Factors Affecting Quality of Life in Patients with Unruptured Intracranial Aneurysm: A Systematic Review / 기본간호학회지

Purpose@#The purpose of this study was to comprehensively explore factors affecting quality of life in patients with unruptured intracranial aneurysm (UIA). @*Methods@#This study was conducted base on the National Evidence-based Healthcare Collaborating Agency (NECA) and Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). To search studies related to quality of life in patients with UIA. KoreaMed, Kmbase, Kiss, Pubmed, EMBASE, Cochrane Central and CINAHL were used. Key words were 'unruptured intracranial aneurysm', 'quality of life' and 'well-being'. A total of 136 studies were identified. After confirming duplication and abstracts, 15 studies were selected for analysis. @*Results@#As a result, factors affecting the quality of life in patients with UIA were categorized into individual factors, disease related factors, symptom related factors, and functional related factors. The Short form-36 was one of the most frequently used measurements. @*Conclusion@#To improve the quality of life of patients with UIA, researchers need to explore the multiple factors affecting quality of life in patients with UIA, and consider application of tools that can reflect the disease specific quality of life in patients with UIA.

Clinical validation of ImmuneCheck IgE for the rapid detection of serum total IgE

PURPOSE: Conventional serum IgE assay was costly, required the skills of expert, and relied heavily on expensive equipment. Quantitative measurement of total IgE using Point of Care Test (POCT) device can be the solution for these limitations. This study evaluated and validated the reproducibility of ImmuneCheck IgE. METHODS: This study included 120 patients of allergic diseases such as allergic rhinitis, asthma, drug allergy, food allergy, atopic dermatitis, or anaphylaxis . The reliability of POCT ImmuneCheck IgE was evaluated by comparing results from the naked eye and from the Q-Reader. Intratest reproducibility and intertest correlation were analyzed using intraclass correlation coefficient (ICC). RESULTS: Of the 120 enrolled patients, 51 were males and 69 were females. The ages ranged from 19 to 84 years, with an average age of 51.5 years. The concentration of serum total IgE measured by Phadia ImmunoCAP IgE ranged from 5.95 to 5,000 IU/mL. ICC for Intratest reproducibility of ImmuneCheck IgE by naked eye and by Q-Reader were 0.991 (P < 0.001) and 0.989 (P < 0.001), respectively. In addition, intertest correlation between ImmuneCheck IgE and Phadia ImmunoCAP IgE results of naked eye and Q-Reader were 0.968 (P < 0.001) and 0.948 (P < 0.001), respectively. CONCLUSION: The ImmuneCheck IgE was reproducible and highly correlated with conventional Phadia ImmunoCAP IgE assay. This result suggests that ImmuneCheck IgE can be a useful tool for rapid and precise detection of total IgE.

Clinical Usefulness of ImmuneCheck™ IgG for Rapid Semiquantitation of Total IgG

BACKGROUND: Conventional IgG assays require costly equipment and skilled experts. Semiquantitative measurement of total IgG using point-of-care testing devices may be the solution for these limitations. This study evaluated the reproducibility of the ImmuneCheck™ IgG assay (ProteomeTech Inc., Korea) and the correlation of its results with conventional laboratory IgG results in the serum and whole blood. METHODS: Both the serum and whole blood samples from 120 patients were used. To evaluate the intra-test reproducibility and inter-test correlation, intraclass correlation coefficient (ICC) analysis was used. RESULTS: The concentration of serum total IgG measured by cobas® 6000 (Roche Diagnostics, Switzland) ranged from 690.4 to 2,756.4 mg/dL. The intra-test reproducibility of ImmuneCheck™ IgG was high (Serum ICC=0.724, P < 0.001; Whole blood ICC=0.843, P < 0.001). The inter-test correlation between the ImmuneCheck™ IgG and cobas® 6000 results was very good (Serum ICC=0.805, P < 0.001; Whole blood ICC=0.842, P < 0.001). Because there were no samples with a total IgG level lower than 600 mg/dL, the pre-existing serum samples were diluted and then the linearity tests were conducted. The intra-test reproducibility for the diluted serum samples was almost perfect (ICC=0.995, P < 0.001), and the inter-test correlation between the ImmuneCheck™ IgG and cobas® 6000 results was also strong (ICC=0.992, P < 0.001). CONCLUSIONS: The ImmuneCheck™ IgG assay is reproducible and highly correlated with the conventional IgG assay for the serum and whole blood. It could be applied for the rapid detection of total IgG.

