Objective: Two years after the 2017 Pohang earthquake, some people sought follow-up mental health support. The demographic and clinical characteristics of this unique group of people were investigated to identify some insights on the predisposing factors of the longterm need for psychiatric help after a severe earthquake disaster. Methods: De-identified data from those seeking mental health support 2 years after the 2017 Pohang earthquake were used. The descriptive statistics of demographic and clinical characteristics of the study group was identified and paired with general population data obtained from open and public governmental websites. Sex, age distribution, destruction of house, and psychiatric disorder were compared between the follow-up sample and general population. Results: The proportion of women in the group seeking support was two times higher than that in the general population, and people ages between 50 and 70 years commonly sought support. The severity of home destruction was higher among people who sought and needed follow-up mental health support programs than in the general population. There was a higher proportion of people with psychiatric disorders in the group seeking support than in the general population. Conclusion The need for long-term mental health support 2 years after an earthquake was higher in women than in men and those aged between 50 and 70 years, and those with a previous psychiatric history and with a higher severity of home destruction, which lead to necessitating leaving the home. Future earthquake response should include screening and psychiatric treatment referral and residential support in vulnerable people.

Humans ; Palliative Care ; Telemedicine

OBJECTIVETFo compare the efficacy and complications rate of intramedullary (IM) nailing or K-wire versus plating fixation for clavicular fractures.

METHODSPubmed, Embase, Cochrane Library databases, CNKI, VIP and Wangfang databases were searched to find all randomized or quasi-randomized controlled trials of clavicle fractures using plating versus IM nailing or K-wire. The methodologic quality of the studies was assessed. After independent study selection by 2 authors ,data were collected and extracted independently. Outcomes of postoperative shoulder functional measurement, the efficacy and information of the operation and complications rate were meta-analyzed using RevMan 5 software.

RESULTSNine hundreds and seventy-six patients in 10 randomized controlled trials (RCTs) and 3 quasi-RCTs were involved in the meta-analysis,of which 5 studies compared the K-wire and the plating fixations and 8 studies compared the IM nailing and the plating fixations. The overall odds ratio(OR) (with 95% CI) of the operation efficacy for K-wire versus the plating was 3.79 (1.93, 7.46). The overall weighted mean difference (with 95% CI) of Constant Shoulder score for plating versus IM fixation was -1.39 (-3.43, 0.65) in 6 studies. The overall OR of the plating versus IM nailing was 9.34(2.70, 32.32) for the overall major complications in 5 studies and 5.04 (1.52,16.77) for the revision rate in 5 studies.

CONCLUSIONThe current limited evidences suggested that the IM fixation could reduce the incidences of the overall major complications and the revision surgery, while the post-operative efficacy of the plating was superior to the K-wire. More high quality RCTs are still needed in the future.

Bone Nails ; Bone Wires ; Clavicle ; injuries ; surgery ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Fractures, Bone ; surgery ; Humans ; Randomized Controlled Trials as Topic

INTRODUCTIONThere is a need for a simple-to-use and easy-to-carry CPR feedback device for laypersons. We aimed to determine if a novel CPRcard™ feedback device improved the quality of chest compressions.

METHODSWe compared participants' chest compression rate and depth with and without feedback. Compression data was captured through the CPRcard™ or Resusci Anne's SimPad® SkillReporter™. Compression quality was defined based on 2010 international guidelines for rate, depth and flow fraction.

RESULTSOverall, the CPRcard group achieved a better median compression rate (CPRcard 117 vs. control 122, p = 0.001) and proportion of compressions within the adequate rate range (CPRcard 83% vs. control 47%, p < 0.001). Compared to the no-card and blinded-card groups, the CPRcard group had a higher proportion of adequate compression rate (CPRcard 88% vs. no-card 46.8%, p = 0.037; CPRcard 73% vs. blinded-card 43%, p = 0.003). Proportion of compressions with adequate depth was similar in all groups (CPRcard 52% vs. control 48%, p = 0.957). The CPRcard group more often met targets for compression rate of 100-120/min and depth of at least 5 cm (CPRcard 36% vs. control 4%, p = 0.022). Chest compression flow fraction rate was similar but not statistically significant in all groups (92%, p = 1.0). Respondents using the CPRcard expressed higher confidence (mean 2.7 ± 2.4; 1 = very confident, 10 = not confident).

CONCLUSIONUse of the CPRcard by non-healthcare workers in simulated resuscitation improved the quality of chest compressions, thus boosting user confidence in performing compressions.

