Journal of Korean Medical Science最新文献

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Injection-Based Therapies for Migraine in Older Adults: A Narrative Review of OnabotulinumtoxinA, Greater Occipital Nerve Block, and Anti-Calcitonin Gene-Related Peptide Monoclonal Antibodies. 老年人偏头痛的注射治疗:肉毒杆菌毒素、枕大神经阻滞和抗降钙素基因相关肽单克隆抗体的叙述性回顾
IF 2.3 3区 医学
Journal of Korean Medical Science Pub Date : 2025-09-29 DOI: 10.3346/jkms.2025.40.e297
Mi-Kyoung Kang, Soohyun Cho, Byung-Kun Kim, Heui-Soo Moon, Mi Ji Lee, Soo-Kyoung Kim, Hong-Kyun Park, Min-Kyung Chu, Woo-Seok Ha, Byung-Su Kim, Soo-Jin Cho
{"title":"Injection-Based Therapies for Migraine in Older Adults: A Narrative Review of OnabotulinumtoxinA, Greater Occipital Nerve Block, and Anti-Calcitonin Gene-Related Peptide Monoclonal Antibodies.","authors":"Mi-Kyoung Kang, Soohyun Cho, Byung-Kun Kim, Heui-Soo Moon, Mi Ji Lee, Soo-Kyoung Kim, Hong-Kyun Park, Min-Kyung Chu, Woo-Seok Ha, Byung-Su Kim, Soo-Jin Cho","doi":"10.3346/jkms.2025.40.e297","DOIUrl":"10.3346/jkms.2025.40.e297","url":null,"abstract":"<p><p>As global populations age, the clinical approach to managing migraine must evolve. Migraine in older adults presents unique treatment challenges due to comorbidities, poor adherence to treatment, altered pharmacokinetics, and polypharmacy. Injection -based preventive treatments such as onabotulinumtoxinA (BoNT-A), greater occipital nerve blocks (GONB), and anti-calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs) offer promising alternatives. This narrative review highlights the underrepresentation of older adults in migraine clinical trials and summarizes the effectiveness and safety of BoNT-A, GONB, and CGRP mAbs in patients over 65 years of age. To identify relevant studies addressing migraine management in the older adults, we conducted a comprehensive literature search of PubMed, Embase, and Cochrane Library. The search was limited from the past ten years, up to 5 April 2025. Studies were included if clinical trial, observational, real-world data, or review examined migraine treatment in adults over 65 years, with separate data according to age. A total of 22 studies were included: 4 on BoNT-A, 2 on GONB, 13 on anti-CGRP mAbs, and 3 reviews on injectable therapies. BoNT-A has shown significant benefits in reducing migraine frequency, acute medication use, and disability in real-world settings though randomized trials did not include older adults. GONB has demonstrated high response rates in older adults, although there was no separate analysis for patients over 65 years of age in randomized controlled trials. In contrast, CGRP mAbs have increasingly included in trials, with some trials enrolling patients up to 75 years. Subgroup analyses and real-world data support their comparable effectiveness and safety in older adults. BoNT-A, GONB and CGRP mAbs show effectiveness and are well tolerated for migraine prevention in older adults. Given the growing ageing population and their unique therapeutic needs, proactive migraine management in older migraine patients with injection-based and oral preventive is essential.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 38","pages":"e297"},"PeriodicalIF":2.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12480954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Analysis of Retracted Publications on Methotrexate. 甲氨蝶呤撤稿分析。
IF 2.3 3区 医学
Journal of Korean Medical Science Pub Date : 2025-09-29 DOI: 10.3346/jkms.2025.40.e243
Burhan Fatih Kocyigit, Kairat Zhakipbekov, Marlen Yessirkepov
{"title":"Analysis of Retracted Publications on Methotrexate.","authors":"Burhan Fatih Kocyigit, Kairat Zhakipbekov, Marlen Yessirkepov","doi":"10.3346/jkms.2025.40.e243","DOIUrl":"10.3346/jkms.2025.40.e243","url":null,"abstract":"<p><strong>Background: </strong>Methotrexate (MTX) is a frequently used antifolate agent in rheumatology, oncology, and dermatology. Retractions are crucial for preserving scientific integrity by fixing the literature when errors, ethical violations, or data falsification are detected. This study seeks to comprehensively examine retracted MTX publications, detecting trends, reasons, and potential ramifications.