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2023 Obesity Fact Sheet: Prevalence of Obesity and Abdominal Obesity in Adults, Adolescents, and Children in Korea from 2012 to 2021

J Obes Metab Syndr. 2024 Mar 27. doi: 10.7570/jomes24012. Online ahead of print.

ABSTRACT

BACKGROUND: The 2023 Obesity Fact Sheet aims to present an updated overview of obesity prevalence across all age groups, including children and adolescents.

METHODS: This study included individuals aged ≥20 years who underwent health checkups provided by the Korean National Health Insurance Service between 2012 and 2021. The prevalence of obesity and abdominal obesity was standardized by age and sex using data from the 2010 population and housing census. For children and adolescents (6 to 18 years), we used the Korea National Health and Nutrition Examination Survey (2012 to 2021), and obesity was defined by the corresponding sex- and age-specific body mass index percentile of 95th or greater based on the 2017 Korean National Growth Chart for Children and Adolescents.

RESULTS: The overall prevalence of obesity in 2021 is 38.4% (49.2% in men and 27.8% in women), which is a 1.27-fold increase from 30.2% in 2012. The prevalence of obesity has increased across all age groups, particularly among those aged 20, 30, and 80 years. The prevalence of class III obesity substantially increased from 0.35% (men) and 0.42% (women) in 2012 to 1.21% and 0.97% in 2021, with 3.46- and 2.31-fold increases, respectively. This increase was particularly pronounced in young adults. The prevalence of obesity in children and adolescents has surged from 9.7% in 2012 to 19.3% in 2021, with a greater increase among boys.

CONCLUSION: Our study provides information on the current status of obesity prevalence based on the 2023 Obesity Fact Sheet, emphasizing the urgency of implementing timely strategies to reverse this increasing trend.

PMID:38531533 | DOI:10.7570/jomes24012

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Effect of platelet-rich plasma on healing of lower extremity diabetic skin ulcers: A meta-analysis

Int Wound J. 2024 Apr;21(4):e14856. doi: 10.1111/iwj.14856.

ABSTRACT

The aim of this research is to explore the therapeutic efficacy of platelet-rich plasma (PRP) on the cutaneous ulceration of diabetes mellitus (DM). From the beginning of the database until January 2024, we looked through several databases to obtain randomised, controlled PRP studies to treat the wound healing of DM in adult patients. The Cochrane Collaboration’s Risk-Of-Bias Instrument was used to evaluate the risk of bias in randomised, controlled studies. Funnel plots, sensitivity analyses and Egger regression tests were employed to determine the reliability and effectiveness of the meta-analyses. Depending on the degree of heterogeneity, a fixed or random effect model has been used. The statistical significance was determined to be below 0.05. Altogether 281 trials were collected from the database and entered into Endnote Software for screening, and 15 trials were analysed. It was found that PRP was associated with a higher rate of wound healing (OR, 3.23; 95% CI, 2.42, 4.31 p < 0.0001). PRP was associated with a reduction in the risk of post-operative wound infection (OR, 0.46; 95% CI, 0.21, 0.99 p = 0.05). PRP was associated with a reduction in the risk of amputations amongst those with DM (OR, 0.50; 95% CI, 0.30, 0.84 p = 0.009). Overall, PRP treatment for DM is expected to improve the rate of wound healing, decrease the risk of wound infection and decrease the risk of amputations.

PMID:38531532 | DOI:10.1111/iwj.14856

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Developing and Validating Clinical Prediction Models in Hepatology-an Overview for Clinicians

J Hepatol. 2024 Mar 24:S0168-8278(24)00213-7. doi: 10.1016/j.jhep.2024.03.030. Online ahead of print.

ABSTRACT

Prediction models are everywhere in clinical medicine. We use them to assign a diagnosis or a prognosis, and there is a continuous effort to develop better prediction models. It is important to understand the fundamentals of prediction modeling, and here we describe nine steps to develop and validate a clinical prediction model with the intention of implementing it in clinical practice: Determine if there is a need for a new prediction model; define the purpose and intended use for the model; assess the quality and quantity of the data you wish to develop the model on; develop the model using sound statistical methods; generate risk predictions on the probability scale (0-100%); evaluate the performance of the model in terms of discrimination, calibration, and clinical utility; validate the model using bootstrapping to correct for the apparent optimism in performance; validate the model on external datasets to assess the generalizability and transportability of the model; and finally publish the model so that it can be implemented or validated by others.

