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1.
Antioxidants (Basel) ; 10(3)2021 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-33802485

RESUMO

Inula britannica var. chinensis (IBC) has been used as a traditional medicinal herb to treat inflammatory diseases. Although its anti-inflammatory and anti-oxidative effects have been reported, whether IBC exerts neuroprotective effects and the related mechanisms in cortical neurons remain unknown. In this study, we investigated the effects of different concentrations of IBC extract (5, 10, and 20 µg/mL) on cortical neurons using a hydrogen peroxide (H2O2)-induced injury model. Our results demonstrate that IBC can effectively enhance neuronal viability under in vitro-modeled reaction oxygen species (ROS)-generating conditions by inhibiting mitochondrial ROS production and increasing adenosine triphosphate level in H2O2-treated neurons. Additionally, we confirmed that neuronal death was attenuated by improving the mitochondrial membrane potential status and regulating the expression of cytochrome c, a protein related to cell death. Furthermore, IBC increased the expression of brain-derived neurotrophic factor and nerve growth factor. Furthermore, IBC inhibited the loss and induced the production of synaptophysin, a major synaptic vesicle protein. This study is the first to demonstrate that IBC exerts its neuroprotective effect by reducing mitochondria-associated oxidative stress and improving mitochondrial dysfunction.

2.
Medicine (Baltimore) ; 100(9): e24778, 2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-33655942

RESUMO

BACKGROUND: Scoliosis is a spinal deformity and is diagnosed as Cobb angle being greater than 10°. Because it is accompanied with structural dysfunction, it can cause pain, worsen the patient's general health and quality of life. The prevalence of scoliosis has been increasing and many treatments, including surgical treatment and conservative treatment, such as observation, bracing, physiotherapy, and Chuna manual therapy (CMT), have been suggested. CMT is a manual therapy in Korean medicine that provides effective stimulation to the patient's body structure to treat structural dysfunction. After Korean national health insurance's coverage of CMT in 2019, the application of CMT for scoliosis has increased, and many studies have been reported. There have been attempts to elucidate the effectiveness of CMT on scoliosis; however, its effectiveness still remains unconfirmed. Therefore, the aim of this study is to evaluate the effectiveness and safety of CMT on scoliosis. METHODS: The published randomized controlled trials that evaluated the effectiveness and safety of CMT for scoliosis will be searched for in multiple electronic databases without the limitation of country and language. Data on characteristics of studies, interventions, comparators, outcome measures, results, and information for assessment of study quality will be extracted. The primary outcome will be the Cobb angle and the secondary outcomes will be the scales of pain, function, quality of life and disability, and adverse events. Data synthesis and analysis will be conducted using the Review Manager software for Windows (RevMan ver. 5.3.; Copenhagen; The Nordic Cochrane Center, The Cochrane Collaboration, 2014). Subgroup analysis to identify the differences between different CMT maneuvers will also be performed. For risk of bias assessment, the "risk of bias" tool from Cochrane Collaboration will be used. RESULTS: This study will present the clinical evidence on the effectiveness and safety of CMT on scoliosis. CONCLUSION: This study will propose useful evidence for treatment, further research, and health policies in the future.


Assuntos
Medicina Tradicional Coreana/métodos , Manipulações Musculoesqueléticas/métodos , Escoliose/terapia , Humanos , Metanálise como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Resultado do Tratamento
3.
Health Qual Life Outcomes ; 19(1): 99, 2021 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-33743725

RESUMO

BACKGROUND: "Unmet healthcare needs" refers to the situation in which patients or citizens cannot fulfill their medical needs, likely due to socioeconomic reasons. The purpose of this study was to analyze factors related to unmet healthcare needs among South Korean adults. METHODS: We used a retrospective cross-sectional study design. This nationwide-based study included the data of 26,598 participants aged 19 years and older, which were obtained from the 2013-2017 Korea National Health and Nutrition Examination Surveys. Using multiple logistic regression models, we analyzed the associations between factors that influence unmet healthcare needs and participants' subgroups. RESULTS: Despite South Korea's universal health insurance system, in 2017, 9.5% of South Koreans experienced unmet healthcare needs. In both the male and female groups, younger people (age 19-39) had a higher odds ratio (OR) of experiencing unmet healthcare needs compared to older people (reference: age ≥ 60) (men: OR 1.83, 95% confidence interval [CI] = 1.35-2.48; women: OR 1.42, 95% CI 1.12-1.81). In particular, unlike men, women's unmet healthcare needs increased as their incomes decreased (1 quartile OR 1.55, 2 quartiles OR 1.29, 3 quartiles OR 1.26). Men and women showed a tendency to have more unmet healthcare needs with less exercise, worse subjective health state, worse pain, and a higher degree of depression. CONCLUSIONS: The contributing factors of unmet healthcare needs included having a low socioeconomic status, high stress, severe pain, and severe depression. Considering our findings, we suggest improving healthcare access for those with low socioeconomic status.

