Background: Diabetes mellitus (DM) is prevalent among adults, many of whom require surgical interventions. Although metformin may improve postoperative outcomes by reducing inflammation, its effects on postoperative mortality and complications remain unclear. This study aimed to determine whether preoperative metformin use is associated with improved postoperative outcomes after noncardiac surgery. Methods: This retrospective study included adult patients with type 2 DM who underwent noncardiac surgery between 2011 and 2019. Patients were assigned to one of two groups based on the use of preoperative metformin at admission. To evaluate dose-related effects, patients in the metformin group were further divided into low- and high-dose groups based on daily dose (< or ≥ 1,000 mg). The primary outcome was one-year mortality after surgery, and the secondary outcomes were 30-day mortality, five-year mortality, and postoperative complications in major organs within 7 d. Results: Among 22 944 patients, 12 536 (54.6%) were exposed to preoperative metformin. After inverse probability of treatment weighting, preoperative metformin use was associated with a reduced one-year mortality (hazard ratio: 0.76, 95% CI [0.68–0.85]). For secondary outcomes, metformin use decreased postoperative complications in respiratory (odds ratio [OR]: 0.76, 95% CI [0.61−0.93]) and renal systems (OR: 0.66, 95% CI [0.58−0.74]). In a dose-related analysis, both doses were associated with a lower risk of postoperative mortality, with reductions in respiratory complications primarily due to high-dose metformin (OR: 0.69, 95% CI [0.54−0.89]). Conclusion Preoperative use of metformin is associated with reduced postoperative mortality and complications in diabetic patients undergoing noncardiac surgery.

Background: There are few safe effective ways to relieve osteoarthritis (OA) pain; as a result, off-label psychotropic drug prescriptions have increased worldwide. This study examined the change in psychotropic drug prescriptions for patients with OA from 2011 to 2020 using the Korean National Health Insurance Service dataset. Methods: The study population consisted of patients with hip or knee OA aged ≥ 65 years.Psychotropic drugs included opioids, benzodiazepines, non-benzodiazepine hypnotics (Z-drugs), anti-epileptics, tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), typical antipsychotics, atypical antipsychotics, and anxiolytics. The prevalence and long-term (> 3 months) prescription rates of psychotropic drugs in OA patients were calculated. Results: The study included 1,821,158 patients with OA (mean age 71.7 years; 65.32% female).Of the cohort, 49% had comorbidities for which psychotropics were indicated. The prevalence of psychotropic prescriptions decreased from 58.2% to 52.0% in 2018 and then leveled off.The long-term prescription rate remained constant until 2018 and then increased slightly.The most commonly prescribed psychotropics were opioids and long- and short-acting benzodiazepines. The prescription rates of opioids and long-acting benzodiazepines decreased from 2011 to 2020. For those with psychiatric co-morbidities, the prescription rates of anti-epileptics and SNRIs increased, while the prescription rates of anti-epileptics, SSRIs, other antidepressants, and atypical psychotropics increased for those without such co-morbidities. The most commonly prescribed psychotropics were diazepam and alprazolam, excluding tramadol and tramadol–acetaminophen combination. For those with psychiatric co-morbidities, the prescription rates of gabapentin and fentanyl increased, while for those without such co-morbidities, the prescription rates of lorazepam, fentanyl, escitalopram and quetiapine increased. Conclusion A significant number of older Korean patients with OA were prescribed psychotropic drugs in the absence of comorbidities requiring such drugs, including drugs that have little effect on OA and unfavorable safety profiles in older adults.

This retrospective study aims to analyze the incidence and characteristics of sportsrelated dental injuries in pediatric patients, providing foundational data for the prevention and management of such injuries. Medical records of 2,382 patients aged 3 – 18 who visited Chosun University Dental Hospital between January 2018 and January 2024 were reviewed. Of these, 308 patients who experienced sportsrelated dental trauma were analyzed. Data collected included patient demographics, type of sport, cause of injury, time and location of the trauma, and type of injury. Sports-related dental injuries accounted for 12.9% of all trauma cases in the study population. Males (74.4%) were more commonly affected than females. The most common cause of injury was cycling (21.0%), followed by contact group sports (16.2%) and kickboard (15.5%). Tooth injuries, particularly affecting the maxillary anterior teeth, were the most prevalent type of trauma (63.6%). The presence of a supervisor significantly reduced the time to initial management, indicating the importance of prompt response to dental injuries. Sports-related dental trauma represents a significant public health concern among pediatric and adolescent populations. Increased supervision during sports activities and preventive measures, including the use of protective gear like mouthguards, are essential to reducing the incidence and severity of injuries.

