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Rev. Assoc. Med. Bras. (1992) ; 68(2): 165-169, Feb. 2022. tab
Article in English | LILACS | ID: biblio-1365335

ABSTRACT

SUMMARY OBJECTIVE: In this study, we evaluated the clinical characteristics and seasonal distribution of patients with primary spontaneous pneumothorax and examined the relationships between meteorological factors and pneumothorax development overall and in terms of first episode and recurrence. METHODS: The hospital records of 168 pneumothorax patients treated in our clinic between January 2016 and December 2020 were reviewed retrospectively. A cluster was defined as two or more patients with pneumothorax presenting within three consecutive days. Meteorological factors were compared between days with and without pneumothorax patients. This comparison was based on meteorological data from the day of symptom onset (D), the day before symptom onset (D1), and the difference between those days (D-D1). Meteorological data from the index day (D) were also compared between patients with first episode and recurrence of pneumothorax. RESULTS: The study included 149 (88.7%) men and 19 (11.3%) women. The mean age was 25.02±6.97 (range, 17-35; median, 26) years. Of note, 73 (43.4%) patients underwent surgery. The highest number of patients presented in November (n=19, 11.3%). In terms of season, most presentations occurred in autumn. Humidity was significantly lower on recurrence days compared with first episode (p=0.041). CONCLUSION: Our results indicated that meteorological factors (i.e., atmospheric pressure, humidity, wind speed, temperature, and precipitation) were not associated with pneumothorax development. By comparing the patients with first episode and recurrence, the humidity was significantly lower in the recurrence group.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Pneumothorax/etiology , Pneumothorax/epidemiology , Recurrence , Atmospheric Pressure , Weather , Retrospective Studies , Meteorological Concepts
3.
Article in English | WPRIM | ID: wpr-921342

ABSTRACT

Objective@#Previous studies have shown that meteorological factors may increase COVID-19 mortality, likely due to the increased transmission of the virus. However, this could also be related to an increased infection fatality rate (IFR). We investigated the association between meteorological factors (temperature, humidity, solar irradiance, pressure, wind, precipitation, cloud coverage) and IFR across Spanish provinces ( @*Methods@#We estimated IFR as excess deaths (the gap between observed and expected deaths, considering COVID-19-unrelated deaths prevented by lockdown measures) divided by the number of infections (SARS-CoV-2 seropositive individuals plus excess deaths) and conducted Spearman correlations between meteorological factors and IFR across the provinces.@*Results@#We estimated 2,418,250 infections and 43,237 deaths. The IFR was 0.03% in < 50-year-old, 0.22% in 50-59-year-old, 0.9% in 60-69-year-old, 3.3% in 70-79-year-old, 12.6% in 80-89-year-old, and 26.5% in ≥ 90-year-old. We did not find statistically significant relationships between meteorological factors and adjusted IFR. However, we found strong relationships between low temperature and unadjusted IFR, likely due to Spain's colder provinces' aging population.@*Conclusion@#The association between meteorological factors and adjusted COVID-19 IFR is unclear. Neglecting age differences or ignoring COVID-19-unrelated deaths may severely bias COVID-19 epidemiological analyses.


Subject(s)
Adult , Aged , Aged, 80 and over , COVID-19/virology , Humans , Meteorological Concepts , Middle Aged , Pandemics/statistics & numerical data , SARS-CoV-2/physiology , Spain/epidemiology , Weather , Young Adult
4.
Article in English | WPRIM | ID: wpr-762176

