Racial Disparity in Localized Prostate Cancer Mortality

This study aims to examine racial differences in all-cause mortality between African American (AA) and non-African American localized prostate cancer patients. This study advances academic discussion by being among the first to use a sample more representative of the general population that is different from certain subpopulations examined in literature. This study adopted a retrospective cohort study design using the Florida Cancer Data System. The hierarchical logistic regression was employed to analyze mortality in 2004 among living patients with localized prostate cancer from baseline 2000. Among 9617 patients, the odds of mortality in AAs were 57.6% higher than the non-AAs (Adjusted OR = 1.576, 95% CI: 1.243–1.999). Among prostate cancer patients, AA, older age, unmarried status, conservative treatment, Medicaid, and tumor grade III diagnosis predicted higher mortality relative to the reference group. Screening programs at a younger age can be considered, family and community support and aggressive treatments are suggested to prevent AA against adverse health outcomes.     

The Waiting List Mortality of Pediatric Heart Transplantation Candidates in Korea before the Pediatric Ventricular Assist Device Era

BackgroundDespite advancements in heart transplantation for pediatric patients in Korea, the waiting list mortality has not been reported. Therefore, we investigated the waiting list mortality rate and factors associated with patient mortality.MethodsWe reviewed the medical records of pediatric patients who were registered for heart transplantation at three major hospitals in Korea from January 2000 to January 2020. All patients who died while waiting for heart transplantation were investigated, and we identified the waiting list mortality rate, causes of mortality and median survival periods depending on the variable risk factors.ResultsA total of 145 patients received heart transplantations at the three institutions we surveyed, and the waiting list mortality rate was 26%. The most common underlying diseases were cardiomyopathy (66.7%) and congenital heart disease (30.3%). The leading causes that contributed to death were heart failure (36.3%), multi-organ failure (27.2%), and complications associated with extracorporeal membrane oxygenation (ECMO) (25.7%). The median survival period was 63 days. ECMO was applied in 30 patients. The different waiting list mortality percentages according to age, cardiac diagnosis, use of ECMO, and initial Korean Network of Organ Sharing (KONOS) level were determined using univariate analysis, but age was the only significant factor associated with waiting list mortality based on a multivariate analysis.ConclusionThe waiting list mortality of pediatric heart transplantation candidates was confirmed to be considerably high, and age, underlying disease, the application of ECMO, and the initial KONOS level were the factors that influenced the survival period.     

Lower Regional Pediatric In-hospital Mortality Albeit Racial/ethnic Disparities

Purpose

Variability in pediatric morbidity and mortality tends to be influenced by several factors including though not limited to social determinants of health, namely health inequity as an exposure function of health disparities. We aimed to assess the cumulative incidence of pediatric mortality, racial/ethnic disparities, and the predisposing factors for the disparities.

成年人个性特征的年龄差异再研究

目的 :再研究成年人个性特征的年龄差异 ,横断法应用的特点及个性和心理健康的关系。方法 :采用NEO—FFI个性问卷 ,被试为 2 0至 97岁青年至老老年四年龄组成年人 762名。结果 :1 开放性特征 ( 0 )随增龄明显下降 ,老老年组及青年组认真负责 (C)分及和谐性 (A )分较低 ,神经质 (N )分较高。外向性(E)分无明显差异。 2 女性N分显著高于男性 ,A分略高于男性 ,E分略低于男性。 3 与 93年结果比较 ,青年组Cl>C2 ;老老年组 0 1>0 2 ,余 18项结果一致。本次结果出现较多的年龄差异 ,可能和其老老年组年龄较大、健康状况较差有关。结论 :相隔三年的两批横断法研究结果大体一致 ,同时表现横断法结果受所研究群体的具体情况的影响。个性特征和心境、家庭满意度等诸多心理健康因素有关。     

成人期自我策略的年龄与性别差异

目的 :了解成人期自我策略的年龄与性别差异。方法 :以修订的加州心理量表为工具 ,对 447名成人被试处理紧张事件的策略进行年龄与性别差异考察。结果 :处于不同年龄段或性别不同的成人所采取的自我策略具有不同的倾向性 ;年龄越大并不意味着其自我策略越灵活或越成熟 ,而应该对具体策略作具体分析 ;男性倾向于采用灵活的、正视现实的、理性的和指向外部的策略 ,女性倾向于采用指向个人内部的自我调节策略。结论 :成人期自我策略有年龄与性别差异。     

