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Purpose@#This study aimed to investigate the effect of a video-based enteral nutrition education program using QR codes on the perception, knowledge, and performance of enteral nutrition for intensive care unit (ICU) nurses. @*Methods@#This was a quasi-experimental study with a nonequivalent control group pre- and post-test design. The participants were nurses working at six ICUs within a single university hospital, with 55 nurses in the experimental group and 55 nurses in the control group. The video-based enteral nutrition education program using QR codes was repeated three times to the experimental group. @*Results@#There was a statistically significant pre-post difference in perceptions between the two groups (Z = -4.04, p < .001) with 2.00 points (± 5.57) for the control group and 7.89 points (± 7.95) for the experimental group, in knowledge (Z = -7.48, p < .001) with 0.02 points (± 1.91) for the control and 4.18 points (± 2.33) for the experimental, and in performance (Z = -2.20, p = .028) with 0.06 points (± 3.96) for the control and 2.00 points (± 5.14) for the experimental. @*Conclusion@#The video-based enteral nutrition education program using QR codes was effective in improving the perceptions, knowledge, and performance of enteral nutrition among ICU nurses. This enteral nutrition education program using QR codes in clinical education can contribute to evidence-based nursing practice by improving perceptions and knowledge of enteral nutrition.
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Objectives@#This study aimed to analyze trends in the timely diagnosis of malaria cases over the past 10 years in relation to the utilization of different types of healthcare facilities. @*Methods@#The study included 3,697 confirmed and suspected cases of malaria reported between January 1, 2013, and December 31, 2022, in the national integrative disease and healthcare management system. Some cases lacking a case report or with information missing from the case report were excluded from the analysis. A generalized linear model with a Poisson distribution was constructed to estimate rate ratios and 95% confidence intervals adjusted for other variables, such as distance. @*Results@#When cases involving diagnosis >5 days after symptom onset in confirmed patients (5DD) were examined according to the type of healthcare facility, the rate ratio of 5DD cases was found to be higher for public health facilities than for tertiary hospitals. Specifically, the rate ratio was higher when the diagnosis was established at a tertiary hospital, even after a participant had visited primary or secondary hospitals. In an analysis adjusted for the distance to each participant’s healthcare facility, the results did not differ substantially from the results of the crude analysis. @*Conclusion@#It is imperative to improve the diagnostic capabilities of public facilities and raise awareness of malaria at primary healthcare facilities for effective prevention and control.
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Background@#Early prediction of bacteremia is important because sepsis may develop if bacteremia is not treated in time. We aimed to determine whether blood tests are clinically useful in predicting gram-negative versus gram-positive bacteremia. @*Methods@#We retrospectively analyzed the medical records of 16,569 patients who underwent blood culture testing among those who visited St. Mary’s Hospital of Uijeongbu, Catholic University from January 1, 2018 to December 31, 2018. After excluding 15,580 patients with insufficient data for analysis, the total study population was 989. @*Results@#In the multivariable logistic regression analysis for gram-negative bacteremia, after adjusting for major variables, procalcitonin (odds ratio [OR] 1.02, P < 0.001), high-sensitivity C-reactive protein (OR 1.03, P = 0.010), and albumin (OR 0.55, P = 0.010) were significant. In the same model, lactic acid (OR 1.08, P = 0.010), blood urea nitrogen (BUN) (OR 1.02, P = 0.010), and albumin (OR 0.50, P = 0.005) were significant for gram-positive bacteremia.We constructed blood indicators by combining blood tests that were significant in multivariable logistic regression analysis. Comparing the area under the curve (AUC) of the receiver operating characteristic curve, the AUC of the procalcitonin/albumin ratio in gramnegative bacteremia was significantly higher than that of procalcitonin (0.846 vs. 0.837, P = 0.005), and the AUC of the BUN/albumin ratio in gram-positive bacteremia was significantly higher than that of BUN (0.709 vs. 0.679, P = 0.007). @*Conclusion@#The procalcitonin/albumin ratio is expected to be helpful in the early prediction of gram-negative bacteremia, whereas the BUN/albumin ratio in the early prediction of grampositive bacteremia.