4.
Medicine (Baltimore) ; 100(4): e23990, 2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33530196

RESUMO

ABSTRACT: The association between anemia and body mass index (BMI) in Koreans, considering kidney function, has not been clarified. Thus, we aimed to examine the association between anemia and BMI among Korean adults aged ≥19 years.This retrospective cross-sectional study evaluated male and female Korean adults aged ≥19 years who participated in the 5th, 6th, and 7th Korean National Health and Nutrition Examination Surveys (KNHANES) conducted between 2010 and 2017 were used. The participants were classified as underweight, normal weight, and overweight according to their BMI. Anemia was defined as hemoglobin levels of <13 g/dL for men and <12 g/dL for women according to the World Health Organization standards. Kidney function was evaluated according to the estimated glomerular filtration rate (eGFR), with abnormal kidney function in men defined as eGFR <60 mL/min/1.73 m2. Clinicodemographic variables were analyzed using logistic regression adjusted for weight. After propensity score matching (PSM), 6596 study participants were divided into 2 groups of 3298 participants each. Additionally, subgroup analysis by sex and kidney function was performed.On PSM, similar distribution patterns were obtained between the anemia and non-anemia groups; significant differences in BMI; kidney function; level of hemoglobin, hematocrit, and serum creatinine; iron intake; and eGFR were also observed between these groups. Anemia and BMI showed a significant association in both crude and adjusted logistic regression models. In model 2, which was adjusted for age, sex, education level, household income, alcohol consumption, smoking status, and exercise period, underweight men with abnormal kidney function showed a significantly higher risk of anemia than did normal weight men (odds ratio [OR]: 3.27; 95% confidence interval [CI]: 1.25-8.57; P = .016). Meanwhile, overweight men showed a significantly lower risk of anemia than did normal weight men (OR: 0.48; 95% CI: 0.33-0.70, P < .001).Anemia is associated with BMI according to sex. Compared with normal weight men, underweight men with abnormal kidney function had a significantly higher prevalence of anemia after adjusting for kidney function and sex, thus highlighting their need for careful management for anemia.


Assuntos
Anemia/epidemiologia , Índice de Massa Corporal , Insuficiência Renal/epidemiologia , Adulto , Idoso , Peso Corporal , Creatinina/sangue , Estudos Transversais , Feminino , Taxa de Filtração Glomerular , Comportamentos Relacionados com a Saúde , Inquéritos Epidemiológicos , Hemoglobinas/análise , Humanos , Masculino , Pessoa de Meia-Idade , Pontuação de Propensão , República da Coreia/epidemiologia , Fatores de Risco , Fatores Socioeconômicos , Adulto Jovem
5.
Arch Osteoporos ; 16(1): 22, 2021 02 02.
Artigo em Inglês | MEDLINE | ID: mdl-33527234

RESUMO

We aimed to investigate the association between cadmium levels and the risk of osteopenia and osteoporosis in Korean post-menopausal women. There was a significant positive association between cadmium levels and the risk of osteopenia and osteoporosis, but further studies for dose response are required. PURPOSE: Cadmium exposure can exert detrimental effects on bone health, particularly in post-menopausal women. However, previous studies have failed to report an association in Korean post-menopausal women. We aimed to investigate the association between cadmium levels and the risk of osteopenia and osteoporosis in Korean post-menopausal women. METHODS: In total, 5432 participants from the 4th and 5th Korean National Health and Nutrition Examination Survey (KNHANES) were randomly sampled for measurements of heavy metal concentrations in the blood, bone mass density (BMD), and nutrient intake. We analyzed data for 1031 post-menopausal women ≥50 years of age. Blood cadmium levels were categorized into quartiles, and a multinomial logistic regression model was used for analysis. RESULTS: There was a significant positive association between cadmium levels and the risk of osteopenia and osteoporosis, but the odds ratio (OR) at the 4th level was lower than that at the 3rd level (OR and 95% confidence interval (CI) for osteopenia: 2nd quartile: 1.24, 0.88-1.74; 3rd quartile: 3.22, 2.24-4.64; 4th quartile: 1.27, 0.87-1.85; P for trend <0.001; OR and 95% CI for osteoporosis: 2nd quartile: 1.54, 1.05-2.25; 3rd quartile: 3.63, 2.31-5.69; 4th quartile: 1.70, 1.03-2.81; P for trend <0.001). This trend was consistent in the sensitivity analysis. CONCLUSION: Our findings suggest that there is an association between blood cadmium levels and the risk of osteopenia and osteoporosis in Korean post-menopausal women. However, further prospective studies are required to determine whether there is a dose-response relationship and address potential selection bias, especially in patients with femoral neck osteoporosis.


