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1.
Psychiatr Q ; 92(4): 1657-1671, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34169388

RESUMO

Nonsuicidal self-injury (NSSI) is a major public health concern. Web-based personalized feedback interventions (PFIs) may be a cost-effective and efficient way to treat NSSI. In order to develop a PFI, it is imperative to assess descriptive and injunctive norms. The current study examines descriptive and injunctive norms of NSSI within college students and adults in the community, comparing how perceived norms may differ for those who do or do not engage in NSSI. Study 1 calculated percentages of NSSI behavior within the student sample. Study 2 then examined perceived descriptive and injunctive norms between those with and without history of NSSI in both samples. Study 1 indicated that 19% of undergraduate students had histories of NSSI. Additionally, there was a general tendency to overestimate the percentage of people who engage in NSSI and the number of times a typical person engages in NSSI. Finally, those who engaged in NSSI believed that most people do not understand why individuals engage in NSSI; comparatively, the majority of people without history of NSSI still indicated that they understand why others would engage in NSSI. These research findings may be utilized in a PFI to reduce shame and NSSI behavior.


Assuntos
Comportamento Autodestrutivo , Universidades , Adulto , Humanos , Comportamento Autodestrutivo/epidemiologia , Estudantes
2.
J Korean Med Sci ; 33(34): e234, 2018 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-30127709

RESUMO

BACKGROUND: Many women with endometriosis have become pregnant through assisted reproductive technology (ART), and have often experienced placenta previa (PP) during pregnancy. The objective of this study was to assess the association between women with endometriosis, especially those who conceived with ART, and the risk of PP. METHODS: Two reviewers independently determined studies that were considered suitable for meta-analyses published in various medicine-related databases from March 1, 2004 through July 31, 2017 without language restrictions. Eight studies met the inclusion criteria, with a combined sample size of 21,930 women. Of these 21,930 pregnancies, 6,256 had endometriosis (endometriosis) and 15,674 had no endometriosis. Four of these studies included 8,161 women who conceived with ART, 1,640 of whom had endometriosis (endometriosis + ART), and 6,521 of whom did not have endometriosis. Meta-analyses were estimated with odds ratios (ORs) and 95% confidence intervals (CIs) using random effect analysis according to heterogeneity of studies. RESULTS: These meta-analyses showed women with endometriosis (endometriosis) have an increased risk of PP (OR, 4.038; 95% CI, 2.291-7.116; P = 0.000). These results showed women who conceived with ART (endometriosis + ART), have a substantially increased risk of PP (OR, 5.543; 95% CI, 1.659-18.523; P = 0.005). CONCLUSION: These meta-analyses demonstrate women with endometriosis have an increased risk of PP.


Assuntos
Endometriose , Estudos de Casos e Controles , Feminino , Humanos , Placenta Prévia , Gravidez , Técnicas de Reprodução Assistida , República da Coreia , Fatores de Risco
3.
J Korean Med Sci ; 31(6): 909-14, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27247500

RESUMO

The increasing interest in healthcare and health screening events is revealing additional cases of asymptomatic isolated microscopic hematuria (IMH). However, a consensus of the evaluation and explanation of the IMH prognosis is controversial among physicians. Here, we present the natural course of IMH together with the pathological diagnosis and features to provide supportive data when approaching patients with IMH. We retrospectively evaluated 350 patients with IMH who underwent a renal biopsy between 2002 and 2011, and the pathological diagnosis and chronic histopathological features (glomerulosclerosis, interstitial fibrosis, and tubular atrophy) were reviewed. Deterioration of renal function was examined during follow up. The patients with IMH were evaluated for a mean of 86 months. IgA nephropathy was the most common diagnosis in 164 patients (46.9%). Chronic histopathological changes were observed in 166 (47.4%) but was not correlated with proteinuria or a decline in renal function. Ten patients developed proteinuria, and all of them had IgA nephropathy. Three patients progressed to chronic kidney disease with an estimated glomerular filtration rate < 60 mL/min/1.73 m(2) but none progressed to end stage renal disease. In conclusion, IMH had a generally benign course during 7-years of observation, although IgA nephropathy should be monitored if it progresses to proteinuria. Future prospective randomized studies may help conclude the long-term prognosis and lead to a consensus for managing IMH.