Background: There are few safe effective ways to relieve osteoarthritis (OA) pain; as a result, off-label psychotropic drug prescriptions have increased worldwide. This study examined the change in psychotropic drug prescriptions for patients with OA from 2011 to 2020 using the Korean National Health Insurance Service dataset. Methods: The study population consisted of patients with hip or knee OA aged ≥ 65 years.Psychotropic drugs included opioids, benzodiazepines, non-benzodiazepine hypnotics (Z-drugs), anti-epileptics, tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), typical antipsychotics, atypical antipsychotics, and anxiolytics. The prevalence and long-term (> 3 months) prescription rates of psychotropic drugs in OA patients were calculated. Results: The study included 1,821,158 patients with OA (mean age 71.7 years; 65.32% female).Of the cohort, 49% had comorbidities for which psychotropics were indicated. The prevalence of psychotropic prescriptions decreased from 58.2% to 52.0% in 2018 and then leveled off.The long-term prescription rate remained constant until 2018 and then increased slightly.The most commonly prescribed psychotropics were opioids and long- and short-acting benzodiazepines. The prescription rates of opioids and long-acting benzodiazepines decreased from 2011 to 2020. For those with psychiatric co-morbidities, the prescription rates of anti-epileptics and SNRIs increased, while the prescription rates of anti-epileptics, SSRIs, other antidepressants, and atypical psychotropics increased for those without such co-morbidities. The most commonly prescribed psychotropics were diazepam and alprazolam, excluding tramadol and tramadol–acetaminophen combination. For those with psychiatric co-morbidities, the prescription rates of gabapentin and fentanyl increased, while for those without such co-morbidities, the prescription rates of lorazepam, fentanyl, escitalopram and quetiapine increased. Conclusion A significant number of older Korean patients with OA were prescribed psychotropic drugs in the absence of comorbidities requiring such drugs, including drugs that have little effect on OA and unfavorable safety profiles in older adults.

This retrospective study aims to analyze the incidence and characteristics of sportsrelated dental injuries in pediatric patients, providing foundational data for the prevention and management of such injuries. Medical records of 2,382 patients aged 3 – 18 who visited Chosun University Dental Hospital between January 2018 and January 2024 were reviewed. Of these, 308 patients who experienced sportsrelated dental trauma were analyzed. Data collected included patient demographics, type of sport, cause of injury, time and location of the trauma, and type of injury. Sports-related dental injuries accounted for 12.9% of all trauma cases in the study population. Males (74.4%) were more commonly affected than females. The most common cause of injury was cycling (21.0%), followed by contact group sports (16.2%) and kickboard (15.5%). Tooth injuries, particularly affecting the maxillary anterior teeth, were the most prevalent type of trauma (63.6%). The presence of a supervisor significantly reduced the time to initial management, indicating the importance of prompt response to dental injuries. Sports-related dental trauma represents a significant public health concern among pediatric and adolescent populations. Increased supervision during sports activities and preventive measures, including the use of protective gear like mouthguards, are essential to reducing the incidence and severity of injuries.

This retrospective study aims to analyze the incidence and characteristics of sportsrelated dental injuries in pediatric patients, providing foundational data for the prevention and management of such injuries. Medical records of 2,382 patients aged 3 – 18 who visited Chosun University Dental Hospital between January 2018 and January 2024 were reviewed. Of these, 308 patients who experienced sportsrelated dental trauma were analyzed. Data collected included patient demographics, type of sport, cause of injury, time and location of the trauma, and type of injury. Sports-related dental injuries accounted for 12.9% of all trauma cases in the study population. Males (74.4%) were more commonly affected than females. The most common cause of injury was cycling (21.0%), followed by contact group sports (16.2%) and kickboard (15.5%). Tooth injuries, particularly affecting the maxillary anterior teeth, were the most prevalent type of trauma (63.6%). The presence of a supervisor significantly reduced the time to initial management, indicating the importance of prompt response to dental injuries. Sports-related dental trauma represents a significant public health concern among pediatric and adolescent populations. Increased supervision during sports activities and preventive measures, including the use of protective gear like mouthguards, are essential to reducing the incidence and severity of injuries.