ABSTRACT

PURPOSE: Oak is the dominant tree species in Korea. Oak pollen has the highest sensitivity rate among all allergenic tree species in Korea. A deep neural network (DNN)-based estimation model was developed to determine the concentration of oak pollen and overcome the shortcomings of conventional regression models. METHODS: The DNN model proposed in this study utilized weather factors as the input and provided pollen concentrations as the output. Weather and pollen concentration data were used from 2007 to 2016 obtained from the Korea Meteorological Administration pollen observation network. Because it is difficult to prevent over-fitting and underestimation by using a DNN model alone, we developed a bootstrap aggregating-type ensemble model. Each of the 30 ensemble members was trained with random sampling at a fixed rate according to the pollen risk grade. To verify the effectiveness of the proposed model, we compared its performance with those of models of regression and support vector regression (SVR) under the same conditions, with respect to the prediction of pollen concentrations, risk levels, and season length. RESULTS: The mean absolute percentage error in the estimated pollen concentrations was 11.18%, 10.37%, and 5.04% for the regression, SVR and DNN models, respectively. The start of the pollen season was estimated to be 20, 22, and 6 days earlier than that predicted by the regression, SVR and DNN models, respectively. Similarly, the end of the pollen season was estimated to be 33, 20, and 9 days later that predicted by the regression, SVR and DNN models, respectively. CONCLUSIONS: Overall, the DNN model performed better than the other models. However, the prediction of peak pollen concentrations needs improvement. Improved observation quality with optimization of the DNN model will resolve this issue.


Subject(s)
Korea , Pollen , Quercus , Rhinitis, Allergic , Rhinitis, Allergic, Seasonal , Seasons , Trees , Weather
5.
Article in English | WPRIM | ID: wpr-816604

ABSTRACT

BACKGROUND: The weather has well-documented effects on infectious disease and reports suggest that summer peaks in the incidences of gram-negative bacterial infections among hospitalized patients. We evaluated how season and temperature changes affect bloodstream infection (BSI) incidences of major pathogens to understand BSI trends with an emphasis on acquisition sites.METHODS: Incidence rates of BSIs by Staphylococcus aureus, Enterococcus spp., Escherichia coli, Klebsiella pneumoniae, Acinetobacter spp., and Pseudomonas aeruginosa were retrospectively analyzed from blood cultures during 2008–2016 at a university hospital in Seoul, Korea according to the acquisition sites. Warm months (June–September) had an average temperature of ≥20℃ and cold months (December–February) had an average temperature of ≤5℃.RESULTS: We analyzed 18,047 cases, where 43% were with community-onset BSI. E. coli (N = 5,365) was the most common pathogen, followed by Enterococcus spp. (N = 3,980), S. aureus (N = 3,075), K. pneumoniae (N = 3,043), Acinetobacter spp. (N = 1,657), and P. aeruginosa (N = 927). The incidence of hospital-acquired BSI by Enterococcus spp. was weakly correlated with temperature, and the median incidence was higher during cold months. The incidence of community-onset BSI by E. coli was higher in warm months and was weakly correlated with temperature.CONCLUSION: We found seasonal or temperature-associated variation in some species-associated BSIs. This could be a useful information for enhancing infection control and public health policies by taking season or climate into consideration.


Subject(s)
Acinetobacter , Climate , Climate Change , Communicable Diseases , Enterococcus , Escherichia coli , Gram-Negative Bacterial Infections , Humans , Incidence , Infection Control , Klebsiella pneumoniae , Korea , Pneumonia , Pseudomonas aeruginosa , Public Health , Retrospective Studies , Seasons , Seoul , Staphylococcus aureus , Tertiary Care Centers , Weather
6.
J. bras. pneumol ; 46(5): e20200183, 2020.
Article in English | LILACS | ID: biblio-1134896

ABSTRACT

ABSTRACT Coronavirus disease 2019 (COVID-19), caused by the highly contagious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is probably systemic, has a major respiratory component, and is transmitted by person-to-person contact, via airborne droplets or aerosols. In the respiratory tract, the virus begins to replicate within cells, after which the host starts shedding the virus. The individuals recognized as being at risk for an unfavorable COVID-19 outcome are those > 60 years of age, those with chronic diseases such as diabetes mellitus, those with hypertension, and those with chronic lung diseases, as well as those using chemotherapy, corticosteroids, or biological agents. Some studies have suggested that infection with SARS-CoV-2 is associated with other risk factors, such as smoking, external environmental pollution, and certain climatic conditions. The purpose of this narrative review was to perform a critical assessment of the relationship between COVID-19 and these potential risk factors.


