Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 15 de 15
Filtrar
Más filtros

Bases de datos
País/Región como asunto
Tipo del documento
País de afiliación
Intervalo de año de publicación
1.
Int J Eat Disord ; 55(7): 977-982, 2022 07.
Artículo en Inglés | MEDLINE | ID: mdl-35686716

RESUMEN

OBJECTIVE: We aimed to evaluate the feasibility, acceptability, and potential impact of a tele-guided digital-based intervention based on the addictive appetite model of recurrent binge eating. METHOD: Female college students with bulimia nervosa (BN) or binge-eating disorder (BED) (n = 22) received a 6-week guided intervention targeting addictive processes and emotion regulation. The feasibility of the intervention was evaluated, and the outcomes were assessed at baseline, the end of the intervention, and 1-month follow-up. RESULTS: Of the participants, 86.4% (n = 19) completed the intervention. The self-help materials were viewed 6.03 ± 3.06 times per week, and the duration of using the self-help materials was 113.16 ± 160.19 min/week. The intervention group experienced a significant reduction with a moderate effect on binge eating at the end of the intervention (Hedges' g = 0.58), and the effects lasted through follow-up (Hedges' g = 0.82). DISCUSSION: The results suggest that the digital intervention targeting a maintenance mechanism of recurrent binge eating was feasible and acceptable for patients with BN and BED, proving the potential for symptom improvement. PUBLIC SIGNIFICANCE: The addictive appetite model provides the framework for new interventions to improve treatments for BN and BED. This study found that the digital intervention based on the model was feasible and acceptable for patients with BN and BED.


Asunto(s)
Trastorno por Atracón , Bulimia Nerviosa , Apetito , Trastorno por Atracón/psicología , Bulimia Nerviosa/psicología , Estudios de Factibilidad , Femenino , Humanos , República de Corea
2.
J Magn Reson Imaging ; 47(5): 1237-1250, 2018 05.
Artículo en Inglés | MEDLINE | ID: mdl-28901685

RESUMEN

BACKGROUND: Imaging studies, including computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET), have an essential role in the detection and localization of colorectal liver metastasis (CRLM). PURPOSE: To systematically determine the diagnostic accuracy of multidetector row CT (MDCT), gadoxetate disodium-enhanced MRI, and PET/CT for diagnosing CRLM and the sources of heterogeneity between the reported results. STUDY TYPE: Systematic review and meta-analysis. SUBJECTS: In all, 2151 lesions in CT studies, 2301 lesions in MRI studies, 1846 lesions in PET/CT studies, FIELD STRENGTH: 1.5T and 3.0T. ASSESSMENT: We identified research studies that investigated MDCT, gadoxetate disodium-enhanced MRI, and PET/CT to diagnose CRLM by performing a systematic search of PubMed MEDLINE and EMBASE. Study quality was assessed using Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). STATISTICAL TESTS: According to the types of imaging tests, study heterogeneity and the threshold effect were analyzed and the meta-analytic summary of sensitivity and specificity were estimated. Meta-regression analysis was performed to further investigate study heterogeneity. RESULTS: Of the 860 articles screened, we found 36 studies from 24 articles reporting a diagnosis of CRLM (11 CT studies, 12 MRI studies, and 13 PET/CT studies). The meta-analytic summary sensitivity for CT, MRI, and PET/CT were 82.1% (95% confidence interval [CI], 74.0-88.1%), 93.1% (95% CI, 88.4-96.0%), and 74.1% (95% CI, 62.1-83.3%), respectively. The meta-analytic summary specificity for CT, MRI, and PET/CT were 73.5% (95% CI, 53.7-86.9%), 87.3% (95% CI, 77.5-93.2%), and 93.9% (95% CI, 83.9-97.8%), respectively. There was no threshold effect in any of the imaging tests. Neoadjuvant chemotherapy significantly decreased the sensitivity of CT and MRI (P < 0.01), although it did not significantly affect the sensitivity of PET/CT. The study design, type of reference standard, and study quality also affected the diagnostic performances of imaging studies. DATA CONCLUSION: Despite the heterogeneous accuracy between studies, gadoxetate disodium-enhanced MRI showed the highest sensitivity, and gadoxetate disodium-enhanced MRI and PET/CT had similar specificities for diagnosing CRLM. LEVEL OF EVIDENCE: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:1237-1250.


