• Tuberculosis and Respiratory Diseases
• /
• 제84권4호
• /
• pp.299-316
• /
• 2021

Background: The lack of effective medications for coronavirus disease 2019 (COVID-19) has led to a trend of drug repurposing such as the case of azithromycin which shows immunomodulatory and anti-viral effect. Several clinical trials have shown conflicting results. It is currently unclear whether the available evidence is in favor or against the use of azithromycin in COVID-19 patients. Thus, the aim of this study was to investigate the efficacy and safety of azithromycin in COVID-19 patients. Methods: Four independent reviewers selected relevant studies from PubMed, ScienceDirect, EBSCO, and ProQuest published prior to March 2021. The protocol used in this study has been registered in PROSPERO (CRD42020224967). Results: We included 17 studies and found that the mortality rate (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.76-1.19), need of respiratory support (OR, 1.30; 95% CI, 0.98-1.73), hospitalization rate (standardized mean difference, 0.12; 95% CI, -0.02 to 0.27), and intensive care unit transfer (OR, 1.21; 95% CI, 0.79-1.86) of azithromycin-treated group did not differ significantly (p>0.05) from those of the control group. Azithromycin treatment did not significantly increase the risk of getting secondary infection (OR, 1.23; 95% CI, 0.83-1.82), hypoglycemia (OR, 0.73; 95% CI, 0.38-1.40), gastrointestinal problems (OR, 1.03; 95% CI, 0.73-1.45) or electrocardiogram abnormalities (OR, 1.16; 95% CI, 0.94-1.42). The overall quality of evidence ranged from low to very low. Conclusion: Azithromycin did not result in a superior clinical improvement in COVID-19 patients, although it was well-tolerated and safe to use.

• 대한종양외과학회지
• /
• 제14권2호
• /
• pp.135-141
• /
• 2018

Purpose: Axillary lymph node dissection (ALND) and sentinel lymph node biopsy (SLNB) are important for staging of patients with node-positive breast cancer. However, these can be avoided in select micrometastatic diseases, preventing postoperative complications. The present study evaluated the ability of axillary lymph node maximum standardized uptake value (SUVmax) on positron emission tomography-computed tomography (PET-CT) to predict axillary metastasis of breast cancer. Methods: The records of invasive breast cancer patients who underwent pretreatment (surgery and/or chemotherapy) PET-CT between January 2006 and December 2014 were reviewed. ALNs were preoperatively evaluated by PET-CT. Lymph nodes were dissected by SLNB or ALND. SUVmax was measured in both the axillary lymph node and primary tumor. Student t-test and chi-square test were used to analyze sensitivity and specificity. Receiver operating characteristic (ROC) and area under the ROC curve (AUC) analyses were performed. Results: SUV-tumor (SUV-T) and SUV-lymph node (SUV-LN) were significantly higher in the triple-negative breast cancer (TNBC) group than in other groups (SUV-T: 5.99, P<0.01; SUV-LN: 1.29, P=0.014). The sensitivity (0.881) and accuracy (0.804) for initial ALN staging were higher in fine needle aspiration+PET-CT than in other methods. For PET-CT alone, the subtype with the highest sensitivity (0.870) and negative predictive value (0.917) was TNBC. The AUC for SUV-LN was greatest in TNBC (0.797). Conclusion: The characteristics of SUV-T and SUV-LN differed according to immunohistochemistry subtype. Compared to other subtypes, the true positivity of axillary metastasis on PET-CT was highest in TNBC. These findings could help tailor management for therapeutic and diagnostic purposes.

• 대한두경부종양학회지
• /
• 제37권2호
• /
• pp.33-41
• /
• 2021

Background/Objectives: Extra-nodal extension (ENE) is one of the strongest prognosticators in oral cancers. Here we tried to evaluate clinicopathological factors associated with the presence of ENE. Materials & Methods: We retrospectively analyzed clinical information of 120 patients who diagnosed with oral cancer and received curative surgery at our hospital from Mar 2012 to Apr 2020. We comparatively analyzed clinicopathological factors associated with the presence of lymph node (LN) metastasis and ENE, respectively. Results: Variable factors of primary tumor characteristics such as lymphovascular invasion, perineural invasion, largest diameter of tumor, depth of invasion and maximum standardized uptake value were significantly associated with the presence of cervical LN metastasis. The largest diameter of tumor was statistically significant also in multivariate analysis for predicting the LN metastasis. Meanwhile, the association between primary tumor characteristics and the presence of ENE were not statistically significant except the primary tumor size. Importantly, factors associated with LN characteristics including the maximum diameter and number of metastatic LNs were significantly associated with ENE. Conclusion: In this study, several factors affecting cervical LN metastasis and ENE in oral cancer patients were identified. The ENE seems to be influenced by the status of the metastatic LNs, such as the number of metastatic LNs, rather than the characteristics of the primary tumor itself.