Assuntos
Hematúria/diagnóstico , Rim/patologia , Adolescente , Adulto , Biópsia , Feminino , Taxa de Filtração Glomerular , Glomerulonefrite por IGA/diagnóstico , Hematúria/patologia , Humanos , Rim/fisiologia , Falência Renal Crônica/diagnóstico , Masculino , Pessoa de Meia-Idade , Prognóstico , Proteinúria/diagnóstico , Estudos Retrospectivos , Adulto Jovem
4.
Clin Kidney J ; 17(6): sfae102, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38883161

RESUMO

Background: Intradialytic hypotension (IDH) is the primary complication of haemodialysis (HD); however, its diverse pathophysiology and inconsistent definitions complicate its prediction. Despite attempts using the heart rate variability (HRV) test for IDH prediction, studies on its usefulness for predicting IDH diagnosed per the nadir 90 criterion are lacking. We aimed to evaluate HRV test efficacy and reproducibility in predicting IDH based on the nadir 90 criterion. Methods: Seventy patients undergoing HD participated in this multicentre prospective observational study. The HRV test was performed during non-HD periods and IDH was monitored during 12 HD sessions. IDH was diagnosed according to the nadir 90 criterion, defined as a decrease in systolic blood pressure of ≤90 mmHg during HD. After monitoring, the HRV test was repeated. An HRV-IDH index was developed using multivariate logistic regression analysis employing HRV test parameters. The predictive power of the HRV-IDH index was analysed using the area under the receiver operating characteristics curve (AUROC). Reproducibility was evaluated using correlation analysis of two HRV tests on the same patient. Results: There were 37 and 33 patients in the IDH and non-IDH groups, respectively. The HRV-IDH index predicted IDH occurrence with AUROCs of 0.776 and 0.803 for patients who had experienced at least one or repeated IDH episodes, respectively. Spearman's correlation coefficient for HRV-IDH indices was 0.859 for the first and second HRV tests. Conclusions: The HRV test holds promise for predicting IDH, particularly for patients with recurring IDH diagnosed based on the nadir 90 criterion.

5.
Kidney Res Clin Pract ; 43(4): 528-537, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38934026

RESUMO

BACKGROUND: Continuous renal replacement therapy (CRRT) has become the standard modality of renal replacement therapy (RRT) in critically ill patients. However, consensus is lacking regarding the criteria for discontinuing CRRT. Here we validated the usefulness of the prediction model for successful discontinuation of CRRT in a multicenter retrospective cohort. METHODS: One temporal cohort and four external cohorts included 1,517 patients with acute kidney injury who underwent CRRT for >2 days from 2018 to 2020. The model was composed of four variables: urine output, blood urea nitrogen, serum potassium, and mean arterial pressure. Successful discontinuation of CRRT was defined as the absence of an RRT requirement for 7 days thereafter. RESULTS: The area under the receiver operating characteristic curve (AUROC) was 0.74 (95% confidence interval, 0.71-0.76). The probabilities of successful discontinuation were approximately 17%, 35%, and 70% in the low-score, intermediate-score, and highscore groups, respectively. The model performance was good in four cohorts (AUROC, 0.73-0.75) but poor in one cohort (AUROC, 0.56). In one cohort with poor performance, attending physicians primarily controlled CRRT prescription and discontinuation, while in the other four cohorts, nephrologists determined all important steps in CRRT operation, including screening for CRRT discontinuation. CONCLUSION: The overall performance of our prediction model using four simple variables for successful discontinuation of CRRT was good, except for one cohort where nephrologists did not actively engage in CRRT operation. These results suggest the need for active engagement of nephrologists and protocolized management for CRRT discontinuation.

