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OBJECTIVES: This study aimed to evaluate the outcomes and anatomical predictors of the complications of flared limb (FL) use for ectatic common iliac arteries accompanied by abdominal aortic aneurysm treated with endovascular aneurysm repair (EVAR). METHODS: In this single-center retrospective study, we reviewed data from 391 patients (638 limbs) treated between 2005 and 2020. The cohort was divided into two groups. The standard limbs (SLs, n = 403) included stent graft (SG) of <20 mm in diameter and the FLs (n = 235) included stent graft of ≥20 mm in diameter. Complications within 30 days were investigated as the short-term outcome. Limb events during follow-up including type Ib endoleak (EL), type IIIa EL, and limb occlusion were compared between SLs and FLs using log-rank test. RESULTS: Early results indicated that the FL group had a significantly higher incidence of intraoperative type Ib EL at 5.1% (12), than 1.7% (7) in the SLs (p = .016). For 19 patients in whom intraoperative type Ib EL was discovered, SG extension alone or internal iliac artery embolization was all performed before completing the procedure. Overall, we noted one case of type Ib EL and two cases of limb events in each group at 30 days. Over a median follow-up of 39 months, 31 (4.9%) events (17 type Ib EL, 2 type IIIa EL, and 12 limb events), 13 (5.5%) in FLs and 18 (4.5%) in SLs (p = .984), were observed. The FLs had significantly higher rates of aortic sac enlargement, with 46 (19.6%) cases for FLs and 36 (8.9%) for SLs (p < .001). The Kaplan-Meier analysis revealed significant differences at 5 years in SLs versus FLs for freedom from type Ib EL (96.6% vs 82.4%, respectively; p < .001) and no difference in freedom from limb events (94.7% vs 84.5%, respectively; p = .519). Furthermore, no difference was observed for overall survival and aneurysm-related mortality. CONCLUSIONS: Although an FL for EVAR is used to treat dilated iliac arteries, there is an increased risk of intraoperative and late type Ib EL and aortic sac enlargement. Long-term close follow-up is mandatory, especially in the patients who undergo EVAR using FLs.
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We propose the introduction of a magnesium oxide (MgOx) layer to reduce the temperature required for the activation of indium gallium zinc oxide (IGZO) thin films. By incorporating the MgOx layer between the IGZO channel layer and the gate insulator layer, the required activation temperature is lowered from 300 to 200 °C while enhancing the electrical performance of the IGZO thin-film transistor (TFT). Specifically, the field effect mobility is improved from 6.40 to 16.12 cm2/(V s), the on/off current ratio is enhanced from 1.62 × 109 to 7.16 × 109, and subthreshold swing is enhanced from 0.48 to 0.46 V/decade. Furthermore, IGZO TFTs with the MgOx layer exhibit enhancements in threshold voltage (VTH) shift compared to TFTs without the MgOx layer under positive bias stress (VGS = 20 V and VDS = 0.1 V for 10,000 s) and negative bias stress (VGS = -20 V and VDS = 0.1 V for 10,000 s): the VTH shifts are decreased from 2.40 to 1.72 V and from 0.56 to 0.53 V, respectively. These enhancements are verified through various analyses and are attributed to the diffusion of Mg atoms into the IGZO front channel during the low-temperature activation process, which results in the formation of Mg-doped IGZO between the MgOx and IGZO channel layers.
