Risk Factors for Delayed Bleeding after Colonoscopic Polypectomy / 대한소화기내시경학회지

BACKGROUND/AIMS: The aim of this study was to identify risk factors for delayed bleeding after colonoscopic polypectomy. METHODS: 3,530 polypectomies in 1,542 patients were evaluated. Risk factors were identified among patient-related factors (age, sex, comorbidity, anticoagulants, antiplatelets), polyp-related factors (size, shape, location, histology), and procedure-related factors (experience of the endoscopist, sedation, resection method). RESULTS: Delayed bleeding occurred in 26 lesions (0.7%) of 24 patients (1.6%). Polyp-based multivariate analysis revealed that polyp size greater than 15 mm (OR, 2.882; 95% CI, 1.106 to 7.506; p=0.030) and sedation-free colonoscopy (OR, 2.606; 95% CI, 1.116 to 6.084; p=0.027) were significant risk factors for delayed bleeding after polypectomy. In colonoscopy-based analysis, hypertension increased the risk of delayed bleeding after polypectomy (OR, 2.938; 95% CI, 1.009 to 8.557; p=0.048). CONCLUSIONS: Large polyp size, sedation-free colonoscopy, and hypertension are associated with delayed bleeding after colonoscopic polypectomy.

A perinephric abscess caused by Streptococcus agalactiae / 대한내과학회지

Group B streptococcus (GBS, Streptococcus agalactiae) has recently been recognized as an important, increasingly common cause of invasive disease in non-pregnant adults with underlying medical conditions. Diabetes mellitus, malignancies, liver cirrhosis, and previous trauma history increase the risk for invasive GBS disease. We report a rare case of perinephric abscess caused by GBS in a non-pregnant diabetic woman. A 24-year-old woman with diabetes and a history of urinary tract infection presented with a 4-week history of intermittent febrile sensation, chills, right flank pain, and anorexia. Computed tomography revealed an 8-cm right perinephric abscess. She was treated with percutaneous drainage of the abscess and intravenous antibiotics directed at the GBS, which had grown from the abscess drainage. She had a satisfactory clinical course.

A brain abscess caused by Porphyromonas gingivalis / 대한내과학회지

Porphyromonas gingivalis is a gram-negative, anaerobic, rod-shaped bacterium originally classified within the Bacteroides genus, and a major etiological agent in the initiation and progression of severe periodontal disease. P. gingivalis has occasionally been involved in otitis media, lung abscesses, gas gangrene, appendicitis, sinusitis, paranasal mucocele, peri-tonsillar abscesses, pleura-pulmonary infections, and thoracic empyema. We report the case of a 44-year-old male who presented with a brain abscess in which the organism, presumably originated from his poor dentition. He was successfully treated with surgical drainage and antibiotics.

A brain abscess caused by Porphyromonas gingivalis / 대한내과학회지

Porphyromonas gingivalis is a gram-negative, anaerobic, rod-shaped bacterium originally classified within the Bacteroides genus, and a major etiological agent in the initiation and progression of severe periodontal disease. P. gingivalis has occasionally been involved in otitis media, lung abscesses, gas gangrene, appendicitis, sinusitis, paranasal mucocele, peri-tonsillar abscesses, pleura-pulmonary infections, and thoracic empyema. We report the case of a 44-year-old male who presented with a brain abscess in which the organism, presumably originated from his poor dentition. He was successfully treated with surgical drainage and antibiotics.

A Case of Humeral Osteomyelitis and Soft Tissue Abscess Accompanied with Streptococcus anginosus Bacteremia / 감염과화학요법

Streptococcus anginosus is a normal flora found in multiple body sites and belongs to the Streptococcus milleri group. It has often been associated with pyogenic infection, such as perio-dontitis, endocarditis, pulmonary abscess and abdominal or cerebral abscess. Also uncommonly, it can cause osteomyelitis. A 42-year-old man was admitted due to gastric ulcer perforation. At 12th hospital day, left humeral osteomyelitis and soft tissue abscess developed. Streptococcus anginosus grew in blood culture. He was treated with intravenous penicillin and surgical debridement of the necrotic tissue which lead to a satisfactory result. We report a rare case of Streptococcus anginosus-induced humeral osteomyelitis and soft tissue abscess.

A Case of Humeral Osteomyelitis and Soft Tissue Abscess Accompanied with Streptococcus anginosus Bacteremia / 감염과화학요법

Streptococcus anginosus is a normal flora found in multiple body sites and belongs to the Streptococcus milleri group. It has often been associated with pyogenic infection, such as perio-dontitis, endocarditis, pulmonary abscess and abdominal or cerebral abscess. Also uncommonly, it can cause osteomyelitis. A 42-year-old man was admitted due to gastric ulcer perforation. At 12th hospital day, left humeral osteomyelitis and soft tissue abscess developed. Streptococcus anginosus grew in blood culture. He was treated with intravenous penicillin and surgical debridement of the necrotic tissue which lead to a satisfactory result. We report a rare case of Streptococcus anginosus-induced humeral osteomyelitis and soft tissue abscess.

Comparison of Nursing Activities Reflected in Nursing Notes and In-depth Interviews of Nurses in an Acute Hospital / 간호학회지

PURPOSE: The purpose of this study was to compare the nursing activities delineated by interview of nurses with those on nursing notes. METHOD: The participants of interview were 18 nurses working in medical and surgical units of a large hospital in Seoul. Each nurse was asked to choose one patient who demand most nursing care among her patients. The nurse was then interviewed to describe what her nursing activities for the patient was that day. The audio-taped interview was transcribed and the content was analyzed by researchers. Nursing notes of each nurses' patients were copied and the content analyzed by researchers. Finally, themes from the interview data and those from nursing notes were compared. RESULT: Activities related to emotional or psychological nursing, education for patient and families, and problem solving related to treatment or nursing procedure were most often omitted in nursing notes. Most of the documentation in nursing notes were related to physical condition of patients or physician's orders. Nurses described that they will do better recording if they were given less patient care responsibility, had better nursing knowledge, had better recording system, and received more training on nursing record. CONCLUSION: Nursing notes did not reflect nursing activities properly. Few independent nursing roles were documented in the nursing notes. Development of nursing education program and nursing record system is needed for improvement of nursing record.