RESUMO
Objective@#To investigate whether reader training improves the performance and agreement of radiologists in interpreting unenhanced breast magnetic resonance imaging (MRI) scans using diffusion-weighted imaging (DWI). @*Materials and Methods@#A study of 96 breasts (35 cancers, 24 benign, and 37 negative) in 48 asymptomatic women was performed between June 2019 and October 2020. High-resolution DWI with b-values of 0, 800, and 1200 sec/mm 2 was performed using a 3.0-T system. Sixteen breast radiologists independently reviewed the DWI, apparent diffusion coefficient maps, and T1-weighted MRI scans and recorded the Breast Imaging Reporting and Data System (BI-RADS) category for each breast. After a 2-h training session and a 5-month washout period, they re-evaluated the BI-RADS categories. A BI-RADS category of 4 (lesions with at least two suspicious criteria) or 5 (more than two suspicious criteria) was considered positive.The per-breast diagnostic performance of each reader was compared between the first and second reviews. Inter-reader agreement was evaluated using a multi-rater κ analysis and intraclass correlation coefficient (ICC). @*Results@#Before training, the mean sensitivity, specificity, and accuracy of the 16 readers were 70.7% (95% confidence interval [CI]: 59.4–79.9), 90.8% (95% CI: 85.6–94.2), and 83.5% (95% CI: 78.6–87.4), respectively. After training, significant improvements in specificity (95.2%; 95% CI: 90.8–97.5; P = 0.001) and accuracy (85.9%; 95% CI: 80.9–89.8; P = 0.01) were observed, but no difference in sensitivity (69.8%; 95% CI: 58.1–79.4; P = 0.58) was observed. Regarding inter-reader agreement, the κ values were 0.57 (95% CI: 0.52–0.63) before training and 0.68 (95% CI: 0.62–0.74) after training, with a difference of 0.11 (95% CI: 0.02–0.18; P = 0.01). The ICC was 0.73 (95% CI: 0.69–0.74) before training and 0.79 (95% CI: 0.76–0.80) after training (P = 0.002). @*Conclusion@#Brief reader training improved the performance and agreement of interpretations by breast radiologists using unenhanced MRI with DWI.
RESUMO
Objective@#To prospectively investigate the influence of the menstrual cycle on the background parenchymal signal (BPS) and apparent diffusion coefficient (ADC) of the breast on diffusion-weighted MRI (DW-MRI) in healthy premenopausal women. @*Materials and Methods@#Seven healthy premenopausal women (median age, 37 years; range, 33–49 years) with regular menstrual cycles participated in this study. DW-MRI was performed during each of the four phases of the menstrual cycle (four examinations in total). Three radiologists independently assessed the BPS visual grade on images with b-values of 800 sec/mm2 (b800), 1200 sec/mm2 (b1200), and a synthetic 1500 sec/mm2 (sb1500). Additionally, one radiologist conducted a quantitative analysis to measure the BPS volume (%) and ADC values of the BPS (ADCBPS) and fibroglandular tissue (ADCFGT). Changes in the visual grade, BPS volume (%), ADCBPS, and ADCFGT during the menstrual cycle were descriptively analyzed. @*Results@#The visual grade of BPS in seven women varied from mild to marked on b800 and from minimal to moderate on b1200 and sb1500. As the b-value increased, the visual grade of BPS decreased. On b800 and sb1500, two of the seven volunteers showed the highest visual grade in the early follicular phase (EFP). On b1200, three of the seven volunteers showed the highest visual grades in EFP. The BPS volume (%) on b800 and b1200 showed the highest value in three of the six volunteers with dense breasts in EFP. Three of the seven volunteers showed the lowest ADCBPS in the EFP. Four of the seven volunteers showed the highest ADCBPS in the early luteal phase (ELP) and the lowest ADCFGT in the late follicular phase (LFP). @*Conclusion@#Most volunteers did not exhibit specific BPS patterns during their menstrual cycles. However, the highest BPS and lowest ADCBPS were more frequently observed in EFP than in the other menstrual cycle phases, whereas the highest ADCBPS was more common in ELP. The lowest ADCFGT was more frequent in LFP.
