Background: Atherogenic dyslipidemia, which is frequently associated with type 2 diabetes (T2D) and insulin resistance, contributes to the development of vascular complications. Statin therapy is the primary approach to dyslipidemia management in T2D, however, the role of non-statin therapy remains unclear. Ezetimibe reduces cholesterol burden by inhibiting intestinal cholesterol absorption. Fibrates lower triglyceride levels and increase high-density lipoprotein cholesterol (HDL-C) levels via peroxisome proliferator- activated receptor alpha agonism. Therefore, when combined, these drugs effectively lower non-HDL-C levels. Despite this, few clinical trials have specifically targeted non-HDL-C, and the efficacy of triple combination therapies, including statins, ezetimibe, and fibrates, has yet to be determined. Methods: This is a multicenter, prospective, randomized, open-label, active-comparator controlled trial involving 3,958 eligible participants with T2D, cardiovascular risk factors, and elevated non-HDL-C (≥100 mg/dL). Participants, already on moderate-intensity statins, will be randomly assigned to either Ezefeno (ezetimibe/fenofibrate) addition or statin dose-escalation. The primary end point is the development of a composite of major adverse cardiovascular and diabetic microvascular events over 48 months. Conclusion This trial aims to assess whether combining statins, ezetimibe, and fenofibrate is as effective as, or possibly superior to, statin monotherapy intensification in lowering cardiovascular and microvascular disease risk for patients with T2D. This could propose a novel therapeutic approach for managing dyslipidemia in T2D.

Background: Limited data are available on hepatitis C virus (HCV) infection in persons who inject drugs (PWID) in South Korea. The present study aimed to investigate the seroprevalence of HCV antibodies, risk factors for HCV seropositivity, and HCV treatment status in PWID between January 2012 and May 2022. Methods: We retrospectively reviewed the medical records of 418 drug users who underwent HCV antibody testing in three hospitals caring for 90% of known PWID in South Korea, of whom 373 were PWID. Results: The HCV seroprevalence was 39.7% (148/373) in PWID vs. 6.7% (3/45) in noninjection drug users (P < 0.001). Age ≥ 40 years, hospital type (58.2% in the prison hospital vs. 34.0% in the private hospital), and enrollment year (68.2% in 2012–2014 vs. 30.0% in 2021–2022) were independently associated with HCV seropositivity. Among the HCVseropositive PWID, 90.5% (134/148) were diagnosed with HCV infection; however, only 6.8% (10/148) received HCV treatment. The hepatitis B virus surface antigen and human immunodeficiency virus antibody positivity were 4.0% (14/352) and 1.9% (6/317) in tested PWID, respectively. Conclusion The HCV seroprevalence in PWID was 39.7% with a very low treatment rate, which prompts active measures to test and treat PWID for HCV infection in South Korea.

Carbohydrate-restricted diets and intermittent fasting (IF) have been rapidly gaining interest among the general population and patients with cardiometabolic disease, such as overweight or obesity, diabetes, and hypertension. However, there are limited expert recommendations for these dietary regimens. This study aimed to evaluate the level of scientific evidence on the benefits and harms of carbohydrate-restricted diets and IF to make responsible recommendations. A meta-analysis and systematic literature review of 66 articles on 50 randomized controlled trials (RCTs) of carbohydrate-restricted diets and 10 articles on eight RCTs of IF was performed. Based on the analysis, the following recommendations are suggested. In adults with overweight or obesity, a moderately-low carbohydrate or low carbohydrate diet (mLCD) can be considered as a dietary regimen for weight reduction. In adults with type 2 diabetes mellitus, mLCD can be considered as a dietary regimen for improving glycemic control and reducing body weight. In contrast, a very-low carbohydrate diet (VLCD) and IF are recommended against in patients with diabetes. Furthermore, no recommendations are suggested for VLCD and IF in adults with overweight or obesity, and carbohydrate-restricted diets and IF in patients with hypertension. Here, we describe the results of our analysis and the evidence for these recommendations.

