• Title/Summary/Keyword: Fever management

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Clinical Analysis of Suspected Airway Foreign Bodies in Infants and Children (의증 유소아 기도이물의 임상적 고찰)

  • 안병훈;송달원;최용식;박기철;이근양;김중강
    • Korean Journal of Bronchoesophagology
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    • v.3 no.1
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    • pp.84-93
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    • 1997
  • The bronchoscopy is usually performed in the patients who present symptoms of wheezing, hemoptysis, signs of airway obstruction, unexplained long-term chronic cough with or without radiologic features of pneumonia, emphysema or atelectasis. The symptoms and signs of cases of suspected airway foreign body are of often cofused with those of asthma pneumonia and other respiratory tract disease. The ventilating bronchoscopy will be helpful for removal of certain foreign bodies as well as alleviating medically-unresponsive bronchopulmonary conditions via removing abnormal secretions or merely improving ventilation. The authors have performed clinical analysis of 59 patients who were suspected of airway foreign bodies and treated by ventilating bronchoscopy from September 1985 to February 1995. The results were as follows: 1) Among the 59 cases of bronchoscopy, 51 cases(97%) were under the age of 3. The ratio of male and female was 2.69:1 2) Most common presenting symptom was coughing(84.7%) followed by dyspnea, fever, wheezing and anterior chest pain. 3) Among 39 cases of identified foreign bodies, abnormal findings in the chest X-ray films were found in 33 cases(84.6%) and most common abnormal radiologic feature was pneumonia in 10 cases(25.6%) followed by combination of pneumonia and emphysema, or emphysema alone. All the 20 cases of absent foreign body presented abnormal radiologic features and common findings were pneumonia and atelectasis. 4) Vegetable foreign bodies were the most common form of removed airway foreign bodies(69.2%) followed by metallic foreign bodies(12.8%) and plastic foreign bodies(7.7%). 5) By distribution of the location of foreign bodies, 29 cases(74.4%) were located in the main bronchus( 16 cases of right side and 13 cases of left side), 8 cases were in the trachea and 2 cases were found at the cordal level. 6) By duration of foreign body lodgement in the airway, 9 cases(23.1%) were removed within 7 to 30 days, 10 cases(5.6%) within 3 days and 5 cases(12.8%) were enlodged over 30 days. 7) In the cases of absent foreign bodies, common bronchoscopic findings were mucopurulent or thick mucoid discharge in the main bronchi, erythema or edema of bronchial mucosa and all the cases were improved after ventilating bronchoscopy with concomitant medical management.

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Clinical spectrum and short-term outcomes of multisystem inflammatory syndrome in children in a south Indian hospital

  • Balagurunathan, Muruganantham;Natarajan, Thrilok;Karthikeyan, Jothilakshmi;Palanisamy, Venkateshwaran
    • Clinical and Experimental Pediatrics
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    • v.64 no.10
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    • pp.531-537
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    • 2021
  • Background: Multisystem inflammatory syndrome in children (MIS-C) is a new hyperinflammatory variant that evolved during the coronavirus disease 2019 pandemic. Although the precise pathophysiology of MIS-C is uncertain, it is thought to be due to immune dysregulation occurring after recovery from acute infection. Purpose: Our study aimed to analyze the clinical spectrum, laboratory parameters, imaging characteristics, treatment strategies, and short-term outcomes of children with a diagnosis of MIS-C. Methods: This retrospective and prospective observational study included children less than 16 years of age who were admitted to the pediatric unit of a tertiary care teaching hospital in south India between August 2020 to January 2021 with a diagnosis of MIS-C according to World Health Organization criteria. Results: Twenty-one children were included in the analysis; all had fever with variable combinations of other symptoms. The mean age was 6.9 years; 71.4% were male. Gastrointestinal (80.9%) and cardiovascular (80.9%) systems were the most commonly affected. The majority of children had elevated inflammatory markers, and 16 (76.2%) had echocardiographic abnormalities mimicking Kawasaki disease. Eleven children (52.4%) required intensive care admission, 3 (14.3%) required supplemental oxygen, and 4 (19%) required inotropes. Nine (42.9%) were treated with intravenous immunoglobulin alone, 6 (28.6%) with steroids alone, and 3 (14.3%) with steroids and immunoglobulin. The median hospital stay was 6 days; there were no fatalities. Overweight/obesity, elevated ferritin, and mucocutaneous involvement were significantly associated with a prolonged hospital stay (≥7 days). Sixteen children (76.2%) were followed up till now and all of them had no clinical concerns. Conclusion: MIS-C is an emerging disease with variable presentation. A high index of suspicion is necessary for its early identification and appropriate management. Further research is essential for developing optimal treatment strategies.