RESUMO A doença denominada COVID-19, causada pelo vírus altamente contagioso denominado SARS-CoV-2, é uma doença provavelmente sistêmica com importante componente respiratório e é transmitida pelo contato com uma pessoa infectada por meio de gotículas e/ou aerossóis. Após atingir o trato respiratório, o vírus inicia a multiplicação intracelular e, a seguir, sua semeadura. Os grupos de risco reconhecidos para uma evolução desfavorável são indivíduos com idade > 60 anos, portadores de doenças crônicas, como diabetes mellitus, hipertensão arterial sistêmica e/ou doenças pulmonares crônicas, assim como aqueles em uso de quimioterápicos, corticosteroides ou imunobiológicos. Alguns estudos mostram uma possível associação do SARS-CoV-2 com outros fatores de risco, como tabagismo, poluição ambiental externa e determinadas condições climáticas. O objetivo desta revisão narrativa foi avaliar criticamente a relação entre COVID-19 e esses possíveis fatores de risco.


Subject(s)
Humans , Pneumonia, Viral/epidemiology , Weather , Smoking/adverse effects , Coronavirus Infections/epidemiology , Environmental Pollution/adverse effects , Risk Factors , Pandemics , Betacoronavirus , SARS-CoV-2 , COVID-19
7.
Journal of Public Health and Epidemiology ; 12(3): 246-260, 2020. ilus
Article in English | AIM, AIM | ID: biblio-1264499

ABSTRACT

The potential reasons why COVID-19 is not spreading rapidly in Sub-Saharan Africa include sociopolitical, biological and environmental variables. Among the latter, some studies indicate temperature and atmospheric pressure as significantly influential. Could they have impact on the number of COVID-19 cases in Mozambique? The aim of this study is to analyze the relationships between weather and the frequency of confirmed COVID-19 cases in Mozambique, Southern Africa. The study was conducted in Mozambique, Maputo area (Province and City) and Nampula Province. Daily history of weather variables ­ daily maximum and minimum temperatures and atmospheric pressure ­ was obtained from three online databases (AccuWeather, Time and Date AS and WeatherSpark) and the number of COVID-19 cases from official Government's daily Bulletins. The main statistical analyses were Pearson correlations between the variables. The first case was observed in the Maputo area on 22 March, 2020 and the cases in Mozambique increased exponentially up to 769 by 24 June, 2020. The first three cases in Nampula province were observed on 24 May 2020 but its frequency surpassed Maputo area's within one month. Temperatures showed negative correlations with the number of cases in all areas and pressure showed positive correlations in Maputo area and Nampula Province. A bubble chart allowed the visualization of the combined relationship of both weather variables and the number of cases, suggesting that the number of cases increases as temperature decreases and pressure increases. Temperature and atmospheric pressure seems to be correlated with the number of confirmed cases of COVID-19 in Mozambique. Thus, decision-makers should consider weather as a predictor of the rate at which the pandemic is spreading in the country


Subject(s)
COVID-19 , Atmospheric Pressure , Mozambique , Temperature , Weather
8.
Ciênc. Saúde Colet ; 24(8): 2959-2970, ago. 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-1011863

ABSTRACT

Resumo A morbimortalidade por doenças diarreicas infecciosas ainda representa um grave problema de saúde no Brasil e está altamente relacionada a fatores como condições climáticas, ambientais e de vida da população. O objetivo deste estudo foi analisar a associação das taxas de internações por doenças diarreicas infecciosas na população do município de Rio Branco/AC com a precipitação, o nível do rio, a umidade e a temperatura, entre os anos de 2000 e 2013. Os dados foram extraídos do Sistema de Informações Hospitalares do SUS, do Instituto Nacional de Meteorologia e da Agência Nacional das Águas. Foram ajustados modelos múltiplos de regressão de Poisson e binomial negativa. Os resultados mostram que existe uma associação positiva entre as internações por doenças diarreicas infecciosas e o nível do Rio Acre (RT:1,07; IC95%:1,04 a 1,1); houve um decréscimo de 14% nestas taxas de internações entre os anos de 2000 e 2013 (RT:0,86; IC95%:0,85 a 0,87); o grupo mais vulnerável pertence à faixa etária de menores de 1 ano de vida. Este estudo mostrou a vulnerabilidade de uma cidade na Amazônia quanto à variabilidade climática e a respectiva influência epidemiológica na incidência de internações por doenças diarreicas infecciosas.