OBJECTIVES: The purposes of this study are to examine the sociodemographic factors that increase the prevalence of insomnia, as well as to identify the relationship between the prevalence of insomnia and health conditions by navigating through the prevalence rates of insomnia in two different geographical regions with different socioeconomic structures. METHODS: A survey was conducted targeting 937 residents of Guri-si and Yangpyeong-gun in Gyeonggi Province, Korea. The Insomnia Severity Index was used to verify whether a respondent was experiencing insomnia. The Abbreviated Self-Rated Korean version of the Mini-International Neuropsychiatric Interview was used in diagnosis of mental diseases. Chi-square test was performed to determine the unique relationship between sociodemographic characteristics and the prevalence of insomnia. Multivariate logistic regression analysis was performed to examine the association of prevalence of insomnia with categorized relevant factors. RESULTS: The overall prevalence rate of insomnia for all respondents was 9.26%. The prevalence rate for Yangpyeong-gun was 11.75%, marking a significantly higher figure compared with the prevalence rate for Guri-si, which was 6.87%. Advanced age, female, other marital statuses than married, lower education, lower income, non-existence of private health insurance, and unemployment were risk factors for insomnia. The prevalence of insomnia showed strong association with physical and mental conditions, particularly with mental disorders, urologic diseases, and risk of injury from fall. CONCLUSION: The prevalence rates of insomnia in those two surveyed regions showed a meaningful difference even after controlling for sociodemographic characteristics. These findings suggest that such regional differences merits further attention and additional nationwide epidemiologic studies are needed.
Surveys and Questionnaires ; Diagnosis ; Education ; Epidemiologic Studies ; Female ; Gyeonggi-do* ; Humans ; Insurance, Health ; Korea* ; Logistic Models ; Marital Status ; Mental Disorders ; Mental Health ; Prevalence* ; Risk Factors ; Sleep Initiation and Maintenance Disorders* ; Unemployment ; Urologic Diseases

PURPOSE: To investigate the clinical features and treatment outcomes between methicillin-sensitive Staphylococcus epidermidis (MSSE) and methicillin-resistant Staphylococcus epidermidis (MRSE) keratitis groups. METHODS: A retrospective analysis of case series was conducted of all patients with keratitis caused only by Staphylococcus epidermidis from January 1997 through December 2008. Sex, age, history of trauma, systemic disease, previous ocular history, antibiotic sensitivity test results, and treatment outcomes were evaluated. Patients were categorized into two groups as MSSE and MRSE according to methicillin-sensitivity result, and a comparative analysis was performed. RESULTS: There were no significant differences in clinical features, such as risk factors or size or location of keratitis between the two groups. All MSSE and MRSE isolates were sensitive to vancomycin, moxifloxacin, and levofloxacin. All MSSE and 17%, 50%, 52%, and 57% of MRSE isolates were sensitive to cephalothin, norfloxacin, ciprofloxacin, and erythromycin, respectively (p < 0.05). There was no significant difference in visual acuity between the two groups. CONCLUSIONS: All MSSE and MRSE isolates were sensitive to vancomycin and to third- or fourth-generation fluoroquinolones In addition, approximately 50% of MRSE isolates were sensitive to norfloxacin and ciprofloxacin. There were no significant differences in clinical features of keratitis caused by MSSE versus those of MRSE isolates. Both keratitis groups had relatively good visual prognoses.
Aza Compounds ; Cephalothin ; Ciprofloxacin ; Epidemiologic Studies ; Erythromycin ; Fluoroquinolones ; Humans ; Keratitis ; Methicillin Resistance ; Norfloxacin ; Ofloxacin ; Prognosis ; Quinolines ; Retrospective Studies ; Risk Factors ; Staphylococcus ; Staphylococcus epidermidis ; Vancomycin ; Visual Acuity

OBJECTIVES: Epidemiological studies have supplied growing evidence of an association between the prevalence of psychiatric disorders and the urban/rural division. We investigated the prevalence and risk factors of the main psychiatric disorders in two areas of Gyeonggi Province of South Korean with different levels of urbanization. METHODS: A survey was conducted of the adult population (over 40 years of age) in Yangpyeong-gun (lower level of urbanization ; n=639) and Guri-si (higher level of urbanization ; n=335) in Gyeonggi Province. The Korean version of the Mini-International Neuropsychiatric Interview (K-MINI) was used as a structured psychiatric diagnostic interview instrument. Major depressive disorder (MDD), suicidality, alcohol dependence, alcohol abuse, generalized anxiety disorder (GAD), somatoform disorder, bipolar disorder, and schizophrenia were selected as the 8 main psychiatric problems. RESULTS: The prevalence of the 8 main psychiatric disorders in Guri-si (25.6%) was higher than those of Yangpyeong-gun (15.1%, p<0.05). In particular, the prevalence of MDD, suicidality, and GAD, which are thought to be strongly influenced by psychosocial factors, were significantly higher in Guri-si (p<0.05). CONCLUSION: A greater prevalence of almost all major psychiatric disorders is associated with higher levels of urbanization, exceptions being somatoform disorders and bipolar disorder. This urban.rural difference may be related to environmental risk factors.
Adult ; Alcoholism ; Anxiety Disorders ; Bipolar Disorder ; Depressive Disorder, Major ; Epidemiologic Studies ; Humans ; Prevalence ; Risk Factors ; Schizophrenia ; Somatoform Disorders ; Urbanization

