Nienke Miedema;Inger Sierevelt;Tjarco Dirk Willem Alta;Roderick Jan Maximiliaan Vossen;Arthur van Noort
Clinics in Shoulder and Elbow
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v.26
no.2
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pp.175-181
/
2023
Background: Acromioclavicular (AC) osteoarthritis (OA) is a frequent pathology of the shoulder in elderly patients. Drug injection plays an important role in treatment of AC OA. Literature has demonstrated excellent short-term results regarding shoulder function and pain. However, mid- to long-term results are lacking. The aim of this study was to assess the efficacy of a single intra-articular AC injection in patients with AC OA and to identify predictive factors for success. Methods: A retrospective study was performed to analyze success rate, shoulder function, and pain perception after a single intra-articular injection in patients with AC OA. Success was defined as the absence of reinterventions such as additional injection or surgery. Outcome measures were 1-year success rate and clinical outcome scores of Numeric Rating Scale (NRS) for pain, Oxford Shoulder Score, and Subjective Shoulder Value. Results: Ninety-eight patients participated in this study. At a median final follow-up of 0.8 years (interquartile range, 0-6), 57 of these patients (58%) had undergone a reintervention. The 1-year success rate was 47% (95% confidence interval, 37%-57%), with NRS at rest as the sole factor significantly associated with success. Thirty patients not requiring reintervention reported significant improvement from baseline for all reported outcome measures at final follow-up. Conclusions: AC injections offer a 1-year success rate of 47%. The AC injection produces good mid- to long-term clinical outcomes regarding shoulder function, quality of life, and pain perception in one-third of patients. Further research is essential to analyze mid- to long-term outcomes of AC injections.
Background: Poor sleep quality is associated with psychoactive substance abuse/addiction/withdrawal. Auricular acupuncture (AA) is a nonpharmacological method used for the treatment of sleep disturbances. This study aimed to examine the quality of sleep before and after AA in participants with mental and behavioral disorders due to prior multiple drug use in the therapeutic community. Methods: This was a consecutive case series of 27 participants (25 male [92.6%]). The median age was 35.0 years (interquartile range [IQR], 29.0-37.2 years), methadone/buprenorphine were not used, and the participants were treated with AA (median number of treatments, 15.0 [IQR, 12.0-18.0]) during a median period of 51.0 days (IQR, 49.0-51.0 days) according to the National Acupuncture Detoxification Association (NADA)-Acudetox protocol. Sleep quality was determined using the Pittsburgh Sleep Quality Index (PSQI), a self-rated questionnaire that assesses sleep quality and disturbances over a 1-month interval. Results: The global PSQI score dropped (indicating better sleep quality) by a median of 3.0 points (IQR, 0.0-8.0 points) after treatment. In the multivariate logistic regression analysis, with an increase in global PSQI score during AA by 1 point, there was a 0.73-fold reduction in the risk of poor sleep quality post-AA (adjusted odds ratio, 0.73; 95% confidence interval, 0.52-1.01; p<0.055; Nagelkerke's R2 =0.66). Conclusion: The results revealed a positive effect of AA (by the NADA-Acudetox protocol) on sleep quality (as measured by PSQI) among participants in a treatment center with mental and behavioral disorders due to multiple drug use.
