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1.
Nutr Neurosci ; : 1-10, 2024 Mar 11.
Article in English | MEDLINE | ID: mdl-38462966

ABSTRACT

Objectives: This study aimed to explore the relationship between breakfast skipping and its effects on sleep disorders, mental health, and health-related quality of life among Korean adults.Methods: Utilizing data from the 2018 Korea Community Health Survey, this cross-sectional analysis included 173,272 adults aged 19 years and older. Instruments used for assessment included the Patient Health Questionnaire-9 for depression, the EuroQol 5-dimension (EQ-5D) for health-related quality of life, and the Pittsburgh Sleep Quality Index for sleep disorders. The complex sample logistic regression analysis was employed to adjust for potential confounders.Results: Breakfast skipping was found to be significantly associated with delayed mid-sleep time, an increased propensity for daytime sleepiness, and a notable decline in sleep quality. Additionally, it was linked to a significant increase in depression risk, compromised health-related quality of life, and elevated stress levels across both genders. All five dimensions of the EQ-5D were negatively impacted by breakfast skipping.Discussion: The findings highlight the detrimental effects of skipping breakfast on sleep patterns, mental health, and overall quality of life, stressing the importance of regular breakfast consumption for enhancing these health outcomes. The study suggests the need for further research to uncover the mechanisms behind these associations and to devise targeted interventions to mitigate the negative impacts of breakfast skipping.

2.
Chronobiol Int ; 41(1): 1-9, 2024 01.
Article in English | MEDLINE | ID: mdl-38108132

ABSTRACT

This cross-sectional study examined the relationship of mid-sleep time (MST) with depression, quality of life, and sleep deprivation. This study included 173 284 adults aged ≥ 19 years who participated in the 2018 Korea Community Health Survey. The Patient Health Questionnaire-9 for depression, EuroQol-5 dimension for health-related quality of life, and the Pittsburgh Sleep Quality Index for MST, daytime sleepiness, and sleep quality were used. Regression and logistic regression analysis was used for complex sample analysis. The results showed that individuals with later MST had a higher risk of depression, poor quality of life, poor sleep quality, and excessive daytime sleepiness than intermediate-type individuals, whereas earlier MST was associated with good sleep quality in the total population. This association was significant in both men and women. The later type was associated with all items of health-related quality of life in both men and women. These findings suggest that the later type is a significant predictor of mental health, quality of life, sleep quality, and daytime sleepiness. Identifying an individual's mid-sleep time may help tailor interventions and treatment strategies that optimize sleep, mental health outcomes, and quality of life.


Subject(s)
Disorders of Excessive Somnolence , Sleep Wake Disorders , Male , Adult , Humans , Female , Sleep Deprivation , Quality of Life , Depression/epidemiology , Public Health , Cross-Sectional Studies , Circadian Rhythm , Sleep , Surveys and Questionnaires , Republic of Korea
3.
Life (Basel) ; 13(8)2023 Jul 26.
Article in English | MEDLINE | ID: mdl-37629482

ABSTRACT

This study aimed to investigate whether obstructive sleep apnea (OSA) is associated with an increased risk of chronic kidney disease (CKD) and to perform subgroup analysis by sex and working hours. This cross-sectional study was conducted on 8157 subjects who participated in the Korea National Health and Nutrition Examination Survey (KNHANES). The adults completed the STOP-BANG score to measure their risk of OSA, and blood and urine samples were collected to ascertain the severity of CKD based on the estimated glomerular filtration rate and urine albumin-to-creatinine ratio. Multivariate logistic regression was used for complex sample analysis. After fully adjusting for the confounding variables, the high-risk OSA group showed a significantly higher risk of developing albuminuria and CKD than the low-risk group, particularly among men. Odds ratio (OR) 1.72, 95% confidence interval (CI) 1.13-2.6 and (OR 1.67, 95% CI 1.14-2.45), respectively. Additionally, men who worked for 40 h/week showed a significant association between OSA, CKD, and albuminuria. This study supports the link between OSA and the risk of kidney disease, especially among men and those who work long hours. Screening and treating OSA may be a crucial strategy for preventing kidney disease, particularly in high-risk populations.

