• Title/Summary/Keyword: Prospective Cohort Study

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Preventive effect of tacrolimus on patients with post-endoscopic retrograde cholangiopancreatography pancreatitis

  • Harshavardhan B. Rao;Paul K. Vincent;Priya Nair;Anoop K. Koshy;Rama P. Venu
    • Clinical Endoscopy
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    • v.55 no.5
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    • pp.665-673
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    • 2022
  • Background/Aims: In patients undergoing endoscopic retrograde cholangiopancreatography (ERCP), calcineurin activates zymogen, which results in pancreatitis. In this study, we aimed to determine the efficacy of tacrolimus, a calcineurin inhibitor, in preventing post-ERCP pancreatitis (PEP). Methods: This was a prospective pilot study in which patients who underwent ERCP received tacrolimus (4 mg in two divided doses); this was the Tac group. A contemporaneous cohort of patients was included as a control group. All patients were followed-up for PEP. PEP was characterized by worsening abdominal pain with an acute onset, elevated pancreatic enzymes, and a duration of hospital stay of more than 48 hours. Serum tacrolimus levels were measured immediately before the procedure in the Tac group. Results: There were no differences in the baseline characteristics between the Tac group (n=48) and the control group (n=51). Only four out of 48 patients (8.3%) had PEP in the Tac group compared to eight out of 51 patients (15.7%) who had PEP in the control group. The mean trough tacrolimus level in patients who developed PEP was significantly lower (p<0.05). Conclusions: Oral tacrolimus at a cumulative dose of 4 mg safely prevents PEP. Further randomized controlled studies are warranted to establish the role of tacrolimus in this context.

Association between Relative Preference for Vegetables and Meat and Cancer Incidence in Korean Adults: A Nationwide Population-based Retrospective Cohort Study (채소 및 육류 섭취의 상대적인 선호도와 암 발생의 연관성: 국민건강보험공단 국민건강정보자료 활용)

  • Yie, Ga-Eun;Kim, An Na;Cho, Hyun Jeong;Kang, Minji;Moon, Sungji;Kim, Inah;Ko, Kwang-Pil;Lee, Jung Eun;Park, Sue K.
    • Korean Journal of Community Nutrition
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    • v.26 no.3
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    • pp.211-227
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    • 2021
  • Objectives: We aimed to examine the association between the relative preference for vegetables and meat and cancer incidence, in a population-based retrospective cohort in Korea. Methods: We included 10,148,131 participants (5,794,124 men; 4,354,007 women) who underwent national health screening between 2004 and 2005 from the National Health Information Database of the National Health Insurance Service (NHIS-NHID). Participants were asked whether they preferred consuming 1) vegetables more often, 2) both vegetables and meat or 3) meat more often. Participants were followed up to Dec. 31, 2017. All cancer and eighteen common cancer cases were identified through the code from the International Classification of Diseases, 10th revision. We estimated sex-specific relative risks and 95% confidence intervals, adjusting for age, body mass index, alcohol consumption, smoking, physical activity, and income level. Results: During an average follow-up of 12.4 years, 714,170 cancer cases were documented. In men, consuming meat more often was associated with lower risk of esophageal, liver, and stomach cancers, but higher risk of lung and kidney cancers. Consuming both vegetables and meat was associated with higher risk of prostate cancer, but with lower risk of esophageal, liver, and stomach cancers in men. In women, consuming meat more often was associated with a higher risk of colorectal cancer and breast, endometrial, and cervical cancers diagnosed before the age of 50. Consuming both vegetables and meat was associated with lower risk of liver cancer in women. Conclusions: Our study suggests a potential link between vegetable and meat intake and cancer incidence in the Korean population. Further investigation on the association between the intake of specific types of vegetables and meat and cancer risk in Korean prospective cohort studies is needed.