Asunto(s)
Neoplasias Colorrectales/diagnóstico por imagen , Neoplasias Hepáticas/diagnóstico por imagen , Imagen por Resonancia Magnética , Tomografía Computarizada por Tomografía de Emisión de Positrones , Tomografía Computarizada por Rayos X , Neoplasias Colorrectales/patología , Gadolinio DTPA , Humanos , Neoplasias Hepáticas/secundario , Metástasis de la Neoplasia , Radiofármacos , Análisis de Regresión , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
3.
Pain Med ; 19(12): 2546-2555, 2018 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-29590446

RESUMEN

Objectives: More than half of the patients have reported improper management of breakthrough cancer pain. Empirical evidence is lacking concerning the effectiveness of cancer pain education on breakthrough pain control. This study aimed to examine the effects of individual pain education on pain control, use of short-acting analgesics for breakthrough pain, quality of life outcomes, and rectification of patients' misconceptions regarding cancer pain. Design: A quasi-experimental design was used. In total, 176 (102 inpatients and 74 outpatients) and 163 (93 inpatients and 70 outpatients) cancer patients completed questionnaires on pain intensity, quality of life, use of short-acting medication for breakthrough pain, and misconceptions about cancer pain and opioid use before and immediately and/or seven days after individual pain education. Results: The mean age of the participants was 60.9 years (±11.2), and 56.3% were male. The most common cancers were lung cancer (17.0%), colon cancer (15.9%), and breast cancer (12.5%). The subjects' reasons for attrition were conditional deterioration, death, or voluntary withdrawal (N = 13, 7.4%). Following the education, there was a significant reduction in overall pain intensity over 24 hours (P < 0.001). The outpatients showed more use of short-acting analgesics for breakthrough pain. Sleep quality change was most significantly associated with intervention; other quality of life aspects (e.g., general feelings and life enjoyment) also improved. Pain education also significantly reduced misconceptions regarding cancer pain management. Conclusions: The present educational intervention was effective in encouraging short-acting analgesic use for breakthrough pain, improving quality of life outcomes, and rectifying patients' misconceptions about analgesic use.


Asunto(s)
Analgésicos Opioides/uso terapéutico , Dolor en Cáncer/tratamiento farmacológico , Manejo del Dolor , Calidad de Vida , Adulto , Anciano , Analgésicos/uso terapéutico , Dolor Irruptivo/tratamiento farmacológico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Educación del Paciente como Asunto
4.
Clin Gastroenterol Hepatol ; 15(10): 1509-1520.e4, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28342950

RESUMEN

BACKGROUND & AIMS: It is not clear how best to manage patients with low-risk intraductal papillary mucinous neoplasms (IPMNs) of the pancreas because little is known about IPMN progression to cancer. We sought to determine the cumulative incidence of development of pancreatic cancer in persons with unresected IPMNs (particularly low-risk IPMNs). METHODS: We performed a systematic search of the MEDLINE and Embase databases through November 30, 2016 for studies reporting the cumulative incidence of pancreatic cancer in patients with unresected IPMNs or studies that provided data in sufficient detail for us to calculate cumulative incidence values. We categorized patient series as studies on low-risk IPMNs (lesions without main pancreatic duct involvement or mural nodules) or non-low-risk IPMNs. We calculated meta-analytic cumulative incidence values for pancreatic cancer at 1, 3, 5, and 10 years of follow-up by using the inverse variance method and random-effects model. RESULTS: Among 1514 articles screened, we identified 10 studies of low-risk IPMNs (n = 2411) and 9 studies of non-low-risk IPMNs (n = 825). In studies of low-risk IPMNs, the meta-analytic cumulative incidence values for pancreatic cancer were 0.02% at 1 year (95% confidence interval [CI], 0.0%-0.23%; I2= 0.0%), 1.40% at 3 years (95% CI, 0.58%-2.48%; I2 = 58.5%), 3.12% at 5 years (95% CI, 1.12%-5.90%; I2 = 88.0%), and 7.77% at 10 years (95% CI, 4.09%-12.39%; I2 = 79.8%). These values were much higher in studies of non-low-risk IPMNs; cumulative incidence values for pancreatic cancer were 1.95% at 1 year (95% CI, 0.0%-5.99%; I2 = 84.2%), 5.69% at 3 years (95% CI, 1.10%-12.77%; I2 = 89.9%), 9.77% at 5 years (95% CI, 3.04%-19.27%; I2 = 92.0%), and 24.68% at 10 years (95% CI, 14.87%-35.90%; I2 = 74.3%). The pooled cumulative incidence steadily increased linearly as the follow-up duration increased. CONCLUSIONS: In a systematic review and meta-analysis, we found that low-risk IPMNs have almost 8% chance of progressing to pancreatic cancer within 10 years, and higher-risk IPMNs have almost 25% chance of progressing to cancer in 10 years; incidence values increase linearly with time. Continued long-term surveillance is therefore vital for patients with low-risk IPMNs.