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Purpose: This study was performed to analyze the association between age and outcomes of carotid endarterectomy (CEA) by comparing postoperative outcomes between octogenarians and younger patients. Methods: From November 1994 to December 2022, 1,585 internal carotid arteries of 1,434 patients were enrolled. Patients were stratified into 2 groups: octogenarians (≥80 years old) and non-octogenarians (<80 years old). Primary endpoints were early (≤30 days) outcomes of ipsilateral stroke, any stroke, myocardial infarction, death, and major adverse cardiovascular events (MACE). We also compared overall any stroke and death between the 2 groups. Results: One of 132 octogenarians (0.8%) and 17 of 1,453 non-octogenarians (1.1%) experienced ipsilateral stroke within 30 days. Thirty-day MACE occurred in 4 of 132 octogenarians (3%) and 44 of 1,453 non-octogenarians (3%). There were no significant differences in any early (≤30 days) outcomes. Symptomatic status was associated with increased 30-day MACE (odds ratio [OR], 2.610; 95% confidence interval [CI], 1.450-4.696; P = 0.003) and 30-day any stroke (OR, 3.999; 95% CI, 1.627-9.828; P = 0.003). Symptomatic status was also associated with overall any stroke (hazard ratio [HR], 2.885; 95% CI, 1.865-4.463; P < 0.001), but age of ≥80 years was not associated with 30-day MACE, 30-day any stroke, or overall stroke. Age of ≥80 years was only associated with overall survival (HR, 2.644; 95% CI, 1.967-3.555; P < 0.001). Conclusion: CEA would be a safe and effective treatment for octogenarians with low 30-day complications and long-term stroke rates, comparable with that of younger counterparts. Advanced age is not a contraindication for CEA.
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Effective oral care is important for maintaining a high quality of life. Therefore, plaque control can prevent the development and recurrence of periodontitis. Brushing with a toothbrush and toothpaste is a common way to remove plaque; however, excessive brushing or brushing with abrasive toothpaste can cause wear and tear on the dental crown. Hence, we aimed to quantitatively compare the plaque-removal efficiency and tooth wear of toothbrushes using the bioelectric effect (BE) with those of electric-mechanical toothbrushes. To generate the BE signal, an electronic circuit was developed and embedded in a toothbrush. Further, typodonts were coated with cultured artificial plaques and placed in a brushing simulator. A toothpaste slurry was applied, and the typodonts were eluted with tap water after brushing. The plaques of the typodonts were captured, and the images were quantified. For the tooth wear experiment, polymethyl methacrylate disk resin blocks were brushed twice a day, and the thickness of the samples was measured. Subsequently, statistical differences between the experimental toothbrushes and typical toothbrushes were analyzed. The BE toothbrush had a higher plaque-removal efficiency and could minimize tooth wear. This study suggests that the application of BE may be a new solution for oral care.
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BACKGROUND: Carotid body paraganglioma (CBP) is a rare, highly vascularized, and slow-growing neuroendocrine tumor. Surgical resection is the definitive treatment for CBP, however, it remains challenging due to the tumor's proximity to critical blood vessels and cervical cranial nerves. This study aimed to document the characteristics of CBP and examine the clinical outcomes of patients following surgical extirpation of CBP. METHODS: This is a single-center retrospective review analyzed patients who underwent CBP extirpation. We examined the patient demographics, preoperative clinical features, tumor characteristics, levels of catecholamines and their metabolites in the serum and urine. Surgeries were performed by one vascular surgeon with follow-ups at 1,3,6 months and yearly thereafter. Logistic regression analysis was conducted to identify risk factors associated with the occurrence of either permanent or temporary cervival cranial nerve palsy (CNP). RESULTS: From September 2020 to February 2023, this study examined 21 cases of CBP removal surgeries that were carried out in 19 patients. The mean age of the patients was 38.9 ± 10.9 years and the percentage of males was 57.1% (n = 12). The most common preoperative clinical feature was painless neck mass (n = 12; 57.1%). Complete resection was achieved in 20 cases; excluding one case with pathologically proven sclerosing paraganglioma. Vascular procedures were performed in four cases (ECA resection, n = 2; primary repair of ICA tear without carotid shunting, n = 1; and ICA patch angioplasty with carotid shunting, n = 1). Temporary cranial neurologic complications, specifically aspiration and hoarseness occurred in four (19.0%), and three (14.3%) cases, respectively. Hoarseness associated with permanent CNP persisted for more than 6 months in two cases (9.5%). No recurrence or mortality was observed during the follow-up period. CONCLUSIONS: Surgical resection is the primay treatment approach for CBP; however, it poses risks of vascular or cervical CNP. The intraoperative estimated blood loss was the only identified risk factor for CNP.