4.
PLoS One ; 18(6): e0287182, 2023.
Article in English | MEDLINE | ID: mdl-37319130

ABSTRACT

OBJECTIVES: This study assessed the effects of obstructive sleep apnea (OSA) on mental health, health-related quality of life (HRQoL), and multimorbidity in Korean adults. METHODS: The study included 8030 participants from the Korea National Health and Nutrition Examination Survey Ⅷ (2019-2020). The risk of OSA was assessed using STOP-BANG questionnaire. Depression was measured using the Patient Health Questionnaire-9 (PHQ-9), and stress was measured using a questionnaire. HRQoL was determined by EuroQol 5-dimension (EQ-5D) and Health-related Quality of Life Instrument with 8 Items (HINT-8) scores. Multimorbidity was defined as the presence of 2 or more chronic diseases. A complex sample multivariate logistic regression analysis was conducted. RESULTS: Participants with a high OSA risk were more likely to a have high PHQ-9 score (OR 4.31, 95% confidence interval [CI] 2.80-6.65), total depression (OR 4.07, 95% CI 2.67-6.19) stress (OR 2.33, 95% CI 1.85-2.95), lower EQ-5D (OR 2.88, 95% CI 2.00-4.15) and HINT-8 scores (OR 2.87, 95% CI 1.65-4.98), and multimorbidity (OR 2.62, 95% CI 2.01-3.41) than participants with low OSA risk. High OSA risk was significantly associated with all EQ-5D and HINT-8 items. CONCLUSIONS: This study adds to the few population-based studies showing associations between mental health, HRQoL, and multimorbidity using nationwide data. OSA prevention might be helpful for good mental health, improving HRQoL, and comorbidity burdens. The results provide novel insights regarding the association between sleep apnea and multimorbidity.


Subject(s)
Quality of Life , Sleep Apnea, Obstructive , Adult , Humans , Multimorbidity , Mental Health , Nutrition Surveys , Surveys and Questionnaires , Logistic Models , Republic of Korea/epidemiology , Sleep Apnea, Obstructive/epidemiology
5.
Sci Adv ; 9(16): eadf4049, 2023 Apr 21.
Article in English | MEDLINE | ID: mdl-37083532

ABSTRACT

An integrated textile electronic system is reported here, enabling a truly free form factor system via textile manufacturing integration of fiber-based electronic components. Intelligent and smart systems require freedom of form factor, unrestricted design, and unlimited scale. Initial attempts to develop conductive fibers and textile electronics failed to achieve reliable integration and performance required for industrial-scale manufacturing of technical textiles by standard weaving technologies. Here, we present a textile electronic system with functional one-dimensional devices, including fiber photodetectors (as an input device), fiber supercapacitors (as an energy storage device), fiber field-effect transistors (as an electronic driving device), and fiber quantum dot light-emitting diodes (as an output device). As a proof of concept applicable to smart homes, a textile electronic system composed of multiple functional fiber components is demonstrated, enabling luminance modulation and letter indication depending on sunlight intensity.

6.
Nanoscale Horiz ; 8(4): 522-529, 2023 Mar 27.
Article in English | MEDLINE | ID: mdl-36790218

ABSTRACT

InP quantum dots (QDs) are attracting significant interest as a potentially less toxic alternative to Cd-based QDs in many research areas. Although InP-based core/shell QDs with excellent photoluminescence properties have been reported so far, sophisticated interface treatment to eliminate defects is often necessary. Herein, using aminophosphine as a seeding source of phosphorus, we find that H2S can be efficiently generated from the reaction between a thiol and an alkylamine at high temperatures. Apart from general comprehension that H2S acts as a S precursor, it is revealed that with core etching by H2S, the interface between InP and ZnS can be reconstructed with S2- incorporation. Such a transition layer can reduce inherent defects at the interface, resulting in significant photoluminescence (PL) enhancement. Meanwhile, the size of the InP core could be further controlled by H2S etching, which offers a feasible process to obtain wide band gap InP-based QDs with blue emission.

