Analysis of Knowledge, Attitudes, Practices, and Educational Needs for Safe Medication Use in Pregnant or Breastfeeding Women: A Questionnaire-Based Study

Objective@#There is a growing interest in the safe use of medications in pregnant and breastfeeding women. Therefore, the purpose of this study is to find ways to improve education about safe medication use by investigating the status of medication use of pregnant and breastfeeding women, and by evaluating their knowledge, attitudes, and practices toward safe medication use. @*Methods@#In this study, a self-report questionnaire was conducted on pregnant or breastfeeding women in Seoul and Gyeonggi Province. The questionnaire consisted of the following four sections; 1) sociodemographic characteristics of participants, 2) experience of medication use, 3) experience of being educated on safe medication use, and 4) knowledge, attitudes, and practices about medication use during pregnancy/breastfeeding. @*Results@#A total of 203 participants were included in the analysis. Of these, 38.4% reported to take prescription medications during pregnancy and breastfeeding. Regarding education on safe medication use, nearly 90% of the participants answered that they were not educated or were unsure whether they had it. In the knowledge-attitude-practice evaluation on safe medication use, the knowledge level was the highest (mean, 4.45), followed by the attitude level (mean, 3.58) and the practice level (mean, 3.33). The preferred education method of the participants was online education using a computer or mobile phone application, etc. @*Conclusions@#This study suggests that there is a need for systematic and effective education that can link knowledge of safe medication use with attitudes and practices in pregnant and breastfeeding women.

Comparison of glucagon-like peptide-1 receptor agonists and thiazolidinediones on treating nonalcoholic fatty liver disease: A network meta-analysis

Background/Aims@#Previous studies have revealed that glucagon-like peptide-1 receptor agonist (GLP-1RA) and thiazolidinedione (TZD) can improve nonalcoholic fatty liver disease (NAFLD) or nonalcoholic steatohepatitis (NASH). However, comprehensive research comparing the effects of GLP-1RA and TZD is limited. Thus, this study aimed to compare the effects of GLP-1RA and TZD on NAFLD or NASH through a network meta-analysis. @*Methods@#The PubMed, Embase, Web of Science, and Scopus databases were searched for randomized controlled trials (RCTs) that explored the efficacy of GLP-1RAs or TZDs in adult patients with NAFLD or NASH. The outcomes were liver biopsy-based (NAFLD activity score [NAS], fibrosis stage, and NASH resolution), noninvasive technique-based (liver fat content on proton magnetic resonance spectroscopy [1H-MRS] and controlled attenuation parameter [CAP]), biological, and anthropometric indicators. A random effects model was used to calculate the mean difference (MD) and relative risk with 95% confidence interval (CI). @*Results@#Twenty-five RCTs with 2,237 overweight or obese patients were included. GLP-1RA was significantly superior in reducing liver fat content evaluated using 1H-MRS (MD –2.42, 95% CI –3.84 to –1.00), body mass index (MD –1.60, 95% CI –2.41 to –0.80), and waist circumference (MD –4.89, 95% CI –8.17 to –1.61) than TZD. In liver biopsy-based evaluation and liver fat content assessment using CAP, GLP-1RA tended to surpass TZD, albeit not significantly. Sensitivity analysis showed consistent results with the main results. @*Conclusions@#Compared with TZD, GLP-1RA had better effects on liver fat content, body mass index, and waist circumference in overweight or obese patients with NAFLD or NASH.

A Case of Vanishing Bile Duct Syndrome after Drug-Induced Liver Injury Caused by Pelubiprofen

Vanishing bile duct syndrome (VBDS) is a rare disease characterized by ductopenia and cholestasis, and is linked to immunological damage to the bile duct system. VBDS can be triggered by infection, ischemia, autoimmune diseases, adverse drug reactions, and humoral factors associated with malignancy. A few cases of VBDS associated with nonsteroidal anti-inflammatory drug-related drug-induced liver injury (DILI) have been reported. Here, we report a case of a 29-year-old patient who developed DILI that progressed to VBDS after the administration of pelubiprofen.