Atypical Hemolytic Uremic Syndrome after Traumatic Rectal Injury: A Case Report

  • Kang, Ji-Hyoun;Lee, Donghyun;Park, Yunchul
    • Journal of Trauma and Injury
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    • v.34 no.4
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    • pp.299-304
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    • 2021
  • Atypical hemolytic uremic syndrome (aHUS) is a rare, progressive, life-threatening condition of thrombotic microangiopathy characterized by thrombocytopenia, microangiopathic hemolytic anemia, and renal impairment. The mechanisms underlying aHUS remain unclear. Herein, we present the first case in the literature of aHUS after a traumatic injury. A 55-year-old male visited the emergency department after a traumatic injury caused by a tree limb. Abdominal computed tomography revealed a rectal wall defect with significant air density in the perirectal space and preperitoneum, implying rectal perforation. Due to the absence of intraperitoneal intestinal perforation, we performed diverting sigmoid loop colostomy. An additional intermittent simple repair was performed due to perianal and anal injuries. One day postoperatively, his urine output abruptly decreased and serum creatinine level increased. His platelet level decreased, and a spiking fever occurred after 2 days. The patient was diagnosed with acute renal failure secondary to aHUS and was treated with fresh frozen plasma replacement. Continuous renal replacement therapy (CRRT) was also started for oliguria and uremic symptoms. The patient received CRRT for 3 days and intermittent hemodialysis thereafter. After hemodialysis and subsequent supportive treatment, his urine output and renal function improved. The hemolytic anemia and thrombocytopenia also gradually improved. Dialysis was terminated on day 22 of admission and the patient was discharged after recovery. This case suggests that that a traumatic event can trigger aHUS, which should be considered in patients who have thrombocytopenia and acute renal failure with microangiopathic hemolytic anemia. Early diagnosis and appropriate management are critical for favorable outcomes.

Development of Real-time PCR Assay Based on Hydrolysis Probe for Detection of Epichloë spp. and Toxic Alkaloid Synthesis Genes

  • Lee, Ki-Won;Woo, Jae Hoon;Song, Yowook;Rahman, Md Atikur;Lee, Sang-Hoon
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.42 no.3
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    • pp.201-207
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    • 2022
  • Fescues, which are widely cultivated as grasses and forages around the world, are often naturally infected with the endophyte, Epichloë. This fungus, transmitted through seeds, imparts resistance to drying and herbivorous insects in its host without causing any external damage, thereby contributing to the adaptation of the host to the environment and maintaining a symbiosis. However, some endophytes, such as E. coenophialum synthesize ergovaline or lolitrem B, which accumulate in the plant and impart anti-mammalian properties. For example, when livestock consume excessive amounts of grass containing toxic endophytes, problems associated with neuromuscular abnormalities, such as convulsions, paralysis, high fever, decreased milk production, reproductive disorders, and even death, can occur. Therefore, pre-inoculation with non-toxic endogenous fungi or management with endophyte-free grass is important in preventing damage to livestock and producing high-quality forage. To date, the diagnosis of endophytes has been mainly performed by observation under a microscope following staining, or by performing an immune blot assay using a monoclonal antibody. Recently, the polymerase chain reaction (PCR)-based molecular diagnostic method is gaining importance in the fields of agriculture, livestock, and healthcare given the method's advantages. These include faster results, with greater accuracy and sensitivity than those obtained using conventional diagnostic methods. For the diagnosis of endophytes, the nested PCR method is the only available option developed; however, it is limited by the fact that the level of toxic alkaloid synthesis cannot be estimated. Therefore, in this study, we aimed to develop a triplex real-time PCR diagnostic method that can determine the presence or absence of endophyte infection using DNA extracted from seeds within 1 h, while simultaneously detecting easD and LtmC genes, which are related to toxic alkaloid synthesis. This new method was then also applied to real field samples.