Background: There are few safe effective ways to relieve osteoarthritis (OA) pain; as a result, off-label psychotropic drug prescriptions have increased worldwide. This study examined the change in psychotropic drug prescriptions for patients with OA from 2011 to 2020 using the Korean National Health Insurance Service dataset. Methods: The study population consisted of patients with hip or knee OA aged ≥ 65 years.Psychotropic drugs included opioids, benzodiazepines, non-benzodiazepine hypnotics (Z-drugs), anti-epileptics, tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), typical antipsychotics, atypical antipsychotics, and anxiolytics. The prevalence and long-term (> 3 months) prescription rates of psychotropic drugs in OA patients were calculated. Results: The study included 1,821,158 patients with OA (mean age 71.7 years; 65.32% female).Of the cohort, 49% had comorbidities for which psychotropics were indicated. The prevalence of psychotropic prescriptions decreased from 58.2% to 52.0% in 2018 and then leveled off.The long-term prescription rate remained constant until 2018 and then increased slightly.The most commonly prescribed psychotropics were opioids and long- and short-acting benzodiazepines. The prescription rates of opioids and long-acting benzodiazepines decreased from 2011 to 2020. For those with psychiatric co-morbidities, the prescription rates of anti-epileptics and SNRIs increased, while the prescription rates of anti-epileptics, SSRIs, other antidepressants, and atypical psychotropics increased for those without such co-morbidities. The most commonly prescribed psychotropics were diazepam and alprazolam, excluding tramadol and tramadol–acetaminophen combination. For those with psychiatric co-morbidities, the prescription rates of gabapentin and fentanyl increased, while for those without such co-morbidities, the prescription rates of lorazepam, fentanyl, escitalopram and quetiapine increased. Conclusion A significant number of older Korean patients with OA were prescribed psychotropic drugs in the absence of comorbidities requiring such drugs, including drugs that have little effect on OA and unfavorable safety profiles in older adults.

Background: There are few safe effective ways to relieve osteoarthritis (OA) pain; as a result, off-label psychotropic drug prescriptions have increased worldwide. This study examined the change in psychotropic drug prescriptions for patients with OA from 2011 to 2020 using the Korean National Health Insurance Service dataset. Methods: The study population consisted of patients with hip or knee OA aged ≥ 65 years.Psychotropic drugs included opioids, benzodiazepines, non-benzodiazepine hypnotics (Z-drugs), anti-epileptics, tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), typical antipsychotics, atypical antipsychotics, and anxiolytics. The prevalence and long-term (> 3 months) prescription rates of psychotropic drugs in OA patients were calculated. Results: The study included 1,821,158 patients with OA (mean age 71.7 years; 65.32% female).Of the cohort, 49% had comorbidities for which psychotropics were indicated. The prevalence of psychotropic prescriptions decreased from 58.2% to 52.0% in 2018 and then leveled off.The long-term prescription rate remained constant until 2018 and then increased slightly.The most commonly prescribed psychotropics were opioids and long- and short-acting benzodiazepines. The prescription rates of opioids and long-acting benzodiazepines decreased from 2011 to 2020. For those with psychiatric co-morbidities, the prescription rates of anti-epileptics and SNRIs increased, while the prescription rates of anti-epileptics, SSRIs, other antidepressants, and atypical psychotropics increased for those without such co-morbidities. The most commonly prescribed psychotropics were diazepam and alprazolam, excluding tramadol and tramadol–acetaminophen combination. For those with psychiatric co-morbidities, the prescription rates of gabapentin and fentanyl increased, while for those without such co-morbidities, the prescription rates of lorazepam, fentanyl, escitalopram and quetiapine increased. Conclusion A significant number of older Korean patients with OA were prescribed psychotropic drugs in the absence of comorbidities requiring such drugs, including drugs that have little effect on OA and unfavorable safety profiles in older adults.

Background/Aims: Sorafenib is the standard of care in the management of advanced hepatocellular carcinoma (HCC). The purpose of this study was to investigate the characteristics, treatment patterns and outcomes of sorafenib among HCC patients in South Korea. Methods: This population-based retrospective, single-arm, observational study used the Korean National Health Insurance database to identify patients with HCC who received sorafenib between July 1, 2008, and December 31, 2014. A total of 9,923 patients were recruited in this study. Results: Among 9,923 patients, 6,669 patients (68.2%) received loco-regional therapy prior to sorafenib, and 1,565 patients (15.8%) received combination therapy with concomitant sorafenib;2,591 patients (26.1%) received rescue therapy after sorafenib, and transarterial chemoembolization was the most common modality applied in 1,498 patients (15.1%). A total of 3,591 patients underwent rescue therapy after sorafenib, and the median overall survival was 14.5 months compared to 4.6 months in 7,332 patients who received supportive care after sorafenib. The mean duration of sorafenib administration in all patients was 105.7 days; 7,023 patients (70.8%) received an initial dose of 600 to 800 mg. The longest survival was shown in patients who received the recommended dose of 800 mg, subsequently reduced to 400 mg (15.0 months). The second longest survival was demonstrated in patients with a starting dose of 800 mg, followed by a dose reduction to 400–600 mg (9.6 months). Conclusions Real-life data show that the efficacy of sorafenib seems similar to that observed in clinical trials, suggesting that appropriate subsequent therapy after sorafenib might prolong patient survival.