Journal of The Korean Society of Clinical Toxicology
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v.6
no.2
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pp.91-98
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2008
Purpose: The hypnotic effect of zolpidem is comparable to benzodiazepines, but has less abuse and addiction potential than benzodiazepines, so is one of the most commonly prescribed hypnotics. The frequency of acute zolpidem overdose has increased, but clinical analysis and severity predictors are not known in Korea. Methods: A retrospective evaluation of histories, clinical courses, and laboratory findings of each patient treated from June, 2000, to May, 2006, in a university hospital for acute zolpidem intoxication. Results: We evaluated 30 patients, including 16 co-intoxication cases. Twenty-five patients presented mental alterations but became alert within 2 days. All patients recovered completely. The median zolpidem concentration was 0.9 mg/L (range: $0.2{\sim}7.4\;mg/L$). There was a weak correlation between the amount ingested and zolpidem concentration (r=0.25). None of them presented severe laboratory abnormalities, and these abnormalities did not relate to zolpidem concentration. Conclusion: The clinical progress of acute zolpidem intoxication is mild. We could not predict zolpidem concentration or clinical severity from the amount ingested and could not predict the clinical course from laboratory findings in the emergency department.
Background: As the coronavirus disease 2019 (COVID-19) outbreak continues to evolve, it is crucially important for pediatricians to be aware of the differences in demographic and clinical features between COVID-19 and influenza A and B infections. Purpose: This study analyzed and compared the clinical features and laboratory findings of COVID-19 and influenza A and B infections in children. Methods: This retrospective study evaluated the medical data of 206 pediatric COVID-19 and 411 pediatric seasonal influenza A or B patients. Results: COVID-19 patients were older than seasonal influenza patients (median [interquartile range], 7.75 [2-14] years vs. 4 [2-6] years). The frequency of fever and cough in COVID-19 patients was lower than that of seasonal influenza patients (80.6% vs. 94.4%, P<0.001 and 22.8 % vs. 71.5%, P<0.001, respectively). Ageusia (4.9%) and anosmia (3.4%) were present in only COVID-19 patients. Leukopenia, lymphopenia, and thrombocytopenia were encountered more frequently in influenza patients than in COVID-19 patients (22.1% vs. 8.5%, P=0.029; 17.6% vs. 5.6%, P=0.013; and 13.2% vs. 5.6%, P=0.048, respectively). Both groups showed significantly elevated monocyte levels in the complete blood count (70.4% vs. 69.9%, P=0.511). Major chest x-ray findings in COVID-19 patients included mild diffuse ground-glass opacity and right lower lobe infiltrates. There were no statistically significant intergroup differences in hospitalization or mortality rates; however, the intensive care unit admission rate was higher among COVID-19 patients (2.4% vs. 0.5%, P=0.045). Conclusion: In this study, pediatric COVID-19 patients showed a wide range of clinical presentations ranging from asymptomatic/mild to severe illness. We found no intergroup differences in hospitalization rates, oxygen requirements, or hospital length of stay; however, the intensive care unit admission rate was higher among COVID-19 patients.
Rahmawaty, Setyaningrum;Ramadhani, Farhanah Erwida;Anwar, Innani Kharisma;Puspitasari, Ola;Dewi, Tri Suci Kusuma;Meyer, Barbara J
Nutrition Research and Practice
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v.15
no.6
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pp.761-772
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2021
BACKGROUD/OBJECTIVES: Understanding the factors associated with fish consumption is necessary to determine strategies to improve the fish consumption particularly those high in omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA). The aim of this study was to analyse the correlation between a mother's perspective on fish and actual fish consumption in their children. SUBJECTS/METHODS: Two hundred thirty-one elementary school children grade 3-6 and their mothers in Surakarta were recruited using multi stage random sampling for this study. Data was collected in July and August 2017. A validated questionnaire consisted of 3 topics including knowledge related to the health benefits and organoleptic properties of fish and cooking technique-related attitudes on fish were used to measure the mother's response to the fish properties. A validated food frequency questionnaire and a food picture book of fish specifically designed for the survey were developed and used to assess fish consumption of the children. A χ2 test was used to analyse the correlation between the mothers' perspective on fish and their children's fish consumption. RESULTS: The median fish consumption in children was 65 g/d with fried non-oily or lean fish, e.g., milkfish (locally called Bandeng) and catfish (locally called Lele) were consumed more than oily fish as well as processed fish products. Of all children, 31% met the fish consumption recommended by the Environmental Protection Agency-Food and Drug Administration 2017. There was no relationship between a mother's knowledge related to health benefits, organoleptic properties and cooking technique-related attitude toward fish and her child's fish consumption. CONCLUSIONS: The fish consumption of children is not influenced by their mother's perspective on fish. Nutrition education strategies are warranted to improve fish consumption and maintain the optimal benefits by consuming fish, including fish high in n-3 LCPUFA.