INTRODUCTIONVictims of out-of-hospital cardiac arrests require timely cardiopulmonary resuscitation (CPR) and early defibrillation. Callers to emergency medical services are asked to provide dispatcher-guided responses until an ambulance arrives. Knowing what to expect in such circumstances should reduce both delay and confusion.

METHODSThis study was conducted among schoolchildren aged 11-17 years using ten-item pre- and post-training surveys. We aimed to observe any knowledge and attitude shifts regarding CPR and automated external defibrillator (AED) use subsequent to the training.

RESULTSA total of 1,196 students across five schools completed the pre- and post-training surveys. Survey questions tested basic CPR knowledge and attitudes towards CPR and AED use. The overall response rate was 80.8% and 81.5% in the pre- and post-training surveys, respectively. There was a statistically significant improvement in the students' CPR knowledge. The number of students who selected all the correct answers for the knowledge-based questions in the post-training survey increased by 64.7% (95% confidence interval 61.9%-67.5%; p < 0.001). There was also an improvement in their willingness to administer CPR (likely/very likely to administer CPR pre-training vs. post-training: 13.0% vs. 71.0%; p < 0.001) and use AED (likely/very likely to administer AED pre-training vs. post-training: 11.7% vs. 78.0%; p < 0.001) after training.

CONCLUSIONThe training programme imparted new information and skills, and improved attitudes towards providing CPR and using AED. However, some concerns persisted about hurting the victim while performing CPR.

Objective:To investigate the protective effects of Lactobacillus casei Zhang ( Lcz) on mice with Acetaminophen (APAP)-induced acute liver injury.Methods:Mice were randomly divided into five groups:Control group (ctrl),APAP-induced liver injury group ( APAP ) , N-Acetylcysteine positive control group ( NAC ) , Lcz preventive group ( Lcz/APAP ) and Lcz control group (Lcz).Mice were orally administrated with Lcz (1×109 CFU/ml) for 30 continuous days prior to APAP exposure.Positive control group were intraperitoneally injected with 150 mg/kg NAC 1 h before APAP challenge.Mice in the APAP,NAC and Lcz/APAP group were intraperitoneally injected with 300 mg/kg APAP.Blood and liver samples were collected 18 h post APAP challenge.The expression of HO-1,SOD2,Bcl-2 and TLR4 were detected by Western blot.Results: Lcz could significantly inhibit APAP-induced increase in ALT and AST levels.Furthermore,pretreatment with Lcz increased the hepatic expression of HO-1,SOD2 and Bcl-2,while suppressing the expression of Toll-like receptor 4 (TLR4).Conclusion:Lcz can protect against APAP-induced acute liver injury in mice.The hepato-protective effects of Lcz are associated with its anti-oxidative and anti-inflammatory capacity.

ObjectiveTo measure the iodine content of normal thyroid and the sternocleidomastoid muscle with gemstone spectral imaging (GSI),in order to offer diagnostic reference for iodine excess or iodine deficiency disorders.MethodsA total of 226 cases of patients with suspected neck or cervical disease underwent GSI of the neck,the thyroid and the sternocleidomastoid muscle.One hundred and nineteen cases were male and 107 female,aged 18 to 77 years,average age(46 ± 17) years.Data were transmitted to AW 4.4 workstation and processed using GSI Viewer software to obtain the best contrast-to-noise ratio(CNR) of thyroid to sternocleidomastoid muscle and corresponding singe-energy images.Iodine content of left and right thyroid lobes and both sides of sternocleidomastoid muscle as well as iodine content ratio of thyroid to sternocleidomastoid muscle were calculated in the iodine-based images.ResultsTotal iodine content of the left and the right lobes of the thyroid was (1.5233 ±0.4318)mg/cm3,of the left lobe was (1.5230 ± 0.4271 )mg/cm3,of the right lobe was (1.5236 ± 0.4365 )mg/cm3,there was no significant difference statistically between the two(t =0.0084,P ＞ 0.05).The iodine content of the male was (1.6395 ± 0.4105)mg/cm3,and of the female was (1.4238 ± 0.3832)mg/cm3,there was statistically a significant difference between the two(t =3.4743,P ＜ 0.01 ).Iodine content ratio of thyroid to sternocleidomastoid muscle was 96.6271 ± 33.2442,the ratio in male was 94.6250 ± 37.3621 and in female was 98.0000 ± 29.0737,there was no statistical difference between the two(t =0.3817,P ＞ 0.05).The iodine content of thyroid decreased gradually with age,the difference between groups was statistically significant(F =9.66,P ＜ 0.01 ).The iodine content in ＜ 40 age group[(1.7256 ± 0.4631)mg/cm3] was higher than that in 40 - 60 age group[(1.4517 ±0.3643)mg/cm3] and ＞ 60 age group [(1.4368 ± 0.3465)mg/cm3; q =5.6195,5.4158,all P ＜ 0.01).Conclusions It is easy to calculate thyroid iodine content with gemstone spectral imaging,which can reflect the iodine level of our body,and is helpful for the diagnosis of iodine excess or iodine deficiency disorders.

