression by PHQ-9 and the agreement between PHQ-2 and ‘currently diagnosed as depression’ were analyzed using Cohen's kappa. The correlation between EuroQol-5D (EQ-5D) index scores and PHQ-2 scores was analyzed using Student's t-test.RESULTS: Using ‘depression by PHQ-9’ as the criterion standard, PHQ-2 scores ≥2 had a sensitivity of 89% and a specificity of 87%, and a receiver operating characteristic analysis identified PHQ-2≥2 as the optimal cut point for screening. The agreement between PHQ-2 and depression by PHQ-9 was 0.430 when PHQ-2 ≥2 was used as a cut point. The agreement between PHQ-2 and ‘depression by questionnaire’ was poor. The EQ-5D index score of the depressive group was significantly lower than that of the normal group.CONCLUSION: The PHQ-2 is an effective measure for screening depression and is expected to be useful in busy clinical settings.
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Humanos , Anedonia , Depressão , Programas de Rastreamento , Inquéritos Nutricionais , Curva ROC , Sensibilidade e Especificidade , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Dietary patterns have a significant impact on prognosis, recurrence, and survival in patients with cancer. This study investigated dietary patterns using the Diet Quality Index-International (DQI-I) in cancer survivors compared to those in the general population without cancer.METHODS: Using the Korea National Health and Nutrition Examination Survey VI data, cancer survivors were defined as those diagnosed with cancer more than 1 year before the survey. The associations between possible predictors and the DQI-I score were examined using t-tests and analysis of variance. Adjusted multiple linear regression analysis was performed to compare the differences in DQI-I scores between cancer survivors and controls.RESULTS: In univariate analysis of 9,351 subjects (433 cancer survivors and 8,918 controls), age, sex, body mass index, marital status, education level, income, residential area, smoking status, and alcohol consumption were associated with the DQI-I score (each P-value < 0.05). After adjustment, cancer survivors showed higher DQI-I scores than the controls (67.40±8.90 vs. 65.50±9.40, P-value=0.007). In subgroup analysis, cancer survivors within 5 years after cancer diagnosis showed higher DQI-I scores than the controls (68.70±8.30 vs. 65.50±9.40, P-value=0.034), whereas those who survived beyond 5 years post-diagnosis did not show significant differences from the controls (66.70±9.20 vs. 65.50±9.40, P-value=0.063).CONCLUSION: Cancer survivors within 5 years of cancer diagnosis showed better dietary patterns than those in the general population. However, the differences were not observed after 5 years post-diagnosis. To reduce the risks of second primary cancer and mortality, targeted inventions for dietary habits are necessary for long-term survivors of cancer.
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Humanos , Consumo de Bebidas Alcoólicas , Índice de Massa Corporal , Diagnóstico , Dieta , Educação , Comportamento Alimentar , Invenções , Coreia (Geográfico) , Modelos Lineares , Estado Civil , Mortalidade , Segunda Neoplasia Primária , Inquéritos Nutricionais , Prognóstico , Recidiva , Fumaça , Fumar , SobreviventesRESUMO
PURPOSE: The purpose of this study was to investigate the effect of smoking habit change on the risk of cancer. MATERIALS AND METHODS: From the Korean National Health Insurance Service database, we determined the change in smoking habit between the first (2002 and 2003) and second (2004 and 2005) health examination periods. A total of 143,071 men were categorized into baseline heavy (≥ 20 cigarettes per day), moderate (10-19 cigarettes per day), light (< 10 cigarettes per day) smokers, quitters, and never smokers, after which the change in smoking status was determined during the second health examination. The participants were then followed up from 2006 to 2013 for all cancer, smoking related cancer, and lung cancer. RESULTS: Compared to heavy continual smokers, heavy smokers who quit had reduced risk of smoking related cancer (hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.56 to 0.97) and tended to have reduced risk of all cancer (HR, 0.87; 95% CI, 0.75 to 1.00). Moderate smokers who reduced the amount of smoking to light levels had decreased risk of all cancer (HR, 0.82; 95% CI, 0.72 to 0.94), smoking related cancer (HR, 0.74; 95% CI, 0.59 to 0.93), and lung cancer (HR, 0.55; 95% CI, 0.38 to 0.79) compared to heavy continual smokers. CONCLUSION: Smoking reduction decreases the risk of all cancer, smoking related cancer, and lung cancer. While smoking cessation should be the treatment of choice for smokers, smoking reduction may serve as an alternative strategy for those who cannot quit.