• 임상간호연구
• /
• 제28권2호
• /
• pp.167-176
• /
• 2022

Purpose: Driveline infection (DLI) is one of the major adverse events of Left Ventricular Assist Device (LVAD). The purpose of this study was to explore the incidence of DLI according to the driveline dressing methods. Methods: This study was a retrospective cohort study that investigated the medical records of 75 patients who implanted LVAD from January 2015 to December 2020 at a hospital in Seoul, Korea. Traditionally, sandwich dressing method was applied until October 2019, after which newly winded dressing method was adopted for driveline dressing to LVAD patients. The outcome variables were compared between sandwich dressing method applied group (n=41) and winded dressing method applied group (n=34). The follow-up period for DLI was 1 year. Results: When compared participants' characteristics, there was no difference between the two groups, except the type of LVAD device. The incidence of DLI was 17.1% in sandwich dressing group, while no infection was found in winded dressing group (p=.011). Conclusion: Although there were difference in the LVAD devices, it is considered that winded dressing contributed to the reduction of DLI. Further research on standardized dressing methods was required for DLI prevention in Korea.

• Journal of Korean Biological Nursing Science
• /
• 제25권3호
• /
• pp.143-159
• /
• 2023

Purpose: The purpose of this study was to provide evidence for future research by analyzing the contents, delivery methods, and educational effects of educational programs for hemodialysis patients. Methods: A literature review was conducted in the following order: problem identification, literature search and data collection, data evaluation, data analysis, and data presentation. In total, 936 documents were retrieved from the search, and 24 documents were finally included in this study. Results: The contents of the educational programs were comprehensive hemodialysis-related knowledge education in seven studies, exercise-related education in 10 studies, diet-related education in four studies, drug-related education in one study, and complex education in two studies. The delivery methods were pamphlets in six studies, audio-visual materials in four studies, direct guidance by researchers in six studies, and multiple methods in seven studies. The effects of the educational program were divided into physical indicators, emotional indicators, and knowledge and performance related to hemodialysis. Sixteen out of 20 articles using physical indicators showed significant outcomes, and 10 out of 12 articles using emotional indicators derived positive results. Hemodialysis-related knowledge and performance were measured in eight and 10 studies, respectively, and meaningful results were found in six studies for knowledge and seven studies for performance. Conclusion: Future research will require the development of a systematic and standardized educational program with comprehensive content that can be provided to all hemodialysis patients, as well as a highly accessible education delivery method to enhance the effectiveness of education.

• Journal of Trauma and Injury
• /
• 제36권3호
• /
• pp.231-241
• /
• 2023

Purpose: Overtriage and undertriage rates are critical metrics in trauma, influenced by both trauma team activation (TTA) criteria and compliance with these criteria. Analysis of undertriaged patients at a level I trauma center revealed suboptimal compliance with existing criteria. This study assessed triage patterns after implementing compliance-focused process interventions. Methods: A physician-driven, free-text alert system was modified to a nonphysician, hospital dispatcher-guided system. The latter employed dropdown menus to maximize compliance with criteria. The preintervention period included patients who presented between May 12, 2020, and December 31, 2020. The postintervention period incorporated patients who presented from May 12, 2021, through December 31, 2021. We evaluated appropriate triage, overtriage, and undertriage using the Standardized Trauma Assessment Tool. Statistical analyses were conducted with an α level of 0.05. Results: The new system was associated with improved compliance with existing TTA criteria (from 70.3% to 79.3%, P=0.023) and decreased undertriage (from 6.0% to 3.2%, P=0.002) at the expense of increasing overtriage (from 46.6% to 57.4%, P<0.001), ultimately decreasing the appropriate triage rate (from 78.4% to 74.6%, P=0.007). Conclusions: This study assessed a workflow change designed to improve compliance with TTA criteria. Improved compliance decreased undertriage to below the target threshold of 5%, albeit at the expense of increased overtriage. The decrease in appropriate triage despite compliance improvements suggests that the current criteria at this institution are not adequately tailored to optimally balance the minimization of undertriage and overtriage. This finding underscores the importance of improved compliance in evaluating the efficacy of TTA criteria.

• Journal of Korean Biological Nursing Science
• /
• 제26권1호
• /
• pp.1-15
• /
• 2024

Purpose: This study aimed to evaluate the effectiveness of exercise in patients with hemophilia. Methods: We carried out a systematic review and meta-analysis in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. A literature search was conducted of published randomized controlled trials for exercise interventions from January 1, 2014 to March 15, 2023. To estimate the size of the effects of exercise, a meta-analysis was performed using the R package "meta." Results: Five databases were searched to obtain articles published in Korean or English. Of 1,150 articles reviewed, 13 were included in the systematic review and 9 in the meta-analysis. The risk of bias was assessed using RoB 2.0. The overall effect sizes of exercise interventions, calculated as the standardized mean difference, were -0.11 (95% confidence interval [CI] = -1.41 to -1.20) for pain, -2.13 (95% CI = -3.33 to -0.93) for joint health, 9.96 (95% CI = 7.51 to 12.28) for physical activity, and 0.59 (95% CI = -0.39 to -1.56) for quality of life. Conclusion: These findings suggest that exercise is useful for improving the joint health and physical activity of patients with hemophilia. Thus, it is necessary to develop and apply exercise interventions for patients with hemophilia to reduce their pain and improve their quality of life.

