• Pediatric Infection and Vaccine
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• v.29 no.1
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• pp.1-15
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• 2022

Coronavirus disease 2019 (COVID-19) presents as a mild-to-moderate respiratory illness in most children. However, a small proportion of children with COVID-19 develop severe or critical illnesses. Although pediatric clinical trials for the treatment of COVID-19 are sparse, some drugs are available for children and adolescents with severe COVID-19. This review summarizes clinical data focusing on antiviral agents and immunomodulators for use in treating COVID-19. In addition, current recommendations for therapeutics for children and adolescents with COVID-19 are discussed.

• Mood & Emotion
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• v.16 no.3
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• pp.129-133
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• 2018

Objectives : The fourth revision of Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was performed in 2018, to provide newer guidelines for clinicians. In this section, we examined expert opinions to facilitate clinical decisions relative to treating bipolar disorder with medical comorbidity. Methods : The survey was completed by the review committee, consisting of 61 experienced psychiatrists. This part of the survey constitutes treatment strategies, under major medical comorbidities. The executive committee analyzed results, and discussed the final production of algorithm. Results : Aripiprazole was the first-line medication for bipolar patients with metabolic syndrome, cardiovascular, hepatic, renal, and cerebrovascular comorbidities. Ziprasidone also was recommended as the first-line medication in case of metabolic syndrome. Lithium also was regarded as the first-line medication, in case of hepatic problems. Valproate also was considered as the first-line medication, in case of cerebrovascular problems. Conclusion : This study provided the most recent consensus among experts, for treatment of bipolar disorder with physical problems.

• Journal of Medicine and Life Science
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• v.15 no.2
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• pp.108-111
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• 2018

Extra-corporeal membrane oxygenation (ECMO) has the potential to rescue patients in cardiac arrest or respiratory failure. ECMO has two systems such as veno-arterial and veno-venous circulation. In cardiac arrest resulting from acute myocardial infarction, veno-arterial ECMO is mandatory for systemic circulation and oxygenation. A 75-year old female patient underwent primary coronary intervention for acute myocardial infarction. Despite successful revascularization, recurrent ventricular tachycardia and heart failure were progressing. We performed a veno-arterial ECMO through the femoral artery and vein, then the patient seemed to be stable clinically. However, laboratory studies, echocardiography, and vital signs indicated multi-organ failure and decreasing cardiac function. We found out an error that we performed veno-venous ECMO instead of veno-arterial ECMO. We added a femoral artery cannula and exchange the circuit system to veno-arterial ECMO. While the systemic circulation seemed to be recovered, the left ventricular function was decreased persistently. A hypovolemia resulting from pulmonary hemorrhage was occurred, which lead to ECMO failure. The patient died of cardiac arrest and multi-organ failure 23 hours after ECMO. Because the color of arterial and venous circuits represent the position and efficacy of ECMO, if unexpected or abnormal circuit colors are detected, prompt and aggressive evaluation for ECMO function is mandatory.

• Mood & Emotion
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• v.16 no.3
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• pp.123-128
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• 2018

Objectives : The fourth revision of Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was performed to provide more proper guidelines for clinicians. In this study, we evaluated treatment strategies of elderly patients with bipolar disorders of KMAP-BP 2018. Methods : Sixty-one psychiatrists of the review committee with vast clinical experiences in treating bipolar disorders, completed the survey. An expert consensus was obtained, on pharmacological treatment strategies for elderly patients with bipolar disorder. The executive committee analyzed results, and discussed the results to produce the final algorithm. Results : In elderly patients with bipolar disorder, first-line treatment option for acute manic episode is monotherapy, with atypical antipsychotics or mood stabilizer, and a combination of mood stabilizer and atypical antipsychotics. First-line treatment option for acute depressive episode, was a combination of mood stabilizer and atypical antipsychotics, monotherapy with atypical antipsychotic or mood stabilizer, and atypical antipsychotics with lamotrigine. Conclusion : In KMAP-BP 2018, the recommendation for treatment option in elderly patients with bipolar disorder, was newly introduced. We expect this algorithm may provide valuable information, and facilitate treatment of elderly patients with bipolar disorder.

• Journal of Korean Clinical Nursing Research
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• v.27 no.3
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• pp.257-266
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• 2021

Purpose: This study examined the levels of traumatic event experience, self disclosure, social support, and posttraumatic growth of intensive care unit nurses and their relationships. Methods: Participants were 142 nurses who had worked for more than 3 months in six general hospitals, J province from August 7 to September 25, 2020. Collected data were analyzed using descriptive statistics, independent t-test, ANOVA, Pearson's correlation coefficient, and multiple regression using the program SPSS version 22.0. Results: The posttraumatic growth was found to correlate significantly with self disclosure (r=.23, p=.005), individual support (r=.54, p<.001), and organizational support (r=.32, p<.001). Factors influencing the participants of the posttraumatic growth were individual support (β=.46, p<.001) and organizational support (β=.21, p=.007). These factors explained 32.0% of the variance of ICU nurses' posttraumatic growth (F=14.13, p<.001). Conclusion: Efforts to support positive changes after traumatic event experience for ICU nurses are needed. We suggest to develop individual and organizational supportive programs for posttraumatic growth for ICU nurses and to investigate the effects of the programs.