RESUMO
Purpose@#This study was performed to investigate the association between step volume and intensity with the prevalence of metabolic syndrome (MS) in Korean adults. @*Methods@#The study analyzed 2,038 adults from the 2014 to 2017 Korea National Health and Nutrition Examination Survey, defining MS based on waist circumference, blood pressure, triglycerides, glucose, and high-density lipoprotein cholesterols. Step volume and intensity were calculated using average number of steps per day and peak 30-minute cadence, respectively. Logistic regression analysis was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of MS by tertiles of step volume and intensity. A joint analysis was conducted to examine the combined association between step volume and intensity with the prevalence of MS. We divided the participants into nine groups according to their step volume (tertiles) and intensity (tertiles). @*Results@#There were 478 MS cases. Compared to the lowest tertile of volume, the ORs of MS were 1.06 (95% CI, 0.79–1.42) and 0.64 (95% CI, 0.47–0.88) in the middle and highest tertile of volume. Compared to the lowest tertile of intensity, the ORs were 1.02 (95% CI, 0.76–1.36) and 0.74 (95% CI, 0.55–1.01) in the middle and highest tertile of intensity. In the joint analysis, compared to the group with both lowest volume and intensity, the ORs were significantly lower in all groups with the highest volume, except the group with the lowest intensity. @*Conclusion@#Although only greater step volume, not intensity, was independently related to MS, both step volume and intensity appear to be important for preventing MS.
RESUMO
Purpose@#The purpose of the present study was to investigate the relationship between changes in sitting time (ST) with the risk of developing metabolic syndrome. @*Methods@#This study examined 2,814 adults aged 40 to 69 years who participated in the Korean Genome and Epidemiology Study, a community-based cohort study, for a total of 10 years. Changes in ST were assessed using the results obtained from physical activity questionnaires completed during the baseline and follow-up surveys. The diagnosis of metabolic syndrome was classified according to the criteria established by the International Diabetes Federation. We conducted survival analysis by the multivariate extended Cox regression model. The significance level for all analyses was set at p＜ 0.05. @*Results@#We compared the newly ST group with ST less than 7 hours in the baseline and more than 7 hours in the first follow-up to the consistently non-ST group with ST less than 7 hours in both the baseline and the first follow-up. In this comparison, we found that the hazard ratio (HR) for the incidence of metabolic syndrome increasedby 33% (HR, 1.33; 95% confidence interval [CI], 1.02–1.74) for changes in total daily sedentary time and by 47% (HR, 1.47; 95% CI, 1.13–1.92) for changes in weekday sedentary time in the newly ST group. @*Conclusion@#Changes in ST are associated with the risk of developing metabolic syndrome. These findings can serve as fundamental data for further research on the relationship between changes in ST, and the occurrence of metabolic syndrome.
RESUMO
Purpose@#This study aimed to confirm the joint association of hard of hearing and handgrip strength with falls among Koreans aged 65 years and above. @*Methods@#This cross-sectional study was based on the 2020 Korean Longitudinal Study of Aging data and included 4,372 participants who completed a falls-related questionnaire. Grip strength was measured, and hearing status was self-reported. Multivariate logistic regression assessed associations between hearing status, handgrip strength, and falls. Analyses were adjusted for variables such as age, sex, body mass index, education level, and medical history. @*Results@#The study found a significant association between being hard of hearing and increased odds of falls (odds ratio [OR], 2.73; 95% confidence interval [CI], 1.56–4.78). Additionally, individuals with low handgrip strength had higher odds of falls (OR, 1.70; 95% CI, 0.88–3.31) than those with normal handgrip strength. Among individualswho were hard of hearing, the group with normal handgrip strength showed 28% lower odds of falls (OR, 0.72; 95% CI, 0.18–2.87), although this result did not reach statistical significance. @*Conclusion@#These findings highlight the high fall odds associated with being hard of hearing and suggest that handgrip strength may have a potential protective effect in individuals aged 65 years and older. Our study contributes to an increased understanding of risk factors for falls in older adults and emphasizes the need to address sensory impairment and muscle strength in prevention efforts. Future studies must validate and extend these findings to improve quality of life and reduce fall-related injuries in older adults.