Asunto(s)
Adenocarcinoma Mucinoso/epidemiología , Adenocarcinoma Mucinoso/patología , Carcinoma Ductal Pancreático/epidemiología , Carcinoma Ductal Pancreático/patología , Neoplasias Pancreáticas/epidemiología , Neoplasias Pancreáticas/patología , Progresión de la Enfermedad , Humanos , Incidencia , Medición de Riesgo
5.
J Neurooncol ; 128(2): 185-94, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-27108275

RESUMEN

This study aims to evaluate the value of perfusion MRI as a predictive/prognostic biomarker and a pharmacodynamic biomarker in patients with recurrent glioma treated with a bevacizumab-based regimen. We identified thirteen literature reports that investigated dynamic susceptibility-contrast (DSC) MRI or dynamic contrast-enhanced (DCE) MRI for predicting the patient outcome and analyzing the anti-angiogenic effect of bevacizumab by performing a systematic search of MEDLINE and EMBASE. The relative cerebral volume (rCBV) of DSC-MRI is currently the most common perfusion MRI parameter used as a predictive/prognostic biomarker. Pooled hazard ratios between responders and non-responders, as determined by rCBV, were 0.46 (95 % CI 0.28-0.76) for progression-free survival from five articles with a total 226 patients and 0.47 (95 % CI 0.29-0.76) for overall survival from six articles with a total 247 patients, and thus indicating that rCBV is helpful for predicting disease progression and the eventual outcome after treatment. Regarding the pharmacodynamic value of perfusion MRI parameters derived from either DSC-MRI or DCE-MRI, most perfusion MRI parameters (rCBV, Ktrans, CBVmax, Kpsmax, fpv, Ve and Kep) demonstrated a consistent decrease on the follow-up MRI after treatment, indicating that perfusion MRI may be helpful for evaluating the anti-angiogenic effect of a bevacizumab-based treatment regimen. However, the lack of standardization of imaging acquisition and analysis techniques for various perfusion MRI parameters needs to be resolved in the future. Despite these unsolved issues, the current evidence favoring the use of perfusion MRI as a predictive/prognostic or pharmacodynamic biomarker should be considered in patients with glioma treated using a bevacizumab-based regimen.


Asunto(s)
Bevacizumab/uso terapéutico , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/tratamiento farmacológico , Glioma/diagnóstico por imagen , Glioma/tratamiento farmacológico , Imagen por Resonancia Magnética , Encéfalo/diagnóstico por imagen , Encéfalo/efectos de los fármacos , Encéfalo/metabolismo , Neoplasias Encefálicas/metabolismo , Medios de Contraste , Glioma/metabolismo , Humanos , Recurrencia Local de Neoplasia/diagnóstico por imagen , Recurrencia Local de Neoplasia/tratamiento farmacológico , Recurrencia Local de Neoplasia/metabolismo , Pronóstico
6.
Materials (Basel) ; 12(10)2019 May 16.
Artículo en Inglés | MEDLINE | ID: mdl-31100907

