H. pylori infection was significantly associated with the development of NAFLD, independent of metabolic and inflammatory risk factors. H. pylori infection may play a pathophysiologic role in NAFLD development, indicating that H. pylori eradication might play a role in reducing the risk of NAFLD.

Epidemiologic and clinical data suggest that Helicobacter pylori infection is a contributing factor in the progression of atherosclerosis. However, the specific cardiovascular disease risk factors associated with H. pylori remain unclear. We performed a cross-sectional study of 37,263 consecutive healthy subjects who underwent a routine health check-up. In multivariable log Poisson regression models adjusted for potential confounders, the associations of H. pylori seropositivity with higher LDL-C (relative risk [RR], 1.21; 95% confidence interval [CI], 1.12–1.30) and lower HDL-C level (RR, 1.10; 95% CI, 1.01–1.18) were significant and independent. In multiple linear regression analyses, H. pylori infection was significantly associated with higher total cholesterol level (coefficient = 2.114, P < 0.001), higher LDL-C level (coefficient = 3.339, P < 0.001), lower HDL-C level (coefficient = −1.237, P < 0.001), and higher diastolic blood pressure (coefficient = 0.539, P = 0.001). In contrast, H. pylori infection was not associated with obesity-related parameters (body mass index, waist circumference), glucose tolerance (fasting glucose, glycated hemoglobin), and systolic blood pressure. We found that H. pylori infection was significantly and independently associated with dyslipidemia, but not with other cardiometabolic risk factors, after adjusting for potential risk factors of atherosclerosis.

Sepsis is a major cause of mortality and morbidity in critically ill patients. Procalcitonin (PCT) and C-reactive protein (CRP) are the most frequently used biomarkers in sepsis. We investigated changes in PCT and CRP concentrations in critically ill patients with sepsis to determine which biochemical marker better predicts outcome. We retrospectively analyzed 171 episodes in 157 patients with severe sepsis and septic shock who were admitted to the Samsung Medical Center intensive care unit from March 2013 to February 2014. The primary endpoint was patient outcome within 7 days from ICU admission (treatment failure). The secondary endpoint was 28-day mortality. Severe sepsis was observed in 42 (25%) episodes from 41 patients, and septic shock was observed in 129 (75%) episodes from 120 patients. Fifty-five (32%) episodes from 42 patients had clinically-documented infection, and 116 (68%) episodes from 99 patients had microbiologically-documented infection. Initial peak PCT and CRP levels were not associated with treatment failure and 28-day mortality. However, PCT clearance (PCTc) and CRP (CRPc) clearance were significantly associated with treatment failure (p = 0.027 and p = 0.030, respectively) and marginally significant with 28-day mortality (p = 0.064 and p = 0.062, respectively). The AUC for prediction of treatment success was 0.71 (95% CI, 0.61–0.82) for PCTc and 0.71 (95% CI, 0.61–0.81) for CRPc. The AUC for survival prediction was 0.77 (95% CI, 0.66–0.88) for PCTc and 0.77 (95% CI, 0.67–0.88) for CRPc. Changes in PCT and CRP concentrations were associated with outcomes of critically ill septic patients. CRP may not be inferior to PCT in predicting outcome in these patients.

This study aimed to evaluate the prevalence of comorbidities in patients with rheumatoid arthritis (RA) compared with the non-RA population. The 2010–2012 Korea National Health and Nutrition Examination Survey (KNHANES), which assesses the general health status of populations in South Korea using interviews and basic health assessment, was analyzed retrospectively. Weighted prevalence and odds ratio (OR) of comorbidities were analyzed in patients with RA compared with the non-RA population. The overall weighted (n = 37,453,158) prevalence of RA was 1.5%. Patients with RA were older and more female predominant than subjects without RA. The prevalence of living in an urban area, college graduation, alcohol consumption and smoking was lower in patients with RA than non-RA. Patients with RA had more comorbidities including hypertension, dyslipidemia, myocardial infarction (MI) or angina, stoke, osteoarthritis, lung cancer, colon cancer, pulmonary tuberculosis, asthma, diabetes, depression, thyroid disease and chronic kidney disease. After adjusting socioeconomic and lifestyle characteristics, RA was associated with an increased prevalence of MI or angina (OR 1.86, 95% CI 1.17–2.96, p = 0.009), pulmonary TB (OR 1.95, 95% CI 1.24–3.09, p = 0.004), asthma (OR 1.97, 95% CI 1.05–3.71, p = 0.036), thyroid disease (OR 1.71, 95% CI 1.05–2.77), depression (OR 2.38, 95% CI 1.47–3.85, p < 0.001) and hepatitis B (OR 2.34, 95% CI 1.15–4.80, p = 0.020) compared with the non-RA population. Prevalence of solid cancer was not significantly associated with RA after adjustment.