RESUMO
Purpose@#This study aimed to conduct a systematic literature review and meta-analysis of the exercise intervention effects for the prevention of musculoskeletal injuries in military personnel. @*Methods@#Among studies that included military personnel as participants, we identified randomized controlled trials (RCTs) and cluster-RCT studies that used exercise interventions as a method for injury prevention. Exercise encompassed all types of physical activity, and the effect size was determined by the ratio of injuries between groups.Literature searches were conducted with search terms modified to ensure common inclusion of keywords such as “Soldier,” “Injury prevention,” and “Exercise.” For the analysis of potential factors, variables selected for group differentiation included gender, risk of bias, exercise volume, injury location, exercise type, and study design. @*Results@#Among a total of 8,598 search results, 10 papers were finally confirmed. The meta-analysis of all 10 papers showed that there was no statistically significant injury prevention effect, and significant heterogeneity was observed among the studies (incidence rate ratio, 0.82; 95% confidence interval, 0.62–1.09, I2 =83%). Subgroup analysisrevealed a significant 44% reduction in injuries in studies where exercise volume for injury prevention was relatively high. However, no significant injury prevention effects were observed in other potential factors between groups. @*Conclusion@#The results of this study suggest that the effectiveness of injury prevention exercises in military settings was not statistically significant. However, through the analysis of potential factors, it was confirmed that increasing the time spent on injury prevention exercises may have a preventive effect on injuries.
RESUMO
The aim of this study was to develop evidence-based recommendations for determining the surgical extent in patients with locally invasive differentiated thyroid cancer (DTC). Locally invasive DTC with gross extrathyroidal extension invading surrounding anatomical structures may lead to several functional deficits and poor oncological outcomes. At present, the optimal extent of surgery in locally invasive DTC remains a matter of debate, and there are no adequate guidelines. On October 8, 2021, four experts searched the PubMed, Embase, and Cochrane Library databases; the identified papers were reviewed by 39 experts in thyroid and head and neck surgery. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the quality of evidence, and to develop and report recommendations. The strength of a recommendation reflects the confidence of a guideline panel that the desirable effects of an intervention outweigh any undesirable effects, across all patients for whom the recommendation is applicable. After completing the draft guidelines, Delphi questionnaires were completed by members of the Korean Society of Head and Neck Surgery. Twenty-seven evidence-based recommendations were made for several factors, including the preoperative workup; surgical extent of thyroidectomy; surgery for cancer invading the strap muscles, recurrent laryngeal nerve, laryngeal framework, trachea, or esophagus; and surgery for patients with central and lateral cervical lymph node involvement. Evidence-based guidelines were devised to help clinicians make safer and more efficient clinical decisions for the optimal surgical treatment of patients with locally invasive DTC.
RESUMO
Although hanging is the most common method of suicide in Korea, there are few reports of dysphagia following laryngeal injuries due to near-hanging. This is a case report of a patient who complained of dysphagia after a complex fracture of the neck structures caused due to attempted suicide by hanging. A 51-year-old male visited our hospital with neck injuries after a near-hanging episode. Laryngoscopy suspected dislocation of the right arytenoid cartilage. A computed tomography (CT) scan revealed fractures of the right hyoid bone and thyroid cartilage, as well as soft tissue emphysema. A closed reduction for the dislocation of the right arytenoid cartilage was performed. After surgery, oral feeding was attempted five days after surgery but stopped due to a large amount of aspiration. After two weeks, a videofluoroscopic swallowing study (VFSS) revealed a decreased laryngeal elevation and severe impairment of the upper esophageal sphincter opening. The patient was then given rehabilitation for oropharyngeal dysphagia to restore swallowing function. Four months after the injury, VFSS showed that the residue in the pyriform sinus after multiple swallowing attempts decreased compared to the previous studies. However, oral diet and enteral feeding were combined due to the patient experiencing early fatigue due to swallowing difficulties.Our observations, in this case, show that it was necessary to provide treatment through a multidisciplinary approach coupled with long-term follow-up for patients with dysphagia after complex fractures by near-hanging.
RESUMO
Purpose@#This study aimed to investigate the association between sedentary behavior and generalized anxiety disorder (GAD) according to changes in physical activity after coronavirus disease 2019 (COVID-19) in Korean adolescents. @*Methods@#This study included 52,723 South Korean middle and high school students who had obtained a complete Korea youth risk behavior survey, 2021. To identify the association between sitting time and GAD (GAD-7 scale≥10), odds ratio (OR) and 95% confidence interval (CI) were calculated using complex sample logistic regression analysis (p＜0.05). @*Results@#After adjusting for confounding variables, higher sitting time was associated with higher GAD risk (OR [95% CI]: 5–10 hours, 1.15 [1.04–1.27]; 10–15 hours, 1.23 [1.12–1.35]; ≥15 hours, 1.28 [1.15–1.43]). In adolescents whose physical activity has not changed or has increased after COVID-19, as the sitting time increased, the OR (95% CI) of GAD increased (5–10 hours, 1.15 [1.02–1.31]; 10–15 hours, 1.20 [1.07–1.35]; ≥15 hours, 1.35 [1.17–1.54]). But, not in adolescents whose physical activity has decreased after COVID-19. @*Conclusion@#We observed the independent associations between sedentary behavior and GAD, and sedentary behavior and GAD are associated by change in physical activity after COVID-19 among adolescents. Therefore, in the pandemic era reducing sedentary behavior and increasing physical activity is necessary for adolescents to enhance mental health and decrease the case of GAD.