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Purpose@#This study investigated the knowledge, attitudes, and perceptions of a safe environment, as well as self-reported and observed compliance with the use of personal protective equipment (PPE), among intensive care unit (ICU) nurses. @*Methods@#This study was conducted in October 2021 with 55 nurses working in the medical and surgical ICUs of a general hospital in Seoul. A self-reported questionnaire and an observational tool for compliance with the use of PPE were used to collect data.Result: Except for masks, the observed compliance for all other PPE types was lower than the self-reported compliance. Male nurses showed significantly higher observed compliance than female nurses. Self-reported compliance with PPE use, including “when there is a possibility of contact with objects contaminated with blood or body fluids, mucous membranes, damaged skin, or contaminated skin” (r=.23, p=.015) and “when there is a possibility of contact with blood, body fluids, secretions, or exudates” (r=.27, p=.004) showed significant correlations with knowledge of PPE. In the results for self-reported compliance with PPE use, gown use had a significant correlation with knowledge (r=.24, p<.001) and perceptions of a safe environment (r=.15, p=.016) for PPE, and gloves showed significant correlations with attitudes (r=.14, p=.024) and perceptions of a safe environment (r=.18, p=.003). @*Conclusion@#The observed compliance with PPE use tended to be lower than the self-reported compliance among ICU nurses. It is necessary to develop and apply an effective educational program that can enhance improve actual compliance with PPE use among intensive care unit nurses.
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Purpose@#This study aimed to identify the colonization rate of carbapenem-resistant Enterobacteriaceae (CRE), the characteristics of CRE isolates, and risk factors for CRE colonization in patients transferred to the general wards of a small/medium-sized hospital. @*Methods@#This retrospective study was conducted on patients who underwent CRE culture tests within 24 hours of admission among patients transferred to a small/medium-sized hospital. Forty-seven patients confirmed as positive for CRE were classified as belonging to the patient group. For the control group, 235 patients (five times the number of the patient group) were matched by sex, age, and diagnosis, and then selected at random. Data were analyzed using descriptive analysis and multiple logistic regression analysis. @*Results@#The CRE colonization rate was 5% (47 out of 933 patients), and Klebsiella pneumoniae (68.0%) was the most common isolate of CRE. The positivity rate of carbapenemase-producing Enterobacteriaceae was 61.7%. The risk factors for CRE colonization included renal disease (odds ratio [OR]=4.93; 95% confidence interval [CI], 1.49-16.31), heart disease (OR=3.86; 95% CI, 1.35-11.01), indwelling urinary catheters (OR=4.43; 95% CI, 1.59-12.36), and cephalosporin antibiotic use (OR=8.57; 95% CI, 1.23-59.60). @*Conclusion@#Having a comorbid renal or cardiac disease, an indwelling urinary catheter, or a history of exposure to cephalosporin antibiotics could be classified as risk factors for CRE colonization in patients transferred to small and medium-size hospitals. It is necessary to perform active infection control through proactive CRE culture testing of patients with risk factors.
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Floating-Harbor syndrome (FHS) is a rare genetic disorder. This report introduced in a patient with FHS. Distinctive facial characteristics, severe skeletal class 3 malocclusion with underdeveloped maxilla and protruded mandible, congenital missing teeth, microdontia and ectopic positions of maxillary teeth were presented in the patient. In his twin sister, mild skeletal class 3 malocclusion with protruded mandible was observed but congenital missing teeth and microdontia were not observed. High-arched palate, narrow V-shaped maxillary arch compared to wide and ovoid mandibular arch and inverse relationship between the maxillary and mandibular intermolar width resulted in posterior crossbite were confirmed by model analysis of the patient. These were not observed in the twins. Behaviorally, poor cooperation during dental treatment because of mental retardation was observed in the patient.
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The purpose of this study was to analyze treatment methods, results, timings and clinical signs and symptoms in failed cases of each treatment method of dens evaginatus on the premolar areas. In this study, 151 patients and 417 teeth were included. Resin restoration and direct pulp capping as preventive treatment and pulp revascularization, apexification and conventional endodontic treatment as endodontic treatment were included for treatment methods. In the preventive resin restoration, successful results were shown in the intact tubercles and also effective when the tubercles were fractured. In the direct pulp capping, resolved clinical symptoms and growth of the roots were shown when there was only pain during chewing without apical lesion. Apical lesion was the most common pretreatment signs and symptoms of the pulp revascularization, apexification and conventional endodontic treatment. In the pulp revascularization, successful results was obtained in most cases. But in some cases, root length or root wall thickness was not increased. Effective results were shown both of the apexification and conventional endodontic treatment. In order to increase success rate of preventive treatment of dens evaginatus, resin restoration was required to be done when tubercle did not occluded or in the presence of intact tubercles. When tubercle was fractured, root development stage and pulp condition should be considered for successful treatment.
