Potentially Unnecessary Gastrointestinal Drug Use in Patients with Acute Cystitis

Background@#Gastrointestinal (GI) drugs are often co-prescribed with other medications to prevent GI complications. This study aimed to evaluate the prescribing pattern of potentially unnecessary GI drugs in patients with acute cystitis who were prescribed oral antibiotics and investigate the influencing factors affecting this. @*Methods@#We identified female patients ≥20 years with acute cystitis who visited the outpatient clinic and were prescribed oral antibiotics between July and December by analyzing Health Insurance Review and Assessment Service (HIRA)-National Patients Sample (NPS)-2019 data. Patients with no prior history of GI disorders within 180 days prior to acute cystitis, excluding or including the date of diagnosis of acute cystitis, were selected (Group A and B). Multiple logistic regression analysis was performed to estimate the factors affecting the prescription of potentially unnecessary GI drugs. @*Results@#A total of 1,544 in Group A and 552 patients in Group B were included for the final analysis. Potentially unnecessary GI drugs were presc ribed in 1,176 patients in Group A (76.2%) and 231 patients in Group B (41.8%). Third generation cephalosporines and sulfonamides showed the lower odds ratio for prescribing GI drugs than penicillins. Prescribers from Urology clinics showed more than twice odds ratio for the prescription of GI drugs compared to prescribers from internal medicine clinics. @*Conclusion@#The results of this study showed that potentially unnecessary GI drug prescriptions for patients with acute cystitis were high in South Korea. The positive risk factors affecting the prescription of unnecessary GIs were not patient-related factor but healthcare facility and prescriber-related factors.

Effects of the Gymnastics Program on Body Composition and Fatigue of Workers in Manufacturing / 한국직업건강간호학회지

Purpose@#To evaluate the effect of a gymnastics program for eight weeks to maintain better body composition and decrease fatigue among factory workers. @*Methods@#Data were collected in 54 female workers in their 50s and 60s in a factory located in the S city of the K region between April and July in 2019. The subjects were divided into two groups: 1) experimental group (n=27) received a 30 minute-gymnastics program three times per week, and 2) control group participated in lecture series about the principle and effect of the gymnastics program. Body composition and fatigue levels were measured before and after the intervention and analyzed using the SPSS 23.0 program. To evaluate the differences in demographic and clinical characteristics between the experimental and control groups, the chi-squared test and the t-test were used. Repeated measures two-way ANOVA was performed to evaluate the change between outcomes of the pre-and post-investigation. Pairwise comparisons were used to assess the differences between the groups and the time. @*Results@#There are statistically significant differences in body fat mass (p<.001), body fat percentage (p<.001), basal metabolic rate (p<.001), and body mass index (p<.022) in the experimental group compared to the control group. In particular, there is a significant interaction between the groups and the time in body fat mass (F=6.308, p=.015), basal metabolic rate (F=11.397, p=.001), fatigue (F=6.933, p=.011). @*Conclusion@#Our findings suggest that using the gymnastics program helps women in their 50s and 60s who work in factories promote better body composition and reduce fatigue levels.

The effect of cetirizine, a histamine 1 receptor antagonist, on bone remodeling after calvarial suture expansion / 대한치과교정학회지

OBJECTIVE@#The objective of this study was to evaluate the effects of cetirizine, a histamine 1 receptor antagonist, on bone remodeling after calvarial suture expansion.@*METHODS@#Sixty male Sprague–Dawley rats were divided into 4 groups; the phosphate-buffered saline (PBS)-injected no expansion group, cetirizine-injected no expansion group, PBS-injected expansion group, and cetirizine-injected expansion group, and were observed at 7, 14, and 28 days. Five rats per group were examined at each observation day. Daily injections of cetirizine or PBS were administered to the relevant groups starting 2 weeks prior to expander insertion. A rapid expander was inserted in the calvarial bone to deliver 100 cN of force to the parietal suture. The specimens were prepared for hematoxylin and eosin and tartrate-resistant acid phosphatase (TRAP) staining. Suture opening and bone regeneration were evaluated using microcomputed tomography and bone histomorphometric analysis. Serum blood levels of osteocalcin and carboxy-terminal collagen crosslinks (CTX) were also evaluated.@*RESULTS@#TRAP-positive cell counts and CTX levels decreased while osteocalcin levels increased in the cetirizine-injected expansion group at observation day 28. In the expansion groups, the mineralized area gradually increased throughout the observation period. At day 28, the cetirizine-injected expansion group showed greater bone volume density, greater mineralized area, and narrower average suture width than did the PBS-injected expansion group.@*CONCLUSIONS@#Cetirizine injection facilitated bone formation after suture expansion, mostly by suppressing osteoclastic activity. Histamine 1 receptor antagonists may aid in bone formation after calvarial suture expansion in the rat model.