Assuntos
Doenças Ósseas Metabólicas , Osteoporose Pós-Menopausa , Osteoporose , Densidade Óssea , Doenças Ósseas Metabólicas/induzido quimicamente , Doenças Ósseas Metabólicas/epidemiologia , Cádmio , Estudos Transversais , Feminino , Humanos , Inquéritos Nutricionais , Osteoporose/induzido quimicamente , Osteoporose/epidemiologia , Osteoporose Pós-Menopausa/epidemiologia , Pós-Menopausa , Estudos Prospectivos , República da Coreia/epidemiologia
6.
Sci Rep ; 11(1): 4077, 2021 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-33603083

RESUMO

Unnecessary surgery could be prevented through continuity of care (COC). The present study aimed to investigate the relationships between COC, surgery and cost associated with chronic shoulder pain. We used the Health Insurance Review and Assessment Service national patient sample (HIRA-NPS) in 2017. A total of 1717 patients were included. Bice-Boxerman Continuity of Care Index was used as the indicator for measuring the COC. Occurrence of surgery, associated costs, and direct medical costs were analysed. Logistic regression, a two-part model with recycled predictions and generalized linear model with gamma distribution were used. The majority of patients were 40-65 years old (high COC: 68.4%; low COC: 64.4%). The odds ratio (OR) for surgery was 0.41 in the high-COC group compared to the low COC group (95% CI, 0.20 to 0.84). Direct medical cost was 14.09% (95% CI, 8.12% to 19.66%) and 58.00% lower in surgery cost (95% CI, 57.95 to 58.05) in the high-COC group. Interaction with COC and shoulder impingement syndrome was significant lower in direct medical cost (15.05% [95% CI, 1.81% to 26.51%]). High COC was associated with low medical cost in patients diagnosed with chronic shoulder pain.

7.
Medicine (Baltimore) ; 100(5): e23851, 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33592841

RESUMO

BACKGROUND: Presentation of musculoskeletal symptoms, such as pain, discomfort, or disability, caused by a traffic accident (TA) is a common occurrence. However, studies on treatment and management of sudden low back pain (LBP) caused by a TA are very scarce, while studies on the effectiveness of motion style acupuncture therapy (MSAT) used on such patients are also rare. Accordingly, a randomized controlled trial (RCT) is planned to assess the effectiveness and safety of MSAT using traction (T-MSAT) for the treatment of pain and functional problems in patients with acute LBP caused by a TA. METHODS: This study will be conducted at Jaseng Hospital of Korean Medicine in South Korea, using a two-armed, parallel, assessor-blinded RCT design. The study population will consist of 100 participants who will be randomly assigned in a 1:1 ratio to either the T-MSAT+integrative Korean medicine therapy (IKMT) group or IKMT control group. The treatment will be applied continuously for 3 days after admission. The primary outcome will be the difference between the numeric rating scale (NRS) scores at admission and immediately after treatment on the fourth day of admission. Secondary outcomes will include visual analogue scale (VAS) for LBP and radiating leg pain; NRS for radiating leg pain; lumbar active range of motion; Oswestry Disability Index (ODI); Patient Global Impression of Change (PGIC); the Post-traumatic Stress Disorder Checklist for DSM-5 (PCL-5-K); and 12-item short-form health survey (SF-12). DISCUSSION: This study is a RCT to assess the effectiveness and safety of T-MSAT for acute LBP caused by a TA. The findings could be used by healthcare-related policy makers and clinicians in primary care institutions, which are frequently visited by patients suffering from LBP caused by a TA.


Assuntos
Acidentes de Trânsito , Terapia por Acupuntura/métodos , Dor Aguda/terapia , Dor Lombar/terapia , Dor Aguda/etiologia , Adulto , Idoso , Feminino , Humanos , Pacientes Internados , Dor Lombar/etiologia , Masculino , Pessoa de Meia-Idade , Medição da Dor , Ensaios Clínicos Controlados Aleatórios como Assunto , República da Coreia , Método Simples-Cego , Resultado do Tratamento , Adulto Jovem
8.
Spine J ; 2021 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-33460811

