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Factors Affecting Pain Intensity Among Korean Women With Rheumatoid Arthritis: A Cross-Sectional Analysis
No full textThis cross-sectional study investigated the factors affecting pain intensity among Korean women with rheumatoid arthritis (RA) (n = 246). Data included pain site and intensity, physical function, fatigue, medication attitudes, and learned helplessness (LH) from patient self-report, and Disease Activity Score 28 (DAS28) from chart review. The overall pain intensity was 3.59 out of 10, with a median of 3. The mean number of painful joints was 8.4, with the most commonly reported painful joint groups being the fingers, wrists, and knees. Higher DAS28, impaired physical function, eight or more painful joints, higher levels of fatigue, and higher levels of LH were significantly associated with pain intensity. Our results suggest that pain in women with RA is closely associated with cognitive or psychological variables such as fatigue and LH in addition to inflammation itself. For improved pain management, patients with RA should receive regular counseling to address their feelings of LH and fatigue
Impact of delayed amputation on clinical outcomes compared to that of early amputation in patients with blunt polytrauma
No full textDelayed amputation after failed limb salvage can lead to negative clinical and functional outcomes due to complications, including re-amputation. This study aimed to compare clinical outcomes and identify risk factors according to the timing of amputation. A retrospective review of lower-extremity injuries managed between January 2016 and December 2022 at a level 1 trauma center was conducted. Outcomes were compared between early amputation (within 48 h) and delayed amputation (beyond 48 h) groups. The primary outcome was the risk of a more proximal amputation level according to the timing of amputation. Secondary outcomes included trauma-related complications and clinical outcomes. Trauma-related complications were more common in the delayed amputation group, with no significant differences in 30-day mortality. Delayed amputation and deep surgical infection at the stump site were associated with higher odds of a more proximal amputation level than initially predicted. The overall hospital stay was significantly longer in the delayed amputation group. While there is no established standard for deciding between limb salvage and amputation strategies, delayed amputation could be a risk factor for shorter limb stumps owing to re-amputation, and patients may experience more trauma-related complications and prolonged hospitalization
Epidemiology of lateral and medial epicondylitis in South Korea: A nationwide population-based study
No full textFew studies have reported the epidemiology of lateral epicondylitis (LE) and medial epicondylitis (ME) in nationwide databases. This study aimed to investigate the epidemiology of LE and ME in South Korea. We analyzed data from the nationwide database of the Korean Health Insurance Review and Assessment Service from 2013 to 2017. We investigated the incidence, prevalence, and surgical trends in patients with LE or ME. Between 2013 and 2017, we identified 2813,431 and 836,610 patients with LE and ME, respectively. LE and ME were more frequently diagnosed in women than in men. During the study period, the mean annual age-adjusted incidence rates of LE and ME were 9.7 per 1000 people and 2.9 per 1000 people, respectively. The incidence of LE did not change significantly during the study period, but the prevalence rate increased significantly. Conversely, the incidence and prevalence rates of ME have significantly increased. Furthermore, 0.8% and 1.0% of patients with LE and ME, respectively, required surgical treatment, showing an annual increase in the number of surgical treatments for LE and ME, respectively. The proportion of arthroscopic surgeries performed for LE did not significantly change during the study period. The prevalence of LE and ME has increased in South Korea. Consequently, the number of surgeries performed annually for LE and ME has increased
Exploring Fat Fraction and Vertebral Bone Quality Score in Lumbar Spine Magnetic Resonance Imaging: A Cross-Sectional Study on Associations and Clinical Implication
No full textBackground/Objectives: While gradient-echo (GRE)-based chemical shift-encoded magnetic resonance imaging (CSE-MRI) offers precise method for measuring adiposity in bone marrow, its limitation lies in the need for additional imaging. On the other hand, spin-echo (SE)-based CSE-MRI can seamlessly integrate into conventional protocols. Recently, a novel technique called the vertebral bone quality (VBQ) score has been introduced. The objective of this study was to investigate the association between fat fraction (FF) measured by GRE-based CSE-MRI (FF(GRE)) and FF measured by SE-based CSE-MRI (FF(SE)) or the VBQ score. Methods: A retrospective study with 344 patients assessed the correlation between FF and the VBQ score and each measurement's correlation with age using Pearson's correlation (r). Concordance between FF(GRE) and FF(SE) was assessed using Lin's concordance correlation coefficient (rho(c)). Vertebral lesions (n = 41) were categorized as benign and malignant, and the Mann-Whitney U test was used for comparison. Results: FF(GRE) demonstrated strong positive correlations with FF(SE) and the VBQ score (r = 0.861 and 0.708, respectively). However, the concordance between FF(GRE) and FF(SE) was poor (rho(c) = 0.295). All measurements moderately correlated with age (FF(GRE), r = 0.583; FF(SE), r = 0.477; VBQ score, r = 0.468). FF was significantly higher in benign lesions (FF(GRE), p = 0.004; FF(SE), p = 0.007), while the VBQ score did not show statistically significant differences between the two groups (p = 0.089). Conclusions: FF(GRE) exhibited a high correlation with the VBQ score. FF(SE) showed a strong correlation with FF(GRE), but replacing FF(GRE) with FF(SE) may be challenging. Both FF and the VBQ score moderately correlated with age. FF demonstrated statistically significant differences between benign and malignant lesions, while the VBQ score did not provide a distinguishable separation