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Tumor do Corpo Carotídeo , Humanos , Masculino , Feminino , Tumor do Corpo Carotídeo/cirurgia , Tumor do Corpo Carotídeo/patologia , Estudos Retrospectivos , Adulto , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Seguimentos , Prognóstico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Resultado do TratamentoRESUMO
Purpose: Type 2 endoleaks (T2EL) are the most common form of endoleaks after endovascular aneurysm repair (EVAR). Several studies on the feasibility of embolization using ethylene vinyl alcohol copolymer (Onyx, Medtronic) for T2EL have been reported. The purpose of this study was to compare coil and Onyx embolization for T2EL treatment after EVAR. Methods: Between August 2005 and July 2022, 46 patients underwent endovascular embolization for treatment of T2EL (15 Onyx and 31 coils). The primary endpoint was endoleaks resolution or significant aneurysm sac growth of >5 mm in maximal diameter after T2EL embolization. In addition, periprocedural factors, reintervention, sac rupture, and survival analysis were assessed. Results: The follow-up period after embolization was significantly shorter in the Onyx group (11.6 months vs. 34.7 months, P = 0.016), and there was no difference in aneurysm sac growth rate between both groups (20.0% vs. 51.6%; P = 0.472, log-rank test). However, cases with multiple endoleak origins tended to be treated with Onyx (P = 0.002). When applying Onyx, there was no significant difference in results between the transarterial and translumbar approaches. Conclusion: There appears to be no significant difference in the results of Onyx and coil embolization for T2EL treatment, although it is difficult to evaluate effectiveness due to the small number of cases and short follow-up period. However, in cases of multiple origin endoleaks or when the transarterial approach is not feasible, the Onyx by translumbar approach may be a more effective method.
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Melatonin, a pineal hormone that modulates circadian rhythms, sleep, and neurotransmitters, is widely used to treat sleep disorders. However, there are limited studies on the safety of melatonin. Therefore, we aimed to present the overall patterns of adverse events (AEs) following melatonin administration and identify potential safety signals associated with melatonin. Using VigiBase, a global individual case safety report (ICSRs) database managed by the World Health Organization (WHO), we conducted a retrospective, observational, pharmacovigilance study of melatonin between January 1996 and September 2022. Disproportionality analysis was conducted using two comparator settings: all other drugs and other sleep medications. We used multivariable logistic regression to estimate reporting odds ratios (RORs) with 95% confidence intervals (CIs) to compare the frequencies of AEs reporting between melatonin and each comparator setting. Furthermore, we assessed adverse events of special interests (AESIs) that could potentially be associated with melatonin. Signals were identified when the following criteria were met: cases ≥3, x2 ≥ 4, IC025 ≥ 0, and the lower end of the 95% CI of ROR > 2. These signals were then compared with the AE information on the drug labels provided by regulatory bodies. A total of 35 479 AE reports associated with melatonin were identified, with a higher proportion of reports from females (57.1%) and individuals aged 45-64 years (20.8%). We identified 21 AEs that were commonly detected as safety signals in the disproportionality analyses, including tic, educational problems, disturbance in social behavior, body temperature fluctuation, and growth retardation. In AESI analyses, accidents and injuries (adjusted ROR 2.97; 95% CI, 2.80-3.16), fall (2.24; 2.12-2.37), nightmare (4.90; 4.37-5.49), and abnormal dreams (3.68; 3.19-4.25) were detected as a signal of melatonin when compared to all other drugs, whereas those signals were not detected when compared to other sleep medications. In this pharmacovigilance study, exogenous melatonin showed safety profiles comparable to other sleep medications. However, several unexpected potential safety signals were identified, underscoring the need for further investigation at the population level.
