• Title/Summary/Keyword: 30 days mortality

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Comparison of mortality between open and closed pelvic bone fractures in Korea using 1:2 propensity score matching: a single-center retrospective study

  • Jaeri Yoo;Donghwan Choi;Byung Hee Kang
    • Journal of Trauma and Injury
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    • v.37 no.1
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    • pp.6-12
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    • 2024
  • Purpose: Open pelvic bone fractures are relatively rare and are considered more severe than closed fractures. This study aimed to compare the clinical outcomes of open and closed severe pelvic bone fractures. Methods: Patients with severe pelvic bone fractures (pelvic Abbreviated Injury Scale score, ≥4) admitted at a single level I trauma center between 2016 and 2020 were retrospectively analyzed. Patients aged <16 years and those with incomplete medical records were excluded from the study. The patients were divided into open and closed fracture groups, and their demographics, treatment, and clinical outcomes were compared before and after 1:2 propensity score matching. Results: Of the 321 patients, 24 were in the open fracture group and 297 were in the closed fracture group. The open fracture group had more infections (37.5% vs. 5.7%, P<0.001) and longer stays in the intensive care unit (median 11 days, interquartile range [IQR] 6-30 days vs. median 5 days, IQR 2-13 days; P=0.005), but mortality did not show a statistically significant difference (20.8% vs. 15.5%, P=0.559) before matching. After 1:2 propensity score matching, the infection rate was significantly higher in the open fracture group (37.5% vs. 6.3%, P=0.002), whereas the length of intensive care unit stay (median 11 days, IQR 6-30 days vs. median 8 days, IQR 4-19 days; P=0.312) and mortality (20.8% vs. 27.1%, P=0.564) were not significantly different. Conclusions: The open pelvic fracture group had more infections than the closed pelvic fracture group, but mortality was not significantly different. Aggressive treatment of pelvic bone fractures is important regardless of the fracture type, and efforts to reduce infection are important in open pelvic bone fractures.

Impact of Socioeconomic Status on 30-Day and 1-Year Mortalities after Intensive Care Unit Admission in South Korea: A Retrospective Cohort Study

  • Oh, Tak Kyu;Jo, Jihoon;Jeon, Young-Tae;Song, In-Ae
    • Acute and Critical Care
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    • v.33 no.4
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    • pp.230-237
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    • 2018
  • Background: Socioeconomic status (SES) is closely associated with health outcomes, including mortality in critically ill patients admitted to intensive care unit (ICU). However, research regarding this issue is lacking, especially in countries where the National Health Insurance System is mainly responsible for health care. This study aimed to investigate how the SES of ICU patients in South Korea is associated with mortality. Methods: This was a retrospective observational study of adult patients aged ${\geq}20$ years admitted to ICU. Associations between SES-related factors recorded at the time of ICU admission and 30-day and 1-year mortalities were analyzed using univariable and multivariable Cox regression analyses. Results: A total of 6,008 patients were included. Of these, 394 (6.6%) died within 30 days of ICU admission, and 1,125 (18.7%) died within 1 year. Multivariable Cox regression analysis found no significant associations between 30-day mortality after ICU admission and SES factors (P>0.05). However, occupation was significantly associated with 1-year mortality after ICU admission. Conclusions: Our study shows that 30-day mortality after ICU admission is not associated with SES in the National Health Insurance coverage setting. However, occupation was associated with 1-year mortality after ICU admission.

Effect of Ecofriendly Pesticides Against Adoxophyes orana (Lepidoptera: Tortrididae) on Tea Tree (Camellia sinensis L.)

  • Lee, Chong Kyu;Kang, Young Min
    • Journal of Forest and Environmental Science
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    • v.30 no.3
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    • pp.301-306
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    • 2014
  • A study was carried out to identify the life cycle of Adoxophyes orana (Lepidoptera: Tortrididae) that inflicts tea tree leaves in Korea and selected three ecofriendly pesticides (Common name for commercial: Essential oil, Nemacatch, and Wormstop in Korean Farmers' Market) of A. orana for pest control. A. orana appeared to follow four life cycle phases a year; each presenting varying developmental periods dependent on seasonal and environmental factors. The fecundity of A. orana female was $24.6{\pm}4.10$ for $1^{st}$, $36.7{\pm}12.77$ for$ 2^{nd}$, and $27.9{\pm}4.22$ for $3^{rd}$ phase during 2011, while it was $65.0{\pm}32.72$, $49.7{\pm}30.27$, $63.8{\pm}27.22$ for corresponding phases during 2012. The average longevity of adult A. orana was 7.72 days. The average number of eggs deposited by each female in this study group was 44.62 with an average of 2.47. In three selected ecofriendly pesticides, the mortality of A. orana on treating with the Essential oil [The essential oil of Chamaecyparis obtuse (100%)] and Nemacatch [Azadirachtin 800-900 ppm (75%)] were 36.67% and 43.33% after 3 days and were 48.30% and 56.67% after 7days, respectively. Besides, the mortality of A. orana on treating with Wormstop [Azadirachtin 500 ppm (5%) and Salannin+Liminoids (95%)] was 61.67% and 78.33% after 3 and 7 days, respectively. Therefore, the application of Wormstop was the most useful to control the diseases caused by A. orana.

