Background Acellular dermal matrix (ADM) allografts and their putative benefits have been increasingly described in prosthesis based breast reconstruction. There have been a myriad of analyses outlining ADM complication profiles, but few large-scale, multi-institutional studies exploring these outcomes. In this study, complication rates of acellular dermis-assisted tissue expander breast reconstruction were compared with traditional submuscular methods by evaluation of the American College of Surgeon's National Surgical Quality Improvement Program (NSQIP) registry. Methods Patients who underwent immediate tissue expander breast reconstruction from 2006-2010 were identified using surgical procedure codes. Two hundred forty tracked variables from over 250 participating sites were extracted for patients undergoing acellular dermis-assisted versus submuscular tissue expander reconstruction. Thirty-day postoperative outcomes and captured risk factors for complications were compared between the two groups. Results A total of 9,159 patients underwent tissue expander breast reconstruction; 1,717 using acellular dermis and 7,442 with submuscular expander placement. Total complications and reconstruction related complications were similar in both cohorts (5.5% vs. 5.3%, P=0.68 and 4.7% vs. 4.3%, P=0.39, respectively). Multivariate logistic regression revealed body mass index and smoking as independent risk factors for reconstructive complications in both cohorts (P<0.01). Conclusions The NSQIP database provides large-scale, multi-institutional, independent outcomes for acellular dermis and submuscular breast reconstruction. Both thirty-day complication profiles and risk factors for post operative morbidity are similar between these two reconstructive approaches.
Purpose: Microvascular reconstructive surgery has become an integral part of the treatment of head and neck cancer patients. This review of 121 free flaps for head and neck cancer patients performed over the last 11 years was done to evaluate circulatory crisis, salvage, and secondary reconstruction and to investigate which factors may contribute to these rates. Method: Nine emergent explorations among 121 head and neck reconstruction with free flaps were reviewed to analyze detection of vascular crisis, the time interval from detection of circulatory crisis to exploration, operation procedures and results, and secondary reconstructions. Emergent exploration was done with our protocol. Result: Nine free flaps exhibited signs of vascular problems between 1 day and 6 days postoperatively. The emergent exploration rate of this series was 7.4% (9/121). The salvage rate was 55.6% (5/9), giving an overall flap viability of 96.7% (117/121). In our study, preoperative radiation therapy, positive smoking history, alcohol consumption history, combined disease such as diabetes mellitus and hypertension, recipient vessels and types of vascular anastomosis were not related to the causes of circulatory crisis. The mean time interval between the onset of clinical recognition of impaired flap perfusion and re-exploration of the salvaged 5 flaps was 3.2 hours, that of failed 4 flaps was 11.25 hours. Conclusion: Despite high overall success rate, relatively low salvage rate may be attributed to late detection of circulatory crisis and in long time interval between detection and exploration. We conclude that early detection of circulatory crisis and expeditious re-exploration are a matter of great importance for the success of salvage operation.
This study was conducted to evaluate the relations between alcohol intake and blood lipid level in a group of 1,138 Korean adult men, ages 20 to 69 years. Total number of each of a variety of drinks in the previous two weeks was obtained by questionnaire and converted into grams of alcohol consumed in a week. The levels of blood lipid such as Cholesterol, HDL-Cholesterol, Triglyceride and LDL-Cholesterol were examined by enzyme method. We also observed the effects of various variables such as age, body mass index, smoking, exercise and blood pressure on blood lipid level. The results obtained were as follows : 1. Average weekly alcohol intake was $129.0{\pm}167.4gm$ and that of 30-39 age group was the highest as $149.3{\pm}170.4gm$. 2. Levels of Cholesterol Triglyceride and LDL-Cholesterol tended to increase with increasing age, but level of HDL-Cholesterol showed no significant relationship with age. 3. The positive linear regressions of alcohol intake on HDL-Cholesterol and Triglyceride were noted statistically significant. 4. Multiple regression analysis demonstrated that the effect of alcohol on HDL-Cholesterol and Triglyceride was statistically significant and the contribution rates were 5.0% and 0.8%, respectively. And, in the case of HDL-Cholesterol, the alcohol intake was the most significant independent variable.
