• Physical Therapy Korea
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• v.30 no.1
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• pp.1-7
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• 2023

Background: Like many other countries, falls and related injuries in older adults are great concerns in South Korea. In particular, falls are common in medical institutions, often causing the increase of the length of hospitalization. Objects: The purpose of this review was to help understand and address falls in hospitalized individuals in South Korea. Methods: The review was conducted on literature published in Korean from 2010 to 2022, searched in the Korea Citation Index and PubMed. Keywords used for the search were as follows: falls, fall risk, fall risk assessment, hospital, inpatient, intervention, Korea, and prevention. Results: A total of 54 articles were found and reviewed. The most common place of fall accidents was the inpatient room, where there were many cases of falls while walking. Loss of balance was the most common cause of falls, and many falls occurred in patients admitted to the internal medicine. Furthermore, a risk of falling increased with the type of medications taken. In terms of tools to assess patients' fall risk, the Morse Fall Scale (MFS) was commonly used. Patient-specific fall prevention activities were common to address falls, and they decreased the frequency of falls and the fear of falling. Factors influencing the effectiveness of the fall prevention activities included attitudes toward falls, education, environmental factors, patient safety culture, and self-efficacy in preventing falls. Conclusion: Our results should help understand and address falls and injuries in medical institutions.

• Journal of Digestive Cancer Research
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• v.10 no.2
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• pp.107-111
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• 2022

In 2019, coronavirus disease (COVID-19), which originated in Wuhan, has spread worldwide. In most people, COVID-19 symptoms are not severe. However, the mortality rate and severity were high in risk groups such as in older people and patients with underlying diseases. As patients with cancer are one of the risk groups, the vaccination for COVID-19 is emphasized in these patients. However, COVID-19 vaccines are not tested enough in special groups such as in patients with cancer because these vaccines are developed at an unprecedented speed. This causes confusion about whether patients undergoing chemotherapy should be vaccinated or not. In this study, international guidelines and studies were reviewed. Most of the studies recommended vaccination. No evidences of any negative effects for the efficacy or safety were recorded in patients undergoing cytotoxic, targeted, and immune agents. However, in critical conditions such as cytopenia, vaccination must be decided according to the patient's condition. COVID-19 vaccines were also recommended for patients on surgery or radiation therapy. If possible, vaccine is given before surgery to avoid confusion between surgical complications and side effects of the vaccine. The radiation recall phenomenon after vaccination has been reported in some cases of radiation therapy. Clinicians should consider these situations before vaccinating each patient. We hope that clearer guidelines will be established by accumulating verified data.

• Journal of Neurocritical Care
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• v.7 no.2
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• pp.104-110
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• 2014

Background: Cefepime is a fourth-generation cephalosporin widely used for empiric treatment of severe infections. Neurotoxicity by cefepime have been reported due to γ-aminobutyric acid A receptor inhibition or other mechanisms. The aim of this study was to evaluate the risk factors for cefepime-induced neurotoxicity between group showing cefepime-induced neurotoxicity and group without neurotoxicity. Methods: From Jan 2005 to June 2010, a total of 2,461 patients (older than 20) who used cefepime were considered in this study. We compared patients who developed cefepime-induced neurotoxicity (patient group, n=21) to patients who had no cefepime-induced neurotoxicity (control group, n=31). We analyzed demographic, underlying diseases, and metabolic parameters before cefepime treatment and during cefepime treatment between the two groups. Statistical analysis was performed using SPSS 18 software. Results: Of the total 2461 patients, 21 (0.85%) were diagnosed with cefepime-induced neurotoxicity. Impaired glomerular filtration rate (GFR at 15-30 ml/min) before cefepime use were significantly (P<0.05) higher risk for developing cefepime-induced neurotoxicity in patient group compared to that in the control group. Age, sex, and other metabolic parameters except GFR before and during, usage of cefepime did not show any statistical difference between the two groups. Conclusion: The present study revealed that cefepime-induced neurotoxicity was prone to develop in patients with impaired renal function before cefepime usage.