A Study on the Three-Year Weight Changes of Workers at a Manufacturing Company and the Comparison of Metabolic Syndrome Diagnosis Components: Focused on the Data of Korean National Health Screening (2015~2017) / 산업간호학회지

PURPOSE: This study aims to provide preliminary data for weight management, and prevention and management of cardiovascular and cerebrovascular diseases. We examined the effect of changes in the weight of workers at a manufacturing company over three years on their metabolic syndrome and metabolic syndrome diagnosis components.METHODS: Necessary data were collected from the questionnaire and the results of the Korean National Health Screening of 2015 and 2017, which included 228 workers at a manufacturing company in G region. The collected data were analyzed using the SPSS/WIN 23.0 program. ANCOVA was used to examine the differences in the metabolic syndrome diagnosis components according to weight change. In addition, multiple logistic regression analysis was used to obtain the odds ratios of metabolic syndrome and metabolic syndrome analysis component, based on the weight changes in the normal weight group and the obesity group.RESULTS: Waist measure, systolic blood pressure, and blood pressure were found to have significant effects based on participants' weight change over three years. These factors increased with a larger increase in weight at a statistically significant level. This study analyzed the weight changes of the normal weight group and the obesity group considering the data from the National Health Screening of 2015, and found that the risk of metabolic syndrome increased at a statistically significant level as body weight increased; thus, the obesity group showed a higher risk in this regard. It was also found that waist measure, fasting blood sugar, and high-density low cholesterol increased at a statistically significant level as body weight increased.CONCLUSION: Health administrators need to recognize the importance of workers' weight management, select an intensive management group based on a time series analysis of weight changes, and develop and implement programs to manage the metabolic syndrome diagnosis components.

A Study on the Three-Year Weight Changes of Workers at a Manufacturing Company and the Comparison of Metabolic Syndrome Diagnosis Components: Focused on the Data of Korean National Health Screening (2015~2017) / 한국직업건강간호학회지

PURPOSE@#This study aims to provide preliminary data for weight management, and prevention and management of cardiovascular and cerebrovascular diseases. We examined the effect of changes in the weight of workers at a manufacturing company over three years on their metabolic syndrome and metabolic syndrome diagnosis components.@*METHODS@#Necessary data were collected from the questionnaire and the results of the Korean National Health Screening of 2015 and 2017, which included 228 workers at a manufacturing company in G region. The collected data were analyzed using the SPSS/WIN 23.0 program. ANCOVA was used to examine the differences in the metabolic syndrome diagnosis components according to weight change. In addition, multiple logistic regression analysis was used to obtain the odds ratios of metabolic syndrome and metabolic syndrome analysis component, based on the weight changes in the normal weight group and the obesity group.@*RESULTS@#Waist measure, systolic blood pressure, and blood pressure were found to have significant effects based on participants' weight change over three years. These factors increased with a larger increase in weight at a statistically significant level. This study analyzed the weight changes of the normal weight group and the obesity group considering the data from the National Health Screening of 2015, and found that the risk of metabolic syndrome increased at a statistically significant level as body weight increased; thus, the obesity group showed a higher risk in this regard. It was also found that waist measure, fasting blood sugar, and high-density low cholesterol increased at a statistically significant level as body weight increased.@*CONCLUSION@#Health administrators need to recognize the importance of workers' weight management, select an intensive management group based on a time series analysis of weight changes, and develop and implement programs to manage the metabolic syndrome diagnosis components.

