BACKGROUND: Postherpetic neuralgia(PHN) is a distressing complication of herpes zoster that can persist for months or even years. Information on this condition is important because antiviral therapy may change the clinical course of the disease. OBJECTIVE: The aim of this study is to estimate prevalence of PHN according to several risk factors. METHODS: We observed prevalence of PHN in 96 patients who had herpes zoster with severe pain and treated with antiviral therapy during the admission. Also, we compared them by age group, dermatomal distribution, and starting day of antiviral therapy, respectively. RESULTS: The prevalence of PHN according to the age was 5.9% in patients younger than 49 years, 40.0% in 50~59 years, 46.9% in 60~69 years, and 58.8% in 70 years and older. Sex and dermatomal distribution were not predictors of PHN. The odds ratio per one day difference in antiviral therapy was 1.62(95% confidence interval, 1.56 to 2.23). CONCLUSION: In herpes zoster with severe pain, age and starting day of antiviral therapy may be significant predictors of PHN.
Herpes Zoster* ; Humans ; Neuralgia, Postherpetic* ; Odds Ratio ; Prevalence ; Risk Factors

INTRODUCTION: A promising strategy for HER2-negative metastatic breast cancer (mBC) is to target the veascular endothelial growth factor receptor using bevecizumab. Several randomized controlled trials (RCTs) have consistently demonstrated improvement in progression-free survival (PFS).
METHODS: This meta-analysis was undertaken to determine the added benefit of bevacizumab (BV) to chemotherapy in HER2-negative locally recurrent and mBC. RCTs that compared the efficacy and safety of BV+chemotherapy to placebo+chemotherapy in the first- or second-line setting were selected. The primary outcome was PFS. The secondary outcome measures were overall survival (OS) and objective response rate (ORR). Analysis of safety was done by pooling grades 3-5 toxicities. Four RCTs were included in the meta-analysis: E2100, AVADO, RIBBON-1, and RIBBON-2.
RESULTS: The use of BV+chemotherapy showed statistically significant improvement in PFS (HR 0.73 [0.65, 0.82] 95% Cl, p<0.0001); subgroup analysis of triple-negative breast cancer (TNBC) also showed statistically significant increase in PFS (HR 0.56 [0.47, 0.67] 95% Cl, P<0.00001). The ORR was statistically significant with a risk ratio of 1.36 in favour of BV (P<0.00001). OS did not reach statistical significance (HR 0.85 [0.56, 1.27] 95% Cl, p=0.42). Grades 3-5 toxicities were consistently higher in the BV arm with a risk ratio of 1.90 (p<0.00001).
CONCLUSION: BV prolongs PFS and increases ORR in patients with HER2-negative locally-recurrent and mBC. OS was comparable in both arms. Toxicities significantly increased with the addition of BV to chemotherapy, but fatal reactions were rare in all four trials. The addition of BV to conventional first- or second-line chemotherapy is justified in TN mBC since there is still no standard treatment fot this. 

OBJECTIVETo explore the relationship between obesity and migraine.

METHODSThe online databases inlcuding PubMed, EMBASE, Wanfang, CNKI and Chinese Biological Medicine Database were searched for studies assessing the relationship between obesity and migraine according to the Cochrane Collaboration guidelines. Stata12.0 software was used for meta- analysis. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the relationship between obesity and the risk of migraine.

RESULTA total of 14 studies involving 193 274 individuals were included in the analysis. The results of meta-analysis showed that obese individuals had an increased risk of migraine by 19% as compared with normal weight individuals [OR, 1.19; 95% CI, 1.02-1.38; P=0.029) and by 19% as compared with non-obese individuals (OR, 1.19; 95%CI, 1.02-1.38; P=0.024).

CONCLUSIONObesity is associated with an increased risk of migraine.