Radiologic Findings and Patient Factors Associated with 30-Day Mortality after Surgical Evacuation of Subdural Hematoma in Patients Less Than 65 Years Old

  • Han, Myung-Hoon;Ryu, Je Il;Kim, Choong Hyun;Kim, Jae Min;Cheong, Jin Hwan;Yi, Hyeong-Joong
    • Journal of Korean Neurosurgical Society
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    • v.60 no.2
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    • pp.239-249
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    • 2017
  • Objective : The purpose of this study is to evaluate the associations between 30-day mortality and various radiological and clinical factors in patients with traumatic acute subdural hematoma (SDH). During the 11-year study period, young patients who underwent surgery for SDH were followed for 30 days. Patients who died due to other medical comorbidities or other organ problems were not included in the study population. Methods : From January 1, 2004 to December 31, 2014, 318 consecutive surgically-treated traumatic acute SDH patients were registered for the study. The Kaplan-Meier method was used to analyze 30-day survival rates. We also estimated the hazard ratios of various variables in order to identify the independent predictors of 30-day mortality. Results : We observed a negative correlation between 30-day mortality and Glasgow coma scale score (per 1-point score increase) (hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.52-0.70; p<0.001). In addition, use of antithrombotics (HR, 2.34; 95% CI, 1.27-4.33; p=0.008), history of diabetes mellitus (HR, 2.28; 95% CI, 1.20-4.32; p=0.015), and accompanying traumatic subarachnoid hemorrhage (hazard ratio, 2.13; 95% CI, 1.27-3.58; p=0.005) were positively associated with 30-day mortality. Conclusion : We found significant associations between short-term mortality after surgery for traumatic acute SDH and lower Glasgow Coma Scale scores, use of antithrombotics, history of diabetes mellitus, and accompanying traumatic subarachnoid hemorrhage at admission. We expect these findings to be helpful for selecting patients for surgical treatment of traumatic acute SDH, and for making accurate prognoses.

Effect of Medicinal Plant Extracts on Mealy Bugs (Maconellicoccus hirsutus Green) Affecting Mulberry

  • Govindaiah, Govindaiah;Gayathri, M.C.;Nagaveni, V.
    • International Journal of Industrial Entomology and Biomaterials
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    • v.13 no.2
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    • pp.103-108
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    • 2006
  • Efficacy of aqueous leaf extracts of medicinal plants viz., Eucalyptus globulus, Ocimum sanctum and Piper betle were evaluated against the hatching of eggs, mortality of nymphs and mortality and fecundity of adult mealy bugs (Maconellicoccus hirsutus Green) under in vitro conditions. Totally seven concentrations 1, 5, 10, 20, 50, 70 and 100 percent were tested against mealy bugs. The results revealed that with the increase in the concentration of extracts, there was a corresponding decrease in hatching, nymphal & adult mortality and fecundity in all the extracts tested. The hatching of eggs was minimum at 100 percent concentration in E. globulus (20.00%) followed by O. sanctum (30.42%) and P. betle (36.06%) over control (96.73%). The growth and development of nymphs and adults were adversely affected after the treatment. The nymphs did not attain the adult stage and there was total mortality of nymphs in different treatments. The duration of nymphal stage was reduced by 2-10 days in E. globulus, 1-7 days in O. sanctum and 1-2days P. betle at higher concentrations. However, at lower concentrations it was prolonged by 2-4 days in all the three extracts. At lower concentrations the mortality of adults was on par with the control. Similarly the adult duration was also reduced by 3-4 days at 100 percent concentration and prolonged by 5-6 days at lower concentrations in all the extracts. With the increase in concentrations of the extracts there was decrease in the fecundity of eggs. Thus, the leaf extracts of E. globulus was found to be most effective followed by O. sanctum and P. betle against mealy bugs.