RESUMEN

The aim of this study was to evaluate the bone regeneration effect of recombinant human bone morphogenetic protein-2 (rhBMP-2) on a subperiosteal bone graft in a rat model. A subperiosteal space was made on the rat calvarium, and anorganic bovine bone (ABB), ABB/low bone morphogenetic protein (BMP) (5 µg), and ABB/high BMP (50 µg) were grafted as subperiosteal bone grafts. The new bone formation parameters of bone volume (BV), bone mineral density (BMD), trabecular thickness (TbTh), and trabecular spacing (TbSp) were evaluated by microcomputed tomography (µ-CT), and a histomorphometric analysis was performed to evaluate the new bone formation area. The expression of osteogenic markers, such as bone sialoprotein (BSP) and osteocalcin, were evaluated by immunohistochemistry (IHC). The ABB/high BMP group showed significantly higher BV than the ABB/low BMP (p = 0.004) and control groups (p = 0.000) and higher TbTh than the control group (p = 0.000). The ABB/low BMP group showed significantly higher BV, BMD, and TbTh than the control group (p = 0.002, 0.042, and 0.000, respectively). The histomorphometry showed significantly higher bone formation in the ABB/low and high BMP groups than in the control group (p = 0.000). IHC showed a high expression of BSP and osteocalcin in the ABB/low and high BMP groups. Subperiosteal bone grafts with ABB and rhBMP-2 have not been studied. In our study, we confirmed that rhBMP-2 contributes to new bone formation in a subperiosteal bone graft with ABB.

7.
Ann Surg Treat Res ; 96(6): 283-289, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31183332

RESUMEN

PURPOSE: Long-term results following bariatric surgery compared to conventional treatments has never been reported in morbidly obese Korean patients. This study aimed to evaluate the long-term efficacy of bariatric surgery in morbidly obese Korean patients compared to conventional medical treatments. METHODS: In this multicenter retrospective cohort study, we reviewed 137 obese subjects between January 2008 and February 2011 with a body mass index (BMI) > 30 kg/m2 who had more than 5 years of follow-up clinical data after bariatric surgery (surgery group, n = 49) or conventional treatment (conventional treatment group, n = 88). Anthropometric data and the status of comorbidities were compared between the 2 groups. RESULTS: The median follow-up period was 72.1 months (range 19.3-109.7 months). At the last follow-up, the surgery group showed a greater amount of total weight loss than the conventional treatment group (24.9% vs. 2.8%, P < 0.001). The prevalence of diabetes and hypertension significantly decreased in the surgery group, while the conventional treatment group showed a marked increase in these comorbidities. In the surgery group, Roux-en-Y gastric bypass and sleeve gastrectomy achieved comparable long-term weight loss (26.5% vs. 22.4%, respectively; P = 0.087). CONCLUSION: In the long-term, bariatric surgery achieved and maintained significantly greater weight reduction, as well as a decrease in obesity-related comorbidities, than did conventional medical therapy in morbidly obese Korean patients.

8.
Atherosclerosis ; 290: 66-73, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31586872

RESUMEN

BACKGROUND AND AIMS: Given the potential benefit of medical therapy in patients with non-obstructive coronary artery disease (CAD), there is a need for risk stratification and treatment strategy for these patients. We aimed to develop a risk prediction model for non-obstructive CAD patients for risk stratification and guidance of statin and aspirin therapy. METHODS: From a cohort of consecutive patients who underwent coronary computed tomography angiography (CCTA) (n = 25,087), we identified patients with non-obstructive CAD of 1-49% diameter-stenosis (n = 6243) and developed a risk prediction model for 5-year occurrence of a composite of all-cause mortality, myocardial infarction, and late coronary revascularization using a derivation cohort (n = 4391). RESULTS: Age, sex, hypertension, diabetes, anemia, C-reactive protein, and the extent of non-obstructive CAD were incorporated in the prediction model (risk score 0-13, C-index = 0.716). Patients were categorized into 4 groups; risk score of 0-3 (low-risk), 4-6 (intermediate-risk), 7-9 (high-risk), and ≥10 (very high-risk). Patients with very high-risk demonstrated unfavorable outcome comparable to patients with obstructive CAD. The low-risk group exhibited favorable outcome similar to those with no CAD. While statin therapy was associated with better outcomes in high- or very high-risk group (hazard ratio, 0.62; 95% confidence interval, 0.39-0.96; p = 0.033), aspirin use was associated with an increased risk in low-risk group (hazard ratio, 2.57; 95% confidence interval, 1.34-4.90; p = 0.004). CONCLUSIONS: A dedicated risk scoring system for non-obstructive CAD using clinical factors and CCTA findings accurately predicted prognosis. According to our risk prediction model, statin therapy can be beneficial for high-risk patients, whereas aspirin can be harmful for low-risk patients.