6.
Artigo em Inglês | MEDLINE | ID: mdl-38934039

RESUMO

Background: The aim of this study is to investigate the specific pathway involved in human leukocyte antigen (HLA) sensitization using single-cell RNA-sequencing analysis and an allo-sensitized mouse model developed with an HLA.A2 transgenic mouse. Methods: For sensitization, wild-type C57BL/6 mouse received two skin grafts from C57BL/6-Tg(HLA-A2.1)1Enge/J mouse (allogeneic mouse, ALLO). For syngeneic control (SYN), skin grafts were transferred from C57BL/6 to C57BL/6. We performed single-cell RNA-sequencing analysis on splenocytes isolated from ALLO and SYN and compared the gene expression between them. Results: We generated 9,190 and 8,890 single-cell transcriptomes from ALLO and SYN, respectively. Five major cell types (B cells, T cells, natural killer cells, macrophages, and neutrophils) and their transcriptome data were annotated according to the representative differentially expressed genes of each cell cluster. The percentage of B cells was higher in ALLO than it was in SYN. Kyoto Encyclopedia of Genes and Genomes enrichment analyses indicated that the highly expressed genes in the B cells from ALLO were mainly associated with antigen processing and presentation pathways, allograft rejection, and the Th17 cell differentiation pathway. Upregulated genes in the T cells of ALLO were involved in the interleukin (IL)-17 signaling pathway. The ratio of Th17 cluster and Treg cluster was increased in the ALLO. On flow cytometry, the percentage of Th17 (IL-17+/CD4+ T) cells was higher and regulatory T cells (FOXP3+/CD4+ T) was lower in the ALLO compared to those in the SYN. Conclusion: Our results indicate that not only the B cell lineage but also the Th17 cells and their cytokine (IL-17) are involved in the sensitization to HLA.

7.
Psychiatry Res ; 329: 115526, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37839319

RESUMO

The current study examines the prevalence rates of borderline personality disorder (BPD) symptoms and nonsuicidal self-injury (NSSI) behaviors amongst college students over a five-year period, including pre- and during the COVID pandemic. Online prescreener surveys were completed by undergraduate students (n = 12,756) attending a large Southern Plains University every semester from Spring of 2017 to Spring of 2021. The percentage of students with NSSI history and significant BPD symptoms were visualized by semester to examine trends over time. A series of logistic regressions and negative binomial regressions were conducted on NSSI history and BPD symptoms to examine whether the endorsement rates have been increasing over time and to compare before and during COVID pandemic. There was an increasing trend of NSSI rates and significant BPD symptoms over time for all sexes. Furthermore, there was a steeper increase in BPD symptoms specifically in female students over the last five years. Additionally, there was a significant increase in odds of elevated BPD symptoms and NSSI behaviors in the college students enrolled during the COVID pandemic compared with pre-COVID. Overall, there has been an increasing trend in BPD symptoms and NSSI rates over the last few years, including during the COVID pandemic.


Assuntos
Transtorno da Personalidade Borderline , Comportamento Autodestrutivo , Humanos , Feminino , Transtorno da Personalidade Borderline/epidemiologia , Transtorno da Personalidade Borderline/diagnóstico , Prevalência , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/diagnóstico , Inquéritos e Questionários , Estudantes
8.
Micromachines (Basel) ; 14(10)2023 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-37893336

RESUMO

BACKGROUND: Voltammetric analysis of the neurotransmitter epinephrine (EP) was performed using bismuth immobilized on a carbon nanotube paste electrode (BCE), whose properties were compared with those of a carbon nanotube paste electrode (CE). BCE was found to be more efficient in detecting EP. METHODS: The analytical parameters used were 0.3 V square-wave (SW) stripping voltammetric amplitude, 400 Hz frequency, -0.8 V initial potential, and 0.015 V increment potential. The optimized conditions were applied to an assay of a carp's front fin. RESULTS: A BCE was inserted into a carp's front fin muscle, and a stimulus was given every 50 s. This circuit is easy to use and does not require much analytical preparation time. CONCLUSIONS: The working electrode is miniscule, and its detection limit is very low. The in vivo muscle's chronoamperometric nerve currents were analyzed. These results have potential for applications in medical diagnostics, pharmaceuticals, interface controllers, and other fields.