Background and Objectives The picosecond 755 nm alexandrite laser was first approved by the US FDA in 2012. A previous study described the use of a 1,064 nm picosecond laser with a micro-lens array (MLA) in peri-areolar scarring from breast reconstruction surgery and reported significant improvement in the texture and aesthetic appearance of the scar without other wound complications. The purpose of this study was to evaluate the improvement of overall scarring, not just pigmentation, in the picosecond laser treatment of patients with pigmentations. Materials and Methods Sixteen patients who underwent 1,064 nm picosecond laser treatment from June 2016 to December 2018 were enrolled in this study. Patients received two to six sessions of picosecond laser treatment at intervals of 4 weeks. Before and after the laser treatment, the patients evaluated their own satisfaction score and a physician evaluated the Vancouver Scar Scale. To evaluate the satisfaction score and complication rate, a retrospective chart review was done. Results Seven were female and nine were male. The mean of the patients' satisfaction score before the treatment was 1.44 (interquartile range [IQR], 1-2) and 3.00 (IQR 2.25-3.75) six months after treatment. The mean of the Vancouver Scar Scale before the treatment was 9.69 (IQR 8-11), and 6.25 (IQR 5-7.75) six months after treatment. All the results were statistically significant (p<0.01). Conclusion This study provides evidence that the use of a 1,064 nm picosecond laser treatment for pigmented scars can be effective in improving the pigmentation and overall scar status, including vascularity, height, and pliability, with the results of a decrease in the VSS scores between treatments.
George Samanidis;Konstantinos Kostopanagiotou;Meletios Kanakis;Georgios Kourelis;Kyriaki Kolovou;Georgios Vagenakis;Dimitrios Bobos;Nicholas Giannopoulos
Journal of Yeungnam Medical Science
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v.40
no.2
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pp.187-192
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2023
Background: This study aimed to present the short- and midterm outcomes after complete atrioventricular canal defect (CAVC) repair using a single-patch technique. Methods: This study included 30 children who underwent surgical correction of the CAVC using a single-patch technique. Results: The median age of the patients was 5.7 months (interquartile range [IQR], 5.0-7.5 months), and 23 patients (76.7%) had type A CAVC. Fourteen patients (46.7%) were female and 17 (56.7%) had been diagnosed with Down syndrome. The in-hospital mortality rate was 0%. No deaths were observed during a median follow-up of 4 years (IQR, 3.5-5.0 years). Patients without Down syndrome were associated with late moderate mitral regurgitation (MR) (p=0.02). Late MR less than moderate degree was observed in 96.6%, 78.5%, and 50% of patients after 2, 4, and 5 years of follow-up, respectively, while late tricuspid valve regurgitation less than moderate degree was observed in 96.7%, 85.9%, and 59.0% of patients after 2, 4, and 6 years of follow-up, respectively. After a median follow-up of 4 years, only one patient had required surgical repair of a left ventricular outflow tract obstruction, which occurred 26 months after the first operation. Multivariable logistic regression analysis adjusted for the type of CAVC, sex, Down syndrome, age, and weight revealed that the absence of Down syndrome was a risk factor for late moderate MR (MR-2) (odds ratio, 0.05; 95% confidence interval, 0.006-0.50; p=0.01). Conclusion: A single-patch technique for CAVC surgical repair is a safe method with acceptable short- and midterm results.
Ju-Yong Lee;Jae-Young Lee;Jiwoo Lee;Sangmun Shin;Jun-hyuk Jang;Jun-Hee Han
Journal of Korean Society of Industrial and Systems Engineering
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v.46
no.3
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pp.186-197
/
2023
In this study, we focus on the improvement of data quality transmitted from a weather buoy that guides a route of ships. The buoy has an Internet-of-Thing (IoT) including sensors to collect meteorological data and the buoy's status, and it also has a wireless communication device to send them to the central database in a ground control center and ships nearby. The time interval of data collected by the sensor is irregular, and fault data is often detected. Therefore, this study provides a framework to improve data quality using machine learning models. The normal data pattern is trained by machine learning models, and the trained models detect the fault data from the collected data set of the sensor and adjust them. For determining fault data, interquartile range (IQR) removes the value outside the outlier, and an NGBoost algorithm removes the data above the upper bound and below the lower bound. The removed data is interpolated using NGBoost or long-short term memory (LSTM) algorithm. The performance of the suggested process is evaluated by actual weather buoy data from Korea to improve the quality of 'AIR_TEMPERATURE' data by using other data from the same buoy. The performance of our proposed framework has been validated through computational experiments based on real-world data, confirming its suitability for practical applications in real-world scenarios.
