Background: Return to work (RTW) is widely used in occupational and rehabilitation research as a marker for recovery after illness. For cancer survivors, returning to employment may be influenced by demographic factors, comorbid conditions, treatment exposures, and job characteristics. Aim: We conducted a retrospective cohort study to evaluate determinants of RTW among Taiwanese workers newly diagnosed with gastric cancer and to examine whether RTW is associated with long-term survival. Methods: Using linked national databases, 4467 eligible workers diagnosed between 2004 and 2015 were followed for up to 11 years. Predictors of RTW at the 2- and 5-year time points were assessed with Cox regression, and survival differences by RTW status were evaluated using Kaplan–Meier methods. Results: Older age, male sex, selected comorbidities, receipt of chemotherapy or radiotherapy, and manual occupations were associated with a lower probability of RTW, whereas surgery and earlier pathologic stage increased the likelihood of returning to employment. After multivariable adjustment, stage I disease showed markedly higher RTW hazards compared with more advanced stages (hazard ratio [HR] = 4.67, 95% confidence interval [CI]: 2.99–7.31 at year 2; HR = 7.44, 95% CI: 4.12–13.43 at year 5). Across all stages, reemployed survivors demonstrated superior survival, and RTW remained associated with reduced all-cause mortality (adjusted HR = 0.49, 95% CI: 0.38–0.65). Conclusion: Interventions that address modifiable barriers and reinforce facilitators of RTW may support workforce reintegration and improve outcomes among gastric cancer survivors.
Background: Military underwater operations personnel are repeatedly exposed to hyperbaric environments and increased respiratory workload, which may influence pulmonary function over time. However, the association between years of diving service and detailed pulmonary function parameters remains unclear in military diving populations. Aim: To investigate the association between years of diving service and pulmonary function among military underwater operations personnel. Methods: This cross-sectional study enrolled personnel of the Underwater Operations Unit who underwent comprehensive pulmonary function testing, including spirometry and body plethysmography. Participants were categorized as either shorter-service (<10 years of diving service) or longer-service (≥10 years of diving service) divers. Pulmonary function parameters included static lung volumes and flow–volume loop-derived indices. Between-group comparisons were performed using the Mann–Whitney U test, and correlations between years of diving service and pulmonary function parameters were assessed using Spearman’s rank correlation analysis. Results: Most of the lung volumes and conventional spirometric indices did not differ significantly between shorter-service and longer-service divers. However, longer-service divers exhibited significantly lower functional residual capacity and reduced residual volume/total lung capacity expressed as a percentage of measured/predicted values. The forced expiratory volume in 1s/forced vital capacity ratio was also significantly lower in longer-service divers. Conclusion: Among military underwater operations personnel, longer diving service duration is associated with specific alterations in lung volume distribution and expiratory flow ratios, whereas overall ventilatory capacity remains preserved. These findings are consistent with functional respiratory adaptations rather than pulmonary impairment.
Background: Long-term real-world evidence regarding the efficacy and safety of micropulse transscleral cyclophotocoagulation (MPCPC) remains limited. Aim: To evaluate the 5-year efficacy and safety of MPCPC in refractory glaucoma. Methods: This single-center retrospective study evaluated 42 eyes of 30 patients who underwent MPCPC between January 1, 2019, and May 31, 2020. All procedures followed a standardized protocol using a 2.0 W power setting for 180 s. The primary outcome was surgical success, defined as an intraocular pressure (IOP) reduction of ≥20% from baseline. Secondary outcomes included changes in visual acuity, antiglaucoma medication burden, and the incidence of ocular adverse events. Results: Mean IOP significantly decreased from 28.9 ± 11.6 mm Hg at baseline to 24.4 ± 10.4 mm Hg at 12 months and 21.5 ± 11.5 mm Hg at 60 months (all P < 0.05). Success rates were 54.3% at 1 year and 51.7% at 5 years. In the multivariable Firth regression model, each 1 mm Hg increase in baseline IOP was associated with a 16% increase in the probability of 1-year success (odds ratio: 1.16; 95% confidence interval: 1.05–1.29; P = 0.0048). While the topical medication burden remained unchanged, oral acetazolamide use significantly decreased at 1 month ( P = 0.039). Visual acuity declined in 58.1% of eyes at 5 years, largely attributable to disease progression in this refractory cohort. No severe complications, such as hypotony or phthisis bulbi, were observed. Conclusion: MPCPC provides a sustained, long-term IOP-lowering effect with a favorable safety profile in a real-world refractory population. This study addresses a critical evidence gap by demonstrating treatment durability up to 5 years and identifying preoperative IOP as a key predictor of success in an ethnically Chinese cohort.
Objective: This study aimed to determine the effectiveness of extracorporeal Shock Wave Lithotripsy and retrograde Intrarenal Surgery on obtaining stone-free status for renal pelvic stones measuring 1-2 cm in diameter. Material & Methods: This quasi-experimental study was conducted at the Department of Urology, Khyber Teaching Hospital, Peshawar, where a total of 60 patients with renal pelvic stones measuring 1–2 cm were randomly assigned to two equal groups: ESWL (n = 30) and RIRS (n = 30). Stone clearance was assessed on the 7th postoperative day using ultrasound and X-ray KUB. Results: The mean age of participants in Group A (ESWL) increased to 41 years (SD = 10.67), while the mean in Group B (RIRS) increased to 42 years (SD = 9.09). For Group A (ESWL), the sample included 20 males and 10 females, representing 67% and 33%, respectively. For Group B (RIRS), 21 participants were males, and 9 were females, accounting for 70% and 30%, respectively. The Chi-square test results indicate no statistically significant difference between the two groups regarding gender ratio (p = 0.7813). The data indicated that the patients with renal pelvic stones of 1–2 cm were more likely to be stone-free after retrograde intrarenal surgery (RIRS) than after extracorporeal shock wave lithotripsy (ESWL). In the RIRS group, 73% were stone-free, while only 33% were stone-free in the ESWL group (p = 0.0019). Conclusion: The study finds that RIRS is more effective than ESWL for managing 1-2cm renal pelvic stones. RIRS achieves higher stone-free rates, especially when anatomical difficulties and challenges associated with ESWL are common, and it can precisely locate stones and utilize advanced laser treatment features.
We report a rare case of delayed methicillin-resistant Staphylococcus aureus (MRSA) infection following elective mini-open trigger finger release in a 55-year-old male with asthma receiving anti-interleukin (IL)-5 therapy. The patient initially recovered uneventfully but developed signs of infectious flexor tenosynovitis on postoperative day 36. Culture confirmed MRSA, and surgical debridement was required. The patient continued anti-IL-5 therapy throughout the perioperative period. Although a causal relationship cannot be established, this case raises awareness of a potential association between biologic therapy and delayed postoperative infection.