Anxiety and Depression Are Associated with Poor Long-term Quality of Life in Moderate-to-Severe Ulcerative Colitis: Results of a 3-Year Longitudinal Study of the MOSAIK Cohort
No full textBACKGROUND/AIMS: We previously reported that patients with moderate-to-severe ulcerative colitis (UC) often experience common mental disorders (CMDs) such as anxiety and depression, necessitating immediate psychological interventions within the first 4 weeks of diagnosis. In this 3-year follow-up study of the MOSAIK cohort in Korea, we examined the effects of CMDs at initial diagnosis on clinical outcomes and health-related quality of life (HRQoL). METHODS: We examined differences in clinical outcomes (evaluated based on clinical response, relapse, hospitalization, and medication use) and HRQoL (assessed using the Inflammatory Bowel Disease Questionnaire [IBDQ] and Short Form 12 [SF-12]) according to Hospital Anxiety and Depression Scale (HADS) scores at diagnosis. RESULTS: In a study involving 199 UC patients, 47.7% exhibited significant psychological distress (anxiety and/or depression) at diagnosis. Clinical follow-up showed no major differences in outcomes, including remission rates, response rates, or hospitalization rates, between patients with anxiety or depression at diagnosis and patients without anxiety or depression at diagnosis. The HRQoL at the end of follow-up was notably lower in those with baseline CMDs, particularly anxiety, across all domains of the IBDQ and SF-12. Linear mixed-effect models revealed that higher HADS scores, as well as higher Mayo scores, were independently associated with lower IBDQ scores and both summary domains of the SF-12. Additionally, regular attendance at follow-up visits during the study period was also related to improvements in HRQoL (all p<0.05). CONCLUSIONS: While CMDs present at the time of UC diagnosis did not influence long-term clinical outcomes, they persistently impaired HRQoL. Our findings support the routine incorporation of psychological interventions into the long-term management of moderate-to-severe UC
Relationships Between Chronic Cough and Asthma Control and Quality of Life in Patients With Severe Asthma: A 6-Month Longitudinal Analysis
No full textBACKGROUND: The prevalence and clinical implications of chronic cough (CC) in patients with severe asthma receiving asthma treatment remain relatively unknown. OBJECTIVE: This study aimed to evaluate the relationships between CC and asthma control and quality of life (QoL) in patients with severe asthma through longitudinal analysis. METHODS: Baseline and 6-month follow-up data from the Korean Severe Asthma Registry were analyzed. CC was defined as a cough visual analog scale (VAS) score of >/=40 at both baseline and 6 months. Demographic parameters and clinical outcomes were compared between patients with severe asthma and CC and those without CC. Generalized estimating equation (GEE) analysis was performed to identify associations of CC with asthma control and QoL scores. RESULTS: Of the total 286 participants with severe asthma, 116 (40.6%) were defined as having CC. Patients with CC had higher baseline cough and wheeze severity VAS scores (all P < .001), poorer asthma control (P < .001), and worse QoL (Severe Asthma Questionnaire [SAQ] and Euro-QoL 5-Dimension [EQ-5D] index, all P < .001) than those without CC. During the follow-up, patients with CC were more frequently exposed to oral corticosteroids (58.6% vs 38.6%, P = .010) and experienced more frequent asthma exacerbations (48.3% vs 28.6%, P = .009) than those without CC. GEE analysis revealed that CC was independently associated with poor asthma control, lower SAQ scores, and a lower EQ-5D index after adjusting for confounders. CONCLUSION: The presence of CC was associated with worse asthma control and QoL in patients with severe asthma. Further studies are warranted to better evaluate and manage CC in these patients
A Multicenter Study on Hepatocellular Adenomas in Korea: Clinicopathological and Imaging Features With an Emphasis on β-Catenin Mutated Subtype
No full textBACKGROUND & AIMS: The clinicopathologic and imaging features of hepatocellular adenomas (HCAs) in Asian population remain unclear. We aimed to analyse clinicopathologic and imaging features of HCAs in Korea and propose an imaging-based method to differentiate beta-catenin mutated HCA (betaHCA) from other subtypes. METHODS: This retrospective multicenter study included pathologically confirmed HCAs from three tertiary institutions in Korea between 2010 and 2023. HCA subtypes were determined according to the current World Health Organization classification using immunohistochemical staining. Two abdominal radiologists reviewed computed tomography and magnetic resonance imaging scans. The clinical characteristics and imaging features of HCA subtypes were compared. A scoring system for betaHCA was developed and validated using development (January 2010-April 2021) and