Purpose: The Geriatric Trauma Outcome Score (GTOS) is a new prognostic tool used to predict mortality of geriatric trauma patients. We aimed to apply this model to Korean geriatric trauma patients and compare it with the Trauma and Injury Severity Score (TRISS) method. Materials and Methods: Patients aged ≥65 years who were admitted to a level 1 trauma center from 2014 to 2018 were included in this study. Data on age, Injury Severity Score (ISS), packed red blood cell transfusion within 24 h, TRISS, admission disposition, mortality, and discharge disposition were collected. We analyzed the validity of GTOS and TRISS by comparing the area under the survival curve. Subgroup analysis for age, admission disposition, and ISS was performed. Results: Among 2586 participants, the median age was 75 years (interquartile range: 70–81). The median ISS was 9 (interquartile range: 4–12), with a transfusion rate (within 24 h) of 15.9% and mortality rate of 6.1%. The areas under the curve (AUCs) were 0.832 [95% confidence interval (CI), 0.817–0.846] and 0.800 (95% CI, 0.784–0.815) for GTOS and TRISS, respectively. On subgroup analysis, patients with ISS ≥9 showed a higher AUC of GTOS compared to the AUC of TRISS (p<0.05). Other subgroup analyses showed equally good power of discrimination for mortality. Conclusion GTOS can be used to predict mortality of severely injured Korean geriatric patients, and also be helpful in deciding whether invasive or aggressive treatments should be administered to them.

BACKGROUND: Pulmonary thromboembolism (PTE) is a life-threatening disease with high mortality. This study aimed to assess the outcomes of surgical embolectomy and to clarify the sustained long-term effects of surgery by comparing preoperative, postoperative, and long-term follow-up echocardiography outcomes. Of 22 survivors, 21 were followed up for a mean (median) period of 6.8±5.4 years (4.2 years). METHODS: We retrospectively reviewed 27 surgical embolectomy cases for massive or submassive acute PTE from 2003 to 2016. Immediate and long-term follow-up outcomes of surgical embolectomy were assessed on the basis of 30-day mortality, long-term mortality, postoperative complications, right ventricular systolic pressure, and tricuspid regurgitation grade. RESULTS: The 30-day and long-term mortality rates were 14.8% (4 of 27) and 4.3% (1 of 23), respectively. Three patients had major postoperative complications, including hypoxic brain damage, acute kidney injury, and endobronchial bleeding, respectively (3.7% each). Right ventricular systolic pressure (median [range], mm Hg) decreased from 62.0 (45.5–78.5) to 31.0 (25.7–37.0, p<0.001). The tricuspid valve regurgitation grade (median [range]) decreased from 1.5 (0.63–2.00) to 0.50 (0.50–1.00, p<0.05). The improvement lasted until the last echocardiographic follow-up. CONCLUSION: Surgical embolectomy revealed favorable mortality and morbidity rates in patients with acute massive or submassive PTE, with sustained long-term improvements in cardiac function.
Acute Kidney Injury ; Blood Pressure ; Cardiopulmonary Bypass ; Echocardiography ; Embolectomy ; Follow-Up Studies ; Hemorrhage ; Humans ; Hypoxia, Brain ; Mortality ; Postoperative Complications ; Pulmonary Embolism ; Retrospective Studies ; Survivors ; Tricuspid Valve Insufficiency

