1
|
Ching THW, Finkelstein-Fox L, Lee SY, Watson RJ. Effects of sexual and gender minority stress on depressive symptoms among adolescents of color in the United States. Cultur Divers Ethnic Minor Psychol 2024; 30:309-318. [PMID: 36048116 PMCID: PMC9975117 DOI: 10.1037/cdp0000562] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE There is a need for more research on minority stress theory (MST) with sexual and gender minority (SGM) adolescents of color, because of their disproportionate risk for depression. METHOD We recruited 1,627 SGM adolescents of color in the United States to complete measures assessing lesbian, gay, bisexual, transgender, and queer (LGBTQ) climate, LGBTQ microaggressions within one's ethnoracial community, internalized LGBTQ stigma, stress management ability, and depressive symptoms. Using structural equation modeling, a hybrid measurement-structural model was tested, indicating good model fit. RESULTS Multiple significant indirect pathways linking LGBTQ climate and depressive symptoms emerged. A less positive LGBTQ climate was associated with more microaggression-related stress, more internalized LGBTQ stigma, and worse stress management ability, all of which were associated with greater depressive symptoms. A serial mediation with more microaggression-related stress being associated with greater internalized LGBTQ stigma approached significance. CONCLUSIONS Our findings generally support MST processes in terms of depressive symptoms in SGM adolescents of color, suggesting that psychosocial interventions targeting these processes may have meaningful implications for the mental health of this vulnerable group. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Collapse
Affiliation(s)
| | | | - Sharon Y. Lee
- Warren Alpert Medical School of Brown University, Providence, RI
| | - Ryan J. Watson
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT
| |
Collapse
|
2
|
Lee SY, Jao NC, Gaffey AE, Reid BM, Vergara-Lopez C, Bublitz MH, Stroud LR. Female adolescents' early life stress and body mass index: Differential effects of anger and anxiety in response to rejection. J Adolesc 2024. [PMID: 38402417 DOI: 10.1002/jad.12302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/26/2024]
Abstract
INTRODUCTION Early life stress is linked to childhood obesity. As children enter adolescence, early life stress may be associated with increased rejection sensitivity, resulting in activation of behavioral and physiological changes that contribute to higher body mass index (BMI). Understanding the potential influence of rejection sensitivity on the association between early life stress and BMI is important to examine in female adolescents. For this secondary data analysis, we hypothesized that female adolescents with greater early life stress and greater rejection sensitivity would exhibit higher BMI-for-age 12 months later. METHODS Seventy-eight adolescents (Mage = 13.1 years; 100% female sex; MBMI = 23.2 kg/m2 ) in the United States completed study procedures from 2012 to 2016. Among these procedures, the Psychosocial Schedule was used to assess cumulative early life stress and the Children's Rejection Sensitivity Questionnaire was used to assess anger and anxiety in response to rejection. Twelve months later, height and weight were measured to derive BMI-for-age. RESULTS Higher early life stress was associated with higher BMI-for-age among female adolescents with low rejection-provoked anger (1 SD below the mean). However, this association was not observed among female adolescents with high rejection-provoked anger (1 SD above the mean). Finally, there was no significant interaction between early life stress and rejection-provoked anxiety in predicting BMI-for-age. CONCLUSIONS Experiencing early life stress may interact with rejection-provoked anger, but not anxiety, to predict BMI-for-age. Findings inform a developmental perspective of how rejection sensitivity may influence the association between early life stress and early cardiometabolic risk.
Collapse
Affiliation(s)
- Sharon Y Lee
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island, USA
| | - Nancy C Jao
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
| | - Allison E Gaffey
- Department of Internal Medicine (Cardiovascular Medicine), Yale School of Medicine, New Haven, Connecticut, USA
- VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Brie M Reid
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island, USA
| | - Chrystal Vergara-Lopez
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island, USA
| | - Margaret H Bublitz
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
- Department of Medicine, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
- Women's Medicine Collaborative, The Miriam Hospital, Providence, Rhode Island, USA
| | - Laura R Stroud
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island, USA
| |
Collapse
|
3
|
Basak I, Wicky HE, McDonald KO, Xu JB, Palmer JE, Best HL, Lefrancois S, Lee SY, Schoderboeck L, Hughes SM. Correction: A lysosomal enigma CLN5 and its significance in understanding neuronal ceroid lipofuscinosis. Cell Mol Life Sci 2024; 81:45. [PMID: 38236309 PMCID: PMC10796411 DOI: 10.1007/s00018-023-05047-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2023] [Indexed: 01/19/2024]
Affiliation(s)
- I Basak
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
| | - H E Wicky
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
| | - K O McDonald
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
| | - J B Xu
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
| | - J E Palmer
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
| | - H L Best
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
- School of Biosciences, Cardiff University, Sir Martin Evans Building, Museum Avenue, CF10 3AX, Wales, UK
| | - S Lefrancois
- Centre INRS-Institut Armand-Frappier, INRS, H7V 1B7, Laval, Canada
- Department of Anatomy and Cell Biology, McGill University, H3A 2B2, Montreal, Canada
| | - S Y Lee
- Department of Biochemistry and Molecular Biology, University of Kansas Medical Center, 66160, Kansas City, KS, USA
| | - L Schoderboeck
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
| | - S M Hughes
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand.
| |
Collapse
|
4
|
Kim JC, Choi MG, Park JS, Lee SY, Park CW, Chung BY, Misery L, Kim HO. Sensitive skin is associated with contact sensitization and decreased nociceptive threshold. J Eur Acad Dermatol Venereol 2024; 38:e125-e127. [PMID: 37556672 DOI: 10.1111/jdv.19398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 08/03/2023] [Indexed: 08/11/2023]
Affiliation(s)
- J C Kim
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - M G Choi
- Department of Computer Science, Kwangwoon University, Seoul, South Korea
| | - J S Park
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - S Y Lee
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - C W Park
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - B Y Chung
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - L Misery
- Department of Dermatology, University Hospital of Brest, Brest, France
| | - H O Kim
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| |
Collapse
|
5
|
Gaffey AE, Goldstein CM, Lee SY, Hays MM, Gaalema DE. Psychological Risk Factors in Pulmonary Rehabilitation: ANXIETY, DEPRESSION, SOCIAL ISOLATION, AND COGNITIVE IMPAIRMENT. J Cardiopulm Rehabil Prev 2024; 44:E3-E4. [PMID: 38079256 PMCID: PMC10842152 DOI: 10.1097/hcr.0000000000000843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2023]
Affiliation(s)
- Allison E. Gaffey
- Department of Internal Medicine (Cardiovascular Medicine), Yale School of Medicine
- VA Connecticut Healthcare System
| | - Carly M. Goldstein
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University
- Weight Control and Diabetes Research Center, The Miriam Hospital
| | - Sharon Y. Lee
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University
- Center for Behavioral and Preventive Medicine, The Miriam Hospital
| | - Megan M. Hays
- Department of Physical Medicine and Rehabilitation, Heersink School of Medicine, The University of Alabama at Birmingham
| | - Diann E. Gaalema
- Department of Internal Medicine (Division of Cardiovascular Medicine), University of Texas Medical Branch
| |
Collapse
|
6
|
Stroud LR, Jao NC, Ward LG, Lee SY, Marsit CJ. Differential impact of prenatal PTSD symptoms and preconception trauma exposure on placental NR3C1 and FKBP5 methylation. Stress 2024; 27:2321595. [PMID: 38676353 DOI: 10.1080/10253890.2024.2321595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 02/16/2024] [Indexed: 04/28/2024] Open
Abstract
Perinatal stress is associated with altered placental methylation, which plays a critical role in fetal development and infant outcomes. This proof-of-concept pilot study investigated the impact of lifetime trauma exposure and perinatal PTSD symptoms on epigenetic regulation of placenta glucocorticoid signaling genes (NR3C1 and FKBP5). Lifetime trauma exposure and PTSD symptoms during pregnancy were assessed in a racially/ethnically diverse sample of pregnant women (N = 198). Participants were categorized into three groups: (1) No Trauma (-T); (2) Trauma, No Symptoms (T - S); and (3) Trauma and Symptoms (T + S). Placental tissue was analyzed via bisulfite pyrosequencing for degree of methylation at the NR3C1 promoter and FKBP5 regulatory regions. Analyses of covariance were used to test group differences in percentages of NR3C1 and FKBP5 methylation overall and at each CpG site. We found a significant impact of PTSD symptoms on placental NR3C1 methylation. Compared to the -T group, the T + S group had greater NR3C1 methylation overall and at CpG6, CpG8, CpG9, and CpG13, but lower methylation at CpG5. The T + S group had significantly higher NR3C1 methylation overall and at CpG8 compared to the T - S group. There were no differences between the T - S group and - T group. Additionally, no group differences emerged for FKBP5 methylation. Pregnant trauma survivors with PTSD symptoms exhibited differential patterns of placental NR3C1 methylation compared to trauma survivors without PTSD symptoms and pregnant women unexposed to trauma. Results highlight the critical importance of interventions to address the mental health of pregnant trauma survivors.
Collapse
Affiliation(s)
- Laura R Stroud
- COBRE Center for Stress, Trauma, and Resilience*, Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
| | - Nancy C Jao
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - L G Ward
- COBRE Center for Stress, Trauma, and Resilience*, Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
| | - Sharon Y Lee
- COBRE Center for Stress, Trauma, and Resilience*, Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
| | - Carmen J Marsit
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| |
Collapse
|
7
|
Gnall KE, Garnsey C, Lee SY, Park CL. Does use of health behaviours to cope with stress predict sleep impairment in trauma-exposed community adults? Stress Health 2023. [PMID: 38018759 DOI: 10.1002/smi.3350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 09/12/2023] [Accepted: 11/12/2023] [Indexed: 11/30/2023]
Abstract
Individuals who have been exposed to trauma experience high levels of sleep impairment. Given the well-established negative effects of stress on sleep, the ways in which trauma-exposed individuals cope with stress is likely to be associated with their sleep. This study examined how the use of health behaviours (i.e., exercise, comfort eating, and maintaining a self-care routine) to cope relate to sleep impairment in a community sample of trauma-exposed adults (N = 84, mean age = 35.1, 83% female). We also tested whether use of health behaviours to cope moderates the relationship between psychological distress and sleep impairment. Results demonstrate that exercise and maintaining a self-care routine to cope are associated with less sleep impairment, while comfort eating to cope is associated with greater sleep impairment. Further, comfort eating to cope moderated the relationship between distress and sleep impairment. Findings suggest that the use of health behaviours to cope is differentially associated with sleep impairment, which has important clinical and research implications for the health of trauma-exposed adults.
