The First Case of an HIV Patient Diagnosed with COVID-19 in Korea

Although some comorbidities, such as diabetes mellitus, lung disease, and chronic kidney disease, are known as risk factors for poor clinical outcome in patients with coronavirus disease 2019 (COVID-19), it is unknown if human immunodeficiency virus (HIV) patients with COVID-19 would have poor prognosis than others. Rare cases of HIV patients with COVID-19 have been reported. As of May 25th, 2020, over 11,000 patients have been diagnosed with COVID-19 and over 13,000 are living with HIV in Korea. Here, we present the first HIV patient with COVID-19 in Korea. The 29-year-old Korean man had been taking Genvoya® regularly for seven years and HIV was well suppressed with CD4 counts of 555/mm 3 . He had mild symptoms of sore throat, dry cough, loss of taste and smell. He received hydroxychloroquine while Genvoya® was continued. Pneumonia diagnosed in chest computed tomography improved without oxygen supplementation. He was discharged on hospital day 31. HIV patients are considered as immunocompromised, but this case suggests that well controlled HIV patients have satisfactory prognosis following proper medical care.

Coronavirus Disease 2019 (COVID-19): Pandemic and the Challenge of Public Health

Infectious diseases caused by the novel coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2), the first outbreak in China, are currently pandemic in the world, including in Korea. Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 has not been proven and there has been no proper target medicine and vaccine, so it is virtually unprotected and is a serious health problem. A mitigation strategy that lowers and slows the peak of the epidemic is required to ensure efficient distribution of medical resources and time to development of therapeutic medicines and preventive vaccine. For this, close cooperation between the government and medical practitioners are required, and national prevention and prevention of the spread of the community and preparation for inflow from abroad will be required. In addition, large-scale studies on drugs including hydroxychloroquine, remdesivir, etc., which are known to be effective as therapeutic agents for COVID-19, are required to develop a vaccine for prevention. The authors hope that this review will assist primary care physicians currently engaged in patient care.

The Development of Automated Bed-allocation Expert System in Clinical Research Ward

BACKGROUND: Demands for complicated and long-term administration clinical trials have been increased since investigators actively involved in early stage clinical trials including first-in-human (FIH) trials. Research wards in our clinical trial center were mainly used for phase 1 trials. In order to perform several clinical trials simultaneously during a short period with a minimum number of rooms, beds, and equipment, staffs have to spend a lot of time for efficient operation of limited numbers of facilities. In this study, automated bed-allocation system was developed for efficient scheduling of the research ward based on clinical trial condition and status like experts. METHODS: The system was developed based on clinical trial design, schedule, and the information on research bed and availability stored and updated in database (DB). Automatic assignment system was designed to find an optimal schedule according to the given information using expert rules and algorithms. The optimal solution can be visualized on Gantt chart using C# and Chart FX API. RESULTS: The system was developed to demonstrate the schedule on color chart. It turned out to be well-designed to find an optimal schedule for bed allocation. The system also allows automatic updating of the schedule and information in the DB. CONCLUSION: Automated bed-allocation system developed in this study could save time and improve the efficiency for using space and equipment in clinical trial center. The system can be also applied to similar works or tasks in other fields.

The Effect of CPR and Abdominal Thrust Education on Teachers in Child Care Centers

PURPOSE: Education of adult laypersons in cardiopulmonary resuscitation (CPR) has been done frequently and done worldwide. Effective performance of bystander CPR has a decisive effect on outcomes for children as well as for adults. Although the chance of coming into contact with cardiac arrest and acute airway obstruction in a child is relatively high, there are only a few studies of the performance of CPR and abdominal thrust (Heimlich maneuver) done by teachers in child care centers. Therefore, we investigated the effects of CPR and abdominal thrust (Heimlich maneuver) education on teachers in child care centers, especially on their confidence and attitude while performing CPR and Heimlich maneuvers. METHODS: Between August 2009 and October 2009, 245 participants who worked in child care centers received 2 hours of education regarding CPR & emergency procedures for airway obstruction (Heimlich maneuver, abdominal thrust). Participants were asked questions (using a questionnaire) about their confidence and willingness to perform bystander CPR & the Heimlich maneuver. These questions were asked both before their education session and afterwards. Those who answered that they wouldn't perform bystander CPR & Heimlich maneuvers were asked to state the reason. In addition, participants were asked if they were aware of the law exempts from liability bystanders who are not health care providers and who provide CPR or Heimlich as an emergency procedure. RESULTS: The 'definitely yes' answer to 'willingness to perform CPR and abdominal thrust on a child increased from 33.1%, 41.2% before the education session to, respectively, 82.9%, 86.9% afterward (p<0.001). If we included 'yes' and 'relatively yes' answers, the accuracy of performance of acute airway obstruction (abdominal thrust, Heimlich maneuver) increased from 36% before education to 86.9% after. Meanwhile, the reasons for not performing bystander CPR and abdominal thrust, the ratio of 'fear of disease transmission' and 'fear of legal liability' was high in comparison to the ratio of 'fear of poor knowledge/performance'. Only 20.8% answered 'yes' to 'awareness that the law provided exemptions from liability for bystanders doing such emergency procedures. CONCLUSION: Adequate, constant education, including theoretical and practical child CPR and emergency maneuvers for acute airway obstruction of non-health care providers increased their confidence, accuracy and willingness to perform bystander CPR and abdominal thrust maneuvers.

The Delivery of Diabetic Care and Preventive Services among Diabetic Patients in Family Practice

BACKGROUND: The delivery of proper diabetes care and preventive services is essential for diabetic patients in family practice. However, there are few studies on preventive service practice. This study aimed to survey the delivery of preventive services among diabetic patients in an outpatient department of family medicine in a general hospital. METHODS: We reviewed all of the electronic medical records and charts of patients with a recent diagnosis code of type II diabetes mellitus in an outpatient department of family medicine at Asan Medical Center from January 1, 2001, to December 31, 2002, encompassing documentation of laboratory tests, treatment, and cancer screening. RESULTS: This study included 124 patients with diabetes. Blood pressure measurement, fundus examination, and nutritional counseling were performed in 96.7%, 80.6%, and 50% of subjects, respectively. Lipid profiles and urine microalbumin were checked in 91.1% and 58.2%, respectively. Anti-platelet and anti-smoking agents were prescribed in 17.7% and 13.2%, respectively. In males, the rate of cancer screening for stomach and colon were 55.9 and 53.2%, respectively. In females, the rate of cancer screening for stomach, colon, breast, and cervix were 45.5, 51.6, 43.2, and 38.6%, respectively. CONCLUSION: Diabetic care related services were delivered more often than those of preventive services, such as cancer screening and prescription of anti-smoking or anti-platelet agents. Efforts to improve the delivery of preventive services are needed among diabetic patients in family practice.

Dermatofibrosarcoma Protubrans at Peri-inguinal Area / 대한비뇨기과학회지

Dermatofibrosarcoma protuberans is an unusual locally aggressive cutaneous neoplasm of low grade malignancy. We report the case of a 47 years- old male who presented with an asymptomatic erythematous firm protruding mass in the left peri-inguinal area. Histopathologically, the tumor showed spindle-shape cells, arranged in a storiform pattern. The tumor cells stained positively for Vimentin and CD34 on immunohistochemical staining. Herein, we report a case of dermatofibrosarcoma protuberans.