OBJECTIVE: To analyze the recent severity of COVID-19 in various countries. METHODS: Data were ollected on the epidemic situation of COVID-19 in various countries as of January 16, 2021, and the scale and overall trend of the epidemic were retrospectively described; combined with the recent trend of newly confirmed cases, from January 10 to 16 (the 54th week) and the newly confirmed cases indexes, such as the number and incidence density the severity of the epidemic was classified. Feasible suggestions were put forward based on the variation of the virus, actual data of vaccine research and development and possible existence in many countries. RESULTS: Up to January 16, 2021, there were 92 510 419 confirmed cases worldwide; 4 849 301 new confirmed cases were confirmed in the 54th week, and they were still growing. Among all the continents, the cumulative number of confirmed cases in Europe, North America, and Asia has exceeded 21 million, and the number of new confirmed cases in a single week in North America, South America and Asia were all increasing. Among the countries, the cumulative number of confirmed cases in 18 countries including the United States, India, and Brazil was more than 1 million, accounting for 77.04% of the total number of cumulative confirmed cases in the world. Eleven countries including the United States, Brazil, France, Spain, Colombia, The United Kingdom, Russia, Germany, South Africa, Italy, and India are at higher risk of the epidemic; The United States, Brazil, France, Spain, and Colombia were still experiencing new confirmed cases and increasing status, the risk of the epidemic was greater. Novel coronavirus mutates frequently, up to February 2021, there had been 3 931 mutant genotypes in the world. At the same time, a total of 11 vaccines were successfully launched, however we were still facing some troubles, such as the global shortage of vaccines, the public's willingness to vaccinate needed to be improved, and equity in the distribution of vaccines. CONCLUSION The global epidemic situation is still getting worse, with repeated epidemics in all the continents and countries, and has not been fundamentally controlled. At the continent level, North America, South America, and Europe have the most severe epidemics; at the national level, The United States, Brazil, France, Spain, Colombia and other countries have higher epidemic risks. Focusing on the severely affected countries will help bring the global epidemic under control as soon as possible. Under the premise of ensuring the safety and effectiveness of the vaccines, it is a key and feasible direction to improve the yield and vaccination rate of the vaccines, shorten the onset time of the vaccines and prolong the immune persistence.
Asia ; Brazil ; COVID-19 ; Europe ; France ; Humans ; India ; Italy ; North America ; Retrospective Studies ; SARS-CoV-2 ; Spain ; United Kingdom ; United States

The policies developed for the treatment of Helicobacter pylori infection in adults may not be the most suitable ones to treat children and adolescents. Methods used to treat children and adolescents in Europe and North America may not be appropriate for treating children and adolescents in Korea due to differences in epidemiological characteristics of H. pylori between regions. Moreover, the agreed standard guidelines for the treatment of H. pylori infection in children and adolescents in Korea have not been established yet. In this study, the optimal treatment strategy for H. pylori infection control in children and adolescents in Korea is discussed based on these guidelines, and recent progress on the use and misuse of antimicrobial agents is elaborated. Non-invasive as well as invasive diagnostic test and treatment strategy for H. pylori infection are not recommendable in children aged less than ten years or children with body weight under 35 kg, except in cases of clinically suspected or endoscopically identified peptic ulcers. The uncertainty, whether enough antimicrobial concentrations to eradicate H. pylori can be maintained when administered according to body weight-based dosing, and the costs and adverse effects outweighing the anticipated benefits of treatment make it difficult to decide to eradicate H. pylori in a positive non-invasive diagnostic test in this age group. However, adolescents over ten years of age or with a bodyweight of more than 35 kg can be managed aggressively as adults, because they can tolerate the adult doses of anti-H. pylori therapy. In adolescents, the prevention of future peptic ulcers and gastric cancers is expected after the eradication of H. pylori. Bismuth-based quadruple therapy (bismuth-proton pump inhibitor-amoxicillin/tetracycline-metronidazole) with maximal tolerable doses and optimal dose intervals of 14 days is recommended, because in Korea, the antibiotic susceptibility test for H. pylori is not performed at the initial diagnostic evaluation. If the first-line treatment fails, concomitant therapy plus bismuth can be attempted for 14 days as an empirical rescue therapy. Finally, the salvage therapy, if needed, must be administered after the H. pylori antibiotic susceptibility test.
Adolescent ; Adult ; Anti-Infective Agents ; Bismuth ; Body Weight ; Child ; Diagnostic Tests, Routine ; Europe ; Helicobacter pylori ; Helicobacter ; Humans ; Infection Control ; Korea ; North America ; Peptic Ulcer ; Salvage Therapy ; Stomach Neoplasms ; Uncertainty