Collapse
Affiliation(s)
- Katherine E Gnall
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Camille Garnsey
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Sharon Y Lee
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island, USA
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| |
Collapse
|
8
|
Gaffey AE, Goldstein CM, Hays MM, Lee SY, Gaalema DE. Psychological Risk Factors in Cardiac Rehabilitation: ANXIETY, DEPRESSION, SOCIAL ISOLATION, AND ANGER/HOSTILITY. J Cardiopulm Rehabil Prev 2023; 43:E20-E21. [PMID: 37729630 PMCID: PMC10615851 DOI: 10.1097/hcr.0000000000000828] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Affiliation(s)
- Allison E. Gaffey
- Yale School of Medicine, Department of Internal Medicine (Cardiovascular Medicine)
- VA Connecticut Healthcare System
| | - Carly M. Goldstein
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University
- Weight Control and Diabetes Research Center, The Miriam Hospital
| | - Megan M. Hays
- Department of Physical Medicine and Rehabilitation, Heersink School of Medicine, The University of Alabama at Birmingham
| | - Sharon Y. Lee
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University
- Center for Behavioral and Preventive Medicine, The Miriam Hospital
| | | |
Collapse
|
9
|
Pyo JH, Lee SY, Lee IJ, Kim SM, Kim JW. Beneficial Role of Multi-Disciplinary Treatment for Anaplastic Thyroid Cancer with Initial Distant Metastasis. Int J Radiat Oncol Biol Phys 2023; 117:e616-e617. [PMID: 37785850 DOI: 10.1016/j.ijrobp.2023.06.1996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Anaplastic thyroid cancer (ATC) is a rare, highly aggressive tumor, with median survival around 5 months. Approximately half of the ATC patients presents with distant metastases at diagnosis, showing even more devastating prognosis, yet no outcome analysis had been reported. In this study, we aim to evaluate the clinical outcome of M1 ATC patients, and to define the group of patients who would benefit from local treatment based on multi-disciplinary approach. MATERIALS/METHODS A total of 133 histology-confirmed ATC patients underwent protocol-based multidisciplinary treatment including surgery and chemoradiotherapy (CRT) between May 2016 and January 2022. Patients received intensity-modulated radiotherapy of 30 fractions concurrently with paclitaxel on days 1, 8 and 15 every 4 weeks, and lenvatinib was added upon progression. After 18 fractions of CRT, interim response analysis using modified RECIST was conducted for adaptive treatment planning. We reviewed 58 patients with distant metastasis at diagnosis (stage IVC). Overall survival (OS) and progression-free survival (PFS) were measured from the day of diagnosis. RESULTS Most common metastatic site was lung (91.4%), followed by bone (31.0%) and brain (5.2%). Lenvatinib was added for 35 patients after any sign of progression. Fourteen patients received upfront surgery (16 debulking and 5 total) followed by adjuvant CRT in 16 patients. Thirty-one patients received upfront CRT with 2 patients receiving total resection after sufficient down-staging. Six (10%) patients could not complete radiotherapy but continued receiving systemic treatment. The median follow-up was 5.9 months. The median and 1-year OS were 6.2 months and 20.5%, and PFS were 3.7 months and 3.5%. Total RT dose over 60 Gy significantly improved median OS (7.5 vs 4.1 months, p = 0.012) and median PFS (4.4 vs 3.0, p = 0.010). Patients with less than 10 initial metastatic tumors showed better median OS (9.1 vs 4.6 months, p = 0.002) but not PFS (5.1 vs 3.6, p = 0.485). At interim analysis, early response (CR, PR and SD) of primary tumor was not associated with survival, while progression of distant metastases showed significantly worse median OS (9.8 vs 4.6 months, p = 0.001). More than 10 metastatic tumors (HR 2.73, 95% CI 1.32-5.66) and stable metastasis at interim analysis (HR 2.39, 95% CI 1.04-5.48) remained as significant factor in the multivariable cox regression analysis. Median OS and PFS of patients with less than 10 metastases showing no progression at interim analysis were 9.1 months, and 5.1 months. CONCLUSION Local treatment combined with chemotherapy for M1 ATC patients showed outcome comparable to those of non-metastatic ATC results. Active local treatment should be considered especially for patients with less than 10 metastases, and patients without distant progression in early response evaluation.
Collapse
Affiliation(s)
- J H Pyo
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - S Y Lee
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - I J Lee
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - S M Kim
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - J W Kim
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| |
Collapse
|
10
|
Stroud LR, Morningstar M, Vergara-Lopez C, Bublitz MH, Lee SY, Sanes JN, Dahl RE, Silk JS, Nelson EE, Dickstein DP. Neural activation to peer acceptance and rejection in relation to concurrent and prospective depression risk in adolescent and pre-adolescent girls. Biol Psychol 2023; 181:108618. [PMID: 37352911 PMCID: PMC10530136 DOI: 10.1016/j.biopsycho.2023.108618] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 06/07/2023] [Accepted: 06/13/2023] [Indexed: 06/25/2023]
Abstract
Neurobiological sensitivity to peer interactions is a proposed marker of risk for adolescent depression. We investigated neural response to peer rejection and acceptance in relation to concurrent and prospective depression risk in adolescent and pre-adolescent girls. Participants were 76 girls (Mage=13, 45% racial/ethnic minorities) varying in depression risk: 22 with current major depressive disorder (MDD), 30 at High Risk for MDD based on parental history, and 24 at Low Risk with no psychiatric history. Girls participated in the Chatroom-Interact task-involving rejection and acceptance feedback from fictitious peers-while undergoing functional magnetic resonance neuroimaging. Activation in response to peer rejection and acceptance was extracted from regions of interest. Depressive symptoms were assessed at 6- and 12-month follow-up. Girls with MDD showed blunted left subgenual anterior cingulate response to acceptance versus girls in High and Low Risk groups. Girls in the High Risk group showed greater right temporo-parietal junction (rTPJ) and right anterior insula (AI) activation to both acceptance and rejection versus girls in the MDD (rTPJ) and Low Risk (rTPJ, AI) groups. Greater rTPJ response to rejection was associated with fewer depressive symptoms at 12-months and mediated the association between High Risk group status and 12-month depressive symptoms; greater rTPJ response to acceptance mediated the association between High Risk and increased 12-month depressive symptoms. Our finding of associations between altered neural response to peer interactions and concurrent and prospective depression risk/resilience highlights the importance of neural underpinnings of social cognition as risk and compensatory adaptations along the pathway to depression.
Collapse
Affiliation(s)
- Laura R Stroud
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA; Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.
| | - Michele Morningstar
- Department of Psychology & Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada; Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, OH, USA
| | - Chrystal Vergara-Lopez
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA; Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Margaret H Bublitz
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Sharon Y Lee
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA; Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Jerome N Sanes
- Department of Neuroscience, Brown University, Providence, RI, USA
| | - Ronald E Dahl
- School of Public Health, Institute of Human Development, University of California, Berkeley, Berkeley, CA, USA
| | - Jennifer S Silk
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Eric E Nelson
- Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, OH, USA
| | | |
Collapse
|
11
|
Lee SY, Vergara-Lopez C, Bublitz MH, Gaffey AE, D’Angelo C, Stroud LR. Adolescent girls' cardiovascular responses to peer rejection: exploring the impact of early life stress. J Behav Med 2023; 46:451-459. [PMID: 36334168 PMCID: PMC10160243 DOI: 10.1007/s10865-022-00366-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 09/13/2022] [Indexed: 11/09/2022]
Abstract
Detrimental effects of early life stress on cardiovascular health are evident in adolescence. Cardiovascular reactivity and recovery in response to interpersonal stress may be a mechanism. This study aimed to evaluate if adolescent girls with higher early life stress demonstrated greater cardiovascular reactivity and slower recovery to peer rejection. A sample of 92 adolescent girls (age: M = 13.24) self-reported early life stressors. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were continuously measured before, during, and after a laboratory peer rejection paradigm. Counter to hypotheses, adolescent girls with higher early life stress had lower, not higher, HR during the recovery period. Early life stress was not associated with SBP or DBP recovery. Additionally, early life stress was not associated with SBP, DBP, or HR reactivity. Future research is needed to assess if blunted cardiovascular reactivity to interpersonal rejection during adolescence is a mechanism linking early life stress and later cardiovascular disease risk in women.
Collapse
Affiliation(s)
- Sharon Y. Lee
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University
- Center for Behavioral and Preventive Medicine, The Miriam Hospital
| | - Chrystal Vergara-Lopez
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University
- Center for Behavioral and Preventive Medicine, The Miriam Hospital
| | - Margaret H. Bublitz
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University
- Department of Medicine, Warren Alpert Medical School, Brown University
- Women’s Medicine Collaborative, The Miriam Hospital
| | - Allison E. Gaffey
- Yale School of Medicine, Department of Internal Medicine (Cardiovascular Medicine)
- VA Connecticut Healthcare System
| | - Christina D’Angelo
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University
- Bradley Hasbro Children’s Research Center, Rhode Island/Hasbro Children’s Hospital
| | - Laura R. Stroud
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University
- Center for Behavioral and Preventive Medicine, The Miriam Hospital
| |
Collapse
|
12
|
Lee SY, Gathright EC, Wu WC, Salmoirago-Blotcher E. Mindfulness-Based Interventions for Patients with Cardiovascular Disease: A Focused Review for Practicing Clinicians. Curr Cardiol Rep 2023; 25:185-191. [PMID: 36862351 DOI: 10.1007/s11886-023-01846-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/03/2023] [Indexed: 03/03/2023]
Abstract
PURPOSE OF REVIEW With growing scientific and public interest in the health benefits of mindfulness, clinicians increasingly face questions and solicitations for advice from patients about the efficacy of mindfulness-based interventions (MBIs) for cardiovascular disease (CVD). In this clinician-focused review, we aim to revisit empirical studies on MBIs for CVD with the purpose of informing clinicians' decisions on how to provide recommendations consistent with updated scientific findings to patients interested in MBIs. RECENT FINDINGS We start by defining MBIs and identifying the possible physiological, psychological, behavioral, and cognitive mechanisms underlying the potentially positive effects of MBIs for CVD. Potential mechanisms include the reduction of sympathetic nervous system activity, improved vagal control, and biological markers (physiological); psychological distress and cardiovascular health behaviors (psychological and behavioral); and executive function, memory, and attention (cognitive). Then, we summarize the extant evidence to identify gaps and limitations in MBI research for the purpose of informing future directions for cardiovascular and behavioral medicine researchers. We conclude with practical recommendations for clinicians communicating with patients with CVD who are interested in MBIs.
Collapse
Affiliation(s)
- Sharon Y Lee
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.,Alpert Medical School, Brown University, Providence, RI, USA
| | - Emily C Gathright
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.,Alpert Medical School, Brown University, Providence, RI, USA
| | - Wen-Chih Wu
- Alpert Medical School, Brown University, Providence, RI, USA.,Lifespan Cardiovascular Institute Wellness and Prevention Center, Providence, RI, USA
| | - Elena Salmoirago-Blotcher
- Alpert Medical School, Brown University, Providence, RI, USA. .,Lifespan Cardiovascular Institute, The Miriam Hospital, One Hoppin Street, Providence, RI, 02903, USA.
| |
Collapse
|
13
|
Choi JI, Kweon HY, Lee YL, Lee JH, Lee SY. Efficacy of Silkworm Pupae Extract on Muscle Strength and Mass in Middle-Aged and Older Individuals: A Randomized, Double-Blind, Placebo-Controlled Trial. J Nutr Health Aging 2023; 27:578-585. [PMID: 37498105 DOI: 10.1007/s12603-023-1942-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 06/06/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVES We investigated the efficacy and safety of silkworm pupae extract (SWP) consumption for 12 weeks on muscle mass and strength in middle-aged and older individuals with relatively low skeletal muscle mass who do regular low-intensity exercise. DESIGN A randomized double-blinded placebo-controlled trial. PARTICIPANTS The study was conducted with 54 participants with relatively low skeletal muscle mass (SMM) (64.4 ± 6.1 years; body mass index, 23.8 ± 2.4 kg/m2). INTERVENTION AND MEASUREMENTS Participants were randomly assigned to one of two groups: 1000 mg of SWP/day plus regular exercise (SWP group, n=27) or placebo plus regular exercise (placebo group, n=27). All participants were required to engage in 30-60 minutes/day of walking for ≥3 days/week for 12 weeks. The primary outcome was knee extension/flexion strength (Nm), measured at the velocity of 60°/s. Secondary outcomes included body composition, biomarkers (creatine kinase and creatinine), handgrip strength, and quality of life questionnaire. RESULTS Both the intention-to-treat (ITT) and per-protocol (PP) analyses revealed no significant impact of SWP on knee strength compared to the placebo group over 12 weeks. On the other hand, the SWP group had significantly greater increases in right-handgrip strength by 1.94 kg (95% CI: 0.08-3.79; p = 0.041) and left-handgrip strength by 1.83 kg (0.25-3.41; p = 0.024) compared to the placebo group in the ITT population, after 12 weeks. Moreover, in the PP population, the SWP group revealed an even greater increase in right-handgrip strength by 2.07 kg (0.15-3. 98; p = 0.035) and left-handgrip strength by 2.21 kg (0.60-3.83; p = 0.008) for the 12-week period. However, this study resulted in a failure to detect significant differences in the body composition, biomarkers, quality of life questionnaire, physical activity, and caloric intake between the groups. None of the participants in the SWP group experienced any significant adverse events. In the placebo group, two participants experienced urticaria and allergic side effects, leading to their withdrawal from the study and two exhibited elevated levels of liver enzyme and increased diastolic blood pressure, respectively at 12 weeks. CONCLUSION SWP, in addition to low-intensity exercise, may enhance handgrip strengths in middle-aged and older adults with relatively lower SMM. Future studies need to use a large sample size over longer periods to validate our findings. This trial was registered at clinicaltrials.gov as NCT04994054.
