BACKGROUND: Restless-legs syndrome (RLS) is known to be caused by dopaminergic hypofunction in the brain. We investigated whether antipsychotics that act as antidopaminergics increase the risk of RLS. METHODS: We prospectively recruited 72 schizophrenic patients who had been medicated with antipsychotic drugs in a psychiatry clinic. We evaluated RLS diagnostic criteria and basic sleep habits using the Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index by face-to-face interviews using a structured questionnaire. We also applied the Unified Parkinson's Disease Rating Scale to evaluate extrapyramidal symptoms. RESULTS: Three of the 72 patients (4.2%) met RLS criteria, which is similar to the previously reported RLS incidence among the general population in Korea. CONCLUSIONS: There is no evidence that antipsychotics increase the risk of RLS. We believe that the mild antidopaminergic effect of antipsychotics does not overwhelm their prominent antipsychotic effect.
Antipsychotic Agents ; Brain ; Humans ; Incidence ; Parkinson Disease ; Prospective Studies ; Surveys and Questionnaires ; Restless Legs Syndrome ; Risk Factors ; Schizophrenia

OBJECTIVES: This study was performed to identify the effect of physical activity at work on obesity and to analyze the contribution of socioeconomic factors and health behaviors to this association, which has been relatively little studied. METHODS: From the Korean National Cancer Center Community Cohort, a total of 5,587 adults (2,125 men; 3,462 women) aged more than 30 years living in rural areas were enrolled. Information on socio-demographic factors, health behaviors, and body mass index was gathered using face-to-face interviews and measurements of height and weight. RESULTS: Inverse associations were identified between vigorous-intensity physical activity at work and obesity in both men and women, while no association was found between vigorous-intensity physical activity during leisure time and obesity. High household income was independently associated with a lower risk of obesity among those who had low levels of vigorous-intensity physical activity at work. Vigorous physical activity at work showed an inverse association with obesity in rural areas where heavy manual labor is common. CONCLUSIONS Our findings indicate the necessity to account for various types of physical activity to improve the assessment and prevention of obesity.

OBJECTIVES: This study was performed to identify the effect of physical activity at work on obesity and to analyze the contribution of socioeconomic factors and health behaviors to this association, which has been relatively little studied. METHODS: From the Korean National Cancer Center Community Cohort, a total of 5,587 adults (2,125 men; 3,462 women) aged more than 30 years living in rural areas were enrolled. Information on socio-demographic factors, health behaviors, and body mass index was gathered using face-to-face interviews and measurements of height and weight. RESULTS: Inverse associations were identified between vigorous-intensity physical activity at work and obesity in both men and women, while no association was found between vigorous-intensity physical activity during leisure time and obesity. High household income was independently associated with a lower risk of obesity among those who had low levels of vigorous-intensity physical activity at work. Vigorous physical activity at work showed an inverse association with obesity in rural areas where heavy manual labor is common. CONCLUSIONS Our findings indicate the necessity to account for various types of physical activity to improve the assessment and prevention of obesity.

BACKGROUND AND OBJECTIVES: The correlations between plaque characteristics and plaque rupture location according to segmental lesion analysis have not been well defined. The aim of this study was to assess those characteristics of ST-segment elevation myocardial infarction (STEMI) culprit lesions according to segmental lesion geometry using virtual histology intravascular ultrasound (VH-IVUS). METHODS: Sixty single discrete lesions found in the left anterior descending (LAD) coronary arteries of 60 patients with STEMI were included. Each lesion was divided into 3 segments based on lumen area (LA) index, calculated by dividing the lesion LA by the reference LA. RESULTS: Among the 3 segments, the mid-segment showed the highest proportion of necrotic core (NC; proximal, mid-, and distal segments: 20.9±11.8%, 22.7±11.3%, and 17.5±11.2%, respectively, p=0.044). VH-IVUS-derived thin-cap fibroatheroma (VH-TCFA) was also more frequently found in the mid-segment than in proximal and distal segments (36.7%, 58.3%, and 16.7%, p < 0.001). The mid-segment also showed the highest prevalence of plaque rupture (45.0%, 78.3% and 11.7%, p < 0.001) and thrombus (61.7%, 95.0%, and 41.7%, p < 0.001) compared to proximal or distal segments. When the lesions were divided into 2 groups according to the median value (4.0 mm2) of minimum lumen area (MLA), plaque rupture at the distal segment was observed only in high MLA lesions (23.3% vs. 0.0%, p=0.011). CONCLUSION: Analysis of longitudinal lesion geometry using the LA index can be useful in evaluating plaque vulnerability and the incidence of plaque rupture and thrombus in STEMI patients.
Coronary Artery Disease ; Coronary Vessels ; Diagnostic Imaging ; Humans ; Incidence ; Myocardial Infarction* ; Plaque, Atherosclerotic ; Prevalence ; Rupture ; Thrombosis ; Ultrasonography

