• Journal of Gastric Cancer
• /
• v.20 no.3
• /
• pp.267-276
• /
• 2020

Purpose: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) risk calculator is useful in predicting postoperative adverse events. However, its accuracy in specific disorders is unclear. We validated the ACS NSQIP risk calculator in patients with gastric cancer undergoing curative laparoscopic surgery. Materials and Methods: We included 207 consecutive early gastric cancer patients who underwent laparoscopic gastrectomy between January 2018 and January 2019. The preoperative characteristics and risks of the patients were reviewed and entered into the ACS NSQIP calculator. The estimated risks of postoperative outcomes were compared with the observed outcomes using C-statistics and Brier scores. Results: Most of the patients underwent distal gastrectomy with Roux-en-Y reconstruction (74.4%). We did not observe any cases of mortality, venous thromboembolism, urinary tract infection, renal failure, or cardiac complications. The other outcomes assessed were complications such as pneumonia, surgical site infections, any complications requiring re-operation or hospital readmission, the rates of discharge to nursing homes/rehabilitation centers, and the length of stay. All C-statistics were <0 and the highest was for pneumonia (0.65; 95% confidence interval: 0.58-0.71). Brier scores ranged from 0.01 for pneumonia to 0.155 for other complications. Overall, the risk calculator was inconsistent in predicting the outcomes. Conclusions: The ACS NSQIP surgical risk calculator showed low predictive ability for postoperative adverse events after laparoscopic gastrectomy for patients with early gastric cancer. Further research to adjust the risk calculator for these patients may improve its predictive ability.

• Journal of Preventive Medicine and Public Health
• /
• v.54 no.6
• /
• pp.422-430
• /
• 2021

Objectives: Pregnant women are especially vulnerable to respiratory infections such as coronavirus disease 2019 (COVID-19), but insufficient research has investigated pregnancy and its outcomes in women with COVID-19. This cross-sectional study compared birth outcomes related to COVID-19 between Bangladeshi pregnant women with and without COVID-19. Methods: The study was conducted at 3 tertiary referral hospitals in Dhaka, Bangladesh, from March to August 2020. Pregnant women admitted for delivery at these hospitals with laboratory results (reverse-transcription polymerase chain reaction) were analyzed. Using convenience sampling, we included 70 COVID-19-positive and 140 COVID-19-negative pregnant women. Trained and experienced midwives conducted the interviews. Data were analyzed using the t-test, the chi-square test, and univariate and multivariable linear and logistic regression. Results: Pregnant women with COVID-19 were more likely to give birth to a preterm baby (adjusted odds ratio [aOR], 2.15; 95% confidence interval [CI], 1.06 to 4.37) and undergo a cesarean section (aOR, 3.27; 95% CI, 1.51 to 7.07). There were no significant differences in birth weight, premature rupture of membranes, and the Apgar score at 1 minute or 5 minutes post-delivery between women with and without COVID-19. All the newborn babies who were born to COVID-19-positive women were COVID-19-negative. Conclusions: Our study suggests that pregnant women with COVID-19 were more likely to give birth to a preterm baby and undergo a cesarean section. For this reason, physicians should be particularly cautious to minimize adverse birth outcomes among pregnant women with COVID-19 and their newborn babies.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.25 no.3
• /
• pp.251-262
• /
• 2022

Purpose: Endoscopic drainage is an established treatment modality for adult patients with pancreatic fluid collections (PFCs). Available data regarding the efficacy and safety of endoscopic drainage in pediatric patients are limited. In this systematic review and meta-analysis, we aimed to analyze the outcomes of endoscopic drainage in children with PFCs. Methods: A literature search was performed in Embase, PubMed, and Google Scholar for studies on the outcomes of endoscopic drainage with or without endoscopic ultrasonography (EUS) guidance in pediatric patients with PFCs from inception to May 2021. The study's primary objective was clinical success, defined as resolution of PFCs. The secondary outcomes included technical success, adverse events, and recurrence rates. Results: Fourteen studies (187 children, 70.3% male) were included in this review. The subtypes of fluid collection included pseudocysts (60.3%) and walled-off necrosis (39.7%). The pooled technical success rates in studies where drainage of PFCs were performed with and without EUS guidance were 95.3% (95% confidence interval [CI], 89.6-98%; I²=0) and 93.9% (95% CI, 82.6-98%; I²=0), respectively. The pooled clinical success after one and two endoscopic interventions were 88.7% (95% CI, 82.7-92.9%; I²=0) and 92.3% (95% CI, 87.4-95.4%; I²=0), respectively. The pooled rate of major adverse events was 6.3% (95% CI, 3.3-11.4%; I²=0). The pooled rate of recurrent PFCs after endoscopic drainage was 10.4% (95% CI, 6.1-17.1%; I²=0). Conclusion: Endoscopic drainage is safe and effective in children with PFCs. However, future studies are required to compare endoscopic and EUS-guided drainage of PFCs in children.