The Current State of Maternity Care and Suggestions for Improvement in the Management of High-risk Pregnancies in South Korea

Since the year 2000, low birth rates have resulted in significant decreases to maternity care services throughout many Korean hospitals. However, there has been a concomitant increase in the number of high-risk pregnancies, due to growing trends in delayed marriages and subsequent pregnancies. Increased maternal age is a risk factor associated with complicated pregnancies and high-risk deliveries, both of which are strongly related to maternal death. With this in mind, the Ministry of Health and Welfare has supported the establishment of a regional perinatal center for high-risk pregnancies, estimated to be be fully completed by the year 2020. Despite this, maternity care services for high-risk pregnancies remain insufficient. According to previous reports, the total number of maternity care hospitals and beds available for high-risk pregnant women were 60 and 399, respectively. This is in stark contrast to previous bed estimates of 1,640. The establishment of a maternity care system for high-risk pregnant women is integral to ensuring optimal conditions for both pregnancy and childbirth. This review briefly evaluates the existing maternity care system for high-risk pregnancies, and proposes several new suggestions for improvements.

Effect of Whole Body Horizontal Vibration Exercise in Chronic Low Back Pain Patients: Vertical Versus Horizontal Vibration Exercise

OBJECTIVE: To elucidate the effect of a 12-week horizontal vibration exercise (HVE) in chronic low back pain (CLBP) patients as compared to vertical vibration exercise (VVE). METHODS: Twenty-eight CLBP patients were randomly assigned to either the HVE or VVE group. All participants performed the exercise for 30 minutes each day, three times a week, for a total of 12 weeks. Altered pain and functional ability were evaluated using the visual analog scale (VAS) and Oswestry Disability Index (ODI), respectively. Changes in lumbar muscle strength, transverse abdominis (TrA) and multifidus muscle thicknesses, and standing balance were measured using an isokinetic dynamometer, ultrasonography, and balance parameters, respectively. These assessments were evaluated prior to treatment, 6 weeks and 12 weeks after the first treatment, and 4 weeks after the end of treatment (that is, 16 weeks after the first treatment). RESULTS: According to the repeated-measures analysis of variance, there were significant improvements with time on VAS, ODI, standing balance score, lumbar flexor, and extensor muscle strength (all p < 0.001 in both groups) without any significant changes in TrA (p=0.153 in HVE, p=0.561 in VVE group) or multifidus (p=0.737 in HVE, p=0.380 in VVE group) muscle thickness. Further, there were no significant differences between groups according to time in any of the assessments. No adverse events were noticed during treatment in either group. CONCLUSION: HVE is as effective as VVE in reducing pain, strengthening the lumbar muscle, and improving the balance and functional abilities of CLBP patients. Vibrational exercise increases muscle strength without inducing muscle hypertrophy.

Posterior Epidural Migration of a Lumbar Intervertebral Disc Fragment Resembling a Spinal Tumor: A Case Report

Posterior epidural migration of a lumbar intervertebral disc fragment (PEMLIF) is uncommon because of anatomical barriers. It is difficult to diagnose PEMLIF definitively because of its relatively rare incidence and the ambiguity of radiological findings resembling spinal tumors. This case report describes a 76-year-old man with sudden-onset weakness and pain in both legs. Electromyography revealed bilateral lumbosacral polyradiculopathy with a mass-like lesion in L2-3 dorsal epidural space on lumbosacral magnetic resonance imaging (MRI). The lesion showed peripheral rim enhancement on T1-weighted MRI with gadolinium administration. The patient underwent decompressive L2-3 central laminectomy, to remove the mass-like lesion. The excised lesion was confirmed as an intervertebral disc. The possibility of PEMLIF should be considered when rim enhancement is observed in the epidural space on MRI scans and electrodiagnostic features of polyradiculopathy with sudden symptoms of cauda equina syndrome.

Is remediation program using team-based learning effective for at-risk medical students? / 한국의학교육

PURPOSE: Although remediation and reassessment of at-risk students are essential functions of medical education, there are no guidelines on how best to remediate such students. In this study, we described and examined the effectiveness of a remediation program that was delivered as team-based learning (TBL) sessions. METHODS: After a written examination, 15 of 145 fourth-year students were found to require remediation, and assigned to teams of four to five students. Clinical topics related to items of the Korean Medical License Examination were taught in the remediation period of 3 weeks, and all students took reexamination. Changes in test scores were analyzed, and student feedback was documented. RESULTS: Students who participated in the remediation program had significantly better total scores on re-examination (remediation group 225.8 to 263.0 vs. control group 290.8 to 304.0, p<0.05). Most students found that the remediation program was instructive and helped them prepare for the examination. Moreover, students gained confidence, and all of them passed the graduation examination. CONCLUSION: TBL is an effective method of remediating at-risk students. Further research with regard to the successful design and implementation of a remediation program for at-risk students is needed.