PMID:38531493 | DOI:10.1016/j.jhep.2024.03.030

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Prevalence of Pain With Movement in Active Duty US Army Soldiers

Mil Med. 2024 Mar 26:usae048. doi: 10.1093/milmed/usae048. Online ahead of print.

ABSTRACT

INTRODUCTION: Soldiers must be able to perform a multitude of physically demanding tasks as part of their regular duty, but their physical readiness is often degraded due to pain and musculoskeletal injury (MSKI). The presence of pain with movement has been associated with increased MSKI risk in Soldiers. Improved awareness of the prevalence of painful movements in uninjured Soldiers could help inform Army injury mitigation efforts. The purpose of this study was to identify the prevalence of pain with movement in a population of healthy active duty Soldiers.

MATERIALS AND METHODS: The Selective Functional Movement Assessment-Top Tier Movements (SFMA-TTM), active range of motion (AROM) of the hips and shoulders, and the elicitation of pain with movement were measured in 268 healthy US Army Soldiers. Descriptive statistics were generated for the number of painful movements for each measure and inferential statistics; independent t-test and one-way independent analysis of variance (ANOVA) were used for analysis of the other measures.

RESULTS: Greater than half (59%) of the participants reported pain with at least 1 movement and more than 41% reported pain with 2 or more movements. Soldiers reported a mean of 1.35 painful movements on the SFMA-TTM assessment and a mean of 1.54 painful AROM movements.

CONCLUSIONS: Pain with functional movement patterns was common across a sample of uninjured Soldiers. The presence of pain with movement warrants further evaluation as it may impact a Soldier’s physical performance, risk for future injury, and overall quality of life.

PMID:38531071 | DOI:10.1093/milmed/usae048

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Timing of Endoscopic Retrograde Cholangiopancreatography in Postcholecystectomy Patients and Its Effect on Post-ERCP Complications

J Laparoendosc Adv Surg Tech A. 2024 Mar 27. doi: 10.1089/lap.2024.0037. Online ahead of print.

ABSTRACT

Background: Due to the increasing use of laparoscopy for symptomatic cholelithiasis and other gallbladder disorders, as well as the ongoing issue of associated biliary tree injuries, endoscopic retrograde cholangiopancreatography (ERCP) still holds a significant position in the diagnosis and treatment of postcholecystectomy disorders. In our study, we aimed to examine the relationship between the time elapsed between cholecystectomy and ERCP with the post-ERCP complications. Methods: Ninety-six patients with a history of cholecystectomy who underwent ERCP between January 2016 and January 2021 at the General Surgery Clinic of the University of Health Sciences Bakırköy Dr. Sadi Konuk Health Application and Research Center were retrospectively evaluated. Patient and procedure-related factors were analyzed statistically through univariate analyses. Results: In the matter of post-ERCP complication status, differences observed in terms of age, body mass index (BMI) values, gender, comorbidities, number of ERCP procedures, and the time elapsed between cholecystectomy and ERCP among cases were not statistically significant. Discussion: Our study demonstrates that age, BMI values, gender, comorbidities, ERCP count, and the time between procedures are not significant risk factors for post-ERCP complications. Regardless of the time between surgery and ERCP, the presence of post-ERCP complications is comparable.

PMID:38531045 | DOI:10.1089/lap.2024.0037

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Retinal Nerve Fiber Layer Changes in Patients With Chronic Obstructive Pulmonary Disease Compared to Healthy Controls: A Meta-analysis

Ophthalmic Surg Lasers Imaging Retina. 2024 Mar 1:1-9. doi: 10.3928/23258160-20240220-01. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: This study investigated changes in retinal nerve fiber layers (RNFL) in patients diagnosed with chronic obstructive pulmonary disease (COPD) compared to healthy control patients, using optical coherence tomography.

METHODS: PubMed, Cochrane Library, and Google Scholar databases were systematically searched for published articles comparing RNFL between patients with COPD and healthy controls. Standardized mean difference (SMD) with 95% confidence interval (CI) was computed to compare continuous variables.