Abstract Morbimortality due to infectious diarrheal diseases still is a serious health issue in Brazil and is highly related to factors such as weather, environment, and people's life conditions. This study aimed to analyze the relationship between hospitalization rates due to infectious diarrheal diseases among the population of the municipality of Rio Branco (AC), Brazil and precipitation, river level, humidity and temperature between 2000 and 2013. Data were retrieved from the Hospital Information System of the SUS (Unified Health System), the National Institute of Meteorology and the National Water Agency. Multiple Poisson and negative binomial regression models were adjusted. Results showed that there is a positive association between hospitalization due to infectious diarrheal diseases and the level of the Acre river (RR: 1.07; CI 95%: 1.04 to 1.1); these hospitalization rates fell 14% between 2000 and 2013 (RR: 0.86; CI 95%: 0.85 to 0.87). The most vulnerable group was the age group of less than 1 year of age. This study showed the vulnerability of an Amazonian city to climate variability and its respective epidemiological influence on the incidence of hospitalizations due to infectious diarrheal diseases.


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Climate , Dysentery/epidemiology , Hospitalization/statistics & numerical data , Temperature , Weather , Brazil/epidemiology , Incidence , Cities , Rivers , Humidity , Middle Aged , National Health Programs
9.
Article in Korean | WPRIM | ID: wpr-759771

ABSTRACT

BACKGROUND: Acne is a common inflammatory skin disease that involves the seborrheic area, developing not only in adolescence but also in adulthood. Abnormal epidermal barrier function in acne is reported and suspected as a risk factor that leads to sensitive skin through a few experimental studies. Impaired skin barrier function against environmental factors and irritants may play a role in increasing sensitivity of the skin in patients with acne. OBJECTIVE: This study aimed to investigate the clinical characteristics of patients with acne and analyze the association between acne and sensitive skin. METHODS: Acne severity and history of treatments were recorded and subjective symptoms of sensitive skin with aggravating factors were analyzed through a questionnaire. Acne severity was determined using the Investigator's Global Assessment scale of acne severity and Global Acne Grading System. The score and severity of sensitive skin were determined using the Baumann skin-type test. RESULTS: Of 100 patients with acne, 76% were actually confirmed to have sensitive skin. However, there was no significant association between acne severity and severity of sensitive skin (p=0.805). The most common aggravating factor of sensitive skin was washing the face (60%), followed by cosmetics use (56%) and hot weather (55%). The most common symptom of sensitive skin was itching (55%), which was proven as the only factor associated with severity of sensitive skin (p=0.016). CONCLUSION: Cosmetics use on the face is a noticeable important aggravating factor of sensitive skin, which can provoke itching, which is proven as the only symptom significantly related with severity of sensitive skin. Therefore, in the treatment of acne with sensitive skin, proper use of moisturizers and careful washing are required, and it is important to avoid hot weather and excessive sun exposure and carefully choose cosmetics.


Subject(s)
Acne Vulgaris , Adolescent , Clinical Study , Humans , Irritants , Pruritus , Risk Factors , Skin Diseases , Skin , Solar System , Weather
10.
Article in Korean | WPRIM | ID: wpr-759749

ABSTRACT

BACKGROUND: The nose plays an important aesthetic, functional role and is located at the center of the face. Due to the characteristics of its anatomical location, the nose is easily exposed and damaged due to weathering, trauma, and inflammation. OBJECTIVE: This study aimed to provide information on the most common benign and malignant tumors according to their location on the nose. METHODS: A retrospective study was conducted on 217 patients who visited the Department of Dermatology at Chosun University Hospital and underwent biopsy for suspected skin tumors in the past 6 years. The tumor was classified as benign, pre-cancerous, and malignant. Differences in the distribution of the anatomical locations of each disease group were analyzed according to the eight anatomical locations of the nose. RESULTS: Based on the external nose anatomy, the most common site where skin tumors usually occurred was the nasal alar (29%), followed by the nasal dorsum and nasal sidewall (23.5% and 20.2%, respectively). The most common skin tumor was malignant tumor (72.3%), followed by benign tumor (21.1%) and premalignant disease (6.4%). CONCLUSION: I In this study, among patients who underwent biopsy for suspected tumor in the nose, the most common neoplasm was malignant skin tumor and the most common anatomical location was the nasal alar. Therefore, a rapid diagnosis and treatment of skin tumors that occur in the nasal alar wound be necessary.