Collapse
Affiliation(s)
- J I Choi
- Sang Yeoup Lee, Family Medicine Clinic, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea, Telephone: +82-55-390-1442, E-mail: , Fax: +82-51-510-8125
| | | | | | | | | |
Collapse
|
14
|
Lee SY, Park CL, Cilhoroz BT, Pescatello LS. PTSD symptom clusters and cardiovascular responses to stress: Reactivity and recovery. J Psychosom Res 2022; 161:110996. [PMID: 35933739 PMCID: PMC9588198 DOI: 10.1016/j.jpsychores.2022.110996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 05/29/2022] [Accepted: 07/23/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) symptoms are associated with high blood pressure (BP) and decreased heart rate variability (HRV) at rest and in response to acute stress. Unique contributions of PTSD symptom clusters to cardiovascular responses to stress are rarely investigated. This study tested whether PTSD-related arousal/reactivity drives relationships of higher PTSD symptoms with higher BP and lower HRV during rest, reactivity (stressor-induced change from baseline), and recovery. METHODS Using a cross-sectional observational design, we enrolled 84 trauma-exposed community adults (83% female; 68% White; Mage = 35) who endorsed at least one core PTSD symptom. Participants completed a physical exam, self-reports of trauma history and PTSD symptoms, and BP and HRV frequency domain measurements during rest, stressor (mental arithmetic task), and recovery. RESULTS Arousal/reactivity was not associated with BP or HRV reactivity but associated with a higher low (LF) to high (HF) frequency (HF) ratio (LF/HF) during recovery reflecting sympathetic predominance. During the stressor, more avoidance and intrusion were associated with increased diastolic blood pressure (DBP) from baseline; more avoidance was associated with parasympathetic predominance (lower LF/HF); and more negative cognitions/mood was associated with decreased systolic blood pressure (SBP), DBP, and LF from baseline. During recovery, more intrusion and negative cognitions/mood were associated with increased SBP from baseline; less negative cognitions/mood was associated with sympathetic predominance (higher LF/HF). CONCLUSIONS PTSD symptom clusters demonstrated differential relationships with SBP, DBP, and HRV during reactivity and recovery. Findings may inform targeted PTSD symptom reduction interventions for disrupting links between PTSD and CVD risk.
Collapse
Affiliation(s)
- Sharon Y Lee
- Brown University, Warren Alpert Medical School, Department of Psychiatry and Human Behavior, USA.
| | - Crystal L Park
- University of Connecticut, Department of Psychological Sciences, USA.
| | | | | |
Collapse
|
15
|
Lee SY, Park CL, Laflash S. Perceived posttraumatic growth in cardiac patients: A systematic scoping review. J Trauma Stress 2022; 35:791-803. [PMID: 35122706 PMCID: PMC9232897 DOI: 10.1002/jts.22799] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/15/2021] [Accepted: 09/20/2021] [Indexed: 11/08/2022]
Abstract
Despite the life-threatening nature of many cardiac conditions, patients often report perceived posttraumatic growth (PPTG) in their recovery. To date, this research remains scattered across the literature, and no systematic review across cardiac patient populations is available. To understand the state of the literature on PPTG in cardiac patients, we conducted a systematic scoping review, aiming to (a) describe patient populations included, (b) characterize associations between PPTG and mental and physical health indices, (c) identify potential psychosocial resources that moderate or mediate the effects of a cardiac condition on PPTG, and (d) describe and critique study methodologies. A systematic search was conducted on June 21, 2021, using the PubMed and PsycInfo databases. Two authors independently screened the results for eligibility and resolved discrepancies before extracting study data. We identified 21 studies that met the search and eligibility criteria (i.e., original, peer-reviewed, English language). Most studies focused on a single cardiac condition (61.9%), with myocardial infarction the most common. PPTG was studied in relation to myriad mental health and physical health indices. The findings suggested that appraisal and coping may mediate and psychosocial resources (e.g., social support) may moderate the effects of a cardiac condition on PPTG. The generalizability of results is limited, as most studies employed a cross-sectional design with mostly male and majority White samples. Future research would benefit from studying PPTG in more diverse cardiac populations, assessing appraisals of the cardiac condition as traumatic, measuring posttraumatic depreciation in tandem with PPTG, and conducting prospective studies.
Collapse
Affiliation(s)
- Sharon Y. Lee
- Department of Psychiatry and Human Behavior Brown, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA,Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island, USA
| | - Crystal L. Park
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Samantha Laflash
- Center for Physician Assistant Studies, Albany Medical College, Albany, New York, USA
| |
Collapse
|
16
|
Kang SY, Choi MG, Wei ET, Selescu T, Lee SY, Kim JC, Chung BY, Park CW, Kim HO. TRPM8 agonist (cryosim-1) gel for scalp itch: A randomized, vehicle controlled clinical trial. J Eur Acad Dermatol Venereol 2022; 36:e588-e589. [PMID: 35293031 DOI: 10.1111/jdv.18080] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S Y Kang
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea
| | - M G Choi
- Department of Computer Science and Engineering, Kwangwoon University, Seoul, Korea
| | - E T Wei
- School of Public Health, University of California, Berkeley, CA, 94720, USA
| | - T Selescu
- Department of Anatomy, Physiology and Biophysics, Faculty of Biology, University of Bucharest, Bucuresti, Romania
| | - S Y Lee
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea
| | - J C Kim
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea
| | - B Y Chung
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea
| | - C W Park
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea
| | - H O Kim
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea
| |
Collapse
|
17
|
Lee SY, Agocha VB, Hernandez PR, Park CL, Williams M, Carney LM. Coping styles moderate the relationship between perceived discrimination and eating behaviors during the transition to college. Appetite 2022; 168:105699. [PMID: 34543691 PMCID: PMC8671288 DOI: 10.1016/j.appet.2021.105699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 09/11/2021] [Accepted: 09/15/2021] [Indexed: 01/03/2023]
Abstract
The transition to college is a critical developmental window during which eating behaviors are susceptible to dysregulation. Changes in exposure to discrimination contribute to alterations in eating behaviors, which may be exacerbated or attenuated by coping styles. The present longitudinal study examines whether increases in perceived discrimination predict increases in overeating and decreases in eating well during the transition to college. We expect that adaptive coping styles will buffer against, while maladaptive coping styles will exacerbate, the effects of increases in perceived discrimination on increases in overeating and decreases in eating well. First year students (n = 804) were assessed at two time points: the spring before freshman year (Time 1) and one year later during the spring semester of freshman year (Time 2). Two distinct coping styles emerged from a factor analysis: adaptive (active coping, planning, emotional support, positive reframing, acceptance, instrumental support) and maladaptive coping (denial, venting, self-blame, self-distraction). Increases in perceived discrimination, lower adaptive coping, and higher maladaptive coping had main effects for predicting more overeating at Time 2. Among students who reported increases in perceived discrimination, higher use of adaptive coping was associated with less overeating at Time 2 while higher use of maladaptive coping was associated with more overeating. While adaptive and maladaptive coping styles had main effects on eating well, change in perceived discrimination did not. Neither adaptive nor maladaptive coping styles interacted with change in perceived discrimination to predict eating well. Findings inform a gap in the literature about the relationship between discrimination and eating behaviors from a developmental perspective by demonstrating that adaptive and maladaptive coping styles influence the effects of changes in perceived discrimination on overeating during the college transition.
Collapse
Affiliation(s)
- Sharon Y. Lee
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT 06269-1020
| | - V. Bede Agocha
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT 06269-1020
| | - Paul R. Hernandez
- Department of Teaching, Learning, and Culture, Texas A&M University, 308 Harrington Tower, College Station, TX, 77843
| | - Crystal L. Park
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT 06269-1020
| | - Michelle Williams
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT 06269-1020
| | - Lauren M. Carney
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT 06269-1020
| |
Collapse
|
18
|
Lee SY, Waring ME, Park CL, Blake EC. Do Depressive Symptoms Predict Blood Pressure Control in US Veterans? J Gen Intern Med 2022; 37:57-63. [PMID: 33772439 PMCID: PMC8738794 DOI: 10.1007/s11606-021-06709-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 01/15/2021] [Accepted: 03/09/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND High blood pressure is the most common chronic condition among US veterans. Blood pressure control is essential to preventing and managing cardiovascular diseases. While depressive symptoms are a known risk factor for uncontrolled blood pressure and veterans experience high rates of depressive symptoms, no research has examined the relationship between depressive symptoms and blood pressure control among US veterans. OBJECTIVE We examined whether moderately severe-to-severe depressive symptoms, compared to none-to-minimal, are associated with higher risk of uncontrolled blood pressure among US veterans. DESIGN We analyzed a population-based sample of veterans from the National Health and Nutrition Examination Survey (2013-2016). Logistic regression models were adjusted for marital status, age, and body mass index. All analyses were weighted; results are generalizable to US veterans. PARTICIPANTS A sample of 864 veterans was analyzed, representing approximately 18.8 million US veterans. MAIN MEASURES Depressive symptoms were assessed by the Patient Health Questionnaire-9. Uncontrolled blood pressure was defined as average systolic blood pressure ≥ 130 and/or diastolic blood pressure ≥ 80. KEY RESULTS For depressive symptoms, 78.2% (SE = 1.6) of US veterans had none-to-minimal, 18.2% (SE = 1.2) had mild-to-moderate, and 3.5% (SE = 0.8) had moderately severe-to-severe. Forty-three percent (SE = 3.0) of US veterans had uncontrolled blood pressure. Moderately severe-to-severe depressive symptoms, compared to none-to-minimal, were associated with lower risk for uncontrolled blood pressure (aOR = .28, 95% CI [.09, .85]). Mild-to-moderate depressive symptoms were not associated with blood pressure control (aOR = .98, 95% CI [.59, 1.65]). CONCLUSIONS US veterans with moderately severe-to-severe depressive symptoms were less likely to have uncontrolled blood pressure than veterans with none-to-minimal symptoms. Future research should examine factors unique to veterans that may explain findings opposite of the hypothesized relationship between depressive symptoms and blood pressure control.
Collapse
Affiliation(s)
- Sharon Y Lee
- Department of Psychological Sciences, University of Connecticut, Storrs, USA.
| | - Molly E Waring
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, USA
| | - Erin C Blake
- Department of Psychological Sciences, University of Connecticut, Storrs, USA
| |
Collapse
|
19
|
Kim JC, Lee SY, Kang SY, Kim HO, Park CW, Chung BY. Erythema annulare centrifugum induced by COVID-19 vaccination. Clin Exp Dermatol 2021; 47:591-592. [PMID: 34731529 PMCID: PMC8652630 DOI: 10.1111/ced.15002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/27/2021] [Accepted: 11/01/2021] [Indexed: 12/19/2022]
Affiliation(s)
- J C Kim
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - S Y Lee
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - S Y Kang
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - H O Kim
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - C W Park
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - B Y Chung
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| |
Collapse
|
20
|
Finkelstein-Fox L, Sinnott SM, Lee SY, Carney LM, Park CL, Mazure CM, Hoff R. Meaningful military engagement among male and female post-9/11 veterans: An examination of correlates and implications for resilience. J Clin Psychol 2021; 77:2167-2186. [PMID: 33960411 DOI: 10.1002/jclp.23150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 03/03/2021] [Accepted: 03/30/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Post-9/11 military deployment is commonly reported as stressful and is often followed by psychological distress after returning home. Yet veterans also frequently report experiencing meaningful military engagement (MME) that may buffer detrimental effects of military stressors. Focusing on the under-investigated topic of association of MME with post-deployment psychological adjustment, this study tests gender differences in MME and post-deployment outcomes. METHOD This cross-sectional study examined the relationship of MME with deployment stressors, subsequent psychological distress (posttraumatic stress symptoms (PTSS) and depression), and gender among 850 recent-era U.S. veterans (41.4% female). RESULTS On average, both male and female veterans reported high MME. Greater MME was associated with less PTSS and depression following combat and general harassment, and more depression after sexual harassment. For men only, MME associated with less PTSS after sexual harassment. CONCLUSIONS MME is high among post-9/11 veterans, but its stress-buffering effects depend on gender and specific stressor exposure.
Collapse
Affiliation(s)
- Lucy Finkelstein-Fox
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Sinead M Sinnott
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Sharon Y Lee
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Lauren M Carney
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Carolyn M Mazure
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.,Women's Health Research at Yale, New Haven, Connecticut, USA
| | - Rani Hoff
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.,Women's Health Research at Yale, New Haven, Connecticut, USA.,VISN1 MIRECC, VA Connecticut Healthcare System, West Haven, Connecticut, USA
| |
Collapse
|
21
|
Basak I, Wicky HE, McDonald KO, Xu JB, Palmer JE, Best HL, Lefrancois S, Lee SY, Schoderboeck L, Hughes SM. A lysosomal enigma CLN5 and its significance in understanding neuronal ceroid lipofuscinosis. Cell Mol Life Sci 2021; 78:4735-4763. [PMID: 33792748 PMCID: PMC8195759 DOI: 10.1007/s00018-021-03813-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 01/09/2023]
Abstract
Neuronal Ceroid Lipofuscinosis (NCL), also known as Batten disease, is an incurable childhood brain disease. The thirteen forms of NCL are caused by mutations in thirteen CLN genes. Mutations in one CLN gene, CLN5, cause variant late-infantile NCL, with an age of onset between 4 and 7 years. The CLN5 protein is ubiquitously expressed in the majority of tissues studied and in the brain, CLN5 shows both neuronal and glial cell expression. Mutations in CLN5 are associated with the accumulation of autofluorescent storage material in lysosomes, the recycling units of the cell, in the brain and peripheral tissues. CLN5 resides in the lysosome and its function is still elusive. Initial studies suggested CLN5 was a transmembrane protein, which was later revealed to be processed into a soluble form. Multiple glycosylation sites have been reported, which may dictate its localisation and function. CLN5 interacts with several CLN proteins, and other lysosomal proteins, making it an important candidate to understand lysosomal biology. The existing knowledge on CLN5 biology stems from studies using several model organisms, including mice, sheep, cattle, dogs, social amoeba and cell cultures. Each model organism has its advantages and limitations, making it crucial to adopt a combinatorial approach, using both human cells and model organisms, to understand CLN5 pathologies and design drug therapies. In this comprehensive review, we have summarised and critiqued existing literature on CLN5 and have discussed the missing pieces of the puzzle that need to be addressed to develop an efficient therapy for CLN5 Batten disease.
