1.Factors associated with Hypertensive Retinopathy among People with Hypertension: A Systematic Review
Ihn Sook JEONG ; Chan Mi KANG ; Eun Joo LEE ; Seol Bin KIM ; Young Kyung SEO ; Young Shin SON ; Kun Hyung KIM
Journal of Korean Academy of Community Health Nursing 2025;36(1):130-149
Purpose:
The associated factors for hypertensive retinopathy (HTR) are rarely investigated. This study aimed to identify the associated factors for HTR using a systematic review.
Methods:
The review included cross-sectional, case-controlled, and cohort studies on HTR risk factors published in Korean and English with full texts available from PubMed, Embase, CINAHL, Web of Science, and Korean databases. Methodological quality was assessed using the Joanna Briggs Institute (JBI) checklist.
Results:
Eleven studies were finally selected, and three studies including patients with hypertension without diabetes mellitus, older age, male sex, alcohol consumption, the duration of hypertension, hyperglycemia, dyslipidemia, microalbuminuria, high creatinine levels, chronic kidney disease, and cardiovascular changes were identified as factors associated with HTR. Conversely, in the remaining eight studies, younger age, non-smoking status, and renal function indicators (albuminuria, high creatinine levels, chronic kidney disease, and uric acid) were identified as associated factors.
Conclusions
Regardless of the inclusion of patients with diabetes mellitus, impaired kidney functions were determined as significant factors associated with retinopathy in patients with HTR. However, considering a limited number of evidence and lack of evidence to confirm causality, we recommend further research on renal function and HTR.
2.Utilization of Acid Suppressants After Withdrawal of Ranitidine in Korea: An Interrupted Time Series Analysis
Jeong Pil CHOI ; Sangwan KIM ; Jung Su PARK ; Mi-Sook KIM ; Nam-Kyong CHOI ; Cheol Min SHIN ; Joongyub LEE
Journal of Preventive Medicine and Public Health 2025;58(1):21-30
Objectives:
This study was performed to evaluate the utilization patterns of acid suppressants following the withdrawal of ranitidine in Korea.
Methods:
Health Insurance Review & Assessment Service (HIRA) data from January 2016 to May 2023 were utilized to assess the usage of histamine H2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs) for acid-related diseases. Drug utilization was calculated for each agent based on the defined daily dose (DDD). To evaluate changes in utilization following the ranitidine recall, an interrupted time series analysis was conducted using segmented linear regression and an autoregressive integrated moving average model.
Results:
Before the withdrawal of ranitidine, the DDD per 100 000 inhabitants per day was increasing by 6.9 (95% confidence interval [CI], 4.7 to 9.0) for H2RAs and by 19.3 (95% CI, 16.9 to 21.8) for PPIs each month. After the recall, H2RA utilization immediately declined by -1041.7 (95% CI, -1115.8 to -967.7), followed by a monthly increase of 6.6 (95% CI, 3.7 to 9.6) above the previous trend. PPI utilization temporarily surged by 235.2 (95% CI, 149.1 to 321.3), then displayed a monthly increase of 4.1 (95% CI, 0.7 to 7.6) on top of the pre-recall trend. Among PPIs, esomeprazole and rabeprazole demonstrated notable increases, representing the most commonly used acid suppressants in 2023.
Conclusions
PPI usage rose prominently following the withdrawal of ranitidine from the market. Considering the potential adverse effects of PPIs, further research is necessary to evaluate the public health implications of shifts in the utilization of acid suppressants.
3.Risk of non-cancer respiratory diseases attributed to humidifier disinfectant exposure in Koreans: age-period-cohort and differences-in-difference analyses
Jaiyong KIM ; Kyoung Sook JEONG ; Seungyeon HEO ; Younghee KIM ; Jungyun LIM ; Sol YU ; Suejin KIM ; Sun-Kyoung SHIN ; Hae-Kwan CHEONG ; Mina HA ;
Epidemiology and Health 2025;47(1):e2025006-
OBJECTIVES:
Humidifier disinfectants (HDs) were sold in Korea from 1994 until their recall in 2011. We examined the incidence patterns of 8 respiratory diseases before and after the HD recall and estimated the attributable risk in the Korean population.
METHODS:
Using National Health Insurance data from 2002 to 2019, we performed age–cohort–period and differences-in-diffference analyses (comparing periods before vs. after the recall) to estimate the population-attributable fraction and the excess number of episodes. The database comprised 51 million individuals (99% of the Korean population). The incidence of 8 diseases—acute upper respiratory infection (AURI), acute lower respiratory infection (ALRI), asthma, pneumonia, chronic sinusitis (CS), interstitial lung disease (ILD), bronchiectasis, and chronic obstructive pulmonary disease (COPD)—was defined by constructing episodes of care based on patterns of medical care and the clinical characteristics of each disease.