7.
Nutrients ; 14(17)2022 Aug 24.
Article in English | MEDLINE | ID: mdl-36079719

ABSTRACT

This study investigated the effects of folic acid on obesity and high-sensitivity C-reactive protein (CRP) levels. Using data from the Korea National Health and Nutrition Examination Survey (KNHANES VII 2016-2018), 6394 adults (aged 19-80 years) who met the study criteria were identified and divided into young, middle-aged, and older adult groups. The analysis assessed associations using logistic regression for complex samples. Obesity was measured using body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), a body shape index (ABSI), and body roundness index (BRI). The odds ratio (OR) of obesity based on BMI were statistically significant for young adults and older participants with low levels of folic acid compared to those with high levels (OR: 1.33 and 1.58, respectively). The OR of obesity based on BMI, WC, WHtR, ABSI, and BRI was significant with low levels of folic acid in middle-aged individuals (OR: 1.36, 1.32, 1.41, 1.29, and 1.47, respectively). Low folate levels were related to higher high-sensitivity CRP levels in middle-aged patients. In conclusion, folate level showed a significant inverse association with obesity and inflammatory biomarkers, especially in the middle-aged group. Further longitudinal or randomized controlled trials are needed to confirm and expand our results.


Subject(s)
C-Reactive Protein , Obesity , Aged , Body Mass Index , Folic Acid , Humans , Middle Aged , Nutrition Surveys , Obesity/complications , Risk Factors , Waist Circumference , Waist-Height Ratio , Young Adult
8.
Nat Commun ; 13(1): 4189, 2022 Aug 03.
Article in English | MEDLINE | ID: mdl-35922408

ABSTRACT

We propose a computational design framework to design the architecture of a white lighting system having multiple pixelated patterns of electric-field-driven quantum dot light-emitting diodes. The quantum dot of the white lighting system has been optimised by a system-level combinatorial colour optimisation process with the Nelder-Mead algorithm used for machine learning. The layout of quantum dot patterns is designed precisely using rigorous device-level charge transport simulation with an electric-field dependent charge injection model. A theoretical maximum of 97% colour rendering index has been achieved with red, green, cyan, and blue quantum dot light-emitting diodes as primary colours. The white lighting system has been fabricated using the transfer printing technique to validate the computational design framework. It exhibits excellent lighting performance of 92% colour rendering index and wide colour temperature variation from 1612 K to 8903 K with only the four pixelated quantum dots as primary.

9.
Nat Commun ; 13(1): 814, 2022 Feb 10.
Article in English | MEDLINE | ID: mdl-35145096

ABSTRACT

Smart textiles consist of discrete devices fabricated from-or incorporated onto-fibres. Despite the tremendous progress in smart textiles for lighting/display applications, a large scale approach for a smart display system with integrated multifunctional devices in traditional textile platforms has yet to be demonstrated. Here we report the realisation of a fully operational 46-inch smart textile lighting/display system consisting of RGB fibrous LEDs coupled with multifunctional fibre devices that are capable of wireless power transmission, touch sensing, photodetection, environmental/biosignal monitoring, and energy storage. The smart textile display system exhibits full freedom of form factors, including flexibility, bendability, and rollability as a vivid RGB lighting/grey-level-controlled full colour display apparatus with embedded fibre devices that are configured to provide external stimuli detection. Our systematic design and integration strategies are transformational and provide the foundation for realising highly functional smart lighting/display textiles over large area for revolutionary applications on smart homes and internet of things (IoT).

10.
Ann Coloproctol ; 38(6): 423-431, 2022 Dec.
Article in English | MEDLINE | ID: mdl-34875819

ABSTRACT

PURPOSE: Most of the causes of small bowel obstruction (SBO) in patients without a history of abdominal surgery are unclear at initial assessment. This study was conducted to identify the etiology and clinical characteristics of SBO in virgin abdomens and discuss the proper management. METHODS: A retrospective review involving operative cases of SBO from a single institute, which had no history of abdominal surgery, was conducted between January 2010 and December 2020. Clinical information, including radiological, operative, and pathologic findings, was investigated to determine the etiology of SBO. RESULTS: A total of 55 patients were included in this study, with a median age of 57 years and male sex (63.6%) constituting the majority. The most frequently reported symptoms were abdominal pain and nausea or vomiting. Neoplasm as an underlying cause accounted for 34.5% of the cases, of which 25.5% were malignant cases. In patients aged ≥60 years (n=23), small bowel neoplasms were the underlying cause in 12 (52.2%), of whom 9 (39.1%) were malignant cases. Adhesions and Crohn disease were more frequent in patients aged <60 years. Coherence between preoperative computed tomography scans and intraoperative findings was found in 63.6% of the cases. CONCLUSION: There were various causes of surgical cases of SBO in virgin abdomens. In older patients, hidden malignancy should be considered as a possible cause of SBO in a virgin abdomen. Patients with symptoms of recurrent bowel obstruction who have no history of prior abdominal surgery require thorough medical history and close follow-up.

