Is Rheumatoid Arthritis Related to Coffee Consumption in Korea? A Nationwide Cross-Sectional Observational Study.

Coffee consumption is gradually increasing in Korea. As a result, interest in the relationship between coffee consumption and various diseases is growing. Several factors affect the development of rheumatoid arthritis (RA), and coffee consumption may be related. We conducted a nationwide cross-sectional study using data from the Korea National Health and Nutrition Examination Survey (2012-2016). A total of 12,465 eligible participants (4819 men and 7646 women) were included in the study. Participants with RA were defined as those who were diagnosed and currently being treated by physicians. Daily coffee consumption amounts were categorized as none, <1 cup, 1-2 cups, 2-3 cups, and ≥3 cups a day based on a self-report. A multivariable logistic regression model was employed, and we calculated the odds ratios (ORs) and 95% confidence intervals (CIs) for the odds of participants having RA with respect to coffee consumption. Compared to the no-coffee group, the ORs for RA in the <1 cup and 1-2 cups groups were 2.99 (95% CI 0.33-27.28) and 2.63 (95% CI 0.31-22.63) in men, respectively, and the ORs for RA for women in the <1 cup, 1-2 cups, 2-3 cups, and ≥3 cups groups were 0.62 (95% CI 0.31-1.26), 0.67 (95% CI 0.33-1.37), 1.08 (95% CI 0.35-3.36), and 1.43 (95% CI 0.25-8.36), respectively. Our study concludes, therefore, that daily coffee consumption is not related to the prevalence of RA in the general Korean population.

Long-Term Follow-Up of Inpatients with Failed Back Surgery Syndrome Who Received Integrative Korean Medicine Treatment: A Retrospective Analysis and Questionnaire Survey Study.

INTRODUCTION: this study aimed to investigate the long-term clinical efficacy and satisfaction degree of integrative Korean medicine (KM) treatment for patients with failed back surgery syndrome (FBSS). METHODS: we performed a follow-up questionnaire survey and retrospective analysis of medical records for patients with FBSS who underwent inpatient treatment for ≥ 1 week. The primary evaluation indices were numeric rating scale (NRS) scores for low back pain (LBP) and leg pain at admission and discharge. Sub-evaluation indices included the Oswestry Disability Index (ODI) and EuroQol 5-dimension (EQ-5D) score. The follow-up questionnaire survey obtained information regarding previous surgeries; reasons for satisfaction/dissatisfaction with surgical and KM treatment; and current status. RESULTS: compared with at admission, there was a significant post-treatment decrease in the NRS scores for LBP and leg pain, as well as the ODI score. Further, there was a significant post-treatment increase in the EQ-5D score. Regarding the patients' global impression of change for KM treatment administered during admission and at the follow-up questionnaire survey, 101 (95.3%) patients selected "minimally improved" or better. CONCLUSION: integrative KM treatment could effectively reduce pain, as well as improve function and health-related quality of life, in patients with FBSS.

Empiric Versus Clarithromycin Resistance-Guided Therapy for Helicobacter pylori Based on Polymerase Chain Reaction Results in Patients With Gastric Neoplasms or Gastric Mucosa-Associated Lymphoid Tissue Lymphoma: A Randomized Controlled Trial.

INTRODUCTION: We investigated to compare the effect of empirical therapy vs clarithromycin resistance-guided tailored therapy (tailored therapy) for eradication of Helicobacter pylori. METHODS: In this prospective, single center, open-label randomized controlled trial, we enrolled 72 patients with H. pylori infection from January 2019 through June 2019 in Korea. The patients were randomly assigned to both groups received empirical (n = 36) or tailored therapy (n = 36). Empirical therapy was defined as triple therapy with esomeprazole, amoxicillin, and clarithromycin for 10 days irrespective of clarithromycin resistance. Tailored therapy was triple or quadruple therapy with esomeprazole, metronidazole, tetracycline, and bismuth for 10 days based on genotype markers of resistance determined by gastric biopsy. Resistance-associated mutations in 23S rRNA were confirmed by multiplex polymerase chain reaction. Eradication status was assessed by C-urea breath test, and the primary outcome was eradication rates. RESULTS: H. pylori was eradicated in 27 patients (75.0%), given empirical therapy and 32 patients (88.9%) treated with tailored therapy (P = 0.136) in intention-to-treat analysis. In per protocol analysis, the eradication rate was 97.0% and 81.8% in tailoredvs empirical groups (P = 0.046). Although clarithromycin-resistant H. pylori was eradicated in 3/9 (33.3%) with empirical therapy, it was treated in 11/12 (91.7%) with tailored therapy (P = 0.009). There was no difference in compliance between 2 groups. The rate of adverse events of the tailored group was higher than that of the empirical group (P = 0.036) because quadruple therapy had more side effects than those of triple therapy (P = 0.001). DISCUSSION: Tailored therapy based on polymerase chain reaction is a good alternative to increase eradication rates in a region of high prevalence of clarithromycin resistance (see Visual Abstract, Supplementary Digital Content 1, http://links.lww.com/CTG/A342).

Intramuscular hematoma with motor weakness after trigger point injection: A case report.

RATIONALE: Although trigger point injection is known as an easy and low-risk procedure, it is contraindicated to patients with hemorrhagic disorders or who regularly take anticoagulants/antiplatelets. However, taking clopidogrel is not a defined contraindication to this low-risk procedure. PATIENT CONCERNS: The chief complaint of a 76-year old woman regularly taking clopidogrel was low back and left buttock pain which prolonged for several years. DIAGNOSES: The patient was diagnosed with L4-5 and L5-S1 spinal stenosis at the orthopedics department and was referred for lumbar spinal epidural steroid injection. INTERVENTION: She was treated with trigger point injection. OUTCOMES: Three hours after the injection, she complained motor weakness and pain in the injection area. A hematoma on left gluteus medium muscle was detected with ultrasonography and ultrasound-guided needle aspiration was accomplished to relieve the symptom. LESSONS: Trigger point injection for patients taking clopidogrel should be done with a caution to prevent such complication.