9.
Ann Lab Med ; 43(4): 364-374, 2023 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-36843405

RESUMO

Background: The clinical significance of low-level donor-specific anti-HLA antibody (low-DSA) remains controversial. We investigated the impact of low-DSA on posttransplant clinical outcomes in kidney transplant (KT) recipients. Methods: We retrospectively reviewed 1,027 KT recipients, namely, 629 living donor KT (LDKT) recipients and 398 deceased donor KT (DDKT) recipients, in Seoul St. Mary's Hospital (Seoul, Korea) between 2010 and 2018. Low-DSA was defined as a positive anti-HLA-DSA result in the Luminex single antigen assay (LABScreen single antigen HLA class I - combi and class II - group 1 kits; One Lambda, Canoga Park, CA, USA) but a negative result in a crossmatch test. We compared the incidence of biopsy-proven allograft rejection (BPAR), changes in allograft function, allograft survival, patient survival, and posttransplant infections between subgroups according to pretransplant low-DSA. Results: The incidence of overall BPAR and T cell-mediated rejection did not differ between the subgroups. However, antibody-mediated rejection (ABMR) developed more frequently in patients with low-DSA than in those without low-DSA in the total cohort and the LDKT and DDKT subgroups. In multivariate analysis, low-DSA was identified as a risk factor for ABMR development. Its impact was more pronounced in DDKT (odds ratio [OR]: 9.60, 95% confidence interval [CI]: 1.79-51.56) than in LDKT (OR: 3.76, 95% CI: 0.99-14.26) recipients. There were no significant differences in other outcomes according to pretransplant low-DSA. Conclusions: Pretransplant low-DSA has a significant impact on the development of ABMR, and more so in DDKT recipients than in LDKT recipients, but not on long-term outcomes.


Assuntos
Transplante de Rim , Humanos , Transplante de Rim/efeitos adversos , Estudos Retrospectivos , Teste de Histocompatibilidade , Anticorpos , Doadores de Tecidos , Rejeição de Enxerto/diagnóstico , Antígenos HLA , Isoanticorpos , Sobrevivência de Enxerto
10.
Infect Chemother ; 55(4): 505-509, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38183395

RESUMO

We reviewed 24 kidney transplantat recipients (KTRs) who had radiologically confirmed coronavirus disease 2019 (COVID-19) pneumonia. Enrolled KTRs were divided into a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-vaccination (+) group (n = 18) and a vaccination (-) group (n = 6). Clinical outcomes of the two groups including death, pulmonary outcome, and renal outcome were compared. COVID-19 pneumonia was worse in vaccination (-) KTRs. Two out of six vaccination (-) KTRs needed continuous renal replacement therapy (CRRT) and mechanical ventilator (MV) and expired. In contrast, only one KTR expired and required CRRT and MV out of 18 vaccination (+) KTRs. Our results suggest that SARS-CoV-2 vaccination attenuates severity of COVID-19 pneumonia in KTRs.

11.
Assessment ; 29(1): 34-45, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34823365

RESUMO

This article outlines the Phase 1 efforts of the HiTOP Measure Development group for externalizing constructs, which include disinhibited externalizing, antagonistic externalizing, attention deficit hyperactivity disorder, substance use, and externalizing/maladaptive behaviors. We provide background on the constructs included and the process and issues involved in developing a measure for this diverse range of psychopathology symptoms, traits, and behaviors.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Comportamento Problema , Transtornos Relacionados ao Uso de Substâncias , Humanos , Psicopatologia
12.
Assessment ; 28(5): 1334-1344, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-32948115

RESUMO

Borderline personality disorder (BPD) is one of the most studied personality disorders and is associated with significant outcomes such as suicide. Although BPD is represented in DSM-5 as a categorical diagnosis, it may be better characterized dimensionally, such as from the perspective of the five-factor model of general personality (FFM). The Five-Factor Borderline Inventory (FFBI) assesses BPD from the perspective of maladaptive variants of FFM traits. Previous research suggests that informant-reports may increase the validity of personality disorder assessment, providing additional information that may supplement self-report. Therefore, the current study developed an informant measure of the FFBI, Informant Five-Factor Borderline Inventory (IFFBI) and examined its convergent and discriminant validity compared with the self-report FFBI, FFM, and traditional measure of BPD. Overall, the IFFBI demonstrated good convergent validity and moderate discriminant validity with the FFBI, FFM, and other traditional measures of BPD.