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Melatonina , Farmacovigilância , Feminino , Humanos , Sistemas de Notificação de Reações Adversas a Medicamentos , Melatonina/efeitos adversos , Estudos Retrospectivos , Organização Mundial da SaúdeRESUMO
BACKGROUND: Although obese patients seem to be susceptible to chronic diseases, obesity paradox has been observed in the field of vascular surgery, in which many previous studies have reported that overweight patients have good postoperative outcomes and underweight patients have poor postoperative outcomes. The purpose of our study is to evaluate the impact of body mass index (BMI) and serum albumin levels, which are evaluated as indicators of nutritional status, on outcomes of open abdominal aortic aneurysm (AAA) repair. METHODS: We reviewed the vascular surgery database of a single tertiary referral center for all patients who underwent open AAA repair due to degenerative etiology from 1996 to 2021. To analyze the effect of BMI, patients were classified into 4 groups according to the Asian-Pacific classification of BMI: underweight (UW) (<18.5 kg/m2), normal weight (NW) (18.5-22.9 kg/m2), overweight (OW) (23-24.9 kg/m2), and obese (OB) (≥25 kg/m2). The χ2, Fisher's exact, and Kruskal-Wallis tests were used to compare demographics, comorbidities, radiologic findings, surgical details, and 1-year mortality rates between the 4 groups. We also compared the preoperative serum albumin levels of each group to assess nutritional status indirectly. Cox's proportional hazards model was performed to determine factors associated with mortality. A Kaplan-Meier survival analysis was performed, and the differences were analyzed by a log-rank test. We did not perform an analysis for 30-day mortality because cases of 30-day mortality in UW patients were rare due to the unbalanced distribution of the number of patients in the 4 groups. RESULTS: Among a total of 678 patients, 22 were classified as UW (3.2%), 200 as NW (29.5%), 183 as OW (27.1%), and 273 as OB (40.1%). The median age was 70 (64-75) years and 577 of 678 (85.1%) patients were male gender. Higher serum albumin level was associated with decreased 1-year mortality (hazard ratio [HR], 0.3; 95% confidence interval [CI], 0.15-0.63; P = 0.001). UW patients had a higher 1-year mortality rate than NW patients (HR, 3.67; 95% CI, 1.02-13.18; P = 0.046). OB patients had a lower overall mortality rate than NW patients (HR, 0.73; 95% CI, 0.53-1; P = 0.05). CONCLUSIONS: Low BMI (<18.5 kg/m2) and low serum albumin level were associated with poor 1-year survival after elective open AAA repair. These patients also need more careful preoperative intervention, like weight gain or nutritional support, for better outcomes. The obesity paradox existed in our study; high BMI (≥25 kg/m2) was associated with better overall survival after elective open AAA repair.
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Aneurisma da Aorta Abdominal , Sobrepeso , Idoso , Feminino , Humanos , Masculino , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aneurisma da Aorta Abdominal/cirurgia , Aneurisma da Aorta Abdominal/complicações , Índice de Massa Corporal , Obesidade/complicações , Obesidade/diagnóstico , Obesidade/epidemiologia , República da Coreia , Estudos Retrospectivos , Fatores de Risco , Albumina Sérica , Magreza/diagnóstico , Resultado do Tratamento , Procedimentos Cirúrgicos Vasculares/efeitos adversosRESUMO
Chub mackerels (Scomber japonicus) are a migratory marine fish widely distributed in the Indo-Pacific Ocean. They are globally consumed for their high Omega-3 content, but their population is declining due to global warming. Here, we generated the first chromosome-level genome assembly of chub mackerel (fScoJap1) using the Vertebrate Genomes Project assembly pipeline with PacBio HiFi genomic sequencing and Arima Hi-C chromosome contact data. The final assembly is 828.68 Mb with 24 chromosomes, nearly all containing telomeric repeats at their ends. We annotated 31,656 genes and discovered that approximately 2.19% of the genome contained DNA transposon elements repressed within duplicated genes. Analyzing 5-methylcytosine (5mC) modifications using HiFi reads, we observed open/close chromatin patterns at gene promoters, including the FADS2 gene involved in Omega-3 production. This chromosome-level reference genome provides unprecedented opportunities for advancing our knowledge of chub mackerels in biology, industry, and conservation.
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Cyprinidae , Genoma , Perciformes , Animais , Cromossomos , Cyprinidae/genética , Oceano Pacífico , Perciformes/genéticaRESUMO
Dental implant inflammation is primarily caused by oral biofilms, which form within 8 h, particularly at 37 °C, thereby requiring diligent cleaning. Considering the complex management of dental implants, a novel technology based on the bioelectric effect (BE) to combat inflammation has emerged. A BE-integrated toothbrush was developed and clinically tested on patients with dental implants (N = 36). Our findings revealed a significant average plaque index reduction of 67% with BE technology compared with that at baseline (P < 0.05), whereas non-BE did not yield statistical significance even after 4 weeks of use (P > 0.05). The bleeding index demonstrated a 59% average reduction in all surfaces with BE technology (P < 0.05), whereas the non-BE group exhibited no significant change. Substantial reductions in total plaque and bleeding indices suggest that using BE toothbrushes can help effectively remove oral biofilms and treat bleeding symptoms.
