Health-promoting behaviors among middle-aged breast cancer survivors compared with matched non-cancer controls: A KNHANES VI-VII (2013-2018) study.

This study aimed to compare health-promoting behaviors between middle-aged breast cancer survivors and matched non-cancer controls. We conducted a retrospective, cross-sectional, matched case-control study using data from Korean National Health and Nutrition Examination Surveys (KNHANES) VI-VII (2013-2018) to compare health-promoting behaviors. We selected breast cancer survivors aged 40 to 65 who completed the surveys, and each case was matched with 5 non-cancer controls (1:5) based on propensity scores. With multivariable logistic regression, middle-aged breast cancer survivors were compared with controls in terms of their last screening for a second primary cancer (SPC), current smoking status, alcohol consumption, aerobic physical activity (PA), sedentary time, and self-reported diet control. The final study sample consisted of 117 middle-aged breast cancer survivors and 585 non-cancer controls after propensity score matching (PSM). In the multivariable analysis, middle-aged breast cancer survivors were less likely to consume alcohol (odds ratio [OR] 0.58, 95% confidence interval [CI], 0.35-0.95), more likely to engage in aerobic PA (OR, 1.60; 95% CI, 1.01-2.54), and more likely to self-report diet control (OR, 2.12; 95% CI, 1.27-3.53). There were no significant intergroup differences in SPC screening uptake within 2 years, smoking status, or sedentary times. There is a need to educate middle-aged breast cancer survivors about SPC screening, smoking cessation, and minimizing sedentariness to reduce the risks of associated with breast cancer recurrence, SPCs, and comorbid chronic diseases.

Effective Timing of Introducing an Inpatient Smoking Cessation Program to Cancer Patients.

PURPOSE: We aimed to identify factors influencing smoking cessation success among cancer patients registered in an inpatient smoking cessation program at a single cancer center. MATERIALS AND METHODS: The electronic medical records of enrolled patients with solid cancer were retrospectively reviewed. We evaluated factors associated with 6-month smoking cessation. RESULTS: A total of 458 patients with cancer were included in this study. Their mean age was 62.9±10.3 years, and 56.3% of the participants had lung cancer. 193 (42.1%) had not yet begun their main treatment. The mean number of counseling sessions for the participants was 8.4±3.5, and 46 (10.0%) patients were prescribed smoking cessation medications. The 6-month smoking cessation success rate was 48.0%. Multivariate analysis showed that younger age (<65 years), cohabited status, early stage, and the number of counseling sessions were statistically significant factors affecting 6-month smoking cessation success (p<0.05). Initiation of a cessation program before cancer treatment was significantly associated with cessation success (odds ratio, 1.66; 95% confidence interval, 1.02-2.70; p=0.040). CONCLUSION: Smoking cessation intervention must be considered when establishing a treatment plan immediately after a cancer diagnosis among smokers.

Relationship between frailty and mortality after gastrectomy in older patients with gastric cancer.

OBJECTIVES: Frail older adults with gastric cancer are at an increased risk of poor postoperative outcomes. We assessed whether geriatric frailty assessed using the Study of Osteoporotic Fractures (SOF) index could predict post-gastrectomy mortality. MATERIALS AND METHODS: We retrospectively assessed older adults (age ≥ 65 years) who underwent gastrectomy for gastric cancer between April 2012 and September 2015. Frailty status was assessed using the SOF index (range, 0-3) and categorized as robust (0), pre-frail (1), and frail (2-3). The Kaplan-Meier method and log-rank tests were used to compare survival between frailty groups. Univariate and multivariate analyses were used to identify mortality-associated risk factors. RESULTS: Among 231 patients (the median age 72.04 years and 140 (60.6%) men), 138 (59.7%) were robust, 58 (25.1%) were pre-frail, and 35 (15.2%) were frail. The mortality rate was 14.5% among robust patients, 20.7% among pre-frail patients, and 20.0% among frail patients (log-rank test, P = 0.032). Frail patients had more than a 3-fold increased risk of mortality compared with robust patients (adjusted HR = 3.331; 95% CI, 1.161-9.559). Multivariate analysis revealed that the SOF index and TNM stage were associated with increased mortality. CONCLUSIONS: SOF index predicted post-gastrectomy mortality among older patients independently of age, sex, TNM stage, type of approach, gastrectomy type, and extent of lymph node dissection. SOF index may be used with ease to assess frailty status among older patients with gastric cancer in busy clinics and subgroups that may benefit from targeted frailty interventions before cancer treatments.