</p><p><strong>Methods: </strong>A descriptive cross-sectional study was performed by searching PubMed for retracted MTX publications without temporal constraints. Bibliometric data were retrieved, encompassing publication details, journal indexing, citation metrics, and Altmetric Attention Scores (AAS). Reasons for retraction were categorized.</p><p><strong>Results: </strong>Thirty-six retracted papers were identified. The predominant cause for retraction encompassed data concerns (n = 15), fraudulent activity (n = 11), and manipulation of the peer review process (n = 10). China recorded the most retractions (n = 14), followed by the USA (n = 6) and Egypt (n = 3). The median period until retraction was 712 (91-9,893) days. Most retracted articles were published in non-rheumatology journals. Citation analysis showed a median of 5 (0-105) citations. Additionally, the median AAS was 1 (0-14).</p><p><strong>Conclusion: </strong>Data integrity concerns, fraudulent activities, and manipulation of peer review processes constitute major obstacles in MTX-related research. The considerable number of retractions in certain countries underscores the need to promote research ethics and measures to protect scientific integrity. Enhancing peer review, implementing more intense data transparency, and promoting post-publication evaluation are essential measures to protect scientific integrity and uphold confidence in clinical recommendations.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 38","pages":"e243"},"PeriodicalIF":2.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12480959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correlating Urinary Tract Infection Risks With Sodium-Glucose Cotransporter-2 Inhibitors: Insights From the National Health Insurance Data of Korea. 尿路感染风险与钠-葡萄糖共转运蛋白-2抑制剂的相关性:来自韩国国民健康保险数据的见解
IF 2.3 3区 医学
Journal of Korean Medical Science Pub Date : 2025-09-29 DOI: 10.3346/jkms.2025.40.e244
Byeong Jo Jeon, You Jin Ko, Jae Young Park, Jae Hyun Bae, Bum Sik Tae
{"title":"Correlating Urinary Tract Infection Risks With Sodium-Glucose Cotransporter-2 Inhibitors: Insights From the National Health Insurance Data of Korea.","authors":"Byeong Jo Jeon, You Jin Ko, Jae Young Park, Jae Hyun Bae, Bum Sik Tae","doi":"10.3346/jkms.2025.40.e244","DOIUrl":"10.3346/jkms.2025.40.e244","url":null,"abstract":"<p><strong>Background: </strong>In this study, we aimed to investigate the correlation between the use of sodium-glucose cotransporter-2 inhibitors (SGLT2is) and the risk of urinary tract infections (UTIs) in patients with type 2 diabetes mellitus (T2DM), based on data from the National Health Insurance Service (NHIS) in South Korea.</p><p><strong>Methods: </strong>This retrospective, population-based cohort study was conducted using NHIS data. As a part of a dual-therapy regimen, either SGLT2is or any other anti-diabetic agent, was administered in patients diagnosed with T2DM and under metformin therapy. The incidence of UTIs was measured and hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using Cox proportional hazards models. Kaplan-Meier survival analysis was performed to estimate the cumulative incidence of UTIs.</p><p><strong>Results: </strong>This study included 27,128 patients, of whom 1,274 were treated with SGLT2is. The HR for the incidence of UTIs in SGLT2i users compared to the control group was 0.874 (95% CI, 0.585-1.309; <i>P</i> = 0.510), indicating no statistical significance in increase of UTI risk among SGLT2i users. Kaplan-Meier analysis showed no significant difference in the incidence of UTIs between the groups.</p><p><strong>Conclusion: </strong>In this large population-based cohort study, the use of SGLT2is was not associated with a statistically significant increase in the risk of UTIs. Although SGLT2i use is linked to increased glucose excretion in urine, this study indicates that the clinical impact on UTI risk is minimal. Overall, continuous monitoring and patient education regarding UTI symptoms remain to be important in clinical practice.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 38","pages":"e244"},"PeriodicalIF":2.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12480961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exploring the Barriers and Facilitators of Deprescribing in Older Adults: Qualitative Study of Patients and Geriatrics Experts. 探索老年人开处方的障碍和促进因素:对患者和老年病学专家的定性研究。