This study examined the health-related factors and nutritional status of 89 single women workers in their 20's who work night and day shift at the take-out coffee shops and the 89 single women office workers. The results of the study are summarized as follows: The shift-workers showed lower rate of office tenure (p < 0.001), income (p < 0.001), job satisfaction (p < 0.05), weight (p < 0.05), and higher rate of weight change (p < 0.001) than the non shift-workers. The shift-workers showed lower rate of of exercise (p < 0.001), sleeping hours (p < 0.01), and good health condition (p < 0.01), and higher rates of smoking (p < 0.001), presence of disease (p < 0.001), gastric and intestinal illnesses (p < 0.001) than the non shift-workers. More than 88.8% of the shift workers answered that they ate alone (p < 0.001). The shift workers showed lower rate of regularity of meal (p < 0.001), balanced diet (p < 0.001), and mealtime (p < 0.001), and higher rate of skipping breakfast (p < 0.001), consumption of salty and spicy food (p < 0.001), and overeating (p < 0.01) than the non shift-workers. The shift workers consumed (p < 0.001) less frequently rice, soup and side dishes, and more frequently noodles and snack, bread than the non-shift-workers. The shift workers showed lower rate of consumption of beer (p < 0.01), and higher rate of consumption of coffee (p < 0.001), tea (p < 0.01) and soju (p < 0.001) in once a week or more intakes than the non-shift-workers. The shift workers showed higher rate of consumption of carbohydrates (p < 0.05), and calcium (p < 0.05) and lower rate of consumption of protein (p < 0.05), fiber (p < 0.05), vitamin C (p < 0.05), and folate (p < 0.05) intakes than the non-shift-workers.
Purpose: Forests have positive effects on health due to phytoncide, thus increasing physical activity and stress relief. However, research has not been conducted on the daily health benefits of existing forests. Therefore, this study attempts to compare the health status and behaviors of residents in urban and forested areas. Methods: This cross-sectional study used anthropometric measures, blood tests, heart rate variability, depression, stress, and health behavior self-reports for adults between 35 and 79 years from two regions. Results: Adults living in a forested region had better health consequences-including lower prevalence of osteoarthritis (6.4%) and mean bone mineral density (-0.84) -than those in an urban region (osteoarthritis: 13.7%; bone mineral density: -1.55). The percentage of 'physically active' participants (measured in MET-minutes) differed significantly different between the forested (49.1%) and urban (7.3%) areas. However, health behaviors such as smoking, alcohol consumption, and regular heath check-up rates were worse among residents from the forested, than the urban area. Conclusion: We concluded that more proactive forest therapy programs are needed to prove the health differences.
As the usage of e-cigarettes and its effects on health harms receive attentions, the debate over regulating e-cigarette industry's' social media marketing has been heated. While the industry has aggressively employed social media marketing such as YouTube, little research has examined what kinds of e-cigarette information is delivered to Korean viewers through YouTube. This study investigated the presence of product-related information and health harm information in the videos, and the characteristics of YouTube creators. The proportion of female creators was smaller than male creators, but more than female smoking rates. The results showed that product-related information such as taste, design and convenience was mentioned more than half the videos, but health ham was mentioned less. Videos which mentioned convenience and design tended to not mention health harm. These results could be used to support the current regulation approach over e-cigarette YouTube marketing.
Busenlechner, Dieter;Furhauser, Rudolf;Haas, Robert;Watzek, Georg;Mailath, Georg;Pommer, Bernhard
Journal of Periodontal and Implant Science
/
v.44
no.3
/
pp.102-108
/
2014
Purpose: Rehabilitation of the incomplete dentition by means of osseointegrated dental implants represents a highly predictable and widespread therapy; however, little is known about potential risk factors that may impair long-term implant success. Methods: From 2004 to 2012, a total of 13,147 implants were placed in 4,316 patients at the Academy for Oral Implantology in Vienna. The survival rates after 8 years of follow-up were computed using the Kaplan-Meier method, and the impact of patient- and implant-related risk factors was assessed. Results: Overall implant survival was 97% and was not associated with implant length (P=0.930), implant diameter (P=0.704), jaw location (P=0.545), implant position (P=0.450), local bone quality (P=0.398), previous bone augmentation surgery (P=0.617), or patient-related factors including osteoporosis (P=0.661), age (P=0.575), or diabetes mellitus (P=0.928). However, smoking increased the risk of implant failure by 3 folds (P<0.001) and a positive history of periodontal disease doubled the failure risk (P=0.001). Conclusions: Summing up the long-term results of well over 10,000 implants at the Academy for Oral Implantology in Vienna it can be concluded that there is only a limited number of patients that do not qualify for implant therapy and may thus not benefit from improved quality of life associated with fixed implant-retained prostheses.
