Background: Evidence consistently shows that diabetes is a risk factor for increased prevalence of gingivitis and periodontitis. But there is a controversy about the relationship between diabetes related factors and periodontal health. The aim of the present study is to explore the relationship between diabetes related factors such as glycosylated hemoglobin, fasting blood glucose, duration of diabetes and compliance to diabetes self management and periodontal health status. Methods: Periodontal health of 125 participants with type-2 diabetes mellitus was measured by the number of missing teeth, community periodontal index (CPI), Russell’s periodontal index and papillary bleeding index. Information on sociodemographic factors, oral hygiene behavior, duration and compliance to self management of diabetes, levels of glycosylated hemoglobin(HbA1c) and fasting blood glucose(FBG) were collected by interview and hospital medical records. Statistically, independent t-test, an analysis of variance (ANOVA), chi-squared test and multiple regression analyses were used to assess the association between diabetes-related factors and periodontal health. Results: Periodontal parameters including the number of missing teeth and papillary bleeding index were significantly influenced by duration of diabetes, FBG and compliance to self management of diabetes. CPI was significantly influenced by duration of diabetes, FBG and HbA1C. And Russell’s periodontal index was significantly influenced by duration of diabetes, FBG, HbA1C and compliance to self management of diabetes. Results of multiple linear regression analysis showed that the duration of diabetes showed significant positive correlation with all of the periodontal health parameters, except for missing teeth. HbA1c was correlated with Russell's periodontal and papillary bleeding index. FBG and compliance to self management of diabetes were correlated with missing teeth and papillary bleeding index respectively. Conclusions: Diabetes-related factors such as duration of diabetes, FBG, HbA1c and compliance to self management of diabetes were significantly correlated with periodontal health among individuals with type-2 diabetes.

A system for managing chronic disease including diabetes mellitus based on primary care clinics has been used in Korea since April 2012. This system can reduce copayments for patients that are managed by a single primary-care provider and lead to improve continuity of care. The aim of this study is to determine whether there is an association between continuity of care for outpatients and hospital admission and identify the continuity index that best explains hospital admissions for patients with type 2 diabetes. We performed a cross-sectional study using 2009 National Health Insurance Sample (NHIS) from the Health Insurance Review & Assessment Services (HIRA) of Korea. The dependent variable was hospital admission due to type 2 diabetes mellitus. Continuity of care was measured using the Usual Provider Care index (UPC), Continuity of Care index (COC), Sequential Continuity of Care index (SECON), and Integrated Continuity of Care index (ICOC). Patients with low COC scores (<0.75) were more likely to be hospitalized [odds ratio, 2.44; 95% CI, 2.17–2.75] compared with the reference group (COC ≥0.75), after adjusting for all covariates. we calculated the area under the receiver operating characteristic (AUROC) curve for each index to find which index had the greatest explanatory ability for hospital admission. The AUROC of the COC was the greatest (0.598), but the AUROC curves for the UPC (0.597), SECON (0.593), and ICOC (0.597) were similar. High continuity of care may reduce the likelihood for hospital admission. The COC had marginally more explanatory power.

The LACE index accounts for: Length of stay (L), Acuity of admission (A), Comorbidities (C), and recent Emergency department use (E). This study aimed to explore the LACE index to predict the high risk of 30-day readmission in patients with diverse disease conditions by an updated systematic review. A systematic review carried out by electronic databases from 2011–2021. The studies included a LACE index score for 30-day of readmission and patients with all types of diseases and were published in the English language. The meta-analysis was performed by using a random-effects model with a 95% confidence interval. Of 3300 records, a total of 16 studies met the inclusion criteria. The country of publication was primarily the USA (n = 7) and study designs were retrospective and perspective cohorts. The average mean age was 64 years. The C-statistics was 0.55 to 0.81. The pooled random effects of relative risk readmission were overall (RR, 0.20; 95% CI, 0.12–0.34) and it was favorable. The subgroup analysis of the opted disease-based relative risk of readmissions of all causes, cardiovascular and pulmonary diseases, and neurological diseases were consistent and statistically significant at p < 0.001 level. Current evidence of this review suggested that incorporating a high-risk LACE index showed favorable to risk prediction and could be applied to predict 30-day readmission with chronic conditions. Future study would be planned to predict the high risk of 30-day readmission in acute clinical care for utility, and applicability of promising LACE index in South Korean hospitals.