RESUMO

BACKGROUND CONTEXT: Lumbar intervertebral disk herniation (LDH) is a common disease that causes low back pain, radiating leg pain, and sensory impairment. Preclinical studies rely heavily upon standardized animal models of human diseases to predict clinical treatment efficacy and to identify and investigate potential adverse events in human subjects. The current method for making the LDH model involves harvesting the nucleus pulposus (NP) from autologous coccygeal disks and applying to the lumbar nerve roots just proximal to the corresponding dorsal root ganglion. However, this surgical method generates a model that exhibits very different characteristics of disk herniation than that observed in human. PURPOSE: To produce a rat LDH model that better resembles disk herniation in humans and a standardized and uniform LDH model using Interleukin-1 beta (IL-1ß). STUDY DESIGN: Experimental rat LDH model. METHODS: We exposed the L5-6 disk dorsolaterally on the right side through hemi-laminectomy without nerve compression. Herniation was initiated by puncturing the exposed disk with a 30-gauge needle at a depth of 4 mm. Interleukin-1 beta (IL-1ß) was injected simultaneously to heighten the pathological processes of disk degeneration, including inflammatory responses, matrix destruction, and herniation of the NP. We performed histological staining to assess morphological changes, immunohistochemistry to analyze inflammation- and pain-related expression within and around the puncture site of the L5-6 disk, and real-time polymerase chain reaction to examine expression of markers for degenerative processes. In addition, we performed locomotor tests on the rats. RESULTS: We found that the IL-1ß groups showed that the border between the annulus fibrosis and nucleus pulposus was severely interrupted compared to that of the control (puncture only) group. And, the injection of IL-1ß leads to accelerated disk degeneration and inflammation in a more consistent manner in LDH model. Functional deficit was consistently induced by puncturing and injection of IL-1ß in the exposed disk. CONCLUSIONS: The method proposed here can be used as an index to control the severity of disk degeneration and inflammation through the injected IL-1ß concentration concurrent with surgically induced herniation. CLINICAL SIGNIFICANCE: Our proposed model may facilitate research in drug development to evaluate the efficacy of potential therapeutic agents for disk herniation and neuropathic pain and may also be used for nonclinical studies to more accurately assess the effectiveness of various treatment strategies according to the severity of disk degeneration.

9.
Br J Anaesth ; 126(3): 692-699, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33341226

RESUMO

BACKGROUND: The purpose of this study was to investigate the effectiveness and safety between electroacupuncture (EA) combined with usual care (UC) and UC alone for pain reduction and functional improvement in patients with non-acute low back pain (LBP) after back surgery. METHODS: In this multicentre, randomised, assessor-blinded active-controlled trial, 108 participants were equally randomised to either the EA with UC or the UC alone. Participants in the EA with UC group received EA treatment and UC treatment twice a week for 4 weeks; those allocated to the UC group received only UC. The primary outcome was the VAS pain intensity score. The secondary outcomes were functional improvement (Oswestry Disability Index [ODI]) and the quality of life (EuroQol-5-dimension questionnaire [EQ-5D]). The outcomes were measured at Week 5. RESULTS: Significant reductions were observed in the VAS (mean difference [MD] -8.15; P=0.0311) and ODI scores (MD -3.98; P=0.0460) between two groups after 4 weeks of treatment. No meaningful differences were found in the EQ-5D scores and incidence of adverse events (AEs) between the groups. The reported AEs did not have a causal relationship with EA treatment. CONCLUSIONS: The results showed that EA with UC treatment was more effective than UC alone and relatively safe in patients with non-acute LBP after back surgery. EA with UC treatment may be considered as an effective, integrated, conservative treatment for patients with non-acute LBP after back surgery. CLINICAL TRIAL REGISTRATION: KCT0001939.


Assuntos
Terapia por Estimulação Elétrica/métodos , Eletroacupuntura/métodos , Dor Lombar/terapia , Manejo da Dor/métodos , Fusão Vertebral , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Resultado do Tratamento
10.
BMC Complement Med Ther ; 20(1): 354, 2020 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-33225907

RESUMO

BACKGROUND: An external herbal dispensary (EHD) is a type of pharmacy that provides various types of personalized herbal medicines (PHMs) to other traditional Korean medicine (TKM) institutions. Such dispensaries were legalized by the Ministry of Health and Welfare (MoHW) in 2008 in South Korea. The purpose of this study is to understand the current status of the EHD facilities and their quality controls and compare them with the good manufacture practice (GMP) guidelines to contribute to the establishment of the safety and quality control criteria for PHMs. METHODS: We contacted 107 EHD representatives or people in charge of the preparation of PHMs (TKM pharmacists) and invited them to complete a survey questionnaire; of the total, 81 responded. The survey questionnaire was developed in 3 stages: drafting, revision by external experts, and final editing. It consisted of 20 questions covering 3 sections: basic characteristics of EHDs, facility, and quality control. The survey was hosted online from December 2017 to January 2018 as guided by the MoHW. RESULTS: The completion rate was 75.7% (n = 81). In terms of facilities, the five facilities (water supply, manufacture, pest control, hygiene management and warehousing) that corresponded to the legal requirements of EHD were mostly equipped, but the types of facilities and equipment differed. Two facilities (sterilization and cross-contamination that were not legally required for EHD were found to have mostly pharmacopuncture-EHD (P-EHD), but hardly any herbal medicine-EHD (H-EHD). In our findings regarding quality control of non-medicinal herbs, sensory evaluation that included checks for foreign bodies and deterioration were conducted. In terms of the quality control of herbal medicines, residual pesticides and heavy metals tests were performed and for pharmacopuncture, pH, salinity, sterility, and endotoxin tests along with gross examination were performed. In the end, we found that 6 of the 38 standard items as required by the Korea GMP were suitable. CONCLUSIONS: In this study, detailed information for each existing EHD law was determined through a nationwide questionnaire. Moreover, the basis for its reflection in additional legal standards should be introduced so that safe herbal medicine can be prepared in EHDs.