Concurrent advancements in imaging and genomic biomarkers have created opportunities to identify non-invasive imaging surrogates of molecular phenotypes. In order to develop such imaging surrogates radiomics and radiogenomics/imaging genomics will be necessary; there has been consistent progress in these fields for primary liver cancers. In this article we evaluate the current status of the field specifically with regards to hepatocellular carcinoma and intrahepatic cholangiocarcinoma, highlighting some of the up and coming results that were presented at the annual Radiological Society of North America Conference in 2017. There are an increasing number of studies in this area with a bias towards quantitative feature measurement, which is expected to benefit reproducibility of the findings and portends well for the future development of biomarkers for diagnosis, prognosis, and treatment response assessment. We review some of the advancements and look forward to some of the exciting future applications that are anticipated as the field develops.
Bias (Epidemiology) ; Biomarkers ; Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Diagnosis ; Genomics ; Liver Neoplasms ; Liver ; North America ; Phenotype ; Prognosis

BACKGROUND: The number of children using home mechanical ventilation (HMV) has increased markedly in Europe and North America, but little is known about the situation in Korea. We described the clinical characteristics of children using HMV and investigated the current situation of HMV utilization in children. METHODS: Data on HMV prescriptions in year 2016 for children under the age of 19 was retrieved from the National Health Insurance Service for nationwide information. For more detailed information, data from year 2016 to 2018 was also retrieved from a tertiary center, Severance Children's Hospital. RESULTS: Nationwide, 416 children were prescribed with HMV in 2016, with an estimated prevalence of 4.4 per 100,000 children, of which 64.2% were male and mean age was 6-year-old. The estimated number of patients using invasive ventilators via tracheostomy was 202 (49%). Neuromuscular diseases were the most frequent cause (217; 52%), followed by central nervous system diseases (142; 34%), and cardiopulmonary diseases (57; 14%). In the tertiary center, a total of 62 children were prescribed with HMV (19 [31%] with non-invasive ventilation; 43 [69%] with invasive ventilation]. The number of children with HMV increased from 11 in 2016 to 29 in 2018. The mean age for initiation of HMV was 3.1 years and male patients comprised 65%. The most frequent diagnostic reason for HMV was central nervous system diseases (68%), followed by cardiopulmonary diseases (19%) and neuromuscular diseases (13%). Five patients died during the study period and five patients weaned from HMV. CONCLUSION: This study provides insights on the present situation of HMV utilization in Korean children.
Central Nervous System Diseases ; Child ; Europe ; Humans ; Korea ; Male ; National Health Programs ; Neuromuscular Diseases ; Noninvasive Ventilation ; North America ; Prescriptions ; Prevalence ; Respiration, Artificial ; Tracheostomy ; Ventilators, Mechanical

Lyme borreliosis (LB) is the most common tick-borne infectious disease in North America, and it was designated as a national notifiable infectious disease in Korea in December 2010. While no cases in Jeju-do were recorded from 2012 to 2016, a recent survey reported that the seroprevalence of Borrelia burgdorferi using enzyme-linked immunosorbent assays in horses in Jeju-do was 19.0% (95% confidence interval, 12.0 to 28.3%). This fact suggests that horses may be a potential reservoir of LB in Jeju-do and that individuals in close contact with horses may be a high-risk group. Thus, a serological study in this high-risk group is urgently needed.
Borrelia burgdorferi ; Communicable Diseases ; Enzyme-Linked Immunosorbent Assay ; Horses* ; Ixodes ; Jeju-do* ; Korea* ; Lyme Disease* ; North America ; Seroepidemiologic Studies ; Ticks