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Implantes Dentários , Gengivite , Humanos , Método Simples-Cego , Escovação Dentária , Inflamação/terapia , Biofilmes , Índice de Placa Dentária , Desenho de Equipamento , Gengivite/terapiaRESUMO
Pancreaticoduodenal and gastroduodenal artery aneurysms (PDAAs and GDAAs) are rare visceral aneurysms. Considering the rupture risk regardless of size, treatment should be provided promptly. We reviewed the characteristics and management of peripancreatic aneurysms in a retrospective, single-center review of consecutive patients with PDAAs and GDAAs between 2000 and 2022. Demographics, clinical characteristics, radiologic features, treatment, and outcomes were recorded. Nineteen PDAAs and seven GDAAs were identified in 24 patients. The median sizes of the PDAAs and GDAAs were 21 mm (range: 8-50 mm) and 14 mm (range: 11-32 mm), respectively. There were 4 ruptured cases (15.4%). Ten aneurysms (38.5%) had concomitant visceral aneurysms, and 16 (61.6%) were associated with celiac pathology. Aneurysms were managed using endovascular in 12 (46.2%), surgical in 4 (15.4%), and combined methods in 3 (11.5%) cases; 7 patients (26.9%) were lost to follow-up or refused treatments. During a median 13.8-month follow-up (range: 1-147.6), two complications (7.7%) occurred including pancreatitis and coil migration into the superior mesenteric artery after embolization within 30 days. After 30 days, aorto-common hepatic artery bypass graft stenosis was identified in one PDAA. Depending on the characteristics of peripancreatic aneurysms, endovascular, surgical, and hybrid approaches might all be practical treatment options.
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Effective oral care is a critical requirement to maintain a high quality of life. Most oral diseases are caused by plaque (oral biofilm), which is also correlated with systemic diseases. A common method to remove biofilm is brushing teeth with toothpaste. However, 3.5 billion people in the world have oral diseases, meaning that more efficient methods of removing biofilms are needed. We have developed a toothbrush that applies a bioelectric effect (BE) utilizing an electric force for biofilm removal. It demonstrated significantly higher biofilm removal efficiency than non-BE manual toothbrushes. Tests were performed in saline and toothpaste conditions using various pressures. Results showed that the BE toothbrush had a significantly higher biofilm removal efficiency in saline (0.5 N: 215.43 ± 89.92%, 2.5 N: 116.77 ± 47.02%) and in a toothpaste slurry (0.5 N: 104.96 ± 98.93%, 2.5 N: 96.23 ± 35.16%) than non-BE manual toothbrushes. Results also showed that BE toothbrushes were less dependent on toothpaste. This study suggests that the application of BE can be a new solution to plaque problems in oral care.
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Aortic endograft infection (AEI) is a rare but life-threatening complication of endovascular aneurysm repair (EVAR). The clinical features of AEI range from generalized weakness and mild fever to fatal aortic rupture or sepsis. The diagnosis of AEI usually depends on clinical manifestations, laboratory tests, and imaging studies. Management of Aortic Graft Infection Collaboration (MAGIC) criteria are often used to diagnose AEI. Surgical removal of the infected endograft, restoration of aortic blood flow, and antimicrobial therapy are the main components of AEI treatment. After removing an infected endograft, in situ aortic reconstruction is often performed instead of an extra-anatomic bypass. Various biological and prosthetic aortic grafts have been used in aortic reconstruction to avoid reinfection, rupture, or occlusion. Each type of graft has its own merits and disadvantages. In patients with an unacceptably high surgical risk and no evidence of an aortic fistula, conservative treatment can be an alternative. Treatment results are determined by bacterial virulence, patient status, including the presence of an aortic fistula, and hospital factors. Considering the severity of this condition, the best strategy is prevention. When encountering a patient with AEI, current practice emphasizes a multidisciplinary team approach to achieve an optimal outcome.