Arteriovenous fistula flow dysfunction is the leading cause of vascular access thrombosis and loss in patients undergoing hemodialysis. However, data regarding the influence of access flow rate measurements on the long-term outcomes of access are limited. This study aims to identify accesses at a high risk of thrombosis and loss among patients undergoing hemodialysis by measuring the access flow rate and exploring an optimal threshold value for predicting future access thrombosis. We enrolled 220 patients with arteriovenous fistula undergoing hemodialysis. The primary outcome was the occurrence of access thrombosis. Access flow rates were measured monthly using the ultrasound dilution method and were averaged using all measurements from patients with patent access. In patients experienced access thrombosis, those immediately before the thrombosis were selected. Using these data, we calculated the access flow rate threshold for thrombosis occurrence by analyzing the receiver operating characteristic curve, and the patients were divided into two groups according to whether access flow rates were higher or lower than 400 mL/min. During a median follow-up period of 3.1 years, 4,510 access flows were measured (median measurements per patient, 33 times; interquartile range, 11-54). A total of 65 access thromboses and 19 abandonments were observed. Access thrombosis and loss were higher in the lowflow group than in the high-flow group. This study revealed that low access flow rates are strongly associated with access thrombosis occurrence and subsequent loss of arteriovenous fistulas in patients undergoing hemodialysis.
Seong Ryeong Kang;Yo Han Ahn;Hee Gyung Kang;Naye Choi
Childhood Kidney Diseases
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v.27
no.2
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pp.105-110
/
2023
Purpose: To analyze electrocardiograms (ECGs) of patients with a salt-losing tubulopathy (SLT) and to determine the frequency and risk factors for long QT and arrhythmia. Methods: A total of 203 patients aged <19 years with SLT, specifically Bartter syndrome and Gitelman syndrome, who had a 12-lead ECG were included in this retrospective study. We analyzed the presence of an arrhythmia or prolonged corrected QT (QTc) on ECGs obtained for these patients. Demographic and laboratory data were compared between patients with abnormal and normal ECG findings. Results: Out of the 203 SLT patients, 38 (18.7%) underwent electrocardiography and 10 (40.0%) of 25 patients with inherited SLT had abnormal ECG findings, including prolonged QTc and arrhythmias. The abnormal ECG group had significantly lower serum potassium levels than the normal group (median [interquartile range]: 2.50 mmol/L [2.20-2.83] vs. 2.90 mmol/L [2.70-3.30], P=0.036), whereas other serum chemistry values did not show significant differences. The cutoff level for a significant difference in QTc interval was serum potassium level <2.50 mmol/L. One cardiac event occurred in a 13-year-old boy, who developed paroxysmal supraventricular tachycardia and underwent cardiac ablation. No sudden cardiac deaths occurred in this cohort. Conclusions: The incidence of ECG abnormalities in patients with inherited SLT was 40.0%, whereas the ECG screening rate was relatively low (18.7%). Therefore, we recommend ECG screening in patients with inherited SLT, especially in those with serum potassium level <2.50 mmol/L.
Journal of Information Science Theory and Practice
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v.11
no.4
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pp.51-81
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2023
This study aimed to study its required performance requirements and proposes a competency framework necessary for the digital workforce of the Provincial Offices in Thailand. The specific primary informants were determined as 17 people. The collecting process was performed using the Delphi technique and the electronic Delphi technique in two phases, totaling four rounds. In the first time, a structured interview was used to conduct online interviews for 15 people. Content validation was performed to determine issues of the competency framework essential for the digital workforce with 7-level scaled questionnaires, and then online reviews were collected between 10-15 people (2nd to 4th times). A consensus was found and confirmed four times with descriptive statistics, namely frequency, mean, standard deviation, mode, median, and the absolute value of the difference between mode and median, interquartile range, and application of the conceptual framework. The research findings revealed that the essential competency requirements for the digital workforce were covered in digital literacy (six aspects), digital skills (four aspects), and digital characteristics (four aspects). Consensus was confirmed for 84 issues. Therefore, it was concluded that 61 points for building an essential competency framework for the digital workforce made them effective in using digital technology as a labor-saving instrument, as well as for expanding the breadth of development of digital expertise to include members of the organization's digital practitioner network. This development will benefit government agencies and the private sector, both national and international, in the future.