RESUMO
Head and neck squamous cell carcinoma (HNSCC) include epithelial tumors arising in the structures of aerodigestive tract such as oral and nasal cavity, pharynx, larynx, paranasal sinuses, and local lymph nodes. HNSCC is the sixth most common cancer worldwide, and its prognosis is very poor. MicroRNAs (miRNAs) are small single stranded noncoding RNAs which are about 19-25 nucleotides involved in cell proliferation, development, differentiation and metastasis. It is believed that miRNA alterations correlate with initiation and progression of cancer cell proliferation or inhibition of tumorigenesis especially in development, progression, and metastasis of HNSCC. Altered expression of miRNAs could be novel molecular biomarkers for the diagnosis and prognosis of HNSCC. Despite the advances in cancer treatment, the mortality rate of HNSCC is still high. The potential application of miRNAs for cancer therapy has been demonstrated in many studies. In this review, we discuss the very recent studies on different aspects of miRNA dysregulation with their clinical significance and miRNA-based therapy.
RESUMO
This study aimed to evaluate the imaging and pathological findings in axillary lymph nodes in patients with breast cancer who received concurrent ipsilateral coronavirus disease 2019 (COVID-19) vaccination. Of the 19 women with breast cancer who received concurrent COVID-19 vaccination shot in the arm ipsilateral to breast cancer, axillary lymphadenopathy was observed in 84.2% (16 of 19) of patients on ultrasound (US) and 71.4% (10 of 14) of patients on magnetic resonance imaging (MRI), and 21.0% (4 of 19) of patients were diagnosed with metastasis. Abnormal US and MRI findings of cortical thickening, effacement of the fatty hilum, round shape, and asymmetry in the number or size relative to the contralateral side were noted in more than half of the non-metastatic and metastatic lymph nodes; however, statistical significance was not noted. Axillary lymphadenopathy is commonly observed in patients with breast cancer who receive concurrent ipsilateral COVID-19 vaccination without specific differential imaging features. Thus, understanding the limitations of axillary imaging and cautious interpretation is necessary to avoid overestimation or underestimation of the axillary disease burden.
RESUMO
Objective@#To compare the screening performance of diffusion-weighted (DW) MRI and combined mammography and ultrasound (US) in detecting clinically occult contralateral breast cancer in women with newly diagnosed breast cancer. @*Materials and Methods@#Between January 2017 and July 2018, 1148 women (mean age ± standard deviation, 53.2 ± 10.8 years) with unilateral breast cancer and no clinical abnormalities in the contralateral breast underwent 3T MRI, digital mammography, and radiologist-performed whole-breast US. In this retrospective study, three radiologists independently and blindly reviewed all DW MR images (b = 1000 s/mm2 and apparent diffusion coefficient map) of the contralateral breast and assigned a Breast Imaging Reporting and Data System category. For combined mammography and US evaluation, prospectively assessed results were used. Using histopathology or 1-year follow-up as the reference standard, cancer detection rate and the patient percentage with cancers detected among all women recommended for tissue diagnosis (positive predictive value; PPV2) were compared. @*Results@#Of the 30 cases of clinically occult contralateral cancers (13 invasive and 17 ductal carcinoma in situ [DCIS]), DW MRI detected 23 (76.7%) cases (11 invasive and 12 DCIS), whereas combined mammography and US detected 12 (40.0%, five invasive and seven DCIS) cases. All cancers detected by combined mammography and US, except two DCIS cases, were detected by DW MRI. The cancer detection rate of DW MRI (2.0%; 95% confidence interval [CI]: 1.3%, 3.0%) was higher than that of combined mammography and US (1.0%; 95% CI: 0.5%, 1.8%; p = 0.009). DW MRI showed higher PPV2 (42.1%; 95% CI: 26.3%, 59.2%) than combined mammography and US (18.5%; 95% CI: 9.9%, 30.0%; p = 0.001). @*Conclusion@#In women with newly diagnosed breast cancer, DW MRI detected significantly more contralateral breast cancers with fewer biopsy recommendations than combined mammography and US.
