Respiratory syncytial virus (RSV) infection constitutes a substantial disease burden in the general population. However, the risk of death for RSV infection has been rarely evaluated with confounders or comorbidities adjusted. We aimed to evaluate whether RSV infection is associated with higher mortality than seasonal influenza after adjusting for confounders and comorbidities and the effect of oseltamivir on the mortality in patients with influenza infection. A retrospective cohort study was conducted on adult (≥18 years) patients admitted to the emergency department and ward of a university teaching hospital for suspected viral infection during 2013–2015 (N = 3743). RSV infection was diagnosed by multiplex PCR (N = 87). Adults hospitalized for seasonal influenza during the study period were enrolled as a comparison group (n = 312). The main outcome was 20-day all-cause mortality.We used Cox proportional hazard regression analyses to calculate the relative risk of death. Adult patients were less likely to be diagnosed with RSV than with influenza (2.3 vs 8.3%, respectively), were older and more likely to be diagnosed with pneumonia, chronic obstructive pulmonary disease, hypoxemia, and bacterial co-infection. In patients with RSV infection, the 20-day all-cause mortality was higher than that for influenza, (18.4 vs 6.7%, respectively). RSV infection showed significantly higher risk of death compared to the seasonal influenza group, with hazard ratio, 2.32 (95% CI, 1.17–4.58). Oseltamivir had no significant effect on mortality in patients with influenza. RSV infection was significantly associated with a higher risk of death than seasonal influenza, adjusted for potential confounders and comorbidities.

The aim of this study was to investigate factors associated with sleep disorders in male firefighters working in a metropolitan city in South Korea. Self-administered questionnaires including the Nordic Musculoskeletal Questionnaire, Korean Occupational Stress Scale-Short Form, Psychosocial Well-Being Index-Short Form, Pittsburg Sleep Quality Index, and Beck-Depression Inventory-2 as well as surveys collecting socio-demographic characteristics and work-related factors were given to 730 male firefighters. After exclusion for missing data, 657 male firefighters were included, and logistic regression analysis adjusted for the work-related factors, psychosocial factors, and general risk factors were used to assess the relationship between sleep disorders and associated factors. The prevalence of sleep disorders was 48.7%. Shift work (adjusted OR 1.58, 95% CI = 1.02-2.45), musculoskeletal symptoms (adjusted OR 2.89, 95% CI = 2.02-4.14), and depression (adjusted OR 7.04 95% CI = 4.03-12.30) were associated with sleep disorders. Musculoskeletal symptoms, shift work, and depression are associated with sleep disorders. Integrated health management is needed to promote good sleep quality among firefighters.

Background: Hemodynamic status and cardiac function are important factors for predicting pulmonary embolism (PE) prognosis. Although inflammation is considered a risk factor for deep vein thrombosis, the prognostic significance of both systemic inflammatory response syndrome (SIRS) and leukocytosis has not been elucidated. This study evaluates PE prognostic factors, including SIRS and leukocytes. Methods: This retrospective cohort study included 667 PE patients. Risk evaluation included SIRS and leukocytosis. A prediction model was developed based on independent predictors of 30-day mortality. Results: Fifty-seven patients (8.5%) died within 30 days of PE. Multivariate analysis showed that SIRS satisfying the WBC criteria (odds ratio [OR], 2.8; 95% confidence interval [CI], 1.5–5.4), altered mental status (OR, 4.0; 95% CI, 1.8–8.7), shock (OR, 2.6; 95% CI, 1.0-7.1), and right-to-left ventricle diameter ratio (OR, 1.7; 95% CI, 1.0-2.8) were associated with 30-day mortality. SIRS criteria, including body temperature (OR, 4.6; 95% CI, 1.4–14.8), heart rate (OR, 2.0; 95% CI, 1.1–3.6), respiratory rate (OR, 2.5; 95% CI, 1.4–4.6), and white blood cells (WBC) count (OR, 1.9; 95% CI, 1.2–3.5) predicted short-term mortality following PE. The area under the receiver operating characteristic curve for the prognostic model performance was 0.76 (95% CI, 0.66–0.85); pulmonary embolism severity index (PESI) and PESI + WBC count were 0.72 (95% CI, 0.68–0.75) and 0.76 (95% CI, 0.72–0.79, P < 0.001 versus PESI), respectively. Conclusions: Leukocytosis and SIRS are important factors in determining short-term outcomes in PE patients.

Background: The aim of this study was to investigate the associations between attention deficit hyperactivity disorder (ADHD), the most common neuropsychiatric disorder in school children, and childhood allergic disease by evaluating their respective prevalence.Methods: Subjects were comprised of first and second grade students in twenty two elementary schools in a city in the Republic of Korea. The mode of measurement for ADHD was based on DSM-IV from clinical interviews conducted by child psychiatrists. Along with the diagnostic interviews, we also used the epidemiological questionnaires, Computerized Attention Deficit-Hyperactivity Disorder Diagnostic System, the abbreviated Conner’s Parent Rating Scale (CPRS), and DuPaul’s ADHD Rating Scales. Allergic conditions, such as asthma, have been separately evaluated based on the questionnaire items whose validity and reliability were proved by the International Study of Asthma and Allergies in Children (ISAAC). All questionnaires were completed by the subjects’ parents.Results: The lifetime prevalence rate of asthma in ADHD patients was 36.6%, compared to a prevalence of 24.3% in control subjects. The lifetime prevalence rate of allergic rhinitis in ADHD patients was 59.0%, compared to a prevalence of 47.0% in control subjects. Statistically significant difference has been found between the two groups. In the logistic regression model of the ADHD and the control group, the relative risk of asthma was 1.60 times higher (confidence interval 1.301-1.964), the relative risk of allergic rhinitis was 1.38 times higher (confidence interval 1.124-1.681), which showed statistical significance.Conclusions: The findings of this study suggest significant association between ADHD and childhood asthma and allergic rhinitis. Therefore, appropriate evaluation and treatment are needed for asthmatic children with attention-deficit symptoms, or allergic rhinitis with ADHD. Besides, further research is needed to determine the etiological approach towards ADHD, asthma, and allergic rhinitis.

BACKGROUND:Hepatocellular carcinoma (HCC) is one of the most common malignancies occurring worldwide and is most frequent type of liver cancer. The risk for developing HCC increases with the severity of inflammation and fibrosis. The members of the i...

The concentration of particulate matter in the air varies depending on the region because it is lightweight and generated from a variety of sources. To assess the relationship between particulate matter and eye disease, this study analyzes the concentration data obtained from spatial analysis of particulate matter and emergency visit data. The study included 769 residents of Daegu, Korea who had visited an emergency room for the problem of conjunctivitis or keratitis. Concentrations of PM10 and other air pollutants were obtained from the Korean Ministry of the Environment. PM10 concentrations and the number of patients from each of 143 administrative dongs (sub-municipal level administrative units) of the city of Daegu were obtained using spatial analysis. The patient distribution and PM10 concentration were mapped for comparison, and their relationship was examined using scatter plot, regression analysis, and the independent sample t-test. The number of patients with conjunctivitis and keratitis was significantly higher in the regions of the top 20% areas than the bottom 20% areas in terms of PM10 concentration. The distribution of PM10 concentration and number of patients was visually similar on the map. The concentration of PM10 and the number of patients showed a dose–response relationship. When the concentrations of other air polluta9nts were controlled for, the numbers of conjunctivitis and keratitis patients were 0.04 per 1000 ER patients and 0.10 per 1000 ER patients, respectively. As PM10 is associated with the prevalence of conjunctivitis and keratitis, measures to reduce particulate matter through environmental methods are needed.