OBJECTIVES: We aimed to examine how comorbidities were associated with outcomes (illness severity or death) among hospitalized patients with coronavirus disease 2019 (COVID-19). METHODS: Data were provided by the National Medical Center of the Korea Disease Control and Prevention Agency. These data included the clinical and epidemiological information of all patients hospitalized with COVID-19 who were discharged on or before April 30, 2020 in Korea. We conducted comorbidity network and multinomial logistic regression analyses to identify risk factors associated with COVID-19 disease severity and mortality. The outcome variable was the clinical severity score (CSS), categorized as mild (oxygen treatment not needed), severe (oxygen treatment needed), or death. RESULTS: In total, 5,771 patients were included. In the fully adjusted model, chronic kidney disease (CKD) (odds ratio [OR], 2.58; 95% confidence interval [CI], 1.19 to 5.61) and chronic obstructive pulmonary disease (COPD) (OR, 3.19; 95% CI, 1.35 to 7.52) were significantly associated with disease severity. CKD (OR, 5.35; 95% CI, 2.00 to 14.31), heart failure (HF) (OR, 3.15; 95% CI, 1.22 to 8.15), malignancy (OR, 3.38; 95% CI, 1.59 to 7.17), dementia (OR, 2.62; 95% CI, 1.45 to 4.72), and diabetes mellitus (OR, 2.26; 95% CI, 1.46 to 3.49) were associated with an increased risk of death. Asthma and hypertension showed statistically insignificant associations with an increased risk of death. CONCLUSIONS Underlying diseases contribute differently to the severity of COVID-19. To efficiently allocate limited medical resources, underlying comorbidities should be closely monitored, particularly CKD, COPD, and HF.

OBJECTIVES: We aimed to examine how comorbidities were associated with outcomes (illness severity or death) among hospitalized patients with coronavirus disease 2019 (COVID-19). METHODS: Data were provided by the National Medical Center of the Korea Disease Control and Prevention Agency. These data included the clinical and epidemiological information of all patients hospitalized with COVID-19 who were discharged on or before April 30, 2020 in Korea. We conducted comorbidity network and multinomial logistic regression analyses to identify risk factors associated with COVID-19 disease severity and mortality. The outcome variable was the clinical severity score (CSS), categorized as mild (oxygen treatment not needed), severe (oxygen treatment needed), or death. RESULTS: In total, 5,771 patients were included. In the fully adjusted model, chronic kidney disease (CKD) (odds ratio [OR], 2.58; 95% confidence interval [CI], 1.19 to 5.61) and chronic obstructive pulmonary disease (COPD) (OR, 3.19; 95% CI, 1.35 to 7.52) were significantly associated with disease severity. CKD (OR, 5.35; 95% CI, 2.00 to 14.31), heart failure (HF) (OR, 3.15; 95% CI, 1.22 to 8.15), malignancy (OR, 3.38; 95% CI, 1.59 to 7.17), dementia (OR, 2.62; 95% CI, 1.45 to 4.72), and diabetes mellitus (OR, 2.26; 95% CI, 1.46 to 3.49) were associated with an increased risk of death. Asthma and hypertension showed statistically insignificant associations with an increased risk of death. CONCLUSIONS Underlying diseases contribute differently to the severity of COVID-19. To efficiently allocate limited medical resources, underlying comorbidities should be closely monitored, particularly CKD, COPD, and HF.

The time course of recovery in vestibular neuritis varies between individuals. The aim of this study was to identify the predictors for the early or late recovery of vestibular neuritis. The inclusion criteria were patients 1) who had an acute onset of vertigo lasting at least 24 hours, 2) with a horizontal-torsional unidirectional spontaneous nystagmus, and 3) with a canal paresis of 20% or more on the bithermal caloric tests. The primary endpoint for this study was an early or late recovery of vestibular neuritis as a dependent variable. A functional level scale was used to define the late recovery (5 or more points) at seven days after the symptom onset. The secondary endpoint was the duration of hospitalization. One hundred twenty eight patients met the inclusion criteria for this study, and among them, 71 patients had an early recovery. Multiple logistic regression analysis showed that diabetes mellitus was the only independent significant variable for the prediction of a late recovery of vestibular neuritis. In addition, the diabetes mellitus was a predicting variable for long duration of hospitalization. Diabetes mellitus was a predictor for a late recovery of vestibular neuritis.

