Effects of a Dementia Family Education Program for Dementia Recognition, Burden, and Depression in Caregivers of Elders with Dementia / 정신간호학회지

PURPOSE: This study was to investigate effects of the dementia family education program on dementia recognition, burden, and depression in caregivers of elders with dementia. METHODS: Aquasi-experimental research with a nonequivalent control group non-synchronized pre and post design was used with 52 caregivers of elders with dementia living in D city. Data were collected from August 12 to December 12, 2013. The dementia family education program was provided to the experimental group once a week over 8 weeks, for 90 minutes per session. Data were analyzed using χ² test, Fisher exact probability test, t-test. RESULTS: Experimental group participants who took part in the dementia family education program had higher dementia recognition scores than the control group that did not participate (t=3.79, p<.001). Experimental group participants who took part in the dementia family education program had lower burden and depression scores than the control group that did not participate (t=-2.90, p=.006) (t=-2.22, p=.034). CONCLUSION: The findings indicate that the dementia family education program enhances dementia recognition by caregivers of elders with dementia and lowers burden and depression in these caregivers. Use of the dementia family education program is recommended as an effective nursing intervention for caregivers of elders with dementia.

Vancomycin Pharmacokinetics in Oliguric Patients Undergoing Continuous Venovenous Hemodialysis and Continuous Venovenous Hemodiafiltration / 대한신장학회지

PURPOSE: Critically ill patients receiving continuous renal replacement therapy are susceptible to infection with methicillin-resistant bacteria, which require treatment with vancomycin. However, there are limited reports regarding vancomycin pharmacokinetics in the continuous venovenous hemodialysis (CVVHD) and continuous venovenous hemodiafiltration (CVVHDF). We performed this study to investigate the pharmacokinetics of vancomycin in oliguric patients receiving CVVHD and CVVHDF. METHODS: Data at steady-state obtained as part of our routine drug monitoring of vancomycin therapy in critically ill adult oliguric patients undergoing CVVHD or CVVHDF, retrospectively. Data were available for 35 cases of 23 patients assessed for 2 years. We analyzed the pharmacokinetic parameters of these cases. RESULTS: 8 cases on CVVHD and 27 cases on CVVHDF were available. The mean intensity of CVVHD was 17.7+/-4.9 mL/hour/kg and that of CVVHDF was 32.1+/-3.9 mL/hour/kg (p=0.000). The mean clearance of vancomycin was 16.4+/-3.8 mL/min in the CVVHD group and 21.6+/-5.1 mL/min in the CVVHDF group (P=0.007). The elimination of vancomycin correlated with the intensity of CVVHD and CVVHDF (CVVHD; r2=0.745, p=0.012, CVVHDF; r2=0.452, p=0.000). CONCLUSION: CVVHD and CVVHDF are effective for vancomycin elimination and there is a strong dependency of the vancomycin removal on the intensity of continuous renal replacement therapy. Strategies for individualization of vancomycin therapy in patients receiving CVVHD and CVVHDF are proposed.

Polyneuropathy and Cerebral Infarction Complicating Scrub Typhus

We describe a 64-year-old man with scrub typhus who presented with both polyneuropathy and cerebral infarction. A eurological examination revealed a confused mental state, stiff neck, hearing impairment, symmetric weakness, sensory loss, and ataxia. Electrophysiologic studies showed demyelinating sensorimotor polyneuropathy and sensorineural hearing loss. Brain magnetic resonance imaging showed multiple infarctions. Brain involvement or polyneuropathy associated with scrub typhus has been rarely reported, and the pathogenic mechanism underlying the multiple neurological complications remains to be elucidated.

Pathologic Gambling in Parkinson Disease

Pathologic gambling (PG) is an impulse control disorder (ICD) or dopamine dysregulation syndrome (DDS) in patients with Parkinson disease (PD). ICD/DDS is presumed to be related to dopaminergic treatment in PD. Although increasing number of patients with ICD/DDS is being reported, ICD/DDS such as PG has not been reported in Korean PD patients. We describe a PD patient who developed PG secondary to dose adjustment of levodopa and pramipexole. His symptoms was controlled by reducing the dopaminergic drugs and adding a small amount of atypical antipsychotics.