Prevalence of workplace violence against registered nurses and their perceptions of relevant management systems in acute care hospitals / 한국간호교육학회지

Purpose@#This study investigated the prevalence and perceptions of workplace violence against registered nurses (RNs) in hospitals. @*Methods@#One thousand RNs replied to a nationwide survey from November 14 to December 22, 2022. They reported their general characteristics, prevalence of and their responses to different types of workplace violence from patients, family caregivers, physicians, and nurse peers, as well as their perceptions of workplace violence management systems. @*Results@#A total of 71.1% of the RNs reported that they had experienced workplace violence in the last six months. The violence and sexual harassment experienced from patients and family caregivers were 57.3% and 19.1%, respectively. Furthermore, violence, sexual harassment, and workplace harassment from physicians were experienced by 24.6%, 4.0%, and 7.4%, respectively, of the RNs, and those from nurse peers by 21.4%, 3.1%, and 11.3%, respectively. The RNs stated that they often responded to workplace violence with passive and inactive behaviors, which were more serious toward physicians’ workplace violence or sexual harassment from different perpetrators. Only 69.5% were aware of their hospital’s workplace violence management systems, while only 14.7%~27.4%, according to the type of hospital (p=.471), perceived the systems as effective. Multiple important strategies were identified to prevent workplace violence. @*Conclusion@#Critical suggestions are discussed for the prevention of workplace violence, including protecting the human rights of healthcare professionals, inter-organizational collaboration, and a culture of person-centered healthcare, and training nurse managers’ competency in managing workplace violence.

Foreign Body of External Auditory Canal: Review of 170 Cases / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Foreign bodies in the external auditory canal (EAC) are frequently encountered by otolaryngologists, emergency care physicians and pediatricians. The purpose of this study was to assess clinical characteristics, complications, as well as to investigate the proper management of foreign bodies in the EAC. SUBJECTS AND METHOD: We retrospectively reviewed and analyzed clinical records of patients who presented with foreign bodies in the EAC at the otolaryngologic department of Keimyung University Dongsan Hospital from January, 2011 to October, 2016. RESULTS: One-hundred seventy patients with aural foreign bodies were identified. The age of patients ranged from 12 months to 83 years, with 34.1% of the patients being under 10 years of age. Thirteen different types of foreign bodies were found, where insects, cottons and beads were the most common. Approximately 98% of the foreign bodies were removed without general anesthesia by using proper instruments under direct vision. Complications were observed in 5.8% of the patients: these included laceration and bleeding from the EAC (80%) and traumatic perforation of the tympanic membrane (20%). CONCLUSION: Various methods are available for foreign body removal from the EAC. In order to remove foreign bodies successfully and reduce complications, patients should be given precautions, such as, regarding adequate immobilization, prior to removing foreign bodies using proper instruments with a surgical microscope under appropriate anesthesia.

The Value of PROPELLER Diffusion-Weighted Image in the Detection of Cholesteatoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: This study was to done to determine the value of PROPELLER diffusion-weighted imaging in detecting cholesteatoma. SUBJECTS AND METHOD: Sixty-five patients were evaluated by preoperative magnetic resonance imaging (MRI) with PROPELLER diffusion-weighted imaging. Of 65 patients, 16 patients had chronic otitis media without cholesteatoma and 49 patients with cholesteatoma. Surgical and pathologic findings were compared with the preoperative findings by PROPELLER diffusion-weighted imaging to assess the sensitivity, specificity, positive and negative predictive values. RESULTS: In 49 patients with cholesteatoma, high signal intensity compatible with cholesteatoma was found in 46 patients, whereas in 16 patients without cholesteatoma, high signal intensity was not detected in any of them. The sensitivity, specificity, positive and negative predictive values for PROPELLER diffusion-weighted imaging were 94.1%, 100%, 100%, and 84.2%, respectively. CONCLUSION: PROPELLER diffusion-weighted imaging can be a useful tool in detecting cholesteatoma.

