Background/Aims Although the epidemiology of pyogenic liver abscess (PLA) continues to change, only a few population‐based studies have been conducted in Korea. This study investigated the epidemiology and clinical outcomes of PLA patients during a period of 10 years. Methods We analysed the Health Insurance Review and Assessment Service data between 2007 and 2017. The data included annual incidence rates, demographic data, underlying diseases, complications and mortality of PLA patients. Results The annual incidence of PLA for all age groups was 10.9 per 100 000 population. The incidence was gradually increased from 5.7 per 100 000 in 2007 to 14.4 per 100 000 in 2017. In patients with liver abscess, the prevalence of diabetes and malignancy were 37.24% and 26.5% respectively. Metastatic infection was reported in 1.74% of the patients, and endophthalmitis was most common. The mean in‐hospital mortality was 9.6%, and there was no significant difference in mortality by year during the observation period. Mortality increased with age and was greatly affected by the underlying diseases, especially cancer. Based on the multivariate analysis results, the mortality of PLA patients was associated with older age, female sex, diabetes, malignancy and chronic kidney disease. Conclusion The PLA incidence is rapidly increasing in Korea, especially in people with comorbidities. In addition, the causes and risk factors of PLA infections are changing and thus further research on epidemiology, different diagnosis and management approaches is required.

Women with endometriosis may experience uncertainty owing to the characteristics of the disease, including vague symptom patterns, delayed diagnosis, and long-term management with no cure. However, women use various coping strategies to adapt to the uncertainty caused by their endometriosis. This descriptive qualitative study explored the coping experiences of women with endometriosis to reduce their uncertainty about the disease and to achieve successful adaptation to their lives with endometriosis. By using convenience and purposive sampling methods, qualitative data were collected from 14 women in South Korea (mean age = 37.7 years, age range = 27-54 years), who were diagnosed with endometriosis through laparoscopy or open surgery. All interview data were thematically analyzed. Four themes were identified as adaptive coping experiences: (1) gaining self-control over the ambiguous disease; (2) regaining the daily routines destroyed by the disease; (3) being emotionally supported and expressing oneself when feeling unsupported by society; and (4) taking an active role in one's treatment plan by being self-directed. Patients' sense of self-control and self-directedness regarding the disease and the treatment process were important to adapt to life with endometriosis. In addition, regaining stable daily routines as well as being emotionally supported were critical for decreasing their uncertainty. This paper has widespread implications, including the need for training or a continuing education program for health professionals to enhance their competencies when caring for women with endometriosis and the need for social efforts to increase awareness of the disease.

Herpesviruses affect the development of dementia. We investigated the association between herpes infection and subsequent diagnoses of dementia. Data from the National Health Insurance Service of South Korea were used. Patients aged ≥50 years with the relevant diagnostic codes in the reference year 2009 were included and prospectively reviewed from January 2010 to December 2018. All study participants were followed from the index date until the onset of dementia, death, or the study endpoint. The three cohorts comprised 92,095 patients with herpes simplex virus (HSV) infections, 97,323 patients with varicella-zoster virus (VZV) infections, and 183,779 controls. During the follow-up period, 15,831 (17.19%) subjects with HSV infection and 17,082 (17.55%) VZV-infected subjects, compared to 27,028 (14.17%) control subjects, were subsequently diagnosed with dementia (all, P < .001). The adjusted hazard ratio for developing dementia was found to be 1.18 (95% confidence interval [CI]; 1.16–1.20) in HSV and 1.09 (95% CI; 1.07–1.11) in VZV patients (all, P < .001). HSV1 infections such as oral or ocular subtypes, but not HSV2, anogenital subtype, were associated with dementia, including several subtypes such as Alzheimer’s disease (AD), vascular dementia, and dementia with Lewy bodies. VZV infection is also associated with AD. In this Korean nationwide population-based cohort study, both HSV and VZV infections were associated with a higher risk of dementia, particularly AD. Among the subtypes of HSV infection, HSV1 is associated with a risk of dementia. Further studies including appropriate public health interventions could evaluate the causality of these relationships.

No abstract

No abstract