Collapse
Affiliation(s)
- I Basak
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
| | - H E Wicky
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
| | - K O McDonald
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
| | - J B Xu
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
| | - J E Palmer
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
| | - H L Best
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
- School of Biosciences, Cardiff University, Sir Martin Evans Building, Museum Avenue, Wales, CF10 3AX, United Kingdom
| | - S Lefrancois
- Centre INRS-Institut Armand-Frappier, INRS, Laval, H7V 1B7, Canada
- Department of Anatomy and Cell Biology, McGill University, Montreal, H3A 2B2, Canada
| | - S Y Lee
- Department of Biochemistry and Molecular Biology, University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - L Schoderboeck
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
| | - S M Hughes
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand.
| |
Collapse
|
22
|
Park CL, Sacco SJ, Finkelstein-Fox L, Sinnott SM, Scoglio AAJ, Lee SY, Gnall KE, Mazure C, Shirk SD, Hoff RA, Kraus SW. Post-9/11 military veterans' adjustment to civilian life over time following separation from service. J Clin Psychol 2021; 77:2077-2095. [PMID: 33871869 DOI: 10.1002/jclp.23144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 02/18/2021] [Accepted: 03/25/2021] [Indexed: 01/06/2023]
Abstract
OBJECTIVES US military veterans face many challenges in transitioning to civilian life; little information is available regarding veterans' reintegration experiences over time. The current study characterized veterans' postdeployment stressful life events and concurrent psychosocial wellbeing over one year and determined how stressors and wellbeing differ by demographic factors. METHODS Recent Post-911 veterans (n = 402) were assessed approximately every three months for 1 year. Participants were 60% men, primarily White (78%), and 12% Latinx; the average age was 36 years. RESULTS The frequency of stressful events decreased over time but was higher for men and minority-race veterans (independent of time since separation). Veterans reported high mean levels of posttraumatic stress disorder, anxiety, and insomnia symptoms, which improved slightly over time. Minority-race and Latinx veterans had higher symptom levels and slower rates of symptom reduction. CONCLUSION Veterans remain distressed in their overall transition to civilian life. Interventions to promote resilience and help veterans manage readjustment to civilian life appear urgently needed.
Collapse
Affiliation(s)
- Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Shane J Sacco
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Lucy Finkelstein-Fox
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Sinead M Sinnott
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Arielle A J Scoglio
- Institute for Health Equity and Social Justice Research, Northeastern University, Boston, Massachusetts, USA
| | - Sharon Y Lee
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Katherine E Gnall
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Carolyn Mazure
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Steven D Shirk
- Division of Addiction, VISN1 New England MIRECC, Edith Nourse Rogers Memorial Veterans Hospital and University of Massachusetts Medical School, Bedford, Massachusetts, USA
| | - Rani A Hoff
- Northeast Program Evaluation Center (NEPEC), VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Shane W Kraus
- Department of Psychology, University of Nevada, Las Vegas, Nevada, USA
| |
Collapse
|
23
|
Rhie YH, Lee SY, Walck JL, Hidayati SN. Seed dormancy and germination of Asarum sieboldii, a disjunct relict species in East Asia. Plant Biol (Stuttg) 2021; 23:300-306. [PMID: 33289269 DOI: 10.1111/plb.13224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 11/09/2020] [Indexed: 06/12/2023]
Abstract
Disjunct species in the same genus are a common feature of the flora in the temperate forests of East Asia and eastern North America. This study aimed to evaluate whether the kind of seed dormancy was maintained after species in the genus Asarum (Aristolochiaceae) were separated from their common ancestor. We classified the seed dormancy of Asarum sieboldii, an East Asian species, based on a phenology study and experiments in controlled temperature conditions, and then compared it to that of the previously studied A. canadense, an eastern North American species. The underdeveloped embryo of A. sieboldii grew and germinated (radicle emergence) in autumn but shoot emergence did not occur until the following spring. The seeds of A. sieboldii had deep simple epicotyl morphophysiological dormancy because the seeds with emerged radicle required a relatively long period of cold stratification to break epicotyl dormancy and produce a shoot. Although the seed of A. sieboldii had weaker radicle dormancy and stronger epicotyl dormancy compared to A. canadense, the kind of seed dormancy was the same for the two species. The trait of seed dormancy was inherited from a shared common ancestor and maintained in populations well after the two species (or their ancestors) separated. However, quantitative differences in temperature requirements for radicle and shoot emergence suggest the possibility of adaptation to the environment.
Collapse
Affiliation(s)
- Y H Rhie
- Department of Horticulture and Forestry, Pai Chai University, Daejeon, Korea
| | - S Y Lee
- Division of Horticulture & Medicinal Plant, Andong National University, Andong, Korea
| | - J L Walck
- Department of Biology, Middle Tennessee State University, Murfreesboro, TN, USA
| | - S N Hidayati
- Department of Biology, Middle Tennessee State University, Murfreesboro, TN, USA
| |
Collapse
|
24
|
Ju YJ, Lee JE, Lee SY. Associations between Chewing Difficulty, Subjective Cognitive Decline, and Related Functional Difficulties among Older People without Dementia: Focus on Body Mass Index. J Nutr Health Aging 2021; 25:347-355. [PMID: 33575727 DOI: 10.1007/s12603-020-1521-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE This study aimed to determine whether chewing difficulty is associated with subjective cognitive decline (SCD) and related functional difficulties by body mass index. DESIGN A population-based cross-sectional study. SETTING AND PARTICIPANTS A nationwide sample of 54,004 individuals aged ≥65 years from the 2018 Korea Community Health Survey. MEASUREMENTS SCD and SCD-related functional difficulties were measured using the cognitive decline module of the Behavioral Risk Factor Surveillance System. Chewing difficulty was assessed based on a self-report questionnaire from an oral health-related behaviors interview survey. BMI was calculated from objective values by measuring height and weight through a physical meter. RESULTS Among the 54,004 individuals, the prevalence of SCD in underweight, overweight, and obesity group was 33.6% (n = 806), 30.3% (n = 9,691), and 28.7% (n=5,632) respectively. Chewing difficulty was associated with SCD and SCD-related functional difficulties. This association was more pronounced in underweight (BMI: <18.5 kg/m2) people [underweight: (odds ratio [OR] = 1.68, 95% confidence interval [CI] 1.48-1.92); normal weight: OR = 1.13, 95% CI 1.04-1.22; obese: OR = 1.15, 95% CI 1.05-1.27]. Similar trends were demonstrated for SCD-related functional difficulties (underweight: OR = 1.53, 95% CI 1.17-2.01; normal weight: OR = 1.36, 95% CI 1.15-1.63; obese: OR = 1.50, 95% CI 1.22-1.86). CONCLUSIONS Chewing difficulty was associated with SCD and SCD-related functional difficulties in older people. Our results suggest that underweight status may play roles in the associations between chewing difficulty and SCD and SCD-related functional difficulties.
Collapse
Affiliation(s)
- Y J Ju
- Soon Young Lee, MD, PhD, Department of Preventive Medicine and Public Health, Ajou University School of Medicine 206 World cup-ro, Yeongtong-gu, Suwon-si Gyeonggi-do 16499, Republic of Korea, T: 82-31-219-5301, F: 82-31-219-5084, E:
| | | | | |
Collapse
|
25
|
Lee CT, Chen MZ, Yip CYC, Yap ES, Lee SY, Merchant RA. Prevalence of Anemia and Its Association with Frailty, Physical Function and Cognition in Community-Dwelling Older Adults: Findings from the HOPE Study. J Nutr Health Aging 2021; 25:679-687. [PMID: 33949637 DOI: 10.1007/s12603-021-1625-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES The prevalence of anemia and its impact on frailty and physical function amongst the multiethnic older populations in the Southeast Asian (SEA) countries are often not well studied. Singapore, a nation comprised of multiethnic communities, is one of the most rapidly aging population globally. We aim to evaluate the prevalence of anemia and its impact on frailty, and physical function in Healthy Older People Everyday (HOPE)- an epidemiologic population-based study on community-dwelling older adults in Singapore. DESIGN Cross-sectional study. SETTING Community. PARTICIPANTS 480 adults ≥ 65 years old. MEASUREMENTS Data were collected from interviewers-administered questionnaires on socio-demographics, FRAIL scale, Mini-Mental State Examination, EQ-5D, Barthel Index, and Lawton index. Hemoglobin concentration and physical assessments, including anthropometry, grip strength, timed up-and-go (TUG) were measured. RESULTS The overall prevalence of anemia was 15.2% (73 out of 480). The Indian ethnic group had the highest prevalence of anemia (32%, OR=3.02; 95%CI= 1.23-7.41) with the lowest hemoglobin concentration compared to the overall population (13.0±1.3g/L and 13.5±1.4g/L, p=0.02). Hemoglobin levels and anemia were significantly associated with frailty (OR=2.28; 95% CI=1.02-5.10), low grip strength (OR=1.79; 95% CI=1.01-3.03), ≥ one IADL impairment (OR=2.35; 95% CI=1.39-3.97). Each 1 g/dL increase in hemoglobin was associated with a 6% decrease in frailty odds after adjusting for potential covariates (OR = 0.94, 95% CI: 0.90-0.99). There was a significant difference in the mean TUG between the non-anemic (11.0±3.4 seconds) and anemic (12.3±6.0 seconds, p=0.01) counterparts, but no difference in the number of falls. CONCLUSION In our multiethnic Asian population, anemia was adversely associated with frailty, decreased muscle strength, and IADL impairment. Health policies on anemia screening should be employed to avoid or potentially delay or reverse these adverse outcomes associated with anemia. Recognition, evaluation, and treatment of anemia amongst this vulnerable population is warranted.
Collapse
Affiliation(s)
- C-T Lee
- Chun-Tsu Lee, MBBS(Mal.), M.Med (S'pore), MRCP(UK), FRCPath (UK), FAMS, Fast and Chronic Program, Alexandra Hospital, National University Health System, 378 Alexandra Road, Singapore 159964. Telephone: +65 64722000.
| | | | | | | | | | | |
Collapse
|
26
|
Chan NH, Lee SY, Cheng NHY, Wong HY, Lo WK, Lung DC. Hospital infection control best practice: Five essential elements to successfully minimize healthcare-associated COVID-19. Infect Prev Pract 2020; 3:100110. [PMID: 34316572 PMCID: PMC7837126 DOI: 10.1016/j.infpip.2020.100110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 12/10/2020] [Indexed: 01/22/2023] Open
Affiliation(s)
- N H Chan
- Infection Control Team, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - S Y Lee
- Infection Control Team, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - N H Y Cheng
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - H Y Wong
- Infection Control Team, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - W K Lo
- Infection Control Team, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - D C Lung
- Infection Control Team, Queen Elizabeth Hospital, Hong Kong Special Administrative Region.,Department of Pathology, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| |
Collapse
|
27
|
Park CL, Williams MK, Hernandez PR, Agocha VB, Lee SY, Carney LM, Loomis D. Development of emotion regulation across the first two years of college. J Adolesc 2020; 84:230-242. [PMID: 33011579 PMCID: PMC7588228 DOI: 10.1016/j.adolescence.2020.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 09/08/2020] [Accepted: 09/21/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Emotion regulation is thought to develop substantially from late adolescence into early adulthood; further, the rate of development purportedly varies based on personal and contextual characteristics. However, little research has explicitly documented this maturation in young adulthood or identified its determinants. We aimed to (1) characterize how adaptive (positive reappraisal, emotional social support-seeking) and maladaptive (suppression, substance use coping) emotion regulation strategies changed over time and (2) predict change in each strategy based on baseline personal, social, and motivational characteristics. METHODS We followed a sample of 1578 students entering university in the northeastern United States across their first two years, assessing them four times. RESULTS As expected, social support-seeking increased and suppression decreased. However, contrary to expectations, cognitive reappraisal declined over time while substance use coping increased. Women generally used more adaptive emotion regulation strategies than did men; social engagement and connection and eudaimonic well-being were generally predictive of using more adaptive coping over time. CONCLUSIONS Overall, students did not consistently demonstrate maturation to more adaptive emotion regulation and in fact exhibited decrements over the first two years of college. Students' baseline characteristics accounted for substantial degrees of change in emotion regulation. These findings suggest potentially fruitful directions for interventions to assist college students in developing more adaptive emotion regulation skills.
