• Safety and Health at Work
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• v.9 no.3
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• pp.239-248
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• 2018

Background: Workers may be exposed to various types of occupational hazards at the same time, potentially increasing the risk of adverse health outcomes. The aim of this review was to analyze the effects of multiple occupational exposures and coexposures to chemical, biomechanical, and physical hazards on adverse health outcomes among agricultural workers. Methods: Articles published in English between 1990 and 2015 were identified using five popular databases and two complementary sources. The quality of the included publications was assessed using the methodology developed by the Effective Public Health Practice Project assessment tool for quantitative studies. Results: Fifteen articles were included in the review. Multiple chemical exposures were significantly associated with an increased risk of respiratory diseases, cancer, and DNA and cytogenetic damage. Multiple physical exposures seemed to increase the risk of hearing loss, whereas coexposures to physical and biomechanical hazards were associated with an increased risk of musculoskeletal disorders among agricultural workers. Conclusion: Few studies have explored the impact of multiple occupational exposures on the health of agricultural workers. A very limited number of studies have investigated the effect of coexposures among biomechanical, physical, and chemical hazards on occupational health, which indicates a need for further research in this area.

• Annals of Laboratory Medicine
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• v.38 no.6
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• pp.538-544
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• 2018

Background: Serum copeptin has been demonstrated to be useful in early risk stratification and prognostication of patients with acute myocardial infarction (AMI). However, the prognostic value of copeptin after percutaneous coronary intervention (PCI) for clinical outcomes remains uncertain. We investigated the prognostic role of serum copeptin levels immediately after successful PCI as a prognostic marker for major adverse cardiac events (MACE; comprising death, repeat PCI, recurrent MI, or coronary artery bypass grafting) in patients with AMI. Methods: A retrospective study was performed in 149 patients with AMI who successfully received PCI. Serum copeptin levels were analyzed in blood samples collected immediately after PCI. The association between copeptin levels and MACE during the follow-up period was evaluated. Results: MACE occurred in 34 (22.8%) patients during a median follow-up of 30.1 months. MACE patients had higher copeptin levels than non-MACE patients did. Multiple logistic regression analysis showed that the increase in serum copeptin levels was associated with increased MACE incidence (odds ratio=1.6, P =0.005). Conclusions: A high level of serum copeptin measured immediately after PCI was associated with MACE in patients with AMI during long-term follow-up. Serum copeptin levels can serve as a prognostic marker in patients with AMI after successful PCI.

• Journal of Korean Traditional Oncology
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• v.24 no.1
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• pp.19-28
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• 2019

Objective : The purpose of this study is to report and observe effects of Integrative Cancer Treatment (ICT) on metastatic breast cancer patient. Method : A left breast cancer patient diagnosed with recurrence on liver and bones April 2018. The patient had received paclitaxel chemotherapy for two months and discontinued it because of tumor progression and side effects. The patient has been treated with ICT since March 2018 and has been taking capecitabine since October 2018. The clinical outcomes were measured by computed tomography, laboratory findings including tumor markers (CEA, CA15-3). The clinical outcomes were measured by computed tomography, laboratory findings including tumor markers (CEA, CA15-3), liver function test (AST, ALT), Eastern Cooperative Oncology Group performance status (ECOG PS), and numeric rating scales (NRS). Results : After the ICT, tumor size was partially decreased accompanying by reducing the levels of tumor markers. Major clinical symptoms induced by paclitaxel chemotherapy were improved. There were no severe adverse events induced by ICT based on National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.0. Conclusion : This case suggests that ICT may have synergistic effect for the treatment of metastatic breast cancer patient in conjunction with capecitabine.

• Journal of Acupuncture Research
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• v.38 no.4
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• pp.265-275
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• 2021

This review investigated the effectiveness and safety of acupotomy treatment for scoliosis. There were 7 online databases used in the search from inception to March 17, 2021, for randomized controlled trials of the use of acupotomy in patients with scoliosis. The Cochrane risk-of-bias tool was used to assess the methodological quality of the studies included (n = 12). A quantitative synthesis of the randomized controlled trials was performed using RevMan Version 5.3. The effect sizes of studies were presented as mean differences for continuous outcomes and risk ratios for dichotomous outcomes, with a 95% confidence interval. As part of combined therapy, acupotomy was reported to significantly improve Cobb's angle compared with other treatments. Likewise, the Visual Analog Scale score, the Oswestry Disability Index score, and pulmonary function were also reported to be improved following acupotomy combination therapy. Although 5 studies mentioned the criteria for reporting adverse events, only 1 study reported adverse events. In conclusion, acupotomy may be an effective treatment for scoliosis. However, the small number, and heterogeneity of the included studies, as well as the poor methodological quality, indicate that higher-quality studies should be conducted to verify the effectiveness and safety of acupotomy treatment for scoliosis.