BACKGROUND: Pulmonary thromboembolism (PTE) is a life-threatening disease with high mortality. This study aimed to assess the outcomes of surgical embolectomy and to clarify the sustained long-term effects of surgery by comparing preoperative, postoperative, and long-term follow-up echocardiography outcomes. Of 22 survivors, 21 were followed up for a mean (median) period of 6.8±5.4 years (4.2 years). METHODS: We retrospectively reviewed 27 surgical embolectomy cases for massive or submassive acute PTE from 2003 to 2016. Immediate and long-term follow-up outcomes of surgical embolectomy were assessed on the basis of 30-day mortality, long-term mortality, postoperative complications, right ventricular systolic pressure, and tricuspid regurgitation grade. RESULTS: The 30-day and long-term mortality rates were 14.8% (4 of 27) and 4.3% (1 of 23), respectively. Three patients had major postoperative complications, including hypoxic brain damage, acute kidney injury, and endobronchial bleeding, respectively (3.7% each). Right ventricular systolic pressure (median [range], mm Hg) decreased from 62.0 (45.5–78.5) to 31.0 (25.7–37.0, p<0.001). The tricuspid valve regurgitation grade (median [range]) decreased from 1.5 (0.63–2.00) to 0.50 (0.50–1.00, p<0.05). The improvement lasted until the last echocardiographic follow-up. CONCLUSION Surgical embolectomy revealed favorable mortality and morbidity rates in patients with acute massive or submassive PTE, with sustained long-term improvements in cardiac function.

BACKGROUND/OBJECTIVES: This study aimed to identify preschool children’s eating behaviors associated with early childhood obesity and its multi-level, socio-ecological determinants. SUBJECTS/METHODS: In a cross-sectional study of 364 mothers of preschool children aged 3–5 years, these children’s healthy eating behaviors were assessed using a validated preschool nutrition quotient (NQ-P) questionnaire. The children’s overweight or obesity statuses were determined based on body mass index percentiles from the 2017 Korean National Growth Chart. The associations between the NQ-P score and risk of overweight or obesity were examined using multivariable logistic regression. The associations of individual, maternal, physical, and media environmental factors with the NQ-P score were also examined using multivariable linear regression. RESULTS: Preschool children with greater NQ-P scores were at a significantly lower risk of overweight or obesity (P < 0.01). The NQ-P score had a significantly positive association with maternal body mass index and an inverse association with household income (all P < 0.05). Maternal parenting and feeding practices exhibited associations with the NQ-P score.Positive associations were observed with “warm,” “structured,” and “autonomy-supportive” parenting as well as monitoring feeding practices (all P < 0.05). In addition, the NQ-P score had a significantly positive association with the childcare center’s anti-obesogenic environment, such as the provision of nutritional and physical-activity support and vicinity of the built food environment to the home, including access to good-quality food, fruits and vegetables, and low-fat foods (all P < 0.05). Regarding media environments, the NQ-P score demonstrated more significant associations with viewing and eating and/or cooking content displayed on online video platforms (all P < 0.05) than with that on television. CONCLUSIONS Our findings confirm the significance of healthy eating behaviors in earlychildhood-obesity prevention and underscore the importance of multilevel maternal, physical, and media environmental interventions that effectively guide eating behaviors in preschool children.

Background: Fingertip injuries are the most common type of traumatic injury treated at emergency departments and require prompt and adequate interventions for favorable wound survival outcomes. Hyperbaric oxygen (HBO2) therapy is well known for its many positive effects on wound healing. We hypothesized that treatment with HBO2 would improve the graft survival outcomes of amputated fingertip injuries treated with composite grafts. Methods: This retrospective observational study included fingertip amputations that were treated between January 2013 and December 2017. A conventional group and an HBO2 therapy group were statistically compared to evaluate the effect of HBO2 treatment. Graft survival was categorized as either success or failure. Results: Among 55 cases (digits), 34 digits were conventionally treated, while 21 digits were treated with HBO2. No statistically significant differences were observed between the groups with regard to general characteristics. Among patients with guillotine-type injuries, the composite graft success rate was statistically significantly higher in the group that received HBO2 therapy than in the conventional group (P=0.0337). Overall, the HBO2 group also demonstrated a statistically significantly shorter healing time than the conventional group (P=0.0075). As such, HBO2 treatment facilitates composite graft survival in cases of fingertip injury. Conclusions HBO2 treatment was associated with an increased composite graft survival rate in guillotine-type fingertip injuries and reduced the time required for grafts to heal.

