Weight Loss for Obstructive Sleep Apnea: Pharmacological and Surgical Management

Obstructive sleep apnea (OSA) is a relatively common sleep disorder characterized by repetitive narrowing or obstruction of the upper airway, including the nasal cavity, pharynx, and larynx, during sleep. OSA can cause a variety of symptoms and/or complications, such as excessive daytime sleepiness, reduced concentration, hypertension, type II diabetes, and stroke. Accordingly, an accurate diagnosis and appropriate treatments are required for OSA. Obesity is an important risk factor for OSA and is characterized by the abnormal accumulation of fat in the body, including the upper airway. When the body weight increases, adipose tissue accumulates in the pharynx, which can narrow the diameter of the upper airway and lead to dysfunction of the pharynx dilator muscles. These changes caused by weight gain can cause or exacerbate OSA. Various therapeutic options exist for patients with overweight or obesity, including diet, behavioral modifications, exercise, pharmacological treatments, and surgical procedures. Of these, diet, behavioral modifications, and exercise constitute the first-line management for obesity. However, their results are relatively unsatisfactory, and pharmacotherapy and bariatric surgery are generally implemented in obese patients with OSA. Therefore, the purpose of this paper is to review pharmacological and surgical management strategies for obesity that are currently commonly used in overweight or obese adult patients with OSA.

Neck Discomfort after Thyroidectomy

Thyroid and parathyroid surgery is commonly performed for diagnostic or therapeutic purposes for benign tumors as well as malignant tumors. Vocal cord paralysis and hypoparathyroidism are known as major complications. However, majority of patients experience neck pain or discomfort after surgery without any significant cause. Recent studies have reported various and ambiguous symptoms group after thyroidectomy as post-thyroid syndrome. There is still controversy over the etiology of post-thyroidectomy syndrome, however the assumable causes identified so far are damage to the laryngeal mucosa caused by tracheal intubation, disturbances of blood circulation of larynx, synechia of strap muscles, limited vertical motion of laryngeal skeleton, fibrosis during healing process of extrinsic laryngeal muscles. This is the systematic review of the post-thyroidectomy symptoms by cause.

The Effects of Border Shutdowns on the Spread of COVID-19 / 예방의학회지

Objectives@#At the beginning of the coronavirus disease 2019 (COVID-19) pandemic, some countries imposed entry bans against Chinese visitors. We sought to identify the effects of border shutdowns on the spread of the COVID-19 outbreak. @*Methods@#We used the synthetic control method to measure the effects of entry bans against Chinese visitors on the cumulative number of confirmed cases using World Health Organization situation reports as the data source. The synthetic control method constructs a synthetic country that did not shut down its borders, but is similar in all other aspects. @*Results@#Six countries that shut down their borders were evaluated. For Australia, the effects of the policy began to appear 4 days after implementation, and the number of COVID-19 cases dropped by 94.4%. The border shutdown policy took around 13.2 days to show positive effects and lowered COVID-19 cases by 91.7% on average by the end of February. @*Conclusions@#The border shutdowns in early February significantly reduced the spread of the virus. Our findings are informative for future planning of public health policies.

Can Obesity Cause Depression? A Pseudo-panel Analysis / 예방의학회지

OBJECTIVES: The US ranks ninth in obesity in the world, and approximately 7% of US adults experience major depressive disorder. Social isolation due to the stigma attached to obesity might trigger depression. METHODS: This paper examined the impact of obesity on depression. To overcome the endogeneity problem, we constructed pseudo-panel data using the Behavioral Risk Factor Surveillance System from 1997 to 2008. RESULTS: The results were robust, and body mass index (BMI) was found to have a positive effect on depression days and the percentage of depressed individuals in the population. CONCLUSIONS: We attempted to overcome the endogeneity problem by using a pseudo-panel approach and found that increases in the BMI increased depression days (or being depressed) to a statistically significant extent, with a large effect size.

A Strategy Toward Reconstructing the Healthcare System of a Unified Korea / 예방의학회지

This road map aims to establish a stable and integrated healthcare system for the Korean Peninsula by improving health conditions and building a foundation for healthcare in North Korea through a series of effective healthcare programs. With a basic time frame extending from the present in stages towards unification, the roadmap is composed of four successive phases. The first and second phases, each expected to last five years, respectively, focus on disease treatment and nutritional treatment. These phases would thereby safeguard the health of the most vulnerable populations in North Korea, while fulfilling the basic health needs of other groups by modernizing existing medical facilities. Based on the gains of the first two phases, the third phase, for ten years, would prepare for unification of the Koreas by promoting the health of all the North Korean people and improving basic infrastructural elements such as health workforce capacity and medical institutions. The fourth phase, assuming that unification will take place, provides fundamental principles and directions for establishing an integrated healthcare system across the Korean Peninsula. We are hoping to increase the consistency of the program and overcome several existing concerns of the current program with this roadmap.

Workplace Smoking Ban Policy and Smoking Behavior / 예방의학회지

OBJECTIVES: To evaluate the impact of the workplace smoking ban in South Korea, where the male smoking rate is high (57%), on smoking behavior and secondhand smoke exposure. METHODS: A workplace smoking ban legislation implemented in April 2003 requires offices, meeting rooms, and lobbies located in larger than 3,000 square meter buildings (or 2,000 square meter multipurpose buildings) should be smoke free. A representative cross-sectional survey, the third wave (2005) of health supplements in the National Health Nutrition Survey of South Korea, was used to measure the impact of the 2003 workplace smoking ban implementation on smoking behavior. It contained 3,122 observations of adults 20 to 65 years old (excluding self-employed and non-working populations). A multivariate statistical model was used. The self-reported workplace smoking ban policy (full workplace ban, partial workplace ban, and no workplace ban) was used as the key measure. RESULTS: A full workplace smoking ban reduced the current smoking rate by 6.4 percentage points among all workers and also decreased the average daily consumption among smokers by 3.7 cigarettes relative to no smoking ban. Secondhand smoke showed a dramatic decrease of 86 percent (= -1.74/2.03)from the sample mean for full workplace ban. However, public anti-smoking campaign did not show any significant impact on smoking behavior. CONCLUSIONS: The full workplace ban policy is effective in South Korea. Male group showed bigger impact of smoking ban policy than female group. The public antismoking campaign did not show any effectiveness.