Collapse
|
28
|
Wong SCY, Kwong RTS, Wu TC, Chan JWM, Chu MY, Lee SY, Wong HY, Lung DC. Risk of nosocomial transmission of coronavirus disease 2019: an experience in a general ward setting in Hong Kong. J Hosp Infect 2020; 105:119-127. [PMID: 32259546 PMCID: PMC7128692 DOI: 10.1016/j.jhin.2020.03.036] [Citation(s) in RCA: 156] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 03/27/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) was first reported in Wuhan in December 2019 and has rapidly spread across different cities within and outside China. Hong Kong started to prepare for COVID-19 on 31st December 2019 and infection control measures in public hospitals were tightened to limit nosocomial transmission within healthcare facilities. However, the recommendations on the transmission-based precautions required for COVID-19 in hospital settings vary from droplet and contact precautions, to contact and airborne precautions with placement of patients in airborne infection isolation rooms. AIM To describe an outbreak investigation of a patient with COVID-19 who was nursed in an open cubicle of a general ward before the diagnosis was made. METHOD Contacts were identified and risk categorized as 'close' or 'casual' for decisions on quarantine and/or medical surveillance. Respiratory specimens were collected from contacts who developed fever, and/or respiratory symptoms during the surveillance period and were tested for SARS-CoV-2. FINDINGS A total of 71 staff and 49 patients were identified from contact tracing, seven staff and 10 patients fulfilled the criteria of 'close contact'. At the end of 28-day surveillance, 76 tests were performed on 52 contacts and all were negative, including all patient close contacts and six of the seven staff close contacts. The remaining contacts were asymptomatic throughout the surveillance period. CONCLUSION Our findings suggest that SARS-CoV-2 is not spread by an airborne route, and nosocomial transmissions can be prevented through vigilant basic infection control measures, including wearing of surgical masks, hand and environmental hygiene.
Collapse
Affiliation(s)
- S C Y Wong
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - R T-S Kwong
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - T C Wu
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - J W M Chan
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - M Y Chu
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - S Y Lee
- Infection control Team, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - H Y Wong
- Infection control Team, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - D C Lung
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong Special Administrative Region; Infection control Team, Queen Elizabeth Hospital, Hong Kong Special Administrative Region.
| |
Collapse
|
29
|
Lee SY, Yeom SS, Kim CH, Kim YJ, Kim HR. A new aortoiliac calcification scoring system to predict grade C anastomotic leak following rectal cancer surgery. Tech Coloproctol 2020; 24:843-849. [PMID: 32468245 DOI: 10.1007/s10151-020-02246-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 05/19/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Aortoiliac calcification may be a surrogate marker of decreased visceral perfusion causing anastomotic leak (AL). The aim of this study was to evaluate the predictive role of aortoiliac calcification for AL after rectal cancer surgery. METHODS We enrolled patients with primary rectal cancer who had restorative resection at our institution between January 2013 and December 2015. An aortoiliac calcification score was calculated as the sum of calcification scores at the infrarenal aorta (0: no, 1: ≤ 3 cm, 2: > 3 cm) and the common iliac arteries (0: no, 1: unilateral, 2: bilateral). AL was classified into three grades: grade A, requiring no intervention; grade B, requiring therapeutic intervention without re-laparotomy; and grade C, requiring re-laparotomy. Clinicopathological characteristics were analyzed to identify risk factors for AL. RESULTS There were 583 patients. Three-hundred forty-five (59.2%) had an aortoiliac calcification score ≥ 3, and 37 (6.3%) patients experienced AL, in 30 cases (5.1%) grade C AL. Patients with an aortoiliac calcification score ≥ 3 had a higher incidence of grade C AL (6.7% vs. 2.9%, p = 0.045). Multivariate logistic regression analysis revealed that an aortoiliac calcification score ≥ 3 was an independent risk factor for grade C AL (odds ratio = 2.669, 95% confidence interval 1.066-6.686, p = 0.036). CONCLUSIONS Aortoiliac calcification may be considered a risk factor for grade C AL after rectal cancer surgery.
Collapse
Affiliation(s)
- S Y Lee
- Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro Hwasun-eup, Hwasun-gun, Jeonnam, 58128, South Korea
| | - S-S Yeom
- Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro Hwasun-eup, Hwasun-gun, Jeonnam, 58128, South Korea
| | - C H Kim
- Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro Hwasun-eup, Hwasun-gun, Jeonnam, 58128, South Korea
| | - Y J Kim
- Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro Hwasun-eup, Hwasun-gun, Jeonnam, 58128, South Korea
| | - H R Kim
- Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro Hwasun-eup, Hwasun-gun, Jeonnam, 58128, South Korea.
| |
Collapse
|
30
|
Kim KW, Chung S, Lee SY, Yoon SS, Kang HR. Successful Infusion of Obinutuzumab by Desensitization: A Case of Anaphylactic Shock During Desensitization. J Investig Allergol Clin Immunol 2020; 30:457-459. [PMID: 32376522 DOI: 10.18176/jiaci.0581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- K W Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - S Chung
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - S Y Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.,Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea
| | - S S Yoon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - H R Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.,Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.,Drug Safety Monitoring Center, Seoul National University Hospital, Seoul, Korea
| |
Collapse
|
31
|
Kim YJ, Jeong YJ, Kim SH, Kim YJ, Lee SY, Kim TY, Choi MS, Ahn JH. Preparedness for COVID-19 infection prevention in Korea: a single-centre experience. J Hosp Infect 2020; 105:370-372. [PMID: 32302723 PMCID: PMC7194524 DOI: 10.1016/j.jhin.2020.04.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 04/09/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Y J Kim
- Division of Infectious Disease, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea; Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea.
| | - Y J Jeong
- Division of Infectious Disease, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea; Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea
| | - S H Kim
- Division of Infectious Disease, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea; Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea
| | - Y J Kim
- Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea
| | - S Y Lee
- Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea
| | - T Y Kim
- Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea
| | - M S Choi
- Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea
| | - J H Ahn
- Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea; Division of Pulmonology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| |
Collapse
|
32
|
Lee SY, Finkelstein-Fox L, Park CL, Mazure CM, Huedo-Medina TB, Hoff R. Bidirectionality of Pain Interference and PTSD Symptoms in Military Veterans: Does Injury Status Moderate Effects? Pain Med 2020; 20:934-943. [PMID: 30016463 DOI: 10.1093/pm/pny133] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Pain and post-traumatic stress disorder (PTSD) symptoms are strongly correlated in veteran populations. Arguments for which one condition predicts or worsens the other condition have gone in both directions. However, research addressing this issue has been primarily limited to cross-sectional studies rather than examinations of a potential bidirectional relationship between pain interference and PTSD symptoms over time. In addition, no studies have examined deployment injury status as potentially moderating this bidirectional effect in veterans. To address these gaps in the literature, the present longitudinal study examined whether there is a bidirectional relationship between pain interference and PTSD symptoms in a sample of male and female veterans returning from Operation Iraqi Freedom, Operation Enduring Freedom, or Operation New Dawn (N = 729) and whether deployment injury status moderates this relationship. METHODS Participants completed phone interviews regarding pain interference and PTSD symptoms at three time points, each three months apart. RESULTS Pain interference at Time 1 predicted worse PTSD symptoms at Time 2 for the subset of veterans who sustained injuries during deployment (n = 381) but not for veterans with pain interference who did not sustain injuries (n = 338). From Time 1 to Time 3, elevations in PTSD symptoms were mediated by pain interference for injured veterans; in contrast, PTSD symptoms did not appear to drive changes in pain interference in either group. CONCLUSIONS These results indicate that physical symptom management should be a crucial target of psychological intervention for returning veterans with PTSD symptoms and deployment-related injuries.
Collapse
Affiliation(s)
- Sharon Y Lee
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Lucy Finkelstein-Fox
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Carolyn M Mazure
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,Women's Health Research at Yale, New Haven, CT, USA
| | | | - Rani Hoff
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,Women's Health Research at Yale, New Haven, CT, USA.,VISN1 MIRECC, VA Connecticut Healthcare System, New Haven, CT, USA
| |
Collapse
|
33
|
Park CL, Finkelstein-Fox L, Groessl EJ, Elwy AR, Lee SY. Exploring how different types of yoga change psychological resources and emotional well-being across a single session. Complement Ther Med 2020; 49:102354. [PMID: 32147083 DOI: 10.1016/j.ctim.2020.102354] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 02/23/2020] [Accepted: 02/24/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Yoga demonstrates beneficial effects in many populations, yet our understanding of how yoga brings about these effects is quite limited. Among the proposed mechanisms of yoga are increasing psychological resources (mindfulness, body consciousness, self-transcendence, spiritual peace, and social connectedness) that may bring about salutary effects on emotional wellbeing. Further, yoga is a complex practice comprising meditation, active and restorative postures, and breathwork; however little is known about how different components may affect mechanisms. We aimed to determine how an acute session of yoga (and its specific components) related to pre- to post- session changes in proposed mechanisms (psychological resources) and whether those changes were associated with positive changes in emotions. DESIGN 144 regular yoga practitioners completed measures of mindfulness, body consciousness, self-transcendence, social connectedness, spiritual peace, and exercise-induced emotions (positive engagement, revitalization, tranquility, exhaustion) immediately before and after a yoga session (N = 11 sessions, each a different type of yoga). Perceived properties of each yoga session, exercise exertion and engagement with the yoga teacher were assessed immediately following the session. RESULTS Pre-to post- yoga, levels of positive emotions (engagement, tranquility and revitalization) increased while exhaustion decreased. Further, all psychological resources increased and closely tracked improved emotions. Additionally, aspects of the yoga session correlated with changes in psychological resources (mechanisms) and emotions. CONCLUSIONS Yoga may influence multiple psychological mechanisms that influence emotional well-being. Further, different types of yoga may affect different mechanisms. Results can inform yoga interventions aiming to optimize effects through specific mechanisms such as mindfulness or spirituality.
Collapse
Affiliation(s)
| | | | | | | | - Sharon Y Lee
- University of Connecticut, USA; University of California, San Diego, USA; Brown University, USA
| |
Collapse
|
34
|
Woo W, Jeong JS, Kim DK, Lee CM, Choi SH, Suh JY, Lee SY, Harjo S, Kawasaki T. Stacking Fault Energy Analyses of Additively Manufactured Stainless Steel 316L and CrCoNi Medium Entropy Alloy Using In Situ Neutron Diffraction. Sci Rep 2020; 10:1350. [PMID: 31992801 PMCID: PMC6987211 DOI: 10.1038/s41598-020-58273-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 01/10/2020] [Indexed: 11/08/2022] Open
Abstract
Stacking fault energies (SFE) were determined in additively manufactured (AM) stainless steel (SS 316 L) and equiatomic CrCoNi medium-entropy alloys. AM specimens were fabricated via directed energy deposition and tensile loaded at room temperature. In situ neutron diffraction was performed to obtain a number of faulting-embedded diffraction peaks simultaneously from a set of (hkl) grains during deformation. The peak profiles diffracted from imperfect crystal structures were analyzed to correlate stacking fault probabilities and mean-square lattice strains to the SFE. The result shows that averaged SFEs are 32.8 mJ/m2 for the AM SS 316 L and 15.1 mJ/m2 for the AM CrCoNi alloys. Meanwhile, during deformation, the SFE varies from 46 to 21 mJ/m2 (AM SS 316 L) and 24 to 11 mJ/m2 (AM CrCoNi) from initial to stabilized stages, respectively. The transient SFEs are attributed to the deformation activity changes from dislocation slip to twinning as straining. The twinning deformation substructure and atomic stacking faults were confirmed by electron backscatter diffraction (EBSD) and transmission electron microscopy (TEM). The significant variance of the SFE suggests the critical twinning stress as 830 ± 25 MPa for the AM SS 316 L and 790 ± 40 MPa for AM CrCoNi, respectively.