Pig meat production in the European Union-27: current status, challenges, and future trends

  • G. G. Mateos;N. L. Corrales;G. Talegon;L. Aguirre
    • Animal Bioscience
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    • v.37 no.4_spc
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    • pp.755-774
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    • 2024
  • The main objective of this study was to present data on the current situation and future trends of pig meat production in the European Union-27 (EU). Pig production has played an important social and economic role for centuries in many states of the EU. In 2022, pig meat production in the EU reached 23 M tons, which represented 21% of total production worldwide. The two key reasons that justify such amount of pork produced, are the acceptance and high consumption of the meat by the local population and the high quality of the meat produced which facilitated pork export. However, current data show a reduction in pork production for the last three years, as a consequence of a series of events that include i) problems with the chain of ingredients supply, ii) uncontrolled increase in African Swine Fever (ASF) outbreaks, iii) fast recovery of pig production in China, iv) increasing concerns by the rural population on the high cost to meet future requirements of the EU legislation on farm management, environmental sustainability and animal welfare, v) increased cost of all inputs involved in pig production and vi) limited interest of the new farmer generation to work on the pig sector. Consequently, pork production is expected to decrease in the EU for the next years, although sales will be maintained at a relative high level because pork is the meat preferred by local consumers in most EU countries. In order to maintain the favourable position of the pork industry in the near future, strategies to implement include: i) maintain the quality of the meat destinated to export markets, ii) improve the control of outbreaks of ASF and other swine diseases, iii) implementation of technological innovations to improve working conditions making more attractive to work in the pork sector of the food chain to the new generation of farmers and workers.

Clinical Presentation and Prognosis of SARS-CoV-2 Infection in Infants Aged ≤90 Days: Insights for Management During Outbreaks

  • Hye Jeong Moon;Mi Seon Han;Kyung Min Kim;Kyung Jin Oh;Ju Young Chang;Seong Yong Lee;Ji Eun Choi
    • Pediatric Infection and Vaccine
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    • v.30 no.2
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    • pp.84-90
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    • 2023
  • Purpose: Infants aged ≤90 days with fever are susceptible to severe infections. This study aimed to analyze the clinical features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in this particular age group. Methods: Infants aged ≤90 days who were diagnosed with coronavirus disease 2019 (COVID-19) and hospitalized between March 1, 2020, and May 1, 2022 were included. Medical records of patients were retrospectively reviewed. Results: A total of 105 infants with COVID-19 were included; 27 (25.7%) neonates aged <28 days, and 48 (45.7%) and 30 (28.6%) infants aged 28-59 days and 60-90 days, respectively. Five (4.7%) patients remained asymptomatic and 68 (62.8%) were febrile, with a median fever duration of 2 days. The most common symptoms were respiratory including cough (66.6%), nasal stuffiness (51.4%), and rhinorrhea (40.9%). Blood cultures were performed in 10 infants but no organisms were detected. Cultures of bag-collected urine specimens from 8 infants were grown, resulting in positive growth for 2 without pyuria. Nine (8.6%) infants were treated with empirical antibiotics for a median duration of 2.3 days (range, 1-7 days). All 105 infants showed improvement without any complications, and there were no fatal cases. Conclusions: In this study, most infants aged ≤90 days with COVID-19 presented with mild symptoms and none of those evaluated had documented bacterial co-infection. The favorable prognosis among young infants with SARS-CoV-2 may aid clinicians in tailoring their approach to evaluation and management during outbreaks.

An Analysis on Nursing Activity in Oriental Hospital (한방근무 간호사의 업무분석)

