Search

Objectives: To evaluate the effects of sarcopenia and excess visceral fat accumulation on early urinary function after I‐125 low‐dose‐rate brachytherapy for prostate cancer. Methods: We retrospectively reviewed consecutive patients who underwent brachytherapy for prostate cancer. Pre‐treatment computed tomography was used to measure skeletal muscle index at the L3 level to assess sarcopenia and visceral fat area at the umbilical level. The International Prostate Symptom Score and the University of California Los Angeles Prostate Cancer Index were used to assess quality of life during the 24 months after brachytherapy. Logistic regression analysis was used to examine whether sarcopenia and excess visceral fat accumulation had clinically significant effects on post‐treatment quality of life. Results: Among 246 patients, 92 (37.4%) were stratified into the sarcopenia group and 141 (57.3%) into the excess visceral fat accumulation group. The sarcopenia group had significantly lower University of California Los Angeles Prostate Cancer Index urinary function than the non‐sarcopenia group 24 months post‐brachytherapy. The excess visceral fat accumulation group had significantly poorer International Prostate Symptom Score total, storage, and voiding scores than the non‐excess accumulation group 12 months post‐brachytherapy. In the multivariate analysis, sarcopenia had a clinically significant adverse effect on the University of California Los Angeles Prostate Cancer Index urinary function at 12 months. Excess visceral fat accumulation had a clinically significant adverse effect on the International Prostate Symptom Score voiding and storage scores at 12 months. Conclusions: Sarcopenia and excess visceral fat accumulation negatively affect urinary function early after I‐125 low‐dose‐rate brachytherapy for prostate cancer. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate students' subjective symptoms associated with exposure to low levels of formaldehyde (FA) during a gross anatomy course and to survey how the risk of subjective symptoms was affected by exposure to FA. Methods: We conducted three questionnaire surveys of 125 students enrolled in an anatomy course (FA exposure group) and 124 students not enrolled in the course (FA nonexposure group) before, during, and 6 months after the course. The questionnaire included questions inquiring about subjective symptoms, sex, age, and allergies. We analyzed differences in the prevalence of subjective symptoms in distinct survey periods. Furthermore, we analyzed the relationship between the subjective symptoms and exposure to FA after adjusting for allergy, sex, and age using multiple logistic regression analysis. Results: The prevalence of some of the ocular, nasal, and nonspecific symptoms in the FA exposure group was low before the course, increased during the course and decreased 6 months after the course. A significant positive relationship was observed between exposure to FA and some symptoms after adjusting for allergy, sex, and age. Conclusions: We identified some concrete symptoms associated with exposure to FA. We suggest that the exposure to low levels of FA influences students' subjective symptoms. [ABSTRACT FROM AUTHOR]

To investigate factors contributing to the mental health of Vietnamese technical intern trainees in the food manufacturing industry, a questionnaire survey was conducted twice with a six-month interval. A total of 111 technical trainees who participated in two surveys were included in the analysis. We used a mixed-effects model, where items with statistically significant associations in the univariate analysis were fixed effects, factories were random effects, and the outcome was defined as the K6 score at follow-up. The mean K6 score increased from 3.13 (SD 3.5) at baseline to 3.86 (SD 4.1) at follow-up, with 26.1% and 34.2% exhibiting poor mental health (K6≥5) at baseline and follow-up, respectively. Insomnia and years of training experience were significantly associated with the K6 score at follow-up. Those with insomnia had significantly higher K6 score at follow-up. Compared to the first year of training, K6 score at follow-up increased significantly for training in their third year or more. It is important to understand the sleeping conditions of trainees and support them based on their years of training experience.

Decompression illness (DCI) is well known in compressed-air diving but has been considered anecdotal in breath-hold divers. Nonetheless, reported cases and field studies of the Japanese Ama, commercial or professional breath-hold divers, support DCI as a clinical entity. Clinical characteristics of DCI in Ama divers mainly suggest neurological involvement, especially stroke-like cerebral events with sparing of the spinal cord. Female Ama divers achieving deep depths have rarely experienced a panic-like neurosis from anxiety disorders. Neuroradiological studies of Ama divers have shown symptomatic and/or asymptomatic ischaemic lesions situated in the basal ganglia, brainstem, and deep and superficial cerebral white matter, suggesting arterial insufficiency. The underlying mechanism(s) of brain damage in breath-hold diving remain to be elucidated; one of the plausible mechanisms is arterialization of venous nitrogen bubbles passing through right to left shunts in the heart or lungs. Although the treatment for DCI in Ama divers has not been specifically established, oxygen breathing should be given as soon as possible for injured divers. The strategy for prevention of diving-related disorders includes reducing extreme diving schedules, prolonging surface intervals and avoiding long periods of repetitive diving. This review discusses the clinical manifestations of diving-related disorders in Ama divers and the controversial mechanisms., (Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.)