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Background@#Plasmodium vivax is a major pathogen that causes malaria in South Korea.Several genetic polymorphisms in dihydrofolate reductase (pvdhfr), P. vivax multidrug resistance protein 1 (pvmdr1 ), and P. vivax hydroxymethylpterin pyrophosphokinasedihydropteroate synthetase (pvdhps) genes are known to be associated with drug resistance in P. vivax. The objective of this study was to profile the known polymorphisms of P. vivax resistance genes in patients at a secondary hospital in South Korea. @*Methods@#A total of 12 patients with confirmed P. vivax infections were enrolled for this study. Sanger sequencing was performed for the pvdhfr, pvmdr1, and pvdhps genes to detect polymorphisms of these drug resistance genes. @*Results@#Each specimen had single or double polymorphism in pvdhfr. One specimen had a polymorphism in pvdhps. However, no specimen had any polymorphisms in pvmdr1. There was no strain with multi-polymorphisms exceeding double polymorphisms, which reported the geographic location of treatment failure. @*Conclusion@#No specimen showed chloroquine-resistance polymorphism in pvmdr1.Treatment with first-line therapy was successful. The prevalence of F57L in pvdhfr was higher than that reported previously. This change must be confirmed by further monitoring and surveillance of the strains with multi-polymorphisms.
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Oral mucocele is a common exophytic lesion resulting from the accumulation of saliva due to pathological changes in the minor salivary glands. It is typically asymptomatic and painless and characterized by semipermeable, fluctuant nodules. General treatment methods for mucocele include surgical excision, marsupialization, cryosurgery, and steroid injection. This case report presents the treatment of oral mucocele using micro-marsupialization and a tying method as minimally invasive techniques rather than surgical treatment. Based on this case report, it is suggested that micro-marsupialization and the tying method can be used as alternative methods for the treatment of oral mucocele infants and children with behavioral control problems.
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The purpose of this study is to analyze the fracture resistance of reattached tooth according to the resin materials and tooth preparation type under physiological conditions.Uncomplicated crown fracture in the oblique direction was reproduced on the extracted 64 anterior teeth. Depending on the composite resin material, reattachment was performed using a flowable resin and a packable resin. Depending on retentive forms, reattachment was performed using simple reattachment, 1.0 mm × 1.0 mm labial chamfer bevel, 1.0 mm × 1.0 mm lingual chamfer bevel and 1.0 mm × 1.0 mm circumferential bevel. A load was applied to the palatal surface of the tooth using a universal testing machine at an angle of 125 degree, which is the interincisal angle of normal children. Under the masticatory pressure condition, fracture resistance of lingual chamfer groups was 28.28 ± 7.41 MPa and 27.54 ± 4.45 MPa, which was significantly higher than those of simple reattachment groups, 17.21 ± 5.87 MPa and 20.10 ± 6.00 MPa, in both flowable and packable resin groups.When considering the lingual force similar to masticatory pressure, the fragment retention was significantly improved when the lingual chamfer was formed compared to the simple reattachment. Clinicians may consider the design of the lingual chamfer in order to improve fracture resistance to masticatory pressure during fragment reattachment.
