Temporal Changes of Metabolic Indicators and Quality of Life by a Two-Day Patient Education Program for Metabolic Syndrome Patients

Metabolic syndrome (MetS) is a disease with a high prevalence that threatens the health of modern people. Patient education is essential to control MetS. This prospective study aimed to evaluate 6-month changes in health indicators following a two-day education program for patients with MetS aged 45 or older. Education about MetS, lifestyle modification, nutrition, and physical activity was provided. At 3 and 6 months after the program, participants visited for follow-up. Twenty-two patients completed the 6-month study. Waist circumference was reduced, and life quality and depression index improved in 3 and 6 months compared to pre-education. Blood pressure decreased, and anxiety index improved at three months. Nutritional knowledge was well maintained for 3 and 6 months. High-density lipoprotein-cholesterol levels increased at six months. Three out of twenty-two patients did not satisfy MetS criteria at the end of the study due to improved indicators. A two-day multidisciplinary education program positively affected health indicators in MetS patients. Participation in the program also help with life satisfaction and positive emotional condition. However, some indicators improved in 3 months, but the effect disappeared 6 months after the program.

Comment on Matsuo et al. Impact of Olfactory Change on Postoperative Body Weight Loss in Patients with Gastric Cancer after Gastrectomy. Nutrients 2024, 16, 851

I read with interest the paper by Matsuo et al [...].

Prognosis palliative care study, palliative prognostic index, palliative prognostic score and objective prognostic score in advanced cancer: a prospective comparison

BACKGROUND

Predicting how long a patient with far advanced cancer has to live is a significant part of hospice and palliative care. Various prognostic models have been developed, but have not been fully compared in South Korea.

OBJECTIVES

We aimed to compare the accuracy of the Prognosis in Palliative Care Study (PiPS), Palliative Prognostic Index (PPI), Palliative Prognostic Score (PaP) and Objective Prognostic Score (OPS) for patients with far advanced cancer in a palliative care unit in South Korea.

METHODS

This prospective study included patients with far advanced cancer who were admitted to a single palliative care unit at the National University Hospital. Variables for calculating the prognostic models were recorded by a palliative care physician. The survival rate was estimated using the Kaplan-Meier method. The sensitivity, specificity, positive predictive value and negative predictive value of each model were calculated.

RESULTS

A total of 160 patients participated. There was a significant difference in survival rates across all groups, each categorised through the five prognostic models. The overall accuracy (OA) of the prognostic models ranged between 54.5% and 77.6%. The OA of clinicians' predictions of survival ranged between 61.9% and 81.3%.

CONCLUSION

The PiPS, PPI, PaP and OPS were successfully validated in a palliative care unit of South Korea. There was no difference in accuracy between the prognostic models, and OA tended to be lower than in previous studies.

Effect of fermented oyster (Crassostrea gigas) extracts and regular walking on muscle strength and mass in older adults with relatively low muscle mass: A randomized controlled trial

INTRODUCTION

Oysters possess an excellent nutritional profile containing γ-aminobutyric acid (GABA). Previous data suggest that GABA is a potent bioactive compound for improving muscle health. Lactic acid fermentation is thought to increase GABA content. However, the effect of oral supplementation of fermented oyster extracts (FO) on human muscle strength and mass is unclear. Therefore, we tested the effects and safety of consumption of FO combined with regular walking for 12 weeks on muscle strength and mass in older adults with relatively low muscle mass.

MATERIALS AND METHODS

A randomized controlled trial was conducted on 54 adults between 50 and 78 years of age. Participants were randomized to receive either placebo or 1,200 mg FO daily for 12 weeks. By fermentation with Lactobacillus brevis BJ20, FO was prepared from Crassostrea gigas. At baseline and at 12 weeks after treatment, the following parameters of the participants were examined: knee strengths, handgrip strengths, body composition, blood tests, and 24-h dietary recall. All participants were required to walk for 30-60 min/day for >3 days/week during the trial period. Physical activity was assessed using an exercise log during the study.

RESULTS

Of the 54 participants, 49 completed the trial without reporting adverse effects. FO supplementation over 12 weeks did not cause any increase in knee or grip strength compared to the control group. Also, no differences were observed in the muscle mass, growth hormone, muscle biomarkers, anti-inflammatory markers, and antioxidative markers between the two groups. None of the participants experienced adverse events. Application of FO was well tolerated, and no notable adverse effect was reported in both groups.

DISCUSSION

FO supplementation with regular walking did not improve remarkably muscle function compared to regular walking alone in adults with relatively low muscle mass.

CLINICAL TRIAL REGISTRATION

[www.ClinicalTrials.gov], identifier [NCT04109911].