We present a pulmonary sarcoidosis patient with specific elevation of serum Krebs von den lungen-6 (KL-6) levels, who was successfully treated with inhaled corticosteroids. Pulmonary sarcoidosis was initially identified as a chest radiograph abnormality during a routine medical examination, and subsequently confirmed by a high serum level of soluble interleukin 2 receptor. The patient was started on high-dose inhaled budesonide because of high serum levels of angiotensin-converting enzyme (ACE) and KL-6. Following treatment, radiographic findings improved, ACE levels normalized, and serum KL-6 levels markedly decreased. No recurrence was detected at 100 months with a budesonide dosage of 800 μg/day. This case demonstrates the efficacy of highdose inhaled corticosteroids for the initial treatment of pulmonary sarcoidosis.

Diving accident in breath-hold (BH) divers (Ama) is a stroke-like neurological condition involving the brain. Ama divers are at a risk of ischemic brain injuries which are situated in watershed or terminal zones of cerebral arteries, and/or corticomedullary junctional area of cerebral arteries. The underlying mechanisms of brain damage in BH diving remains to be elucidated. After repetitive BH dives, nitrogen (N2) bubbles may be formed in the venous side of tissues and flow into the right atrium. N2 bubbles passing through the heart or the lungs is the most likely contributing factor. The pathophysiology of diving accident in BH diving is unclear, and more studies for stroke are needed to further elucidate its nature. (Received 29 July, 2019; Accepted 10 January, 2020; Published 1 May, 2020).

Objectives: The aim of this study is to clarify factors that support the work engagement of nurses, who bear the burden of extended day shifts, by focusing on the advantages of the variable shift system and workday break activities., Methods: Nurses who were working under a variable shift system were asked to complete a self-report questionnaire to examine the workload, work engagement, work stressors, stress-coping strategies, and stress-coping break time activities, as well as the advantages and disadvantages of the variable shift system. Nine break activities were classified into the following four categories: social activities, rest/relaxation, entertainment, and cognitive activities. The advantages or disadvantages of the variable shift system were scored by developing composite variables using principal component analysis. These variables were used to perform a multiple regression analysis with work engagement as the dependent variable., Results: The advantage score was the variable most strongly correlated with work engagement. In contrast, "Quantitative workload" was negatively correlated with work engagement. Among break activities, in the social activities category correlations were observed in "Both conversation and Email/SNS" and "Conversation only". Although in fact most nurses chose conversation as one of the break options, more than half of the nurses selected rest/relaxation as their ideal break activity., Conclusion: Our study suggested that the variable shift system supported the work engagement of nurses who worked extended day shifts. The results also suggested that it would be useful to arrange the employee lounge environment so that employees could freely choose between "conversation" or "taking a rest" depending on the circumstances.

The Renewable energy is a key driver of generating clean energy because it continuously lower air pollution. In particular, the development of wind power energy has been remarkable, and it currently accounts for approximately one-third of renewable electricity. Germany has the largest onshore wind deployment. On the other hand, the United Kingdom is most highly expected to develop offshore wind power. Germany and Denmark have assessed the usefulness of wind turbines, and they benefited from wind energy. Execution of not only environmental impact assessment (EIA) but also health impact assessment (HIA) is an obligation in the United Kingdom, the practice of EIA and HIA is important for the successful construction of wind turbine facilities. We in Japan should learn the method of handling renewable energy systems from major European countries.

The diagnosis of decompression illness (DCI), which is based on a history of decompression and clinical findings, can sometimes be confounded with other vascular events of the central nervous system. The authors report three cases of divers who were urgently transported to a hyperbaric facility for hyperbaric oxygen treatment of DCI which at admission turned out to be something else. The first case, a 45-year-old experienced diver with unconsciousness, was clinically diagnosed as having experienced subarachnoid hemorrhage, which was confirmed by CT scan. The second case, a 49-year-old fisherman with a hemiparesis which occurred during diving, was diagnosed as cerebral stroke, resulting in putaminal hemorrhage. The third case, a 54-year-old fisherman with sensory numbness, ataxic gait and urinary retention following sudden post-dive onset of upper back pain, was diagnosed as spinal epidural hematoma; he also showed blood collection in the spinal canal. Neurological insults following scuba diving can present clinically with confusing features of cerebral and/or spinal DCI. We emphasize the importance of considering cerebral and/or spinal vascular diseases as unusual causes of neurological deficits after or during diving., Competing Interests: The authors of this paper declare no conflicts of interest exist with this submission., (Copyright© Undersea and Hyperbaric Medical Society.)