Collapse
Affiliation(s)
- W Woo
- Neutron Science Center, Korea Atomic Energy Research Institute, Daejeon, 34057, Korea.
| | - J S Jeong
- Materials Technology Development Team, Doosan heavy industries, Changwon, 44610, Korea
| | - D-K Kim
- School of Mechanical Engineering, University of Ulsan, Ulsan, 44610, Korea
| | - C M Lee
- Neutron Science Center, Korea Atomic Energy Research Institute, Daejeon, 34057, Korea
| | - S-H Choi
- Department of Printed Electronics Engineering, Sunchon National University, Sunchon, 57922, Korea
| | - J-Y Suh
- High Temperature Energy Materials Research Center, Korea Institute of Science and Technology, Seoul, 02792, Korea
| | - S Y Lee
- Department of Materials Science and Engineering, Chungnam National University, Daejeon, 34134, Korea
| | - S Harjo
- J-PARC Center, Japan Atomic Energy Agency, 2-4 Shirakata, Tokai, Naka, Ibaraki, 319-1195, Japan
| | - T Kawasaki
- J-PARC Center, Japan Atomic Energy Agency, 2-4 Shirakata, Tokai, Naka, Ibaraki, 319-1195, Japan
| |
Collapse
|
35
|
Lee SY, Lee SH, Park YH. P799 The echocardiographic and clinical characteristics of Fabry patients without overt left ventricular hypertrophy but progressing despite on enzyme replacement therapy. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Fabry disease (FD) is X-linked genetic disorder caused by the deficiency or absent activity of lysosomal α- galactosidase. When the heart is involved, progressive left ventricular hypertrophy (LVH) is the key feature. Although, LVH is not present in all subjects, some of them progress with LVH despite enzyme replacement therapy (ERT). The present study aimed to evaluate the characteristics of patient of FD without overt LVH, but progresses with their left ventricular mass index (LVMI).
Method : This study includes subjects carrying genetic mutations for FD without LVH (n = 12) in a single tertiary center. ‘Decreasing LVMI group (Group1)’ was defined when pre-ERT LVMI minus last LVMI value obtained by echocardiography was positive, and when negative, defined as ‘Increasing LVMI group (Group 2)’. The baseline characteristics and echocardiographic parameters including global strain was analyzed.
Result : Total 6 patients were classified as Group 1 and 2 each. The median age at diagnosis for male was 21 vs 27 for each group, and 21 vs 31 for female. The median follow-up duration was 4.0 vs 5.7 yr. The antibody formation for replaced enzyme was 3 for Group 2 and any family member who developed overt LVH was much 1 vs 3 for group 1 vs 2. Initial 3 plane GLS was worse and showed trend to drop in Group 2.
Conclusion : In the Fabry patients get worse with their LVMI but still not developed overt LVH despite enzyme replacement therapy, there are some clinical and echo-parameter difference. These findings could suggest insufficient enzyme replacement therapy.
Group 1 (n = 6) Group 2 (n = 6) Female/Male 4/2 3/3 Age of at Dx (Female) (median) 21 28 Age of at Dx (Male) (median) 21 31 F/U duration (median) 4.0 yrs 5.7 yrs Antibody formation 0 3 Any Overt LVH family Genotype c.56T > C c.40-11T > A, 782_delG, c.658C > T Initial LVMI (Median) 98.2g/m2 70.9g/m2 Initial GLS (3P) -19 -17.8 Continuously elevated LysoGb3 2 4 Proteinuria >300mg 1 3 (1 preparing HD)
Collapse
Affiliation(s)
- S Y Lee
- Pusan National University Yangsan Hospital, Yangsan-si, Korea (Republic of)
| | - S H Lee
- Pusan National University Yangsan Hospital, Yangsan-si, Korea (Republic of)
| | - Y H Park
- Pusan National University Yangsan Hospital, Yangsan-si, Korea (Republic of)
| |
Collapse
|
36
|
Wang Y, Hays RD, Marcus M, Maida CA, Shen J, Xiong D, Coulter ID, Lee SY, Spolsky VW, Crall JJ, Liu H. Developing Children's Oral Health Assessment Toolkits Using Machine Learning Algorithm. JDR Clin Trans Res 2019; 5:233-243. [PMID: 31710817 DOI: 10.1177/2380084419885612] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Evaluating children's oral health status and treatment needs is challenging. We aim to build oral health assessment toolkits to predict Children's Oral Health Status Index (COHSI) score and referral for treatment needs (RFTN) of oral health. Parent and Child toolkits consist of short-form survey items (12 for children and 8 for parents) with and without children's demographic information (7 questions) to predict the child's oral health status and need for treatment. METHODS Data were collected from 12 dental practices in Los Angeles County from 2015 to 2016. We predicted COHSI score and RFTN using random Bootstrap samples with manually introduced Gaussian noise together with machine learning algorithms, such as Extreme Gradient Boosting and Naive Bayesian algorithms (using R). The toolkits predicted the probability of treatment needs and the COHSI score with percentile (ranking). The performance of the toolkits was evaluated internally and externally by residual mean square error (RMSE), correlation, sensitivity and specificity. RESULTS The toolkits were developed based on survey responses from 545 families with children aged 2 to 17 y. The sensitivity and specificity for predicting RFTN were 93% and 49% respectively with the external data. The correlation(s) between predicted and clinically determined COHSI was 0.88 (and 0.91 for its percentile). The RMSEs of the COHSI toolkit were 4.2 for COHSI (and 1.3 for its percentile). CONCLUSIONS Survey responses from children and their parents/guardians are predictive for clinical outcomes. The toolkits can be used by oral health programs at baseline among school populations. The toolkits can also be used to quantify differences between pre- and post-dental care program implementation. The toolkits' predicted oral health scores can be used to stratify samples in oral health research. KNOWLEDGE TRANSFER STATEMENT This study creates the oral health toolkits that combine self- and proxy- reported short forms with children's demographic characteristics to predict children's oral health and treatment needs using Machine Learning algorithms. The toolkits can be used by oral health programs at baseline among school populations to quantify differences between pre and post dental care program implementation. The toolkits can also be used to stratify samples according to the treatment needs and oral health status.
Collapse
Affiliation(s)
- Y Wang
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA, USA.,Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.,Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - R D Hays
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, CA, USA.,Department of Medicine, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.,RAND Corporation, Santa Monica, CA, USA
| | - M Marcus
- Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - C A Maida
- Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.,Division of Oral Biology and Medicine, School of Dentistry, University of California, Los Angeles, CA, USA
| | - J Shen
- Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - D Xiong
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA, USA.,Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - I D Coulter
- Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.,RAND Corporation, Santa Monica, CA, USA
| | - S Y Lee
- Division of Constitutive & Regenerative Sciences, Section of Restorative Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - V W Spolsky
- Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - J J Crall
- Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - H Liu
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA, USA.,Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.,Department of Medicine, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| |
Collapse
|
37
|
Lee SY, Chau JPC, Choi KC, Lo SHS. Feasibility of a guided participation discharge program for very preterm infants in a neonatal intensive care unit: a randomized controlled trial. BMC Pediatr 2019; 19:402. [PMID: 31684903 PMCID: PMC6827218 DOI: 10.1186/s12887-019-1794-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 10/21/2019] [Indexed: 11/26/2022] Open
Abstract
Background Previous studies showed that parents of very preterm infants expressed feelings of incompetence and experienced high levels of stress upon the discharge of their infants. We conducted a systematic review of seven studies and observed potential benefits for parental outcomes when using discharge interventions that adopted guided participation (GP). More evidence is needed on the effective doses of discharge interventions underpinned by the principles of GP. Aim To investigate the feasibility and preliminarily estimate the effects on parental competence and stress outcomes of a newly developed, nurse-led, GP discharge program for mothers of very preterm infants. Methods A two-arm randomized controlled trial was conducted in a neonatal intensive care unit (NICU). Mothers of infants with gestational ages of ≤32 weeks who had no congenital malformations and did not need to undergo major surgeries were recruited. All mothers were the primary caregivers to their infants. The intervention group received a nurse-led GP discharge intervention (three structured 30- to 60-min GP sessions and one follow-up phone call). The control group received usual care. The parental outcomes were measured using the Parenting Sense of Competence Scale (C-PSOC) and Perceived Stress Scale (C-PSS) at baseline (T0), on the day of discharge (T1), after the follow-up phone call (within 72 h after discharge) (T2), and 1 month after discharge (T3). The outcomes were analyzed using generalized estimating equations based on intention-to-treat principles. Results Thirty infant–mother dyads were recruited. Greater improvements in the C-PSOC score were observed in the intervention group than in the control group at T1 and T2, although these differences were statistically insignificant. The intervention group exhibited greater improvements than the control group in the C-PSS scores at T1, T2, and T3, although these differences were also not statistically significant. Conclusions The findings suggest that a GP discharge intervention could improve parenting competence and stress among mothers with very preterm infants. The absence of adverse events suggests that the GP discharge intervention could be feasibly implemented in NICU settings. This feasibility study was not powered to determine the effectiveness of the intervention but is anticipated to lay the foundation for a future full-scale study. Trial registration ClinicalTrials.gov Identifier: NCT03668912. Date of registration: 13 September 2018 (retrospectively registered).
Collapse
Affiliation(s)
- S Y Lee
- Department of Pediatrics, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, N.T., Hong Kong SAR
| | - J P C Chau
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR.
| | - K C Choi
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR
| | - S H S Lo
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR
| |
Collapse
|
38
|
Hong D, Choi KH, Youn T, Lee SY, Bak M, M KM, Cho YH, Yang JH. P1711The association of multidisciplinary team approach with clinical outcomes in patients with acute myocardial infarction underwent veno-arterial extracorporeal membrane oxygenation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Multidisciplinary team approach is necessary for the management of critically-ill patients. However, limited data are available on the impact of specialized extracorporeal membrane oxygenation (ECMO) team on clinical outcomes in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock.
Objectives
This study aimed to identify whether specialized ECMO team is associated with improved in-hospital mortality in AMI patients underwent venoarterial ECMO.
Methods
A total of 255 AMI patients underwent venoarterial ECMO from May 2004 to July 2018 were enrolled. In January 2014, multidisciplinary ECMO team was founded at our institution. Eligible patients were classified into pre-ECMO team group (n=131) and post-ECMO team group (n=124). The primary outcome was in-hospital mortality.
Results
In-hospital mortality (54.2% vs. 33.9%, p=0.002) and cardiac intensive care unit mortality (45.0% vs. 25.0%, p=0.001) were significantly lower after the implantation of multidisciplinary ECMO team (pre ECMO team vs. post-ECMO team). On binary logistic regression model, the multidisciplinary ECMO team approach was associated with lower risk of in-hospital mortality (odds ratio 0.36, 95% confidence interval 0.19–0.67, p=0.001). Incidence of all-cause mortality (58.3% vs. 35.2%, p<0.001) and rehospitalization due to heart failure (28.2% vs. 6.4%, p=0.001) at 6-months follow-up were also significantly lower in the post-ECMO team group than in the pre-ECMO team group.
Clinical outcomes Variables Total (N=255) Pre-ECMO team (N=131) Post-ECMO team (N=124) P value In-hospital mortality 113 (44.3) 71 (54.2) 42 (33.9) 0.002 Cardiovascular death 90 (35.3) 59 (45.0) 31 (25.0) 0.001 Noncardiovascular death 23 (9.0) 12 (9.2) 11 (8.9) >0.99 Cardiac intensive care unit mortality 106 (41.6) 68 (51.9) 38 (30.6) 0.001 Successful weaning of ECMO 169 (66.3) 75 (57.3) 94 (75.8) 0.002 Data are presented as n (%). Abbreviations: ECMO, extracorporeal membrane oxygenation.
Incidence of death, readmission for HF
Conclusions
The multidisciplinary ECMO team approach was associated with improved clinical outcomes in AMI patients complicated by cardiogenic shock. Our data support that specialized ECMO team is indispensable to improve outcomes in patients with AMI with refractory cardiogenic shock.
Collapse
Affiliation(s)
- D Hong
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - K H Choi
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - T Youn
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - S Y Lee
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - M Bak
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - K M M
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - Y H Cho
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - J H Yang
- Samsung Medical Center, Seoul, Korea (Republic of)
| |
Collapse
|
39
|
Rhee MY, Kim JH, Namgung J, Lee SY, Cho DK, Choi TY, Kim SY. P800Proposal of an algorithm for the diagnosis of hypertension by using out-of-office blood pressure measurements. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and purpose
Based on the data of patients who measured office BP (OBP) in controlled condition, home BP (HBP), and 24-hour ambulatory BP (24hABP) for diagnosis of hypertension, we developed and validated a diagnostic algorithm for hypertension.