Asunto(s)
Aspirina/uso terapéutico , Toma de Decisiones Clínicas , Enfermedad de la Arteria Coronaria/tratamiento farmacológico , Estenosis Coronaria/tratamiento farmacológico , Técnicas de Apoyo para la Decisión , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Inhibidores de Agregación Plaquetaria/uso terapéutico , Anciano , Aspirina/efectos adversos , Angiografía por Tomografía Computarizada , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/mortalidad , Estenosis Coronaria/diagnóstico por imagen , Estenosis Coronaria/mortalidad , Progresión de la Enfermedad , Femenino , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/efectos adversos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/mortalidad , Infarto del Miocardio/prevención & control , Revascularización Miocárdica , Inhibidores de Agregación Plaquetaria/efectos adversos , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento
9.
Korean J Intern Med ; 33(4): 753-762, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-28859466

RESUMEN

Background/Aims: We evaluated the prevalence and characteristics of thyroid nodules detected by thyroid ultrasound (US) at health checkups and the associated clinical parameters. METHODS: A total of 72,319 subjects who underwent thyroid US at three health checkup centers in Korea from January 2004 to December 2010 were included in this study. The correlations between the presence of thyroid nodules and other clinical parameters were analyzed. RESULTS: The prevalence of thyroid nodules and cysts was 34.2% (n = 24,757). Thyroid nodules were more prevalent in women and older age groups. Among the subjects with thyroid nodules with size information (n = 24,686), 18,833 (76.3%) had nodules measuring ≤ 1.0 cm. Women and older age groups showed higher proportion of larger nodules. Percentage of women, age, body mass index (BMI), waist circumference, body fat composition, blood pressure, and the level of fasting glucose, total cholesterol, and low density lipoprotein cholesterol were higher in the subjects with thyroid nodules compared to those without nodules. The prevalence of metabolic syndrome and overt/subclinical thyrotoxic state was higher in the subjects with thyroid nodules. In the multivariable logistic regression analysis, women, age, BMI, metabolic syndrome, and thyrotoxicosis were independently associated with the presence of thyroid nodules. Conclusions: The high prevalence of thyroid nodules in people who underwent thyroid US at a health checkup suggests that increased detection of thyroid nodules resulted in an increased prevalence in the general population. However, metabolic disturbances may also have contributed to the increase in thyroid nodule prevalence in Korea.


Asunto(s)
Nódulo Tiroideo , Adulto , Anciano , Femenino , Humanos , Masculino , Síndrome Metabólico , Persona de Mediana Edad , Prevalencia , República de Corea/epidemiología , Nódulo Tiroideo/epidemiología , Ultrasonografía , Circunferencia de la Cintura
10.
Blood Res ; 52(1): 31-36, 2017 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-28401099

RESUMEN

BACKGROUND: A number of alternative donor options exist for patients who fail to find domestic HLA-matched donors for allogeneic hematopoietic stem cell transplantation (allo-HSCT). We assessed physicians' perspectives on allo-HSCT donor selection when a matched domestic donor is not available. METHODS: We administered a questionnaire survey to 55 hematologists (response rate: 28%) who attended the annual spring conference of the Korean Society of Haematology in 2015. The questionnaire contained four clinical allo-HSCT scenarios and the respondents were asked to choose the most preferred donor among the given options. RESULTS: In all four scenarios, the hematologists preferred a matched international donor over partially mismatched unrelated domestic or haplo-matched family donors. The numbers of hematologists who chose a matched international donor (HLA 8/8) in cases of acute myeloid leukemia, chronic myeloid leukemia, acute lymphoblastic leukemia, and aplastic anemia were 37 (67.3%), 41 (74.6%), 33 (60.0%), and 36 (65.5%), respectively. The important factors that affected donor selection included "expecting better clinical outcomes (40.5%)" and "lower risk of side effects (23.4%)." The majority of participants (80%) responded that allo-HSCT guidelines for donor selection customized for the Korean setting are necessary. CONCLUSION: Although hematologists still prefer perfectly matched foreign donors when a fully matched domestic allo-HSCT donor is not available, we confirmed that there was variation in their responses. For evidence-based clinical practice, it is necessary to provide further comparative clinical evidence on allo-HSCT from haplo-matched family donors and fully matched unrelated international donors.