Grip strength mediates the relationship between muscle mass and frailty.

BACKGROUND: Although sarcopenia and frailty are important diseases in geriatrics, few studies have investigated the association between the two diseases. Thus, this study aimed to examine the relationship between two components of sarcopenia (muscle mass and muscle function) and frailty. METHODS: In total, 997 Korean older adults (456 men and 541 women) were included in this cross-sectional observational study. We used a polynomial linear regression analysis to obtain standardized sex, age, and height-adjusted appendicular skeletal muscle mass (zASM), as well as to standardized sex, age, and height-adjusted grip strength (zGS). We then performed a causal mediation analysis to confirm the relationship between zASM and frailty. RESULTS: In both men and women, zGS mediated the relationship between zASM and frailty (average causal mediation effect in men: -0.096 {-0.159 to -0.050}; in women: -0.053 {-0.098 to -0.010}). For every one-point increase in zGS score, the relative risk of a one-point increase in frailty was reduced by 21% in men (e-0.238  = 0.788) and by 11% in women (e-0.113  = 0.893). CONCLUSIONS: In this study on Korean older adults, muscle mass did not have a direct effect on frailty but had an indirect effect through altered muscle function.

Reliability of an Electronic Inspiratory Loading Device for Assessing Pulmonary Function in Post-Stroke Patients.

BACKGROUND: The purpose of this study was to examine the inter- and intra-rater reliability of an electronic inspiratory loading device for the assessment of pulmonary functions: maximum inspiratory pressure, peak inspiratory flow, and vital capacity. MATERIAL/METHODS: Subjects were 50 patient volunteers in a rehabilitation hospital who had experienced their first episode of unilateral stroke with hemiparesis during the previous 6 months (26 men, 24 women; mean age [±SD], 55.96 [±12.81] years), with no use of medications that could induce drowsiness, evidence of restrictive lung disease, history of asthma, use of psychotropic drugs, or alcohol consumption habit. Maximum inspiratory pressure, peak inspiratory flow, and vital capacity for pulmonary functions were assessed using an electronic inspiratory loading device (PowerBreathe, K5, 2010) by 2 examiners, with patients in an unassisted sitting position, and 1 examiner re-assessed with same patients at the same time of a day after 1 week. Intra-class correlation coefficients were used to assess reliability. RESULTS: Intra-rater reliability ranged from intra-class correlation coefficients (ICCs)=0.959 to 0.986 in variables. For the inter-rater reliability between 2 examiners, the ICCs ranged from 0.933 to 0.985. Intra-rater and inter-rater reliability were good in variables (maximal inspiratory pressure, peak inspiratory flow, and vital capacity). CONCLUSIONS: The intra- and inter-examiner reliability of the pulmonary function measurements, maximum inspiratory pressure, peak inspiratory flow, and vital capacity, for the post-stroke patients was very high. The results suggest that the electronic inspiratory loading device would be useful for clinical rehabilitative assessment of pulmonary function.

Evaluation of research trends in physical therapy through analysis of articles published at the world confederation for physical therapy congress.

[Purpose] The purpose of this study was to examine research trends in physical therapy through analysis of articles published at the 2015 World Confederation for Physical Therapy Congress. [Subjects and Methods] A total of 1,339 were analyzed (presentations: 346, posters: 993). The number of papers per subject area, number of oral presentations and posters, and the number of moderator nations and regional publications were analyzed by subject area. The mean and standard deviation was used for statistical analysis. [Results] Of 1,339 items published, the musculoskeletal spine was the most common theme, with 89. Among oral presentations, 24 had cardiorespiratory themes; among poster presentations, themes related to the elderly were the most common, at 76. Eleven moderators were from Australia, and the most frequent regional source of papers was Japan, with 238. [Conclusion] The 2015 WCPT Congress published papers in a variety of subject areas; Australia and the UK presented many papers, but Japan had the most of any region, at 238.

Reliability of rehabilitative ultrasonographic imaging for muscle thickness measurement of the rhomboid major.