• Journal of Pharmacopuncture
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• v.24 no.4
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• pp.153-164
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• 2021

Objectives: Despite the low cost and high accessibility of manual acupuncture (MA) treatments for the carpal tunnel syndrome (CTS), this intervention has not been uniformly evaluated in systematic reviews (SR), and no SR has evaluated MA monotherapy for CTS. This review was conducted to summarize the findings and undertake a quality assessment of randomized controlled trials (RCTs) of acupuncture treatment methods for mild-to-moderate CTS to identify clinical evidence for the use of MA in CTS. Methods: We searched five databases for articles on relevant RCTs that were published until June 2021 without imposing specific restrictions, such as age or sex, on CTS patients. RCTs that evaluated MA were included without any restriction on comparator interventions. Measurement tools for evaluating pain reduction and functional improvement or for evaluating efficacy using electrophysiological indicators were included as outcome measures. Results: We included seven RCTs, of which three studies reported both post-treatment improvement effects and statistical significance using p-values for all outcomes. Five studies reported statistically significant intergroup differences (p-values for all outcomes) in posttreatment improvement. None of the studies reported severe adverse effects of MA. In all of the RCTs, the reporting rates of the 2c, 2a, and 6a items of STRICTA 2010 were 14%, 29%, and 29%, respectively. PC7 (Daereung) was used to treat CTS in all of the included studies. Conclusion: MA can be used for CTS treatment without serious adverse effects. PC7 was the most commonly used acupoint. In order to ensure objective and reliable reporting, accurate standardization of acupuncture treatment methods acupoint terms should be undertaken in future RCTs.

• Journal of Chest Surgery
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• v.56 no.5
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• pp.313-321
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• 2023

Background: This study evaluated the early, 1-year, and 3-year graft patency rates and mid-term clinical outcomes after no-touch saphenous veins (NT-SVs) were used as aortocoronary grafts in coronary artery bypass grafting (CABG). Methods: In total, 101 patients who underwent CABG using NT-SVs as aortocoronary grafts were included. The 2 most common indications for performing aortocoronary grafting with NT-SVs were unavailability of the left internal thoracic artery (n=36) and moderate lesions where flow competition was expected (n=27). Early (median, 1 day; interquartile range [IQR], 1-2 days), 1-year (median, 13 months; IQR, 11-16 months), and 3-year (median, 34 months; IQR, 27-41 months) graft angiography was performed in 98 (97.0%), 84 (83.2%), and 40 patients (39.6%), respectively. The median follow-up duration was 43 months (IQR, 13-76 months). Overall survival rates and the cumulative incidence of major adverse cardiac events were evaluated. Results: The operative mortality rate was 2% (2 of 101 patients). Early postoperative patency rates for overall and aortocoronary NT-SV grafts were 98.2% (223 of 227 distal anastomoses) and 98.2% (164 of 167), respectively. The 1- and 3-year patency rates for aortocoronary SV grafts were 94.9% (131 of 138) and 90.6% (58 of 64), respectively. The overall survival rates at 5 and 10 years were 81.7% and 59%, respectively. The cumulative incidence of major adverse cardiac events at 5 and 10 postoperative years was 20.7% and 39%, respectively. Conclusion: The feasibility of using NT-SVs as aortocoronary grafts in CABG was shown in this study, based on the graft patency rates up to 3 years and the mid-term clinical outcomes.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.26 no.3
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• pp.146-155
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• 2023

Purpose: The starting time for probiotic supplementation in preterm infants after birth varies widely. This study aimed to investigate the optimal time for initiating probiotics to reduce adverse outcomes in preterm or very low birth weight (VLBW) infants. Methods: Medical records of preterm infants born at a gestational age (GA) of <32 weeks or VLBW infants in 2011-2020 were reviewed respectively. The infants who received Saccharomyces boulardii probiotics within 7 days of birth were grouped into an early introduction (EI) group, and those who received supplemented probiotics after 7 days of birth were part of the late introduction (LI) group. Clinical characteristics were compared between the two groups and analyzed statistically. Results: A total of 370 infants were included. The mean GA (29.1 weeks vs. 31.2 weeks, p<0.001) and birth weight (1,235.9 g vs. 1491.4 g, p<0.001) were lower in the LI group (n=223) than in the EI group. The multivariate analysis indicated that factors affecting the LI of probiotics were GA at birth (odds ratio [OR], 1.52; p<0.001) and the enteral nutrition start day (OR, 1.47; p<0.001). The late probiotic introduction was associated with a risk of late-onset sepsis (OR, 2.85; p=0.020), delayed full enteral nutrition (OR, 5.44; p<0.001), and extrauterine growth restriction (OR, 1.67; p=0.033) on multivariate analyses after adjusting for GA. Conclusion: Early supplementation of probiotics within a week after birth may reduce adverse outcomes among preterm or VLBW infants.