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Purpose@#Circulating cell-free single-stranded DNA (ccf-ssDNA) is extracellular DNA and it is a useful biomarker for the diagnosis of tumors and predicting the prognosis of tumors. However, the clinical usefulness of ccf-ssDNA in colorectal cancer (CRC) is not well known. Thus, the purpose of this study was to investigate the clinical usefulness of ccf-ssDNA in CRC. @*Methods@#The study was conducted on 44 patients who had undergone surgery for CRC, and ccf-ssDNA level was measured before surgery and statistical analysis was performed on clinical factors. @*Results@#The association between ccf-ssDNA level and clinicopathological factors was analyzed and compared, and these factors included age, sex, body mass index, diabetes mellitus, hypertension, tumor markers (carcinoembryonic antigen and carbohydrate antigen 19-9), tumor location, size, stage (TNM), recurrence, and death. The group with a ccf-ssDNA level of ≥ 7.5 ng/μL had a lower age (P = 0.010), and was associated with diabetes mellitus (P = 0.037) and lymph node metastasis (P = 0.049). Multivariate analysis of disease-free survival showed that lymph node metastasis and ccf-ssDNA level (hazard ratio, 10.011; 95% confidence interval, 2.269–44.175; P = 0.002) were independent prognostic factors for recurrence. In terms of overall survival, there were no statistically significant results except for vascular invasion. @*Conclusion@#This study showed that ccf-ssDNA level in plasma in CRC patients was an independent prognostic factor that could predict recurrence non-invasively. In this regard, further evaluation with a prospective, large sample size study will be needed to obtain additional results.
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Dilacerations generally involve central incisors; most often maxillary incisors rather than their mandibular counterparts. The clinical features of dilaceration include non-eruption of the responsible tooth or prolonged retention of the deciduous predecessor tooth. In Case 1, the tooth showed a dilaceration at the boundary between the crown and the root, more laterally rather than labiolingually. In Case 2, the dilacerated tooth showed a crown dilaceration with a relatively normal orientation of the dental root. In both cases, no significant space losses for eruption were observed. Moreover, it seems that unlike the maxilla with the palate, the mandibular anterior teeth are limited to show severe displacement.From these cases, it is suggested that if a mandibular permanent incisor shows a crown dilaceration or lateral dilaceration at the boundary between the crown and the root, there is a relatively high probability of spontaneous eruption of the dilacerated tooth.
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The purpose of this study was to investigate the characteristics related to the musculoskeletal disorders in pediatric dentists and general dentists. This study was conducted based on the survey results of a total of 109 dentists who have been working for the last year. Forty - three pediatric dentists and 66 general dentists were surveyed through online survey tool. Both pediatric dentists and general dentists mainly complained of musculoskeletal disorders in the neck, shoulders, wrists, and back. Most pediatric dentists usually suffered from back pain due to their unbalanced posture while giving dental treatments. Pediatric dentists in sedative treatment felt more pain in particular part of their body, such as neck and shoulder. Regular exercise and stretching for the prevention of musculoskeletal disorder have been shown to mainly relieve pain in the back but no other parts in their body.
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This study compared the microleakages and compressive strengths of various base materials.To evaluate microleakages, 50 extracted permanent premolars were prepared. The teeth divided into 5 groups of 10 each according to the base materials. Cavities with a 5.0 mm width, 3.0 mm length, and 3.0 mm depth were formed on the buccal surfaces of the teeth. After filling the cavities with different base materials, a composite resin was used for final restoration. Each specimen was immersed in 2% methylene blue solution and then observed under a stereoscopic microscope (× 30). To evaluate the compressive strength, 5 cylindrical specimens were prepared for each base material. A universal testing machine was used to measure the compressive strength.The microleakage was highest in the Riva light cureTM group and lowest in the BiodentineTM and Well-RootTM PT groups. For the compressive strengths, in all groups, acceptable strength values for base materials were found. The highest compressive strength was observed in the Fuji II LCTM group and the lowest strength in the Well-RootTM PT group.
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Spinal ependymomas are generally located in the intramedullary compartment in adults. Intradural extramedullary spinal ependymomas are extremely rare. Spinal ependymomas show various contrast enhancements on MRI. In this study, we report a rare case of a 52-year-old female who had a pathologically confirmed intradural extramedullary ependymoma that showed no enhancement on MRI.
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Spinal ependymomas are generally located in the intramedullary compartment in adults. Intradural extramedullary spinal ependymomas are extremely rare. Spinal ependymomas show various contrast enhancements on MRI. In this study, we report a rare case of a 52-year-old female who had a pathologically confirmed intradural extramedullary ependymoma that showed no enhancement on MRI.