Effect of Low-fat Diet on Breast Cancer Survival: a Meta-analysis

  • Xing, Mei-Yuan;Xu, Su-Zhen;Shen, Peng
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.3
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    • pp.1141-1144
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    • 2014
  • Background: Even though many studies have examined the possible effect of low-fat diet on breast cancer survival, the relationship remains unclear. Objectives: To summarize the current evidence about the effect of post-diagnostic low-fat diet on recurrence and all-cause mortality of breast cancer. Methods: We conducted a search of Pubmed, Embase, Web of Science, and Cochrane Library and as a result two randomized controlled trials (RCT) and one large multi-center prospective cohort study with 9,966 breast cancer patients were included in this report. Results: Post-diagnostic low-fat diet reduced risk of recurrence of breast cancer by 23% (HR=0.77, 95%CI 0.63 to 0.94, P=0.009) and all cause mortality of breast cancer by 17% (HR=0.83, 95%CI 0.69 to 1.00, P=0.05). Conclusions: This meta-analysis suggested the post-diagnostic low-fat diet can improve breast cancer survival by reducing risk of recurrence. However, more trials of the relationship between low-fat diet and allcause mortality of breast cancer are still needed.

Risk Factors for Premature Birth among Premature Obstetric Labor Women: A Prospective Cohort Study (조기진통 임부의 조산 발생 영향요인: 전향적 코호트 연구)

  • Kim, Yun Kyung;Lim, Kyung Hee
    • Women's Health Nursing
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    • v.24 no.3
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    • pp.233-242
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    • 2018
  • Purpose: To identify risk factors for premature birth among premature obstetric labor women. Methods: Participants were 129 hospitalized women who were diagnosed with potential premature obstetric labor with 20 weeks to 37 weeks of gestation. Data were analyzed using descriptive statistics, $x^2$ test, t-test, and binary logistic regression. Results: Of 129 women, 78(60.5%) gave premature birth and 51 (39.5%) gave full-term birth. Risk factors for premature birth were education level (${\leq}$bachelor's degree), abnormal bowel condition (constipation or diarrhea), time firstly diagnosed with a premature obstetric labor (below 28 weeks of pregnancy), and multiple pregnancy. There were also increased risks of premature birth for participants with high level of anxiety and high level of prenatal stress. In social support, there was an increased risk of premature birth for participants with low level of social support. Conclusion: Prenatal nursing programs should consider not only psychosocial factors such as anxiety, prenatal stress, and social support, but also some general and obstetric factors such as education level, abnormal bowel condition, time firstly diagnosed with a premature obstetric labor, and multiple pregnancy to increase maternal and child health.

Recreational Physical Activity and Risk of Ovarian Cancer: a Meta-analysis

  • Zhou, Li-Min
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5161-5166
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    • 2014
  • Our aim was to access the association between recreational physical activity (RPA) and risk of ovarian cancer (OC). The studies were retrieved from the PubMed and Embase databases up to February 20th, 2014. Risk ratios (OR) and 95% confidence intervals (CI) were used to estimate effect sizes. Random-effects or fixed-effects models were used to pool the data. The trim and fill method was applied for sensitivity analysis. Begg's rank correlation test and Egger's regression asymmetry test were employed to assess the publication bias. A total of 6 studies (435398 participants including 2983 OC patients) were included in this meta-analysis. The overall estimate indicated that there was weakly inverse association between RPA and OC risk (RR=0.90, 95%CI: 0.72-1.12, p=0.335). Meanwhile, for prospective cohort studies, a result consistent with the overall estimate was obtained (RR=1.12, 95% CI: 0.88-1.42, p=0.356). However, for case control studies, the pooled estimate of RR was 0.76 (95%CI: 0.64-0.90, p=0.002), indicating a clear significant association between RPA and OC risk. In addition, the sensitivity analysis indicated a significant link between RPA and risk of OC after removing Lahmann's study (RR=0.80, 95% CI: 0.68-0.93, p=0.004). No significant publication bias was found (Begg's test: p=1.00; Egger's test: p=0.817). In conclusion, our meta-analysis indicated a weakly inverse relationship between RPA and the occurrence of OC.

Maternal Working Conditions on Adverse Pregnancy Outcomes: A Prospective Cohort Study (작업조건이 출산결과에 미치는 영향: 전향적 코호트연구)

  • Kim, Ji-Yong;Chung, Jin-Joo;Ko, Kyung-Sim;Cho, Jung-Jin
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.3
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    • pp.197-204
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    • 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.