• Journal of Yeungnam Medical Science
• /
• 제41권2호
• /
• pp.86-95
• /
• 2024

Background: This study aimed to investigate the impact of coronavirus disease 2019 (COVID-19) on the development of major mental disorders in patients visiting a university hospital. Methods: The study participants were patients with COVID-19 (n=5,006) and those without COVID-19 (n=367,162) registered in the database of Keimyung University Dongsan Hospital and standardized with the Observational Medical Outcomes Partnership Common Data Model. Data on major mental disorders that developed in both groups over the 5-year follow-up period were extracted using the FeederNet computer program. A multivariate Cox proportional hazards model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for the incidence of major mental disorders. Results: The incidences of dementia and sleep, anxiety, and depressive disorders were significantly higher in the COVID-19 group than in the control group. The incidence rates per 1,000 patient years in the COVID-19 group vs. the control group were 12.71 vs. 3.76 for dementia, 17.42 vs. 7.91 for sleep disorders, 6.15 vs. 3.41 for anxiety disorders, and 8.30 vs. 5.78 for depressive disorders. There was no significant difference in the incidence of schizophrenia or bipolar disorder between the two groups. COVID-19 infection increased the risk of mental disorders in the following order: dementia (HR, 3.49; 95% CI, 2.45-4.98), sleep disorders (HR, 2.27; 95% CI, 1.76-2.91), anxiety disorders (HR, 1.90; 95% CI, 1.25-2.84), and depressive disorders (HR, 1.54; 95% CI, 1.09-2.15). Conclusion: This study showed that the major mental disorders associated with COVID-19 were dementia and sleep, anxiety, and depressive disorders.

• 한국간담췌외과학회지
• /
• 제27권4호
• /
• pp.415-422
• /
• 2023

Backgrounds/Aims: Although cancer survivors are at higher risk of developing second primary malignancies, cancer surveillance strategies for them have not yet been established. This study aimed to identify first primary cancers that had high risks of developing second primary exocrine pancreatic cancer (EPC). Methods: Data on individuals diagnosed with primary cancers between 1993 and 2017 were obtained from the Korea Central Cancer Registry. The standardized incidence ratios (SIRs) of second primary EPCs were analyzed according to the primary tumor sites and follow-up periods. Results: Among the 3,205,840 eligible individuals, 4,836 (0.15%) had second primary EPCs, which accounted for 5.8% of the total EPC patients in Korea. Between 1 and 5 years after the diagnosis of first primary cancers, SIRs of second primary EPCs were increased in patients whose first primary cancers were in the bile duct (males 2.99; females 5.03) in both sexes, and in the small intestine (3.43), gallbladder (3.21), and breast (1.26) in females. Among those who survived 5 or more years after the diagnosis of first primary cancers, SIRs of second primary EPCs were elevated in patients whose first primary cancers were in the bile duct (males 2.61; females 2.33), gallbladder (males 2.29; females 2.22), and kidney (males 1.39; females 1.73) in both sexes, and ovary (1.66) and breast (1.38) in females. Conclusions: Survivors of first primary bile duct, gallbladder, kidney, ovary, and female breast cancer should be closely monitored for the occurrence of second primary EPCs, even after 5 years of follow-up.

• Clinical Nutrition Research
• /
• 제12권4호
• /
• pp.320-335
• /
• 2023

Literature showed that soluble fiber has beneficial effects on cardiometabolic risk factors and leptin and adiponectin serum levels. Our aim in this meta-analysis was to determine the effect of soluble fiber supplementation on leptin and adiponectin serum levels. A systematic search was conducted using PubMed, Scopus, and ISI Web of Science for eligible trials up to December 2021. A random-effects model was used to pool calculated effect sizes. Our analysis showed that soluble fiber supplementation did not significantly affect adiponectin (standardized mean difference [SMD], -0.49 Hedges's, 95% confidence interval [CI], -1.20, 0.21, p value = 0.167; I² = 95.4, p value < 0.001) and leptin (SMD, -0.8 Hedges's, 95% CI, -1.70, 0.08, p value = 0.076; I² = 94.6, p value < 0.001) concentrations in comparison with placebo. However, in the subgroup, soluble fiber supplementation had a significant improvement in leptin concentration in overweight and obese patients (SMD, -0.22 Hedges's, 95% CI, -0.43, -0.01, p value = 0.048) and a non-significant beneficial effect in adiponectin level in female (SMD, 0.29 Hedges's, 95% CI, -0.13, 0.71, p value = 0.183) and diabetic patients (SMD, 0.32 Hedges's, 95% CI, -0.67, 1.32, p value = 0.526). A non-linear association between soluble fiber dosage and adiponectin (p_{non-linearity} < 0.001) was observed. Soluble fiber supplementation could not change the circulatory leptin and adiponectin levels. However, beneficial effects were seen in overweight and obese leptin, and increases in adiponectin may also be observed in female and diabetic patients. Further studies are needed to confirm this results.