Subject(s)
Biopsy , Dermatology , Diagnosis , Humans , Inflammation , Nose , Retrospective Studies , Skin , Weather , Wounds and Injuries
11.
Intestinal Research ; : 340-348, 2019.
Article in English | WPRIM | ID: wpr-764157

ABSTRACT

BACKGROUND/AIMS: Ustekinumab is effective in active Crohn's disease. In a retrospective study, we assessed the clinical outcome in nonresponders to anti-tumor necrosis factor therapy, and/or conventional therapy and/or the α4β7-integrin inhibitor vedolizumab. As approval study populations do not always reflect the average “real world” patient cohort, we assessed weather patients who would not have qualified for approval studies show similar outcomes. METHODS: Forty-one patients with mild to severe active Crohn's disease were treated with ustekinumab (intravenous 6 mg per kg/body weight) followed by subcutaneous ustekinumab (90 mg) at week 8. Depending on the clinical response maintenance therapy was chosen every 8 or 12 weeks. Clinical response was defined by Crohn's Disease Activity Index (CDAI) decline, decline of stool frequency or clinical improvement. Inclusion criteria for approval studies were assessed. RESULTS: The 58.5% (24/41) showed clinical response to ustekinumab. The 58.3% of this group (14/24) achieved clinical remission. Clinical response correlated significantly with drop of stool frequency and improvement of CDAI score. The 39 out of 41 patients had no side effects and we observed no serious infections. About a third of our patients would not have met ustekinumab approval study criteria. However, patients who did not meet study criteria showed clinical improvement numerically in the same range compared to patients who would have qualified for approval studies. CONCLUSIONS: Ustekinumab is effective, safe and well tolerated in a highly therapy refractory patient cohort. Even though a reasonable number of patients did not meet ustekinumab approval study criteria, approval study results seem to be representative to the overall patient cohort.


Subject(s)
Biological Therapy , Cohort Studies , Crohn Disease , Humans , Necrosis , Patient Selection , Retrospective Studies , Ustekinumab , Weather
12.
Asia Pacific Allergy ; (4): e35-2019.
Article in English | WPRIM | ID: wpr-762874

ABSTRACT

BACKGROUND: Epidemic thunderstorm asthma (ETSA) severely affected Melbourne, Australia in November 2016. There is scant literature on the natural history of individuals affected by ETSA. OBJECTIVE: A multicentre 12-month prospective observational study was conducted assessing symptomatology and behaviors of ETSA-affected individuals. METHODS: We used a structured phone questionnaire to assess asthma symptom frequency, inhaled preventer use, asthma action plan ownership and healthcare utilization over 12 months since the ETSA. Analysis of results included subgroup analyses of the “current,” “past,” “probable,“ and “no asthma” subgroups defined according to their original 2016 survey responses. RESULTS: Four hundred forty-two questionnaires were analyzed. Eighty percent of individuals reported ongoing asthma symptoms at follow-up, of which 28% were affected by asthma symptoms at least once a week. Risk of persistent asthma symptoms was significantly higher in those with prior asthma diagnosis, current asthma, and probable undiagnosed asthma (all p < 0.01). Of 442 respondents, 53% were prescribed inhaled preventers, of which 51% were adherent at least 5 days a week. Forty-two percent had a written asthma action plan and 16% had sought urgent medical attention for asthma in the preceding year. CONCLUSIONS: Following an episode of ETSA, patients experience a pivotal change in asthma trajectory with both loss of asthma control and persistence of de novo asthma. Suboptimal rates of inhaled preventer adherence and asthma action plan ownership may contribute to asthma exacerbation risk and susceptibility to future ETSA episodes. Longer-term follow-up is needed to determine the extent and severity of this apparent change.