Safety and Effectiveness of Liposuction Modalities in Managing Lipedema: Systematic Review and Meta-analysis

  • Hatan Mortada;Sultan Alaqil;Imtinan Al Jabbar;Fatimah Alhubail;Nicolas Pereira;Joon Pio Hong;Feras Alshomer
    • Archives of Plastic Surgery
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    • v.51 no.5
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    • pp.510-526
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    • 2024
  • Background Lipedema is a chronic, incurable disorder characterized by painful fat accumulation in the extremities. While the application of liposuction in lipedema management has become increasingly popular, the safety and effectiveness of this approach remain contentious. Our systematic review and meta-analysis aimed to assess various liposuction modalities in lipedema management to verify their safety and efficacy. Methods In-line with the Preferred Reporting Items for Systematic Reviews and Metaanalyses guidelines, we performed a comprehensive literature review from inception untilMarch 2023 using the following electronic databases: CENTRAL,MEDLINE, Google Scholar, and EMBASE. Results From the 562 initially identified articles, 20 met our inclusion/exclusion criteria for evaluation. Our review encompassed 14 prospective cohort studies, 3 retrospective studies, 2 case series, and 1 cross-sectional study. Ameta-analysis of nine articles revealed a notable improvement in the quality of life, pain, pressure sensitivity, bruising, cosmetic impairment, heaviness, walking difficulty, and itching among lipedema patients who underwent liposuction. Although complications such as inflammation, thrombosis, seroma, hematoma, and lymphedema-related skin changes were reported, severe complications were rare. Crucially, no instances of shock, recurrence, or mortality were reported.

The Risk Factors for the Development of Hypertension in a Rural Area - An 1-Year Prospective Cohort Study - (농촌 지역 주민들의 고혈압 발생 위험요인 - 1년간 전향성 추적 조사 -)

  • Oh, Hee-Sook;Kam, Sin;Yeh, Min-Hae;Kang, Yun-Sik;Kim, Keon-Yeop;Lee, Young-Sook;Park, Ki-Soo;Son, Jae-Hee;Lee, Sang-Won;Ahn, Moon-Young;Chun, Byung-Yeol
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.2
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    • pp.199-207
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    • 2000
  • Objectives : This study was peformed to identify the risk factors related to the development of hypertension in a rural area. Method : Total of 3,573 subjects in Chung-Song County were interviewed and examined in 1996. The study cohort comprised 2,580 hypertension-free subjects aged above 20. One-year follow up was completed for 1,781 subjects(69.0%) in 1997. General characteristics(age, gender, education level, economic status, marital status), the family history of hypertension, diet, alcohol, smoking, coffee, stress, past history of oral contraceptive and menopausal status in female, height, weight, waist and hip circumference, baseline blood pressure, and serum total cholesterol were considered as risk factors. Results : Multivariate analysis using logistic regression model indicated that age(RH=1.50, 95% CI; 1.15-1.96), the family history of hypertension(RR=2.11, 95% CI; 1.04-4.26), waist-hip ratio(WHR) (RR=2.09, 95%, CI; 1.15-3.79), and baseline systolic blood pressure(130-139/<120mmHg)(RR=3.34, 95% CI; 1.47-7.60) were significant risk factors associated with the development of hypertension above the borderline level in male. In female, age(RR=1.06, 95% CI; 1.03-1.09), change in menopausal status$(no{\rightarrow}yes/no{\rightarrow}no)$ (RR=3.32, 95% CI; 1.01-10.87), baseline systolic blood pressure(120-129/<120mmHg: RR=2.00, 95% CI; 1.02-3.90)(130-139/<120mmHg: RR=2.64, 95% CI; 1.34-5.20) and baseline diastolic blood pressure(85-89/<80mmHg)(RR=4.09, 95% CI; 1.86-8.96) were identified as risk factors. Conclusions : Age and high normal blood pressure were significant risk factors for the development of hypertension above the borderline level. In addition, the family history of hypertension and WHR in men, and the change of menopausal status in women might be significant risk factors in Korea.

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