• Anxiety and mood
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• v.18 no.1
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• pp.26-31
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• 2022

Objective : The levels of resilience and gratitude were examined in psychiatric patients with depression and/or anxiety disorders and compared to those of the general population. In addition, we analyzed the associations of positive affect, negative affect, depressive and anxiety symptoms, and gratitude on resilience in this patient population. Methods : The participants included a general population sample (n=155) and psychiatric outpatients with depression and/or anxiety disorders (n=108). All participants completed self-report questionnaires, which included demographic variables, the Connor-Davidson Resilience Scale (CD-RISC), the Gratitude Questionnaire-Six-Item Form (GQ-6), the Positive Affect Negative Affect Scale (PANAS), and the Hospital Anxiety and Depression Scale (HADS). Results : The CD-RISC and GQ-6 scores of patients with depression and/or anxiety disorders were significantly lower than those of the general population. In the patient population, hierarchical regression analysis showed that gratitude was significantly associated with resilience while controlling for a range of demographic and clinical variables. Conclusion : Patients with depression and/or anxiety disorder generally had lower resilience and gratitude. Moreover, our findings showed that gratitude could influence the levels of resilience in patients with depression and/or anxiety disorders.

• Journal of Korean Critical Care Nursing
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• v.12 no.1
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• pp.13-21
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• 2019

Purpose : The aim of this study was to identify the factors influencing nursing performance in caring for patients with delirium. Methods: This study included 166 nurses who worked for more than 6 months at 4 general hospitals in Jeju Province, South Korea. Patients were administered a self-reported questionnaire. The study was carried out from May 20, 2014, to June 19, 2014. Data analyses were conducted using stepwise multiple regression, Pearson's correlation coefficients, t-test, and analysis of variance using the SAS WIN 9.2 program (SAS Institute, Cary, NC, USA). Results: The factors associated with nurses' performance in delirium care were work position (${\beta}=.22$, t=2.58, p <.001) and having received education on delirium care (${\beta}=.16$, t=2.24, p=.026). Conclusion: The results showed that the nurses' work position and having received education on delirium care affected nursing performance in delirium care. In order to improve nurses' performance in delirium care, hospitals should provide a delirium education program for nurses and establish standard guidelines on delirium care.

• Journal of Medicine and Life Science
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• v.18 no.1
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• pp.1-10
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• 2021

Omega-3 fatty acids (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) may be beneficial for the primary and secondary prevention of cardiovascular events (CVEs), especially in patients with myocardial infarction or heart failure with reduced ejection fraction. For this purpose, one to two seafood meals per week is preferentially recommended. Omega-3 fatty acids with a high-dose EPA formula (4 g/day) may be more effective than EPA+DHA mixed supplements for the secondary prevention of CVE. Krill oil also contains omega-3 fatty acids, but at a much lower dose compared to fish oil. Supplemental vitamins and minerals have not shown the preventive effects on CVE in prospective, and randomized clinical trials, except for one Chinese study showing the stroke prevention effects of folic acid. The clinical benefit of chelation therapy in reducing CVEs is uncertain.

• Journal of Medicine and Life Science
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• v.15 no.2
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• pp.56-61
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• 2018

Advances in medical technology has enabled better management of complicated and chronic wounds. Negative-pressure wound therapy (NPWT) is a novel dressing technique that uses negative pressure to drain exudates and blood from wounds. NPWT increases local blood flow and promotes reduction of edema and wound healing and is suitable for a variety of wounds. It is associated with few adverse effects and shows excellent efficacy and cost-effectiveness. NPWT promotes rapid growth of granulation tissue and wound contraction; thus, it is more advantageous than general dressings as it reduces the size skin of grafts or flaps required for repair, and patients with chronic wounds can be treated as outpatients. We investigated the general usage and mechanism of NPWT, its clinical applications and adverse effects.

• Journal of Medicine and Life Science
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• v.18 no.1
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• pp.20-23
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• 2021

Methemoglobin is generated by the oxidation of ferrous iron to ferric iron within a hemoglobin molecule. Methemoglobin is unable to bind and transport oxygen, resulting in methemoglobinemia, which can lead to fatal tissue hypoxia. The most common cause of methemoglobinemia is poisoning by oxidizing agents such as dapsone, benzocaine, and primaquine. However, methemoglobinemia can also be caused by normal dietary sources. We present two cases of methemoglobinemia that developed after a normal diet in two male patients. In this case report, the patients suddenly developed dyspnea and cyanosis after eating the same meal. They had no history of suspected poisoning, such as the use of drugs, exposure to chemicals, or gas inhalation. Their symptoms did not improve even after a high dose of oxygen was administered; further, an abnormal 'oxygen saturation gap' was observed. Because of CO-oximetry, the methemoglobin levels of the patients were 50.0% and 46.6%, respectively. We administered methylene blue (1 mg/kg), and the patients recovered completely without any complications. Emergency physicians should, therefore, be aware that methemoglobinemia can also be caused by normal dietary sources. In addition, if the source and route of contamination are unclear, an epidemiological investigation should be conducted.