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This study analyzed the longevity of preformed metal crowns (PMCs) in first permanent molars and evaluated factors influencing their survival during a long-term follow-up period. In all, 115 first permanent molars treated with PMCs between June 2008 and June 2018 were retrospectively analyzed. The overall combined success rate for the study group was 84.3%. The 5-year survival rate was 82.8%. Multivariate Cox regression analyses identified distal cavities and mandibular PMC placement as risk factors for restoration failure. Careful placement of PMCs at the final try-in stage augments the longevity of the crown.
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This retrospective study assessed the effectiveness and side effects of conscious sedation using chloral hydrate, hydroxyzine, and N2O/O2 in the sedation of 149 pediatric patients over 188 sedation sessions, and to identify associated variables.The effectiveness of the sedation was evaluated using the Houpt scale, and was considered effective for scale categories of excellent or good. Effectiveness and side effects were assessed every 15 minutes. The effectiveness decreased and side effects increased over time. The effectiveness of sedation during 60 minutes was 57.4%, and one or more side effects occurred in 18.1% of sessions. Effectiveness of sedation increased with body mass index (BMI). When patients were sedated at the beginning of the procedure, the effectiveness was greater. Side effects increased with patient age. When sedation was divided into two sessions, the number of sedation did not affect the effectiveness or side effects.It can be suggested that sedation should be performed over two separate sessions, as a single prolonged session may lead to reduced effectiveness and increased side effects. To maximize effectiveness and minimize side effects, several variables such as BMI, whether to sedate at the beginning of the procedure and age should be considered thoroughly before sedation.
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Background and Objectives@#Acute low-tone hearing loss (ALHL) is gaining attention as an independent disease identity with close association with endolymphatic hydrops and early stage Meniere’s disease (MD). This study aims to compare patients of ALHL with patients exhibiting low-tone hearing loss and ear fullness without vertigo in various audio-vestibular assessments and in progression to overt MD.Subjects and Method A total of 249 patients with low-tone hearing loss with ear fullness without vertigo was enrolled in this study. Of these patients, 58 patients met criteria for ALHL, which was defined as having an average hearing loss of ≥30 dB at 125, 250, and 500 Hz and ≤20 dB at 2, 4, and 8 kHz. Demographics, electrocochleography (ECoG) abnormality, rate of hearing improvement, vestibular functions, and progression to MD were analyzed. @*Results@#An average low-tone hearing loss of ALHL patients was 42.8 dB, which recovered to 18.9 dB following a combined treatment of diuretics and oral steroid therapy. The hearing recovery rate of this group was 87.9% and the ECoG abnormality ratio was 42.5%. Also, 15.5% of ALHL patients eventually progressed to MD. @*Conclusion@#This study described demographics and characteristics of ALHL, demonstrating a successful response to the combined treatment of diuretics and oral steroid. Also, this report demonstrated a close relationship between the degree of low-tone hearing loss and ECoG abnormality and observed the progression to MD in ALHL patients. These data can be usefully applied in clinical setting to explain clinical outcomes of ALHL.
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Background@#Regular exercise can help in the prevention and treatment of such diseases. However, most individuals exercise only rarely or irregularly. This study examined the effects of short-term cardiovascular endurance exercise on body composition and blood pressure in adults who visited an exercise prescription clinic. @*Methods@#From among 505 adults who visited the University Hospital family medicine and exercise prescription clinic from March 2005 to March 2011, data of 105 adults who regularly participated in the cardiovascular endurance exercise program were collected and analyzed. Changes in body composition and blood pressure were measured before and after the 8-week exercise program (types of exercise: stationary bicycles and treadmills; exercise intensity: 60%–85% maximum oxygen consumption; exercise frequency: 3–5 times a week; and exercise duration: 20–45 minutes per session). @*Results@#Obesity, as defined by the percentage of body fat (measured by bioimpedance analysis), was 71.4% and 80.5% for male and female, respectively, and obesity, as defined by body mass index, was 53.5% and 40.2% for male and female, respectively. Percentage of body fat, body mass index, weight, abdominal circumference, diastolic blood pressure, and systolic blood pressure were statistically significantly lower after the exercise program. In addition, with the exercise program, the waist-hip ratio decreased and the lean body mass increased. However, the differences were not statistically significant. @*Conclusion@#Short-term cardiovascular endurance exercises can have a positive effect on body composition and blood pressure. Therefore, doctors should more actively recommend exercise guidance.