Methods
Patients who have high BP (≥140/90 mmHg) at the outpatient clinic were referred to measure OBP in controlled condition, HBP and 24hABP. The OBP was measured three times at each visit for 3 days in controlled condition by using a validated oscillometric device. HBP was measured for 7 days in triplicates every morning and evening. The 24hABP was measured on the 8th day. Same study protocol was used for development and validation population.
Results
In the development of algorithm, 319 patients were recruited and data of 256 patients (51.8±9.7 years, 119 men) with valid HBP and 24hABP measurements were analyzed. In the validation of algorithm, 300 patients were recruited and data of 257 patients (52.4±9.8 years, 126 men) with valid HBP and 24hABP measurements were analyzed. In the development population, the prevalence of masked hypertension was 19.5% (n=50) and most of them (n=47, 94%) was in the range of 130–139/80–89 mmHg. The BP in the range of 130–144/80–94 mmHg was defined as the grey zone of OBP, because prevalence of white-coat hypertension was lowered to 1.6% from 4.3% with threshold of 145/95 mmHg. The diagnostic sensitivity, specificity, positive and negative predictive value of OBP was improved to 97.4%, 76.5, 96.5% and 81.3% after excluding the grey zone of OBP (n=125). The diagnostic agreement between 24hABP and HBP in the grey zone of OBP was 64%. The diagnostic sensitivity, specificity, positive and negative predictive value of HBP were 88.8%, 74.7, 93.5% and 61.5% after excluding the grey zone of HBP (130–134/80–84 mmHg, n=28). Based upon these results, we developed a diagnostic algorithm for hypertension by using on out-of-office BP measurements to improved diagnostic accuracy of hypertension (Figure). In the validation population, the developed algorithm showed similar diagnostic accuracy.
Diagnostic algorithm for hypertension
Conclusion
For accurate diagnosis of hypertension, OBP measurement according to guidelines and 24hABP measurement to grey zone of OBP is preferred. To improve diagnostic accuracy of HBP measurement, 24hABP measurement to grey zone of HBP is required.
Acknowledgement/Funding
Part of this study was supported by a grand from Dong-A ST Co. Ltd., Seoul, Korea.
Collapse
Affiliation(s)
- M Y Rhee
- Dongguk University Ilsan Hospital, Goyang-si, Korea (Republic of)
| | - J H Kim
- Dongguk University Ilsan Hospital, Goyang-si, Korea (Republic of)
| | - J Namgung
- Inje University Ilsan Paik Hospital, Goyang, Korea (Republic of)
| | - S Y Lee
- Inje University Ilsan Paik Hospital, Goyang, Korea (Republic of)
| | - D K Cho
- Hospital Myongji, Goyang, Korea (Republic of)
| | - T Y Choi
- Seoul Red Cross Hospital, Seoul, Korea (Republic of)
| | - S Y Kim
- Seoul Medical Center, Seoul, Korea (Republic of)
| |
Collapse
|
40
|
Sung J, Ahn KT, Cho BR, Lee SY, Kim BJ, Kim DK, Park JI, Lee WS. 1423Adherence to triple component antihypertensive regimen is higher in single-pill combination than two-pill regimen: data from a randomized controlled trial using medication event monitoring system. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Simplicity of regimen is known to be an important determinant of medication adherence and using single-pill combination (SPC) in hypertension treatment resulted in better adherence and persistence than free-equivalent combination. However, this finding has been studied only in dual-component antihypertensive treatments and in observational studies using medication possession ratio as an index of adherence. Medication event monitoring system (MEMS) is considered to be the gold standard in estimating medication adherence.
Purpose
To investigate the superiority in adherence of triple-component SPC compared to equivalent two-pill regimen using MEMS
Methods
This is a multi-center open-label randomized controlled trial. Inclusion criteria were hypertensive patients whose clinic blood pressure is not adequately controlled (systolic >140 mmHg or diastolic >90 mmHg) with combination antihypertensive regimen comprising two of three classes (angiotensin receptor blocker, calcium channel blocker and thiazide diuretics) for at least 4 weeks. Eligible patients were randomized either to single-pill (triple-component SPC, olmesartan/amlodipine/ hydrochlorothiazide 20/5/12.5 mg) or two-pill (dual-component SPC + one free pill, olmesartan/hydrochlorothiazide 20/12.5 mg + amlodipine 5 mg) groups and maintained for 12 weeks. Medications were dispensed in MEMS. Primary outcomes were the difference of percentage of dose taken (PDT) and percentage of days with prescribed dose taken correctly (PDTc) between single- and two-pill therapy, calculated from MEMS data.
Results
From 8 hospitals, 146 hypertensive patients were randomized into single- and two-pill groups. Final analysis was done in 65 and 66 patients in each group from which adherence index could be obtained. Baseline clinical characteristics of the two groups were not different. The single-pill group had significantly higher PDT and PDTc compared to the two-pill group. (median (25–75 percentile) (%), PDT 95.1 (87.9 - 100.0) vs 91.2 (79.8 - 96.5); PDTc 93.1 (79.8 - 96.5) vs 91.3 (70.7 - 96.4), p = both 0.04, by Wilcoxon rank sum test)
Percent dose taken
Conclusion
Single-pill combination of triple-component antihypertensive regimen showed superior adherence compared to equivalent two-pill therapy. Reducing pill burden by using SPC is a relevant strategy to enhance the adherence to multi-drug antihypertensive therapy.
Acknowledgement/Funding
Daiichi-Sankyo
Collapse
Affiliation(s)
- J Sung
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (Republic of)
| | - K T Ahn
- Chungnam National University Hospital, Daejeon, Korea (Republic of)
| | - B R Cho
- Kangwon National University Hospital, Chooncheon, Korea (Republic of)
| | - S Y Lee
- Ilsan Paik Hospital, Goyang, Korea (Republic of)
| | - B J Kim
- Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea (Republic of)
| | - D K Kim
- Busan Paik Hospital, Busan, Korea (Republic of)
| | - J I Park
- VHS Medical Center, Seoul, Korea (Republic of)
| | - W S Lee
- Chung-Ang University Hospital, Seoul, Korea (Republic of)
| |
Collapse
|
41
|
Lee SY, Park CL, Pescatello LS. How trauma influences cardiovascular responses to stress: contributions of posttraumatic stress and cognitive appraisals. J Behav Med 2019; 43:131-142. [PMID: 31165948 DOI: 10.1007/s10865-019-00067-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 05/30/2019] [Indexed: 01/17/2023]
Abstract
Mechanisms for the association between posttraumatic stress disorder (PTSD) symptoms and cardiovascular diseases remain poorly understood. The present study examined associations among PTSD symptoms, appraisals of a current stressor, baseline cardiovascular indices, and cardiovascular responses to the stressor, including appraisals as a potential mediator of PTSD symptoms and cardiovascular responses. A sample of 125 undergraduates provided information about demographics, physical health, trauma history, and PTSD symptoms. Weight, height, blood pressure (BP), and heart rate (HR) measurements were obtained. During a modified Trier Social Stress Task, appraisals of the stressor were assessed and BP and HR were measured again. Findings suggest that PTSD symptoms are associated with current physical health (resting BP and HR) and more negative appraisals of the stressor; in turn, more negative appraisals were associated with increases in cardiovascular response. In particular, threat appraisal mediated the relationship between PTSD symptoms and increases in systolic BP response.
Collapse
Affiliation(s)
- Sharon Y Lee
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269-1020, USA.
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269-1020, USA
| | | |
Collapse
|
42
|
Marcus M, Maida CA, Wang Y, Xiong D, Hays RD, Coulter ID, Lee SY, Spolsky VW, Shen J, Crall JJ, Liu H. Child and Parent Demographic Characteristics and Oral Health Perceptions Associated with Clinically Measured Oral Health. JDR Clin Trans Res 2019; 3:302-313. [PMID: 30938594 DOI: 10.1177/2380084418774549] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To examine child and parent reports about the child's oral health and assess the associations of these reports with clinical assessments of oral health status by dental examiners. METHODS Surveys with 139 items for children and 133 items for parents were administered by Audio Computer-Assisted Self-Interview Software. In addition, the Children's Oral Health Status Index (COHSI) was computed from a dental examination. RESULTS A total of 334 families with children ages 8 to 17 y participated at 12 dental practices in Los Angeles County. Ordinary least squares regression models were estimated separately for child and parent surveys to identify items uniquely associated with the COHSI. Ten of 139 items the children reported regarding their oral health were associated with the COHSI. The strongest associations were found for child's age, aesthetic factors (straight teeth and pleased with teeth), and cognitive factors related to perception of dental appearance (pleased/happy with the look of the child's mouth, teeth, and jaws). Nine of 133 parent items about the child's oral health were associated with the COHSI in the parent model, notably being a single parent, parent's gender, parent born in the United States, pleased or happy with the look of their child's teeth, and accessing the Internet. CONCLUSION These child and parent survey items have potential to be used to assess oral health status for groups of children in programs and practices in lieu of dental screenings. KNOWLEDGE TRANSLATION STATEMENT The paper's results inform the development of a toolkit that can be used by schools, public health agencies, and dental programs to identify children with low oral health status based on parents' and children's responses to survey items across demographic, physical, mental, and social domains. These survey items can be used to inform parents of the desirability of proactively addressing inadequacies in their child's oral health status, enabling them to more rationally address dental needs.
Collapse
Affiliation(s)
- M Marcus
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - C A Maida
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.,2 Division of Oral Biology and Medicine, School of Dentistry, University of California, Los Angeles, CA, USA
| | - Y Wang
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.,3 Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - D Xiong
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.,3 Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - R D Hays
- 4 Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, CA, USA.,5 Department of Medicine, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.,6 RAND Corporation, Santa Monica, CA, USA
| | - I D Coulter
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.,6 RAND Corporation, Santa Monica, CA, USA
| | - S Y Lee
- 7 Division of Constitutive & Regenerative Sciences, Section of Restorative Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - V W Spolsky
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - J Shen
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - J J Crall
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - H Liu
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.,3 Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA, USA.,5 Department of Medicine, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| |
Collapse
|
43
|
Kim K, Jeong Y, Shin KH, Kim JH, Ahn SD, Kim SS, Suh CO, Kim YB, Choi DH, Park W, Cha J, Chun M, Lee DS, Lee SY, Kim JH, Park HJ. Abstract P3-12-12: Impact of regional nodal irradiation for breast cancer patients with supraclavicular and/or internal mammary lymph node involvement: A multicenter, retrospective study (KROG 16-14). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-12-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: To evaluate the treatment outcomes of radiotherapy (RT) for breast cancer with ipsilateral supraclavicular (SCL) and/or internal mammary (IMN) lymph node involvement.
Methods: A total of 353 patients from 11 institutions were included. One hundred and thirty-six patients had SCL involvement, 148 had IMN involvement, and 69 had both. All patients received neoadjvant systemic therapy followed by breast conserving surgery or mastectomy, and postoperative RT to whole breast/chest wall. As for regional lymph node irradiation, SCL RT was given to 344 patients, and IMN RT to 236 patients. The median RT dose was 50.4 Gy.
Results: The median follow-up duration was 61 months (range, 7-173). In-field progression was present in SCL (n=20) and/or IMN (n=7). The 5-year disease-free survival (DFS) and overall survival rates were 57.8% and 75.1%, respectively. On multivariate analysis, both SCL/IMN involvement, number of axillary lymph node ≥4, triple negative subtype, and mastectomy were significant adverse prognosticators for DFS (p = 0.022, 0.001, 0.001, and 0.004, respectively). Regarding the impact of regional nodal irradiation, SCL RT dose ≥54 Gy was not associated with DFS (5-yr rate, 52.9% vs. 50.9%, p = 0.696) in SCL-involved patients, and the receipt of IMN RT was not associated with DFS (5-yr rate, 56.1% vs. 78.1%, p = 0.099) in IMN-involved patients.
Conclusion: Neoadjuvant chemotherapy followed by surgery and postoperative RT achieved an acceptable in-field regional control rate in patients with SCL and/or IMN involvement. However, a higher RT dose to SCL or IMN RT was not associated with the improved DFS in these patients.
Citation Format: Kim K, Jeong Y, Shin KH, Kim JH, Ahn SD, Kim SS, Suh C-O, Kim YB, Choi DH, Park W, Cha J, Chun M, Lee DS, Lee SY, Kim JH, Park HJ. Impact of regional nodal irradiation for breast cancer patients with supraclavicular and/or internal mammary lymph node involvement: A multicenter, retrospective study (KROG 16-14) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-12-12.