Assuntos
Transtorno da Personalidade Borderline , Transtornos da Personalidade , Transtorno da Personalidade Borderline/diagnóstico , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Determinação da Personalidade , Inventário de Personalidade
13.
Kidney Res Clin Pract ; 40(2): 304-316, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34024089

RESUMO

BACKGROUND: This study aimed to investigate whether high body mass index (BMI) and presensitization to human leukocyte antigen (HLA) in kidney transplant recipients (KTRs) affected allograft outcomes. METHODS: From January 2010 to December 2018, 1,290 kidney transplantations (KTs) were performed at the Seoul St Mary's Hospital. Of these, 682 cases of ABO-compatible living donor KT patients were enrolled. They were divided into four groups (low BMI-non-sensitized, high BMI-non-sensitized, low BMI-sensitized, and high BMI-sensitized) according to the median BMI value (22.7 kg/m2) and HLA presensitization status (anti-HLA antibody mean fluorescence intensity > 3,000). Short-term and long-term allograft outcomes were compared between groups. RESULTS: In the high BMI-sensitized group, the decline in allograft function was higher than that in the other three groups. Death-censored graft loss (DCGL) rates were highest in the high BMI-sensitized group (4 of 21 [19.0%], p = 0.04). In the multivariable Cox regression hazard regression model analysis, the hazard ratio (HR) for DCGL was intensified when high BMI and presensitization statuses were combined (HR, 3.75; p = 0.03); these statuses significantly interacted with each other (p-value for interaction = 0.008). CONCLUSION: Our results suggest that presensitization to HLA and high BMI might have an interactive adverse impact on allograft outcomes in KTRs.

14.
Personal Ment Health ; 14(1): 123-141, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31364820

RESUMO

Despite the emphasis on evidence-based treatment for psychological disorders, to date, there has been limited research examining treatment for nine of the 10 categorical personality disorders in DSM-5 Section 2. This is perhaps not surprising given the complex heterogeneity and co-morbidity within personality pathology. The hierarchical taxonomy of psychopathology (HiTOP) was proposed to address limitations within the traditional categorical model of the diagnostic system. Within this system are five spectra: detachment, antagonistic externalizing, disinhibited externalizing, thought disorder and internalizing. These foundational personality traits potentially have direct and specific treatment implications. The purpose of this paper is to highlight potential psychotherapeutic and pharmacological treatment recommendations within the personality spectra. Additionally, we outline the advantages of considering the personality science found within dimensional models of psychopathology in clinical assessment and intervention to aid in treatment planning. © 2019 John Wiley & Sons, Ltd.


Assuntos
Pesquisa Biomédica , Transtornos Mentais/fisiopatologia , Transtornos Mentais/terapia , Modelos Biológicos , Psicoterapia , Psicotrópicos , Humanos , Transtornos Mentais/classificação , Transtornos da Personalidade/classificação , Transtornos da Personalidade/fisiopatologia , Transtornos da Personalidade/terapia
15.
Sci Rep ; 10(1): 7009, 2020 04 24.
Artigo em Inglês | MEDLINE | ID: mdl-32332846

RESUMO

We investigated if clinical outcomes after kidney transplantation (KT) from deceased donors (DDs) with high Kidney Donor Profile Index (KDPI) can be different according to the age of KT recipients (KTRs). Six-hundred fifty-seven KTRs from 526 DDs were included from four transplant centers. We divided KTRs into elderly-KTR and young-KTR groups based on age 60 and each group was subdivided into high- or low-KDPI subgroup based on KDPI score of 65%. We compared short-term and long-term clinical outcomes among those four subgroups (low KDPI-young KTR, low KDPI-elderly-KTR, high KDPI-young-KTR, high KDPI-elderly-KTR). In short-term outcomes including acute rejection, BK virus and CMV infection, there was no significant difference among the four subgroups. In the long-term outcomes, the development of cardiovascular disease was higher in the high KDPI-elderly-KTR group than the other groups. In comparison of allograft survival rate, the high KDPI-young KTR subgroup showed highest risk for allograft failure and there was significant interaction between high-KDPI donors and young-KTR on allograft survival rate (P = 0.002). However, there was no significant difference in comparison of the patient survival rate. In conclusion, clinical impact of high-KDPI in DDs on post-transplant allograft survival may be less significant in elderly-KTR than in young-KTR.