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Unlike other visceral artery aneurysms, pancreaticoduodenal artery aneurysms (PDAAs) should be treated regardless of their size. There are no reports on PDAA associated with celiac artery (CA) dissection. We, here, report the case of a patient with a ruptured PDAA with concomitant CA dissection. A 44-year-old Korean man presented to the emergency room of another hospital 29 days ago due to a sudden onset of abdominal pain. Contrast-enhanced abdominal computed tomography (CT) revealed a large right retroperitoneal hematoma and CA dissection. Subsequently, aortography revealed no specific bleeding focus. He underwent conservative treatment for 16 days, including a transfusion, and then was referred to us. His abdominal CT angiography revealed a diminishing retroperitoneal hematoma, a 7 mm × 8 mm PDAA at the anterior inferior pancreaticoduodenal artery aneurysm (PDA), and CA dissection. Selective celiac angiography revealed sluggish and diminished blood flow to the true lumen of the CA, and the hepatic, gastroduodenal, and splenic arteries were supplied by collaterals arising from the superior mesenteric artery (SMA). We performed elective coil embolization of the anterior PDA using the right femoral approach.We believe that postprocedural surveillance is required after CA dissection because of the potential risk of recurrent PDAA. Additionally, we suggest that hidden PDAA rupture should be considered for spontaneous retroperitoneal bleeding.
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Aneurisma Roto , Embolização Terapêutica , Masculino , Humanos , Adulto , Artéria Celíaca/diagnóstico por imagem , Pâncreas/diagnóstico por imagem , Pâncreas/irrigação sanguínea , Embolização Terapêutica/efeitos adversos , Resultado do Tratamento , Aneurisma Roto/diagnóstico por imagem , Aneurisma Roto/etiologia , Aneurisma Roto/terapia , AortografiaRESUMO
OBJECTIVES: To validate the accuracy of high-risk criteria for carotid endarterectomy (CEA) and analyze the correlation between age and outcome of CEA and carotid artery stenting (CAS) in risk groups. METHODS: We reviewed a prospectively managed vascular surgery database in a single tertiary referral center, and 2482 internal carotid arteries (ICAs) had undergone carotid revascularization from November 1994 to December 2021. To validate high-risk criteria for CEA, patients were classified as high risk (Hr) and normal risk (Nr). Subgroup analysis was performed with patients older or younger than 75 years to investigate the relationship between age and outcome in each group. Primary endpoints were 30-day outcomes including stroke, death, stroke/death, myocardial infraction (MI), and major adverse cardiovascular events (MACEs). RESULTS: A total of 2345 ICAs in 2256 patients were enrolled. The number of patients in the Hr group was 543 (24%) and the number in the Nr group was 1713 (76%). CEA and CAS were performed on 1384 (61%) and 872 (39%) patients, respectively. The 30-day stroke/death rate was higher with CAS than CEA in both the Hr (1.1% vs. 3.9%, p = 0.032) and Nr (1.2% vs. 6.9%, p < 0.001) groups. In unmatched logistic regression analysis of the Nr group (n = 1778), the rate of 30-day stroke/death (OR, 5.575; 95% CI, 2.922-10.636; p < 0.001) was higher for CAS than CEA. In propensity score matching of the Nr group, the rate of 30-day stroke/death (OR, 5.165; 95% CI, 2.391-11.155; p < 0.001) was also higher for CAS than CEA. In the age <75 subgroup of the Hr group (n = 428), CAS was associated with higher 30-day stroke/death (OR, 14.089; 95% CI, 1.314-151.036; p = 0.029). In the age ≥75 subgroup of the Hr (n = 139), there was no difference in 30-day stroke/death between CEA and CAS. In the age <75 subgroup of the Nr group (n = 1318), 30-day stroke/death (OR, 6.300; 95% CI, 2.797-14.193; p < 0.001) was higher in CAS. In the age ≥75 subgroup of the Nr group (n = 460), 30-day stroke/death (OR, 6.468; 95% CI, 1.862-22.471; p = 0.003) was higher in CAS. CONCLUSIONS: In patients older than 75 years in the Hr group, there were relatively poor 30-day treatment outcomes in both CEA and CAS. Alternative treatment is needed that can expect better outcomes in older high-risk patients. In the Nr group, CEA has a significant benefit compared with CAS, and CEA should be recommended more to these patients.