Anaphylaxis is rarely associated with the vasospastic acute coronary syndrome with or without the presence of underlying coronary artery disease. We report here a case of Kounis syndrome in a man with no known cardiovascular risk developed acute ST-elevation myocardial infarction complicated with complete heart block following Solenopsis (fire ant) bite.

Background/Aims: Depression and anxiety are associated with poorer outcomes in patients with hepatocellular carcinoma (HCC). However, the prevalence of depression and anxiety in HCC are unclear. We aimed to establish the prevalence of depression and anxiety in patients with HCC. Methods: MEDLINE and Embase were searched and original articles reporting prevalence of anxiety or depression in patients with HCC were included. A generalized linear mixed model with Clopper-Pearson intervals was used to obtain the pooled prevalence of depression and anxiety in patients with HCC. Risk factors were analyzed via a fractional-logistic regression model. Results: Seventeen articles involving 64,247 patients with HCC were included. The pooled prevalence of depression and anxiety in patients with HCC was 24.04% (95% confidence interval [CI], 13.99–38.11%) and 22.20% (95% CI, 10.07–42.09%) respectively. Subgroup analysis determined that the prevalence of depression was lowest in studies where depression was diagnosed via clinician-administered scales (16.07%;95% CI, 4.42–44.20%) and highest in self-reported scales (30.03%; 95% CI, 17.19–47.01%). Depression in patients with HCC was lowest in the Americas (16.44%; 95% CI, 6.37–36.27%) and highest in South-East Asia (66.67%; 95% CI, 56.68–75.35%). Alcohol consumption, cirrhosis, and college education significantly increased risk of depression in patients with HCC. Conclusions One in four patients with HCC have depression, while one in five have anxiety. Further studies are required to validate these findings, as seen from the wide CIs in certain subgroup analyses. Screening strategies for depression and anxiety should also be developed for patients with HCC.

BACKGROUNDMuch is known about the cytogenetic lesions that characterize multiple myeloma (MM) patients from the USA, Europe, and East Asia. However, little has been published about the disease among Southeast Asians. The aim of this study was to determine the chromosomal abnormalities of MM patients in our Singapore population.

METHODSForty-five newly-diagnosed, morphologically confirmed patients comprising 18 males and 27 females, aged 46 - 84 years (median 65 years) were investigated by karyotyping and fluorescence in situ hybridization (FISH). FISH employing standard panel probes and 1p36/1q21 and 6q21/15q22 probes was performed on diagnostic bone marrow samples.

RESULTSThirty-four cases (75.6%) had karyotypic abnormalities. Including FISH, a total detection rate of 91.1% was attained. Numerical and complex structural aberrations were common to both hyperdiploid and non-hyperdiploid patients. Numerical gains of several recurring chromosomes were frequent among hyperdiploid patients while structural rearrangements of several chromosomes including 8q24.1 and 14q32 characterized non-hyperdiploid patients. With FISH, immunoglobulin heavy chain (IGH) gene rearrangements, especially fibroblast growth factor receptor 3 (FGFR3)/IGH and RB1 deletion/monosomy 13 were the most common abnormalities (43.4%). Amplification 1q21 was 10 times more frequent (42.5%) than del(1p36) and del(6q21).

CONCLUSIONSWe have successfully reported the comprehensive cytogenetic profiling of a cohort of newly-diagnosed myeloma patients in our population. This study indicates that the genetic and cytogenetic abnormalities, and their frequencies, in our study group are generally similar to other populations.

Aged ; Aged, 80 and over ; Chromosome Aberrations ; Cytogenetics ; Female ; Humans ; Immunoglobulin Heavy Chains ; In Situ Hybridization, Fluorescence ; Karyotyping ; Male ; Middle Aged ; Monosomy ; genetics ; Multiple Myeloma ; genetics ; pathology ; Receptor, Fibroblast Growth Factor, Type 3 ; genetics ; Retinoblastoma Protein ; genetics ; Singapore