  • Kang, Hyun Sook;Cho, Kyoul Ja;Kim, Kwang Joo;Kim, Kwuy Bun;Cho, Mi Young;Suh, Yeon Ok;Shin, Hye Sook;Jeon, Eun Young;Chung, Sook Ja;Lee, Hei Jin
    • The Korean Nurse
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    • v.33 no.5
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    • pp.63-75
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    • 1995
  • The need of oriental nursing role is recently increasing. The implication of this trend is enormous not only for the need of independent of independent oriental nursing intervention. Hence, this study was designed to describe the characteristics of oriental nursing activity and identify the meaning of nursing activity in oriental hospital. A total of 24 nurses were selected by convenience sampling from eight units at one oriental hospital. A total of 168 data were collected using minute-by-minute recording during nurse s work shift. The data were analyzed using nova and scheffe method as post-hoc test The results of this study are as follows; 1. the category of nursing activity in oriental hospital 74.4% of nursing activity was the patient-oriented nursing care. The nursing activity included others (18.28%), the function-oriented nursing care (7.07%), and staff-oriented care (0.2%). 29.1 % of the patient-oriented nursing care was the direct care, and 24. 5 % of the patient-oriented nursing care was the indirect care. There was a lack of patient education and the communication patient. 2. Nursing activity in oriental hospital by characteristics 1) Nursing activity by unit For patient-oriented nursing care, there was a statistically significant difference among 8 units. In the critical care unit, the patient-oriented nursing care was mostly performed. For function-oriented nursing care, there was statistically significant difference among 8 units. In the physical therapy unit, the function-oriented nursing care was mostly performed. 2) Nursing activity in oriental hospital For all kinds of nursing activity, there was a statistically significant difference between shifts. In night shift patient-oriented nursing care, function-oriented nursing care, and other kinds of nursing care was mostly performed. Patient-oriented nursing care included indirect care, treatment set management, and the breaktime. In day shift, staff-oriented nursing care was performed. 3) Nursing activity in oriental hospital For all kinds of nursing activity, there was not a statistically significant difference by day. The day has not impact on nursing activity. 3. the meaning of activity in oriental hospital The results of this study show that the patient-oriented care was vital check, input! output check, medication, bedsore prevention, nasogastric feeding, oral care, catheterization care, perinatal care, nursing care associated with acupuncture and moxacautery, observation (fever, sweating), heat and cold application communication with patent and family, and patient room management In conclusion, two issues associated with the findings of the research appeated to be involved in the difficulty of nursing activity in hospital. The first issue was the nursing care in oriental hospital provided by nurses who have a limited understading of the principles of oriental medicine. The second issue was the deficiency of systematic guideling for oriental nursing activity. The findings suggest the need to develop the systematic guideline for oriental nursing activity. The need of continuing education for nurses who work in the oriental hospital, and the need of nursing education including oriental nursing are critical.

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A Study on the Physician's Behavior of Notifiable Communicable Diseases Reporting and its Characteristics Related (법정전염병 신고행태 및 관련특성 연구)

  • 이윤현;맹광호
    • Health Policy and Management
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    • v.9 no.4
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    • pp.41-64
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    • 1999
  • The major concern for this research is to discuss and to offer some solutions to bring the effectiveness of existing notifiable diseases reporting system over the physicians' attitudes of reporting, the actual condition of performance and the reasons of inertia in notifiable diseases reporting through examining the physicians of medical institutions in nationwide such as pediatrics, internal medicine and family medicine. The actual conditions of notifiable communicable diseases(NCD) reporting was surveyed by mail objectifying an internal medicine, pediatrics and family medicine in nationwide on the basis of stratified random sampling method divided into the classification of medical institutions and areas. As a result of survey. the rate of respondents showed 145 persons from physicians, 105 persons from hospitals. 120 persons from general hospitals, and 51 persons from tertiary hospitals. The total number of respondents were 421 and was rated 59.0 %. The analysis of collected survey went through a descriptive analysis primarily to grasp physicians' attitudes on the notifiable communicable diseases reporting, and then upon the dependent variables. Following are major findings obtained form the data analysis. 1. The results of a descriptive analysis on physicians' attitudes towards reporting NCD were as follows: First, the respondents who didn't know that yellow fever is reporting NCD were 11.0% of clinic, 10.5% of hospital. 5.0% of general hospital. 11.8% of tertiary hospital. and in case of hepatitis B, were 26.9% of clinic, 35.2% of hospital. 35.0% of general hospital. 23.5% of tertiary hospital. Second, The rate of physicians' knowledge on penalties of not reporting the NCD by their medical institution were 35.2% of clinic, 45.7% of hospital. 36.7% of general hospital. 62.7% of tertiary hospital. Third, among the no-reporting physicians in whole, the major reason of not reporting NCD were uncertainty of diagnosis(78.9%), no need to report(46.4%), no adequate actions from PHC(29.1%), no knowledge of the cases being notifiable ones in the order of their frequencies(30.4%), meddling from PHC(29.1%), concerning of patient's privacy(26.3%). 2. To analyze the characteristics related to the physicians' behaviors to report NCD, univariate and multiple logistic regression analyses were applied to the variables related to physician, 4 medical facility, PHC, and reporting system. The result were as follows: First, the result of the univariate analysis on physicians' attitude to report NCD and characteristics related to reporting in odds ratio was in the case of hospital. 3.4 times higher positive responses on physicians' attitude to report NCD came up as compared to the clinic. Second, the result of the univariate analysis on physicians' action of reporting NCD and characteristics related to reporting by the classification of medical institutions showed that the odds ratio of hospital was 2.3 times, the odds ratio of general hospital was 2.0 times, the odds ratio of tertiary was 6.8 times significantly higher than clinic. And the medical institution with significantly higher positive attitudes rate by multiple logistic regression analysis was hospital that rated 2.5 times significantly higher than clinic. Also in the PHC related characteristics of reporting, the rate of action in reporting NCD was significantly higher in medical institution that were endowed with the good condition of reporting. In multiple logistic regression analysis, the medical institution that has a good conditions of reporting showed a significantly higher positive rate on the action of reporting than the others.