• Clinics in Shoulder and Elbow
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• v.26 no.4
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• pp.351-356
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• 2023

Background: Total elbow arthroplasty (TEA) is uncommon, but growing in incidence. Traditionally an inpatient operation, a growing number are performed outpatient, consistent with general trends in orthopedic surgery. The aim of this study was to compare TEA outcomes between inpatient and outpatient surgical settings. Secondarily, we sought to identify patient characteristics that predict the operative setting. Methods: Patient data were collected from the American College of Surgeons National Quality Improvement Program. Preoperative variables, including patient demographics and comorbidities, were recorded, and baseline differences were assessed via multivariate regression to predict operative setting. Multivariate regression was also used to compare postoperative complications within 30 days. Results: A total of 468 patients, 303 inpatient and 165 outpatient procedures, were identified for inclusion. Hypoalbuminemia (odds ratio [OR], 2.5; P=0.029), history of chronic obstructive pulmonary disorder or pneumonia (OR, 2.4; P=0.029), and diabetes mellitus (OR, 2.5; P=0.001) were significantly associated with inpatient TEA, as were greater odds of any complication (OR, 4.1; P<0.001) or adverse discharge (OR, 4.5; P<0.001) and decreased odds of reoperation (OR, 0.4; P=0.037). Conclusions: Patients undergoing inpatient TEA are generally more comorbid, and inpatient surgery is associated with greater odds of complications and adverse discharge. However, we found higher rates of reoperation in outpatient TEA. Our findings suggest outpatient TEA is safe, although patients with a higher comorbidity burden may require inpatient surgery. Level of evidence: III.

• Journal of Home Health Care Nursing
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• v.26 no.1
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• pp.5-18
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• 2019

Purpose: Frailty is associated with an increased risk of adverse health outcomes. We aimed to review the relationships between frailty and health outcomes in community-dwelling Korean elderly individuals. Methods: Whittemore and Knafls' framework for conducting integrative reviews was used. PubMed, Cumulative Index to Nursing and Allied Health Literature, and six Korean databases were searched. For analysis, the study included articles written in English and Korean published between January 1960 and June 2018. Of the total 1,488 studies found in the databases, we analyzed 15 studies that met the quality of the evaluation criteria. Results: The prevalence of frailty in Korean elderly individuals ranged from 6.5% to 11.7% when divided into three levels of frailty. The health outcomes assessed in relation to frailty were divided into five domains: quality of life, physical health, psychosocial health, health behavior, and health care quality. Frailty was negatively associated with all five domains. Conclusions: Our study suggested that nurses should be aware of the limitations in the physical and cognitive functions of frail elderly individuals and provide tailored interventions for Korean elderly individuals. Furthermore, a large-scale study is needed to develop the Korean model of the frailty assessment tool and to verify the conceptual model of this study.

• Clinics in Shoulder and Elbow
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• v.24 no.1
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• pp.4-8
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• 2021

Background: As nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids have similar effects, steroids can be avoided to reduce adverse effects. This study aimed to compare the differences in symptom improvement after subacromial injection of steroids or NSAIDs. Methods: Sixty patients with rotator cuff syndrome for at least 3 months were enrolled and divided into steroid and NSAID groups. The steroid group received a mixture of 1 mL of triamcinolone acetonide (40 mg/mL) and 1 mL of lidocaine hydrochloride 2%, while the NSAID group received a mixture of 1 mL of Ketorolac Tromethamine (30 mg/mL) and 1 mL of lidocaine hydrochloride 2%. The patients were assessed before and at 3, 6, and 12 weeks after the procedure. Shoulder scores from visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES), and University of California Los Angeles (UCLA) were used for evaluation. Results: Both groups showed improvements in the clinical outcomes. Overall VAS, ASES, and UCLA scores improved from 6.9, 32.7, and 16.0 before the procedure to 2.0, 1.2, and 1.1; 81.5, 87.6, and 88.5; and 29.7, 31.8, and 32.0 at weeks 3, 6, and 12 weeks after the procedure, respectively. Twenty-six patients (86.7%) in the steroid group and 28 (93.3%) in the NSAID group reported satisfactory treatment outcomes. There were no significant differences in the outcomes between the two groups (p=0.671). Conclusions: Subacromial injection of NSAIDs for rotator cuff tendinitis with shoulder pain had equivalent outcomes with those of steroid injection at the 12-week follow-up.