BACKGROUND: Exposure to organic dust has been widely investigated as a potential risk factor for asthma with different results. To clarify a potential relationship, we performed the present meta-analysis to integrate the results of studies examining the association of organic dust exposure with asthma. METHODS: A comprehensive literature search in the electronic databases including EMBASE, PubMed and Cochrane Library databases (up to August 2018) was conducted. The adjusted odds ratios (ORs) with corresponding 95% confidence interval (CI) for organic dust exposure and asthma were retrieved and pooled to generate summary effect estimates in Revman 5.2. RESULTS: Database searches retrieved 1,016 records. A total of 17 studies containing 3,619 cases and 6,585 controls were finally included in our meta-analysis. The summary estimates suggested that organic dust exposure was positively associated with asthma (OR, 1.48; 95% CI, 1.26–1.75; P < 0.00001), whether among population-based case-control studies (OR, 1.24; 95% CI, 1.13–1.35; P < 0.00001) or hospital-based case-control studies (OR, 2.79; 95% CI, 1.27–6.12; P = 0.01). Subgroup analysis showed that paper/wood (OR, 1.62; 95% CI, 1.38–1.90; P < 0.00001), flour/grain (OR, 1.48; 95% CI, 1.11–1.97; P = 0.008), and textile dust (OR, 1.50; 95% CI, 1.08–2.09; P = 0.02) exposure were significantly associated with asthma. CONCLUSIONS: Based on the studies evaluated, our meta-analysis results prompt that organic dust exposure is a risk factor inducing asthma, although precise analysis focus on specific organic dust materials is still warranted.
Asthma ; Case-Control Studies ; Dust ; Odds Ratio ; Risk Factors ; Textiles

PURPOSE: To investigate the clinical efficacy of intracameral amphotericin injection and to evaluate risk factors affecting primary treatment success in fungal infection invading the anterior segment of the eye. METHODS: Twenty-six eyes of 26 patients diagnosed with fungal infection in the anterior segment were studied. The initial treatment regimen was a topical 0.15% amphotericin application and itraconazole oral administration after culture. Amphotericin (5 ug/0.1 ml, 0.1 cc) was repeatedly injected intracamerally when the infection intensified. Penetrating keratoplasty was conducted for eyes unresponsive to intracameral amphotericin injection. The relative risk ratios of ulcer size, infiltration depth, culture positivity, and hypopyon were compared in each treatment group to evaluate the treatment response. RESULTS: Of patients with fungal infection, 30.7% were cured with intracameral amphotericin injection, while 30.7% needed penetrating keratoplasty. Intracameral amphotericin injection was needed in the presence of large corneal ulcers (>14 mm2), hypopyon, positive fungal culture, use of steroid eye drops, and deep infiltration at initial examination. Large ulcer size (>14 mm2) was the main risk factor for needing penetrating keratoplasty. Of the eyes Candida infection, 66.5% needed evisceration. CONCLUSIONS: Large ulcer size and the isolation of Candida were poor prognostic factors related to the efficacy of intracameral amphotericin injection.
Administration, Oral ; Amphotericin B* ; Candida ; Humans ; Itraconazole ; Keratoplasty, Penetrating ; Odds Ratio ; Ophthalmic Solutions ; Risk Factors* ; Ulcer

PURPOSE: This study was aimed to determine the optimum low-density lipoprotein : high-density lipoprotein-cholesterol (LDL : HDL-C) ratio for predicting coronary heart disease(CHD) in Korean people. METHODS: It was analyzed this data of 5,431 adults who had undergone health examinations in a hospital in Gyeonggi-do between January 2006 and December 2007. The covariation of the coronary risk factors such as age, HbA1C, systolic blood pressure(SBP), and waist-to-stature ratio(WSR) were analyzed by using logistic regression analysis. RESULTS: The LDL : HDL-C ratio in the male and female groups was mostly distributed between 1.5 and 4.0. The LDL : HDL-C ratio was the most significant cholesterol-related parameter influencing CHD(male: B = .306, p = .054, female : B = .940, p = .010), followed by LDL-C and total cholesterol. It was observed a sharp increase in the odds ratios for LDL : HDL-C ratios of 2.25 - 2.50(male) and 2.00 - 2.25(female). A significant difference was observed in both male(2.25 : chi-square = 2.494, p = .072) and female(2.00 : chi-square = 413.742, p = .000) groups. CONCLUSION: The risk level of CHD was set to 2.25 for males and 2.00 for females. Therefore, the optimum LDL : HDL-C ratio for Koreans should be far lower than that for the people in western countries.
Adult ; Cholesterol ; Coronary Disease ; Female ; Heart ; Humans ; Lipoproteins ; Logistic Models ; Male ; Odds Ratio ; Risk Factors