Lifestyle, Dietary Behavior and Snack Preference of Upper-grade Elementary School Students in Cheongju according to the Usage Time of Smartphones / 대한지역사회영양학회지

OBJECTIVES: This study was conducted to examine the length of exposure to smartphone and its association with dietary behavior toward snacks, lifestyle, and nutrition knowledge in elementary school students. METHODS: Subjects were 372 5th and 6th grade schoolchildren in Cheongju, Korea, and data was collected by a self-administered questionnaire. They were divided into two groups by the time spent using smartphone: moderate (< 2 hours/day) and overexposure (≥ 2 hours/day). Data was analyzed using frequency analysis, χ²-test, and independent t-test as well as analysis of covariance when necessary. RESULTS: Approximately half of subjects (41.4%) reported spending ≥ 2 hours/day using smartphone. That habit was more frequent among students in the 6th grade, those who received more monthly allowance, and who has a working mother. 63.4% of the subjects reported that they consumed snacks while watching television, using a computer and/or a smartphone and 48.1% said that they consumed snacks while they use a smartphone. Both situations were most prevalent among those with overexposure to smartphone (≥ 2 hours/day). We also observed that a higher percentage of subjects from the overexposure group spent more money on snack foods with the preference for ice cream, fast food, and carbonated drinks. Further, those in the overexposure group consumed more ice cream, cookies, and carbonated drinks. In addition, they had less desirable dietary behavior and health-related lifestyle (sleep duration and frequency of regular exercise) compared to those with moderate smartphone usage (< 2 hours/day). However, there was no statistical difference in nutrition knowledge among children with different degrees of smartphone usage. CONCLUSIONS: Our results showed that longer smartphone use was associated with less desirable snack preference/consumption and other dietary behavior in elementary school students. Thus interest and positive attitudes towards healthy snacks and diet should be reinforced in nutrition education programs, especially for those who are prone to use smartphones.

Improved Gait Speed After Robot-Assisted Gait Training in Patients With Motor Incomplete Spinal Cord Injury: A Preliminary Study

OBJECTIVE: To evaluate the clinical features that could serve as predictive factors for improvement in gait speed after robotic treatment. METHODS: A total of 29 patients with motor incomplete spinal cord injury received 4-week robot-assisted gait training (RAGT) on the Lokomat (Hocoma AG, Volketswil, Switzerland) for 30 minutes, once a day, 5 times a week, for a total of 20 sessions. All subjects were evaluated for general characteristics, the 10-Meter Walk Test (10MWT), the Lower Extremity Motor Score (LEMS), the Functional Ambulatory Category (FAC), the Walking Index for Spinal Cord Injury version II (WISCI-II), the Berg Balance Scale (BBS), and the Spinal Cord Independence Measure version III (SCIM-III) every 0, and 4 weeks. After all the interventions, subjects were stratified using the 10MWT score at 4 weeks into improved group and non-improved group for statistical analysis. RESULTS: The improved group had younger age and shorter disease duration than the non-improved group. All subjects with the American Spinal Injury Association Impairment Scale level C (AIS-C) tetraplegia belonged to the non-improved group, while most subjects with AIS-C paraplegia, AIS-D tetraplegia, and AIS-D paraplegia belonged to the improved group. The improved group showed greater baseline lower extremity strength, balance, and daily living function than the non-improved group. CONCLUSION: Assessment of SCIM-III, BBS, and trunk control, in addition to LEMS, have potential for predicting the effects of robotic treatment in patients with motor incomplete spinal cord injury.

Clear Cell Renal Cell Carcinoma with Intratumoral Granulomatous Reaction: A Case Report and Review of the Literature

Granulomatous reaction associated with clear cell renal cell carcinoma (CCRCC) is a rare finding, and only a few cases have been described in the literature. It is postulated to occur due to cancer-related antigenic factors such as cancer cells themselves or soluble tumor antigens shed into the blood. Herein, we describe a case of a 56-year-old male patient diagnosed with CCRCC with intratumoral granulomatous inflammation.