IF 2.3 3区 医学
Journal of Korean Medical Science Pub Date : 2025-09-22 DOI: 10.3346/jkms.2025.40.e164
Sun-Wook Kim, Ji Yeon Baek, Mirinae Lee, Seul-Gi Han, Woo-Youn Kim, Dahye Kim, So Jin Park, Ji Eun Yun, Hee-Won Jung
{"title":"Exploring the Barriers and Facilitators of Deprescribing in Older Adults: Qualitative Study of Patients and Geriatrics Experts.","authors":"Sun-Wook Kim, Ji Yeon Baek, Mirinae Lee, Seul-Gi Han, Woo-Youn Kim, Dahye Kim, So Jin Park, Ji Eun Yun, Hee-Won Jung","doi":"10.3346/jkms.2025.40.e164","DOIUrl":"10.3346/jkms.2025.40.e164","url":null,"abstract":"<p><strong>Background: </strong>South Korea is experiencing a rapid increase in the proportion of older adults, leading to a higher prevalence of multimorbidity and polypharmacy. Potentially inappropriate medication (PIM) use among older adults is a growing concern. This study explored the experiences and perceptions of older adults with polypharmacy and PIM and healthcare professionals regarding deprescribing, focusing on barriers, and facilitators.</p><p><strong>Methods: </strong>A qualitative study was conducted from May to August 2023. Participants included 24 older adults aged ≥ 65 years with polypharmacy (≥ 5 medications) and at least one PIM, recruited from tertiary hospitals in South Korea. In-depth interviews were conducted three months after a deprescribing intervention to assess perceptions, experiences, and intervention sustainability. Focus group interviews were also conducted with geriatric healthcare professionals to explore their perspectives on deprescribing.</p><p><strong>Results: </strong>Participants reported visiting multiple healthcare institutions and receiving prescriptions for various conditions and symptoms, resulting in polypharmacy. They had low awareness of the potential harms of polypharmacy and PIMs. Factors influencing polypharmacy included multimorbidity, symptom relief, health beliefs, and healthcare system factors. Participants emphasized the need for raising public awareness, improving prescribing practices, and implementing a geriatric primary care system. Geriatrics experts highlighted the challenges of deprescribing within the current healthcare system and the lack of systematic support for medication management.</p><p><strong>Conclusion: </strong>Addressing barriers to deprescribing in South Korea requires a multifaceted approach, including public awareness campaigns, healthcare provider education, prescription sharing systems, and a geriatric primary care system. Long-term policies incentivizing appropriate medication use and supporting deprescribing interventions are necessary for sustainable medication management in older adults.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 37","pages":"e164"},"PeriodicalIF":2.3,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Shared Decision-Making in Korean Healthcare: A Scoping Review. 共同决策在韩国医疗保健:范围审查。
IF 2.3 3区 医学
Journal of Korean Medical Science Pub Date : 2025-09-22 DOI: 10.3346/jkms.2025.40.e273
Yelim Kwon, Seungmin Nam, Soan Shin, Yoong Cho, Jihyun Yoon, Sang-Ho Yoo
{"title":"Shared Decision-Making in Korean Healthcare: A Scoping Review.","authors":"Yelim Kwon, Seungmin Nam, Soan Shin, Yoong Cho, Jihyun Yoon, Sang-Ho Yoo","doi":"10.3346/jkms.2025.40.e273","DOIUrl":"10.3346/jkms.2025.40.e273","url":null,"abstract":"<p><p>Shared decision-making (SDM) is a collaborative process in which patients and healthcare professionals jointly make informed healthcare decisions. Although SDM is increasingly recognized as a core component of patient-centered care, no comprehensive synthesis has yet mapped SDM research in Korea. This scoping review aimed to examine the scope, key themes, and characteristics of SDM studies in Korean healthcare with a focus on conceptual frameworks, instruments, decision aids, and implementation contexts. Following the Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines, we systematically searched nine electronic databases (PubMed, Embase, PsycINFO, CINAHL, Web of Science, and four Korea-specific databases: KoreaMed, RISS, KISS, and DBpia) for English- and Korean-language studies published until 2024. Eligible studies involved Korean populations and addressed SDM or patient participation in