Subject(s)
Asthma , Australia , Delivery of Health Care , Diagnosis , Environmental Exposure , Follow-Up Studies , Humans , Natural History , Observational Study , Ownership , Prospective Studies , Public Health , Surveys and Questionnaires , Weather
13.
Article in English | WPRIM | ID: wpr-761759

ABSTRACT

Scabies is a parasitic skin infection with intense itching. Scabies infection seriously impairs quality of life, while outbreaks in medical institutions cause financial losses. This study aimed to present the annual and seasonal trend of prevalence of scabies in the national population. Scabies cases were extracted from National Health Insurance Service database and its epidemiologic characteristics were assessed. To analyze the seasonality of scabies occurrence, temperature and humidity were included in the model as weather factors, and the per capita gross national income index was adjusted. The annual prevalence by age group was 0.56–0.69 per 1,000 persons until the age of 40 years and peaked at 3.0–4.1 per 1,000 persons in the age group over 80 years. The number of women diagnosed with scabies has been consistently higher compared to that of men since 2010. Mean number of cases diagnosed as scabies was lowest in spring, approximately 4,000 cases, when the average temperature was less than 5°C at 2 months prior, whereas more than 6,000 scabies cases occurred in autumn when temperatures exceeded 25°C at 2 months prior. This study presents the epidemiological characteristics and seasonality of all cases nationwide over 8 years and will help to establish control policies.


Subject(s)
Climate , Disease Outbreaks , Female , Humans , Humidity , Korea , Male , National Health Programs , Prevalence , Pruritus , Quality of Life , Scabies , Seasons , Skin , Weather
14.
Article in English | WPRIM | ID: wpr-761533

ABSTRACT

Ischemic colitis primarily affects the elderly with underlying disease, but it rarely occurs in young adults with risk factors, such as coagulopathy or vascular disorder. Moreover, it is extremely rare in the very young without risk factors. This paper presents a patient with ischemic colitis associated with heat stroke and rhabdomyolysis after intense exercise under high-temperature conditions. A 20-year-old man presented with mental deterioration after a vigorous soccer game for more than 30 minutes in sweltering weather. He also presented with hematochezia with abdominal pain. The laboratory tests revealed the following: AST 515 U/L, ALT 269 U/L, creatine kinase 23,181 U/L, BUN 29.1 mg/dL, creatinine 1.55 mg/dL, and red blood cell >50/high-power field in urine analysis. Sigmoidoscopy showed ischemic changes at the rectum and rectosigmoid junction. A diagnosis of ischemic colitis and rhabdomyolysis was made, and the patient recovered after conservative and fluid therapy. This case showed that a diagnosis of ischemic colitis should be considered in patients who present with abdominal pain and bloody diarrhea after intense exercise, and appropriate treatment should be initiated immediately.


Subject(s)
Abdominal Pain , Aged , Colitis, Ischemic , Creatine Kinase , Creatinine , Diagnosis , Diarrhea , Erythrocytes , Fluid Therapy , Gastrointestinal Hemorrhage , Heat Stroke , Hot Temperature , Humans , Rectum , Rhabdomyolysis , Risk Factors , Sigmoidoscopy , Soccer , Weather , Young Adult
15.
Article in Korean | WPRIM | ID: wpr-766379

ABSTRACT

Predicting the number of meals in a foodservice organization is an important decision-making process that is essential for successful food production, such as reducing the amount of residue, preventing menu quality deterioration, and preventing rising costs. Compared to other demand forecasts, the menu of dietary personnel includes diverse menus, and various dietary supplements include a range of side dishes. In addition to the menus, diverse subjects for prediction are very difficult problems. Therefore, the purpose of this study was to establish a method for predicting the number of meals including predictive modeling and considering various factors in addition to menus which are actually used in the field. For this purpose, 63 variables in eight categories such as the daily available number of people for the meals, the number of people in the time series, daily menu details, weekdays or seasons, days before or after holidays, weather and temperature, holidays or year-end, and events were identified as decision variables. An ensemble model using six prediction models was then constructed to predict the number of meals. As a result, the prediction error rate was reduced from 10%~11% to approximately 6~7%, which was expected to reduce the residual amount by approximately 40%.