Background: This study researched related causes that make scheduled surgeries canceled not to be conducted and based on the research it is to derive issues in order to reduce surgery cancellation. Methods: We analyzed the association of surgery cancellation with patient characteristics, surgical characteristics and surgery schedule related characteristics, using electronic medical record (EMR) data on surgeries conducted at a university hospital in Korea over 10 years. Additionally, we examined the reasons for surgery cancellation based on patient and hospital characteristics. We used chi-square tests to analyze the distribution of various characteristics according to reasons for surgery cancellation. Multivariate logistic regression analyses were conducted to evaluate the factors associated with surgery cancellation. Results: Among 60,333 cases, surgery cancellation rate was 8.0%. The results of the logistic regression indicated a high probability of surgery cancellation when the patient was too old (odds ratio [OR]: 1.35, 95% confidence interval [CI]: 1.14–1.59), when it was a neurosurgery case (OR: 1.39, 95% CI: 1.21–1.59), when regional anesthesia was used (OR: 1.15, 95% CI: 1.07–1.24) or when it was a planned surgery (OR: 2.45, 95% CI: 2.21–2.73). The surgery cancellation rate was lower when the patient was female (OR: 0.87, 95% CI: 0.82–0.93) or when the surgery was related to Obstetrics & Gynecology (OR: 0.53, 95% CI: 0.46–0.60) or Ophthalmology (OR: 0.66, 95% CI: 0.56–0.79). Among the canceled 4834 cases, the surgery cancellation rate for the reasons of patients was 93.2% and the surgery cancellation rate for the reasons of a hospitalwas 6.8%. Conclusions: This study found that there are related various causes to cancel operations, including patient characteristics, surgery related characteristics and surgery schedule related characteristics and it means that it would be possible for some reasons to be prevented. Every medical institution should consider the operation cancellation as an important issue and systematic monitoring should be needed.

Aim: To examine whether long‐term care insurance (LTCI) reduces medical utilization and the burden of medical costs of beneficiaries.Methods: The elderly cohort database of the National Health Insurance Service during 2005–2013 was used. The participants were 3029 beneficiaries who received consecutive LTCI services. We carried out a 1:3 case–control match on the propensity score to select a comparison group, and the final participants were 12 116 people, including 9087 who formed the control group. The dependent variables were semi‐annually measured medical utilizations (inpatient, outpatient and drug prescription) and the burden of medical costs at the individual level. This study applied the method of generalized estimating equations to the data.Results: The present study showed that the number of hospitalizations of beneficiaries significantly decreased compared with non‐beneficiaries (ratio 0.95, 95% CI 0.95–0.96). Similarly, the length of stay of beneficiaries also showed a significant reduction compared with non‐beneficiaries (ratio 0.76, 95% CI 0.73–0.79). The number of outpatient visits and receipt of drug prescriptions of beneficiaries and non‐beneficiaries increased marginally. The burden of medical costs of beneficiaries reduced considerably compared with non‐beneficiaries (ratio 0.80, 95% CI 0.77–0.83).Conclusions: The study results show that the burden of medical costs for LTCI beneficiaries were significantly reduced compared with non‐beneficiaries, despite the rise in medical costs among older adults. The positive effect of LTCI supports continuous implementation and expansion of the LTCI service for non‐beneficiaries who require care assistance. Geriatr Gerontol Int 2018; 18: 1641–1646.

Diseases are a manifestation of how thousands of proteins interact. In several diseases, such as cancer and Alzheimer’s disease, proteome-wide disturbances in protein-protein interactions are caused by alterations to chaperome scaffolds termed epichaperomes. Epichaperome-directed chemical probes may be useful for detecting and reversing defective chaperomes. Here we provide structural, biochemical, and functional insights into the discovery of epichaperome probes, with a focus on their use in central nervous system diseases. We demonstrate on-target activity and kinetic selectivity of a radiolabeled epichaperome probe in both cells and mice, together with a proof-of-principle in human patients in an exploratory single group assignment diagnostic study (ClinicalTrials.gov Identifier: NCT03371420). The clinical study is designed to determine the pharmacokinetic parameters and the incidence of adverse events in patients receiving a single microdose of the radiolabeled probe administered by intravenous injection. In sum, we introduce a discovery platform for brain-directed chemical probes that specifically modulate epichaperomes and provide proof-of-principle applications in their use in the detection, quantification, and modulation of the target in complex biological systems.