11.
PLoS One ; 15(11): e0242077, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33180888

RESUMO

OBJECTIVES: This study aims to investigate the association between mental health and quality of life of osteoarthritis (OA) patients according to the site of pain. DESIGN: Retrospective cross-sectional study. PARTICIPANTS: Data of 22,948 participants of the sixth Korea National Health and Nutrition Examination Survey conducted from 2013-2015 were used. OUTCOME MEASURES: Participants were asked if they had OA pain in the hip joint, knee joint, and lower back (yes/no) and whether they experienced anxiety or depression. The EQ-5D questionnaire was used to determine the quality of life of patients with hip, knee, and lower back OA. Multiple logistic regression analysis was performed after adjusting. RESULTS: A total of 5,401 patients reported pain in the hip joint, knee joint, or lower back. The analysis showed significant relations between pain sites, mental health, and quality of life. First, more female patients with OA experienced stress and depression than males. Second, for males with OA, stress was reported in the order of: lower back > hip > knee, while pain and depression was reported in the order of: lower back > knee > hip (p < 0.05). For females with OA, stress was reported in the order of: knee > lower back > hip, while depression was reported in the order of: knee > lower back > hip. Third, considering quality of life, for males, hip joint pain had the greatest impact on quality of life and for females, knee joint pain had the largest impact (p < 0.001). CONCLUSIONS: For patients with OA, the effect on the mental health and quality of life differed according to sex and sites of pain. Therefore, this study confirms that pain sites, sex, mental health, and quality of life are independent risk factors when determining OA pain.

12.
BMJ Open ; 10(10): e034924, 2020 10 05.
Artigo em Inglês | MEDLINE | ID: mdl-33020075

RESUMO

OBJECTIVES: Dementia is common in people over the age of 65 years, with 80% of people with dementia older than 75 years. Previous studies have linked dementia to late-life depression, but the association between dementia and mid-life depression is poorly understood. Depression is a preventable and treatable medical condition, which means it is a modifiable factor that can potentially prevent or delay dementia. This study aimed to identify the association between dementia and depression within the life course. DESIGN: A nationwide, retrospective propensity score matched cohort study associating dementia with depression. Depression diagnosed between the ages of 45 and 64 years was classified as 'mid-life' and 'late-life' if diagnosed at 65 years or older. Patients were considered to have depression when one or more International Statistical Classification of Diseases and Related Health Problems, 10th revision codes for depression were recorded as primary or secondary diagnosis. SETTING: National Health Insurance Service-National Sample Cohort database of the National Health Insurance Service in South Korea, containing patient data from 2002 to 2013. PARTICIPANTS: The study included 1824 and 374 852 patients in the case and control groups, respectively. A logistic regression analysis with complex sampling design was performed after adjusting for covariates, using the propensity score matching method without callipers, with a 1:1 nearest neighbour matching algorithm. PRIMARY AND SECONDARY OUTCOME MEASURES: The association of mid-onset and late-onset depression with dementia in terms of sociodemographic characteristics, such as sex and age, within the Korean population. RESULTS: Dementia was significantly associated with the presence of depression (OR=2.20, 95% CI=1.53-3.14); in particular, female patients with depression and patients aged 45-64 years with depression had increased odds of dementia (OR=2.65, 95% CI=1.78-3.93 and OR=2.72, 95% CI=1.41-5.24, respectively) CONCLUSION: Depression is an associated factor for dementia, especially among people aged 45-64 years (mid-life).