RESULTS:
The relative risks (RRs) for AURI, ALRI, asthma, pneumonia, CS, and ILD were elevated among younger individuals (with an RR as high as 82.18 for AURI in males), whereas chronic conditions such as bronchiectasis, COPD, and ILD showed higher RRs in older individuals. During the HD exposure period, the population-attributable risk percentage ranged from 4.6% for bronchiectasis to 25.1% for pneumonia, with the excess number of episodes ranging from 6,218 for ILD to 3,058,861 for CS. Notably, females of reproductive age (19-44 years) experienced 1.1-9.2 times more excess episodes than males.
CONCLUSIONS
This study provides epidemiological evidence that inhalation exposure to HDs affects the entire respiratory tract and identifies vulnerable groups.
4.Changes in Candidemia during the COVID-19 Pandemic: Species Distribution, Antifungal Susceptibility, Initial Antifungal Usage, and Mortality Trends in Two Korean Tertiary Care Hospitals
Ahrang LEE ; Minji KIM ; Sarah KIM ; Hae Seong JEONG ; Sung Un SHIN ; David CHO ; Doyoung HAN ; Uh Jin KIM ; Jung Ho YANG ; Seong Eun KIM ; Kyung-Hwa PARK ; Sook-In JUNG ; Seung Ji KANG
Chonnam Medical Journal 2025;61(1):52-58
This study aimed to investigate changes in candidemia incidence, species distribution, antifungal susceptibility, initial antifungal use, and mortality trends in Korea before and during the COVID-19 pandemic. A retrospective analysis was conducted on candidemia cases from two tertiary care hospitals in Korea between 2017 and 2022. Data were compared between the pre-pandemic (2017-2019) and pandemic (2020-2022) periods. Statistical methods included incidence rate ratios (IRRs) and multivariate Cox regression to assess 30-day mortality risk factors. A total of 470 candidemia cases were identified, with 48.7% occurring pre-pandemic and 51.3% during the pandemic. While the overall incidence of candidemia remained similar across the two periods (IRR 1.15;p=0.13), the incidence in intensive care units (ICUs) significantly increased during the pandemic (IRR 1.50; p<0.01). The distribution of Candida species did not differ significantly between the two periods. Fluconazole non-susceptibility in C. albicans markedly decreased (10.0% vs. 0.9%, p<0.01), whereas C. glabrata exhibited a significant rise in caspofungin non-susceptibility during the pandemic (0% vs. 22.4%, p<0.01).Echinocandin use increased (21.8% vs. 34.4%; p<0.01), while fluconazole use declined (48.0% vs. 32.8%; p<0.01). Although the 30-day mortality rate was higher during the pandemic (60.2% vs. 57.2%), the difference was not statistically significant (p=0.57).The findings highlight the need for region-specific surveillance and tailored management strategies to improve candidemia outcomes, especially during healthcare disruptions like the COVID-19 pandemic.
5.Factors associated with Hypertensive Retinopathy among People with Hypertension: A Systematic Review
Ihn Sook JEONG ; Chan Mi KANG ; Eun Joo LEE ; Seol Bin KIM ; Young Kyung SEO ; Young Shin SON ; Kun Hyung KIM
Journal of Korean Academy of Community Health Nursing 2025;36(1):130-149
Purpose:
The associated factors for hypertensive retinopathy (HTR) are rarely investigated. This study aimed to identify the associated factors for HTR using a systematic review.
Methods:
The review included cross-sectional, case-controlled, and cohort studies on HTR risk factors published in Korean and English with full texts available from PubMed, Embase, CINAHL, Web of Science, and Korean databases. Methodological quality was assessed using the Joanna Briggs Institute (JBI) checklist.
Results:
Eleven studies were finally selected, and three studies including patients with hypertension without diabetes mellitus, older age, male sex, alcohol consumption, the duration of hypertension, hyperglycemia, dyslipidemia, microalbuminuria, high creatinine levels, chronic kidney disease, and cardiovascular changes were identified as factors associated with HTR. Conversely, in the remaining eight studies, younger age, non-smoking status, and renal function indicators (albuminuria, high creatinine levels, chronic kidney disease, and uric acid) were identified as associated factors.
Conclusions
Regardless of the inclusion of patients with diabetes mellitus, impaired kidney functions were determined as significant factors associated with retinopathy in patients with HTR. However, considering a limited number of evidence and lack of evidence to confirm causality, we recommend further research on renal function and HTR.
6.Factors associated with Hypertensive Retinopathy among People with Hypertension: A Systematic Review
Ihn Sook JEONG ; Chan Mi KANG ; Eun Joo LEE ; Seol Bin KIM ; Young Kyung SEO ; Young Shin SON ; Kun Hyung KIM
Journal of Korean Academy of Community Health Nursing 2025;36(1):130-149
Purpose:
The associated factors for hypertensive retinopathy (HTR) are rarely investigated. This study aimed to identify the associated factors for HTR using a systematic review.