11.
Maxillofac Plast Reconstr Surg ; 39(1): 17, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28730146

RESUMEN

BACKGROUND: Schwannomas (or neurilemmomas) of the tongue are benign, usually solitary, encapsulated masses derived from Schwann cells. Clinical evidence indicates that schwannoma is painless and slow growing. In general, schwannoma is treated by surgical excision. Here, we describe a case of schwannoma of the tongue, include a review of the literature from 1955 to 2016, and provide data on age, gender, location, presenting symptoms, size, and treatment methods. CASE PRESENTATION: A 71-year-old female patient presented with a swelling at the base of the tongue of unknown duration. Magnetic resonance images (MRI) showed a large well-circumscribed solid mass and no significant lymph node enlargement. The mass was excised without removing overlying mucosa. CONCLUSIONS: The authors report a case of lingual schwannoma that was completely removed intraorally without preoperative biopsy. No sign or symptoms of recurrence were observed at 12 months postoperatively.

12.
Inflamm Bowel Dis ; 22(3): 669-79, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26457380

RESUMEN

BACKGROUND: To systematically determine the performance of diffusion-weighted imaging magnetic resonance enterography (DWI-MRE) for evaluating bowel inflammation in Crohn's disease and sources of heterogeneity between reported results. METHODS: We identified research studies that investigated DWI-MRE to diagnose bowel inflammation (present versus absent) or to assess bowel inflammatory severity in Crohn's disease by performing a systematic search of PubMed MEDLINE and EMBASE (until March 31, 2015). Study quality was assessed using QUADAS-2. For studies reporting dichotomous diagnosis of bowel inflammation, study heterogeneity and threshold effect were analyzed, summary sensitivity and specificity were estimated, and meta-regression analysis was performed to further explore study heterogeneity. For studies reporting assessment of inflammatory severity, a qualitative summary was performed. RESULTS: Of 159 articles screened, we found 12 studies (1515 bowel segments) reporting a diagnosis of bowel inflammation and 6 studies (1066 bowel segments) reporting assessment of inflammatory severity. The summary sensitivity and specificity were 92.9% (95% CI, 85.8%-96.6%; I = 87.9%) and 91% (95% CI, 79.7%-96.3%; I = 95.1%), respectively. Sensitivity and false-positive rate were inversely correlated (r = -0.650; P = 0.022). Lack of blinding to contrast-enhanced MRE when interpreting DWI-MRE (P = 0.01) and use of contrast-enhanced MRE as a reference standard (P < 0.01) in some studies were significant factors for study heterogeneity and likely caused overestimation of DWI-MRE accuracy. There was rather clear correlation between diffusion-related parameters and bowel inflammation severity, although the strengths were heterogeneous (correlation coefficient, 0.39-0.98). CONCLUSIONS: DWI-MRE accuracy was very heterogeneous between studies and was likely overestimated in some studies. Despite rather clear correlation between diffusion-related parameters and bowel inflammatory severity, its strength was variable.


Asunto(s)
Enfermedad de Crohn/complicaciones , Imagen de Difusión por Resonancia Magnética/métodos , Inflamación/diagnóstico , Intestinos/patología , Enfermedad de Crohn/inmunología , Enfermedad de Crohn/fisiopatología , Estudios de Evaluación como Asunto , Humanos , Inflamación/etiología , Intestinos/inmunología , Pronóstico , Índice de Severidad de la Enfermedad
13.
Yonsei Med J ; 57(4): 956-62, 2016 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-27189291

RESUMEN

PURPOSE: Bariatric surgery is relatively new in Korea, and studies comparing different bariatric procedures in Koreans are lacking. This study aimed to compare the clinical outcomes of laparoscopic adjustable gastric banding (LAGB), Roux-en-Y gastric bypass (RYGB), and sleeve gastrectomy (SG) for treating morbidly obese Korean adults. MATERIALS AND METHODS: In this multicenter retrospective cohort study, we reviewed the medical records of 261 obese patients who underwent different bariatric procedures. Clinical outcomes were measured in terms of weight loss and resolution of comorbidities, such as diabetes, hypertension, and dyslipidemia. Safety profiles for the procedures were also evaluated. RESULTS: In terms of weight loss, the three procedures showed similar results at 18 months (weight loss in 52.1% for SG, 61.0% for LAGB, and 69.2% for RYGB). Remission of diabetes, hypertension, and dyslipidemia was more frequent in patients who underwent RYGB (65.9%, 63.6%, and 100% of patients, respectively). Safety profiles were similar among groups. Early complications occurred in 26 patients (9.9%) and late complications in 32 (12.3%). In the LAGB group, five bands (6.9%) were removed. Among all patients, one death (1/261=0.38%) occurred in the RYGB group due to aspiration pneumonia. CONCLUSION: The three bariatric procedures were comparable in regards to weight-loss outcomes; nevertheless, RYGB showed a higher rate of comorbidity resolution. Bariatric surgery is effective and relatively safe; however, due to complications, some bands had to be removed in the LAGB group and a relatively high rate of reoperations was observed in the RYGB group.


