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Background: With the increasing work-related musculoskeletal disorders, neck and shoulder pain among office workers has also increased. That said, this randomized controlled trial aimed to seek the potential effects of a massage chair (BFR-M8040) on neck and shoulder pain among office workers. Methods: This was conducted at the Wonkwang University Gwangju Medical Center from April 2022 to December 2022. Sixty adult participants were randomly allocated. The mean age of male participants was 39.63 ± 8.09 years while female participants was 43.52 ± 8.27; women participated the most (86.67%). The control group received basic physical treatments, including a 10-min heat treatment for deep regions and a 10-min hot pack for the areas on the neck and shoulder of the complained discomfort. The experimental group received the same treatment as the control group and added 20 min of the electric massage chair's PEMF Neck Mode (XD module 3) (BFR-M8040, Bodyfriend Co., Ltd.). The participants received treatments twice per week. The primary outcome was measured using the numerical rating scale and the Korean version of the neck disability index. And the secondary outcome was measured using pressure pain threshold, range of motion, the Korean occupational stress scale, the Korean version of the Euro-quality of life-5 dimension, and safety evaluation. Results: Fifty-eight participants completed a 6-week follow-up and analyzed (29 in the control group and 29 in the experimental group). There was a significant decrease in the experiment group in both scales for primary outcome measures. For secondary outcome measures, statistically significant increases were observed in pressure pain threshold. The experimental group only showed a slight increase in the quality-of-life measures. There were no reported adverse events. Conclusion: The benefit of using a massage chair (BFR-M8040) was verified to alleviate neck and shoulder pain among office workers; future studies could involve participants from other countries for further investigation.
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OBJECTIVES: The aim of this study was to investigate the impact of lesion site (ostial or shaft vs. distal bifurcation) on long-term outcomes after percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) for left main coronary artery (LMCA) disease. BACKGROUND: Long-term comparative data after PCI and CABG for LMCA disease according to lesion site are limited. METHODS: Patients from the MAIN-COMPARE (Revascularization for Unprotected Left Main Coronary Artery Stenosis: Comparison of Percutaneous Coronary Angioplasty Versus Surgical Revascularization) registry were analyzed, comparing adverse outcomes (all-cause mortality [a composite outcome of death, Q-wave myocardial infarction, or stroke] and target vessel revascularization) between PCI and CABG according to LMCA lesion location during a median follow-up period of 12.0 years. RESULTS: In overall population, the adjusted risks for death and serious composite outcome were higher after PCI than after CABG for distal bifurcation disease, which was mainly separated beyond 5 years. These outcomes were not different for ostial or shaft disease. When comparing drug-eluting stents (DES) and CABG, the adjusted risks for death and serious composite outcome progressively diverged beyond 5 years after DES compared with CABG for distal bifurcation disease (death: hazard ratio: 1.78; 95% confidence interval: 1.22 to 2.59; composite outcome: hazard ratio: 1.94; 95% confidence interval: 1.35 to 2.79). This difference was driven mainly by PCI with a 2-stent technique for distal bifurcation. In contrast, the adjusted risks for these outcomes were similar between DES and CABG for ostial or shaft disease. CONCLUSIONS: Among patients with distal LMCA bifurcation disease, CABG showed lower mortality and serious composite outcome rates compared with DES beyond 5 years. However, there were no between-group differences in these outcomes among patients with ostial or shaft LMCA disease.
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Enfermedad de la Arteria Coronaria , Intervención Coronaria Percutánea , Puente de Arteria Coronaria , Humanos , Factores de Tiempo , Resultado del TratamientoRESUMEN
PURPOSE: The three-dimensional (3D) principal strain represents the major direction and magnitude of the deformation by its definition and can be measured using 3D echocardiography. We aimed to validate 3D echocardiographic left ventricular (LV) global principal strains as an assessment of LV contractility by comparison with gold standard invasive measurements. METHODS: In 14 beagles, the LV pressure-volume loop was recorded to invasively measure the end-systolic pressure-volume relationship (ESPVR) and dP/dt as reference indicators representing LV contractility. The echocardiographic image was obtained simultaneously, and endocardial motions and volume changes were extracted in the form of speckle-tracking point grids to calculate strains. High or low inotropic states were induced pharmacologically by using an intravenous infusion of dobutamine and esmolol, respectively. RESULTS: The direction of 3D endocardial global principal strain (GP1S) appeared to be circumferential. The dP/dt showed the highest Pearson's correlation coefficients with GP1S (r = -0.845, P < 0.001), whereas ESPVR showed the best correlation with global secondary strain (GP2S; r = -0.819, P < 0.001). In comparison with GP1S and GP2S, global circumferential (GCS) and longitudinal strains (GLS) tended to correlate less with invasive measurements, respectively. LV ejection fraction showed excellent correlations with GP1S or GCS, but the correlation with GLS was relatively weak. The correlations between invasive measurements and GP2S or GLS were strengthened when strains were corrected by the LV residual volume ratio, whereas those of GP1S or GCS were weakened after correction. CONCLUSIONS: The principal direction of the LV endocardial contraction presents circumferential behavior reflecting LV volume change. The 3D principal strains derived from 3D echocardiography are reliable indicators for LV contractility and seem better than conventional strains.