RESUMO
Purpose@#The purpose of this study was to examine the associations of aerobic physical activity and musclestrengthening exercise with mental health, respectively. Furthermore, the relationship between combined exercise with depression, stress, and suicidal thoughts was also examined. @*Methods@#The association between adherence to physical activity guidelines and mental health was analyzed among 27,268 adults who participated in the 2014– 2018 Korea National Health and Nutrition Examination Survey. Logistic regression was used to predict the relationship between adherence to physical activity guidelines and mental health. @*Results@#The odds ratio for depression and suicidal thoughts in groups that met both aerobic physical activity and muscle-strengthening exercise guidelines decreased by 27% (95% confidence interval [CI], 0.56– 0.94) and 40% (95% CI, 0.39– 0.93), respectively, compared to those that did not meet both. Stress awareness decreased by 22% (95% CI, 0.67– 0.90) in those who met muscular exercise guidelines, but did not meet aerobic physical activity guidelines. For those who met only the aerobic physical activity guidelines, stress awareness decreased by 12% (95% CI, 0.82 – 0.95). In addition, the odds ratio decreased by 29% (95% CI, 0.62 – 0.80) in groups that met both guidelines. @*Conclusion@#The most positive relationships between adherence to physical activity guidelines and mental health were found when both aerobic and muscular exercise guidelines were met.
RESUMO
This study was conducted to confirm the performance of the microRNA (miRNA) biomarker combination as a new breast cancer screening method in Korean women under the age of 50 with a high percentage of dense breasts. To determine the classification performance of a set of miRNA biomarkers (miR-1246, 202, 21, and 219B) useful for breast cancer screening, we determined whether there was a significant difference between the breast cancer and healthy control groups through box plots and the Mann– Whitney U-test, which was further examined in detail by age group. To verify the classification performance of the 4 miRNA biomarker set, 4 classification methods (logistic regression, random forest, XGBoost, and generalized linear model plus random forest) were applied, and 10-fold cross-validation was used as a validation method to improve performance stability. We confirmed that the best breast cancer detection performance was achievable in patients under 50 years of age when the set of 4 miRNAs were used. Under the age of 50, the 4 miRNA biomarkers showed the highest performance with a sensitivity of 85.29%, specificity of 93.33%, and area under the curve (AUC) of 0.961. Examining the results of 4 miRNA biomarkers was found to be an effective strategy for diagnosing breast cancer in Korean women under 50 years of age with dense breasts, and hence has the potential as a new breast cancer screening tool. Further validation in an appropriate screening population with large-scale clinical trials is required.
RESUMO
Objectives@#. Head and neck squamous cell carcinomas (HNSCs) are frequently diagnosed at the locoregional advanced stage (stage IVa), but controversy remains regarding whether stage IVa HSNCs should be treated with upfront surgery or definitive chemoradiation therapy (CRT). The purpose of this study was to compare overall survival (OS) and disease-free survival (DFS) in patients with stage IVa HNSC treated primarily by surgery with curative intent with/without (neo)adjuvant treatment (surgery group) versus those treated primarily with CRT (CRT group). @*Methods@#. We reviewed data of 1,033 patients with stage IVa HNSC treated with curative intent at 17 cancer centers between 2010 and 2016. @*Results@#. Among 1,033 patients, 765 (74.1%) received upfront surgery and 268 (25.9%) received CRT. The 5-year OS and DFS rates were 64.4% and 62.0% in the surgery group and 49.5% and 45.4% in the CRT group, respectively. In multivariate analyses, OS and DFS were better in the surgery group than in the CRT group (odds ratio [OR] for death, 0.762; 95% confidence interval [CI], 0.592–0.981; OR for recurrence, 0.628; 95% CI, 0.492–0.802). In subgroup analyses, the OS and DFS of patients with oropharyngeal cancer were better in the surgery group (OR for death, 0.548; 95% CI, 0.341–0.879; OR for recurrence, 0.598; 95% CI, 0.377–0.948). In the surgery group, patients with laryngeal cancer showed better OS (OR for death, 0.432; 95% CI, 0.211–0.882), while those with hypopharyngeal cancer DFS was improved (OR for recurrence, 0.506; 95% CI, 0.328–0.780). @*Conclusion@#. A survival benefit from surgery may be achieved even in patients with stage IVa HNSC, particularly those with oropharyngeal and laryngeal cancer. Surgery led to a reduction in the recurrence rate in patients with hypopharyngeal cancer.
