Radiation exposure is a well-known risk factor for thyroid cancer. However, the specific effects of diagnostic radiation exposure on thyroid cancer risk are controversial. The purpose of this study ...was to perform a systematic review and meta-analysis to assess the effects of diagnostic radiation exposure on thyroid cancer risk.
The PubMed and EMBASE databases were searched to identify eligible studies. Summary odds ratio (OR) estimates and confidence intervals (CIs) were used to compute the risk of thyroid cancer using fixed- and random-effects models. Subgroup and sensitivity analyses were performed to evaluate the potential heterogeneity.
Nine studies from 12 publications were included in the meta-analysis. Overall exposure to diagnostic radiation exposure was associated with a significantly increased thyroid cancer risk (OR = 1.52 CI 1.13-2.04). The subgroup and sensitivity analyses revealed similar results. By type of exposure, exposure to computed tomography scans (OR = 1.46 CI 1.27-1.68) or dental x-rays (OR = 1.69 CI 1.17-2.44) were associated with an increased thyroid cancer risk. Head and neck (OR = 1.31 CI 1.02-1.69) and chest (OR = 1.71 CI 1.09-2.69) exposure to diagnostic radiation was associated with an increased thyroid cancer risk.
The results of this meta-analysis indicate that diagnostic radiation exposure is associated with an increased thyroid cancer risk. Therefore, to the extent that it will not compromise the information being sought, radiation exposure to the thyroid should be minimized during diagnostic examinations.
The purpose of this study was to evaluate the association between alanine aminotransferase (ALT) and aspartate aminotransferase (AST), and metabolic syndrome (MS) in the Korean population. A total of ...11,587 adults ≥30 years of age and with complete data were selected from Korea National Health and Nutrition Examination Survey VI conducted from 2013 to 2015. Normal ALT and AST levels were divided into quartiles, and their associations with MS were assessed by logistic regression analysis. Elevated levels of ALT adjusted odds ratio (aOR) = 7.90, 95% confidence interval (CI) = 6.50⁻9.60 and AST (aOR = 3.81, 95% CI = 3.10⁻4.74) were both significantly associated with a higher prevalence of MS. The quartile group containing the highest levels of ALT and AST within the normal range also showed an increased risk of MS and its components. Elevated levels of ALT and AST, even within the normal range, were associated with prevalence of MS.
This study assessed alcohol-induced harm to those not drinking and investigated its association with mental health in Korean adolescents. The 14th Korea Youth Risk Behavior Survey (2018) was used and ...60,040 adolescents were analyzed. Harm from others' alcohol consumption was assessed by four criteria: teasing in public places, being scared in public places, sleep problems, and unsafety of public places due to people drinking alcohol. Mental health included stress, depressive symptoms, suicidal ideation, and attempted suicide. Harm reported due to the alcohol use of others was 5.8% for teasing in public places, 33.6% for being scared in public places, 5.6% for sleep problems, and 40.2% for unsafety of public places among total study participants. Experiences of teasing in public places due to people who drank alcohol were associated with an increased risk of stress, depressive symptoms, suicidal ideation, and suicide attempts. Similarly, experiences of being scared in public places, sleep problems, and unsafety of public places due to people who drank alcohol were associated with poor mental health. In the stratified analysis, alcohol-induced harm was associated with poor mental health in both non-drinkers and drinkers. Harmful experiences from others' alcohol consumption were associated with poor mental health among Korean adolescents.
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Dietary guidelines generally recommend limiting intake of red and processed meat. However, the ...quality of evidence implicating red and processed meat in adverse health outcomes remains unclear.
To evaluate the association between red and processed meat consumption and all-cause mortality, cardiometabolic outcomes, quality of life, and satisfaction with diet among adults.
EMBASE (Elsevier), Cochrane Central Register of Controlled Trials (Wiley), Web of Science (Clarivate Analytics), CINAHL (EBSCO), and ProQuest from inception until July 2018 and MEDLINE from inception until April 2019, without language restrictions, as well as bibliographies of relevant articles.