11.
Nutrients ; 13(10)2021 Oct 15.
Article in English | MEDLINE | ID: mdl-34684620

ABSTRACT

This study investigated how folic acid affects muscle strength and the effects of vitamin A on quality of life in adults. Baseline data from the Korea National Health and Nutrition Examination Survey (KNHANES VII 2016-2018) was used to find 6112 adults (ages 19-80) meeting study criteria. The participants were divided into three groups: young adults (ages 19-39), middle-aged (ages 40-64), and elderly (≥65 years). Muscle strength was measured using a digital grip strength dynamometer. The EuroQol five-dimension questionnaire measured quality of life. Associations were assessed using multivariate regression and logistic regression. Vitamins and handgrip strength were divided into low and high groups based on the mean. Although vitamin A and folate levels were related to handgrip strength in all subjects, regression demonstrated a significant association between folate and handgrip strength in the elderly. The odds ratios (OR) of higher handgrip strength were statistically significant for elderly participants with high levels of folate compared to those with low levels (OR: 1.55). Vitamin A was associated with quality of life, especially in the self-care dimension for the elderly. Further longitudinal research is needed to examine the relationship between vitamins and muscle strength, as well as vitamins and quality of life.


Subject(s)
Folic Acid/pharmacology , Muscle Strength/physiology , Nutrition Surveys , Quality of Life , Vitamin A/pharmacology , Adult , Aged , Aged, 80 and over , Female , Hand Strength/physiology , Humans , Logistic Models , Male , Middle Aged , Muscle Strength/drug effects , Republic of Korea , Young Adult
12.
Nanoscale Horiz ; 6(2): 68-77, 2021 Feb 01.
Article in English | MEDLINE | ID: mdl-33400752

ABSTRACT

Quantum dot light-emitting diodes (QD-LEDs) are widely recognised as great alternatives to organic light-emitting diodes (OLEDs) due to their enhanced performances. This focus article surveys the current progress on the state-of-the-art QD-LED technology including material synthesis, device optimization and innovative fabrication processes. A discussion on the material synthesis of core nanocrystals, shell layers and surface-binding ligands is presented for high photoluminescence quantum yield (PLQY) quantum dots (QDs) using heavy-metal free materials. The operational principles of several types of QD-LED device architectures are also covered, and the recent evolution of device engineering technologies is investigated. By exploring the fabrication process for pixel-patterning of QD-LEDs on an active-matrix backplane for full-colour display applications, we anticipate further improvement in device performance for the commercialisation of next-generation displays.

13.
Medicine (Baltimore) ; 100(1): e23994, 2021 Jan 08.
Article in English | MEDLINE | ID: mdl-33429760

ABSTRACT

ABSTRACT: To date research investigating the associations between handgrip strength and multimorbidity when stratifying by age and sex is limited. Furthermore, this is the first study in a Korean population, and the first to include adults ≥ 19 years of age. Here we investigated the associations between handgrip strength and multimorbidity in Korean adults aged ≥ 19 years.In this cross-sectional study data from the Korean National Health and Nutrition Examination Survey were used. Multimorbidity was defined as having 2 or more chronic diseases. A total of 19,779 participants were eligible for the study (8730 male and 11,049 female). We grouped and analysed participants based on age and sex (men and women aged 19-49 years, men and women aged 50-80 years) and examined the associations between handgrip strength and multimorbidity using multivariate logistic regressions using stratification by age, sex and body mass index (BMI).Multivariate logistic regressions revealed a significant inverse association irrespective of sex, between relative handgrip strength and multimorbidity. Participants with the lowest handgrip strength had a significantly higher odds ratio (OR) of multimorbidity (men aged 19-49 years: 3.76 and aged 50 years to 80 years: 2.11; women aged 19 years to 49 years: 1.52 and aged 50-80 years: 2.15) when compared to those with highest handgrip strength after adjusting for confounding variables. The highest OR was observed in men aged 19 years to 49 years with a BMI ≥ 25 kg/m2.In the current study we observed a significant inverse relationship between handgrip strength and multimorbidity in males and females with 2 or more chronic diseases. Male participants with a low handgrip strength aged between 19 years to 49 years with a BMI ≥25 kg/m2 may be at greater risk of multimorbidity. This study highlights the need for further longitudinal studies to investigate the effects of increasing handgrip strength combined with weight loss, as an effective strategy to reduce the incidence of multimorbidity.