OBJECTIVES: This study was carried to investigate the prevalence and odds ratio of work related musculoskeletal disorders according to the job classification in small-to-medium-sized enterprises(<300 employee). METHODS: A questionnaire survey was given to 746 workers in 8 workplaces. 501 workers (67.2%) were finally selected in this study. The workers in the 8 workplaces was divided into 7 jobs. Those were manufacturers(metal), assemblers(appliances), cashiers, packers(cosmetics), garbage collectors, and VDT workers. Multiple logistic regression was used to estimate the odds ratios of the musculoskeletal symptoms according to the job classification. RESULTS: Univariate analysis showed that the significantly related risk factors for musculoskeletal symptoms are as follows; age, marital status, gender, work load change, work duration, hours worked per day, job demand, decision latitude, type of job. According to the type of job, the prevalence of musculoskeletal symptoms were 7.7%(clerks), 24.3%(manufacturers), 30.0%(assemblers), 23.0%(cashiers), 30.4%(packers), 11.9%(garbage collectors), 29.2%(VDT workers). Multiple logistic regression showed that the following significant odds ratios (referenceclerks): 7.32(packers), 5.63(assemblers), 5.11(cashiers), 4.79(VDT workers), 3.11(manufacturers). CONCLUSION: In small-to-medium-sized enterprises, the job classification was major risk factor for work related musculoskeletal disorders. According to the job classification, the odds ratios of the work related musculoskeletal disorders were different. Considering the odds ratios, the establishment of a prevention program of work related mus-culoskeletal disorders is recommended.
Classification* ; Garbage ; Logistic Models ; Marital Status ; Odds Ratio* ; Prevalence ; Questionnaires ; Risk Factors

PURPOSE: Factors related to nonurologic postoperative complications of laparoscopic surgery in the urologic area were examined. The most significant factors were isolated and analyzed to establish ways to reduce the complication rate. MATERIALS AND METHODS: The medical records of 154 patients who had undergone laparoscopic surgery between March 2004 and March 2008 were reviewed. Age, anesthetic time, American Society of Anesthesiologists physical status classification, operative difficulty, blood loss (ml), body mass index (BMI), and complications were assessed. Complications were divided into 5 groups based on the modified Clavien classification. Grade 0 to 1 was defined as a no complication group and grades 2 to 5 as a complication group. The Armitage trend test was performed to study the relations between the factors and the complications. Univariate and multivariate analyses were performed to determine the risk ratio of each of the factors and the most significant factors. RESULTS: Complications tended to increase as the anesthetic risk and anesthetic time increased (p=0.011, 0.013, respectively). Operative difficulty and blood loss were related to complications (p=0.018, p<0.001, respectively). The univariate analysis revealed that blood loss of more than 400 ml compared with less than 200 ml had a risk ratio of 18.2. Moderate and hard operative difficulties had a significant risk ratio of around 4, and high anesthetic risk had a high risk rate of around 5. The multivariate analysis showed that blood loss and high anesthetic risk were independent risk factors of complications. CONCLUSIONS: Blood loss and high anesthetic risk proved to be independent factors that are associated with complications. Surgeons must keep in mind the patient's anesthetic risk and try to minimize blood loss during the operation to reduce complications after a laparoscopic surgery.
Body Mass Index ; Humans ; Laparoscopy ; Medical Records ; Multivariate Analysis ; Odds Ratio ; Postoperative Complications ; Risk Factors ; Urology

