Performance of Comprehensive Nursing Care Service in an Acute Care Hospital: Focusing on Accidental Falls and Pressure Injuries / 임상간호연구

Purpose@#This study aimed to investigate whether the comprehensive nursing care service positively affected accidental falls and pressure injuries. @*Methods@#This study was a retrospective study that analyzed the accidental falls and pressure injuries cases in an acute care hospital located in Seoul and compared the rates of accidental falls and pressure injuries before and after the comprehensive nursing care service was operated. @*Results@#Comparing the accidental fall incidence rates per 100 person-months between a comprehensive nursing care ward and a general ward, it showed fewer accidental falls by 0.44 in comprehensive nursing care wards, but the result was not statistically significant. In the case of pressure ulcers, the incident rate per 100 person-month was 6.17 in general wards and 4.77 in comprehensive nursing care wards, which showed that the number of pressure ulcer patients was lower in comprehensive nursing care wards, however it was also not statistically significant. @*Conclusion@#It is not confirmed that the operation of the comprehensive nursing care service contributes to the reduction of accidental hospital falls or pressure injuries. Follow-up studies are recommended to determine the effectiveness of comprehensive nursing services in quality indicators.

Relationship between Degenerative Disc Disease and Lipid Profiles in Older Adults

BACKGROUND: Lumbar degenerative disc disease (LDDD) is associated with obesity; however, there are only a few studies on the relationship between LDDD and the specific risk of obesity, such as dyslipidemia. We aimed to identify the independent association between LDDD and serum lipid profiles in older adults.METHODS: A retrospective case-control study was performed with the patients with LDDD, such as spinal stenosis and lumbosacral disc prolapse, and control patients. Sixty-eight patients with LDDD aged 65–85 years were recruited in the LDDD group. Thirty-seven age- and sex-matched controls without LDDD were also enrolled. Logistic regression analysis was performed after adjusting for age, sex and body mass index to assess the association between LDDD and serum lipid profiles.RESULTS: Total cholesterol and triglyceride levels were significantly higher in the LDDD group. The subjects with abnormal triglyceride level (>150 mg/dL) showed a significant odds ratio (7.274, 95% confidence interval [1.552–34.095], P-value=0.012) for LDDD.CONCLUSION: The study findings suggest that higher total cholesterol level may be associated with the patients with LDDD. Therefore, the association between serum triglyceride level and risk of LDDD must be studied further.

Torsade de pointes in liver transplantation recipient after induction of general anesthesia: a case report / 대한마취과학회지

Torsade de pointes (TdP) is an uncommon and specific form of polymorphic ventricular tachycardia, associated with a prolonged QT interval. Prolongation of the QT interval is the most widely recognized electrophysiological abnormality in patients with liver cirrhosis. We observed a case of TdP leading to cardiopulmonary resuscitation after the induction of general anesthesia, in a patient with liver cirrhosis scheduled for emergency cadaveric donor liver transplantation. The patient had mild QT prolongation on preoperative electrocardiography with a corrected QT (QTc) interval of 455 ms. Drugs used in the preoperative period can elongate cardiac repolarization. Sevoflurane and 5-hydroxytryptamine type 3 receptor antagonists such as palonsetron, used during general anesthesia may have triggered further QT prolongation, producing a fatal condition such as TdP. More caution and consideration in selecting drugs for anesthetic management are necessary for liver cirrhosis patients, especially in patients with preoperative QT prolongation.

Discrimination Between Childhood Subacute Necrotizing Lymphadenitis and Nonspecific Cervical Lymph Hyperplasia for Earlier Diagnosis / 소아알레르기및호흡기학회지

PURPOSE: We conducted this research to make an earlier diagnosis and identify better treatment for Kikuchi-Fujimoto disease (KFD) by comparing clinical findings with nonspecifically enlarged cervical lymph nodes in children. METHODS: Nineteen patients were diagnosed with KFD by tissue pathology from a fine needle aspiration biopsy and/or excisional biopsy and were compared with the clinical, radiological, and pathological findings of reactive hyperplasia. RESULTS: The average onset age of onset for patients with KFD was 11.8+/-3.61 years, and the male to female ratio was 1:1.1, whereas patients with reactive hyperplasia were 11.8+/-5.96 years, and the male to female ratio was 1.7:1. Patients with KFD suffered more from fever than patients with reactive hyperplasia (68% vs. 13%, P=0.002). Patients with KFD showed perinodal infiltration (P=0.001) and necrosis on computed tomography, whereas patients with reactive hyperplasia did not show any of these findings. Ultrasonographic findings were similar between the two study groups. In contrast, the histopathological examinations of biopsied cervical lymph nodes were enormously helpful for distinguishing the findings of KFD from those of patients with reactive hyperplasia. CONCLUSION: We recommend a histopathological examination to distinguish KFD from reactive hyperplasia in children with significantly enlarged cervical lymph nodes.

Postnatal cytomegalovirus infection in an extremely premature infant transmitted via breast milk: A case report / 소아과

Cytomegalovirus (CMV) is one of the most commonly encountered viral pathogens in newborn infants and is found in 0.3-2.4% of all live births. It has been demonstrated that 40-96% of seropositive mothers shed the virus via their breast milk. Breast milk containing CMV can cause almost one-third of CMV infections occurring in infants. A case of postnatal CMV infection in an extremely premature infant (gestational age 24(+5) weeks, birth weight 750 g) transmitted via breast milk is presented. For neonatal intensive care unit (NICU) management of severe thrombocytopenia, anemia, and sepsis syndrome, the infant received repeated transfusions of platelets; intravenous (IV) immunoglobulins; and gamma-irradiated, filtrated packed red cells and was fed her mother's breast milk since the second week of life. CMV infection was diagnosed with positive CMV immunoglobulin M (IgM) and positive urine CMV culture at the second month of life. Considering the negative CMV IgM and urine CMV culture at birth, postnatally-acquired CMV infection was suspected and confirmed with completely identical nucleotide sequence alignments of the infantile blood isolate and the maternal breast milk isolate. To our knowledge, this is the first case of proven postnatal CMV infection transmitted via breast milk in an extremely premature infant in Korea.

Postnatal cytomegalovirus infection in an extremely premature infant transmitted via breast milk: A case report / 소아과

Cytomegalovirus (CMV) is one of the most commonly encountered viral pathogens in newborn infants and is found in 0.3-2.4% of all live births. It has been demonstrated that 40-96% of seropositive mothers shed the virus via their breast milk. Breast milk containing CMV can cause almost one-third of CMV infections occurring in infants. A case of postnatal CMV infection in an extremely premature infant (gestational age 24(+5) weeks, birth weight 750 g) transmitted via breast milk is presented. For neonatal intensive care unit (NICU) management of severe thrombocytopenia, anemia, and sepsis syndrome, the infant received repeated transfusions of platelets; intravenous (IV) immunoglobulins; and gamma-irradiated, filtrated packed red cells and was fed her mother's breast milk since the second week of life. CMV infection was diagnosed with positive CMV immunoglobulin M (IgM) and positive urine CMV culture at the second month of life. Considering the negative CMV IgM and urine CMV culture at birth, postnatally-acquired CMV infection was suspected and confirmed with completely identical nucleotide sequence alignments of the infantile blood isolate and the maternal breast milk isolate. To our knowledge, this is the first case of proven postnatal CMV infection transmitted via breast milk in an extremely premature infant in Korea.