Subject(s)
Hand Strength/physiology , Multimorbidity , Adult , Body Mass Index , Cross-Sectional Studies , Female , Humans , Logistic Models , Male , Middle Aged , National Health Programs/organization & administration , National Health Programs/trends , Nutrition Surveys/methods , Republic of Korea
14.
ACS Omega ; 5(34): 21593-21601, 2020 Sep 01.
Article in English | MEDLINE | ID: mdl-32905305

ABSTRACT

We report on the design, fabrication, and characterization of heterostructure In-Zn-O (IZO) thin-film transistors (TFTs) with improved performance characteristics and robust operation. The heterostructure layer is fabricated by stacking a solution-processed IZO film on top of a buffer layer, which is deposited previously using an electron beam (e-beam) evaporator. A thin buffer layer at the dielectric interface can help to template the structure of the channel. The control of the precursors and of the solvent used during the sol-gel process can help lower the temperature needed for the sol-gel condensation reaction to proceed cleanly. This boosts the overall performance of the device with a significantly reduced subthreshold swing, a four-fold mobility increase, and a two-order of magnitude larger on/off ratio. Atomistic simulations of the a-IZO structure using molecular dynamics (both classical and ab initio) and hybrid density functional theory (DFT) calculations of the electronic structure reveal the potential atomic origin of these effects.

15.
Ann Coloproctol ; 36(5): 335-343, 2020 Oct.
Article in English | MEDLINE | ID: mdl-32054243

ABSTRACT

PURPOSE: Because insertion of a foreign body (FB) into the anus is considered a taboo practice, patients with a retained rectal FB may hesitate to obtain medical care, and attending surgeons may lack experience with removing these FBs. We performed this study to evaluate the clinical characteristics of Korean patients with a retained rectal FB and propose management guideline for such cases based on our experience. METHODS: We retrospectively investigated 14 patients between January 2006 and December 2018. We assessed demographic features, mechanism of FB insertion, clinical course between diagnosis and management, and outcomes. RESULTS: All patients were male (mean age, 43 years) and presented with low abdominal pain (n = 2), anal bleeding (n = 2), or concern about a retained rectal FB without symptoms (n = 10). FB insertion was most commonly associated with sexual gratification or anal eroticism (n = 11, 78.6%). All patients underwent general anesthesia for anal sphincter relaxation with the exception of 2 who underwent FB removal in the emergency department. FBs were retrieved transanally using a clamp (n = 2), myoma screw (n = 1), clamp application following abdominal wall compression (n = 2), or laparotomy followed by rectosigmoid colon milking (n = 2). Colotomy and primary repair were performed in four patients, and Hartmann operation was performed in one patient with fecal peritonitis. No morbidity or mortality was reported. All patients refused postextraction anorectal functional and anatomical evaluation and psychological counseling. CONCLUSION: Retained rectal FB is rare; however, colorectal surgeons should be aware of the various methods that can be used for FB retrieval and the therapeutic algorithm applicable in such cases.

16.
Korean J Intern Med ; 35(4): 979-987, 2020 07.
Article in English | MEDLINE | ID: mdl-31648434

ABSTRACT

BACKGROUND/AIMS: Among patients with febrile neutropenia that developed after chemotherapy, high-risk patients, such as those having clinical instability or Multinational Association of Supportive Care in Cancer score of < 21, require hospitalization for intravenous empiric antibiotic therapy. Monotherapy with an anti-pseudomonal ß-lactam agent is recommended. Although many studies reported the microbial etiology of infections and resistant patterns of febrile neutropenia, the patients were not well characterized as having neutropenic septic shock. Therefore, this study aimed to determine the microbial spectrum of infections and resistance patterns of their isolates in patients with chemotherapy-induced neutropenic septic shock. METHODS: Data of adult patients diagnosed with neutropenic septic shock in the emergency department between June 2012 and December 2016 were extracted from a prospectively compiled septic shock registry at a single academic medical center. Thereafter, microbiological studies and antimicrobial susceptibility tests were conducted. RESULTS: In total, 109 bacteria were found in patients with neutropenic septic shock. Gram-negative bacteria were the predominant causative organisms (84, 77.1%). Moreover, 33 microorganisms (30.3%) were multidrug-resistant (MDR) bacteria with extended-spectrum ß-lactamase-producing Escherichia coli (17, 50%) being the commonest. The most commonly affected sites in patients with MDR bacterial infections were the gastrointestinal tract (45%) and unknown (43.5%). Approximately 48.5% of MDR bacteria were resistant to cefepime but not to piperacillin-tazobactam or carbapenem. CONCLUSION: MDR bacteria were prevalent in patients with chemotherapy-induced neutropenic septic shock. Therefore, piperacillin-tazobactam or carbapenem may be considered as empiric antibiotics if MDR bacteria are suspected to be causative agents.