PURPOSE: Ego-integrity in older adults is the central concept related to quality of life in later life. Therefore, for effective interventions to enhance the quality of later life, a scale to measure ego-integrity in older adults is necessary. This study was carried out to develop a scale to measure ego-integrity in older adults. METHODS: This study utilized cronbach's alpha in analyzing the reliability of the collected data and expert group, and factor analysis and item analysis to analyze validity. RESULTS: Seventeen items were selected from a total of 21 items. Cronbach's alpha coefficient for internal consistency was .88 for the 17 items of ego-integrity in the older adults scale. Three factors evolved by factor analysis, which explained 50.71% of the total variance. CONCLUSIONS: The scale for measuring ego-integrity in Korean older adults in this study was evaluated as a tool with a high degree of reliability and validity.
Aged ; Aged, 80 and over ; *Ego ; Female ; Humans ; Korea ; Male ; Questionnaires ; Self Concept

PURPOSE: This study was conducted to examine the knowledge level and assessment experience of nurses in regards to delirium, and to utilize the study results as baseline data for planning delirium education programs for nurses. METHODS: Subjects were 465 nurses who were working in a general hospital. A 'delirium related knowledge and assessment experience' questionnaire was used to collect data. RESULTS: Knowledge levels regarding delirium averaged 70 out of 100, and at each domain, they scored 87 for etiology of delirium, 62 for symptoms, and 69 for nursing management. The knowledge level of delirium was significantly different according to educational level (F=3.851, p=.022), past education related to geriatrics(t=2.471, p=.014), and awareness of need for in-service education on geriatric nursing(F=2.663, p=.032). About 85% of nurses had past experience of dealing with delirious patients and only 7.7% of nurses used delirious state assessment tools. CONCLUSION: According to the above results, it is necessary, not only to provide delirium related educational programs for nurses, but also to emphasize the usefulness of applying the assessment tool.
Delirium* ; Education ; Hospitals, General ; Humans ; Nursing ; Surveys and Questionnaires

PURPOSE: To evaluate the efficacy, stability and complications of implantation of anterior chamber phakic intraocular lens (Phakic 6H) in myopic eyes. METHODS: We retrospectively analyzed 97 myopic eyes of 56 patients who were treated for moderate or high myopia with the implantation of Phakic 6H. Manifest refraction (MR), uncorrected (UCVA) and best corrected visual acuity (BCVA), intraocular pressure, cornea endothelium, possible complications, and subjective symptoms were evaluated. RESULTS: The mean patient age was 26.2 years (2.94 SD; range, 20 to 40 years). There was a statistically significant reduction in the spherical equivalent from -10.91D+/-3.07 (range -5.75D to -21.0D) to -0.96D+/-0.89 (range +0.75D to -2.5D) (p<0.001) at postoperative 6 months. The percentage of patients who had an UCVA of 0.6 better was 78.35%, and 34.02% had an UCVA of 1.0 or better at postoperative 6 months. Mean endothelial cell density was 2714+/-164 cell/mm2 prior to operation, with a-1.85% at 6 months. Glare and halo were observed in eight eyes (8.25%). Other complications were: oval pupil (2.06%), hyphema (2.06%), decenterated IOL (9.28%), temporary increased IOP (6.17%). CONCLUSIONS: The anterior chamber phakic intraocular lens showed encouraging results in treating high myopia. However, additional patients and longer follow-up periods are needed to detect the long-term efficacy and safety of this refractive lens.
Anterior Chamber* ; Cornea ; Endothelial Cells ; Endothelium ; Follow-Up Studies ; Glare ; Humans ; Hyphema ; Intraocular Pressure ; Myopia ; Phakic Intraocular Lenses* ; Pupil ; Retrospective Studies ; Visual Acuity

PURPOSE: The purpose of this study were to investigate the health status, the currency of rehabilitation therapy, and the patient learning needs on hospital with disabilities. METHOD: The subjects consisted of 87 disabled adults on hospital. Data was collected from February until to June 2005, where they asked structured questionnaires. A descriptive survey design was used and the SPSS 12.0 program was used for data analysis, which included t-test, ANOVA and Duncan's multiple comparison test. RESULT: There are a lot of patient through the transfer from the general hospital and the rehabilitation hospital. Their heath status changed good after hospital admission. Patients took exercise therapy the most, which is one of the rehabilitation therapy. But they need to enough physical therapy because patients have limited time for treatment. The education-need-level was high on hospital with disabilities, especially the need of support and care are the highest on the subscale of patient learning need. There are significant patient learning need differences in income and admission location (p< .05). CONCLUSION: Disabled persons on hospital needs to help and learning exercise by nurses. There should be rehabilitation programs for patients who are ready to leave the hospital. After discharging, there needs to be various rehabilitation services, support and care for the community based rehabilitation.
Adult ; Disabled Persons ; Exercise Therapy ; Hospitals, General ; Humans ; Learning ; Patient Education as Topic ; Surveys and Questionnaires ; Rehabilitation* ; Statistics as Topic