Cohort studies with at least 1000 participants that reported an association between unprocessed red or processed meat intake and outcomes of interest.
Teams of 2 reviewers independently extracted data and assessed risk of bias. One investigator assessed certainty of evidence, and the senior investigator confirmed the assessments.
Of 61 articles reporting on 55 cohorts with more than 4 million participants, none addressed quality of life or satisfaction with diet. Low-certainty evidence was found that a reduction in unprocessed red meat intake of 3 servings per week is associated with a very small reduction in risk for cardiovascular mortality, stroke, myocardial infarction (MI), and type 2 diabetes. Likewise, low-certainty evidence was found that a reduction in processed meat intake of 3 servings per week is associated with a very small decrease in risk for all-cause mortality, cardiovascular mortality, stroke, MI, and type 2 diabetes.
Inadequate adjustment for known confounders, residual confounding due to observational design, and recall bias associated with dietary measurement.
The magnitude of association between red and processed meat consumption and all-cause mortality and adverse cardiometabolic outcomes is very small, and the evidence is of low certainty.
None. (PROSPERO: CRD42017074074).
Hand hygiene is the most effective strategy to prevent infectious diseases. This study investigated and compared the hand hygiene practices of adults with diabetes and an age- and gender-matched ...comparison group. Adults with diabetes (
= 22,920) who participated in the 2015 Korea Community Health Survey and an appropriate comparison group (
= 22,920) were selected. Descriptive analyses, chi-square tests, and multiple logistic regression analyses were used. Greater than 98% of participants with diabetes recognized that hand hygiene helps prevent infectious diseases. Among participants with diabetes, 84.3%, 82.4%, 72.5%, and 64.1% washed their hands frequently before eating, after using the restroom, after returning from the outdoors, and with soap or hand sanitizer, respectively, but these values were significantly lower than those of the comparison group. After performing multiple regression analyses, treatments for diabetes, being educated about diabetes management and handwashing, and awareness of hemoglobin A1c levels were significantly associated with hand hygiene practices in participants with diabetes. Almost all people with diabetes were aware of the efficacy of hand hygiene, but handwashing rates were significantly lower in people with diabetes than in the comparison group. Considering treatments for diabetes, educational campaigns regarding handwashing, and increasing awareness of handwashing efficacy will help improve hand hygiene in people with diabetes.
Cancer survivors remain at life-long risk of developing oral complications. This study investigated the oral health status and behavior among cancer survivors in comparison to subjects without a ...history of cancer using a nationwide survey. Cancer survivors and control subjects were selected from the sixth Korean National Health and Nutrition Examination Survey (2013-2015). Survivors reported chewing (34.8%) and speaking difficulties (15.3%) resulting from oral health problems. More than 36% of survivors had periodontal disease and 15.9% needed dentures. In multiple logistic regression analysis, age, household income, education level, smoking status, cancer site, and current cancer status were associated with oral health status. Approximately 43.3% of cancer survivors brushed their teeth more than three times a day. In addition, 44.9% of survivors used secondary oral products, and 30.8% had been screened for oral health problems over the past year. Age, household income and education level were associated with oral health behavior. The oral health status and behavior excepting periodontal disease and the use of secondary oral products were not significantly different between cancer survivors and controls. Although oral health status of cancer survivors was not worse than that of controls, more than half of the survivors maintained unhealthy oral practices.
Purpose
This study aimed to perform a nationwide analysis of medication errors (MEs) from hospitals using national reporting system data and to compare the ME patterns among different age groups.
...Methods
We analyzed medication‐related incidents in acute care hospitals reported to the Korean Patient Safety Reporting and Learning System (KOPS), which is a patient safety reporting system, from July 2016 to December 2020. The stages of the medication use process, type of errors, medication class involved in MEs, and degree of harm were analyzed.