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Background: Depression has been recognized as one of the most significant factors affecting mental health status. For this reason, several efforts to prevent and reduce depression in all ages have been made in various domains to identify the relevant factors as well as the causes of depression. The objective of this meta-analysis was to examine the effect size between physical fitness and depression in adolescents and adults. Methods: A systematic search for meta-analysis (2009-2020) was performed using PubMed, Scopus, Web of Science, and RISS, with key terms such as depression, depressive illness, and physical fitness or fitness. Overall, 19 out of 448 articles were included in the meta-analysis with strict inclusion criteria. Results: The effect size is a medium between physical fitness and depression in adolescents and adults. Two fitness factors, namely cardiovascular endurance and muscle strength, are more relevant for alleviating depression in adolescents and adults, whereas agility was not related to depression. In particular, the cardiovascular fitness factor has an impact on almost all ages; however, muscular strength has less impact on depression in young adolescents, but has a great impact on older adults' depression. Conclusion: The effect size in this study is a medium between physical fitness and depression in adolescents and adults. Thus, more longitudinal and clinical studies with larger sample sizes are needed to clarify the relationship between physical fitness and depression.
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Purpose: Exposure to ionizing radiation over the head and neck accelerates atherosclerotic changes in the carotid arteries. Owing to the characteristics of radiation-induced carotid stenosis (RICS), the results regarding the optimal revascularization method for RICS vary. This study compared treatment outcomes between carotid endarterectomy (CEA) and carotid artery stenting (CAS) in RICS. Methods: This was a single-center retrospective review of consecutive patients who underwent CEA or CAS for carotid stenosis. RICS was defined as carotid stenosis (>50%) with the prior neck irradiation for cancer treatment on either side. For the analyses, demographics, comorbid conditions, carotid lesion characteristics based on imaging studies, surgical complications, neurologic outcomes, and mortality during the follow-up period were reviewed. To compare CEA and CAS results in RICS, a 1:1 propensity score matching was applied. Results: Between November 1994 and June 2021, 43 patients with RICS and 2,407 patients with non-RICS underwent carotid revascularization with CEA or CAS. RICS had fewer atherosclerotic risk factors and more frequent severe carotid stenosis and contralateral carotid occlusions than non-RICS. CAS was more commonly performed than CEA (22.9% vs. 77.1%) for RICS due to more frequent unfavorable carotid anatomy (0 vs. 16.2%). Procedure-related complications were more common in the CEA than in the CAS. However, there was no significant difference in neurologic outcomes and restenosis rates between CEA and CAS in RICS. Conclusion: Considering its lesion characteristics and cumulative incidence, RICS requires more attention than non-RICS. Although CAS has broader indications for RICS, CEA has shown acceptable results if selectively performed.
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Background: Although coronavirus disease 2019 is causing a variety of psychological problems for workers, there are few longitudinal studies on changes in workers' mental health by workplace intervention. This study aimed to evaluate the change in the prevalence of depression and anxiety according to the active involvement of the workplace. Methods: This study was conducted on 1,978 workers at a workplace who underwent a health screening from January 2019 to August 2020, and classified depression and anxiety disorders using a self-report questionnaire. After the first pandemic, the company stopped health screening, took paid leave and telecommuting, and conducted interventions such as operating its own screening clinic. To see if this workplace intervention affects workers' mental health, we conducted generalized estimating equations to compare odds ratio (OR). Results: In the pre-intervention group, 384 people (16.86%) had depression, and 507 people (22.26%) had anxiety disorder. Based on the OR before intervention, the OR of depression decreased to 0.76 (0.66-0.87) and the OR of anxiety disorder decreased to 0.73 (0.65-0.82). Conclusions: As a result of this study, it was confirmed that workplace intervention was related to a decrease in depression and anxiety. This study provides basic data to improve workers' mental health according to workplace intervention, and further research is needed according to workplace intervention in the future.
