ObjectivePolypharmacy is widespread in the elderly because of their multiple chronic health problems. The objective of this study was to investigate the prevalence and predictors associated with polypharmacy in a nationally representative sample of Korean elderly individuals.MethodsWe used the Korea Health Insurance Review and Assessment Service – National Patient Sample (HIRA-NPS) data from 2010 and 2011. We used information on 319,185 elderly patients (aged 65 years or older) between January 1, 2010 and December 31, 2011 from the HIRA-NPS database. We defined ‘polypharmacy’ as the concurrent use of 6 medications or more per person, ‘major polypharmacy’ as 11 medications or more, and ‘excessive polypharmacy’ as 21 medications or more. The frequency and proportion (%) and their 95% confidence intervals were presented according to the polypharmacy definition. Polypharmacy was visualized by the Quantum Geographic Information Systems (QGIS) program to describe regional differences in patterns of drug use. Multivariate ordinal logistic regression was performed to estimate odds ratios (ORs) and their 95% confidence intervals (CI) to investigate the risk factors for polypharmacy.ResultsOf the Korean elderly studied, 86.4% had polypharmacy, 44.9% had major polypharmacy and 3.0% had excessive polypharmacy. Polypharmacy was found to be primarily concentrated in the Southwest region of the country. Significant associations between polypharmacy and the lower-income Medical Aid population (OR = 1.52, 95% CI 1.47, 1.56) compared with National Health Insurance patients was observed.ConclusionsNationwide efforts are needed for managing polypharmacy among Korean elderly patients. In particular, a national campaign and education to promote appropriate use of medicines for the Medical Aid population is needed.

TC and depression were inversely related, with the strongest associations in medically naïve samples, which is noteworthy because such samples should involve fewer confounds. One clinical implication is that the lipids of patients treated for depression should be monitored.

Republication or reproduction of this report or its storage and/or dissemination by electronic means is permitted without theAbstract: Cyclic olefin copolymers comprise a new class of polymeric materials showing properties of high glass-transition temperature, optical clarity, low shrinkage, low moisture absorption, and low birefringence. There are several types of cyclic olefin copolymers based on different types of cyclic monomers and polymerization methods. In this work, we have analyzed the chemical structure of the currently commercialized cyclic olefin copolymers by 13 C NMR, and investigated their glass-transition temperatures and surface characteristics. It was observed that the glass-transition temperature, T g , of cyclic olefin copolymers depended on the bulkiness of the main chain, and the number of rings had an important role in increasing the bulkiness of cyclic olefin copolymers. Cyclic olefin copolymers with polar substituents such as ester or ether groups showed high surface energy per area and peel strength.

Method: This was a quantitative, cross-sectional study, with a descriptive design.Results: The students are knowledgeable that consuming fast food, soda, and processed food are unhealthy and they contain additives. They indicated strong agreement to keep themselves hydrated and choosing food because of taste preference. Even though majority admitted eating fresh fruits, a significant number consume processed food such as chips, cookies, and cereal based on convenience. Smartphone resources, vending machine use, and drinking soda were their least frequently used habits. Conclusion:Students have a fair knowledge of nutritional requirements for health; however, food choices they make are not necessarily healthy. Convenience and taste of food were priority.

OBJECTIVEElevated serum ferritin has been known to be associated with the prevalence of metabolic syndrome (MetS). However, there was no research to examine whether serum ferritin levels have been actually associated with the prospective development of MetS. Accordingly, we carried out a prospective study to evaluate the longitudinal effects of baseline serum ferritin levels on the development of MetS.RESEARCH DESIGN AND METHODSA MetS-free cohort of 18,022 healthy Korean men, who had participated in a medical health checkup program in 2005, was followed until 2010. MetS was defined according to the joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention. Cox proportional hazards models were performed.RESULTSDuring 45,919.3 person-years of follow-up, 2,127 incident cases of MetS developed between 2006 and 2010. After adjusting for multiple covariates, the hazard ratios (95% CI) for incident MetS comparing the second quintile to the fifth quintile of serum ferritin levels versus the first quintile were 1.19 (0.98–1.45), 1.17 (0.96–1.43), 1.36 (1.12–1.65), and 1.66 (1.38–2.01), respectively (P for trend <0.001). These associations were apparent in the clinically relevant subgroup analyses.CONCLUSIONSElevated serum ferritin levels were independently associated with future development of MetS during the 5-year follow-up period.