Results
Among a total of 5071 medication‐related incidents, 37.7% (1911 cases) were incidents that caused patient harm and 1.2% caused long‐term, permanent, and fatal harm. The proportion of medication‐related incidents that resulted in harm was the highest among the <1‐year‐old age group (67 cases, 51.5%), followed by the elderly (≥ 65 years) (828 cases, 40.9%). The cases leading to patient death were most frequently reported in patients aged ≥65 years. Medication‐related incidents occurred mainly in the administration stage (2954 cases, 58.3%), and wrong dose was the most frequently reported ME type. The most prevalent medication class occurring in the 20–64‐year age group (256 cases, 11.7%) was ‘antibacterials for systemic use’, whereas ‘contrast media’ (236 cases, 11.6%) and ‘blood substitutes and perfusion solutions’ (98 cases, 19.3%) were the most prevalent drug classes in the ≥65‐ and <20‐year‐old age groups, respectively.
Conclusions
It is necessary to establish guidelines for the prevention of medication‐related incidents according to the medication use process and patient age group.
Sedative agents are avoided in older adults because of potential risks including cognitive impairment, fall, frailty, and mortality. However, no studies addressing both prediagnostic and ...postdiagnostic period of dementia have evaluated sedative agent usage over an extended period.
To describe a longitudinal change in sedative medication use before and after the diagnosis with dementia over 10 years compared to patients without dementia.
We conducted a retrospective cohort study using longitudinal claims data for senior national health insurance beneficiaries. After 1:4 propensity score matching, 54,165 older patients (≥60 years) were included. Difference-in-difference (DID) of sedative burden and use of sedative agents pre- and post-dementia diagnosis were estimated, and compared to those of patients without dementia. The yearly average daily sedative load (adSL) for each individual was calculated after applying duration, dose, and sedative score of medications from the sedative load model. The medication use for each sedative category was calculated using the defined daily dose (DDD) per 1000 patient-days.
The adSL in patients with dementia was consistently high before and after diagnosis and significantly increased after diagnosis, compared to those of patients without dementia (DID 0.123 unit/day, 95% confidence interval 0.117-0.129). DID of medication use was the highest for antidepressants (64.764 DDD/1000 patient-days) followed by Z-drugs and antipsychotics. Atypical antipsychotic and antidepressant usage steeply increased after dementia diagnosis.
Sedative burden in patients with dementia before and after dementia diagnosis was higher than that in patients without dementia, and was further increased after dementia diagnosis.
: Opioid use in Korea is lower than in other developed countries. However, recent studies have reported an increase in opioid prescriptions and the number of chronic opioid users. The current status ...of adverse events (AEs) associated with opioid analgesics in Korea is unclear. This nested case-control study aimed to evaluate the influence of opioid analgesic use patterns on all emergency department (ED) visits and opioid-related ED visits after opioid analgesic initiation using the national claims database.
Adult non-cancer patients who initiated non-injectable opioid analgesics (NIOA) between January 2017 and June 2018 were included. We defined the case group as patients who visited the ED within six months of opioid initiation, and the control group was selected in a 1:1 ratio using an exact matching method.
A total of 97,735 patients (13.58%) visited the ED within six months of NIOA initiation. Nearly 32% of cases were linked to opioid-related AEs. The most frequent AEs were falls and fractures (61.27%). After adjusting for covariates, opioid initiation at the ED was associated with all-cause or opioid-related ED visits (adjusted odds ratio (aOR) = 3.19, 95% confidence interval (CI) = 3.09-3.29; aOR = 3.82, 95% CI = 3.62-4.04, respectively). Chronic NIOA use was associated with all-cause and opioid-related ED visits (aOR = 1.32, 95% CI = 1.23-1.40; aOR = 1.56, 95% CI = 1.39-1.76, respectively).
This study found that 13% of non-cancer patients visited the ED within six months of NIOA initiation. In addition, the NIOA use pattern was significantly associated with all-cause and opioid-related ED visits.
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