Soonchunhyang University

BackgroundThe clinical and prognostic implications of asymptomatic tuberculosis remain poorly understood.MethodsWe conducted a multicentre prospective cohort study to evaluate the association between asymptomatic tuberculosis (TB) and treatment outcomes. Individuals with rifampicin-susceptible pulmonary TB were enrolled from the Cohort Study of Pulmonary Tuberculosis. Asymptomatic TB was defined as the absence of any TB-related symptoms at diagnosis. The primary outcome was a favourable outcome, defined as treatment success without recurrence. Multivariable logistic regression models were used to assess associations between asymptomatic TB and favourable outcomes. The Cox proportional hazards model was applied to evaluate effect of asymptomatic TB on failure to complete treatment within 1 year. Stratified analyses by symptom status and mode of detection were performed to examine stratum-specific effects.ResultsOf 1071 individuals with pulmonary TB, 32.7% were asymptomatic. Compared to symptomatic patients, asymptomatic individuals were younger, less likely to be underweight and more often diagnosed through population health screening rather than clinical presentation or opportunistic testing. Asymptomatic TB was associated with higher likelihood of favourable outcome in multivariable models (adjusted odds ratio (aOR) 1.50, 95% CI 1.04–2.20) and a reduced risk of failing to complete treatment within one year in survival analyses (adjusted hazard ratio 0.66, 95% CI 0.45–0.95). Asymptomatic TB detected through health screening had the most favourable outcomes (aOR 2.41, 95% CI 1.34–4.66).ConclusionAsymptomatic TB was significantly associated with treatment success without recurrence and particularly in patients identified through health screening. Our results support symptom-agnostic screening in TB control programmes.

Evogliptin, a dipeptidyl peptidase-4 inhibitor with a glucose-dependent mechanism of action, is widely used as a monotherapy or in combination with other agents. However, observational studies in routine clinical settings remain limited. This study aimed to evaluate the effectiveness and safety of evogliptin in combination with other antidiabetic agents frequently used in clinical practice. This study was conducted in 51 hospitals in South Korea. We evaluated evogliptin in three groups: the evogliptin add-on, evogliptin-switching, and initial combination groups. The primary endpoint was the change in haemoglobin A1c (HbA1c) levels (%) from baseline to 12 weeks. The change in HbA1c (%) levels from baseline to 24 weeks was a secondary endpoint in the extended study. Proportions of patients achieving the HbA1c target, changes in fasting and postprandial glucose levels, and safety endpoints were also evaluated. Between-group comparisons were performed between the add-on and initial combination groups. In the 1596 patients of the effectiveness set, the mean changes in HbA1c levels at 12 weeks were -0.8% ± 1.2%, -0.3% ± 0.8% and -1.9% ± 1.4% for the evogliptin add-on, evogliptin-switching and initial combination groups, respectively. Among the 1920 patients in the safety set, 23 experienced adverse drug reactions, and there was no significant difference among the three groups. Evogliptin reduces blood glucose levels and is well-tolerated when used as an add-on, as a switch from other dipeptidyl peptidase 4 inhibitors, or as part of an initial combination therapy in patients with type 2 diabetes mellitus.

The association between kidney function and tuberculosis treatment outcomes remains uncertain. We analyzed a multicenter prospective cohort of adults with rifampicin-susceptible pulmonary tuberculosis enrolled in Korea between 2019 and 2021. Kidney function was categorized using baseline estimated glomerular filtration rate (eGFR) calculated with the 2021 CKD-EPI creatinine equation and grouped as preserved (eGFR ≥ 60 mL/min/1.73 m²) and reduced (eGFR < 60 mL/min/1.73 m²) kidney function. An additional analysis evaluated severely reduced kidney function (eGFR < 30 mL/min/1.73 m²). The primary endpoint was unfavorable outcome, defined as loss-to-follow-up, treatment failure, death, still-on-treatment, transfer to another treatment unit, or recurrence, analyzed using multivariable logistic regression. The secondary endpoint was failure to complete treatment within 9 months of initiation, analyzed by Cox proportional hazards model. All models adjusted for prespecified covariates, with age and sex included in all models. Among 966 participants, 89 (9%) had reduced kidney function. Unfavorable outcomes were more frequent among participants with reduced kidney function (41% vs. 19%; P < 0.001). After multivariable adjustment, reduced kidney function was independently associated with unfavorable outcomes (adjusted odds ratio [aOR], 2.46; 95% confidence interval [CI], 1.49–4.02). Severely reduced kidney function showed higher odds of unfavorable outcome (aOR, 5.52; 95% CI, 2.42–13.01). Reduced kidney function was associated with failure to complete treatment within 9 months (adjusted hazard ratio, 3.07; 95% CI, 1.69–5.59). Reduced kidney function was independently associated with unfavorable TB treatment outcomes. Patients with impaired kidney function at the time of tuberculosis diagnosis may require closer clinical monitoring during treatment.