BACKGROUND: Ambient fine particulate matter (PM2.5) is the major environmental health risk factor in Korea. Exposure to PM2.5 has been a growing public concern nationwide. With the rapid aging of the Korean population, the health effects attributable to long-term exposure to PM2.5 were expected to increase further in the future. We aimed to estimate premature deaths attributable to long-term exposure to ambient PM(2.5) in Korea. METHODS: A modelled estimation of long-term exposure to PM2.5 was used to calculate the nationwide exposure level. Hazard ratios of long-term exposure to PM2.5 were obtained from a large prospective cohort study in North America. Modified cause of death (CoD) data, which applied the garbage code reclassification algorithm, were used to calculate premature deaths attributable to long-term exposure to PM2.5. RESULTS: From 1990 to 2013, the average population-weighted PM2.5 concentration in Korea was 30.2 μg/m3. The estimated number of premature deaths was 17,203 (95% confidence interval [CI], 11,056–22,772). The most common CoD was ischemic stroke (5,382; 3,101–7,403), followed by cancer of trachea, bronchus, and lung (4,958; 2,857–6,820), hemorrhagic stroke (3,452; 1,989–4,748), and ischemic heart disease (3,432; 1,383–5,358). CONCLUSION: Premature deaths due to long-term exposure to PM2.5 accounted for 6.4% of all deaths in Korea. However, individual efforts alone cannot prevent the effects of air pollution. This disease burden study can serve as a basis for the establishment of government policies and budgets and can be used to assess the effectiveness of environmental health policies.
Aging ; Air Pollution ; Bronchi ; Budgets ; Cause of Death ; Cohort Studies ; Environmental Health ; Garbage ; Korea ; Lung ; Mortality ; Mortality, Premature* ; Myocardial Ischemia ; North America ; Particulate Matter* ; Prospective Studies ; Republic of Korea* ; Risk Factors ; Stroke ; Trachea

OBJECTIVE: Isotretinoin is a notorious teratogen otherwise used for the treatment of acne vulgaris. Some countries, including those in North America and the European Union, implemented the pregnancy prevention program (PPP); however, no PPP has yet been established in South Korea. So the aim of this study was to evaluate the rate of pregnant women exposed to isotretinoin among the callers of the Korean Mother Safe Counseling Center. METHODS: This is a prospective cohort study. We evaluated the demographic characteristics, obstetric history, and isotretinoin exposure of pregnant women based on the mother safe registry from April 2010 to July 2016. RESULTS: Among 22,374 callers, 650 (2.9%) pregnant women were exposed to isotretinoin. The mean age was 29.0±4.4 years in the isotretinoin-exposed group and 32.0±4.2 years in the unexposed group (P < 0.001). Moreover, the incidence of pregnancies within 30 days after isotretinoin discontinuation or during isotretinoin intake was 78.9% (513/650). The median duration of isotretinoin exposure was 18 (1–4,231) days. Furthermore, from 2011 to 2015, the incidence of isotretinoin exposure was 2.9±1.2 pregnancies per 10,000 births in South Korea. CONCLUSION: Approximately 80% of pregnant women are exposed to isotretinoin within the recommended 30 days of contraception or during pregnancy. Therefore, the PPP has to be established in South Korea.
Acne Vulgaris ; Cohort Studies ; Contraception ; Counseling ; European Union ; Female ; Humans ; Incidence ; Isotretinoin* ; Korea* ; Mothers ; North America ; Parturition ; Pregnancy ; Pregnant Women* ; Prospective Studies