RESUMO
Objective@#To compare the screening performance of diffusion-weighted (DW) MRI and combined mammography and ultrasound (US) in detecting clinically occult contralateral breast cancer in women with newly diagnosed breast cancer. @*Materials and Methods@#Between January 2017 and July 2018, 1148 women (mean age ± standard deviation, 53.2 ± 10.8 years) with unilateral breast cancer and no clinical abnormalities in the contralateral breast underwent 3T MRI, digital mammography, and radiologist-performed whole-breast US. In this retrospective study, three radiologists independently and blindly reviewed all DW MR images (b = 1000 s/mm2 and apparent diffusion coefficient map) of the contralateral breast and assigned a Breast Imaging Reporting and Data System category. For combined mammography and US evaluation, prospectively assessed results were used. Using histopathology or 1-year follow-up as the reference standard, cancer detection rate and the patient percentage with cancers detected among all women recommended for tissue diagnosis (positive predictive value; PPV2) were compared. @*Results@#Of the 30 cases of clinically occult contralateral cancers (13 invasive and 17 ductal carcinoma in situ [DCIS]), DW MRI detected 23 (76.7%) cases (11 invasive and 12 DCIS), whereas combined mammography and US detected 12 (40.0%, five invasive and seven DCIS) cases. All cancers detected by combined mammography and US, except two DCIS cases, were detected by DW MRI. The cancer detection rate of DW MRI (2.0%; 95% confidence interval [CI]: 1.3%, 3.0%) was higher than that of combined mammography and US (1.0%; 95% CI: 0.5%, 1.8%; p = 0.009). DW MRI showed higher PPV2 (42.1%; 95% CI: 26.3%, 59.2%) than combined mammography and US (18.5%; 95% CI: 9.9%, 30.0%; p = 0.001). @*Conclusion@#In women with newly diagnosed breast cancer, DW MRI detected significantly more contralateral breast cancers with fewer biopsy recommendations than combined mammography and US.
RESUMO
Objectives@#. Head and neck squamous cell carcinomas (HNSCs) are frequently diagnosed at the locoregional advanced stage (stage IVa), but controversy remains regarding whether stage IVa HSNCs should be treated with upfront surgery or definitive chemoradiation therapy (CRT). The purpose of this study was to compare overall survival (OS) and disease-free survival (DFS) in patients with stage IVa HNSC treated primarily by surgery with curative intent with/without (neo)adjuvant treatment (surgery group) versus those treated primarily with CRT (CRT group). @*Methods@#. We reviewed data of 1,033 patients with stage IVa HNSC treated with curative intent at 17 cancer centers between 2010 and 2016. @*Results@#. Among 1,033 patients, 765 (74.1%) received upfront surgery and 268 (25.9%) received CRT. The 5-year OS and DFS rates were 64.4% and 62.0% in the surgery group and 49.5% and 45.4% in the CRT group, respectively. In multivariate analyses, OS and DFS were better in the surgery group than in the CRT group (odds ratio [OR] for death, 0.762; 95% confidence interval [CI], 0.592–0.981; OR for recurrence, 0.628; 95% CI, 0.492–0.802). In subgroup analyses, the OS and DFS of patients with oropharyngeal cancer were better in the surgery group (OR for death, 0.548; 95% CI, 0.341–0.879; OR for recurrence, 0.598; 95% CI, 0.377–0.948). In the surgery group, patients with laryngeal cancer showed better OS (OR for death, 0.432; 95% CI, 0.211–0.882), while those with hypopharyngeal cancer DFS was improved (OR for recurrence, 0.506; 95% CI, 0.328–0.780). @*Conclusion@#. A survival benefit from surgery may be achieved even in patients with stage IVa HNSC, particularly those with oropharyngeal and laryngeal cancer. Surgery led to a reduction in the recurrence rate in patients with hypopharyngeal cancer.
