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Here we present a rare case of an adolescent with hypertension, concurrently diagnosed with fibromuscular dysplasia of the renal artery and Graves’ disease. Although fibromuscular dysplasia and Graves’ disease have distinct pathogenic mechanisms, it is possible to infer the potential correlation between the two from the perspective of vascular involvement. It is believed that transforming growth factor-β, as the shared element of both diseases, may contribute to their development and progression. The overactivation of the sympathetic nervous system in Graves’ disease may induce hyperplasia of vascular smooth muscle cells, similar to that observed in fibromuscular dysplasia. In Graves’ disease, the excessive synthesis and secretion of angiotensin II due to the overactivation of the renin-angiotensin system, along with the up-regulation of angiotensin II receptors, may also induce pathological changes in the vasculature throughout the body. In this regard, exploring the correlation between fibromuscular dysplasia and Graves’ disease is of significant clinical importance.
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Purpose@#The purpose of this study was to investigate the factors that affect post-traumatic growth of general hospital nurses after they experience traumatic events. @*Methods@#A cross-sectional correlation study design was used. Participants were 232 nurses from general hospitals in South Korea. Data, including self-report questionnaires, were collected from July 11th to 31st, 2019, and analyzed using descriptive statistics, t-test, One-way ANOVA, Scheffé test, Pearson's correlation coefficients and hierarchical multiple regression analysis in IBM SPSS Statistics 25.0. @*Results@#Post-traumatic stress (r=.24, p<.001), resilience (r=.36, p<.001), and social support (r=.37, p<.001) for general hospital nurses had a positive correlation with post-traumatic growth. The factors that affected post-traumatic growth were a) sleep disturbance, emotional paralysis and dissociation symptom subcategory of post-traumatic stress (β=.34, p<.001) and b) persistence subcategory of resilience (β=.33, p<.001) and c) evaluation support subcategory of social support (β=.29, p<.001). @*Conclusion@#Results indicate that it is necessary to develop and provide programs to nurses to improve post-traumatic stress management, strengthen their resilience and provide social support.
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PURPOSE: This study investigates the status of medication use of the elderly with chronic disease taking non-opioid analgesics and attempts to identify factors influencing medication adherence. METHODS: Data were collected from September 1 to October 19, 2016. A structured questionnaire was used for face-to-face interview with a convenience sample of 161, elderly people with chronic disease taking non-opioid analgesics. The survey included questions about status of medication use, medication adherence, symptom experience, depression and family function. Data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson's correlation coefficients, and stepwise multiple regression with IBM SPSS 23.0 program. RESULTS: The mean score of medication adherence of the elderly with chronic disease was 4.48±2.35. Experiences of side effects (β=.31, p<.001), use of over-the-counter pain medication (β=.19, p=.009), and family function (β=.16, p=.031) were identified as significant predictors. The final model explained 18.0% of the variation of medication adherence of the elderly with chronic disease taking non-opioid analgesics (F=12.30, p<.001). CONCLUSION: Therefore, as a strategy to improve medication adherence of the elderly with chronic disease, therapeutic intervention should be developed to improve family function and to manage with personalized plans considering experiences of side effects and use of over-the-counter pain medication.
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Waldenstr m's macroglobulinemia(WM) is a disorder of malignant proliferation of plasmacyoid lymphocytes and monoclonal immunoglobulin M. The renal complications of WM are less common and severe than that of multiple myeloma. We present a case of WM which involved the kidney as massive proteinuria, hematuria and renal failure. A biopy specimen of the kidney reveals the intraglomerular hyaline thrombi of immunoglobulin M paraprotein. Three cycles of plasmapheresis and systemic chemotherapy with chlorambucil and prednisolone show improvement in his renal manifestations. We suppose the glomerulonephritis caused by hyaline thrombi in WM may be reversible, at least in its early stage.