Graves disease is the most common disease that causes hyperthyroidism. It is an autoimmune disease characterized by the overproduction of thyroid hormones due to continuous stimulation of the thyroid gland by thyroid-stimulating hormone receptor antibody. Therapeutic modalities for Graves disease include antithyroid drugs (ATDs), radioactive iodine, and thyroidectomy. ATDs are the most preferred therapeutic option by physicians in most countries except North America. However, current treatment strategies are unfortunately aimed at inhibiting thyroid hormone production or ablating the thyroid to induce permanent hypothyroidism, not at inhibiting thyroid-stimulating hormone receptor antibody. ATD therapy has a high relapse rate (more than 50%), and morbidity and mortality increase in cases of relapse. Therefore, the proper and prompt management of relapsed patients is very important.
Antithyroid Agents ; Autoimmune Diseases ; Graves Disease ; Humans ; Hyperthyroidism ; Hypothyroidism ; Iodine ; Iodine Radioisotopes ; Mortality ; North America ; Recurrence ; Thyroid Gland ; Thyroid Hormones ; Thyroidectomy ; Thyrotropin

BACKGROUND: Access to early knee osteoarthritis treatment in low and middle income nations is often believed to be limited. We conducted a cross-sectional study in India to assess prior access to treatment among patients presenting with knee pain to specialist orthopaedic clinics. METHODS: The multi-centre, cross-sectional study included patients presenting with knee pain at 3 hospitals in India. Patients who met the inclusion criteria and provided informed consent completed a questionnaire designed to assess patient demographics, socioeconomic status, knee pain, treatment method, and patient's knowledge on osteoarthritis (OA). Their orthopaedic surgeons also completed a questionnaire on the severity of patient's OA and their recommended treatments. The impact of demographic characteristics on the prescription of treatment options was analyzed using logistic regression. RESULTS: A total of 714 patients met the eligibility criteria and participated in this study. The majority of patients had been experiencing pain for less than 1 year (64.8%) and had previously been prescribed medications (91.6%), supplements (68.6%), and nonpharmacological (81.9%) treatments to manage their knee OA. Current treatment recommendations included oral medications (83.3%), intra-articular injections (29.8%), and surgical intervention (12.7%). Prescription of oral medications was related to younger age, lack of deformities, and lower Kellgren-Lawrence grades (p < 0.01). Patients treated in private hospital settings were more likely to have been previously treated with medications (range, 84.3% to 92.6%; p < 0.01) and physical treatments (range, 61.8% to 84.8%; p < 0.01) than patients treated at government hospitals. CONCLUSIONS: Contrary to the perception, our findings suggest a similar proportion of early knee OA treatment between India and North America.
Congenital Abnormalities ; Cross-Sectional Studies* ; Demography ; Hospitals, Private ; Humans ; India* ; Informed Consent ; Injections, Intra-Articular ; Knee* ; Logistic Models ; Methods ; North America ; Osteoarthritis* ; Osteoarthritis, Knee* ; Prescriptions ; Social Class ; Specialization ; Surgeons ; Surveys and Questionnaires

Autoimmune pancreatitis is a rare type of chronic pancreatitis. Unlike chronic pancreatitis caused by other causes, autoimmune pancreatitis is characterized by a dramatic response to corticosteroid and immunomodulator therapy. Two most widely used drugs for treatment of autoimmune pancreatitis are corticosteroid and immunomodulators. Corticosteroid is the first line drug for autoimmune pancreatitis and used for remission induction. Remission induction rate of corticosteroid therapy is more than 90%, but relapse rate is approximately 30%. Centers in Japan and Republic of Korea prefer low-dose corticosteroid for maintenance. On the other hand, centers in North America and Europe prefer immunomodulators for maintenance. In the future, well-designed studies on methods to decrease relapse rate of autoimmune pancreatitis and effective use of immunomodulators are needed.
Adrenal Cortex Hormones ; Autoimmune Diseases ; Drug Therapy ; Europe ; Hand ; Immunologic Factors ; Japan ; North America ; Pancreatitis* ; Pancreatitis, Chronic ; Recurrence ; Remission Induction ; Republic of Korea