Methods:
The review included cross-sectional, case-controlled, and cohort studies on HTR risk factors published in Korean and English with full texts available from PubMed, Embase, CINAHL, Web of Science, and Korean databases. Methodological quality was assessed using the Joanna Briggs Institute (JBI) checklist.
Results:
Eleven studies were finally selected, and three studies including patients with hypertension without diabetes mellitus, older age, male sex, alcohol consumption, the duration of hypertension, hyperglycemia, dyslipidemia, microalbuminuria, high creatinine levels, chronic kidney disease, and cardiovascular changes were identified as factors associated with HTR. Conversely, in the remaining eight studies, younger age, non-smoking status, and renal function indicators (albuminuria, high creatinine levels, chronic kidney disease, and uric acid) were identified as associated factors.
Conclusions
Regardless of the inclusion of patients with diabetes mellitus, impaired kidney functions were determined as significant factors associated with retinopathy in patients with HTR. However, considering a limited number of evidence and lack of evidence to confirm causality, we recommend further research on renal function and HTR.
7.Risk of non-cancer respiratory diseases attributed to humidifier disinfectant exposure in Koreans: age-period-cohort and differences-in-difference analyses
Jaiyong KIM ; Kyoung Sook JEONG ; Seungyeon HEO ; Younghee KIM ; Jungyun LIM ; Sol YU ; Suejin KIM ; Sun-Kyoung SHIN ; Hae-Kwan CHEONG ; Mina HA ;
Epidemiology and Health 2025;47(1):e2025006-
OBJECTIVES:
Humidifier disinfectants (HDs) were sold in Korea from 1994 until their recall in 2011. We examined the incidence patterns of 8 respiratory diseases before and after the HD recall and estimated the attributable risk in the Korean population.
METHODS:
Using National Health Insurance data from 2002 to 2019, we performed age–cohort–period and differences-in-diffference analyses (comparing periods before vs. after the recall) to estimate the population-attributable fraction and the excess number of episodes. The database comprised 51 million individuals (99% of the Korean population). The incidence of 8 diseases—acute upper respiratory infection (AURI), acute lower respiratory infection (ALRI), asthma, pneumonia, chronic sinusitis (CS), interstitial lung disease (ILD), bronchiectasis, and chronic obstructive pulmonary disease (COPD)—was defined by constructing episodes of care based on patterns of medical care and the clinical characteristics of each disease.
RESULTS:
The relative risks (RRs) for AURI, ALRI, asthma, pneumonia, CS, and ILD were elevated among younger individuals (with an RR as high as 82.18 for AURI in males), whereas chronic conditions such as bronchiectasis, COPD, and ILD showed higher RRs in older individuals. During the HD exposure period, the population-attributable risk percentage ranged from 4.6% for bronchiectasis to 25.1% for pneumonia, with the excess number of episodes ranging from 6,218 for ILD to 3,058,861 for CS. Notably, females of reproductive age (19-44 years) experienced 1.1-9.2 times more excess episodes than males.
CONCLUSIONS
This study provides epidemiological evidence that inhalation exposure to HDs affects the entire respiratory tract and identifies vulnerable groups.
8.Changes in Candidemia during the COVID-19 Pandemic: Species Distribution, Antifungal Susceptibility, Initial Antifungal Usage, and Mortality Trends in Two Korean Tertiary Care Hospitals
Ahrang LEE ; Minji KIM ; Sarah KIM ; Hae Seong JEONG ; Sung Un SHIN ; David CHO ; Doyoung HAN ; Uh Jin KIM ; Jung Ho YANG ; Seong Eun KIM ; Kyung-Hwa PARK ; Sook-In JUNG ; Seung Ji KANG
Chonnam Medical Journal 2025;61(1):52-58
This study aimed to investigate changes in candidemia incidence, species distribution, antifungal susceptibility, initial antifungal use, and mortality trends in Korea before and during the COVID-19 pandemic. A retrospective analysis was conducted on candidemia cases from two tertiary care hospitals in Korea between 2017 and 2022. Data were compared between the pre-pandemic (2017-2019) and pandemic (2020-2022) periods. Statistical methods included incidence rate ratios (IRRs) and multivariate Cox regression to assess 30-day mortality risk factors. A total of 470 candidemia cases were identified, with 48.7% occurring pre-pandemic and 51.3% during the pandemic. While the overall incidence of candidemia remained similar across the two periods (IRR 1.15;p=0.13), the incidence in intensive care units (ICUs) significantly increased during the pandemic (IRR 1.50; p<0.01). The distribution of Candida species did not differ significantly between the two periods. Fluconazole non-susceptibility in C. albicans markedly decreased (10.0% vs. 0.9%, p<0.01), whereas C. glabrata exhibited a significant rise in caspofungin non-susceptibility during the pandemic (0% vs. 22.4%, p<0.01).Echinocandin use increased (21.8% vs. 34.4%; p<0.01), while fluconazole use declined (48.0% vs. 32.8%; p<0.01). Although the 30-day mortality rate was higher during the pandemic (60.2% vs. 57.2%), the difference was not statistically significant (p=0.57).The findings highlight the need for region-specific surveillance and tailored management strategies to improve candidemia outcomes, especially during healthcare disruptions like the COVID-19 pandemic.