Background: The purpose of this study is to provide the data for discussions related to oral health promotion policies for single-person households by analyzing the status of unmet dental needs and related factors in single-person households in Korea, based on the Anderson model. Methods: The data, obtained from 544 single-person households of those over 20 years old who were targeted for the 6th Korea National Health and Nutrition Examination Survey, were analyzed through a complex sample frequency analysis, complex sample cross analysis (Rao-Scott chi-square test), and complex sample binary logistic regression analysis on a complex sampling design. Results: The most frequently given reason for an unmet dental need among single-person households was economic (52.4%). Factors related to the unmet dental needs of single-person households are smoking, which is a predisposing factor; personal income levels, which are an enabling factor; chewing discomfort; and limited daily activities, which are need factors. Smokers, the high-income group, the chewing-discomfort group, and the limited activity group showed high unmet dental care experience. Smokers had a 2.75 times higher rate of unmet dental care than non-smokers, and the high-income group had a 5.29 times higher rate of unmet dental needs than the median group. The rate of unmet dental needs for the chewing discomfort group was 3.27 times higher than the non-chewing discomfort group, and the limited activity group had a 7.87 times higher rate of unmet dental needs than the non-limited activity group. Conclusion: It is necessary to map out policies designed to help maintain and promote met dental needs considered to be internally heterogeneous to single-person householders, based on the Anderson model.
This study describes the reliability of pragmatic combinations of acupuncture points for lateral epicondylalgia (LE) as prescribed by physiotherapists who were experts in acupuncture. Raters (n = 14; 33-59 years) independently prescribed acupuncture points for 30 simulated human patients with LE who were surveyed via a printed questionnaire. The frequency and cooccurrence of acupuncture points prescribed for patients with lateral epicondylitis were assessed. Absolute agreement and Light's kappa (${\kappa}_{Light}$) with 95% confidence interval (CI) were used to quantify the interrater agreement. Raters prescribed 103 unique acupuncture points in different combinations with a median (min-max) of 5 (0-11) acupuncture points. The most prescribed acupuncture point was LI-11 (297 of 420; 71%), and the most common cooccurring acupuncture points were LI-11 and LI-4 (160 of 420; 38%). The absolute agreement for prescribing the acupuncture points ranged from 70% (point GB-20) to 0% (points LI-10, SP-6, LI-11, GB-34, LI-12, and LI-4). Point LR-3 showed the highest interrater reliability for prescribing the acupuncture points [${\kappa}_{Light}=0.112$, 95% CI = (0.055-0.194)], whereas point LI-4 showed the lowest reliability [${\kappa}_{Light}=-0.003$, 95% CI = (-0.024 to 0.024)]. These findings suggest that pragmatic prescriptions of acupuncture points for LE are unreliable among physiotherapists who are experts in acupuncture. Explicit, high-level evidence-based rules for prescribing and teaching combinations of acupuncture points for LE are warranted.