Individual Differences in Heart Rate Responses to Affective Sound

Lacey, Kagan, Lacey and Moss (1963) distinguished between the effects of feedback from the cardiovascular system and from other autonomic systems and suggested that heart rate (HR) acceleration should be associated with stimulus “rejection” and HR deceleration with “attention” or stimulus “acceptance.” The present study quantified certain attributes of the sound of the high speed dental engine and tested the effects of this sound on HR and measures of hostility, depression, and anxiety. The study tested the findings of Lacey et al (1963) and Obrist (1963), Thirty-eight females enrolled at (he University of Bridgeport were assigned to one of four groups predetermined by a questionnaire investigating their past experience and familiarity with the dental engine. Heart rate and measures of hostility, depression, and anxiety varied directly with the subjects' familiarity and subjective experience with the acoustic stimuli. Heart rate was found to be more accelerated in subjects who had less experience with and who rated the acoustic stimulus as more unpleasant. Similarly such subjects demonstrated higher scores on anxiety, depression, and hostility scales.     

Morbidity and Mortality in Jeju Residents over 50-Years of Age with Hip Fracture with Mean 6-Year Follow-Up: A Prospective Cohort Study

This prospective cohort study was performed to estimate the morbidity and mortality with 790 patients over 50-yr of age that sustained a femoral neck or intertrochanteric fracture from 2002 to 2006, followed-up for a mean of 6 yr (range, 4 to 9 yr). Crude and annual standardized mortality ratios (SMRs) were calculated; and mortalities in the cohort and the age and sex matched general population were compared. The risk factors on mortality and activities pre- and post-injury were assessed. Accumulated mortality was 16.7% (132 patients) at 1 yr, 45.8% (337 patients) at 5 yr, and 60% (372 patients) at 8 yr. SMR at 5 yr post-injury was 1.3 times that of the general population. Multivariate analysis demonstrated that age (OR, 1.074; 95% CI, 1.050-1.097; P<0.001), woman (OR, 1.893; 95% CI, 1.207-2.968; P=0.005), and medical comorbidity (OR, 1.334; 95% CI, 1.167-1.524 P<0.001) were independently associated with mortality after hip fracture. Only 59 of the 150 patients (39.3%) who were able to ambulate normally outdoors at preinjury retained this ability at final follow-up. Patients with a hip fracture exhibits higher mortality at up to 5 yr than general population. Age and a preinjury comorbidity are associated with mortality.     

Trends in Hospitalized Acute Myocardial Infarction Patients with Heart Failure in Korea at 1998 and 2008

Heart failure (HF) complicating acute myocardial infarction (AMI) is common and is associated with poor clinical outcome. Limited data exist regarding the incidence and in-hospital mortality of AMI with HF (AMI-HF). We retrospectively analyzed 1,427 consecutive patients with AMI in the five major university hospitals in Korea at two time points, 1998 (n = 608) and 2008 (n = 819). Two hundred twenty eight patients (37.5%) in 1998 and 324 patients (39.5%) in 2008 of AMI patients complicated with HF (P = 0.429). AMI-HF patients in 2008 were older, had more hypertension, previous AMI, and lower systolic blood pressure than those in 1998. Regarding treatments, AMI-HF patients in 2008 received more revascularization procedures, more evidence based medical treatment and adjuvant therapy, such as mechanical ventilators, intra-aortic balloon pulsation compared to those in 1998. However, overall in-hospital mortality rates (6.4% vs 11.1%, P = 0.071) of AMI-HF patients were unchanged and still high even after propensity score matching analysis, irrespective of types of AMI and revascularization methods. In conclusion, more evidence-based medical and advanced procedural managements were applied for patients with AMI-HF in 2008 than in 1998. However the incidence and in-hospital mortality of AMI-HF patients were not significantly changed between the two time points.     