Subject(s)
Dietary Supplements , Holidays , Machine Learning , Meals , Methods , Seasons , Weather
16.
Article in English | WPRIM | ID: wpr-785626

ABSTRACT

OBJECTIVE: Several environmental factors influence the prehospital use of video laryngoscopes (VLs). For example, fogging of the VL lens can occur in cold environments, and the low temperature can cause the VLs to malfunction. As relevant research on the effect of environment on VLs is lacking, we aimed to study the effect of a cold environment on three commonly used VLs.METHODS: McGrath MAC, Pentax Airway Scope (AWS), and GlideScope Ranger were exposed to temperatures of -5°C, -10°C, -20°C, and -25°C for 1 hour each and then applied to a manikin in a thermohydrostat room 5 times. Immediately after turning on the power and inserting the blade, the time until an appropriate glottic image appeared on the screen was measured.RESULTS: McGrath MAC was able to accomplish immediate intubation regardless of the temperature drop. However, GlideScope Ranger required an average of 4.9 seconds (-5°C to -20°C) and 10.1 seconds (-25°C) until appropriate images were obtained for intubation. AWS showed adequate image acquisition immediately after blade insertion despite slight fogging at -20°C, but at -25°C, images suitable for intubation did not appear on the screen for an average of 4.7 minutes.CONCLUSION: All three devices appear to be usable without any limitations up to -20°C. However, GlideScope Ranger and AWS may not produce images immediately at temperatures below -25°C. Thus, medical practitioners performing VL in a cold environment should be aware of the characteristics of the VL devices in advance.


Subject(s)
Cold Temperature , Intubation , Intubation, Intratracheal , Laryngoscopes , Manikins , Weather
17.
Article in English | WPRIM | ID: wpr-787181

ABSTRACT

Ischemic colitis primarily affects the elderly with underlying disease, but it rarely occurs in young adults with risk factors, such as coagulopathy or vascular disorder. Moreover, it is extremely rare in the very young without risk factors. This paper presents a patient with ischemic colitis associated with heat stroke and rhabdomyolysis after intense exercise under high-temperature conditions. A 20-year-old man presented with mental deterioration after a vigorous soccer game for more than 30 minutes in sweltering weather. He also presented with hematochezia with abdominal pain. The laboratory tests revealed the following: AST 515 U/L, ALT 269 U/L, creatine kinase 23,181 U/L, BUN 29.1 mg/dL, creatinine 1.55 mg/dL, and red blood cell >50/high-power field in urine analysis. Sigmoidoscopy showed ischemic changes at the rectum and rectosigmoid junction. A diagnosis of ischemic colitis and rhabdomyolysis was made, and the patient recovered after conservative and fluid therapy. This case showed that a diagnosis of ischemic colitis should be considered in patients who present with abdominal pain and bloody diarrhea after intense exercise, and appropriate treatment should be initiated immediately.


Subject(s)
Abdominal Pain , Aged , Colitis, Ischemic , Creatine Kinase , Creatinine , Diagnosis , Diarrhea , Erythrocytes , Fluid Therapy , Gastrointestinal Hemorrhage , Heat Stroke , Hot Temperature , Humans , Rectum , Rhabdomyolysis , Risk Factors , Sigmoidoscopy , Soccer , Weather , Young Adult
18.
Article in Korean | WPRIM | ID: wpr-770064

ABSTRACT

Herniation of the intervertebral disc is a medical disease manifesting as a bulging out of the nucleus pulposus or annulus fibrosis beyond the normal position. Most lumbar disc herniation cases have a favorable natural course. On the other hand, surgical intervention is reserved for patients with severe neurological symptoms or signs, progressive neurological symptoms, cauda equina syndrome, and those who are non-responsive to conservative treatment. Numerous surgical methods have been introduced, ranging from conventional open, microscope assisted, tubular retractor assisted, and endoscopic surgery. Among them, microscopic discectomy is currently the standard method. Biportal endoscopic spinal surgery (BESS) has several merits over other surgical techniques, including separate and free handling of endoscopy and surgical instruments, wide view of the surgical field with small skin incisions, absence of the procedure of removing fog from the endoscope, and lower infection rate by continuous saline irrigation. In addition, existing arthroscopic instruments for the extremities and conventional spinal instruments can be used for this technique and surgery for recurred disc herniation is applicable because delicate surgical procedures are performed under a brightness of 2,700 to 6,700 lux and a magnification of 28 to 35 times. Therefore, due to such advantages, BESS is a novel technique for the surgical treatment of lumbar disc herniation.