Seong Ryeong Kang;Yo Han Ahn;Hee Gyung Kang;Naye Choi
Childhood Kidney Diseases
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v.27
no.2
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pp.105-110
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2023
Purpose: To analyze electrocardiograms (ECGs) of patients with a salt-losing tubulopathy (SLT) and to determine the frequency and risk factors for long QT and arrhythmia. Methods: A total of 203 patients aged <19 years with SLT, specifically Bartter syndrome and Gitelman syndrome, who had a 12-lead ECG were included in this retrospective study. We analyzed the presence of an arrhythmia or prolonged corrected QT (QTc) on ECGs obtained for these patients. Demographic and laboratory data were compared between patients with abnormal and normal ECG findings. Results: Out of the 203 SLT patients, 38 (18.7%) underwent electrocardiography and 10 (40.0%) of 25 patients with inherited SLT had abnormal ECG findings, including prolonged QTc and arrhythmias. The abnormal ECG group had significantly lower serum potassium levels than the normal group (median [interquartile range]: 2.50 mmol/L [2.20-2.83] vs. 2.90 mmol/L [2.70-3.30], P=0.036), whereas other serum chemistry values did not show significant differences. The cutoff level for a significant difference in QTc interval was serum potassium level <2.50 mmol/L. One cardiac event occurred in a 13-year-old boy, who developed paroxysmal supraventricular tachycardia and underwent cardiac ablation. No sudden cardiac deaths occurred in this cohort. Conclusions: The incidence of ECG abnormalities in patients with inherited SLT was 40.0%, whereas the ECG screening rate was relatively low (18.7%). Therefore, we recommend ECG screening in patients with inherited SLT, especially in those with serum potassium level <2.50 mmol/L.
Purpose : This retrospective study aims to provide basic data for intervention to improve clinical outcomes and identify the characteristics of the rebound hyperthermia (RHG) and non-rebound hyperthermia (NRHG) groups by checking body temperature in patients with post-cardiac arrest syndrome. Method : The study involved 118 patients who completed target temperature management (TTM) in an acute-care unit. Data were analyzed for frequency, percentages, mean, standard deviation, median, and quartiles, and compared using the chi-squared test and Mann-Whitney U-test. Results : Rebound hyperthermia (RH) was observed in 74 (62.7%) patients, predominantly male (69.5%), with an average age of 64.54 ± 15.98, and a body mass index of 23.22 ± 4.75kg/m2 (overweight). Hypertension (50%) was the most common co-morbidity, followed by diabetes and heart disease (33.1%). Neuron-specific enolase levels were higher in the NRHG 24, 48, and 72 hours after recovery of spontaneous circulation (p = .037, p < .001, p = .008). The APHCHE IV was also higher in the NRHG (p < .001). RH occurred 25.49 (7.28-52.96) hours after TTM completion, lasting for 2 (1-3) hours. Temperature reduction strategies included notifying doctors, administering antipyretics, and nursing intervention, with the latter being the most common at 94.6%. Half of the subjects in the RHG and 77.3% in the NRHG fell into cerebral performance categories 3, 4, and 5 (p = .003). Conclusion : RH is more likely a body mechanism related to CPR and TTM than a result of pathogenic infection. Therefore, we require an active intervention for hyperthermia, and a patient-specific nursing intervention protocol.
Objectives: This study investigated the prevalence and characteristics of comorbid conditions in patients exposed to ionizing radiation and those who were involved in the Soviet-Afghan war. Methods: This study analyzed the frequency and spectrum of morbidity and comorbidity in patients over a long-term period (30-35 years) following exposure to ionizing radiation at the Semipalatinsk nuclear test site or the Chornobyl nuclear power plant, and among participants of the Soviet-Afghan war. A cohort study, both prospective and retrospective, was conducted on 675 patients who underwent comprehensive examinations. Results: Numerical data were analyzed using the Statistica 6 program. The results are presented as the mean±standard deviation, median, and interquartile range (25-75th percentiles). The statistical significance of between-group differences was assessed using the Student t-test and Pearson chi-square test. A p-value of less than 0.05 was considered statistically significant. We found a high prevalence of cardiovascular diseases, including hypertension (55.0%) and cardiac ischemia (32.9%); these rates exceeded the average for this age group in the general population. Conclusions: The cumulative impact of causal occupational, environmental, and ultra-high stress factors in the combat zone in participants of the Soviet-Afghan war, along with common conventional factors, contributed to the formation of a specific comorbidity structure. This necessitates a rational approach to identifying early predictors of cardiovascular events and central nervous system disorders, as well as pathognomonic clinical symptoms in this patient cohort. It also underscores the importance of selecting suitable methods and strategies for implementing treatment and prevention measures.