healthcare decision-making. Of the 9,177 records identified, 62 met the inclusion criteria. Most studies used quantitative designs (74.2%), followed by mixed-methods (14.5%), and qualitative (11.3%) approaches. Research has primarily focused on end-of-life care, oncology, and family medicine/primary care across hospital and community settings. Key themes included patient experiences, barriers and facilitators, providers' perspectives, and intervention outcomes. Although several studies have referenced conceptual models, their practical applications are limited. A few culturally tailored frameworks and measurement tools reflect efforts to adapt SDM to the Korean context. Several decision aids and educational interventions have been evaluated in clinical settings. The implementation and uptake of SDM are influenced by multilevel factors, including the individual, interpersonal, organizational, and policy domains. This review highlights a growing but thematically fragmented body of SDM research in Korea. Despite increasing interest, conceptual integration, validated instruments, and systematic implementation remain underdeveloped. To advance SDM practice and policy, culturally grounded frameworks, rigorously validated evaluation tools, and system-level support tailored to Korea's sociocultural and clinical contexts are essential. Findings from the Korean experience may provide valuable insights into advancing SDM efforts in culturally and structurally similar global settings.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 37","pages":"e273"},"PeriodicalIF":2.3,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Crowded Spaces, Contagious Risks: Comparing COVID-19 Incidence After Outdoor Concerts Among University Members and the Community, Republic of Korea, 2022. 拥挤的空间,传染风险:比较大学成员和社区在户外音乐会后的COVID-19发病率,大韩民国,2022。
IF 2.3 3区 医学
Journal of Korean Medical Science Pub Date : 2025-09-22 DOI: 10.3346/jkms.2025.40.e239
Jisun Sung, Jong-Hun Kim
{"title":"Crowded Spaces, Contagious Risks: Comparing COVID-19 Incidence After Outdoor Concerts Among University Members and the Community, Republic of Korea, 2022.","authors":"Jisun Sung, Jong-Hun Kim","doi":"10.3346/jkms.2025.40.e239","DOIUrl":"10.3346/jkms.2025.40.e239","url":null,"abstract":"<p><strong>Background: </strong>A university festival, including outdoor concerts, was held from May 2 to 4, 2022, following the relaxation of coronavirus disease 2019 (COVID-19) restrictions in Korea. This study aimed to assess its impact on COVID-19 cases among university members.</p><p><strong>Methods: </strong>We collected daily COVID-19 case data from university and local government websites and conducted a causal impact analysis using a Bayesian structural time series model.</p><p><strong>Results: </strong>The analysis revealed a significant increase in cases following the event. From May 6 to 29, 2022, the university recorded an average of 5.8 daily cases (total: 138 cases). In the counterfactual scenario without the event, the estimated number of daily cases was 2.5 to 3.0 (total: 57.1 to 72.0 cases) based on three prediction models. The outdoor concerts were associated with an approximately twofold increase in COVID-19 cases among university members.</p><p><strong>Conclusion: </strong>Despite a declining trend in community cases, these findings underscore the potential risks of crowded outdoor gatherings in spreading COVID-19 and highlight the need for caution at such events.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 37","pages":"e239"},"PeriodicalIF":2.3,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Letter to the Editor: Avoiding a Telemedicine Regional Battle - Lessons From Republic of Korea's Platform War for Czechia and Beyond. 致编辑的信:避免一场远程医疗的区域性战斗——从大韩民国的平台战争中给捷克和其他地区的教训。
IF 2.3 3区 医学
Journal of Korean Medical Science Pub Date : 2025-09-22 DOI: 10.3346/jkms.2025.40.e290
Michal Doležel
{"title":"Letter to the Editor: Avoiding a Telemedicine Regional Battle - Lessons From Republic of Korea's Platform War for Czechia and Beyond.","authors":"Michal Doležel","doi":"10.3346/jkms.2025.40.e290","DOIUrl":"10.3346/jkms.2025.40.e290","url":null,"abstract":"","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 37","pages":"e290"},"PeriodicalIF":2.3,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Classifying Eschar Morphologies: Enhancing Early Diagnosis of Scrub Typhus. 分类疮痂形态:提高恙虫病的早期诊断。