Effectiveness of Medical Education Assessment Consortium Clinical Knowledge Mock Examination (2011‐2016)

Good assessment is crucial for feedback on curriculum and to motivate students to learn. This study was conducted to perform item analysis on the Medical Education Assessment Consortium clinical knowledge mock examination (MEAC CKME) (2011–2016) and to evaluate several effects to improve item quality using both classical test theory and item response theory. The estimated difficulty index (P) and discrimination index (D) were calculated according to each course, item type, A (single best answer)/R (extended matching) type, and grading of item quality. The cut-off values used to evaluate P were: >0.8 (easy); 0.6–0.8 (moderate); and

Differential expression of ghrelin mRNA according to anatomical portions of human stomach

BACKGROUND/AIMS

The detailed ghrelin distribution on mRNA level in different anatomical portions of adult stomach and its association with plasma ghrelin levels are not yet well established. We investigated the ghrelin mRNA and peptide expression in different anatomical portions of stomach in human adults.

METHODOLOGY

Stomach tissue samples were obtained from 16 patients with gastric cancer who underwent total gastrectomy. The normal stomach tissues were taken from the upper (gastric fundus and upper body), middle (gastric middle and lower body) and lower (gastric antrum and pylorus) portions of stomach, respectively. The expression of ghrelin mRNA and peptide in stomach tissue samples were measured using RT-PCR and immunohistochemistry.

RESULTS

The ghrelin/actin ratio was 0.78 (range 0-3.38; n=16) at the upper portion, 0.20 (range 0-1.28; n=16) at the middle portion and 0.07 (range 0-0.67; n=16) at the lower portion of the stomach (p=0.001). Ghrelin-positive cells were seen in all parts of the gastric mucosa and were most numerous in the glandular compartment compared to foveolar compartment. Gastric body or fundic mucosa showed ghrelin-positive cells most abundantly as compared to other portions of the gastric mucosa (p<0.001).

CONCLUSIONS

Ghrelin mRNA expression and immunoreactivity is highest at the upper portion of the human stomach.

Useful Biomarkers of Metabolic Syndrome

The Special Issue call for papers on "Metabolic syndrome and its association with biomarkers" was proposed to present research on various markers for pathophysiology and the early detection of metabolic syndrome (MetS) [...].

Factors That Influence Educational Effectiveness and Learning Satisfaction in Biomedical Research Programs during Premedical School

Although student research programs have been implemented worldwide, research programs during premedical school have unique characteristics. The purpose of this study is to evaluate factors that influence the effects of premedical school research programs. Eighty second-year premedical students at Pusan National University were included in the study. Effect elements and influential factors were extracted through reference reviews and in-depth individual interviews. A Likert scale questionnaire was developed using the extracted elements and factors, and Cronbach’s alpha coefficient was used to analyze the reliability of the survey. The mean value and the standard deviation for each question were calculated to evaluate education effectiveness and learning satisfaction, and the influence of each factor on effect was analyzed using correlation analysis. Students’ research skills and knowledge were improved in the short term; however, interest in research or in a career as a researcher did not increase. Student interest, participation, and contributions were important factors. Among professors, passion, considerateness, and teaching method including the level of lesson were influential factors. Implementation of curriculum and support and guidance were influential as well, whereas evaluation system was not a factor. To improve student research programs, several factors that influence education effectiveness and learning satisfaction should be considered.

Index of Cardiac Age Index and Cardiometabolic Biomarkers in Adults with Metabolic Syndrome

Background: The presence of metabolic syndrome (MetS) seems to alter or accelerate the aging process of tissues or organs including the heart. We aim to investigate whether MetS are associated with an index of cardiac age calculated by parameters derived from 128-slice cardiac multidetector computed tomography (MDCT) and cardiometabolic biomarkers in adults. Materials and Methods: In this cross-sectional study, the data were collected from 135 subjects who underwent a comprehensive health checkup, including cardiac MDCT in adults (age ≥18 years). Cardiometabolic biomarkers and an index of cardiac age were measured. Results: Sixty-one (45.2%) had MetS and 44 subjects (32.6%) presented with moderate or severe coronary artery stenosis (CAS) on cardiac MDCT. MetS had positive correlations with several anthropometric variables, metabolic variables [triglyceride, gamma-glutamyl transpeptidase (GGT), homeostatic model assessment of insulin resistance (HOMA-IR)], and systolic blood pressure, cardiac parameters, an index of cardiac age and CAS, whereas had a negative correlation with high-density lipoprotein cholesterol. The diagnostic accuracy for MetS had similar area under the curve among the four variables (index of cardiac age, CAS, HOMA-IR, GGT). On age-adjusted multivariate analysis, only high index of cardiac age (≥55.0 years), and high HOMA-IR (≥1.22) were significantly and independently associated with MetS [odds ratio (OR) 2.48, 95% confidence interval (CI) 1.19-5.18, P = 0.016 and OR 3.41, 95% CI 1.65-7.06, P = 0.001, respectively]. Conclusion: Adults with MetS had higher index of cardiac age and higher HOMA-IR, compared with adults without MetS.