validation (May 2021-March 2023) cohorts. RESULTS: 121 patients (47 men; mean age, 39.0 years +/-13.5) with 138 HCAs were included. HCAs displayed characteristic clinicopathologic features, including a high proportion of male (38.8%) and obese patients (35.5%), with the inflammatory subtype being the most common (38.4%) and a low percentage of patients using oral contraceptive (5.0%). Each HCA subtype demonstrated distinct clinical and imaging features. The scoring system incorporating tumour heterogeneity and iso to high hepatobiliary phase signal intensity on MRI for differentiating betaHCA exhibited high performance in both the development (AUC 0.92, 95% CI: 0.87-0.97) and the validation cohort (AUC 0.91, 95% CI: 0.77-1.00). CONCLUSIONS: This comprehensive analysis of clinicopathologic and imaging features of HCAs in Korea contributes to the characterisation of HCAs across different geographical regions. The imaging-based scoring system effectively differentiates betaHCA
국내 학술지에 게재된 환자보고형 건강평가 측정도구에 대한 체계적 고찰연구의 현황
No full textPurpose: This study aimed to explore the current status of systematic review studies on patient-reported outcome measures (PROMS) published in Korean journals. Methods: Studies on the systematic review of PROMs, which applied the COnsensus-based Standards for selecting health Measurement Instruments (COSMIN) methodology. There were searched from the KoreaMed. The studies were evaluated based on the eight steps suggested by the COSMIN systematic review processes. Results: A total of eight systematic review studies were published in seven Korean journals. Patient-reported outcome measures (PROMS) measure for post-traumatic growth, social adjustment, physical impairment in post-intensive care syndrome, sleep quality, constipation, discharge readiness, post-traumatic stress disorder, and eHealth literacy. Conclusions: No studies adhered to the steps of the COSMIN systematic review guidelines. Among the steps, the weakest points were searching strategies and evaluating measurement properties
Association between Levetiracetam Use and Survival in Patients with Glioblastoma: A Nationwide Population-Based Study
No full textPURPOSE: This study aimed to investigate whether levetiracetam (LEV), the most used antiepileptic drug, influences survival in patients with glioblastoma (GBM), using a national database. MATERIALS AND METHODS: This study used data from the Korea Health Insurance Review and Assessment database. Patients diagnosed with GBM between 2007-2018 treated with standard therapy were included. The study population was divided into long-term (>/= 60 days) and short-term (< 30 days) LEV groups. A separate long-term valproic acid (VPA) group (>/= 60 days) was identified for comparison. Demographics, disease characteristics, and treatment parameters were collected. Kaplan-Meier method and Cox regression were used to compare survival outcomes between the groups. RESULTS: Overall, 2,971 patients were included, with 1,319 and 1,652 in the short-term and long-term LEV groups, respectively. The median overall survival (OS) for the entire population was 19.15 months post-surgery. Kaplan-Meier analysis revealed a significantly longer median OS in the long-term LEV group versus the short-term LEV group. After adjusting for confounders, Cox proportional hazard analysis revealed an association of long-term LEV use with improved survival, which was also observed in a subgroup analysis of patients without preoperative seizure history. The long-term LEV group demonstrated longer median OS, compared with the long-term VPA group. CONCLUSION: Our nationwide population-based study found an association between long-term LEV use and improved survival in patients with GBM, regardless of preoperative seizure history. Prospective studies are needed to validate these findings and investigate the potential impact of LEV on the survival outcomes of patients with GBM
Korean Guidelines for Diagnosis and Management of Interstitial Lung Diseases: Connective Tissue Disease Associated Interstitial Lung Disease
No full textConnective tissue disease (CTD), comprising a range of autoimmune disorders, is often accompanied by lung involvement, which can lead to life-threatening complications. The primary types of CTDs that manifest as interstitial lung disease (ILD) include rheumatoid arthritis, systemic sclerosis, Sjogren's syndrome, mixed CTD, idiopathic inflammatory myopathies, and systemic lupus erythematosus. CTD-ILD presents a significant challenge in clinical diagnosis and management due to its heterogeneous nature and variable prognosis. Early diagnosis through clinical, serological, and radiographic assessments is crucial for distinguishing CTD-ILD from idiopathic forms and for implementing appropriate therapeutic strategies. Hence, we have reviewed the multiple clinical manifestations and diagnostic approaches for each type of CTD-ILD, acknowledging the diversity and complexity of the disease. The importance of a multidisciplinary approach in optimizing the management of CTD-ILD is emphasized by recent therapeutic advancements, which include immunosuppressive agents, antifibrotic therapies, and newer biological agents targeting specific pathways involved in the pathogenesis. Therapeutic strategies should be customized according to the type of CTD, the extent of lung involvement, and the presence of extrapulmonary manifestations. Additionally, we aimed to provide clinical guidance, including therapeutic recommendations, for the effective management of CTD-ILD, based on patient, intervention, comparison, outcome (PICO) analysis