Subject(s)
Neoplasms , Shock, Septic , Adult , Anti-Bacterial Agents/adverse effects , Drug Resistance, Bacterial , Humans , Neoplasms/drug therapy , Piperacillin, Tazobactam Drug Combination/adverse effects , Shock, Septic/drug therapy
17.
Ann Hepatobiliary Pancreat Surg ; 23(4): 334-338, 2019 Nov.
Article in English | MEDLINE | ID: mdl-31824998

ABSTRACT

BACKGROUNDS/AIMS: This study aimed to compare the perioperative and clinical outcomes in patients undergoing laparoscopic cholecystectomy for gallbladder adenomyomatosis (GBA) or early-stage gallbladder cancer (GBC). METHODS: The perioperative and clinical outcomes of 194 patients diagnosed with GBA and 30 patients diagnosed with GBC who underwent laparoscopic cholecystectomy in our institution from January 2011 to December 2017 were retrospectively compared. RESULTS: There were no significant differences between the GBA and GBC groups in sex (male:female ratio 1.0:0.8 vs. 1.0:0.7, p=0.734), BMI (23.9±3.4 vs. 24.0±3.8 kg/m2, p=0.916), or preoperative liver function tests. Patients in the GBC group were significantly older (50.5±14.1 vs. 65.9±10.6 years, p<0.001) and had a higher ASA grade (40.3 vs. 63.4% grade II or III, p=0.043) than patients in the GBA group. Although there was no significant difference in preoperative diagnostic methods (p=0.442), the GBC group showed a significantly higher rate of misdiagnosis on preoperative imaging compared with postoperative histopathologic findings (30.9% vs. 53.3%, p=0.011). There were significantly more patients with gallstones in the GBA group than in the GBC group (68.6% vs. 40.0%, p=0.004). CONCLUSIONS: In older patients hospitalized for biliary colic without gallstones but with a thickened gallbladder wall with inflammation on preoperative diagnostic exam, the possibility of early-stage GBC should be considered.

18.
Acute Crit Care ; 34(2): 141-147, 2019 May.
Article in English | MEDLINE | ID: mdl-31723919

ABSTRACT

BACKGROUND: Hemoglobin levels are a critical parameter for oxygen delivery in patients with shock. On comparing target hemoglobin levels upon transfusion initiation, the correlation between the severity of decrease in hemoglobin levels and patient outcomes remains unclear. We evaluated the association between initial hemoglobin levels and mortality in patients with septic shock treated with protocol-driven resuscitation bundle therapy at an emergency department. METHODS: Data of adult patients diagnosed with septic shock between June 2012 and December 2016 were extracted from a prospectively compiled septic shock registry at a single academic medical center. Patients were classified into four groups according to initial hemoglobin levels: ≥9.0 g/dl, 8.0-8.9 g/dl, 7.0-7.9 g/dl, and <7.0 g/dl. The primary endpoint was 90-day mortality. RESULTS: In total, 2,265 patients (male, 58.3%; median age, 70.0 years [interquartile range, 60 to 78 years]) with septic shock were included. For the four groups, 90-day mortality rates were as follows: 29.1%, 43.0%, 46.5%, and 46.9% for ≥9.0 g/dl (n=1,808), 8.0-8.9 g/dl (n=217), 7.0-7.9 g/dl (n=135), and <7.0 g/dl (n=105), respectively (P<0.001). Multivariate logistic regression showed that initial hemoglobin levels were an independent factor associated with 90-day mortality and mortality proportionally increased with decreasing hemoglobin levels (odds ratio [OR], 1.88; 95% confidence interval [CI], 1.36 to 2.61 for 8.0-8.9 g/dl; OR, 1.97; 95% CI, 1.31 to 2.95 for 7.0-7.9 g/dl; and OR, 2.35; 95% CI, 1.52 to 3.63 for <7.0 g/dl). CONCLUSIONS: Low hemoglobin levels (<9.0 g/dl) were observed in approximately 20% of patients with septic shock, and the severity of decrease in these levels correlated with mortality.