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Humanos , Masculino , Neoplasias Pulmonares , Programas Nacionais de Saúde , Fumaça , Abandono do Hábito de Fumar , Fumar , Produtos do TabacoRESUMO
BACKGROUND: This study aimed to investigate the association between physical activity and depressive mood among Korean adults with chronic diseases. METHODS: This study analyzed the 2014 Korean National Health and Nutrition Examination Survey data. The study was restricted to participants aged ≥20 years who had completed the survey and were not diagnosed as having depression. After exclusion, 4,676 participants were included in the final analysis. Subjects were categorized according to their level of physical activity. Physical activity was assessed using the International Physical Activity Questionnaire. Patients were categorized into two groups according to depressive traits (normal and depressed) based on the 9-item Patient Health Questionnaire scores. RESULTS: In univariate analysis, significant associations were observed between the level of physical activity and depressive mood in both chronic and healthy groups. Participants with higher levels of physical activity had lower risks of depressive mood than those with lower levels of physical activity, especially patients with chronic diseases (odds ratio [OR], 0.47; 95% confidence interval [CI], 0.31–0.73). Similar trends were observed in multivariate logistic regression analysis (OR, 0.54; 95% CI, 0.34–0.88). CONCLUSION: Physical activity significantly decreased the development of depressive mood among Korean adults with chronic diseases compared with their healthy counterparts. Physical activity must be emphasized in patients with chronic diseases.
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Adulto , Humanos , Doença Crônica , Depressão , Modelos Logísticos , Atividade Motora , Inquéritos NutricionaisRESUMO
BACKGROUND: Dyslipidemia is a major risk factor contributing to cardiovascular disease and its prevalence is steadily rising. Although screening tests are readily accessible, dyslipidemia remains undertreated. Evaluating health behavior patterns after diagnosis may help improve lifestyle interventions for the management of dyslipidemia. METHODS: Data from the fifth Korean National Health and Nutrition Examination Survey 2010–2012 were used. A total of 6,624 dyslipidemia patients over 20 years old were included according to National Cholesterol Education Program-Adult Treatment Panel III guidelines. Logistic regression analysis was completed using a weighted method to determine whether awareness of dyslipidemia was associated with health behavior. Health behavior was divided into two categories: behavioral factors (smoking, alcohol consumption, exercise) and nutritional factors (adequate intake of fiber, carbohydrate, fat, protein). RESULTS: There were no significant differences in health behavior among dyslipidemia patients according to awareness after adjustment for covariates, diabetes and hypertension. Awareness in women was associated with decreased smoking (odds ratio [OR], 0.55; 95% confidence interval [CI], 0.32 to 0.94), but when adjusted for diabetes and hypertension the result was not significant (OR, 0.61; 95% CI, 0.35 to 1.06). The same pattern applied to intake of carbohydrate in men (OR, 1.28; 95% CI, 0.99 to 1.67) and protein in women (OR, 1.22; 95% CI, 0.98 to 1.50). In subgroup analysis, awareness of dyslipidemia in men without hypertension or diabetes was associated with adequate intake of carbohydrate (OR, 1.70; 95% CI, 1.06 to 2.72). CONCLUSION: Increasing awareness alone may not be enough to improve healthy behavior in patients with dyslipidemia. Efforts including patient education and counseling through a multi-team approach may be required.
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Adulto , Feminino , Humanos , Masculino , Consumo de Bebidas Alcoólicas , Doenças Cardiovasculares , Colesterol , Aconselhamento , Diagnóstico , Dislipidemias , Educação , Comportamentos Relacionados com a Saúde , Hipertensão , Estilo de Vida , Modelos Logísticos , Programas de Rastreamento , Métodos , Inquéritos Nutricionais , Educação de Pacientes como Assunto , Prevalência , Fatores de Risco , Fumaça , FumarRESUMO
BACKGROUND: Osteoarthritis (OA) is a chronic disease that commonly afflicts the elderly. This disease reduces the health-related quality of life (HRQoL) and causes a significant social burden. Whether the effect of coexisting chronic conditions on HRQoL varies according to the presence of OA remains unclear. Therefore, this study aimed to investigate this notion. METHODS: A total of 13,395 participants were identified from the 2009–2013 Korean National Health and Nutrition Examination Survey for analysis. HRQoL was assessed using the European quality of life-5 dimensions (EQ-5D) index. Patients with OA were defined as those diagnosed by a physician or those who displayed both, symptoms and radiological findings consistent with OA at the time of the survey. Associations between OA and 8 chronic conditions were tested using regression analysis. RESULTS: The EQ-5D index was lower in patients with OA than in those without (mean difference, −0.145; 95% confidence interval [CI], −0.138 to −0.151; P<0.001). Most patients with OA and chronic conditions showed a lower score than those without. EQ-5D was particularly lower in OA patients with hypertension, dyslipidemia, stroke, and renal failure. The estimated β coefficient for the interaction term was significant in renal failure (−0.034; 95% CI, −0.055 to −0.012), after adjusting for demographic and socio-economic variables. CONCLUSION: OA significantly affects HRQoL of Korean elderly individuals alone or when combined with other conditions. OA combined with renal failure is particularly detrimental. These results indicate the importance of managing OA, which is an underestimated disease in public health surveys.