Handgrip strength is a simple measure of muscle function and health outcomes in older adults. Here, we investigated whether higher handgrip strength is associated with a lower risk of cardiovascular (CVD) and cerebrovascular (CeVD) diseases in middle-aged and older adults by focusing on its potential protective role in women. We analyzed data for approximately 9,500 participants of the Korean Longitudinal Study of Aging (aged ≥ 45 years, no CVD/CeVD at baseline). Handgrip strength was measured in multiple waves and treated as time-varying exposure. Cross-sectional logistic regression was used to evaluate baseline associations, while Cox regression models with time-varying handgrip strength were used to assess the 16-year incidences of CVD and CeVD after adjusting for major confounders. The analyses were stratified according to sex. A higher handgrip strength was inversely associated with baseline CVD and CeVD prevalence (odds ratio, ~ 0.94–0.96 per 1-kg increase; p < 0.001). Over a 16-year follow-up, each 1-kg increase in handgrip strength predicted a lower hazard of CeVD (hazard ratio [HR], ~ 0.98) that was driven by a significant protective effect in women (HR, ~ 0.95) versus no association in men. Similarly, a higher handgrip strength predicted a lower CVD risk in women (HR, ~ 0.97) but not men. Greater handgrip strength was associated with lower risks of CVD and CeVD later in life. Although the associations appeared stronger in women, these differences should be interpreted cautiously given potential scaling effects. Handgrip strength may be a simple and clinically practical functional marker for vascular risk stratification in middle-aged and older adults.

This scoping review aimed to examine policy implications from studies investigating the effectiveness of policies related to novel and emerging nicotine and tobacco products (NENTPs) and to identify commonalities in policy implications for NENTPs through thematic analysis. This scoping review involved a comprehensive search across the following four databases: PubMed, Embase, Web of Science, and CINAHL. The latest search was on March 15, 2025. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines were followed. Studies were included if they examined the effectiveness of NENTPs-related policies. After screening titles, abstracts, and full texts, 21 studies were selected and analyzed based on the framework to derive policy implications. Most studies were conducted in high-income countries. Thematic analysis yielded the following two analytical themes: (1) regulatory governance and policy system architecture for NENTPs control, which included three descriptive themes-namely, regulatory spillover control in the national context, evidence-informed policy transition and regulation, government monitoring and compliance assurance; and (2) exposure reduction at the population level and societal regulation of NENTPs use, with four descriptive themes-namely, product attribute restrictions as an initiation control, regulation of access to retail stores and exposure to youth, economic restraint through tax increase, and customized communication for policy education. This study highlights that effective legal regulation of NENTPs requires not only regulatory governance and policy systems but also population-level regulatory mechanisms that reinforce the legal foundation. Our findings provide timely, integrated insights for policymakers by examining commonly shared perspectives among policy researchers.

Atopic dermatitis (AD), allergic rhinitis (AR), and asthma are typical allergic diseases, with a common pathogenesis involving increased type 2 immunity. Despite numerous studies, the association between these diseases and metabolic syndrome (MetS) remains controversial. This study aimed to explore relationships between AD, AR, and asthma both to MetS and to each of its components. Population-based, cross-sectional data were obtained from the Korean National Health and Nutrition Examination Survey from 2019 to 2020. Multiple logistic regression analyses were conducted to evaluate the association between allergic diseases and MetS. The results were compared with those of previous studies of the association between MetS and allergic diseases, identified in a literature review following a search of PubMed and the Cochrane Library. Based on assessments of 1,329, 4,824, and 1,172 patients with AD, AR, and asthma, respectively, negative associations between both AD and AR and MetS were determined, after adjusting for confounding factors. By contrast, asthma was positively associated with MetS (odds ratio [OR] 0.58, 95% confidence interval [CI] 0.50-0.67; OR 0.73, 95% CI 0.67-0.78; OR 1.70, 95% CI 1.51-1.92, respectively). The heterogeneous findings highlight the need for further investigation of associations between the studied allergic diseases and MetS as well as each of its components.