Cervical and thoracic radiculopathies are among the most common causes of neck pain. The most common causes are cervical disc herniation and cervical spondylosis in patients with cervical radiculopathy, and diabetes mellitus and thoracic disc herniation in thoracic radiculopathy. A thorough history, physical examination, and testing that includes electrodiagnostic examination and imaging studies may distinguish radiculopathy from other pain sources. Although various electrodiagnostic examinations may help evaluate radiculopathy, needle electromyography is the most important, sensitive, and specific method. Outcome studies of conservative treatments have shown varying results and have not been well controlled or systematic. When legitimate incapacitating symptoms continue despite conservative treatment attempts, more invasive spinal procedures and intradiscal treatment may be appropriate. Surgery has been shown to have excellent clinical outcomes in patients with disc extrusion and neurological deficits. However, patients with minimal disc herniation have fair or poor surgical outcomes. In addition, conventional open disc surgery entails various inadvertent surgical related risks. Although there has not yet been a non-surgical interventional procedure developed with the therapeutic efficacy of open surgery, conservative procedures can offer substantial benefits, are less invasive, and avoid surgical complications. While more invasive procedures may be appropriate when conservative treatment fails, prospective studies evaluating cervical and thoracic radiculopathies treatment options would help guide practitioners toward optimally cost-effective patient evaluation and care.
Objective: The purpose of this study was to examine pathways from parent attachment to adolescent life satisfaction and to determine the mediating roles of peer attachment and romantic relationships. Methods: The participants were 221 high-school students (117 boys and 104 girls) living in Jeonnam province who had been in a romantic relationship for more than 3 months. The data were analyzed by t -tests, Pearson correlations, and SEM using SPSS 19.0 and Amos 18.0. Results: Based on the research objective, 4 important results were summarized. First, father attachment and mother attachment had direct effects on adolescent life satisfaction. Second, mother attachment had an indirect effect on adolescent life satisfaction through peer attachment. Third, father attachment had an indirect effect on adolescent life satisfaction through romantic relationships. Fourth, mother attachment had an indirect effect on adolescent life satisfaction through peer attachment and romantic relationships. Conclusion: The results from this study highlight the significant roles of parent attachment, peer attachment, and romantic relationships in adolescent life satisfaction. Specifically, the roles of father attachment and of romantic relationships in adolescent life satisfaction, which have seldom been explored in previous studies, should be emphasized. The findings can be used as an important basis for prospective research and practices for improving adolescent life satisfaction.
Objective: To conduct a meta-analysis to investigate the value of EBV DNA in diagnosis of nasopharyngeal cancer (NPC) in Asian populations, and provide important evidence for screening. Methods: Prospective or respective case-control or cohort studies regarding the detection role of EBV DNA for NPC were included in our study. We conducted a comprehensive literature search in PubMed, EMBASE, and the Chinese Biomedical Database (CBM database between January 1980 and March 2012. Results: A total of 18 studies with 1492 NPC cases and 2641 health controls were included. Almost of the included studies were conducted in China, and only one other conducted in Thailand. The overall results demonstrated that the pooled sensitivity, specificity, positive likelihood (+LR) and negative likelihood (-LR) were 0.73 (0.71-0.75), 0.89 (0.88-0.90), 8.84 (5.65-13.84) and 0.19(0.11-0.32), respectively. The overall EBV DNA detection showed the largest area of 0.932 under the summary receiver operator curve (SROC). The accuracy of detection by plasma for NPC (0.86) was higher than in serum (0.81), with largest areas under the SROC of 0.97 and 0.91, respectively. Conclusion: Our results demonstrated the EBV DNA detection in plasma or serum has high sensitivity and specificity in diagnosis of NPC, especially in Chinese populations with a high risk of cancer.
Parikh, Darshit;Ieso, Paolo De;Garvey, Gail;Thachil, Thanuja;Ramamoorthi, Ramya;Penniment, Michael;Jayaraj, Rama
Asian Pacific Journal of Cancer Prevention
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제16권2호
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pp.641-646
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2015
Breast cancer (BC) is potentially a traumatic stressor which may be associated with negative outcomes, such as post-traumatic stress disorder (PTSD) or positive changes, such as post-traumatic growth (PTG). This study aims to identify the core issues of BC related PTSD, PTG and psychological distress by interrogating the literature in BC survivors. We have also highlighted issues related to the assessment, diagnosis and clinical management of PTSD and PTG. The authors systematically reviewed studies published from 1985 to 2014 pertaining to PTSD, psychological distress and PTG in BC survivors with particular attention paid to incidence rates and causative factors. Multiple studies intimated that women with BC have evidence of PTSD at the initial stages of diagnosis, whereas PTG develops once patients undergo treatment. Early diagnosis and treatment of PTSD/PTG is paramount from literature review but the previously mentioned relationship between PTSD and PTG in BC patients could not be verified. It is evident from the literature that a small percentage of BC patients experience PTSD, while the majority experience PTG after BC diagnosis and treatment. Future research should include prospective studies focusing on high-risk patients, causative factors and the development of psychological interventions.