Assuntos
Falência Renal Crônica/cirurgia , Transplante de Rim/estatística & dados numéricos , Adulto , Estudos de Coortes , Feminino , Seguimentos , Sobrevivência de Enxerto , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Transplantados/estatística & dados numéricos , Adulto Jovem
16.
Sci Rep ; 10(1): 3727, 2020 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-32111949

RESUMO

We investigated the impact of acute kidney injury (AKI) in elderly deceased-donors (DDs) vs. AKI in young DDs on post-transplant clinical outcomes. A total of 709 kidney transplant recipients (KTRs) from 602 DDs at four transplant centers were enrolled. KTRs were divided into young-DDKT and elderly-DDKT groups according to the age of DD of 60 years. Both groups were subdivided into non-AKI-KT and AKI-KT subgroups according to AKI in DDs. We investigated short-term and long-term clinical outcomes of non-AKI-DDKT and AKI-DDKT subgroups within young-DDKT and elderly-DDKT groups. The incidence of DGF in the AKI-DDKT subgroup was higher and the allograft function within 12 months after KT in the AKI-DDKT subgroup was lower than those in the non-AKI-DDKT subgroup in both young-DDKT and elderly-DDKT groups. Death-censored allograft survival rate was significantly lower in the AKI-elderly-DDKT subgroup than that in the non-AKI-elderly-DDKT subgroup, but it did not differ between AKI-young-DDKT and non-AKI-young-DDKT subgroup. In multivariable analysis, AKI-elderly-DDKT was an independent risk factor for allograft failure (hazard ratio: 2.648, 95% CI: 1.170-5.994, p = 0.019) and a significant interaction between AKI and old age in DDs on allograft failure was observed (p = 0.001). AKI in elderly DDs, but not in young DDs, can significantly affect long-term allograft outcomes of KTRs.


Assuntos
Injúria Renal Aguda/cirurgia , Transplante de Rim , Injúria Renal Aguda/imunologia , Adulto , Fatores Etários , Estudos de Coortes , Feminino , Sobrevivência de Enxerto , Humanos , Masculino , Pessoa de Meia-Idade , Doadores de Tecidos , Transplante Homólogo , Resultado do Tratamento , Adulto Jovem
17.
Obstet Gynecol Sci ; 62(2): 127-133, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30918881

RESUMO

OBJECTIVE: To assess positive culture rate and antimicrobial susceptibilities of Mycoplasma hominis (MH) and Ureaplasma urealyticum (UU) in symptomatic general population and pregnant women admitted with preterm labor and premature rupture of membranes. METHODS: We retrospectively reviewed medical records of patients who have undergone culture test and antimicrobial susceptibilities at our center from January 2017 to April 2018. Patients with positive culture for MH, UU, or both were included in this study. RESULTS: There were 200 patients who were eligible for enrollment. Of these patients, 34 (17%) were pregnant women and 166 (83%) were non-pregnant women. Of these 200 patients, positive culture results were as follows: MH only, n=10 (5%); UU only, n=58 (29%); and both MH and UU, n=36 (18%). Susceptibilities of MH only to doxycycline, erythromycin, ciprofloxacin, and azithromycin were 100%, 10%, 40%, and 0%, respectively. Susceptibilities of UU only to doxycycline, erythromycin, ciprofloxacin, and azithromycin were 94.8%, 87.9%, 5.2%, and 81%, respectively. Susceptibilities of both MH and UU to doxycycline, erythromycin, ciprofloxacin, and azithromycin were 97.2%, 5.6%, 11.1%, and 11.1%, respectively. CONCLUSION: UU only was the leading causative pathogen for genitourinary infection in our study. MH only accounted for about one sixth of UU only infections. Doxycycline was still the best antibiotics as most patients with MH only, UU only, or both MH and UU positive culture showed susceptibility. For ciprofloxacin, less than 12% of those with UU only and both MH and UU culture positive results showed susceptibility.