Nelson Luis Cahuapaza-Gutierrez;Renzo Pajuelo-Vasquez;Cristina Quiroz-Narvaez;Flavia Rioja-Torres;Maria Quispe-Andahua;Fernando M. Runzer-Colmenares
Clinical and Experimental Vaccine Research
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v.13
no.1
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pp.42-53
/
2024
Purpose: Conduct a systematic review of case reports and case series regarding the development of acute abdomen following coronavirus disease 2019 (COVID-19) vaccination, to describe the possible association and the clinical and demographic characteristics in detail. Materials and Methods: This study included case report studies and case series that focused on the development of acute abdomen following COVID-19 vaccination. Systematic review studies, literature, letters to the editor, brief comments, and so forth were excluded. PubMed, Scopus, EMBASE, and Web of Science databases were searched until June 15, 2023. The Joanna Briggs Institute tool was used to assess the risk of bias and the quality of the study. Descriptive data were presented as frequency, median, mean, and standard deviation. Results: Seventeen clinical case studies were identified, evaluating 17 patients with acute abdomen associated with COVID-19 vaccination, which included acute appendicitis (n=3), acute pancreatitis (n=9), diverticulitis (n=1), cholecystitis (n=2), and colitis (n=2). The COVID-19 vaccine most commonly linked to acute abdomen was Pfizer-BioNTech (messenger RNA), accounting for 64.71% of cases. Acute abdomen predominantly occurred after the first vaccine dose (52.94%). All patients responded objectively to medical (88.34%) and surgical (11.76%) treatment and were discharged within a few weeks. No cases of death were reported. Conclusion: Acute abdomen is a rare complication of great interest in the medical and surgical practice of COVID-19 vaccination. Our study is based on a small sample of patients; therefore, it is recommended to conduct future observational studies to fully elucidate the underlying mechanisms of this association.
The increasing atmospheric imbalance caused by climate change leads to an elevation in precipitation, resulting in a heightened frequency of flooding. Consequently, there is a growing need for technology to detect and monitor these occurrences, especially as the frequency of flooding events rises. To minimize flood damage, continuous monitoring is essential, and flood areas can be detected by the Synthetic Aperture Radar (SAR) imagery, which is not affected by climate conditions. The observed data undergoes a preprocessing step, utilizing a median filter to reduce noise. Classification techniques were employed to classify water bodies and non-water bodies, with the aim of evaluating the effectiveness of each method in flood detection. In this study, the Otsu method and Support Vector Machine (SVM) technique were utilized for the classification of water bodies and non-water bodies. The overall performance of the models was assessed using a Confusion Matrix. The suitability of flood detection was evaluated by comparing the Otsu method, an optimal threshold-based classifier, with SVM, a machine learning technique that minimizes misclassifications through training. The Otsu method demonstrated suitability in delineating boundaries between water and non-water bodies but exhibited a higher rate of misclassifications due to the influence of mixed substances. Conversely, the use of SVM resulted in a lower false positive rate and proved less sensitive to mixed substances. Consequently, SVM exhibited higher accuracy under conditions excluding flooding. While the Otsu method showed slightly higher accuracy in flood conditions compared to SVM, the difference in accuracy was less than 5% (Otsu: 0.93, SVM: 0.90). However, in pre-flooding and post-flooding conditions, the accuracy difference was more than 15%, indicating that SVM is more suitable for water body and flood detection (Otsu: 0.77, SVM: 0.92). Based on the findings of this study, it is anticipated that more accurate detection of water bodies and floods could contribute to minimizing flood-related damages and losses.
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