Purpose: To define the role of robotic gastrectomy for the treatment of gastric cancer, the present systematic review with meta-analysis was performed. Materials and Methods: A comprehensive search up to July 2012 was conducted on PubMed, EMBASE, and the Cochrane Library. All eligible studies comparing robotic gastrectomy versus laparoscopic gastrectomy or open gastrectomy were included. Results: Included in our meta-analysis were seven studies of 1,967 patients that compared robotic (n=404) with open (n=718) or laparoscopic (n=845) gastrectomy. In the complete analysis, a shorter hospital stay was noted with robotic gastrectomy than with open gastrectomy (weighted mean difference: -2.92, 95% confidence interval: -4.94 to -0.89, P=0.005). Additionally, there was a significant reduction in intraoperative blood loss with robotic gastrectomy compared with laparoscopic gastrectomy (weighted mean difference: -35.53, 95% confidence interval: -66.98 to -4.09, P=0.03). These advantages were at the price of a significantly prolonged operative time for both robotic gastrectomy versus laparoscopic gastrectomy (weighted mean difference: 63.70, 95% confidence interval: 44.22 to 83.17, P<0.00001) and robotic gastrectomy versus open gastrectomy (weighted mean difference: 95.83, 95% confidence interval: 54.48 to 137.18, P<0.00001). Analysis of the number of lymph nodes retrieved and overall complication rates revealed that these outcomes did not differ significantly between the groups. Conclusions: Robotic gastrectomy for gastric cancer reduces intraoperative blood loss and the postoperative hospital length of stay compared with laparoscopic gastrectomy and open gastrectomy at a cost of a longer operating time. Robotic gastrectomy also provides an oncologically adequate lymphadenectomy. Additional high-quality prospective studies are recommended to better evaluate both short and long-term outcomes.
The purposes of this study were 1) to identify determinants of exercise behavior 2) to determine theoretical frameworks that were used in other research 3) to investigate the limitations of exercise research. seventy six research papers, published between 1984-1999, were selected by searching Medline for this study. Research subjects, determinants of exercise behavior, exercise measurement, the design of studies, statistical method and theoretical background were examined. The results are as follows. 1. On the research subjects, most research papers studied healthy adults. 2. Thirteen variables were identified that were used more than 5 times in various researches were self efficacy, barrier, social support, benefit, physiological characteristics, habit, personality, intention, health status, motivation, subjective norm, attitude, and affect. The most frequently supported determinant was self efficacy, the second one was social support, the third was affect and so on. But few research papers found any significant relationship between subject norms or attitude and exercise. 3. On exercise measurement, only 22.4% of research papers considered intensity, duration, frequency as elements of exercise, and 64.5% of researches were assessed by self-reported questionnaires. 4. In research design, 80.3% of research papers were survey type research. The most frequently used statistcal method was Regression. 5. 44.8% of research papers were done without any theoretical basis. Based on the above findings the following suggestions are made : 1. Research which includes diverse populations with different levels of health status needs to be studied. 2. Determinants of exercise may be dynamic and varing in their influence, therefore, stages of exercise behavior and processes of change need to be studied. 3. In research design, more prospective, longitudinal studies are needed to identify determinants of exercise habits. 4. It is necessary to develop a reliable, valid exercise measurement tool. 5. Studies are needed to develop a theoretical framework for exercise behavior.
BACKGROUND/OBJECTIVES: A number of studies examined secular trends in blood lipid profiles using time series data of national surveys whereas few studies investigated individual-level factors contributing to such trends. The present study aimed to examine secular trends in dietary and modifiable factors and hyper-LDL-cholesterolemia (HC) prevalence and evaluate their associations using time series data of nationwide surveys. SUBJECTS/METHODS: The study included 41,073 Korean adults aged ≥ 30 years from the 2005, 2007-2009, 2010-2012, 2013-2015, and 2016 Korea National Health and Nutrition Examination Surveys. Stepwise logistic regression analysis was performed to select significant factors associated with HC, which was defined as serum LDL cholesterol levels ≥130 mg/dL. RESULTS: The following factors showed a positive association with HC (P < 0.05): for men having higher body mass index (BMI), being married, having an office job, and consuming higher dairy and vegetable oil products; for women having higher age or BMI, having no job or a non-office job, not in a low-income household, and consuming higher dairy products. In the given model, the 2016 survey data showed that a 2 kg/㎡ reduction in BMI of obese persons resulted in a decreased HC prevalence from 30.8% to 29.3% among men and from 33.6% to 32.5% among women. CONCLUSIONS: Based on these findings, it is suggested that primary prevention programs should advocate having proper BMI for Korean adults with a high-risk of HC. However, whether discouraging consumption of dairy and vegetable oil products can reduce HC prevalence warrants further studies with a prospective longitudinal design.