• Journal of muscle and joint health
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• v.30 no.3
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• pp.208-217
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• 2023

Purpose: The aim of this study was to investigate the degree of stress, resilience, focusing manner, and quality of life among burn rehabilitation patients. Furthermore, it seeks to identify factors affecting the quality of life in this patient group. Methods: The participants of this study were 129 burn patients, aged 19 or older, who received treatment at the rehabilitation of a university hospital in Seoul. Data were collected from June 22 to August 31, 2022 through self-report questionnaires covering stress, resilience, focusing manner and quality of life.The data were analyzed using the SPSS 29.0 program. Results: Multiple regression analysis showed that education level, cause of burn, area of burn, pain, stress, and focusing manner significantly affected the quality of life, explaining 74.5% of the variance. Conclusion: In particular, focusing manner was a major factor affecting the quality of life in burn rehabilitation patients. Therefore, there is a need to develop intervention programs aimed at increasing focusing manner in this patient group.

• Archives of Craniofacial Surgery
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• v.25 no.2
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• pp.85-89
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• 2024

Postoperative atlantoaxial rotatory subluxation (AARS) is a rare complication that develops almost exclusively in children following oropharyngeal and otologic surgeries, proposing that oropharyngeal inflammatory responses and excessive head rotation are responsible factors. However, there have been no reports of AARS after excision of a nevus on the head and neck. Here, we present two cases of AARS following limited head rotation during simple nevus excision. Patient 1, a 9-year-old girl, complained of neck pain and limited range of motion after excision of the nevus on the neck. After 2 months, computed tomography and magnetic resonance imaging finally revealed AARS with a ruptured transverse atlantal ligament. A month of halo traction was required for the treatment. Patient 2, an 11-year-old girl, presented with immediate pain and limited neck extension after tissue expander insertion under the upper chest and excision of the nevus on her left cheek. The diagnosis was promptly made using cervical spine radiography. A cervical collar was applied for 1 month. Both patients recovered without any complications after treatment. This report highlights the importance of suspicion for AARS after surgery regardless of surgical duration or amount of head rotation.

• Hip & pelvis
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• v.36 no.3
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• pp.161-167
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• 2024

Periprosthetic joint infection (PJI) is regarded as a critical factor contributing to the failure of primary and revision total joint arthroplasty (TJA). With the increasing prevalence of TJA, a significant increase in the incidence of PJI is expected. The escalating number of cases, along with the significant economic strain imposed on healthcare systems, place emphasis on the pressing need for development of effective strategies for prevention. PJI not only affects patient outcomes but also increases mortality rates, thus its prevention is a matter of vital importance. The longer-term survival rates for PJI after total hip and knee arthroplasty correspond with or are lower than those for prevalent cancers in older adults while exceeding those for other types of cancers. Because of the multifaceted nature of infection risk, a collaborative effort among healthcare professionals is essential to implementing diverse strategies for prevention. Rigorous validation of the efficacy of emerging novel preventive techniques will be required. The combined application of these strategies can minimize the risk of infection, thus their comprehensive adoption is important. Collectively, the risk of PJI could be substantially minimized by application of a multifaceted approach implementing these strategies, leading to improvement of patient outcomes and a reduced economic burden.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.9
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• pp.341-350
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• 2019

This research study was conducted to investigate the effect of knowledge, attitude and nursing professionalism on the confidence of the performance of nursing students who had experience with clinical practice and also to provide basic data for the development of nursing students' curriculum. The subjects who participated in this study were 286 students in the 4th year of nursing at two colleges in the Daegu and Gyeongbuk regions. The research data was analyzed using the SPSS 22.0 program. Confidence in performance of patient safety was higher for the women than for men, and for the students of an older age and higher academic achievement. Confidence in performance of patient safety was positively related to knowledge (r=.25, p=.000), attitude (r=.39, p=.000), nursing professionalism (r=.33, p=.000) and all these had statistical significance. On the multiple regression analysis, the coefficient of determination ($R^2$) was .49 and the explanatory power of the model was 49.2% (F=24.04, p=.000). The most important factor affecting confidence in performance of patient safety was the experience of having undergone patient safety education. Based on these results, it is necessary to seek various educational methods to expand the concept of patient safety from the beginning of the undergraduate course work. Especially, we think that various education strategies such as simulation education methods or information videos are needed to develop scenarios related to patient safety.