Soo Jung Park;Deok Heon Lee;Youngok Lee;Hanna Jung;Yongkeun Cho
Journal of Chest Surgery
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v.56
no.6
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pp.414-419
/
2023
Background: The recurrence of ventricular arrhythmias (VAs) in patients who have already undergone treatment with antiarrhythmic medication, catheter ablation, and the insertion of implantable cardioverter defibrillators is not uncommon. Recent studies have shown that bilateral cardiac sympathetic denervation (BCSD) effectively treats VAs. However, only a limited number of studies have confirmed the safety of BCSD as a viable therapeutic option for VAs. Methods: This single-center study included 10 patients, who had a median age of 54 years (interquartile range [IQR], 45-65 years) and a median ejection fraction of 58.5% (IQR, 56.2%-60.8%), with VAs who underwent video-assisted BCSD. BCSD was executed as a single-stage surgery for 8 patients, while the remaining 2 patients initially underwent left cardiac sympathetic denervation followed by right cardiac sympathetic denervation. We evaluated postoperative complications, the duration of hospital stays, and VA-related symptoms before and after surgery. Results: The median hospital stay after surgery was 2 days (IQR, 2-3 days). The median surgical time for BCSD was 113 minutes (IQR, 104-126 minutes). No significant complications occurred during hospitalization or after discharge. During the median follow-up period of 13.5 months (IQR, 10.5-28.0 months) from surgery, no VA-related symptoms were observed in 70% of patients. Conclusion: The benefits of a short postoperative hospitalization and negligible complications make BCSD a safe, alternative therapeutic option for patients suffering from refractory VAs.
Soo-Yeon Kim;Nariya Cho;Yunhee Choi;Sung Ui Shin;Eun Sil Kim;Su Hyun Lee;Jung Min Chang;Woo Kyung Moon
Korean Journal of Radiology
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v.21
no.5
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pp.561-571
/
2020
Objective: To evaluate the clinical utility of ultrafast dynamic contrast-enhanced (DCE)-MRI compared to conventional DCE-MRI by studying lesion conspicuity and size according to the level of background parenchymal enhancement (BPE). Materials and Methods: This study included 360 women (median age, 54 years; range, 26-82 years) with 361 who had undergone breast MRI, including both ultrafast and conventional DCE-MRI before surgery, between January and December 2017. Conspicuity was evaluated using a five-point score. Size was measured as the single maximal diameter. The Wilcoxon signed-rank test was used to compare median conspicuity score. To identify factors associated with conspicuity, multivariable logistic regression was performed. Absolute agreement between size at MRI and histopathologic examination was assessed using the intraclass correlation coefficient (ICC). Results: The median conspicuity scores were 5 at both scans, but the interquartile ranges were significantly different (5-5 at ultrafast vs. 4-5 at conventional, p < 0.001). Premenopausal status (odds ratio [OR] = 2.2, p = 0.048), non-mass enhancement (OR = 4.1, p = 0.001), moderate to marked BPE (OR = 7.5, p < 0.001), and shorter time to enhancement (OR = 0.9, p = 0.043) were independently associated with better conspicuity at ultrafast scans. Tumor size agreement between MRI and histopathologic examination was similar for both scans (ICC = 0.66 for ultrafast vs. 0.63 for conventional). Conclusion: Ultrafast DCE-MRI could improve lesion conspicuity compared to conventional DCE-MRI, especially in women with premenopausal status, non-mass enhancement, moderate to marked BPE or short time to enhancement.
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