The number of lower extremity amputations in diabetic foot patients in Korea is increasing annually. In this nationwide population-based retrospective study, we investigated the data of 420,096 diabetes mellitus patients aged ≥18 years using the Korean Health Insurance Review and Assessment Service claim database. We aimed to study the seasonal and monthly trends in diabetic foot amputations in Korea. After applying the inclusion criteria, 8156 amputation cases were included. The analysis showed an increasing trend in monthly amputation cases. In terms of seasonality, the monthly frequency of amputation was commonly observed to be lower in February and September every year. Diabetic foot amputations frequently occurred in March, July, and November. There was no difference between the amputation frequency and mean temperature/humidity. This study is meaningful as it is the first nationwide study in Korea to analyze the seasonal and monthly trends in diabetic foot amputation in relation to climatic factors. In conclusion, we recognize an increased frequency of amputation in March, July, and November and recommend intensive educational program on foot care for all diabetes patients and their caregivers. This could improve wound management and amputation prevention guidelines for diabetic foot patients in the Far East with information on dealing with various seasonal changes.

Adolescent suicide is a serious global health concern. Although familial transmission of suicidal behaviors has been identified in previous research, the effects of parental gender remain unknown. This study identified the influence of parental suicidal behaviors on suicide attempts among adolescent girls. We collected data through a cross-sectional, nationwide, population-based survey in South Korea and evaluated data from 890 adolescent girls (aged 12–18 years) who had attempted suicide and their parents. Hierarchical logistic regression was used to analyze the risk factors related to suicide attempts among adolescent girls. The final model indicated that mothers’ suicidal plans and attempts (OR = 6.39, OR = 12.38, respectively) were important risk factors for suicide attempts in adolescent girls. Future studies should identify specific methods for effective prevention and treatment through path analysis of the related factors affecting suicidal behavior of adolescents according to their parents’ gender.

Purpose Concerns about the risk of osteoporosis and osteoporotic fractures following endocrine therapy have increased with increase in breast cancer survivors. This study aimed to evaluate the incidence of fractures by site between tamoxifen and aromatase inhibitor (AI) users and non-users at premenopausal and postmenopausal ages. Methods This retrospective cohort study used data from the Korea Central Cancer Registry and the Korean National Health Insurance Service. We analyzed 63,021 newly diagnosed breast cancer patients between 2008 and 2016. The risk of fractures was analyzed according to post-surgical endocrine therapy using the multivariable Cox proportional hazard model. Results Herein, 69.1% of the patients received endocrine therapy. The incidence rates of osteoporotic fractures per 1,000 person-years were 7.4 overall, 3.5 in those under 50, and 12.6 in those over 50. After adjusting for confounders, the tamoxifen group showed protection against any fractures in patients over 50 (HR = 0.75, 95% CI 0.62–0.89, p < 0.001) but not in those under 50. The AI ​​group was associated with a significant increase in fractures in those under 50 (HR = 1.54, 95% CI 1.07–2.93, p = 0.019) but not in those over 50. Conclusion Among breast cancer patients aged over 50 years, AI use was not associated with increased risk of compared to non-users. Tamoxifen use was linked to reduced risk of fracture, but not in patients under 50. Considering the relatively young age of breast cancer diagnosis in Korea, long-term follow-up studies are warranted. Summary After adjusting for confounders including age, among breast cancer patients aged over 50 years, AI use was not associated with increased risk of fracture compared to non-users. Tamoxifen use was linked to reduced risk of fracture, but not in patients under 50.

The evidence for the association between diurnal temperature range (DTR) and diabetic foot amputations is limited. We aimed to investigate the region-specific association between DTR and the amputation rate of diabetic foot in Korean national-wide data. Daily data on DTR and the rate of diabetic foot amputations from 16 provincial capital cities in Korea were obtained (2011–2018). In this study, the latitude ranged from 33°11′ N to 38°61′ N, and we classified each region according to latitude. Region 1, which was located at a relatively high latitude, included Seoul, Incheon, Gyeonggi-do, and Gangwon-do. Region 2, which was located at a relatively low latitude, included Busan, Ulsan, Gyeonsannam-do, Gwangju, Jeollanam-do, Jeollabuk-do, and Jeju-do. The region-specific DTR effects on the amputation rate were estimated based on a quasi-Poisson generalized linear model, combined with a distributed lag non-linear model based on the self-controlled case series design. The DTR impacts were generally limited to a period of nine days, while significant effects during lag days 7–14 were only found in the cities of Seoul, Incheon, and Gyeonggi-do (10th lag day: RR [95% CI]; Seoul: 1.015, [1.001–1.029]; Incheon: 1.052 [1.006–1.101]; Gyeonggi-do: 1.018 [1.002–1.034]). In the subgroup analysis (according to the latitude), an increase of 1 °C in DTR was associated with the risk of diabetic foot in relatively high latitude regions. DTR has considerable effects on the risk of diabetic foot amputation in various provinces in Korea, and it was particularly affected by latitude. The results can inform the decisions on developing programs to protect vulnerable subpopulations from adverse impacts.

Park S, et al. Korean Circ J. 2027 ;57:e38. https://doi.org/10.4070/kcj.2026.0017