• Tuberculosis and Respiratory Diseases
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• v.70 no.4
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• pp.307-314
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• 2011

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of death and disability worldwide and one of the most prevalent diseases in Korea. We examined trends and risk factors of health care utilization for COPD in Korea. Methods: We retrospectively analyzed the database of Patient Surveys from 1990 through 2008, which were nationwide surveys of health services utilization through outpatient department (OPD) visits and hospitalization. Physician-diagnosed COPD patients whose ages were 45 years and older were included. Results: OPD visits and hospitalization of COPD patients between 1990 and 2008 were estimated to be 68,552 and 17,774 persons, respectively. Trends in OPD visits and hospitalization for COPD significantly increased from 1990 through 2008 (p=0.019, p=0.001, respectively). The increment rate for OPD visits was 2.0 fold over those years; for hospitalization it was 3.3 fold. Risk factors for OPD visits for COPD were male gender (odd ration [OR], 1.41; 95% confidence interval [CI], 1.39~1.43), those aged 65 years and older (OR, 1.50; 95% CI, 1.47~1.53), residential area other than a metropolis (OR, 1.08; 95% CI, 1.07~1.010) and access to a physician's office (OR, 1.17; 95% CI, 1.14~1.21). Risk factors for hospitalization were male gender (OR, 2.15; 95% CI, 2.07~2.23), those aged 65 year and older (OR, 2.86; 95% CI, 2.72~3.00), residential area other than a metropolis (OR, 1.98; 95% CI, 1.90~2.07) and access to a hospital (OR, 2.88; 95% CI, 2.59~3.22) (p<0.001, both). Conclusion: Health care utilization for COPD subjects increased from 1990 to 2008. Risk factors for the utilization were male gender, older age, and residential area other than a metropolis.

• Journal of the Korean Society of Food Culture
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• v.35 no.4
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• pp.363-370
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• 2020

This study analyzed the health characteristics and comorbidity of adult men aged 40 years by dividing them into a control group of those without any disease related to fine dust and a patient group with one or more diseases related to fine dust in areas with high levels of fine dust pollution using the sixth and seventh Korea National Health and Nutrition Examination Survey (2013-2017). Among the general characteristics, the mean age of the patient group was significantly older than that of the control group (p<0.001), and in terms of the health-related characteristics, the frequency of breakfast consumption in the patient group was higher than in the control group (p<0.043). The body measurements were similar in the patient and control groups. Regarding the prevalence of comorbidity, the patient group showed a higher prevalence of hypertension, dyslipidemia, stroke, myocardial infarction, heart failure, and diabetes than the control group, but the differences were not statistically significant. On the other hand, the prevalence of other cancers (except stomach cancer, liver cancer, colorectal cancer, breast cancer, and cervical cancer) in the patient group was higher than in the control group (p<0.05). In terms of the clinical characteristics, the glycated hemoglobin levels in the patient group were significantly higher than in the control group (p<0.048). Information on nutrition and health in areas with frequent occurrences of fine dust was obtained through the study results, which can be used as basic data for measures of health and diet management against diseases that will increase in relation to fine dust.

• Korean Journal of Clinical Pharmacy
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• v.25 no.4
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• pp.254-263
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• 2015

Objectives: The present study assessed the prevalence of the potentially inappropriate medication (PIM) use in Korean elderly patients with Parkinson's disease. In addition, this study examined risk factors that affect PIM use. Method: A retrospective, observational study was conducted using Korean National Health Insurance claims database of 2009. PIM use in Parkinson's disease patients aged 65 years or older was examined based on 2012 Beers Criteria. Multivariable logistic regression was conducted to identify risk factors for PIM use. Results: Among 5,277 elderly patients with Parkinson's disease, 88.9% of patients used PIM(s) at least once. The average number of PIM items used per patient was 4.2. PIM use ratio, the proportion of total amount of PIMs to all medications per patient, was 12.6%. Frequently used PIM therapeutic classes were benzodiazepines (32.7%), first-generation antihistamines (19.2%), and prokinetics (17.5%). Individual PIMs most commonly used included chlorpheniramine (11.4%), levosulpiride (10.9%), diazepam (9.0%), and alprazolam (7.6%). Women (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.11-1.16), medical aid (OR 1.18, 95% CI 1.15-1.21), and long-term facilities (OR 2.43, 95% CI 2.22-2.65) were shown to be risk factors associated with PIM use. Of particular, wide variation in PIM use was associated with the types of healthcare facility. Conclusion: The PIM prevalence was very high in elderly Parkinson's disease patients. Nationally effective and systematic efforts to identify and prevent PIM use should be made to ensure patient safety and to improve quality of care in the elderly.