• Safety and Health at Work
• /
• v.13 no.4
• /
• pp.379-386
• /
• 2022

Emergency medical services (EMS) personnel are at high risk for adverse mental health outcomes during disease outbreaks. To support the development of evidence-informed mitigation strategies, we conducted a scoping review to identify the extent of research pertaining to EMS personnel's mental health during disease outbreaks and summarized key factors associated with mental health outcomes. We systematically searched three databases for articles containing keywords within three concepts: EMS personnel, disease outbreaks, and mental health. We screened and retained original peer-reviewed articles that discussed, in English, EMS personnel's mental health during disease outbreaks. Where inferential statistics were reported, the associations between individual and work-related factors and mental health outcomes were synthesized. Twenty-five articles were eligible for data extraction. Our findings suggest that many of the contributing factors for adverse mental health outcomes are related to inadequacies in fulfilling EMS personnel's basic safety and informational needs. In preparation for future disease outbreaks, resources should be prioritized toward ensuring adequate provisions of personal protective equipment and infection prevention and control training. This scoping review serves as a launching pad for further research and intervention development.

• Women's Health Nursing
• /
• v.17 no.4
• /
• pp.407-414
• /
• 2011

Purpose: The purpose of this study was to compare birth outcomes between Korean women and immigrant women. Methods: Medical records were reviewed retrospectively from 201 immigrant women and 201 Korean women who delivered babies at K women's hospital in U city from January 2006 to December 2009. Maternal outcomes related factors included nationality, age, obstetric history, delivery type, indications of cesarean section, and complications of pregnancy and delivery. Principal neonatal outcomes were birth weight, Apgar scores, and complications of newborns. Results: Immigrant women were younger and had fewer pregnancies, abortions, and surviving children than Korean women. The rate of primary cesarean section and its indication in immigrant women were not significantly different from Korean women. However, immigrant women's newborn were more likely to have low birth weight and meconium staining. Conclusion: The results of this study indicate less equity of immigrant women in women's health care, although immigrant women's babies had lower Apgar score and more meconium staining. Nurses should help immigrant women cope with labor process effectively to prevent adverse health outcomes for their newborns.

• Journal of Preventive Medicine and Public Health
• /
• v.35 no.3
• /
• pp.197-204
• /
• 2002

Objectives : To evaluate the association between working conditions and adverse pregnancy outcomes in Korea. Methods : We obtained data on health history, lifestyle, housework and Working conditions, such as shift work, hours standing, working time, job demand, lifting at work and at home, between August and September 2000, from self-reported questionnaires. A group of 344, occupationally active, pregnant women from 51 industries were studied. Of the women studied, 328 women were further interviewed by telephone between November 2000 and September 2001. Result : Compared with daytime work, shift work increased the risk for preform birth (an adjusted risk ratio of 2.74, 95% CI=1.02-2.62) and low birth weight (an adjusted risk ratio of 2.74,95% CI=1.02-2.02). A significantly increased risk was found for prolonged standing, with an adjusted risk ratio of preform births of 6.80 (95% CI=2.01-23.0). There were no significant differences in the incidence of spontaneous abortion between the occupational working conditions, with the enception of a previous history of spontaneous abortion. Conclusion : These findings suggest that maternal working conditions, such as shift work and prolonged standing, contribute significantly to preterm birth and low birth weight.