Kim, Seul Ki;Han, E-Jung;Kim, Sun Mie;Lee, Jung Ryeol;Jee, Byung Chul;Suh, Chang Suk;Kim, Seok Hyun
Clinical and Experimental Reproductive Medicine
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제43권4호
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pp.233-239
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2016
Objective: Uterine contraction induced by the embryo transfer (ET) process has an adverse effect on embryo implantation. The aim of this study was to determine the effect of oxytocin antagonist supplementation on the day of ET on in vitro fertilization outcomes via a meta-analysis. Methods: We performed a meta-analysis of randomized controlled trials (RCTs). Four online databases (Embase, Medline, PubMed, and Cochrane Library) were searched through May 2015 for RCTs that investigated oxytocin antagonist supplementation on the day of ET. Studies were selected according to predefined inclusion criteria and meta-analyzed using RevMan 5.3. Only RCTs were included in this study. The main outcome measures were the clinical pregnancy rate, the implantation rate, and the miscarriage rate. Results: A total of 123 studies were reviewed and assessed for eligibility. Three RCTs, which included 1,020 patients, met the selection criteria. The implantation rate was significantly better in patients who underwent oxytocin antagonist infusion (19.8%) than in the control group (11.3%) (n = 681; odds ratio [OR], 1.92; 95% confidence interval [CI], 1.25-2.96). No significant difference was found between the two groups in the clinical pregnancy rate (n = 1,020; OR, 1.57; 95% CI, 0.92-2.67) or the miscarriage rate (n = 456; OR, 0.76; 95% CI, 0.44-1.33). Conclusion: The results of this meta-analysis of the currently available literature suggest that the administration of an oxytocin antagonist on the day of ET improves the implantation rate but not the clinical pregnancy rate or miscarriage rate. Additional, large-scale, prospective, randomized studies are necessary to confirm these findings.
Objectives : The purpose of this study was to provide some information on the development of oral health care programs geared toward diabetics and ways of promoting their oral health. Methods : The subjects in this study were 586 diabetics who were selected from the 2009 third-year raw data of the 4th(2007~2009) National Health & Nutrition Survey. The data were analyzed with the statistical package SPSS 12.0 to grasp the influence of their sociodemographic characteristics and oral health behaviors on the presence or absence of periodontal diseases and missing tooth. Results : 1. Periodontal diseases were twofold more prevalent among the men than the women(p<0.01). By age, those who were in their 60s had 1.11-fold more periodontal diseases than those who were in their 70s and up(p<0.05). 2. The men and women were similar to each other in the number of missing tooth. By age, the number of missing tooth got smaller in proportion to decrease in age. By income, the number of missing tooth was 1.48-fold larger among the patients who earned an income of one million won or less than those who earned an income of two million won or more(p<0.01). Conclusions : The above-mentioned findings suggest that prospective cohort studies should be implemented to present prediction models of periodontal diseases and diabetes instead of merely sticking to cross-sectional studies. And oral health programs should be developed based on the findings of cohort studies to encourage diabetics to care about their oral health, and in which way they should be helped to promote their oral health should carefully be considered.
Objectives : To investigate the association of trial registration status with presence of reporting bias including publication bias and outcome reporting bias in recently published randomized controlled trials (RCTs) of acupuncture. Methods : A PubMed search for RCTs of acupuncture published from March 2016 to February 2017 was conducted. Primary outcomes were identified and the direction of the results was judged as positive (i.e., statistically significant) or negative. The trial registration was identified by manually screening the trial registration number in the main text of the published article and classified into 1) prospective registration; 2) retrospective registration based on the registration date or; 3) no registration. Results : Of the 125 included RCTs, only 40 studies (32.0%) prospectively registered the study protocols. Among 65 RCTs that adequately reported the primary outcome, unregistered trials were more likely to report positive results than the registered ones (p=0.013). Of the 40 prospectively registered studies, 19 trials (47.5%) had the discrepancies between the registered and published primary outcomes and furthermore, 40% of them reported the positive findings. Conclusions : Unregistered trials were more likely to report positive results and the discrepancies between the registered and published primary outcomes were detected in about a half of the prospectively registered studies, 42.1% of which tended to report positive findings. Journal editors and researchers in this field should be alerted to various reporting biases.
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