RESUMO
Purpose@#This study aimed to investigate the associations between physical activity (PA), health-related fitness, and metabolic risk factors in Korean gynecological cancer survivors using propensity score matching. @*Methods@#A cross-sectional analysis was performed using national representative data between 2015 and 2018 from the Korea National Health and Nutrition Examination Survey (KNHANES VI3 and VI1–3). PA was self-reported through the global PA questionnaire, and health-related fitness was measured using handgrip strength and resting heart rate. Metabolic risk factors were measured by performing blood analyses, including fasting glucose, total cholesterol, and triglyceride levels, and blood pressure. @*Results@#The total number of subjects was 268 (gynecological cancer, n=134; non-cancer, n=134). The results showed that the gynecological cancer survivors (time since diagnosis, ＜5 years and ≥5 years) participated in less amounts of weekly total moderate-to-vigorous intensity PA (160.0±170.1 vs. 144.6±177.3 vs. 334.1±191.3 min/wk; p＜0.001), travel PA (94.5±119.3 vs. 109.4±143.9 vs. 215.7±170.7 min/wk; p＜0.001), and walking (190.7±174.5 vs. 258.8±280.8 vs. 444.5±434.7 min/wk; p＜0.001) than did the non-cancer population. Moreover, the gynecological cancer survivors who met the aerobic PA guidelines had significantly lower fasting glucose (p=0.035) and triacylglyceride levels (p=0.013), and systolic blood pressure (p=0.035) than the non-active participants. @*Conclusion@#The PA of the gynecological cancer survivors was lower than that of the general population. Aerobic PA was significantly associated with lower levels of metabolic disturbances in Korean gynecological cancer survivors.
RESUMO
Purpose@#To investigate the safety of and adherence to a prehabilitation program among patients with endometrial cancer and to provide preliminary evidence of the program’s efficacy in terms of health-related fitness (HRF) and patient-reported outcomes. @*Methods@#Nineteen patients with endometrial cancer were recruited in a 2-week trial for a one-on-one supervised exercise program. All patients participated in an individual exercise program—the Challenge, Overcome, Resolve, and Enhance (CORE) program—which consisted of 60 minutes of moderate-to-vigorous intensity resistance, core stability, and aerobic exercise, supervised five times within 2 weeks before surgery. @*Results@#Seventeen (89.5%) of the 19 participants completed the CORE program, and no adverse events occurred. All participants accomplished the daily mean step counts and sustained the prescribed target heart rate (reserve 50%–60%) during the CORE program sessions. Participants who completed the exercise program exhibited significantly improved HRF (cardiorespiratory fitness, 30-second chair stand, hand grip strength, curl-ups, sit and reach, single-leg standing with closed eyes; p＜0.001 for all) without changes in the body mass index (p=0.113). Their quality of life (general, p=0.001; function, p=0.001; symptom, p=0.003), symptom clusters (p=0.006), anxiety (p＜0.001), and depression (p＜0.001) were significantly improved. @*Conclusion@#The 2-week prehabilitation CORE program is safe and feasible for patients scheduled to undergo surgery for early-stage endometrial cancer and may improve their physical and psychological health status.
RESUMO
Purpose@#The purpose of this study was to investigate whether obesity indicators are mediated in the association between muscle strength and inflammation levels, and further confirm the association between muscle strength level by sex and age and inflammatory levels. @*Methods@#In this study, 3,234 adults living in rural areas were surveyed from 2007 to 2015 and the data was finally analyzed on 2,149 adults. To identify that obesity indicators are mediated in relation to the association between relative grip strength and C-reactive protein (CRP) level, odds ratio (OR) and 95% confidence interval (CI) were calculated using logistic regression analysis (p＜ 0.05). @*Results@#As confounding variables were adjusted, the odds ratio for high inflammatory conditions was lower at a high (OR, 0.58; 95% CI, 0.40–0.85) or medium (OR, 0.64; 95% CI, 0.46–0.90) level of relative grip strength than a low level of relative grip strength. However, there were no significant results if the body fat percentage was added for the confounding variable. When the association between relative grip strength and inflammatory conditions was divided by sex, for women, the odds ratio about high inflammatory conditions was gradually decreased as the relative grip level increased (medium level: OR, 0.55; 95% CI, 0.35–0.87; high level: OR, 0.49; 95% CI, 0.30–0.82). The association of relative grip strength with inflammatory conditions was shown differently in age groups. @*Conclusion@#In conclusion, improvement of muscle strength is a factor that can lower the level of inflammation, and it is important to lower the level of inflammation that can cause cardiovascular disease through resistance exercise differentiated by age and sex.