OBJECTIVE: This study was to establish inter-rater and intrarater reliability of the rehabilitative ultrasonographic imaging (RUSI) technique for muscle thickness measurement of the rhomboid major at rest and with the shoulder abducted to 90°. PARTICIPANTS: Twenty-four young adults (eight men, 16 women; right-handed; mean age [±SD], 24·4 years [±2·6]) with no history of neck, shoulder, or arm pain were recruited. METHODS: Rhomboid major muscle images were obtained in the resting position and with shoulder in 90° abduction using an ultrasonography system with a 7·5-MHz linear transducer. In these two positions, the examiners found the site at which the transducer could be placed. Two examiners obtained the images of all participants in three test sessions at random. Intraclass correlation coefficients (ICC) were used to estimate reliability. RESULTS: All ICCs (95% CI) were >0·75, ranging from 0·93 to 0·98, which indicates good reliability. The ICCs for inter-rater reliability ranged from 0·75 to 0·94. For the absolute value of the difference in the intra-examiner reliability between the right and left ratios, the ICCs ranged from 0·58 to 0·91. CONCLUSION: In this study, the intra- and interexaminer reliability of muscle thickness measurements of the rhomboid major were good. Therefore, we suggest that muscle thickness measurements of the rhomboid major obtained with the RUSI technique would be useful for clinical rehabilitative assessment.

Health Behaviors of Korean Gastric Cancer Survivors with Hypertension: A Propensity Analysis of KNHANES III-V (2005-2012).

OBJECTIVE: This study provides a comparison of health behaviors between gastric cancer survivors with hypertension and non-cancer subjects in Korea. METHODS: Data from the Korean National Health and Nutrition Examination Survey (KNHANES) for the period of 2005-2012 were used in this study. A propensity score matching method was used to compare health behaviors. Before the matching of propensity scores, the number of participants was 11034 (102 gastric cancer survivors and 10932 non-cancer participants). A 1:5 propensity score matching procedure yielded a total of 480 participants (80 gastric cancer survivors and 400 non-cancer participants) for the final analysis. Drinking, smoking, physical activity, antihypertensive medication adherence, self-reported diet control, and sodium intake accordance in the two groups were compared. A complex samples logistic regression analysis was conducted to assess any differences between the two groups. RESULTS: The group of hypertensive gastric cancer survivors had lower alcohol consumption (OR = 0.30; 95% CI: 0.14-0.66; p-value = 0.003). They were more likely to be on dietary control than the control group (OR = 3.12; 95% CI: 1.60-6.10; p-value = 0.001). However, there was no significant (p > 0.05) difference in sodium intake accordance or other health behaviors (including medication adherence, smoking, and physical activity) between the two groups. CONCLUSIONS: Our results revealed that gastric cancer survivors with hypertension were more likely to be on dietary control with lower alcohol consumption than the control group. However, there was no significant difference in sodium intake accordance or other health behaviors between the two groups. Therefore, primary care physicians should inform cancer survivors about the appropriate health behaviors to reduce their risk of cardiovascular disease and improve their overall survival rate, even though they say they have been doing health behaviors.

Health Behaviors of Breast Cancer Survivors with Hypertension: A Propensity Analysis of KNHANES III-V (2005-2012).

OBJECTIVE: This study examines health behaviors of breast cancer survivors with hypertension and compares them with those of non-cancer individuals with hypertension. METHODS: In this cross-sectional study, a total of 10,996 hypertensive adults (≥ 19 years) who participated in the 2005-2012 Korean National Health and Nutrition Examination Survey (KNHANES) were considered. Data on alcohol consumption, smoking, physical activity, antihypertensive medication adherence, self-reported diet control, and sodium intake were collected through self-report questionnaire. A total of 64 breast cancer survivors with hypertension and 10,932 non-cancer participants with hypertension were identified. To better compare health behaviors of the two groups, 56 breast cancer survivors and 280 non-cancer participants were selected through the 1:5 nearest available matching based on estimated propensity scores. Multivariate analysis was conducted to determine any differences between the two groups. RESULTS: According to multivariate analysis, breast cancer survivors with hypertension (n = 56) were significantly less likely to consume alcohol (odds ratio (OR): 3.75; 95% confidence interval (CI): 1.06-13.29) but significantly more likely to have sodium intake of more than 2400 mg (OR: 2.98; 95% CI: 1.27-6.97) than the propensity-matched control group (n = 280). There was no significant difference in other health behaviors between the two groups. CONCLUSIONS: Breast cancer survivors require active interventions for healthy behaviors related to the management of comorbid conditions such as hypertension to reduce the risk of cardiovascular disease and improve their overall survival rate.