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A Clinical Review of Broncholithiasis (기관지 결석증의 임상적 고찰)

  • Won, Jun-Hee;Cha, Seung-Ick;Park, Jun-Ku;Kim, Chang-Ho;Park, Jae-Yong;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.677-684
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    • 1995
  • Background: Broncholithiasis is uncommon but clinically important because it may cause a variety of nonspecific symptoms and signs prior to the onset of lithoptysis, and rarely massive hemoptysis. Method: A retrospective clinical study was done on 11 case of broncholithiasis diagnosed at Kyungpook National University Hospital from Jan. 1985 to Dec. 1993. The study investigated the clinical features, radiologic findings, bronchoscopic findings and management. Results: 1) The common symptoms included cough, dyspnea, hemoptysis, fever and purulent sputum. Lithoptysis occurred in 3 patients. 2) The radiologic findings were variable and nonspecific. Hilar calcification and parenchymal calcification were the most common findings. 3) The bronchoscopy was performed in 10 patients and revealed broncholiths in 9 patients. 4) Chemical composition of broncholiths was analyzed in 2 patients. Calcium carbonate was main component. 5) In 6 out of 9 patients in whom broncholiths was revealed by bronchoscopy, broncholiths were successfully extracted through the flexible bronchoscope. 6) In 9 patients, broncholithiasis was related to tuberculosis and in 1 case, related to silicosis. Conclusion: Broncholithiasis shows a variable clinical spectrum. Tuberculosis is the most common cause of broncholithiasis. In the case of no accompanied complication, nonsurgical management such as bronchoscopic removal and conservative therapy is an effective measure.

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An Epidemiological Analysis of 28 Vivax Malaria Cases in Gimpo-si, Korea, 2020

  • Bahk, Young Yil;Cho, Shin-Hyeong;Kim, Kyoung-Nam;Shin, Eun-Hee;Jeon, Byoung-Hak;Kim, Jeong-Hyun;Park, Sookkyung;Kwon, Jeongran;Kan, Hyesu;Kim, Miyoung;Kim, Tong-Soo
    • Parasites, Hosts and Diseases
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    • v.59 no.5
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    • pp.507-512
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    • 2021
  • Since 1993, vivax malaria has been recognized as a public health burden in Korea. Despite of pan-governmental malaria-control efforts and the dramatic reduction in the burden of this disease over the last 10 years, vivax malaria has not been well controlled and has remained continuously endemic. We focused interviewed and examined the charts of 28 confirmed vivax malaria patients given malarial therapy for whom daily records were kept from Gimpo-si, Gyeonggi-do of Korea. Various epidemiological characteristics of vivax malaria, including the incubation period, medication used, and recurrence, and an evaluation of the parasitic characteristics from the focused interviews of patients from this region are described here. Most of the participants indicated the 3 most common symptoms of malaria (headache, chills and fever). Of the 28 cases, 2 experienced a second attack and there were 17 and 11 cases with short- and long-term incubation periods, respectively, yielding a short-term to long-term ratio of 1.5. Based on the parasitemia stages, most of the participants were tested at 5 to 7 days (11 cases) and 7 to 15 days (11 cases) after initial wave of asexual parasites. In conclusion, public health authorities should consider developing management measures to decrease the time lag for diagnosis and drafting unified and robust guidelines for drug use for malaria and drawing up unified and robust guidelines on the use of medication for malaria. It also suggests that routine monitoring, surveillance, and precise medical surveys in high-risk vivax malaria endemic areas are pivotal to controlling this persistent public disease and finally eliminating it from Korea.