STUDY DESIGN: A retrospective observational and case control study. PURPOSE: To identify appropriate treatment options according to the types of surgical site infections (SSI) in instrumented posterior lumbar interbody fusion (PLIF). OVERVIEW OF LITERATURE: There has been no agreement or consensus with regard to this matter. METHODS: Thirty-two consecutive SSIs were included and followed for more than one year. The elapsed time to diagnosis (ETD) according to the type of SSI was analyzed. The treatment options for each type and consequent clinical results were reviewed. The risk factors of removing the implants were analyzed. RESULTS: There were 6/32 (19%) superficial incisional, 6/32 (19%) deep incisional, and 20/32 (62%) organ/space infection cases (SII, DII, and O/SI, respectively) (p=0.002). ETD was 8.5+/-2.3 days in SII, 8.7+/-2.3 days in DII, and 164.5+/-131.1 days in O/SI (p=0.013). All cases of SII and DII retained implants and were treated by repeated irrigation and secondary closure. Among O/SIs, 10/20 were treated conservatively. Nine out of ten underwent posterior one stage simultaneous revision (POSSR) and in one case, the cage was removed anteriorly. Those who had ETDs longer than 3 months showed a significant risk of implant removal (p=0.008, odds ratio [OR]=40.3). The Oswestry disability index (ODI) improved from 47.3% to 33.8% in SII, from 55.0% to 32.3% in DII, and from 53.4% to 42.1% in O/SI (p=0.002). There was no difference among the three groups (p=0.106); however, there was a partial correlation between ETD and final ODI (r=0.382, p=0.034). CONCLUSIONS: Latent O/SI was the most common type of SSI in PLIF. In cases of SII and DII, early aggressive wound management and secondary closure was effective and implant removal was not necessary. In some cases of O/SI, implant removal was unavoidable. However, implant removal could be averted by an earlier diagnosis. POSSR was feasible and safe. Functional outcomes were improved; however, disability increased as ETD increased.
Case-Control Studies ; Consensus ; Diagnosis ; Odds Ratio ; Retrospective Studies ; Risk Factors ; Wounds and Injuries

OBJECTIVES: This study was carried out to suggest preventive methods for hypertension in cold-exposed workers. METHODS: In 11 refrigeration industries, 68 workers working in refrigerated areas more than one time per day were selected as the exposed group, and 68 workers not exposed to cold were selected as the control group. We interviewed the subjects with a questionnaire covering occupational history, and conducted clinical and laboratory tests including measurements of blood pressure and core temperature. RESULTS: The systolic blood pressure in the exposed group(130.0+/-13.3 mmHg) was significantly higher than that recorded in the control group(118.3+/-12.1 mmHg), as was the diastolic blood pressure in the exposed group(82.7+/-8.5 mmHg) versus the control group(77.4 +/-8.7 mmHg). The core temperature in the exposed group(36.1+/-0 . 7degrees C) was significantly lower than that experienced in the control group(36.4+/-0 . 5degrees C). In logistic regression analysis, age, cold exposure severity and milk intake were significant variables, with odds ratios of 5.204(95 % CI 1.440~18.812), 2.674(95 % CI 1.080~6.618), and 0.364(95 % CI 0.141~0.942), respectively. CONCLUSIONS: Our study suggests that cold-exposed workers have higher a higher risk of hypertension, and that their core temperature is lower. Risk factors affecting hypertension of cold-exposed workers include age, cold exposure severity and milk intake. For the prevention of hypertension, cold-exposed workers should minimize cold-exposure time as much as possible.
Blood Pressure ; Hypertension* ; Logistic Models ; Milk ; Odds Ratio ; Questionnaires ; Refrigeration ; Risk Factors