RESULTS: Average RNFL thickness was significantly reduced in COPD patients compared to healthy controls (SMD = -0.31, 95% CI = -0.48 to -0.14, P = 0.0004, I2 = 0%). Average RNFL thickness did not differ significantly between patients with mild/moderate COPD and healthy controls (SMD = -0.17, 95% CI = -0.39 to 0.04, P = 0.12, I2 = 2%), while a statistically significant reduction in average RNFL thickness was noticed in patients with severe COPD compared to healthy controls (SMD = -0.72, 95% CI = -1.23 to -0.21, P = 0.006, I2 = 83%). Average RNFL thickness was significantly higher in patients with mild/moderate COPD compared to patients with severe COPD (SMD = 0.69, 95% CI = 0.29 to 1.09, P = 0.0008, I2 = 66%).

CONCLUSIONS: This meta-analysis showed that RNFL thickness was decreased in patients with COPD compared to healthy controls. Patients diagnosed with severe COPD seem to be more affected and have thinner RNFL. [Ophthalmic Surg Lasers Imaging Retina 2024;55:XX-XX.].

PMID:38531007 | DOI:10.3928/23258160-20240220-01

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Assessment of Microvascular Changes After Rhegmatogenous Retinal Detachment Repair Using Wide-Field Swept-Source Optical Coherence Tomography Angiography

Ophthalmic Surg Lasers Imaging Retina. 2024 Mar 1:1-8. doi: 10.3928/23258160-20240130-01. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Our objective was to evaluate retinal microvascular changes and visual outcomes following rhegmatogenous retinal detachment (RRD) repair using wide-field swept-source optical coherence tomography angiography (WF SS-OCTA).

PATIENTS AND METHODS: The study included 116 eyes of 111 patients with macula-off (n = 68) or macula-on (n = 48) RRD treated with a single successful procedure, 79 fellow eyes, and 183 eyes of control patients imaged with WF SS-OCTA (3 ×3, 6 ×6, and 12 ×12 mm images). Mixed-effects multiple linear regression models were used for statistical analysis.

RESULTS: Vessel density (VD) and vessel skeletonized density (VSD) of the superficial capillary plexus (3 ×3 mm scans) and full-thickness retina (12 ×12 mm) were significantly reduced in RRD eyes compared to fellow and control eyes. Decreased VSD and VD in all layers (3 ×3 mm and 6 ×6 mm) were significantly associated with greater preoperative extent of retinal detachment (P < 0.05) and poorer postoperative best-corrected visual acuity (BCVA) in RRD eyes (P < 0.05). Macula-off status was associated with increased foveal avascular zone irregularity (12 ×12 mm, P = 0.02).

CONCLUSIONS: Decreased VD on WF SS-OCTA is associated with poorer postoperative BCVA following RRD repair. [Ophthalmic Surg Lasers Imaging Retina 2024;55:XX-XX.].

PMID:38530997 | DOI:10.3928/23258160-20240130-01

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Investigating the Utility of Near-Infrared Reflectance Imaging for Diabetic Retinopathy Screening

Ophthalmic Surg Lasers Imaging Retina. 2024 Mar 1:1-8. doi: 10.3928/23258160-20240205-02. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: We investigated the reliability of near-infrared reflectance (NIR) imaging as a method of assessing severity of diabetic retinopathy (DR).

PATIENTS AND METHODS: One hundred ninety-five NIR images were reviewed by two graders for the number of hyporeflective foci, presence or absence of vascular abnormalities, and presumptive DR stage; these were correlated to fundus photography-defined DR stage. Interrater reliability was confirmed via one-way random effects model of intraclass correlation coefficients. Analysis of variance was used in subgroup analysis, receiver operating characteristic (ROC) curves were created to validate reliability of the model, and logistic regression was used to model foci and vascular abnormalities as predictors for moderate or worse disease.