19.
SAGE Open Med Case Rep ; 7: 2050313X19880079, 2019.
Article in English | MEDLINE | ID: mdl-31632677

ABSTRACT

Essential thrombocythemia is a myeloproliferative neoplasm characterized by platelet aggregation and thrombosis. Clinically, essential thrombocythemia increases the risk of both thrombosis and bleeding. Essential thrombocythemia is more involved in micro- and small-sized arteries than in large arteries. Many essential thrombocythemia patients exhibit various symptoms, including microvascular thrombosis with acute coronary disease, digital ischemia, and transient ischemic attack. This study reports a rare case of recurrent thrombosis in relatively large vessels including splanchnic, lower extremity arteries, and aorta in essential thrombocythemia. A 70-year-old woman was admitted to the emergency room with abdominal pain and fever for a day. The patient underwent three operations due to recurrent arterial thrombosis of superior mesenteric, splenic, aorta, and lower extremities. She had recurrent diarrhea and acute kidney injury because of short bowel syndrome after extensive bowel resection. In conclusion, essential thrombocythemia patients aged >60 years and who have risk factors such as history of major ischemic events or severe leukocytosis must be careful of thrombosis of the medium- and large-sized arteries, including splanchnic and lower extremity arteries.

20.
Intern Emerg Med ; 14(3): 433-440, 2019 04.
Article in English | MEDLINE | ID: mdl-30600529

ABSTRACT

Patients with chemotherapy-induced febrile neutropenia (FN) are vulnerable to extended-spectrum b-lactamase-producing Enterobacteriaceae (ESBL-PE) infection. Early identification of patients suspected to have ESBL-PE infection for empirical carbapenem administration is crucial; nevertheless, risk factors for ESBL-PE causing septic shock remain unclear. We identify factors to predict ESBL-PE in septic shock patients with chemotherapy-induced FN. In this observational, prospectively collected registry-based study, consecutive adult chemotherapy-induced FN patients with septic shock who were admitted to the emergency department between June 2012 and June 2018 were enrolled. Clinical and laboratory data extracted from the septic shock registry were assessed to identify risk factors for ESBL-PE. Of 179 chemotherapy-induced FN septic shock patients, ESBL-PE is isolated in 23 (12.8%). ESBL-PE infection is frequently seen in patients with hepatobiliary cancer (17.4% vs. 4.5%, P = 0.037), leukemia (13.0% vs. 2.6%, P = 0.046), and those with profound neutropenia (defined as absolute neutrophil count < 100) (73.9% vs. 43.6%, P = 0.007) in contrast to those with lung cancer (0% vs. 14.7%, P = 0.048) and other solid cancer (0% vs. 19.2%, P = 0.016). Multivariate logistic regression reveals that profound neutropenia (adjusted OR 3.67; 95% CI 1.372-9.799; P = 0.010) is an independent risk factor for ESBL-PE infection after adjusting age, the presence of solid tumor, and the parameters of sepsis severity scores. ESBL-PE is rare (12.9%) in chemotherapy-induced FN patients with septic shock. Early empirical carbapenem therapy might be considered in chemotherapy-induced FN patients with profound neutropenia.


Subject(s)
Chemotherapy-Induced Febrile Neutropenia/etiology , Enterobacteriaceae Infections/complications , Shock, Septic/etiology , APACHE , Aged , Chi-Square Distribution , Drug Therapy/methods , Enterobacteriaceae/drug effects , Enterobacteriaceae/pathogenicity , Enterobacteriaceae Infections/physiopathology , Female , Humans , Male , Middle Aged , Neoplasms/complications , Neoplasms/drug therapy , Neoplasms/physiopathology , Organ Dysfunction Scores , Prevalence , Prospective Studies , Republic of Korea , Risk Factors , Shock, Septic/physiopathology , Statistics, Nonparametric
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