Collapse
Affiliation(s)
- K Kim
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - Y Jeong
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - KH Shin
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - JH Kim
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - SD Ahn
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - SS Kim
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - C-O Suh
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - YB Kim
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - DH Choi
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - W Park
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - J Cha
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - M Chun
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - DS Lee
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - SY Lee
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - JH Kim
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - HJ Park
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| |
Collapse
|
44
|
Lee SY, Kang DY, Kim JY, Yoon SH, Choi YH, Lee W, Cho SH, Kang HR. Incidence and Risk Factors of Immediate Hypersensitivity Reactions Associated With Low-Osmolar Iodinated Contrast Media: A Longitudinal Study Based on a Real-Time Monitoring System. J Investig Allergol Clin Immunol 2019; 29:444-450. [PMID: 30676320 DOI: 10.18176/jiaci.0374] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES We investigated the incidence of immediate hypersensitivity reaction (HSR) caused by different types of low-osmolar contrast media (LOCM) and cumulative exposure to LOCM. METHODS This cohort study included all consecutive patients who underwent LOCM-enhanced computed tomography from 2012 through 2014. We assessed 5 LOCM (iobitridol, iohexol, iomeprol, iopamidol, and iopromide). All patients were monitored for adverse events, and new symptoms and signs were recorded in real time using the Contrast Safety Monitoring and Management System (CoSM2oS). RESULTS The overall incidence of immediate HSR to LOCM was 0.97% (2004 events resulting from 205 726 exposures). Incidence differed significantly depending on whether the patient had a previous history of HSR to LOCM (0.80% in patients with no history and 16.99% in patients with a positive history of HSR to LOCM, P=.001). The incidence of HSR to individual LOCM ranged from 0.72% (iohexol) to 1.34% (iomeprol), although there were no significant differences across the 5 LOCM. A longitudinal analysis demonstrated that the incidence of HSR increased gradually with more frequent previous exposure to LOCM (HR=2.006 [95%CI, 1.517-2.653], P<.001). However, this cumulative increase in risk was observed in patients who had experienced HSR to LOCM, but not in those who had not. CONCLUSION The incidence of HSR did not differ significantly across the 5 LOCM assessed in the study. Repeated exposure to LOCM did not increase the risk of HSR among patients who had never experienced HSR to LOCM.
Collapse
Affiliation(s)
- S Y Lee
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.,Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - D Y Kang
- Drug Safety Monitoring Center, Seoul National University Hospital, Seoul, Korea
| | - J Y Kim
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - S H Yoon
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Y H Choi
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - W Lee
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - S H Cho
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.,Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.,Drug Safety Monitoring Center, Seoul National University Hospital, Seoul, Korea
| | - H R Kang
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.,Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.,Drug Safety Monitoring Center, Seoul National University Hospital, Seoul, Korea
| |
Collapse
|
45
|
Critchley LAH, Ho AMH, Ho M, Lee SY. Right Upper Lobe Collapse Secondary to an Anomalous Bronchus after Endotracheal Intubation for Routine Surgery. Anaesth Intensive Care 2019; 35:274-7. [PMID: 17444320 DOI: 10.1177/0310057x0703500219] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Perioperative hypoxaemia is a common but serious problem with well recognised causes. However, an anomalous bronchus causing lobar collapse as a cause is seldom mentioned. A healthy young male patient was anaesthetised for a knee operation. He required reintubation immediately postoperatively for hypoxia. He was found to have right upper lobe collapse. Fibreoptic examination of the trachea demonstrated an anomalous bronchus as the cause. Intra-operatively, the endotracheal tube had been inserted too deeply and the bronchial orifice had been obstructed by the tip. It took several hours for the lung to re-expand. Greater awareness of this potential complication is needed.
Collapse
Affiliation(s)
- L A H Critchley
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | | | | | | |
Collapse
|
46
|
Lee JR, Lin EP, Hofacer RD, Upton B, Lee SY, Ewing L, Joseph B, Loepke AW. Alternative technique or mitigating strategy for sevoflurane-induced neurodegeneration: a randomized controlled dose-escalation study of dexmedetomidine in neonatal rats. Br J Anaesth 2019; 119:492-505. [PMID: 28969315 DOI: 10.1093/bja/aex219] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2017] [Indexed: 12/26/2022] Open
Abstract
Background Brain injury in newborn animals from prolonged anaesthetic exposure has raised concerns for millions of children undergoing anaesthesia every yr. Alternative anaesthetic techniques or mitigating strategies are urgently needed to ameliorate potentially harmful effects. We tested dexmedetomidine, both as a single agent alternative technique and as a mitigating adjuvant for sevoflurane anaesthesia. Methods Neonatal rats were randomized to three injections of dexmedetomidine (5, 25, 50, or 100 µg kg -1 every 2 h), or 6 h of 2.5% sevoflurane as a single agent without or with dexmedetomidine (1, 5, 10, or 20 µg kg -1 every 2 h). Heart rate, oxygen saturation, level of consciousness, and response to pain were assessed. Cell death was quantified in several brain regions. Results Dexmedetomidine provided lower levels of sedation and pain control than sevoflurane. Exposure to either sevoflurane or dexmedetomidine alone did not cause mortality, but the combination of 2.5% sevoflurane and dexmedetomidine in doses exceeding 1 µg kg -1 did. Sevoflurane increased apoptosis in all brain regions; supplementation with dexmedetomidine exacerbated neuronal injury, potentially as a result of ventilatory or haemodynamic compromise. Dexmedetomidine by itself increased apoptosis only in CA2/3 and the ventral posterior nucleus, but not in prefrontal cortex, retrosplenial cortex, somatosensory cortex, subiculum, lateral dorsal thalamic nucleaus, or hippocampal CA1. Conclusions We confirm previous findings of sevoflurane-induced neuronal injury. Dexmedetomidine, even in the highest dose, did not cause similar injury, but provided lesser degrees of anaesthesia and pain control. No mitigation of sevoflurane-induced injury was observed with dexmedetomidine supplementation, suggesting that future studies should focus on anaesthetic-sparing effects of dexmedetomidine, rather than injury-preventing effects.
Collapse
Affiliation(s)
- J-R Lee
- Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul 120-752, Korea
| | - E P Lin
- Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - R D Hofacer
- Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Program in Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - B Upton
- Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Medical Scientist Training Program, University of Cincinnati, Cincinnati, OH, USA
| | - S Y Lee
- Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - L Ewing
- Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - B Joseph
- Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - A W Loepke
- Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Program in Neuroscience, University of Cincinnati, Cincinnati, OH, USA.,Departments of Anesthesiology and Pediatrics, University of Cincinnati, Cincinnati, OH, USA.,Department of Anesthesiology and Critical Care Medicine, Division of Cardiac Anesthesiology, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| |
Collapse
|
47
|
Lim SK, Beom J, Lee SY, Lim JY. Functional Outcomes of Fragility Fracture Integrated Rehabilitation Management in Sarcopenic Patients after Hip Fracture Surgery and Predictors of Independent Ambulation. J Nutr Health Aging 2019; 23:1034-1042. [PMID: 31781735 DOI: 10.1007/s12603-019-1289-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To compare the changes in the functional level of patients with versus without sarcopenia who received by fragility fracture integrated rehabilitation management (FIRM) after hip fracture (HF) surgery over a 6-month follow-up period and to identify variables influencing independent ambulation (IA) at 6 months after HF. DESIGN Prospective observational study. SETTING Three in-hospital rehabilitation setting. PARTICIPANTS Patients older than 65 years of age (N=80) categorized by the presence of sarcopenia. INTERVENTION The FIRM program during the-2 week hospital stay after surgery. MEASUREMENTS Main outcomes for ambulatory function (Koval score, Functional Ambulatory Category) and other secondary outcomes were measured at rehabilitation admission, at discharge, at 3 months and 6 months after surgery. Other secondary outcomes were measured. The possibility of IA at 6 months after surgery were also investigated. RESULTS Sarcopenia and non-sarcopenia patients did not differ significantly in terms of changes in ambulation or other functions over a 6-month follow-up (p < 0.001 or p = 0.001). The two groups did not differ significantly in terms of final functional status (6 months). The IA ratios of the two groups did not significantly differ at 6 months after surgery (sarcopenia [54.3%] and non-sarcopenia [64.5%]). IA before fracture (p = 0.039) and age (≥80 years) (p = 0.03) were independent predictors and sarcopenia was not a predictor for the possibility of IA at 6-months after surgery. CONCLUSIONS The FIRM program was effective for promoting functional recovery in older patients with fragility HF, either with or without sarcopenia. The present findings provide evidence of the pressing need for integrated rehabilitation management in fragility fracture care to improve functional recovery in patients with sarcopenia.
Collapse
Affiliation(s)
- S-K Lim
- Jae-Young Lim, MD, PhD. Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Rep. of Korea 13620, Telephone: 82- 031-787-7732, Fax: 82-031-787-4051, E-mail:
| | | | | | | |
Collapse
|
48
|
Kim J, Kim SW, Lee SY, Kim TH, Jung JH. Bone mineral density in osteoporotic patients with pyogenic vertebral osteomyelitis: effect of early versus late treatment for osteoporosis. Osteoporos Int 2018; 29:2761-2770. [PMID: 30225674 DOI: 10.1007/s00198-018-4695-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 09/03/2018] [Indexed: 12/19/2022]
Abstract
UNLABELLED Patients with pyogenic vertebral osteomyelitis (PVO) are at greater risk of bone loss. However, treatment guidelines for bone loss have been lacking. Early bisphosphonate treatment within 6 weeks after PVO diagnosis was significantly associated with superior outcome in femoral BMD at 2-year follow-up, compared to that with late treatment. INTRODUCTION Due to absence of concern and proper guidelines, management of bone loss or osteoporosis in PVO is often neglected or delayed. A retrospective cohort study was planned to investigate differences in bone mineral density (BMD) in PVO patients with osteoporosis according to the timing of osteoporosis treatment. METHODS The PVO cohort consisted of 192 patients with osteoporosis who visited our institution between January 2003 and March 2015 and received bisphosphonate treatment for osteoporosis. According to the interval between PVO diagnosis and initiation of bisphosphonate, the patients were divided into three groups: group A (within 6 weeks after PVO diagnosis), group B (between 6 weeks and 3 months after diagnosis), and group C (more than 3 months after PVO diagnosis). RESULTS The percent increase in total femoral BMD in group A was significantly larger than that in group B at 2-year follow-up (p = 0.036). Similarly, the percent increase in trochanteric (p = 0.008) and total femoral (p = 0009) BMD in group A was significantly larger than that in group C at 2-year follow-up. Even after multivariate adjustment, total femoral BMD changes were significantly associated with the treatment group. Group B (odds ratio = 2.824, p = 0.013) and group C (odds ratio = 3.591, p = 0.001) were more significantly associated with total femoral BMD decreases at 2-year follow-up compared with group A. CONCLUSIONS Early bisphosphonate treatment within 6 weeks after PVO diagnosis (group A) was significantly associated with superior outcome in femoral BMD at 2-year follow-up, compared to that with late treatment (groups B and C).
Collapse
Affiliation(s)
- J Kim
- Division of Infection, Department of Pediatrics, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - S W Kim
- Spine Center, Department of Orthopedics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
| | - S Y Lee
- Spine Center, Department of Orthopedics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
| | - T-H Kim
- Spine Center, Department of Orthopedics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea.
| | - J-H Jung
- Spine Center, Department of Orthopedics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
| |
Collapse
|
49
|
Lee SY, Park CL, Russell BS. Does distress tolerance interact with trait anxiety to predict challenge or threat appraisals? Personality and Individual Differences 2018. [DOI: 10.1016/j.paid.2018.05.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
50
|
Park CL, Williams M, Hernandez P, Agocha VB, Carney LM, DePetris A, Lee SY. Self-regulation and STEM persistence in minority and non-minority students across the first year of college. Soc Psychol Educ 2018; 22:91-112. [PMID: 31798314 DOI: 10.1007/s11218-018-9465-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Psychological factors have been implicated in STEM persistence but remain poorly understood. In particular, the role of self-regulation--the cognitive, behavioral, and emotional skills that allow individuals to work efficiently toward their desired goals, especially when under stress--has received minimal attention. Psychological factors may be particularly important for persistence by underrepresented minority (URM) students, many of whom face significant barriers to success in STEM. We examined the extent to which self-regulation predicts STEM persistence in 732 STEM students and whether minority status moderated self-regulation's associations with STEM persistence. We found minimal differences in self-regulation styles between URM and nonunderrepresented minority students. Baseline cognitive-emotional self-regulation predicted intentions to persist in a science career, using alcohol and drugs to cope with stress predicted less persistence in STEM major across the year, and only URM status predicted end-of-year GPA. Minority status did not moderate these associations. Future research is needed on self-regulation skills and students' trajectories of STEM success.
Collapse
|