PURPOSE: To evaluate long-term change in intraocular pressure (IOP) in the fellow eyes after laser iridotomy and early phacoemusification with laser iridotomy in patients with acute angle-closure glaucoma. METHODS: We performed a retrospective, comparative chart review of 62 patients with acute angle-closure glaucoma; 35 patients (Group A) who underwent only prophylactic laser iridotomy on fellow eyes and 27 patients (Group B) who underwent prophylactic laser iridotomy and early phacoemusification on fellow eyes. Patients were followed up at 1 day, 1 week and 1, 3, 6 and 12 months. IOP change was analyzed after laser iridotomy 1 hour and at every follow-up. In addition, visual acuity and complications of laser iridotomy and phacoemusification were determined. RESULTS: In Group A, the mean IOP increase in fellow eyes occurred within 1 month after laser iridotomy (initial, 15.9 ± 5.0 mm Hg; final, 15.9 ± 2.6 mm Hg), However, in Group B, the mean IOP of fellow eyes was maintained up to 12 months without an increase in IOP (initial, 17.0 ± 3.3 mm Hg; final, 13.3 ± 2.8 mm Hg) Among the fellow eyes, 13 patients in Group A (37.14%) and 4 patients in Group B (14.81%, p = 0.032) underwent further medical therapy. The initial visual acuity of fellow eyes in Group A was 0.78 ± 0.21 and 0.71 ± 0.22 in Group B, and at the final visit, 0.73 ± 0.31 in Group A and 0.93 ± 0.27 in Group B (p = 0.003). CONCLUSIONS: We found that most fellow eyes treated with laser iridotomy and phacoemulsification maintained satisfactory IOP and good vision. These results support that laser iridotomy and phacoemulsification in the fellow eye with acute angle-closure glaucoma is a reasonable prophylactic treatment.
Follow-Up Studies ; Glaucoma, Angle-Closure* ; Humans ; Intraocular Pressure* ; Phacoemulsification* ; Retrospective Studies ; Visual Acuity

Background: Change in working time arrangement (WTA) can be harmful to workers' sleep and health. This study aimed to investigate the association between change in working time arrangement and sleep disturbance. Methods: This study used data from the Fifth Korean Working Condition Survey and included 33,203 paid workers. We performed a stratified analysis by sex. After dividing the participants into 6 groups based on whether or not they experienced WTA changes, and their weekly working hours (≤40, 41–52, ≥53 hours), we calculated odds ratio (OR) using the weekly working hours ≤40 hours and with no WTA change as the reference group. Results: Of the 33,203 paid workers, participants who experienced change in working time arrangement had higher prevalence of all three types of sleep disturbance symptoms (difficulty in falling asleep, waking up repeatedly during sleep, and waking up with a feeling of exhaustion and fatigue) in both sexes. Compared to the reference group at 95% confidence interval (CI), the group with change in WTA showed elevated OR values of 1.91 (95% CI:1.73–2.11), 1.93 (95% CI: 1.74–2.14), 2.47 (95% CI: 2.26–2.71) for male workers; and 1.93 (95% CI: 1.73–2.16), 2.02 (95% CI: 1.80–2.27), 2.24 (95% CI: 2.01–2.50) for female workers, for difficulty in falling asleep, waking up repeatedly during the sleep, waking up with a feeling of exhaustion, and fatigue, respectively. Conclusions Workers who experience change in work time arrangement show a high risk of sleep disturbance in both sexes.

Background: Change in working time arrangement (WTA) can be harmful to workers' sleep and health. This study aimed to investigate the association between change in working time arrangement and sleep disturbance. Methods: This study used data from the Fifth Korean Working Condition Survey and included 33,203 paid workers. We performed a stratified analysis by sex. After dividing the participants into 6 groups based on whether or not they experienced WTA changes, and their weekly working hours (≤40, 41–52, ≥53 hours), we calculated odds ratio (OR) using the weekly working hours ≤40 hours and with no WTA change as the reference group. Results: Of the 33,203 paid workers, participants who experienced change in working time arrangement had higher prevalence of all three types of sleep disturbance symptoms (difficulty in falling asleep, waking up repeatedly during sleep, and waking up with a feeling of exhaustion and fatigue) in both sexes. Compared to the reference group at 95% confidence interval (CI), the group with change in WTA showed elevated OR values of 1.91 (95% CI:1.73–2.11), 1.93 (95% CI: 1.74–2.14), 2.47 (95% CI: 2.26–2.71) for male workers; and 1.93 (95% CI: 1.73–2.16), 2.02 (95% CI: 1.80–2.27), 2.24 (95% CI: 2.01–2.50) for female workers, for difficulty in falling asleep, waking up repeatedly during the sleep, waking up with a feeling of exhaustion, and fatigue, respectively. Conclusions Workers who experience change in work time arrangement show a high risk of sleep disturbance in both sexes.

OBJECTIVE: Radio-contrast abdomino-pelvic computed tomography (APCT) is considered the gold standard diagnostic tool for an acute abdomen in the emergency department. On the other hand, APCT has a risk of contrast-induced nephropathy. Emergency physicians evaluate the creatinine (Cr) level prior to taking a APCT for the above reason but it takes time to evaluation the serum Cr level. This study hypothesized that Cr measured by a point-of-care test (POCT) can shorten the time to making clinically important decisions for patients with an acute abdomen. METHODS: This prospective randomized study was conducted between March 2017 and October 2017. The subjects were divided into two groups (Cr measured by laboratory vs. Cr measured by POCT). To analyze the clinical acceptability for creatinine, agreement was demonstrated graphically by Bland-Altman plots. This study compared the time to make a clinically important decision by physicians and the length of stay at the emergency department in both groups. RESULTS: A total of 76 patients were eligible for the study, 38 patients were assigned to each group. There was no statistically significant difference in the time to the first medical examination (P=0.222) and emergency department stay time (P=0.802). On the other hand, the time to recognition of the Cr level (P < 0.001), time to performing APCT (P < 0.001), time to decision making (P < 0.001), and time to initiation of treatment (P < 0.001) were shortened significantly in the point-of-care creatinine group. CONCLUSION: In this study, the POCT for creatinine can allow rapid decision making by shortening the time to performing the radio-contrast APCT than the laboratory for patients with an acute abdomen.
Abdomen, Acute* ; Creatinine* ; Decision Making* ; Emergencies ; Emergency Service, Hospital ; Hand ; Humans ; Length of Stay ; Point-of-Care Systems* ; Prospective Studies