Heart failure in COVID-19 patients: Critical care experience

Patients with heart failure (HF) may be at a higher risk of coronavirus disease 2019 (COVID-19) infection and may have a worse outcome due to their comorbid conditions and advanced age. In this narrative review, we aim to study the interaction between COVID-19 and HF from a critical care perspective. We performed a systematic search for studies that reported HF and critical care-related outcomes in COVID-19 patients in the PubMed and Medline databases. From a total of 1050 papers, we identified 26 that satisfied the eligibility criteria for our review. Data such as patient demographics, HF, intensive care unit (ICU) admission, management, and outcome were extracted from these studies and analyzed. We reported outcomes in heart-transplant patients with COVID-19 separately. In hospitalized patients with COVID-19, the prevalence of HF varied between 4% and 21%. The requirement for ICU admission was between 8% and 33%. HF patients with COVID-19 had an overall mortality rate between 20% and 40%. We identified that HF is an independent predictor of mortality in hospitalized COVID-19 patients, and patients with HF were more likely to require ventilation, ICU admission and develop complications. Patients with HF with reduced ejection fraction did worse than those with HF with midrange ejection fraction, and HF with preserved ejection fraction. COVID-19 patients with HF should be identified early and managed aggressively in an attempt to improve outcomes in this cohort of patients.     

GRO-alpha in Human Serum: Differences Related to Age and Sex

PROBLEM: Human GRO-alpha (GRO-α) is a new member of the chemokine family that is supposed to play an important role in inflammatory and immune reactions. We established a sandwich enzyme-linked immunoassay (ELISA) system with polyclonal antibodies against human GRO-α and investigated the serum level of healthy donors to establish normal ranges for this chemokine in adults. METHODS: GRO-α concentrations were measured cross-sectionally in the sera of 240 healthy adults. The variability of serum GRO-α levels was also measured in normal volunteers, samples from whom were obtained by sequential venipunctures or by a small plastic cannula with a heparin-saline lock, to determine short-term variability. RESULTS: Whereas there was no difference between the concentration of human GRO-α from men (logarithmic mean, 77.6 pg/ml, n = 120) and that from women with normal menstrual cycles (log mean, 71.6 pg/ml, n = 73), the concentration from postmenopausal women (log mean 45.0 pg/ml, n = 31) was lower than that from women with normal menstrual cycles (log mean 71.6 pg/ml, n = 73). However, we could not detect any significant difference between healthy donors' serum levels and those of donors with acute inflammation. Fewer variations were recognized in the case of the sequential venipunctures method than in that of the heparin-saline lock method. CONCLUSION: We found that the GRO-α concentration of postmenopausal women was significantly lower than that of women with normal menstrual cycles. These results suggest the GRO-α serum levels of normal healthy women may have some correlation with sex hormones.     

成年人心理幸福感的年龄差异研究

目的：了解成年人心理幸福感的年龄差异和有关因素。方法：采用Ruff的心理幸福感量表对777名20－94岁的人进行测查。结果：1，量表的信度合格，与抑郁症患者反映的差异显著。2．6个分量表除自主性无明显年龄差异外，个人成长较年青组均高于较年长组。与他人积极关系及生活目的较年青三组均高于老老年组；环境掌握中年组与老年组高于老老年组；自我接受老年组显著高于青年组。3，自主性，个人成长，生活目的和自我接受分均男性显著高于女性，与他人的积极关系分女性稍高于男性。4，影响心理幸福感的因素，青年组以工作学习，教育程度，疾病和心境，中年组以工作学习量，婚姻状态以及人际交往，老年组以心境，健康情况，老老年组则以心境，人际交往，疾病情况，教育程度，家庭关系等因素为主 ；5，与美国比较，个人成长结果基本一致；中国人生活目的，自我接受评价较低，可能受我国传统的中庸之道影响。结论：心理幸福感受年龄影响，量表从积极心理功能角度考虑是合理的，但对除婚姻外的家庭关系涉及过少。     

Voluntary Heart Rate Control as a Function of Individual Differences in Electrodermal Lability

Twenty-four male subjects were run in a paradigm in which they were first asked to rest for 10 min and then given 20 1-min training trials of analog and digital feedback of their heart rate, with instructions to increase the rate. Subjects were rewarded with 0.2 cents for each interbeat interval that was faster than a designated criterion. Subjects were subdivided into “labile” and “stabile” groups on the basis of frequency of spontaneous skin conductance fluctuations during the baseline period. Mean heart rate for the training trials was compared with the baseline period for the most labile and most stabile subjects. Results indicated that there was a significant treatment effect for stabile subjects only, but not for labile subjects.     

