PURPOSE: To evaluate seasonal variations of overactive bladder (OAB) symptoms in women who visited hospital clinics.METHODS: Medical records of female patients treated for OAB symptoms from January 2011 to December 2017 were retrospectively reviewed. Patients with pyuria at the first visit, those who did not complete the questionnaire, and those with <3 overactive bladder symptom scores (OABSS) were excluded. Uroflowmetric parameters, 3-day micturition diary, and OABSS were analyzed.RESULTS: A total of 582 patients with OAB symptoms who visited the hospital were enrolled in this study. Patients were grouped into 1 of the 3 season groups (cold, intermediate, and hot) depending on the average temperature of the month that the patient first visited the urologic department outpatient clinic. The total OABSS was significantly different between the 3 season groups (cold [7.25±3.20] vs. intermediate [6.24±3.40] vs. hot [5.51±3.20], P=0.001). The proportion of patients who had moderate OAB symptoms (6≤OABSS) was higher in the cold season group (56.2%) than in the other season groups (intermediate, 42.1%; hot, 31.8%; P=0.002). Differences in the number of micturitions (12.12±4.56 vs. 10.95±4.39, P=0.021) and number of urgent urinary incontinence episodes (2.06±0.94 vs. 2.48±0.87, P=0.001) between the cold and hot season groups were also significant. However, differences in the nocturia episode, total daytime voided volume, and mean voided volume between season groups were not significant.CONCLUSIONS: Different urinary symptoms and uroflowmetric parameters were correlated with seasonal variation. OAB symptoms might be worse in cold season than in other seasons.
Ambulatory Care Facilities ; Female ; Humans ; Medical Records ; Nocturia ; Pyuria ; Retrospective Studies ; Seasons ; Urinary Bladder, Overactive ; Urinary Incontinence ; Urination

PURPOSE: The purpose of this study was to investigate the prevalence of postthyroidectomy obesity, and the relationship between the extent of thyroidectomy and obesity. METHODS: A survey conducted at an outpatient clinic from June to October 2014 and retrospective charts for patients undergoing thyroidectomy at Konkuk University Medical Centers from June 2009 to December 2013 were reviewed. We compared clinical characteristics and pre- and postoperative obesity-related factors in 227 patients who underwent total thyroidectomy or lobectomy. RESULTS: Patients included 39 males and 188 females with a mean age of 46.0 ± 11.0 years; the mean follow-up period was 23.9 ± 16.7 months, and 90 of the 227 patients showed postthyroidectomy obesity. In effect of operative extent on postoperative obesity, patients who underwent TT (48.2 years) than those who underwent lobectomy (43.4 years). TT group had longer follow-up and the frequency of menopause was higher than in the lobectomy group. No differences in postthyroidectomy obesity, body weight change, or body mass index (BMI), change among 2 groups. The predictors of postthyroidectomy obesity were older age, female, heavy alcohol consumption (P = 0.029), higher preoperative BMI (P < 0.001), larger postoperative weight gain (P = 0.024), and larger BMI change. However, the extent of thyroidectomy did not affect postthyroidectomy obesity. Preoperative BMI (P < 0.001) and heavy alcohol consumption (P = 0.03) were independent factors of postthyroidectomy obesity. CONCLUSION: The extent of thyroidectomy does not affect postthyroidectomy obesity. Preoperative BMI and heavy alcohol consumption are risk factors for postthyroidectomy obesity. Studies are needed to suggest preoperative life style modification to prevent postthyroidectomy obesity.
Academic Medical Centers ; Alcohol Drinking ; Ambulatory Care Facilities ; Body Mass Index ; Body Weight Changes ; Female ; Follow-Up Studies ; Humans ; Life Style ; Male ; Menopause ; Obesity ; Prevalence ; Retrospective Studies ; Risk Factors ; Thyroid Neoplasms ; Thyroidectomy ; Weight Gain

BACKGROUND: Treatment for venous malformations of the head and neck includes sclerotherapy, surgical resection, or a combination of both. Surgical resection can remove or reduce the volume of vascular lesions; however, surgery can cause postoperative scarring and potential surgical complications. This study sought to determine the effectiveness of surgery for the treatment of venous malformations of the head and neck. METHODS: A retrospective review of the medical records of patients who received surgeries for venous malformations of the head and neck from January 2011 to July 2019 was performed. Using clinical photographs, preoperative and postoperative Doppler ultrasonography, outpatient clinic records, and operation records, the postoperative result and complications were evaluated for each case. RESULTS: Among patients who visited our vascular anomalies clinic, 43 patients (ratio of male to female= 24:19) received surgeries for venous malformations of the head and neck. Twenty-nine patients had undergone surgery only, five patients received sclerotherapy after surgery, and nine patients received surgery after preoperative sclerotherapy. In postoperative evaluations, the result was excellent in 24 patients, good in 18 patients, and poor in one patient. Four patients experienced a recurrence of lesions with lagophthalmos, drooping of the corner of the mouth, partial wound necrosis, and scar widening found in one patient each. CONCLUSION: Because the head and neck region is the most exposed area in the body, more active implementation of surgical treatments with or without sclerotherapy is essential to reduce the functional and cosmetic impairments associated with venous malformations.
Ambulatory Care Facilities ; Cicatrix ; Head ; Humans ; Male ; Medical Records ; Mouth ; Neck ; Necrosis ; Recurrence ; Retrospective Studies ; Sclerotherapy ; Surgery, Plastic ; Ultrasonography, Doppler ; Vascular Malformations ; Wounds and Injuries