Background and Aim Knowledge of lymph node metastasis (LNM) status is crucial to determine whether patients with superficial esophageal squamous cell carcinoma (ESCC) can be cured with endoscopic resection alone, without the need for additional esophagectomy. The present study aimed to identify predictive factors and develop a prediction model for LNM in patients with superficial ESCC. Methods Clinicopathologic data from 501 patients with superficial ESCC treated with radical esophagectomy were reviewed. Stepwise logistic regression analysis determined the predictors of LNM. Using these predictors, a nomogram for predicting the risk of LNM was constructed and internally validated using a bootstrap resampling method. Results LNM rates of tumors invading the lamina propria, muscularis mucosa, and SM1 layers were 3.7%, 15.5%, and 40.7%, respectively. Deep tumor invasion depth, moderately or poorly differentiated histology, and lymphovascular invasion were independent predictors of LNM. ESCC with muscularis mucosa and SM1 invasion had odds ratios of 3.635 and 11.834, respectively, compared with that for ESCC confined to the lamina propria. Large tumor size (>2.0 cm) and presence of tumor budding showed borderline significance for LNM prediction. These five variables were incorporated into a nomogram. A constructed nomogram showed good calibration and good discrimination with an area under the receiver‐operating characteristic curve (area under the curve [AUC]) of 0.812. After bootstrapping, AUC was 0.811. Conclusions We developed a nomogram that can facilitate individualized prediction of risk of LNM in patients with superficial ESCC. This model can aid in decision‐making for the need for additional esophagectomy after endoscopic resection for superficial ESCC.

Despite the high prevalence of hearing impairment in the elderly, the rate of hearing aid use is still low. The objectives of this study were to report the nation-wide prevalence of hearing aid use in the Korean population and to determine the associated factors with hearing aid use utilizing a nationally representative data set.We obtained data from the 2010 to 2012 Korea National Health and Nutrition Examination Surveys, which were cross-sectional surveys of the civilian, noninstitutionalized population of the Republic of Korea at age ≥40 years (N = 12,709). A field survey team performed interviews as well as physical examinations. Hearing aid use was assessed using an interviewer-administered questionnaire and pure-tone audiometry was administered for all participants in a sound-attenuating booth. Prevalence of hearing aid acquisition and regular use were calculated in participants who reported perceived hearing loss and who have bilateral hearing thresholds exceeding the 40 dB hearing level. Multivariable analyses were used to examine the associated factors with hearing aid use.The prevalence of hearing aid acquisition and regular use was 17.4% and 12.6%, respectively, in South Korea. Increased hearing threshold (OR 1.05, 95% CI 1.03–1.07), severe perceived hearing loss (OR 10.73, 95% CI 4.52–25.46), annoying tinnitus (OR 3.30, 95% CI 1.61–6.74), balance problems (OR 0.39, 95% CI 0.18–0.86), and myopia (OR 0.30, 95% CI 0.12–0.76) were associated factors of regular use of hearing aids.The prevalence of hearing aid use in Korea is relatively low. Finding relevant factors of hearing aid use could provide further insight in setting up hearing-rehabilitation strategy for the elderly with significant hearing loss.

ObjectivesTo report the nationwide prevalence of facial palsy (FP) of grade III or worse in the House–Brackmann (H–B) grading system in South Korea and assess the associated factors.DesignCross-sectional analysis of a nationwide health survey.SettingsSouth Korea.MethodsWe obtained data from the 2010 to 2012 Korea National Health and Nutrition Examination Surveys, which were cross-sectional surveys of the South Korean civilian population living in households and aged ≥1 year (N=23 533). A field survey team performed interviews, physical examinations and laboratory tests. Facial expression was evaluated based on the H–B grading system.ResultsAmong the population aged ≥1 year, the prevalence of FP of grade III or worse in the H–B grading system was 0.12% (95% CI 0.07% to 0.17%). FP was more prevalent in women (p=0.01) and the prevalence rate increased with age (p<0.001). In participants aged ≥19 years, age, female gender, history of cardiovascular disease and the serum total cholesterol level were associated with FP in a multivariable analysis. In the evaluation of lifestyle, the individuals with FP had a higher rate of depressive mood and were more restricted in their daily activities.ConclusionsConsidering the significance of facial expression in psychosocial activities, public acknowledgement and further intervention are required to support patients with this distressing condition.

In a large-scale study, carefully controlled for confounding factors, involving asymptomatic participants without a history of colonoscopy, H. pylori infection was significantly associated with the risk of any colorectal adenoma and advanced colorectal neoplasm. Prospective studies are necessary to determine whether H. pylori eradication can reduce this risk.