正常人心动周期信号的混沌特征随年龄的变化

心动周期信号（ＨＰＳ）具有混沌特征，含有重要的生理、病理信息。我们利用自行研制的计算机化心动周期信号混沌分析系统，研究了２７１例正常人心动周期信号的混沌特征参数如相对分散度（ＨＲＤ）、李雅普诺夫数（ＨＬＥ）和分维数（ＨＦＤ），发现随着年龄的增加，ＨＲＤ、ＨＬＥ、ＨＦＤ逐步降低，即心血管动力学的复杂性逐步降低     

Health and Mortality in Korean Healthcare Workers

BackgroundTo evaluate the health status of healthcare workers (doctors and nurses) compared to those in the general population based on the National Health Insurance Service database and the cause of death data from Statistics Korea.MethodsThe subjects of this study were 104,484 doctors and 220,310 nurses working in healthcare facilities from 2002 to 2017, and who had undergone at least one general medical examination. Based on the subject definition, the subject data were extracted from the National Health Insurance healthcare facility database and qualification database. We collected medical use details included in the research database, general medical examination results, medical history included in the health examination database, and additional data on the cause of death from the National Statistics database to analyze the main cause of death and mortality.ResultsIn terms of the major causes of death and mortality among healthcare workers, the mortality rate associated with intentional self-harm, injury, transportation accident, heart disease, addiction, and falling was significantly higher than that in the general population. Further, the prevalence of respiratory and gastrointestinal diseases was high. When analyzing the proportional mortality ratio (PMR) by cause of death for healthcare workers, the PMR values for death related to malignant neoplasm was the highest. In terms of diseases, both doctors and nurses had higher rates of infectious diseases such as maternal sepsis, rubella, and measles.ConclusionThe health status of healthcare workers differs from that of the general population. Thus, it is important to consider the occupational characteristics of healthcare personnel. This study is unique in that it was conducted based on medical use indicators rather than survey data.     

Impact of Atrial Fibrillation on Survival in Adults with Congenital Heart Disease: a Retrospective Population-based Study

BackgroundThe number of adults with congenital heart disease (ACHD) with atrial fibrillation (AF) is expected to increase. We sought to assess the impact of AF on survival in Korean ACHD.MethodsRecords of AF in ACHD were extracted from the records of the Korea National Health Insurance Service from 2006 through 2015. Multiple Cox proportional hazards analyses were carried out after adjustment for age, sex, income level, AF, and comorbidities. Survival rates (SRs) with and without AF were compared. The death records from 2006 through 2016 were included.ResultsA total of 3,999 ACHD had AF (51.4% were male) and 62,691 ACHD did not have AF (43.5% were male); the proportion of ACHD who were 60 years and older was 53.0% and 27.0% in those with and without AF, respectively (P < 0.001). The age-standardized incidence rate for AF was 1,842.0 persons per 100,000 people in the Korean general population from 2006 through 2015. For AF in ACHD, it was 5,996.4 persons per 100,000 ACHD during the same period, which was higher than that in the general population (P < 0.001). Significantly higher proportion of death (20.9%) occurred in ACHD with AF than without AF (8.3%) (P < 0.001). The adjusted hazard ratio for AF of death in ACHD was 1.39 (95% confidence interval, 1.29–1.50). The ten-year SR of ACHD with AF was 69.7% whereas it was 87.5% in non-AF (P < 0.001).ConclusionIn ACHD, AF occurs more frequently and has a worse prognosis than seen in the non-valvular general population in Korea. AF is associated with increased death in ACHD, especially with aging.     

Cancer Mortality Projections in Korea up to 2032

Predicting cancer mortality is important to estimate the needs of cancer-related services and to prevent cancer. Despite its significance, a long-term future projection of cancer mortality has not been conducted; therefore, our objective was to estimate future cancer mortality in Korea by cancer site through 2032. The specially designed Nordpred software was used to estimate cancer mortality. The cancer death data from 1983 to 2012 and the population projection data from 1983 to 2032 were obtained from the Korean National Statistics Office. Based on our analysis, age-standardized rates with the world standard population of all cancer deaths were estimated to decline from 2008-2012 to 2028-2032 (men: -39.8%, women: -33.1%). However, the crude rates are predicted to rise (men: 29.8%, women: 24.4%), and the overall number of the cancer deaths is also estimated to increase (men: 35.5%, women: 32.3%). Several cancer deaths are projected to increase (lung, liver and gallbladder, colon and rectum, pancreas and leukemia in both sexes; prostate cancer in men; and breast and ovarian cancer in women), whereas other cancer deaths are expected to decrease (stomach, esophagus and larynx in both sexes and cervical cancer in women). The largest contribution to increasing cancer deaths is due to the aging of the Korean population. In conclusion, a strategy for primary prevention, early detection, and early treatment to cope with the rapidly increasing death of cancer due to population aging is urgently required.