The purpose of this study is to identify health problems and health behaviors of the middle-aged residing in urban areas and to plan and implement health promotion programs based on their health needs. The subjects' age ranged from 30-64 years in 1.040 middle-aged residing in an area of Kangbook-ku in Seoul. The data were collected from September 1998 to February 1999 with structured questionnaire using face-to-face or telephone interviews. The data were analyzed by SPSS-PC+ and identified by $X^2$ test and ANOVA. The results were as follows: 1. 35.4% of the males and 27.8% of the female responded that they were healthy regarding their perceived health status. In the order of chronic illness prevalence in the case of males was hypertension, diabetes, and digestive disorders and. in the case of females, was digestive disorders, hypertension, arthritis, anemia, and diabetes. 2. Male and female's smoking rates were 7.3% and 3.6% each and marked the highest rate of 30 to 40 years: drinking behavior was 66.9% in males and 32.2% in females. 3. The younger males had the worse dietary habits and had the lowest frequency of regular exercise. The older the females were, the more their weight increased. According to the results, health promotion programs by sex are recommended, especially in the target population of 30 to 40 years. and focused on the strategies for promoting self-care and actual health practice: it is strongly suggested that health promotion programs for adolescent and school-aged children before middle aged health behavior begins.
Objectives: This study was conducted to identify the rates of perceived stress of elderly people over 65 years old and to confirm the influence of stress on general health and oral health status. Methods: Using data from the National Health and Nutrition Survey for 2014, 1,472 people over 65 years of age were selected as final subjects. Stress was used as an independent variable and dependent variables were included physical health (perceived health status), mental health (depression), and oral health (perceived oral health status). The following confounding variables were adjusted for the current study: demographic characteristics (gender, age, education level, house income) and health - related characteristics (drinking, smoking, exercise, frequency of tooth brushing, using oral care product, dental exam, comorbidity, restrict activity). Complex sampling analysis was applied and logistic regression was performed to determine the effects of stress on physical health, mental health and oral health status. Odds ratio (OR) and 95% confidence interval (95% Confidence Interval, 95% CI) were calculated. Results: Logistic regression indicated that stress was significantly associated with low physical health (OR=2.18, 95%CI: 1.49-3.20), low mental health (OR=8.68, 95%CI: 4.98-15.11), low oral health (OR=1.53, 95%CI: 1.06-2.21) after adjusting for confounding variables. Conclusions: The perceived stress of the elderly was found to be related to the general health and oral health status. Therefore, it is necessary to evaluate stress as a predictor of health risk for the health promotion of the elderly on multidisciplinary assessment and continuous evaluation. In addition, health support policies should be provided to achieve good health status for elderly.
Objectives: In Indonesia, 61 million adults smoked in 2018, and 59 million were exposed to secondhand smoke at offices or restaurants in 2011. The Presidential Decree 109/2012 encouraged local governments to implement a smoke-free policy (SFP), and the city of Jayapura enacted a local bill (1/2015) to that effect in 2015. This study aimed to evaluate compliance with this bill and to explore challenges in implementing it. Methods: We conducted a mixed-methods study. Quantitatively, we assessed compliance of facilities with 6 criteria (per the bill): the presence of signage, the lack of smoking activity, the lack of sale of tobacco, the lack of tobacco advertisements, the lack of cigarette smoke, and the lack of ashtrays. We surveyed 192 facilities, including health facilities, educational facilities, places of worship, government offices, and indoor and outdoor public facilities. Qualitatively, we explored challenges in implementation by interviewing 19 informants (government officers, students, and community members). Results: The rate of compliance with all 6 criteria was 17% overall, ranging from 0% at outdoor public facilities to 50% at health facilities. Spatial patterning was absent, as shown by similar compliance rates for SFP facilities within a 1-km boundary around the provincial and city health offices compared to those outside the boundary. Implementation challenges included (1) a limited budget for enforcement, (2) a lack of support from local non-governmental organizations and universities, (3) a lack of public awareness at the facilities themselves, and (4) a lack of examples set by local leaders. Conclusions: Overall compliance was low in Jayapura due to many challenges. This information provides lessons regarding tobacco control policy in underdeveloped areas far from the central government.
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