IF 2.3 3区 医学
Journal of Korean Medical Science Pub Date : 2025-09-22 DOI: 10.3346/jkms.2025.40.e234
Chang-Seop Lee, Seonglyeong Kim, Hwanseung You, Jeongeun Song, Seung Hee Choi, Tae-Jong Kang, Hyohyun Yoo, Jin Park
{"title":"Classifying Eschar Morphologies: Enhancing Early Diagnosis of Scrub Typhus.","authors":"Chang-Seop Lee, Seonglyeong Kim, Hwanseung You, Jeongeun Song, Seung Hee Choi, Tae-Jong Kang, Hyohyun Yoo, Jin Park","doi":"10.3346/jkms.2025.40.e234","DOIUrl":"10.3346/jkms.2025.40.e234","url":null,"abstract":"<p><strong>Background: </strong>Scrub typhus, a rickettsial disease caused by <i>Orientia tsutsugamushi</i>, presents with diverse clinical manifestations, with eschar formation being a key diagnostic feature.</p><p><strong>Methods: </strong>In this retrospective study, we analyzed 81 confirmed cases at Jeonbuk National University Hospital between January 2018 and December 2020 to systematically categorize eschar morphology and distribution.</p><p><strong>Results: </strong>Eschars were classified into five types based on their morphology: erythematous macules (2.5%), vesicular (4.9%), erosive/ulcerative (13.6%), crusted (74.1%), and sclerotic (4.9%). The most common site was the anterior body (44.4%) followed by the inguinal area (18.5%). Notably, 25.9% of cases exhibited atypical eschars lacking classical black crust, complicating the diagnosis. Eschar type distribution differed significantly between covered and exposed body areas (<i>P</i> = 0.038), probably due to physiological differences in skin regions or the timing of eschar detection.</p><p><strong>Conclusion: </strong>These findings highlight the need for comprehensive skin examinations and increased awareness of atypical eschars to enhance the diagnostic accuracy and improve the clinical outcomes of scrub typhus.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 37","pages":"e234"},"PeriodicalIF":2.3,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Identification of High-Risk Population for Mortality and Severe Clinical Outcomes Among Patients With Myasthenia Gravis: A Nationwide Population-Based Cohort Study in Korea. 鉴定重症肌无力患者死亡率和严重临床结局的高危人群:韩国一项全国性人群队列研究
IF 2.3 3区 医学
Journal of Korean Medical Science Pub Date : 2025-09-22 DOI: 10.3346/jkms.2025.40.e240
Jieun Woo, Seung Woo Kim, Ju Hwan Kim, Jayeon Yuk, Kyungyeon Jung, Yongtai Cho, Yeongmin Park, Ju-Young Shin, Ha Young Shin
{"title":"Identification of High-Risk Population for Mortality and Severe Clinical Outcomes Among Patients With Myasthenia Gravis: A Nationwide Population-Based Cohort Study in Korea.","authors":"Jieun Woo, Seung Woo Kim, Ju Hwan Kim, Jayeon Yuk, Kyungyeon Jung, Yongtai Cho, Yeongmin Park, Ju-Young Shin, Ha Young Shin","doi":"10.3346/jkms.2025.40.e240","DOIUrl":"10.3346/jkms.2025.40.e240","url":null,"abstract":"<p><strong>Background: </strong>Myasthenia gravis (MG) is a rare chronic neurological condition characterized by skeletal muscle weakness and fatigue. Some patients with MG have poorly controlled symptoms with conventional treatments. While new treatments could be considered in patients with poorly controlled MG, their costs are considerably higher and may impose a financial burden on patients and the national health insurance system. Therefore, we sought to identify high-risk populations for mortality and severe clinical outcomes among MG patients to effectively allocate health resources.</p><p><strong>Methods: </strong>A population-based cohort study was conducted using the Health Insurance Review and Assessment database from South Korea (2007-2023). Among patients with incident MG, we defined six clinical criteria expected to be associated with poor prognosis of MG. Separate study cohorts were constructed for the history of each criterion within two years of the first MG diagnosis to compare the risk of mortality, myasthenic crisis (MC), intensive care unit (ICU) admission, and MG-related hospitalization between patients. To adjust for any potential confounding, each covariate was assessed for inclusion in a multivariate Cox proportional hazards model, and findings were presented using hazard ratios (HRs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>We identified 10,458 patients with incident MG (54.2% aged over 60 years; 56.8% female), of whom 361 and 319 were defined as MG patients with history of MC and refractory MG, respectively. Among MG patients, patients with history of any of the predefined clinical criteria showed worse prognosis than those without. Patients with a history of MC had a significantly higher risk of mortality compared to those without (54.0 vs. 17.9 per 1,000 person-year; HR, 2.33; 95% CI, 1.87-2.89). Similarly, across six different criteria, including refractory MG, the risk of serious clinical outcomes, defined MC, ICU admission, and MG-related hospitalization were increased in patients who met the criteria versus those who didn't.</p><p><strong>Conclusion: </strong>Our study identified high-risk populations among patients with MG. Patients with a history of certain clinical criteria, including MC or refractory MG, had elevated risk of mortality and severe clinical outcomes. These findings may be utilized to establish the reimbursement strategy by identifying MG patients with a priority need for new treatments.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 37","pages":"e240"},"PeriodicalIF":2.3,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Interstitial Lung Abnormality in Health Screening Examinees: Prevalence, Outcomes, and Risk Factors. 健康筛查者间质性肺异常:患病率、结果和危险因素。
IF 2.3 3区 医学
Journal of Korean Medical Science Pub Date : 2025-09-22 DOI: 10.3346/jkms.2025.40.e237
Jooae Choe, Ju Hyun Oh, Han Na Noh, Eun Jin Chae, Jin Woo Song
{"title":"Interstitial Lung Abnormality in Health Screening Examinees: Prevalence, Outcomes, and Risk Factors.","authors":"Jooae Choe, Ju Hyun Oh, Han Na Noh, Eun Jin Chae, Jin Woo Song","doi":"10.3346/jkms.2025.40.e237","DOIUrl":"10.3346/jkms.2025.40.e237","url":null,"abstract":"<p><strong>Background: </strong>The prevalence, outcome and risk factors of interstitial lung abnormality (ILA) in the Asian population remains unclear.</p><p><strong>Methods: </strong>We retrospectively enrolled participants who had health check-up and undergone serial chest computed tomography (CT) more than 5 years apart from baseline. The presence of ILA, as well as the temporal changes, was evaluated. Multivariable logistic regression was used to assess baseline risk factors associated with the progressive ILA (defined as development or progression of equivocal ILA or ILA) upon follow-up.</p><p><strong>Results: </strong>In total, 2,589 participants with a mean baseline age of 49 years (57 years upon follow-up scans) and a median follow-up of 7.0 years were included. We found that the prevalence of ILA or equivocal ILA increased between baseline and follow-up (baseline: 0.2% and 0.3%, respectively; follow-up: 0.8% and 0.9%, respectively) (<i>P</i> < 0.001). Additionally, radiologic progression was observed in 83.3% of participants with ILA at baseline. In the multivariable analysis, older age, ever-smoking status, higher white blood cell counts, higher erythrocyte sedimentation rates, and higher rheumatoid factors at baseline were independent risk factors for progressive ILA upon follow-up. Both ILA and equivocal ILA at the follow-up CT were significantly associated with all-cause mortality (adjusted hazard ratio [aHR] for equivocal ILA, 3.73, <i>P</i> = 0.005; aHR for ILA, 4.01, <i>P</i> = 0.004) when compared with those without ILA; however, progressive ILA further increased the risk of mortality (aHR, 3.92, <i>P</i> < 0.001) compared with non-progressive or no ILA.</p><p><strong>Conclusion: </strong>The prevalence of ILA in middle-aged Korean health screening participants was relatively low but increased with age, with its presence associated with long-term impacts on mortality. Radiologic progression on ILA at baseline was common. Risk factors for progressive ILA, such as age, smoking history, and elevated inflammatory markers, were identified. These findings emphasize the importance of early identification and monitoring of ILA in at-risk populations to improve long-term outcomes.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 37","pages":"e237"},"PeriodicalIF":2.3,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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