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

BACKGROUND/AIMS: Mucosal immunoglobulin A (IgA) may prevent the entrance of allergens. This study examined the relationship between serum IgA levels (within the normal range) and sensitization to house dust mites (HDM) or airway hyper-responsiveness (AHR). METHODS: The clinical records of 1,136 adult patients with suspected asthma, for whom test data for serum IgA level and methacholine-AHR were available, were reviewed retrospectively. The AHR/allergy indices were compared among patient groups with low (<140 mg/dL, group I), intermediate (140 to 280 mg/dL, group II), or high (≥280 mg/dL, group III) IgA levels in serum. RESULTS: The HDM skin sensitization rate progressively decreased from 30.0% in group I (n = 139) to 26.8% and 18.5% in groups II (n = 684) and III (n = 313), respectively (p = 0.003). Although both the HDM sensitization degree and the IgA level were significantly related to age, the adjusted odds ratio (OR) of association of a high IgA level (≥ 280 mg/dL) with HDM sensitization was significant (0.617; 95% confidence interval [CI], 0.415 to 0.916; p = 0.017). Among younger subjects (≤ 45 years of age) with AHR, the prevalence of moderate/severe AHR progressively decreased (70.6%, 52.3%, and 47.1% in groups I, II, and III [n = 34, 149, and 51]), respectively (p = 0.045). The IgA < 140 mg/dL was a significant risk factor for moderate/severe AHR (OR, 2.306; 95% CI, 1.049 to 5.071; p = 0.038). CONCLUSIONS: Sensitization to HDM and methacholine-AHR were significantly associated with serum IgA levels in suspected asthmatics, even when those levels were normal.
Adult ; Allergens ; Asthma ; Humans ; Immunoglobulin A* ; Odds Ratio ; Prevalence ; Pyroglyphidae ; Respiratory Hypersensitivity ; Retrospective Studies ; Risk Factors ; Skin

OBJECTIVES: Effects of aging and leisure time physical activity (LPA) might influence the effect of occupational physical activity (OPA) on risk for cardiovascular disease (CVD). This study was conducted to determine whether OPA affects CVD after controlling the effects of LPA and other risk factors for CVD such as job stress. METHODS: Participants were 131 male Korean manual workers. Tests for heart rate variability (HRV) were conducted for five minutes in the morning at work. We defined OPA as the combined concept of relative heart rate ratio (RHR), evaluated using a heart rate monitor. RESULTS: Whereas high OPA was not related to any HRV items in the younger age group, high OPA was associated with an increased number of low-value cases among all HRV items in older workers. Exercise had beneficial effects only in the younger group. After controlling for exercise and other risk factors, the odds ratios of the root-mean square of the difference of successive normal R-R intervals (rMSSD) and high frequency band power (HF) among the older age and high OPA group compared with the younger age and low OPA group were 64.0 and 18.5, respectively. Social support and shift work were independent risk factors in HRV. CONCLUSIONS: OPA in aging workers increases CVD risks. This study provides support for the need for protection of aging workers from physical work overload, and indicates the need for further study of optimal limits of OPA.
Aging* ; Cardiovascular Diseases ; Heart Rate* ; Heart* ; Humans ; Leisure Activities ; Male* ; Motor Activity* ; Odds Ratio ; Risk Factors

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

BACKGROUND: Waist circumference and BMI have been known as an independent predictor for cardiovascular diseases. But some people with a normal BMI or normal waist circumference may have cardiovascular risk factors. Therefore, the purpose of this study was to investigate the simplicity and the usefulness of waist/height ratio as an index of obesity and to investigate the waist/height ratio as a predictor for metabolic risks in individuals with normal weight and/or normal waist circumference. METHODS: The subjects were 1,157 individuals (635 men, 522 women). The morbidity index for metabolic risk factors was calculated by the sum of the risk factors scores (one point per item, if present). We set the criteria of obesity as BMI>or=25 kg/m2, waist circumference of >or=90 cm in males and >or=80 cm in females, waist/hip ratio of >or=0.9 in males and >or=0.8 in females, and waist/height ratio of >or=50 cm/cm*100. RESULTS: There was a significant correlation among waist/ height ratio, waist/hip ratio, BMI, and waist circumference (P=0.000). The odds ratios for morbidity index (>or=3) in normal BMI, waist circumference, and waist/hip ratio subjects with waist/height over 50 were significantly higher with 4.60, 3.83, and 2.79, respectively, and also higher in normal BMI with normal waist circumference subjects with 3.90 (P=0.000). CONCLUSION: Waist/height ratio may be used a simple and practical index of obesity. Especially, it may be useful in subjects with normal BMI or normal waist circumference when predicting their metabolic risks.
Cardiovascular Diseases ; Female ; Humans ; Male ; Obesity* ; Obesity, Abdominal ; Odds Ratio ; Risk Factors ; Waist Circumference