Mobile Health Management Platform-Based Pulmonary Rehabilitation for Patients With Non-Small Cell Lung Cancer: Prospective Clinical Trial.

BACKGROUND: Lung cancer patients experience various symptoms during treatment. Although pulmonary rehabilitation is an effective way to improve these symptoms, a medical environment of limited availability makes it difficult to provide seamless and adequate rehabilitation for lung cancer patients. OBJECTIVE: This study aimed to investigate the effects of a personalized pulmonary rehabilitation program using real-time mobile patient health data for patients with non-small cell lung cancer. METHODS: We conducted a prospective clinical trial in 64 patients with non-small cell lung cancer aged between 20 and 80 years at a large tertiary hospital in Seoul, South Korea. A 12-week personalized pulmonary rehabilitation program, called efil breath, was administered to determine the effectiveness of the newly developed rehabilitation app. Participants were randomly allocated to the fixed exercise or fixed-interactive exercise group (which received the personalized program). We measured changes in 6-minute walk distance (6MWD) and dyspnea (modified Medical Research Council [mMRC] score) at 6 weeks; and quality of life and service satisfaction at 12 weeks. We used the paired t test to analyze the variables. RESULTS: Patients used the newly developed mobile health pulmonary rehabilitation app and a real-time patient monitoring website. In all participants, significant changes were observed in 6MWD at 12 weeks from a mean of 433.43m (SD 65.60) to 471.25m (SD 75.69; P=.001), and mMRC from a mean score of 0.94 (0.66) to 0.61 (SD 0.82; P=.02). The intervention significantly improved their quality of life (EuroQol-visual analog scale [EQ-VAS]) compared with baseline (mean score 76.05, SD 12.37 vs 82.09, SD 13.67, respectively; P=.002). CONCLUSIONS: A personalized mobile health-based pulmonary rehabilitation app for recording and monitoring real-time health data of patients with non-small cell lung cancer can supplement traditional health care center-based rehabilitation programs. This technology can encourage improvement of physical activity, dyspnea, and quality of life.

Brown alga Ecklonia cava attenuates type 1 diabetes by activating AMPK and Akt signaling pathways.

The antidiabetic therapeutic effect of Ecklonia cava, a brown alga, was investigated using streptozotocin-induced type 1 diabetes mellitus rats and C2C12 myoblasts. The methanol extract of E. cava (ECM), having a strong radical scavenging activity, significantly reduced plasma glucose level and increased insulin concentration in type 1 diabetes mellitus rats. Moreover, the elevation of plasma ALT in diabetic rats was dramatically restored near to normal range by the treatment of ECM, whereas AST level was not meaningfully altered in any group throughout the experiment. The characteristic indications of diabetes, such as polyphagia and polydipsia, were greatly improved by ECM treatment as well. The mechanism of action of ECM appears to be, at least partially, mediated by the activation of both AMP-activated protein kinase/ACC and PI-3 kinase/Akt signal pathways. Taken together, the present results suggest that E. cava has both in vivo and in vitro antidiabetic effects.

A phase I and pharmacologic study of belotecan in combination with cisplatin in patients with previously untreated extensive-stage disease small cell lung cancer.

PURPOSE: Belotecan (Camtobell, CKD602) is a novel camptothecin derivative. This study was designed to determine the maximum tolerated dose (MTD), toxicity profile, and dose-limiting toxicity of belotecan in combination with cisplatin in patients with previously untreated extensive-stage disease small cell lung cancer (SCLC). Furthermore, pharmacokinetics and preliminary antitumor activity against SCLC were evaluated. EXPERIMENTAL DESIGN: Belotecan was administered i.v. as intermittent 30-min infusions on days 1 to 4, starting dose of 0.40 mg/m2/d with increment of 0.05 mg/m2/d. Intrapatient dose escalation was not allowed. Cisplatin (60 mg/m2) was given on day 1. The treatments were repeated every 3 weeks. Pharmacokinetics was determined during the first cycle using noncompartmental pharmacokinetic analysis. RESULTS: Seventeen chemotherapy-naive patients with extensive-stage disease SCLC were treated. The MTD of belotecan was 0.50 mg/m2/d with the dose-limiting toxicity of grade 4 neutropenia with fever. A partial response was seen in 13 of 17 patients (76.5%). The most common toxicity was neutropenia but nonhematologic toxicity was very favorable. Pharmacokinetic analysis revealed that, at the dose of 0.50 mg/m2/d, plasma clearance of belotecan was 5.78 +/- 1.32 L/h and terminal half-life was 8.55 +/- 2.12 h. Fraction of excreted amount in urine was 37.36 +/- 5.55%. Pharmacokinetics of belotecan was not altered by administration of cisplatin compared with historical control. CONCLUSIONS: The MTD and recommended dose of belotecan for phase II studies was 0.50 mg/m2/d on days 1 to 4 in combination with 60 mg/m2 cisplatin on day 1 every 3 weeks.

[Scale development of job stress for home care nurses].

The purpose of this study was to develop a job stress scale for hospital-based home care nurses in Korea. The process was construction of the conceptual framework, development of the preliminary items, verification of the content validity, item analysis and test of the reliability. The preliminary items were based on literature review and in-depth interviews with home care nurses. As a result, eight categories and sixty items were selected. These were reviewed by seven specialists for content validity and finally fifty one items were chosen. Data was collected from 180 home care nurses who were engaged in 87 hospitals from August to September 2003. The result of item analysis one was excepted. The final item count was 50. Categories were as follows: overload work (8 items), lack of specialized knowledge and technique (5 items), ethical dilemma (4 items), role conflict (5 items), interpersonal relationships (6 items), visiting home environment (9 items), driving conditions (4 items) and lack of administrative support (9 items), The reliability of the scale by Cronbach's alpha was .948 and the domain's reliability ranged from .649 to .841. The result of this study could be used to measure the job stress of home care nurses. However, for further validity and reliability, repeated studies will be necessary.