13.
Front Med (Lausanne) ; 7: 524628, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33043034

RESUMO

Objectives: The present study was undertaken to investigate the relationship between acupuncture therapy and surgery rate. Design: Matched, retrospective cohort study. Materials and Methods: From nationwide health insurance data (2002-2013 cohort data published by the National Health Insurance Service of Korea), patients with new cases of knee osteoarthritis that occurred between January 1, 2004 and December 31, 2010 were analyzed. Patients were divided into an acupuncture group (AG) and a control group (CG), based on records of acupuncture therapy. Propensity scores were calculated by using gender, age, income level, and Charlson comorbidity index (CCI), with the groups matched at a ratio of 1:3 (AG:CG). The final analysis period was 2 years after the first acupuncture therapy for AG and 2 years after initial diagnosis for CG; surgery rates were compared between the two groups. Stratified analyses were performed based on age, gender, and income level; sensitivity analyses were performed based on the frequency and duration of acupuncture therapy. Results: Propensity score-matched AG and CG included 8,605 and 25,815 subjects, respectively. Post-matching surgery rates were 0.26 and 0.93% in AG and CG, respectively. For all age groups, AG showed a lower surgery rate than CG. In the analysis based on gender, the female group showed a significantly lower hazard ratio of 0.225. In analysis based on income level, the results of the entire group were significant, with the lower income group showing the lowest hazard ratio. In sensitivity analyses, AG tended to show a lower surgery rate than CG. Conclusions: The present study demonstrated that acupuncture therapy is associated with a low rate of surgery for knee osteoarthritis. Additional studies are needed to support this conclusion.

14.
BMJ Open ; 10(10): e036768, 2020 10 28.
Artigo em Inglês | MEDLINE | ID: mdl-33115889

RESUMO

OBJECTIVE: Temporomandibular joint disorder (TMD) requires long-term management and can be a financial burden for patients. Here, we investigated the treatment received by people diagnosed with TMD and its relevant costs. DESIGN: A descriptive, cross-sectional study. SETTING AND PARTICIPANTS: We performed secondary data analysis of health insurance claims data provided by the Health Insurance Assessment and Review (HIRA) of the Republic of Korea. We reviewed the records of 10 041 patients who were diagnosed with TMD and who utilised outpatient healthcare service at least once between January and December 2017. PRIMARY AND SECONDARY OUTCOME MEASURES: Data on use of medical services, hospitalisations, sociodemographic factors, treatment and medication were retrieved and analysed. Cost was defined as the cost of care incurred by a health insurance beneficiary at a care facility. RESULTS: We reported the characteristics as medians, frequencies and percentages and found that most TMD patients were outpatients, women (58.9%) and in their 20s (46.4%). For visit type, 85.9% of all patients had an outpatient dental medical visit, with most visiting dental clinics and dental hospitals. Western medicine (WM; 9.8%) was prescribed more often, followed by Korean medicine (KM; 8.2%). The median expense per patient was highest among those in their 20s (58.00, 23.90, 53.40, 65.90 US$ for overall, WM, dental medicine (DM) and KM, respectively). Consultation fees accounted for the greatest percentage (42.8%) of DM and WM care expenses, while injection/non-surgical intervention fees accounted for the greatest percentage of KM care expenses. The most commonly used treatments for TMD were temporomandibular joint stimulation therapy (51.1%) and acupuncture (19.9%), considered as the most basic care for TMD. Psychosomatic agents (86.4%) were the most commonly used medications in outpatients. CONCLUSIONS: While people with TMD most commonly received temporomandibular stimulation therapy, the costs and duration of treatment varied significantly for these patients.

15.
Int J Clin Oncol ; 2020 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-33089416

RESUMO

BACKGROUND: Patients with cancer often receive acid-suppressive agents (ASAs) to treat common gastroesophageal reflux and peptic ulcer diseases. Our systematic review addresses the association between ASAs and survival outcomes in these patients. METHODS: We searched MEDLINE, EMBASE, and Cochrane until December 2019, including randomized controlled trials (RCTs), quasi-RCTs, and observational studies concerning ASAs that reported progression-free survival (PFS) and/or overall survival (OS). We estimated hazard ratios (HRs) with 95% confidence intervals (CIs) using the random-effects model, and assessed heterogeneity with I2 statistic. RESULTS: We included 45,626 patients from 7 RCTs and 18 observational studies, including esophageal/gastric, colorectal, pancreatic, lung, breast, prostate, kidney, and other cancers. Five studies showed that ASAs in lung cancer patients received tyrosine kinase inhibitors (TKIs) had significantly worse PFS (HR 1.64, 95% CI 1.14 - 2.37, I2 = 57%) and OS (HR 1.13, 95% CI 1.05 - 1.21, I2 = 0%) than nonusers. Each of five studies found no significant association between ASAs and OS in esophageal/gastric (HR 0.91, 95% CI 0.77 - 1.09, I2 = 32%) or colorectal cancer patients (HR 1.33, 95% CI 0.96- 1.85, I2 = 0%). ASAs were not significantly associated with an OS in patients with kidney cancer (HR 1.04, 95% CI 0.96 - 1.13, I2 = 28%). CONCLUSIONS: Meta-analysis showed that ASAs significantly associated with an increased mortality risk in lung cancer patients treated TKIs, but not in patients with esophageal/gastric, colorectal, or kidney cancer. Until further studies confirm these results, caution should be used when administering ASAs and TKIs to patients with lung cancer.