Objective: This study investigated whether sleep and stress mutually interact to induce changes in white matter integrity. Methods: Diffusion tensor imaging (DTI) was conducted on 36 participants (male=22, female=14; mean age=38.33±12.78 years). Participants were divided into three groups depending on their sleep quality and stress levels: poor sleepers with stress, poor sleepers without stress, and good sleepers. Sleep quality and stress level were evaluated using the Pittsburgh Sleep Quality Index and the Life Experiences Survey, respectively. Fractional anisotropy (FA) values were calculated employing DTI tractography. Results: After controlling for age and sex, poor sleepers with stress exhibited a lower FA of the left inferior cerebellar peduncle (ICP) than did poor sleepers without stress (t=2.81, p=0.02). Poor sleepers without stress showed a higher FA of the right middle longitudinal fasciculus (MdLF) than did good sleepers (t=3.35, p=0.006). Conclusion The current study reports the effects of sleep, stress, and their interaction on the white matter integrities of the ICP and MdLF. ICP change seems to be associated with sleep disturbances related to stress, while MdLF change would be associated with sleep disturbances unrelated to stress.

A significant portion of newly diagnosed lung cancer cases occurs in populations exposed to air pollution. The World Health Organization has identified air pollution as a human carcinogen, prompting many countries to implement monitoring systems for ambient particulate matter (PM). PM is composed of a complex mixture of organic and inorganic particles, both solid and liquid, that are found in the air. Given the carcinogenic properties of PM and the high prevalence of lung cancer among exposed populations, exploring their connection and clinical implications is critical for effectively preventing lung cancer in this group. This review explores the relationship between ambient PM and lung cancer. Epidemiological studies have demonstrated a dose-response relationship between PM exposure and lung cancer risk. PM exposure induces oxidative stress, disrupts the body’s redox balance, and causes DNA damage, which is a crucial factor in cancer development. Recent findings on the strong correlation between ambient PM and adenocarcinoma highlight the importance of understanding the specific molecular and pathological mechanisms underlying pollution-related lung cancer. In addition to efforts to control emission sources at the international level, a more individualized approach is essential for preventing PM-related lung cancer.

A significant portion of newly diagnosed lung cancer cases occurs in populations exposed to air pollution. The World Health Organization has identified air pollution as a human carcinogen, prompting many countries to implement monitoring systems for ambient particulate matter (PM). PM is composed of a complex mixture of organic and inorganic particles, both solid and liquid, that are found in the air. Given the carcinogenic properties of PM and the high prevalence of lung cancer among exposed populations, exploring their connection and clinical implications is critical for effectively preventing lung cancer in this group. This review explores the relationship between ambient PM and lung cancer. Epidemiological studies have demonstrated a dose-response relationship between PM exposure and lung cancer risk. PM exposure induces oxidative stress, disrupts the body’s redox balance, and causes DNA damage, which is a crucial factor in cancer development. Recent findings on the strong correlation between ambient PM and adenocarcinoma highlight the importance of understanding the specific molecular and pathological mechanisms underlying pollution-related lung cancer. In addition to efforts to control emission sources at the international level, a more individualized approach is essential for preventing PM-related lung cancer.

A significant portion of newly diagnosed lung cancer cases occurs in populations exposed to air pollution. The World Health Organization has identified air pollution as a human carcinogen, prompting many countries to implement monitoring systems for ambient particulate matter (PM). PM is composed of a complex mixture of organic and inorganic particles, both solid and liquid, that are found in the air. Given the carcinogenic properties of PM and the high prevalence of lung cancer among exposed populations, exploring their connection and clinical implications is critical for effectively preventing lung cancer in this group. This review explores the relationship between ambient PM and lung cancer. Epidemiological studies have demonstrated a dose-response relationship between PM exposure and lung cancer risk. PM exposure induces oxidative stress, disrupts the body’s redox balance, and causes DNA damage, which is a crucial factor in cancer development. Recent findings on the strong correlation between ambient PM and adenocarcinoma highlight the importance of understanding the specific molecular and pathological mechanisms underlying pollution-related lung cancer. In addition to efforts to control emission sources at the international level, a more individualized approach is essential for preventing PM-related lung cancer.