AIMThe aim of the present study was to describe the prescription of medications for attention-deficit hyperactivity disorder (ADHD) in the UK between 1995 and 2015. METHODSUsing the Clinical Practice Research Datalink (CPRD), we defined a cohort of all patients aged 6-45 years, registered with a general practitioner between January 1995 and September 2015. All prescriptions of methylphenidate, dexamphetamine/lisdexamphetamine and atomoxetine were identified and annual prescription rates of ADHD were estimated using Poisson regression. RESULTSWithin a cohort of 7 432 735 patients, we identified 698 148 prescriptions of ADHD medications during 41 171 528 person-years of follow-up. Usage was relatively low until 2000, during which the prescription rate was 42.7 [95% confidence interval (CI) 20.9, 87.2] prescriptions per 10 000 persons, increasing to 394.4 (95% CI 296.7, 524.2) in 2015, corresponding to an almost 800% increase (rate ratio 8.87; 95% CI 7.10, 11.09). The increase was seen in all age groups and in both sexes but was steepest in boys aged 10-14 years. The prescription rate in males was almost five times that of females. Methylphenidate remained the most prescribed drug during the 20-year study period, representing 88.9% of all prescriptions in the 6-24-year-old group, and 63.5% of all prescriptions in adults (25-45 years of age). CONCLUSIONSPrescription rates of ADHD medications have increased dramatically in the past two decades. This may be due, at least in part, to both an increase in the number of patients diagnosed with ADHD over time and a higher percentage of those patients treated with medication. British Journal of Clinical Pharmacology WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in school-aged children. WHAT THIS STUDY ADDS• Prescription rates of ADHD medications have increased dramatically in the UK in the past two decades, particularly in children and adolescents.• This increase is likely to relate to both an increase in the number of patients diagnosed with ADHD over time and a higher percentage of patients treated with medications. Longer duration of use of ADHD drugs, as well as more frequent off-label use, may also contribute to the increasing prescription rates. IntroductionAttention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in school-aged children, characterized by symptoms of inattention, impulsivity and hyperactivity [1]. Symptoms may persist beyond childhood and some individuals are not diagnosed with ADHD until adulthood [2].In the past few decades, an increased prevalence of ADHD and use of ADHD medications has been observed in several countries [3][4][5][6][7][8][9], including the UK [10], raising concerns about possible overdiagnosis and inappropriate prescription of ADHD medications. In this context, in July 2013 the National Institute for Health and Care Excellence (NICE) issued a reminder to avoid methylphenidate in children and young people with moderate...

Objective To determine whether treatment with methylphenidate in children and young people with attention-deficit/hyperactivity disorder (ADHD) was associated with cardiovascular events.Design Self controlled case series analysis.Setting Nationwide health insurance database, 1 January 2008 to 31 December 2011, in South Korea.Participants 1224 patients aged ≤17 who had experienced an incident cardiovascular event and had had at least one incident prescription for methylphenidate.Main outcome measures A recorded diagnosis (either a primary or secondary cause) of any of the following cardiovascular adverse events: arrhythmias (ICD-10 (international classification of diseases, 10th revision) codes I44, I45, I47, I48, I49), hypertension (codes I10-I15), myocardial infarction (code I21), ischemic stroke (code I63), or heart failure (code I50). Incidence rate ratios were calculated with conditional Poisson regression and adjusted for time varying comorbidity and comedication.Results Increased risk of arrhythmia was observed in all exposed time periods—that is, periods of treatment with methylphenidate—(incidence rate ratio 1.61, 95% confidence interval 1.48 to 1.74), and the risk was highest in the children who had congenital heart disease. No significant risk of myocardial infarction was observed for all exposed time periods (1.33, 0.90 to 1.98), though risk was higher in the early risk periods between eight and 56 days after the start of treatment with methylphenidate. No significant increased risk was observed for hypertension, ischemic stroke, or heart failure.Conclusion The relative risk of myocardial infarction and arrhythmias is increased in the early period after the start of methylphenidate treatment for ADHD in children and young people. Though the absolute risk is likely to be low, the risk-benefit balance of methylphenidate should be carefully considered, particularly in children with mild ADHD.

Purpose Statins, metformin, angiotensin-converting enzyme (ACE) inhibitors, and angiotensin receptor blockers (ARBs) have been suggested for treating age-related macular degeneration (AMD) due to their pleiotropic effects. Therefore, we investigated whether these drugs prevent AMD. Materials and Methods We conducted a nested case-control study using the Korean National Health Insurance Service database. Using risk-set sampling of age, sex, cohort entry date, and follow-up duration, we identified incident patients with AMD and 10 matching controls in cohorts with diabetes mellitus or cardiovascular diseases. Exposure was assessed within one year before the index date using patient prescription records. We conducted conditional logistic regression to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) to evaluate the association between cardiovascular medications and AMD. Results Our study included 2330 cases and 23278 controls from a cohort of 231274 patients. The ORs (95% CI) for AMD occurrence in users prescribed with statins, metformin, ACE inhibitors, and ARBs were 1.12 (0.94–1.32), 1.15 (0.91–1.45), 0.90 (0.61–1.34), and 1.21 (1.05–1.39), respectively. A duration-response was not observed. Conclusion Statins, metformin, ACE inhibitors, and ARBs did not inhibit AMD in elderly patients. The absence of a duration-response supports the lack of a causal relationship.