• Research in Community and Public Health Nursing
• /
• v.28 no.2
• /
• pp.206-215
• /
• 2017

Purpose: This study aimed to verify the predictive validity of Comprehensive Korean Frailty Instrument (CKFI) among older adults. Methods: A secondary analysis of data from a prospective cohort study was conducted. Frailty was determined in older adults (N=9,188) according to the data in 2008 and the effects of frailty on adverse outcomes (such as institutionalization and death) were evaluated according to the data in 2011. The Cardiovascular Health Study (CHS) index was used to compare with the predictive validity of CKFI. Results: The prevalence of frailty was 26.3%. With the CKFI, the frail group had a higher risk of negative health outcomes compared to the robust and pre-frail groups after three years. The two of the highest risks identified using the CKFI and CHS index were institutionalization (5.522 times higher) and mortality (3.210 times higher). For both instruments, the survival analysis revealed that the risk of death increased as the degree of frailty increased. Conclusion: The CKFI consisting of self-report items and multidimensional aspects of frailty can be used as a simple instrument for assessing the frailty of older adults residing in a local community in Korea.

• Safety and Health at Work
• /
• v.8 no.4
• /
• pp.407-409
• /
• 2017

Air pollutants of concern include traffic-related air pollution, including particulate matter in respirable coarse and fine size fractions. There are no critical studies to date into associations between knowledge, awareness, and attitudes in using proper respiratory masks and prevalence of respiratory symptoms among urban street vendors in Thailand. In this study, we estimated adverse respiratory health outcomes among street vendors, in particular young adults, in Bangkok, Thailand, using a self-report questionnaire. Street vendors, who were not currently smoking and not having known diagnosed respiratory diseases, were recruited. They were selected from selected roadsides at Chong Nonsi, Bangkok. Participants (n = 30) reported having lower respiratory (50%), upper respiratory (37%), and other symptoms (70%). Also, 53% of participants had never used respiratory personal protective equipment (PPE: masks). Among those using PPE, all used masks not proper for particulate matter. Results suggested knowledge, awareness, and attitudes concerning proper PPE use needs to be increased among street vendors in Bangkok, Thailand.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.24 no.3
• /
• pp.245-255
• /
• 2021

Necrotizing enterocolitis (NEC) is a disease with high morbidity and mortality that occurs mainly in premature born infants. The pathophysiologic mechanisms indicate that gastrointestinal dysbiosis is a major risk factor. We searched for relevant articles published in PubMed and Google Scholar in the English language up to October 2020. Articles were extracted using subject headings and keywords of interest to the topic. Interesting references in included articles were also considered. Network meta-analysis suggests the preventive efficacy of Bifidobacterium and Lactobacillus spp., but even more for mixtures of Bifidobacterium, Streptococcus, and Bifidobacterium, and Streptococcus spp. However, studies comparing face-to-face different strains are lacking. Moreover, differences in inclusion criteria, dosage strains, and primary outcomes in most trials are major obstacles to providing evidence-based conclusions. Although adverse effects have not been reported in clinical trials, case series of adverse outcomes, mainly septicemia, have been published. Consequently, systematic administration of probiotic bacteria to prevent NEC is still debated in literature. The risk-benefit ratio depends on the incidence of NEC in a neonatal intensive care unit, and evidence has shown that preventive measures excluding probiotic administration can result in a decrease in NEC.

• Tuberculosis and Respiratory Diseases
• /
• v.85 no.4
• /
• pp.289-301
• /
• 2022

Chronic obstructive pulmonary disease (COPD) is a chronic airway inflammation characterized by fixed airflow limitation and chronic respiratory symptoms, such as cough, sputum, and dyspnea. COPD is a progressive disease characterized by a decline in lung function. During the natural course of the disease, acute deterioration of symptoms leading to hospital visits can occur and influence further disease progression and subsequent exacerbation. Moreover, COPD is not only restricted to pulmonary manifestations but can present with other systemic diseases as comorbidities or systemic manifestations, including lung cancer, cardiovascular disease, pulmonary hypertension, sarcopenia, and metabolic abnormalities. These pulmonary and extrapulmonary conditions lead to the aggravation of dyspnea, physical inactivity, decreased exercise capacity, functional decline, reduced quality of life, and increased mortality. In addition, pneumonia, which is attributed to both COPD itself and an adverse effect of treatment (especially the use of inhaled and/or systemic steroids), can occur and lead to further deterioration in the prognosis of COPD. This review summarizes the long-term outcomes of patients with COPD. In addition, recent studies on the prediction of adverse outcomes are summarized in the last part of the review.