Asunto(s)
Gastrectomía , Derivación Gástrica , Obesidad Mórbida/cirugía , Adulto , Estudios de Cohortes , Comorbilidad , Femenino , Gastrectomía/efectos adversos , Derivación Gástrica/efectos adversos , Humanos , Masculino , Obesidad Mórbida/epidemiología , República de Corea , Estudios Retrospectivos , Resultado del Tratamiento , Pérdida de Peso
14.
Gut Liver ; 9(2): 174-80, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25167804

RESUMEN

BACKGROUND/AIMS: This study was conducted to evaluate whether medical costs can be reduced using endoscopic submucosal dissection (ESD) instead of conventional surger-ies in patients with early gastric cancer (EGC). METHODS: Pa-tients who underwent open gastrectomy (OG), laparoscopy-assisted gastrectomy (LAG), and ESD for EGC were recruited from three medical institutions in 2009. For macro-costing, the medical costs for each patient were derived from the ex-penses incurred during the patient's hospital stay and 1-year follow-up. The overall costs in micro-costing were determined by multiplying the unit cost with the resources used during the patients' hospitalization. RESULTS: A total of 194 patients were included in this study. The hospital stay for ESD was 5 to 8 days and was significantly shorter than the 12-day hospital stay for OG or the 11- to 17-day stay for LAG. Using macro-costing, the average medical costs for ESD during the hospital stay ranged from 2.1 to 3.4 million Korean Won (KRW) per patient, and the medical costs for conventional surgeries were estimated to be between 5.1 million and 8.2 million KRW. There were no significant differences in the 1-year follow-up costs between ESD and conventional surger-ies. CONCLUSIONS: ESD patients had lower medical costs than those patients who had conventional surgeries for EGC with conservative indications. (Gut Liver, 2015;9174-180).


Asunto(s)
Costos y Análisis de Costo , Disección/economía , Gastrectomía/economía , Gastroscopía/economía , Neoplasias Gástricas/cirugía , Disección/métodos , Gastrectomía/métodos , Mucosa Gástrica/cirugía , Gastroscopía/métodos , Humanos , Laparoscopía , Tiempo de Internación/estadística & datos numéricos , República de Corea , Neoplasias Gástricas/patología
15.
J Korean Surg Soc ; 83(6): 335-42, 2012 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-23230551

RESUMEN

PURPOSE: In Korea, the results of bariatric surgery have not been compared with those of nonsurgical treatment. The purpose of this study was to evaluate the effectiveness and safety of bariatric surgery vs. conventional nonsurgical treatment in severely obese Koreans. METHODS: In this retrospective cohort study, we reviewed the medical charts of 261 consecutive subjects who underwent bariatric surgery and 224 subjects who were treated with weight control medication and lifestyle modification therapy between January 2008 and February 2011. Measures of clinical effectiveness, including change in weight (%) and comorbid diseases, and occurrence of complications, were investigated for 18 months after bariatric surgery. RESULTS: Body mass index (BMI) was higher in the surgery group than in the conventionally treated group (mean ± standard deviation, 39.0 ± 6.2 vs. 34.3 ± 3.8). Diabetes was more prevalent in the surgery group than in the conventionally treated group (39.1% vs. 12.9%). The change in weight (%) between baseline and 18 months posttreatment was significantly greater in the surgery group (22.6%) than in the conventional therapy group (6.7%). While 57%, 47%, and 84% of subjects recovered from diabetes, hypertension, and dyslipidemia, respectively, in the surgery group, 10%, 20%, and 24% of subjects recovered from these conditions in the conventional group. Fifty-one subjects (19.5%) in the surgery group reported 61 complications (23.4%). CONCLUSION: Bariatric surgery in Korea was significantly more effective than conventional treatment for weight loss and recovery from comorbidities such as diabetes, hypertension, and dyslipidemia, with a reasonable complication rate.

SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA