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Pourmand A, Esmailian G, Mazer-Amirshahi M, Lee-Park O, Tran QK. Topical capsaicin for the treatment of cannabinoid hyperemesis syndrome, a systematic review and meta-analysis. Am J Emerg Med 2021; 43:35-40. [PMID: 33493995 DOI: 10.1016/j.ajem.2021.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 01/03/2021] [Accepted: 01/03/2021] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Cannabinoid hyperemesis syndrome (CHS) is a condition that is being recognized and treated more frequently in emergency departments (EDs) across the United States. Currently, ED providers rely on antiemetics, antipsychotics and benzodiazepines to alleviate the symptoms. Topical capsaicin, a transient receptor potential vanilloid 1 (TRPV1) agonist, has been proposed in recent years as a low-cost and effective alternative to the traditional antiemetic regimen when treating CHS. The aim of this systematic review and meta-analysis is to demonstrate the reliability and the gaps of what is known about this treatment modality. METHODS Articles were extracted from PubMed, SCOPUS, and Google Scholar databases. Publication dates ranged from the inception of the databases to October 2020. Initial searches found 328 studies. After careful review and screening by two investigators, 7 studies met the inclusion criteria and were included for our meta-analysis. Variables that were evaluated included the prevalence of hospital admissions for patients treated with capsaicin, time to relief of symptoms after capsaicin administration, and ED length of stay (LOS). I-square and Q-statistic values were used to assess heterogeneity. RESULTS Among the 7 studies, there was a total of 106 patients. Two studies reported time to resolution of symptoms following capsaicin administration and ED LOS. Means for these outcomes were 325 (95% CI 234-787) and 379 (95% CI 10-747) minutes respectively. I-square was 44%, and Q-statistic was 11 with 6 degrees of freedom, with a p-value of 0.1. DISCUSSION With acceptable time to resolution of symptoms after topical administration and ED LOS, capsaicin appears to be an effective treatment option for symptomatic relief of CHS. Further randomized controlled trials should be conducted to examine if it is the more efficacious and efficient treatment for CHS across various care settings.
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Affiliation(s)
- Ali Pourmand
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
| | - Gabriel Esmailian
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | | | - Owen Lee-Park
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Quincy K Tran
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; Program in Trauma, The R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA
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Kim M, Yoo CB, Lee-Park O, Nang S, Vuthy D, Park KB, Vycheth I. Patterns of Neurosurgical Conditions at a Major Government Hospital in Cambodia. Asian J Neurosurg 2020; 15:952-958. [PMID: 33708669 PMCID: PMC7869294 DOI: 10.4103/ajns.ajns_213_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/03/2020] [Accepted: 07/03/2020] [Indexed: 11/05/2022] Open
Abstract
Background: Low- and middle-income countries (LMICs) have a growing and largely unaddressed neurosurgical burden. Cambodia has been an understudied country regarding the neurosurgical pathologies and case volume. Rapid infrastructure development with noncompliance of safety regulations has led to increased numbers of traumatic injuries. This study examines the neurosurgical caseload and pathologies of a single government institution implementing the first residency program in an effort to understand the neurosurgical needs of this population. Methods: This is a longitudinal descriptive study of all neurosurgical admissions at the Department of Neurosurgery at Preah Kossamak Hospital (PKH), a major government hospital, in Phnom Penh, Cambodia, between September 2013 and June 2018. Results: 5490 patients were admitted to PKH requiring neurosurgical evaluation and care. Most of these admissions were cranial injuries related to road traffic accidents primarily involving young men compared to women by approximately 4:1 ratio. Spinal pathologies were more evenly distributed in age and gender, with younger demographics more commonly presenting with traumatic injuries, while the older with degenerative conditions. Conclusions: Despite increased attention and efforts over the past decade, Cambodia's neurosurgical burden mirrors that of other LMICs, with trauma affecting most patients either on the road or at the workplace. Currently, Cambodia has 34 neurosurgeons to address the growing burden of a country of 15 million with an increasing life expectancy of 69 years of age, stressing the importance of better public health policies and urgency for building capacity for safe and affordable neurosurgical care.
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Affiliation(s)
- Miri Kim
- Department of Neurosurgery, Loyola University Medical Center, Maywood, IL, USA.,Department of Neurosurgery, Preah Kossamak Hospital, Phnom Penh, Cambodia
| | - Chung Bin Yoo
- Department of General Medicine, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK
| | - Owen Lee-Park
- Department of Emergency Medicine, George Washington School of Medicine and Health Sciences, Washington DC, USA
| | - Sam Nang
- Department of Neurosurgery, Preah Kossamak Hospital, Phnom Penh, Cambodia
| | - Din Vuthy
- Department of Neurosurgery, Preah Kossamak Hospital, Phnom Penh, Cambodia
| | - Kee B Park
- Department of Neurosurgery, Preah Kossamak Hospital, Phnom Penh, Cambodia.,Department of Neurosurgery, Preah Kossamak Hospital, Phnom Penh, Cambodia
| | - Iv Vycheth
- Department of Neurosurgery, Preah Kossamak Hospital, Phnom Penh, Cambodia
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Park JJ, Lim AY, Ahn HS, Kim AI, Choi S, Oh DH, Lee-Park O, Kim SY, Jung SJ, Bump JB, Atun R, Shin HY, Park KB. Systematic review of evidence on public health in the Democratic People's Republic of Korea. BMJ Glob Health 2019; 4:e001133. [PMID: 30997161 PMCID: PMC6441257 DOI: 10.1136/bmjgh-2018-001133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 10/03/2018] [Accepted: 10/06/2018] [Indexed: 11/06/2022] Open
Abstract
Background Engaging in public health activities in the Democratic People’s Republic of Korea (DPRK, also known as North Korea) offers a means to improve population health for its citizens and the wider region. Such an engagement requires an understanding of current and future needs. Methods We conducted a systematic search of five English and eight Korean language databases to identify available literature published between 1988 and 2017. A narrative review of evidence was conducted for five major categories (health systems, communicable diseases (CDs), non-communicable diseases (NCDs), injuries, and reproductive, maternal, newborn and child health (RMNCH) and nutrition). Findings We found 465 publications on the DPRK and public health. Of the 253 articles that addressed major disease categories, we found under-representation of publications relative to proportion of disease burden for the two most significant causes: NCDs (54.5% publications vs 72.6% disability adjusted life years (DALYs)) and injuries (0.4% publications vs 12.1% DALYs), in comparison to publications on the third and fourth largest disease burdens, RMNCH and nutrition (30.4% publications vs 8.6% DALYs) and CDs (14.6% publications vs 6.7% DALYs) which were over-represented. Although most disease category articles were on NCDs, the majority of NCD articles addressed mental health of refugees. Only 165 articles addressed populations within the DPRK and among these, we found publication gaps on social and environmental determinants of health, CDs, and NCDs. Conclusion There are gaps in the public health literature on the DPRK. Future research should focus on under-studied, significant burdens of disease. Moreover, establishing more precise estimates of disease burden and their distribution, as well as analysis on health systems responses aimed at addressing them, can result in improvements in population health.
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Affiliation(s)
- John J Park
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ah-Young Lim
- Institute for Health and Unification Studies, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyung-Soon Ahn
- Institute for Health and Unification Studies, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Andrew I Kim
- Harvard Medical School, Boston, Massachusetts, USA
| | - Soyoung Choi
- Institute for Health and Unification Studies, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - David Hw Oh
- Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Owen Lee-Park
- University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Sharon Y Kim
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sun Jae Jung
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jesse B Bump
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Rifat Atun
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Hee Young Shin
- Institute for Health and Unification Studies, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kee B Park
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
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Park KB, Roh YH, Lee-Park O, Park S. History of Neurosurgery in Democratic People's Republic of Korea. World Neurosurg 2015; 84:855-9. [PMID: 25827044 DOI: 10.1016/j.wneu.2015.03.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 03/09/2015] [Accepted: 03/11/2015] [Indexed: 10/23/2022]
Abstract
Neurosurgery in Democratic People's Republic of Korea (DPRK) has undergone remarkable progress since its beginning in the 1950s. With the initial support from socialist countries of the Soviet bloc, especially Professor Constantin Arseni of Romania, the nation has consistently produced a number of its own neurosurgeons each year and fostered further advancement by establishing the Korean Neurosurgery Association (DPRK). Despite the recent international collaborative activity for North Korean neurosurgery-namely with Foundation for International Education in Neurological Surgery, World Federation of Neurological Surgeons, and Korean American Medical Association-the sparse exchange of information, knowledge, and surgical skills still remains largely inadequate.
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Affiliation(s)
- Kee B Park
- Department of Neurosurgery, Preah Kossamak Hospital, Phnom Penh, Cambodia.
| | - Young Han Roh
- Department of Neurosurgery, Pyongyang Medical College, Kim Il Sung University, Pyongyang, Democratic People's Republic of Korea
| | | | - Sophie Park
- Department of Neurosurgery, Preah Kossamak Hospital, Phnom Penh, Cambodia
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