BACKGROUND: The aim of this study was to evaluate the sensitivity of a clinicians' self-report method for the detection of nosocomial infections (NIs) in comparison with a total surveillance method in a neonatal intensive care unit (NICU). METHODS: Two surveillance methods were concurrently performed in the NICU of a university hospital during 5 months in 2003. Clinicians' self-report surveillance (CSRS) was based on the retrospective verification of monthly reports of positive bacteriologic results by NICU clinicians. Total surveillance (TS) was done prospectively by an infection control nurse based on chart review and laboratory data. RESULTS: One hundred fifty nine patients accounting to 2759 patient-days were included in the study. Twenty-seven NIs among 26 patients were identified by TS. The sensitivity of CSRS compared to TS was 14.8% (4 of 27 NIs). The specificity was 98.5% (131 of 133 non-NIs). Kappa measures of agreement were -0.309. CONCLUSIONS: Our results confirm that the retrospective review of charts and laboratory data by clinicians lacks sensitivity and agreement for the surveillance of nosocomial infections.
Cross Infection* ; Humans ; Infant, Newborn ; Infection Control ; Intensive Care, Neonatal* ; Prospective Studies ; Retrospective Studies ; Sensitivity and Specificity

Stroke is the second cause of death worldwide, although the survival period is increasing after the occurrence of stroke, severe physical disability is caused with aftereffect. Oral inflammation is not limited to the oral cavity, it can cause malignant changes in other tissues and organs. In previous studies, we confirmed the relationship between tooth loss and stroke due to periodontal inflammation. The purpose of this study was to investigate the relationship between oral health and stroke such as oral hygiene behavior, tooth loss and periodontal disease among Korean adults over 40 years of age. This study was analyzed using the 6th Korea National Health and Nutrition Examination Survey (KNHANES) data. A total of 3,389 adults over 40 years of age were analyzed as final subjects. Socioeconomic statuses and oral health status was analyzed using a complex sample analysis technique. Logistic regression was used to analyze the relationship of oral health and stroke, and 95% confidence intervals were computed using SPSS. When the prevalence of stroke according to oral hygiene behavior was checked, the prevalence of strokes was lower in subjects who had a lot of brushings per day and subjects who used oral hygiene products (p < 0.05). The risk of stroke was 2.17 times (95% confidence interval, 1.43~3.28) higher in the group with less than 19 remaining teeth, but it was not statistically significant as a result of adjusting for age and sex, income level, education level, drinking and smoking (p>0.05). Loss of teeth was found to be associated with the risk factor of stroke. Therefore, loss of teeth due to periodontal disease is an additional issue that should be considered as a risk factor for stroke.
Adult ; Cause of Death ; Drinking ; Education ; Humans ; Inflammation ; Korea ; Logistic Models ; Mouth ; Nutrition Surveys ; Oral Health ; Oral Hygiene ; Periodontal Diseases ; Prevalence ; Risk Factors ; Smoke ; Smoking ; Social Class ; Stroke ; Tooth ; Tooth Loss

BACKGROUND AND PURPOSE: Sudden cardiac death is one of the leading causes of death in patients with myotonic dystrophy type 1 (DM1). It has been proposed that a prolonged QT interval is associated with sudden cardiac death in several neurological diseases, including multiple system atrophy, idiopathic Parkinson's disease, and diabetic autonomic neuropathy. However, analyses of the corrected QT (QTc) interval in DM1 patients are rare in the literature. The purposes of this study were to determine the association between the QT interval and DM1, and the affecting factors. METHODS: Thirty-nine patients diagnosed with DM1 through genetic testing were enrolled. The QTc interval (calculated using Bazett's formula: QTc=QT/radicalRR) was compared between these patients and 39 normal healthy controls. The clinical and laboratory factors affecting QTc interval in the patient group were investigated. RESULTS: The QTc interval was significantly longer in the DM1 group (411.2+/-44.7 msec, mean+/-SD) than in the normal control group (355.6+/-20.6 msec). Intragroup analysis revealed that a prolonged QTc interval in DM1 patients was associated with being female and older, having a longer disease duration, and exhibiting abnormal electrocardiography findings. CONCLUSIONS: The higher incidence of sudden cardiac death in the DM1 population is associated with the observed prolonged QTc interval in those patients.
Cause of Death ; Death, Sudden, Cardiac ; Diabetic Neuropathies ; Electrocardiography ; Female ; Genetic Testing ; Humans ; Incidence ; Multiple System Atrophy ; Myotonic Dystrophy ; Parkinson Disease

Kawasaki disease is an acute vasculitis of unknown causes that occurs predominantly in infants and young children and produces coronary artery aneurysm. We have recently experienced a case of persistent Kawasaki disease in a 24 month-old-girl improved with pulsed doses of methylprednisolone. Even with an administration of intravenous gamma globulin(IVIG), she repeated the course of recovery and aggravation. After four times repeated doses of IVIG, additional intravenous methylprednisolone pulse therapy was tried and resulted in remarkable improvement. We reported the case with a brief review of the related literature.
Aneurysm ; Child ; Coronary Vessels ; Humans ; Immunoglobulins, Intravenous ; Infant ; Methylprednisolone* ; Mucocutaneous Lymph Node Syndrome* ; Vasculitis