Is aggressive intravenous fluid prescription the answer to reduce mortality in severe pancreatitis? The FLIP study: Fluid resuscitation in pancreatitis

  • Julia McGovern;Samuel J Tingle;Northern Surgical Trainees Research Association (NOSTRA);Stuart Robinson;John Moir
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.4
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    • pp.394-402
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    • 2023
  • Backgrounds/Aims: Acute pancreatitis is an emergency presentation, which can range from mild to life threatening. Intravenous fluids are the cornerstone of management. Although the WATERFALL trial described the optimal fluid rate in mild/moderate pancreatitis, this trial excluded patients with moderate-severe/severe pancreatitis. The aim of this study was to establish clinical practice regarding intravenous fluid administration in acute pancreatitis and assess its effect on mortality. Methods: Prospective multi-centre audit of patients with acute pancreatitis was conducted. Data were collected regarding intravenous fluid administration within 72 hours of admission. The primary outcome was 30-day mortality. Multivariable logistic regression was used to identify predictors of 30-day mortality. Results: Those with severe pancreatitis received more fluid; median 5.7 L versus 4 L in 72 hours (p = 0.003). Participants with severe pancreatitis who died within 30 days received a median of 2,750 mL in the first 24 hours, compared to 4,000 mL in those who survived. The following factors were significant predictors of 30-day mortality: age, Glasgow score, C-reactive protein, ischaemic heart disease, and pancreatitis aetiology. Overall, volume of intravenous fluid was not associated with mortality. However, the effect of intravenous fluid volume on mortality differed significantly depending on pancreatitis severity. In severe pancreatitis, increased volume of intravenous fluid was associated with significant reductions in mortality (odds ratio = 0.655; 0.459-0.936; p = 0.020). Conclusions: In severe pancreatitis, more aggressive fluid prescription was associated with decreased mortality; however, this was not the case in milder disease. Further prospective trials guiding fluid resuscitation in severe pancreatitis are needed, as the impact of fluid on this population appears to differ from that in those with milder disease.

Induction of antiviral mechanisms by interferon-related genes in rock bream (Oplegnathus fasciatus) infected with rock bream iridovirus (RBIV)

  • Myung-Hwa Jung
    • Journal of fish pathology
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    • v.36 no.2
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    • pp.213-228
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    • 2023
  • We evaluated the transcriptional response of interferon (IFN)-related genes in rock bream iridovirus (RBIV)-infected rock bream under high-, low-, or no-mortality conditions induced by different stocking water temperatures. Under the high susceptibility condition (group A, water temperature 26℃, 100% mortality), only the Mx gene was expressed early, with prolonged expression, and with heavy viral loads of approximately 106~107 major capsid protein gene copies/μL from 4 to 10 days post infection (dpi). However, IRF1, IRF3, IRF8, STAT1, ISG15, PKR, Viperin, GVIN1, IFI44, and ISG56 were activated at later time points (8 dpi) and then quickly decreased (10 dpi). For the low susceptibility condition, the water temperature was set at 23℃ for 7 days (group B) and then reduced to 17℃. Group B exhibited a 28% mortality rate, in which persistent and effective antiviral responses were observed for long periods of time. In particular, at 20 and 22 dpi, when virus replication was peaked at approximately 107/μL, the expressions of most of the IFN-related genes (IRF1, IRF3, IRF8, Mx, STAT1, ISG15, PKR, Viperin, GVIN1, IFI44, and ISG56) were significantly higher in group B than in the control group. Moreover, prolonged and higher levels of IRF3 (at least 30 dpi), IRF8 (at least 30 dpi), ISG15 (at least 30 dpi), PKR (at least 28 dpi), Viperin (at least 30 dpi), and IFI44 (at least 30 dpi) were also observed in the recovery stage of infection. Under the no-susceptibility condition at 17℃ (0% mortality), significantly elevated levels of IRF3, Mx, ISG15, and PKR were observed mostly until 20 dpi. The findings indicate that RBIV infection can induce an efficient IFN-mediated antiviral immune response in low- and no-susceptibility conditions. The findings could be valuable for effective control of viral pathogens in fish.

Endoscopic removal of common bile duct stones in nonagenarians: a tertiary center experience

  • Mustafa Jalal;Amaan Khan;Sijjad Ijaz;Mohammed Gariballa;Yasser El-Sherif;Amer Al-Joudeh
    • Clinical Endoscopy
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    • v.56 no.1
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    • pp.92-99
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    • 2023
  • Background/Aims: There are few studies assessed the efficacy and mortality of endoscopic retrograde cholangiopancreatography (ERCP) for the removal of common bile duct (CBD) stones in the elderly aged ≥90 years. We aimed to assess the safety and efficacy of endoscopic removal of CBD stones in nonagenarians. Methods: We retrospectively reviewed ERCP reports for CBD stone removal. The endoscopic and therapeutic outcomes were collected. The length of stay (LOS), the total number of adverse events, and mortality rate were compared between groups. Results: A total of 125 nonagenarians were compared with 1,370 controls (65-89 years old individuals). The mean LOS for nonagenarians was significantly higher than in controls (13.6 days vs. 6.5 days). Completed intended treatment was similar in the nonagenarians and controls (89.8% and 89.5%, respectively). The overall complication rate did not differ between the groups. However, nonagenarians had a higher incidence of post-ERCP pneumonia (3.9%). None of the nonagenarians were readmitted to the hospital within 7 days. Four nonagenarians (3.2%) and 25 (1.8%) controls died within 30 days. Conclusions: Advanced age alone did not affect the decision to perform the procedure. However, prompt diagnosis and treatment of post-ERCP pneumonia in nonagenarians could improve the outcomes and reduce mortality.