18.
Medicine (Baltimore) ; 97(37): e12351, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30212990

RESUMO

RATIONALE: Anaphylaxis is a very rare event in pregnancy, triggering maternal hypotension leading to intrapartum hypoxic-ischemic encephalopathy in infant. Furthermore, cesarean sections are performed at a high rate in anaphylactic pregnant women. PATIENT CONCERNS: A 34-year-old pregnant woman presented with maternal anaphylaxis following prophylactic antibiotic injection for cesarean section. Within a few minutes after initiation of intradermal skin test with cefotetan, the pregnant woman developed generalized itchy rash, chest tightness, and dyspnea. DIAGNOSES: Several minutes after the injection of antibiotics, a diffuse urticarial rash was detected over her face and trunk followed by complaints of chest tightness and dyspnea. She was diagnosed with hypotension and hypoxia. Further, fetal heart tones showed bradycardia. A presumptive diagnosis of anaphylactic reaction induced by cefotetan was made for surgical prophylaxis. INTERVENTIONS: The patient was managed for anaphylaxis, via administration of epinephrine, glucocorticoid, and antihistamine. Emergency cesarean section performed under general anesthesia resulted in a favorable perinatal outcome for the fetus. OUTCOMES: Maternal and fetal outcomes were good after prompt treatment for anaphylaxis and emergency cesarean section. LESSONS: This is the first reported case of anaphylaxis following cefotetan administration in pregnancy. Cefotetan, a second-generation cephalosporin, is a commonly prescribed antibiotic used to treat a wide range of bacterial infections. The case demonstrated life-threatening anaphylactic reaction during pregnancy. Even a skin test using antibiotics alone triggered anaphylaxis.


Assuntos
Anafilaxia/induzido quimicamente , Antibacterianos/efeitos adversos , Antibioticoprofilaxia/efeitos adversos , Cefotetan/efeitos adversos , Complicações na Gravidez/induzido quimicamente , Cuidados Pré-Operatórios/efeitos adversos , Adulto , Cesárea , Toxidermias/etiologia , Feminino , Humanos , Gravidez , Cuidados Pré-Operatórios/métodos
19.
Korean J Intern Med ; 33(5): 961-969, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29551056

RESUMO

BACKGROUND/AIMS: The true incidence of aristolochic acid nephropathy (AAN) is thought to be underestimated because numerous ingredients known or suspected to contain aristolochic acid (AA) are used in traditional medicine in Korea. METHODS: We collected data on cases of AAN since 1996 via a database in Korea. We evaluated the year of AAN development, route to obtaining AA-containing herbal medicine, gender, reason for taking AA-containing herbal medicine, clinical manifestations, histological findings, phytochemical analysis, and prognosis of patients with AAN. RESULTS: Data on 16 cases of AAN were collected. Thirteen cases developed AAN before and three cases after the prohibition of AA-containing herbal medicine by the Korea Food and Drug Administration. Patients were prescribed AA-containing herbal medicine from oriental clinics or had purchased it from traditional markets. AAN was distributed in all age groups. Young females were most commonly exposed to AA-containing herbal medicine for slimming purposes and postpartum health promotion, while older adults took AA-containing compounds for the treatment of chronic diseases. The most common symptoms presented at hospitalization were nausea and vomiting, and acute kidney injury was accompanied by Fanconi syndrome in almost half of the patients. Phytochemical analysis of AA in herbal medicine was available in six cases. Progression to end stage renal disease (ESRD) was observed in seven patients (43.8%), and five patients (31.3%) had progressed to ESRD within 6 months of diagnosis. CONCLUSION: Our report shows that patients were still exposed to AA-containing herbal medicine and that there is a possibility of underdiagnosis of AAN in Korea. A stronger national supervision system of herbal ingredients and remedies in oriental medicine is needed to prevent AAN.


Assuntos
Ácidos Aristolóquicos , Medicamentos de Ervas Chinesas , Falência Renal Crônica , Idoso , Ácidos Aristolóquicos/efeitos adversos , Medicamentos de Ervas Chinesas/efeitos adversos , Feminino , Humanos , Falência Renal Crônica/induzido quimicamente , Masculino , República da Coreia/epidemiologia
20.
J Menopausal Med ; 23(2): 135-137, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28951863

RESUMO

Granular cell tumor (GCT) is a rare soft tissue tumor that derived from Schwann cells. Most are benign, less than 2% are malignant and, in the malignant cases, the prognosis of survival is poor. Most of these tumors are less than 3 cm in size, and they are more common in black women. The disease usually occurs in the 40s to the 60s and occurs after menopause, but there are few cases reported in adolescence. A 45-year-old woman visited the outpatient clinic with a solid mass that developed 2 years ago and present to date on the left side of the clitoris. After complete resection, pathologic examination proved to be a granular cell. The patient has been living without recurrence for one year. We report the first case of the GCT of the clitoris in postmenopausal woman in Korea with a brief review of the literature.

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