Medications as Risk Factor for Falls / 대한평형의학회지

Falls are the most common cause of accidents among the older population, leading to both fatal and non-fatal injuries. Falls is a syndrome resulting from the cumulative effect of various extrinsic and intrinsic factors. It is considered to be a multifactorial disorder. Medication use is considered a risk factor for falls. We reviewed medications associated with falls in older individuals. In geriatrics populations, polypharmacy is associated with falls. Medical doctors should be aware of the possibility that starting a new medication, such as antihypertensive agents, benzodiazepine, antidepressants, opioid agents and antihistamines, may act as a trigger for the onset of a fall.

Vestibular Paroxysmia Mimicking Benign Parxysmal Positional Vertigo / 대한평형의학회지

Vestibular paroxysmia is the name given to the syndrome caused by vascular compression of the vestibulocochlear nerve. The main symptoms of vestibular paroxysmia are recurrent, spontaneous, brief attacks of spinning, non-spinning vertigo or positional vertigo that generally last less than one minute, with or without ear symptoms (tinnitus and hypoacusis). Prior to attributing a patient's symptoms to vestibular paroxysmia, however, clinicians must exclude common conditions like benign paroxysmal positional vertigo, Menière's disease, vestibular neuritis and vestibular migraine. This is usually possible with a thorough history and bedside vestibular/ocular motor examination. Herein, we describe a patient with vestibular paroxysmia that mimicked resolved BPPV with a literature review.

Sonographic Index for Extrathyroidal Extension of Papillary Thyroid Carcinoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Ultrasonography is the most useful tool for detecting extrathyroidal extension, which is the deciding factor in surgical extension of papillary thyroid carcinoma. However, there are few studies on pre-operative ultrasonographic findings about extrathyroidal extension. This research thus evaluates a predictive sonographic index of extrathyroidal extension. SUBJECTS AND METHOD: 265 patients with papillary thyroid carcinoma who underwent preoperative sonography and surgery were respectively reviewed. Sonographic findings were compared with pathological results. RESULTS: There were no differences among the patents in terms of calcification and echo texture, whereas significant differences were observed in terms of mass size, lymph node metastasis, capsule contact, and degree of capsule contact. These four factors were weighted according to the degree of severity and defined the extrathyroidal index as the total of these scores. The index had high sensitivity, specificity and predictability. CONCLUSION: We suggest that the extrathyroidal extension index with sonography is helpful for drawing pre-operative sonographic diagnosis.

Accurate Diagnosis with Chest CT for Bronchial Foreign Body Removal in Young Patient: Report of Three Cases and Review of the Literature / 대한이비인후과학회지

Foreign body aspiration (FBA) is a common accident and remains a serious problem in young children. Undiagnosed and retained FBA could be a life-threatening risk and causes serious complications especially for young children. To prevent complications, prompt diagnosis and removal of foreign body is mandatory. Chest computerized tomography (CT) has recently become a very useful noninvasive diagnostic modality for bronchial FBA. We present here three different patients with bronchial FBA, which had been diagnosed by chest CT and completely removed under ventilating bronchoscopy without complication. The authors reviewed the literature and discussed the usefulness of chest CT on bronchial FBA in children.

Benign Paroxysmal Positional Vertigo After Cochlear Implantation / 대한평형의학회지

Cochlear implantation (CI) has enabled hearing rehabilitation of patients with severe hearing impairment for more than 20 years now. There have been reported that one possible complication of CI is the impairment of balance function with resulting vertigo symptoms. CI still implies trauma on the labyrinthine structures to allow the electrode system to be inserted into the cochlear turns. Benign paroxysmal positional vertigo is an uncommon development after CI. We experienced an 80-year-old woman who had immediate onset of vertigo after CI, which diagnosed in postoperative one day after CI. In postoperative videonystagmography, no spontaneous nystagmus was observed, but in right Dix-Hallpike, torsional nystagmus, where the top of the eye rotates towards the right ear in beating fashion. Vertigo improved after modified Epley maneuver. However there was one recurrence after 12 days later. The case is described along with a review of the literature.