Efficacy and safety of fermented Prunus mume vinegar on fatigue improvement in adults with unexplained fatigue: A randomized controlled trial

BACKGROUND

The accumulation of fatigue leads to reduced physical, emotional, psychological, and social functions.

OBJECTIVES

Fermented Prunus mume vinegar (PV) improves fatigue in animals; however, studies in humans have not been conducted. We aimed to examine the effects and safety of consuming fermented PV for 8 weeks on fatigue indices in adults with unexplained fatigue while considering the placebo effect.

METHODS

A randomized, double-blind, placebo-controlled trial was conducted in adults of >19 years, who were diagnosed with unexplained fatigue for at least 1 month. Eighty participants were randomly assigned to receive daily 70 mL of fermented PV (2.56 mg/g, chlorogenic acid, and 15.3 mg/g, citric acid) or a placebo for 8 weeks. At baseline and 4 and 8 weeks after treatment, the participants were visited for blood tests (liver enzyme, glucose, creatinine, lactate, malondialdehyde [MDA], and creatine kinase [CK]) and questionnaires (Fatigue Severity Scale [FSS], fatigue visual analog scale [VAS], Beck Depression Inventory [BDI], the Korean version of the Brief Encounter Psychosocial Instrument [BEPSI-K], EQ-5D-3L, and EQ-VAS]).

RESULTS

Fermented PV supplementation for 8 weeks did not remarkably improve the fatigue indices when compared to placebo. Additionally, differences in fatigue VAS, BDI, BEPSI-K, EQ-5D-3L, EQ-VAS, lactate, CK, and MDA concentrations between the groups were not observed. However, FSS had positively correlated with fatigue VAS, BDI, and BEPSI-K, whereas it was negatively correlated with EQ-5D-3L and EQ-VAS at the baseline and 8 weeks. None of the participants reported adverse events.

CONCLUSION

The efficacy of fermented PV did not exceed the efficacy of placebo in adults with unexplained fatigue.

CLINICAL TRIAL REGISTRATION

[ClinicalTrials.gov], identifier [NCT04319692].

Association between breakfast consumption frequency and chronic inflammation in Korean adult males: Korea National Health and Nutrition Examination Survey 2016-2018

BACKGROUND

Skipping breakfast is associated with an increased risk of chronic inflammatory diseases. This study aimed to examine the association between breakfast-eating habits and inflammation, using high-sensitivity C-reactive protein (hs-CRP) as a marker.

METHODS

A total of 4,000 Korean adult males with no history of myocardial infarction, angina, stroke, diabetes, rheumatoid arthritis, cancer, or current smoking were included. Data from the 2016-2018 Korea National Health and Nutrition Examination Survey were used for analysis. The frequency of breakfast consumption was assessed through a questionnaire item in the dietary survey section asking participants about their weekly breakfast consumption routines over the past year. Participants were categorized into two groups, namely "0-2 breakfasts per week" and "3-7 breakfasts per week"; hs-CRP concentrations were measured through blood tests.

RESULTS

Comparing between the "infrequent breakfast consumption (0-2 breakfasts per week)" and "frequent breakfast consumption (3-7 breakfasts per week)" groups, the mean hs-CRP was found to be significantly higher in the "infrequent breakfast consumption" group, even after adjusting for age, body mass index, physical activity, alcohol consumption, systolic blood pressure, blood pressure medication, fasting blood glucose, and triglycerides (mean hs-CRP: frequent breakfast consumption, 1.36±0.09 mg/L; infrequent breakfast consumption, 1.17±0.05 mg/L; P-value=0.036).

CONCLUSION

Less frequent breakfast consumption was associated with elevated hs-CRP levels. Further large-scale studies incorporating adjusted measures of daily eating patterns as well as food quality and quantity are required for a deeper understanding of the role of breakfast in the primary prevention of chronic inflammatory diseases.

Evaluation of effectiveness of peer education on smoking behavior among high school students

[No Abstract Available].

Assessment of pediatric residents burnout in a tertiary academic center

[No Abstract Available].