Antidepressants Use in Schizophrenia: Clinical Correlates and Prescription Profiles / 신경정신의학

OBJECTIVES: To identify recent prescription patterns, as well as the demographic and clinical correlates of antidepressants (ADs) usage in schizophrenic patients. METHODS: A total of 297 patients diagnosed with schizophrenia enrolled at Seoul National Hospital in 2013. Brief Psychiatric Rating Scale (BPRS) was used to evaluate current psychiatric symptoms. Bivariate comparisons were used to assess the usage of concomitant psychotropics, demographic and clinical characteristics of ADs users compared with non-users. Multivariate analysis of covariance was performed consecutively. RESULTS: The rate of ADs usage was 26.3% and the most commonly used ADs were selective serotonin reuptake inhibitors. ADs users more often took benzodiazepine than ADs non-users (p=0.005), whereas there were no significant demographic and other clinical difference between the two groups. Regarding BPRS, somatic concern (p=0.022), anxiety (p=0.001) and depressive mood (p=0.009) scores were higher, and excitement (p=0.006) and hostility (p=0.04) scores were lower among ADs users compared to non-users, although there was no significant difference in the other scores of BPRS between the two groups. Moreover, among 5 components of BPRS, scores of affective symptoms (p < 0.001) were significantly higher, and scores of activation symptoms (p=0.014) were significantly lower in ADs users compared to non-users. CONCLUSION: This study suggests that the usage of ADs could be related to affective symptoms regardless of positive and negative symptoms of schizophrenia. Further studies are required in order to confirm the clinical correlates of ADs usage and the interactions between affective symptoms and psychotic symptoms.

A Case of Pulmonary Cryptococcosis in an Immunocompetent Male Patient Diagnosed by a Percutaneous Supraclavicular Lymph Node Biopsy / 결핵및호흡기질환

Cryptococcal pneumonia usually occurs in immunocompromised patients with malignancy, acquired immune deficiency syndrome, organ transplantations, immunosuppressive chemotherapies, catheter insertion, or dialysis. It can be diagnosed by gaining tissues in lung parenchyma or detecting antigen in blood or bronchoalveolar lavage fluid. Here we report an immunocompetent 32-year-old male patient with diabetes mellitus diagnosed with cryptococcal pneumonia after a ultrasound-guided percutaneous supraclavicular lymph node core needle biopsy. We treated him with fluconazole at 400 mg/day for 9 months according to the guideline. This is the first case that cryptococcal pneumonia was diagnosed from a percutaneous lymph node biopsy in South Korea.

Clinical Correlates and Description Profiles of Antipsychotic Polypharmacy for Patients with Schizophrenia / 신경정신의학

OBJECTIVES: Despite increasing use of antipsychotic polypharmacy (APP), few studies have investigated APP for Korean patients with schizophrenia. The aim of this study was to identify the sociodemographic and clinical correlates and recent prescription profiles of APP in schizophrenia patients. METHODS: A total of 297 schizophrenia patients were recruited and interviewed using standardized assessment instruments in Seoul National Hospital. Differences in demographic and clinical characteristics between APP and antipsychotic monopharmacy (APM) groups were analyzed. The prescriptions of psychotropic drugs were collected by a review of medical records. RESULTS: In comparison with the APM group, the APP group showed association with earlier onset, lower employment rate, and higher scores for Clinical Global Impression-Severity and Brief Psychiatric Rating Scale (BPRS) (p<0.001). In particular, the BPRS positive (p<0.001) and affective symptom scores (p<0.001) of the APP group were higher those of the APM group. The most frequent combination pattern of APP was second generation antipsychotics (SGA)+SGA, followed by SGA+first generation antipsychotics (FGA), and SGA+SGA+FGA. For antipsychotics, it was risperidone+quetiapine, followed by clozapine+risperidone, risperidone+sulpiride, and risperidone+haloperidol. CONCLUSION: The current study suggests that the usage of APP for schizophrenia could be related to symptom severity affected by positive and affective symptoms. The prescription profile reflects that the proportion of atypical antipsychotics on APP has increased.