OBJECTIVES: This study is conducted to investigate the prevalence of work-related back pain among Driving and Transport Related Occupations and to identify the risk of mechanical factors and psychosocial factors. METHODS: Subjects were 779 operators and drivers of transportation vehicles selected from respondents from the 1st Korean Working condition survey. The occupation risk factors, including socioeconomic, ergonomic, psychosocial factors, were investigated. We used the multiple logistic regression analysis to determine the relationship between risk factors and low back pain. RESULTS: The prevalence of self-reported work-related low back pain was 27.7%. Adjusting for confounding factors, we determined that whole body vibration(OR 1.64 95% CI: 1.09~2.48), tiring posture(OR 5.18, 95% CI: 3.01~8.93), extended work(OR 1.91, 95% CI: 1.20~3.04), night-time work(OR 2.79, 95% CI: 1.86~4.19), evening work(OR 2.82, 95% CI: 1.78~4.46), shift work(OR 2.35, 95% CI: 1.30~4.26), job dissatisfaction (OR 2.65, 95% CI: 1.76~3.99), and experiencing physical violence at work(OR 5.31, 95% CI: 1.25~22.67) had meaningful relationships with low back pain. CONCLUSIONS: We found that the psychosocial risk factors were the most significant factors among drivers of transportation vehicles in Korea. Therefore, we suggest a health promotion program to relieve Job stress as a solution to prevent and control low back pain among drivers of transportation vehicles in Korea.
Back Pain ; Data Collection ; Health Promotion ; Korea ; Logistic Models ; Low Back Pain ; Occupations ; Prevalence ; Risk Factors ; Transportation ; Violence

STATEMENT OF PROBLEM: The introduction of "The Long-term Care Insurance System"(a public nursing care insurance scheme) is scheduled from July in 2008. Lately, the importance of oral health care had increased. Introduction and establishment of the methodology (nursing care procedure) based on professional dental knowledge is inevitable. PURPOSE: The purpose of this study was to rouse recognition of the importance of dental care in the long term elderly care in nursing homes, with implementation of the new insurance law. MATERIAL AND METHODS: Visited two institutions for the elderly, Yudang Village and Sungjiwon located in Suwon city to investigate the present conditions in terms of (1) the detailsof the institution, (2) the activities concerning with dental care in the institution, and (3) the consciousness and recognition regarding dental care of the staffs. RESULTS: In two institutions, under the present conditions, oral cleaning (including the cleaning of denture) for residents was operated with no professional advices and limited professional dental care. It was found that there was very little awareness of aspiration pneumonia. The members of staff however, did recognizethe necessity of professional maintenance and management of oral care in daily nursing care, and that many residents hold dental problems. They were very eager in introducing the methodology (nursing care procedure) in dental care in nursing homes.
Aged ; Asian Continental Ancestry Group ; Consciousness ; Dental Care ; Dentists ; Humans ; Insurance ; Insurance, Long-Term Care ; Jurisprudence ; Korea ; Long-Term Care ; Nursing Care ; Nursing Homes ; Oral Health ; Pneumonia, Aspiration

OBJECTIVE: The purpose of this study was to evaluate the effect of hormone replacement therapy on endometrial thickness in postmenopausal women and to assess the difference in endometrial thickness by the type of hormone replacement therapy (HRT). MATERIALS AND METHODS: Endometrial thickness was measured in 258 postmenopausal women before and/or during 12 months of HRT. The subjects were grouped into the sequential therapy group (Group 1, 72 women) and continuous combined therapy group (Group 2, 186 women). Group 1 received 0.625 mg of conjugate equine estrogen (CEE) daily with cyclic addition of medroxyprogesterone acetate (MPA, 10 mg/day for 12 days per month). Group 2 received 0.625 mg of CEE with daily addition of MPA (2.5 mg/day). RESULTS: The sequential group showed no significant change in endometrial thickness during HRT compared to that before HRT. However, a significant increase in endometrial thickness was found in the continuous combined group at 12 months of treatment. Before HRT, the endometrial thickness in the continuous combined group was thinner than that of the sequential group. During 12 months of treatment, there was no difference in endometrial thickness between the types of HRT. And the proportion of patients with endometrial thickness of 8mm or greater at 12 months of treatment did not differ significantly from that before treatment in both groups. CONCLUSION: Sequential HRT did not influence the endometrial thickness during treatment. However, continuous combined HRT increased the endometrial thickness during 12 months of treatment compared to that before treatment. The different endometrial responses to each HRT regimen may be due to the difference in endometrial thickness before treatment in each group.
Estrogens ; Female ; Hormone Replacement Therapy* ; Humans ; Medroxyprogesterone Acetate