RESULTS: A statistically significant difference in mean number of hyporeflective foci was found between no DR and moderate non-proliferative DR (NPDR; P < 0.0001), no DR and severe NPDR (P < 0.001), no DR and proliferative DR (PDR; P < 0.0001), mild and moderate NPDR (P = 0.008), mild and severe NPDR (P < 0.001), and mild NPDR and PDR (P < 0.001). The area under the ROC curve was 0.849 (CI: 0.792 to 0.905). The threshold for detection of moderate NPDR or worse was 4.75 foci, with a sensitivity of 79.0% and a false positive rate of 20.0%. Multivariate logistic regression model incorporating hyporeflective foci with vascular abnormalities (odds ratio [OR] = 1.592, 95% CI: 1.381 to 1.835; P < 0.001) was able to accurately predict moderate disease or worse, just moderate disease (OR = 1.045, 95% CI: 1.003 to 1.089; P = 0.035), severe disease (OR = 1.050, 95% CI: 1.006 to 1.096; P = 0.027), and proliferative disease (OR = 1.050, 95% CI: 1.008 to 1.095; P = 0.018).

CONCLUSIONS: NIR imaging may be an adjunct tool in screening for DR. [Ophthalmic Surg Lasers Imaging Retina 2024;55:XX-XX.].

PMID:38530988 | DOI:10.3928/23258160-20240205-02

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Analysis of 10-year income trends for pharmacists and other select health professionals

Am J Health Syst Pharm. 2024 Mar 26:zxae087. doi: 10.1093/ajhp/zxae087. Online ahead of print.

ABSTRACT

DISCLAIMER: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

PURPOSE: To evaluate income trends among pharmacists and other select health professions (dentists, nurse practitioners, registered nurses, and physicians) in the US for the 10-year period of 2012 to 2021, with special attention given to the first 2 years of the COVID-19 pandemic (2020 and 2021).

METHODS: A retrospective analysis was conducted of 2012 to 2021 income data for select health professions, collected from the American Community Survey. Univariate time series analysis was conducted using exponential smoothing to examine income patterns over the 10-year study period and forecast income for the next 5-year period (2022 to 2026) for each health profession. Additionally, time series regression models were constructed for each health profession. Descriptive statistics (mean percent change in income and SD) were calculated for each health profession for the prepandemic era (2012 to 2019) and the first 2 years of the pandemic (2020 and 2021).

RESULTS: Goodness-of-fit statistics for each forecast model indicate highly accurate forecasts. The model for each health profession indicates a significant positive trajectory in income (P < 0.001), although pharmacists are projected to have a lower rate of income growth among the 5 health professions for the next 5-year period, 2022 to 2026. During the first 2 years of the pandemic, pharmacists had the lowest mean percent change in income (mean, 2.0%; SD, 2.0%) among the 5 health professions.

CONCLUSION: Growth in pharmacist income is projected to lag behind that in other health professions in the near future. Individual-, organization-, and profession-level strategies may facilitate opportunities for income growth among pharmacists.

PMID:38530987 | DOI:10.1093/ajhp/zxae087

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Scleral Fixated Secondary IOLs: An Outcomes Comparison Between the Yamane and Gore-Tex-Sutured Techniques

Ophthalmic Surg Lasers Imaging Retina. 2024 Mar 1:1-7. doi: 10.3928/23258160-20240226-01. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Among secondary intraocular lens (IOL) techniques, scleral fixated IOLs (SFIOLs) offer advantages in cases without capsular support. In this article, we compare outcomes between two types of Gore-Tex scleral sutured IOLs with the Yamane technique.

PATIENTS AND METHODS: This study was a retrospective chart review of patients who underwent SFIOL implantation.

RESULTS: Analysis revealed a statistically significant improvement in final postoperative visual acuity (VA) for sutured SFIOLs (P < 0.001, Envista (n = 29) 95% CI 0.47-1.04, Akreos (n = 23) 95% CI 0.32-0.81) with no statistical improvement in the Yamane group (P = 0.44, n = 15, 95% CI -0.33-0.71). Outcomes analysis revealed greater incidences of cystoid macular edema (CME) in the Yamane cohort (P < 0.05) and a higher rate of reoperations in the Akreos cohort (P < 0.02). All complications related to suture material (n = 4) and IOL decentration (n = 2) occurred in the sutured SFIOL group.

CONCLUSIONS: The sutureless Yamane technique offered fewer subsequent surgeries and suture-specific complications while revealing diminished VA improvement in long-term follow-up compared to the sutured SFIOLs. [Ophthalmic Surg Lasers Imaging Retina 2024;55:xx-xx.].

PMID:38530983 | DOI:10.3928/23258160-20240226-01