The Norwood Operation in Infants with Complex Congenital Heart Disease (복잡 선천성 심기형 환자에서의 Norwood 술식)

  • 박정준;김용진
    • Journal of Chest Surgery
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    • v.30 no.3
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    • pp.263-269
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    • 1997
  • From April 1987 to May 1996, 13 infants underwent a Norwood operation for complex congenital heart diseases including hypoplastic left heart syndrome (n : 7), mitral stenosis with small VSD and subaortic stenosis (n : 1), mitral atresia with ventricular septal defect, coarctation of aorta, and subaortic stenosis (n = 1), interrupted aortic arch with ventricular septal defect and subaortic stenosis (n : 1), tricuspid atresia with transposition of the great arteries (n = 1), and complex double-inlet left ventricle (n : 2). All patients without hypoplastic left heart syndrome were associated wit hypoplasia of ascending aorta and arch. Age at operation ranged from 3 days to 8.7 months (mean 60.6 $\pm$ 71.6 days, median 39 days). The operative mortality( < 30 days) was 46% (6 patients). Late mortality was 15% (2 patients). All operative deaths occured during the Erst 24 hours after the operation as a result of cardiopulmonary bypass weaning failure (5 patients) and sudden hemodynamic instability postoperatively (1 patient). Late death was due to aspiration pneumonia in two cases. There are 5 long-term survivals (39%). Three of them have undergone a two-stage repair with a modified Fontan operation in two and total cavopulmonary shunt in one at 12, 17, 4.5 months after Norwood procedure with no mortality. Two patients have entered a three-stage repair strategy by undergoing a bidirectional cavopulmonary shunt at 3 and 5.5 months after initial operation with 1 operative death. The actuarial survival rate for all patients at the first-stage operation, including hospital deaths and ate death was 30.8% at 1 year. In conclusion, the operative mortality of Norwood operation was relatively high compared to other operation for major cardiac anomalies, continuing experience will lead to an improvement in result.

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Development of the Turnip Aphid, Lipaphis erysimi Kaltenbach (Homoptera: Aphididae), and Test of Insecticidal Efficacy of Some Commercial Natural Products

  • Kim, Dong-Young;Chang, Sung-Kwon;Jeong, Hyung-Uk;Kim, Min-Jee;Kim, Ik-Soo
    • International Journal of Industrial Entomology and Biomaterials
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    • v.16 no.2
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    • pp.93-99
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    • 2008
  • The turnip aphid is a worldwide pest, damaging mainly to crucifers. In order to understand the life parameters of Lipaphis erysimi for the eventual goal of control, the developmental periods, survival rates, lifespan, and fecundity of the species were investigated under five temperature regimes ($15^{\circ}C-35^{\circ}C$). Furthermore, the efficacy of several environment-friendly agricultural materials (EFAMs) that are on the market was subjected to test in order to obtain further accurate information. The developmental period of the turnip aphid nymph was longest at $15^{\circ}C$ as 16.9 days, shortened as temperature goes up to $25^{\circ}C$ (5.4 days), and then somewhat increased at $30^{\circ}C$ (5.9 days), suggesting that the most efficient temperature for nymphal development could be around $25^{\circ}C$. Mortality of the nymphal turnip aphid was obvious at $35^{\circ}C$, whereas it was minimal at other temperature schemes. The longevity of adults shortened as temperature goes up to $30^{\circ}C$. In particular, the maximum lifespan for adults continued for 55 days at $15^{\circ}C$, but shortened to 21 days at $30^{\circ}C$. The total fecundity was 35.7 at $15^{\circ}C$, 81 at $20^{\circ}C$, 64.2 at $25^{\circ}C$, and 6.6 individuals at $30^{\circ}C$, showing the highest fecundity at $20^{\circ}C$. After the turnip aphids were successfully stabilized in indoor environment the insecticidal activity was tested and mortality was determined 12, 24, 36, and 48 hrs after EFAMs are treated. Several on-the-market EFAMs showed more than 90% of insecticidal activity within 24 hrs or 48 hrs, but a few showed less than 90% activity, signifying importance of selection of proper EFAMs.