Subject(s)
Diskectomy , Endoscopes , Endoscopy , Extremities , Fibrosis , Hand , Humans , Intervertebral Disc Displacement , Intervertebral Disc , Lumbar Vertebrae , Methods , Orthopedics , Polyradiculopathy , Skin , Surgical Instruments , Weather
19.
Article in English | WPRIM | ID: wpr-766128

ABSTRACT

OBJECTIVES: Many studies have explored the relationship between short-term weather and its health effects (including pneumonia) based on mortality, although both morbidity and mortality pose a substantial burden. In this study, the authors aimed to describe the influence of meteorological factors on the number of emergency room (ER) visits due to pneumonia in Seoul, Korea. METHODS: Daily records of ER visits for pneumonia over a 6-year period (2009-2014) were collected from the National Emergency Department Information System. Corresponding meteorological data were obtained from the National Climate Data Service System. A generalized additive model was used to analyze the effects. The percent change in the relative risk of certain meteorological variables, including pneumonia temperature (defined as the change in average temperature from one day to the next), were estimated for specific age groups. RESULTS: A total of 217 776 ER visits for pneumonia were identified. The additional risk associated with a 1°C increase in pneumonia temperature above the threshold of 6°C was 1.89 (95% confidence interval [CI], 1.37 to 2.61). Average temperature and diurnal temperature range, representing within-day temperature variance, showed protective effects of 0.07 (95% CI, 0.92 to 0.93) and 0.04 (95% CI, 0.94 to 0.98), respectively. However, in the elderly (65+ years), the effect of pneumonia temperature was inconclusive, and the directionality of the effects of average temperature and diurnal temperature range differed. CONCLUSIONS: The term ‘pneumonia temperature’ is valid. Pneumonia temperature was associated with an increased risk of ER visits for pneumonia, while warm average temperatures and large diurnal temperature ranges showed protective effects.


Subject(s)
Aged , Climate , Emergencies , Emergency Service, Hospital , Humans , Information Systems , Korea , Meteorological Concepts , Mortality , Pneumonia , Public Health , Seoul , Weather
20.
Article in English | WPRIM | ID: wpr-765850

ABSTRACT

OBJECTIVE: Ample evidence has suggested that age at onset of Parkinson's disease (PD) is associated with heterogeneous clinical features in individuals. We hypothesized that this may be attributed to different patterns of nigrostriatal dopamine loss. METHODS: A total of 205 consecutive patients with de novo PD who underwent 18F-FP-CIT PET scans (mean follow-up duration, 6.31 years) were divided into three tertile groups according to their age at onset of parkinsonian motor symptoms. Striatal dopamine transporter (DAT) availability was compared between the old- (n = 73) and young-onset (n = 66) groups. In addition, the risk of developing freezing of gait (FOG) and longitudinal requirements for dopaminergic medications were examined. RESULTS: The old-onset PD group (mean age at onset, 72.66 years) exhibited more severe parkinsonian motor signs than the young-onset group (52.58 years), despite comparable DAT availability in the posterior putamen; moreover, the old-onset group exhibited more severely decreased DAT availability in the caudate than the young-onset group. A Cox regression model revealed that the old-onset PD group had a higher risk for developing FOG than the young-onset group [hazard ratio 2.523, 95% confidence interval (1.239–5.140)]. The old-onset group required higher doses of dopaminergic medications for symptom control than the young-onset group over time. CONCLUSION: The present study demonstrated that the old-onset PD group exhibited more severe dopamine loss in the caudate and were more likely to develop gait freezing, suggesting that age at onset may be one of the major determinants of the pattern of striatal dopamine depletion and progression of gait disturbance in PD.


Subject(s)
Age of Onset , Dopamine Plasma Membrane Transport Proteins , Dopamine , Follow-Up Studies , Freezing , Gait , Humans , Parkinson Disease , Positron-Emission Tomography , Putamen , Weather
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