16.
Medicine (Baltimore) ; 99(44): e22871, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33126334

RESUMO

BACKGROUND: Neck pain is a common complaint in the general population. Despite the consistent ongoing pain and the resulting economic burden on affected individuals, there have only been a few studies investigating the treatment of acute neck pain. This study aims to evaluate the effectiveness, safety, and cost-effectiveness of the motion style acupuncture treatment (MSAT) and acupuncture treatment for acute neck pain. METHODS: This 2-armed, parallel, multi-centered randomized controlled trial will be conducted at 4 community-based hospitals in Korea. A total of 128 subjects will be randomly assigned, at a 1:1 ratio, to the MSAT and the acupuncture treatment groups. Treatment will be administered 2 to 3 times a week for 2 weeks. The primary outcome will be the visual analog scale of neck pain on movement. The secondary outcomes will be the numeric rating scale of the neck, neck disability index, Northwick Park questionnaire, patient global impression of change, range of motion of the neck, 5-level EuroQol-5 dimension, 12-item Short-Form Health Survey, and EuroQol visual analogue scale. This protocol has been registered at the Clinicaltrials.gov (NCT04539184). DISCUSSION: To our knowledge, this study is the first well-designed multi-centered randomized controlled trial to evaluate the effectiveness, safety, and cost-effectiveness of MSAT on acute neck pain. The results of this study will be useful for clinicians in primary medical institutions that frequently treat acute neck pain patients and for policymakers working with national health insurance.


Assuntos
Terapia por Acupuntura/métodos , Cervicalgia/terapia , Manejo da Dor/economia , Manejo da Dor/normas , Resultado do Tratamento , Terapia por Acupuntura/economia , Terapia por Acupuntura/normas , Dor Aguda/psicologia , Dor Aguda/terapia , Adulto , Idoso , Análise Custo-Benefício , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cervicalgia/psicologia , Manejo da Dor/métodos , Medição da Dor/métodos , República da Coreia , Inquéritos e Questionários
17.
Health Qual Life Outcomes ; 18(1): 341, 2020 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-33054839

RESUMO

BACKGROUND: No studies have investigated the association between self-rated health (SRH) and high-sensitivity C-reactive protein (hs-CRP) levels in South Koreans. We explored this association and analyzed differences between sexes. METHODS: Using cross-sectional data from the 2015-2017 Korea National Health and Nutrition Examination Survey, we analyzed the association between SRH and high hs-CRP levels (> 1.0 mg/L) in 14,544 Koreans aged ≥ 19 years who responded to the SRH survey and had available hs-CRP test results. Differences in sociodemographic factors were analyzed using the Pearson's chi-square test for categorical variables or the Mann-Whitney U test for continuous variables. Multiple logistic regression analysis was used to measure the association between hs-CRP levels and SRH according to sex while adjusting for other possible confounders. RESULTS: The percentage of very poor to poor SRH was higher in the high hs-CRP group (22.4%) than in the low hs-CRP group (17.66%). Among men, the risk of a high hs-CRP level increased with worse SRH (adjusted for confounders; P for trend < 0.001). After adjusting for all confounders, including chronic diseases, men with very poor SRH showed a higher odds ratio (OR) for high hs-CRP levels than those with very good SRH (fully adjusted OR, 1.74; 95% CI, 1.04-2.90). Significant correlations were absent among women. CONCLUSIONS: Poor SRH was correlated with low-grade inflammation (high hs-CRP levels) among Korean male adults. These findings could be useful for developing health improvement programs and in goal setting at a national scale.