Enteropathy and intestinal malabsorption in patients treated with antihypertensive drugs. A retrospective cohort study

OBJECTIVES

To investigate differences in the incidence of enteropathy or intestinal malabsorption in patients taking angiotensin II receptor blockers (ARBs), angiotensin-converting enzyme inhibitor (ACEI), calcium channel blocker (CCB), and beta blockers (BBs) at a single center in Korea.

METHODS

In this retrospective study, we utilized data from the Yangsan electronic medical records to identify 129,169 patients. These individuals were prescribed olmesartan, other ARBs, ACEI, CCB, and BBs between November 2008 and February 2021.

RESULTS

Of the 44,775 patients, 51 (0.11%) were observed to have enteropathy or intestinal malabsorption. Compared with the ACEI group, the adjusted odds ratios (ORs) for enteropathy and intestinal malabsorption were OR=1.313 (95% confidence interval [CI]: [0.188-6.798], p=0.893) for olmesartan, OR=0.915 (95% CI: [0.525-1.595], p=0.754) for the other ARBs, OR=0.928 (95% CI: [0.200-4.307]; p=0.924) for the CCB, and OR=0.663 (95% CI: [0.151-2.906]; p=0.586) for the BBs group. These findings were adjusted for factors such as age, gender, duration of antihypertensive medication, and comorbidities.

CONCLUSION

In a retrospective cohort study of patients on antihypertensive medications, no significant difference was found in the incidence of enteropathy or intestinal malabsorption when ACEI was compared to olmesartan, other ARBs, CCB, and BBs.

Niemann-Pick C1-like 1 as a Prognostic Marker in Renal Cell Carcinoma: A Retrospective Cohort Study

BACKGROUND

Renal cell carcinoma (RCC) is a highly aggressive malignancy accounting for the majority of kidney cancers. Despite recent advancements in therapeutic options, the prognosis for advanced-stage RCC remains poor. Niemann-Pick C1-Like 1 (NPC1L1) plays a crucial role in cholesterol absorption and has been implicated in cancer progression across various cancers. However, its expression patterns and prognostic significance in RCC remain unclear.

METHODS

In this study, NPC1L1 expression in normal and RCC tissues, including subtypes, was compared using TCGA, GEPIA2, and The Human Protein Atlas. Clinical correlations were assessed, and the impact of NPC1L1 on overall survival (OS) and progression-free survival (PFS) was evaluated. Gene effect scores were analyzed using the DepMap tool to determine the involvement of NPC1L1 in RCC progression.

RESULTS

NPC1L1 expression was significantly lower in RCC tissues compared to normal tissues, particularly in the clear cell RCC (ccRCC), papillary RCC (pRCC), and chromophobe RCC (chRCC) subtypes, but increased in advanced tumor stages. Higher NPC1L1 expression was associated with worse OS and PFS in RCC patients. Multivariable Cox regression confirmed NPC1L1 as an independent prognostic marker. Additionally, gene effect scores showed that NPC1L1 is essential for the survival of specific RCC cell lines.

CONCLUSIONS

This study determines NPC1L1 as an independent prognostic indicator in RCC, with higher expression associated with poor survival outcomes. These findings suggest that NPC1L1 could serve as a valuable marker for identifying high-risk RCC patients. Further research is required to investigate the molecular mechanisms underlying the role of NPC1L1 in RCC progression.

Education on Middle East Respiratory Syndrome and Personal Hygiene Practices of Medical Students

The purpose of this study was to inquire into the knowledge of medical students on the Middle East respiratory syndrome (MERS) and evaluate whether infection prevention education impacts students’ level of knowledge and individual hygiene practices. This study also investigated the route by which medical students obtain disease-related information. The study involved a survey conducted in August of 2015 at two medical schools in Busan. In the first year to fourth year, a total of 345 students are enrolled (111 students in A school and 234 students in B school). Before the study was carried out, university A performed infection prevention education related to MERS, but B did not. We used self-developed questionnaires to survey the demographic characteristics, routes of acquisition of MERS information, degree of knowledge of MERS, educational satisfaction, and personal hygiene practices before and after education. Knowledge level differences according to gender and year in school were not statistically significant. Students obtained their information about MERS from various news media sources and the Internet, and through social network sites. Students practiced sanitary control behaviors in an average of 2.2 manners (standard deviation=0.95). The level of knowledge of MERS revealed a positive correlation with the frequency and total numbers of personal hygiene practices. This finding suggests that the infection prevention education program played a role in knowledge acquisition and personal hygiene practices for the medical students. In order to provide accurate and reliable knowledge of disease and preventive health behavior to medical students, continuous and well-planned education programs are necessary.