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Adulto , Idoso , Humanos , Doença Crônica , Comorbidade , Dislipidemias , Hipertensão , Coreia (Geográfico) , Inquéritos Nutricionais , Osteoartrite , Saúde Pública , Qualidade de Vida , Insuficiência Renal , Acidente Vascular CerebralRESUMO
BACKGROUND: The efficacy of two artificial tears, carboxymethylcellulose (CMC) and hyaluronate (HA), was compared in the treatment of patients with dry eye disease. METHODS: We conducted a systematic review and meta-analysis on randomized controlled trials in the PubMed, Embase, Cochrane Library, and ClinicalTrials.gov databases. The efficacy was compared in terms of the mean change from baseline in tear break-up time. The meta-analysis was conducted using both random and fixed effect models. The quality of the selected studies was assessed for risk of bias. RESULTS: Five studies were included involving 251 participants. Random effect model meta-analysis showed no significant difference between CMC and HA in treating dry eye disease (pooled standardized mean difference [SMD]=-0.452; 95% confidence interval [CI], -0.911 to 0.007; P=0.053). In contrast, fixed effect model meta-analysis revealed significant improvements in the CMC group when compared to the HA group (pooled SMD=-0.334; 95% CI, -0.588 to -0.081; P=0.010). CONCLUSION: The efficacy of CMC appeared to be better than that of HA in treating dry eye disease, although meta-analysis results were not statistically significant. Further research is needed to better elucidate the difference in efficacy between CMC and HA in treating dry eye disease.
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Humanos , Viés , Carboximetilcelulose Sódica , Oftalmopatias , Lubrificantes Oftálmicos , Lágrimas , XeroftalmiaRESUMO
Breast cancer is the second most common malignancy among Korean women. The 2002 National Cancer Center screening guideline breast cancer was revised via an evidence-based approach to provide medical personnel with a standard protocol of screening breast cancer. There is moderate-level evidence that biennial screening mammography in asymptomatic women aged 40 to 69 reduces breast cancer mortality, while low-level evidence suggests that screening mammography in women 70 years or older does not reduce breast cancer mortality. The committee concluded that the current evidence is insufficient to assess the benefits and harms of either ultrasonography or clinical breast examination as screening modalities for breast cancer. Future researches about the benefits and harms of the National Breast Cancer Screening Program in Korea are strongly required because the characteristics of breast cancer in Korea are different from those in the West, especially regarding dense breast. In conclusion, the committee recommends biennial screening mammography in asymptomatic women aged 40 to 69 years (grade B recommendation). The committee recommends selective screening mammography in women 70 years or older according to individual risk and preference (grade C recommendation). The committee neither recommends nor opposes ultrasonography and clinical breast examination as screening modalities (grade I recommendation). Symptomatic and high-risk women, however, should be offered complementary measures including ultrasonography and clinical breast examination under clinical supervision.
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Feminino , Humanos , Mama , Neoplasias da Mama , Coreia (Geográfico) , Mamografia , Programas de Rastreamento , Mortalidade , Organização e Administração , UltrassonografiaRESUMO
BACKGROUND: Personal health records (PHRs) are web based tools that help people to access and manage their personalized medical information. Although needs for PHR are increasing, current serviced PHRs are unsatisfactory and researches on them remain limited. The purpose of this study is to show the process of developing Seoul National University Bundang Hospital (SNUBH)'s own PHR system and to analyze consumer's use pattern after providing PHR service. METHODS: Task force team was organized to decide service range and set the program. They made the system available on both mobile application and internet web page. The study enrolled PHR consumers who assessed PHR system between June 2013 and June 2014. We analyzed the total number of users on a monthly basis and the using pattern according to each component. RESULTS: The PHR service named Health4U has been provided from June 2013. Every patient who visited SNUBH could register Health4U service and view their medical data. The PHR user has been increasing, especially they tend to approach via one way of either web page or mobile application. The most frequently used service is to check laboratory test result. CONCLUSION: For paradigm shift toward patient-centered care, there is a growing interest in PHR. This study about experience of establishing and servicing the Health4U would contribute to development of interconnected PHR.
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Humanos , Comitês Consultivos , Registros Eletrônicos de Saúde , Registros de Saúde Pessoal , Internet , Aplicativos Móveis , Assistência Centrada no Paciente , SeulRESUMO
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is the fifth leading cause of death worldwide. The awareness and treatment rate of the disease are low despite its relatively high prevalence. With the added data, this study aimed to identify changes in prevalence and risk factors of COPD using the data from the 5th KNHNES. METHODS: The subjects of this study were 8,969 individuals aged 40 and older who satisfied suitability and reproducibility for pulmonary function tests. The prevalence, awareness and risk factors of COPD were predicted based on the questionnaires on gender, age, educational level, income level, smoking history, body mass index (BMI) and other COPD related questions. RESULTS: Diagnosis of COPD was based on the airflow limitation (forced expiratory volume in one second/forced vital capacity <0.7) of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. The prevalence of COPD from 2010 to 2012 was 13.7%, of which 23.3% was men and 6.5% women. The prevalence was on the rise, with 12.2% in 2010, 13.2% in 2011, and 15.5% in 2012. In GOLD stage 1, the percentages of those who had cough or sputum and smoking history were 12.1% and 75.5%, respectively, but only 0.1% was diagnosed with COPD. Even after adjusting for asthma and tuberculosis, men, old age, larger amount of smoking were linked with a higher prevalence of COPD, and obese and higher educational level were associated with a lower prevalence of COPD. CONCLUSION: The prevalence of COPD in Korea has been increasing every year, and a higher prevalence was associated with male, older age, more amount of smoking, lower educational level and lower BMI.