9.Risk of non-cancer respiratory diseases attributed to humidifier disinfectant exposure in Koreans: age-period-cohort and differences-in-difference analyses
Jaiyong KIM ; Kyoung Sook JEONG ; Seungyeon HEO ; Younghee KIM ; Jungyun LIM ; Sol YU ; Suejin KIM ; Sun-Kyoung SHIN ; Hae-Kwan CHEONG ; Mina HA ;
Epidemiology and Health 2025;47(1):e2025006-
OBJECTIVES:
Humidifier disinfectants (HDs) were sold in Korea from 1994 until their recall in 2011. We examined the incidence patterns of 8 respiratory diseases before and after the HD recall and estimated the attributable risk in the Korean population.
METHODS:
Using National Health Insurance data from 2002 to 2019, we performed age–cohort–period and differences-in-diffference analyses (comparing periods before vs. after the recall) to estimate the population-attributable fraction and the excess number of episodes. The database comprised 51 million individuals (99% of the Korean population). The incidence of 8 diseases—acute upper respiratory infection (AURI), acute lower respiratory infection (ALRI), asthma, pneumonia, chronic sinusitis (CS), interstitial lung disease (ILD), bronchiectasis, and chronic obstructive pulmonary disease (COPD)—was defined by constructing episodes of care based on patterns of medical care and the clinical characteristics of each disease.
RESULTS:
The relative risks (RRs) for AURI, ALRI, asthma, pneumonia, CS, and ILD were elevated among younger individuals (with an RR as high as 82.18 for AURI in males), whereas chronic conditions such as bronchiectasis, COPD, and ILD showed higher RRs in older individuals. During the HD exposure period, the population-attributable risk percentage ranged from 4.6% for bronchiectasis to 25.1% for pneumonia, with the excess number of episodes ranging from 6,218 for ILD to 3,058,861 for CS. Notably, females of reproductive age (19-44 years) experienced 1.1-9.2 times more excess episodes than males.
CONCLUSIONS
This study provides epidemiological evidence that inhalation exposure to HDs affects the entire respiratory tract and identifies vulnerable groups.
10.Utilization of Acid Suppressants After Withdrawal of Ranitidine in Korea: An Interrupted Time Series Analysis
Jeong Pil CHOI ; Sangwan KIM ; Jung Su PARK ; Mi-Sook KIM ; Nam-Kyong CHOI ; Cheol Min SHIN ; Joongyub LEE
Journal of Preventive Medicine and Public Health 2025;58(1):21-30
Objectives:
This study was performed to evaluate the utilization patterns of acid suppressants following the withdrawal of ranitidine in Korea.
Methods:
Health Insurance Review & Assessment Service (HIRA) data from January 2016 to May 2023 were utilized to assess the usage of histamine H2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs) for acid-related diseases. Drug utilization was calculated for each agent based on the defined daily dose (DDD). To evaluate changes in utilization following the ranitidine recall, an interrupted time series analysis was conducted using segmented linear regression and an autoregressive integrated moving average model.
Results:
Before the withdrawal of ranitidine, the DDD per 100 000 inhabitants per day was increasing by 6.9 (95% confidence interval [CI], 4.7 to 9.0) for H2RAs and by 19.3 (95% CI, 16.9 to 21.8) for PPIs each month. After the recall, H2RA utilization immediately declined by -1041.7 (95% CI, -1115.8 to -967.7), followed by a monthly increase of 6.6 (95% CI, 3.7 to 9.6) above the previous trend. PPI utilization temporarily surged by 235.2 (95% CI, 149.1 to 321.3), then displayed a monthly increase of 4.1 (95% CI, 0.7 to 7.6) on top of the pre-recall trend. Among PPIs, esomeprazole and rabeprazole demonstrated notable increases, representing the most commonly used acid suppressants in 2023.
Conclusions
PPI usage rose prominently following the withdrawal of ranitidine from the market. Considering the potential adverse effects of PPIs, further research is necessary to evaluate the public health implications of shifts in the utilization of acid suppressants.

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