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Oral healthcare is a critical condition for high quality of life. According to statistics, gingivitis is one of major diseases in the world (The Global Burden of Disease Study 2019, 3.5 billion population worldwide). Oral diseases, that initiated by a group of multispecies bacteria with diverse extracellular slime that called biofilms, are modifiable risk factors with the cancer, cardiovascular disease, chronic respiratory disease. Hence, effective management of biofilms is important. Since biofilms are comprised of extracellular matrix that inhibit drug diffusion, the traditional antibiotic treatment requires 500 -5000 times more concentration than planktonic bacterial infection. The biofilm cleaning in dentistry includes time-consuming and painful physical brushing. In this work, we have developed a new electric toothbrush in emphasis on demonstration of convenient and painless gingivitis improvement device. For the first time, the toothbrush has been integrated with an electromagnetic technology for effective biofilm removal, known for bioelectric effect (BE). Biofilms consists of electrically charged molecules that are affected by external electric fields. Thus, when an electric field is applied, it creates interruption of metabolism, reduction of enzyme activity, weakening surface attachment, and nonuniform electrolyte distribution, resulting in separation from the surface. Thus, integration of the BE on a toothbrush enables enhanced biofilm reduction. The toothbrush tested with mild gingival patient (N=40) at the department of dentistry, Ulsan University Hospital, South Korea. The patient used the BE toothbrush and non-BE toothbrush consecutively for 2 weeks in each, following their gingival index (GI) and plaque index (PI) measurement for the quantitative analysis. The results demonstrate 1.75 times more decrease of GI in BE toothbrush than the data of the non-BE device (p < 0.05). In conclusion, a new electromagnetic wave toothbrush has been successfully demonstrated especially in reduction of inflammation. Based on this work, we are going to further develop a medical device that dedicated on the treatment of inflammation.
Assuntos
Gengivite , Qualidade de Vida , Biofilmes , Atenção à Saúde , Gengivite/terapia , Humanos , InflamaçãoRESUMO
BACKGROUND: Although the first choice of treatment for abdominal aortic aneurysm (AAA) is endovascular aneurysm repair, especially in elderly patients, some patients require open surgical repair. The purpose of this study was to compare the mortality outcomes of open AAA repair between octogenarians and younger counterparts and to identify the risk factors associated with mortality. METHODS: All consecutive patients who underwent elective open AAA repair due to degenerative etiology at a single tertiary medical center between 1996 and June 2020 were included in this retrospective review. Medical records and imaging studies were reviewed to collect the following information: demographics, comorbid medical conditions, clinical presentations, radiologic findings, surgical details, and morbidity and mortality rates. For analysis, patients were divided into two groups: older and younger than 80 years of age. Multivariate analysis was performed to identify factors associated with mortality after elective open AAA repair. RESULTS: Among a total of 650 patients who underwent elective open AAA repair due to degenerative AAA during the study period, 58 (8.9%) were octogenarians and 595 (91.1%) were non-octogenarians. Patients in the octogenarian group were predominantly female and more likely to have lower body weight and body mass index (BMI), hypertension, chronic kidney disease, and lower preoperative serum hemoglobin and albumin compared with patients in the non-octogenarian group. Maximal aneurysm diameter was larger in octogenarians. During the median follow-up duration of 34.4 months for 650 patients, the median length of total hospital and intensive care unit stay was longer in octogenarians. The 30-day (1.7% vs. 0.7%, P = 0.374) and 1-year (6.9% vs. 2.9%, P = 0.108) mortality rates were not statistically significantly different between the two groups. Multivariate analysis showed that low BMI was associated with increased 30-day (odds ratio [OR], 16.339; 95% confidence interval [CI], 1.192-224.052; P = 0.037) and 1-year (OR, 8.236; CI, 2.301-29.477; P = 0.001) mortality in all patients. CONCLUSION: Because the mortality rate of octogenarians after elective open AAA repair was not significantly different compared with their younger counterparts, being elderly is not a contraindication for open AAA repair. Low BMI might be associated with increased postoperative mortality.