Purpose: Fear of cancer recurrence (FCR) is a common psychological issue in breast cancer (BC) survivors during early survivorship but whether the same is true among long-term survivors has yet to be empirically evaluated. This study investigated FCR level, its associated factors, and impact on quality of life (QoL) in long-term BC survivors. Materials and Methods: Participants included women diagnosed with BC between 2004 and 2010 at two tertiary hospitals. Survey was conducted in 2020. The study measured FCR with the Fear of Cancer Recurrence Inventory and other patient-reported outcomes, including depression and cancer-related QoL. Logistic regression was used to identify factors associated with FCR, and structural equation modeling was conducted to explore the impact of FCR on other outcomes. Results: Of 333 participants, the mean age at diagnosis was 45.5, and 46% experienced FCR. Age at diagnosis ≤ 45 (adjusted odds ratio [aOR], 2.64; 95% confidence interval [CI], 1.51 to 4.60), shorter time since diagnosis (aOR, 1.75, 95% CI, 1.08 to 2.89), and having a history of recurrence (aOR, 2.56; 95% CI, 1.16 to 5.65) was associated with more FCR. FCR was significantly associated with an increased risk of depression (β=0.471, p < 0.001) and negatively impacted emotional functioning (β=–0.531, p < 0.001). In addition, a higher FCR level may impair overall health-related QoL in long-term BC survivors (β=–0.108, p=0.021). Conclusion Ten years after diagnosis, long-term BC survivors still experienced a high level of FCR. Further, the negative impact of FCR on QoL and increased depression risk require an FCR screening and appropriate interventions to enhance long-term BC survivors' QoL.

Problem: Novel vaccines were developed in an unprecedentedly short time in response to the global coronavirus disease (COVID-19) pandemic, which triggered concerns about the safety profiles of the new vaccines. This paper describes the actions and outcomes of three major adverse events of special interest (AESIs) reported in the World Health Organization’s (WHO’s) Western Pacific Region: anaphylaxis, thrombosis with thrombocytopenia syndrome (TTS) and post-vaccination death. Context: During the large-scale introduction of various novel COVID-19 vaccines, robust monitoring of and response to COVID-19 vaccine safety events were critical. Action: We developed and disseminated information sheets about anaphylaxis and TTS; provided tailor-made training for anaphylaxis monitoring and response, webinars about TTS and AESIs, and an algorithm to support decision-making about AESIs following immunization; as well as provided country-specific technical support for causality assessments, including for possible vaccination-related deaths. Outcome: Each major vaccine event and situation of high concern was responded to appropriately and in a timely manner with comprehensive technical support from WHO. Our support activities have not only strengthened countries’ capacities for vaccine safety surveillance and response, but also enabled countries to decrease the negative impact of these events on their immunization programmes and maintain the confidence of health-care professionals and the general population through proactive delivery of risk communications. Discussion: This paper summarizes selected, major AESIs following COVID-19 vaccination and responses made by WHO’s Regional Office for the Western Pacific to support countries. The examples of responses to vaccine safety events during the pandemic and unprecedented mass vaccination campaigns could be useful for countries to adopt, where applicable, to enhance their preparation for activities related to monitoring vaccine safety.

The speed at which new vaccines against coronavirus disease (COVID-19) were developed and rolled out as part of the global response to the pandemic was unprecedented. This report summarizes COVID-19 vaccine-related safety data in the World Health Organization Western Pacific Region. Data for 1 March 2021 to 31 March 2022 from 36 out of 37 countries and areas in the Western Pacific Region are presented. More than 732 million doses of eight COVID-19 vaccines were administered; reporting rates of adverse events following immunization (AEFIs) and serious AEFIs were 130.1 and 5.6 per 100 000 doses administered, respectively. Anaphylaxis, thrombosis with thrombocytopenia syndrome, and myocarditis/pericarditis were the most frequent COVID-19 adverse events of special interest (AESIs) reported. The reported rates of AESIs in the Western Pacific Region were within the range of expected or background rates. Vaccine benefits far outweigh the risk of reported serious adverse reactions and serious outcomes of COVID-19. Continued AEFI surveillance is recommended to better understand and ensure the safety profiles of novel COVID-19 vaccines.