18.
BMC Womens Health ; 20(1): 213, 2020 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-32972416

RESUMO

BACKGROUND: The effect of joint health on the quality of life of middle-aged and older women is becoming more widely recognized with the aging of the world's population. However, the association of long-term breastfeeding with joint pain and knee osteoarthritis has not been fully examined. The aim of this study was to determine the association of prior breastfeeding duration with current joint pain and knee osteoarthritis in middle-aged Korean women. METHODS: This cross-sectional study was conducted among 3454 women aged ≥50 years who underwent knee radiography and answered a questionnaire on breastfeeding and joint pain for the 5th Korea National Health and Nutrition Examination Survey (2010-2011). After adjusting for confounding sociodemographic, medical history, and obstetric and gynecologic variables, logistic regression analysis was conducted to analyze the prevalence of joint pain and knee osteoarthritis according to breastfeeding and its duration. RESULTS: Among the 3454 participants, 298 had not breastfed and 1042, 815, and 1299 had breastfed for 1-24, 25-48, and ≥ 49 months, respectively. Of all participants, 1731 had joint pain and 739 were diagnosed with knee osteoarthritis after radiography. Using the non-breastfeeding group as a reference, the odds ratio (OR) for joint pain among women who breastfed ≥1 month was 1.49 (95% confidence interval [CI] 1.01-2.21). As the breastfeeding duration increased, the OR of joint pain prevalence also increased (p for trend; p = 0.002). For knee osteoarthritis, the OR was 2.30 in the 25-48 months group (95% CI 1.09-4.86). The OR of knee osteoarthritis in the ≥49 months group was 2.17 (95% CI 1.01-4.64). Sensitivity analysis after selecting only participants aged ≥60 years showed that the prevalence of joint pain and knee osteoarthritis was more positively correlated with extended breastfeeding duration (joint pain, p for trend; p = 0.005) (knee osteoarthritis, p for trend; p = 0.012). CONCLUSIONS: Long-term feeding for more than 25 months was associated with an increased prevalence of joint pain and degenerative arthritis in Korean women aged ≥50 years.

19.
BMJ Open ; 10(9): e039297, 2020 09 24.
Artigo em Inglês | MEDLINE | ID: mdl-32973065

RESUMO

OBJECTIVES: To provide useful information for policy-makers and clinicians by analysing the medical service use-divided into Western medicine (WM) and Korean medicine (KM)-of patients with ankle sprains in South Korea between 2015 and 2017. DESIGN: Cross-sectional, retrospective, observational study. SETTING: Tertiary hospitals, WM hospitals, WM clinics, KM hospitals, KM clinics and others in South Korea. PARTICIPANTS: We analysed claim data and patient information from the 2015 to 2017 Health Insurance Review and Assessment National Patient Sample (HIRA-NPS) dataset, including 151 415 patients diagnosed with a 'dislocation, sprain and strain of joints and ligaments at ankle and foot level' (10th revision of the International Statistical Classification of Diseases code S93) who used medical services at least once in 3 years between January 2015 and December 2017 in South Korea. PRIMARY AND SECONDARY OUTCOME MEASURES: Cost of medical care, number of consultations, type of institution visited, types of treatment. RESULTS: There were 160 200 consultations and 53 044 patients in 2015, 149 956 consultations and 50 830 patients in 2016 and 140 651 consultations and 47 541 patients in 2017. The total treatment costs were US$3 355 044.21, US$3 245 827.70 and US$3 128 938.46 in 2015, 2016 and 2017, respectively. The most common age was 10-19 years. The most frequent type of visit was KM outpatient visit (56%). Physiotherapy was most common in WM outpatient visits, while acupuncture was most common in KM visits. Most patients used one institution, rather than alternating between WM and KM. CONCLUSIONS: By identifying the trends and costs of treatment methods used for ankle sprains and comparing WM and KM, our data provide basic information for future health policy-making. In addition, the duality of the Korean medical system is highlighted as a possible cause of increased costs.

20.
Toxins (Basel) ; 12(9)2020 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-32899913

RESUMO

Inflammation is an essential biological response that eliminates pathogenic bacteria and repairs tissue after injury. Acute kidney injury (AKI) is associated with systemic and intrarenal inflammation as the inflammatory process decreases renal function and promotes progression to advanced chronic kidney disease. Macrophages are key mediators of the inflammatory response; their activation influences the immune system and may have various effects. Classically activated type I macrophages (M1) produce a variety of pro-inflammatory cytokines at the lesion site. However, anti-inflammatory type II macrophages (M2) are alternatively activated upon exposure to anti-inflammatory cytokines and are associated with wound healing and tissue repair following AKI. Here, we used melittin from bee venom to enhance the polarization of M2 macrophages and promote renal recovery after AKI. Melittin was administered to mice intraperitoneally for 5 days at various concentrations (10, 50, and 100 µg/kg); serum creatinine and blood urea nitrogen (BUN) levels were analyzed 72 h after cisplatin administration to confirm renal dysfunction. Melittin inhibited the cisplatin-induced increase in creatinine and BUN, an indicator of renal dysfunction. The expression of M1 markers (CD16/32) decreased significantly, whereas that of M2 markers (CD206, Arg1nase I) increased after melittin administration. Consistently, tubular necrosis was substantially reduced in melittin-treated mice. Thus, melittin alleviates cisplatin-induced AKI by regulating M2 macrophage expression.

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