OBJECTIVES: This study examined the factors associated with suicidal behavior in psychiatric inpatients. METHODS: The medical records of 208 psychiatric inpatients were reviewed retrospectively. The factors related to suicide attempts and ideation at the time of admission, and during outpatient follow-up, were investigated. RESULTS: In total, 120 patients (57.7%) with a history of at least one suicide attempt, and 163 patients (78.4%) who reported active suicide ideation (e.g., a suicide plan or intention to commit suicide) at the time of admission were reviewed. Being unmarried or divorced, substance abuse, impulsivity, and a poor social support system were associated with a history of suicide attempts. The suicidal ideation group had significantly higher rates of coexisting depression, severe depressive symptoms, hopelessness, and impulsivity, as well as a lower incidence of moral objection to suicide and high religiosity. In total, 15 out of 193 patients (7.8%) who were followed-up at outpatient clinics attempted suicide after discharge. Patients who attempted suicide or reported suicidal ideation at the outpatient clinic after discharge were significantly more likely to have a history of previous suicide attempts, or have had active suicide ideation at the time of admission. Good social support and high responsibility to family were inversely associated with suicidal ideation as an outpatient. CONCLUSION: A history of suicide attempts and ideation at the time of hospital admission were the risk factors for future outpatient suicidal behavior. Further study is warranted to develop a checklist and assessment measures of the various risk and protective factors associated with suicidal behavior.
Ambulatory Care Facilities ; Checklist ; Depression ; Divorce ; Follow-Up Studies ; Humans ; Impulsive Behavior ; Incidence ; Inpatients ; Intention ; Medical Records ; Outpatients ; Protective Factors ; Retrospective Studies ; Risk Factors ; Single Person ; Substance-Related Disorders ; Suicidal Ideation ; Suicide ; Suicide, Attempted

PURPOSE: Herpes zoster appears in all ages and its incidence progressively increase. It is more common in elderly people or immunocompromised people and can be accompanied by serious complications. This study was performed to investigate the clinical manifestation of herpes zoster according to immune status in children. METHODS: This study was retrospectively included 307 children under 18 years who were diagnosed and treated with herpes zoster at Inha University Hospital from 1997 to 2017 based on medical records. These patients were divided into two groups according to their immunity and their clinical features were compared. RESULTS: The mean age of the total 307 patients was 10.2 years, 151 (49.2%) in males. Eighty-seven patients were hospitalized and 220 patients were treated in an outpatient clinic. Most patients received antiviral treatment. The most common dermatomal distribution of the skin lesion was the thoracic region, followed by trigeminal, lumbar and sacral, cervical region. Twenty-one patients were immunocompromised and fifteen of them were hematologic disorders. Admission rate, history of chickenpox and mean duration of treatment were significantly higher in immunocompromised group (P < 0.05). There was no significant difference in age, dermatomal distribution and complication between the two groups. Complications were observed in 50 cases and more than half of them were zoster ophthalmicus. Another complication was Ramsay-Hunt syndrome, meningitis and skin infection. CONCLUSION: Immunocompromised patients had a longer duration of treatment and a higher history of chickenpox. The incidence of complications, dermatomal distribution and age did not differ from that of immunocompetent children.
Adolescent ; Aged ; Ambulatory Care Facilities ; Chickenpox ; Child* ; Herpes Zoster* ; Humans ; Immune System ; Immunocompromised Host ; Incidence ; Male ; Medical Records ; Meningitis ; Retrospective Studies ; Skin

Noise in the knee joint is a common symptom that often leads to outpatient clinic visits. However, there have been no previous review articles regarding noise around the knee despite its high prevalence. We will review the noise characteristics according to sound nature and onset as well as factors for differentiation between physiological and pathological noises. In addition, we will describe causes of the physiological and pathological noises and management of noise in the knee. An appropriate review of the characteristics of noise, its pathophysiology, and factors for differentiation between physiological and pathological noises can facilitate patient guidance. It is important to differentiate between physiological noise and pathologic noise. In most cases, noise after surgery is simply the perception of noise that had been present previously due to emotional concerns. Minor problems associated with surgery, such as postoperative noise, can decrease patient satisfaction, especially among patients with high expectations. Following surgical principles and providing accurate information about physiological noise can decrease the risk of both pathological noise and patient dissatisfaction. In total knee arthroplasty, every attempt should be made to avoid patellar crepitus and clunk by using modern prostheses with proper patellofemoral conformity and by avoiding surgical errors.
Ambulatory Care Facilities ; Arthroplasty, Replacement, Knee ; Humans ; Knee Joint ; Knee* ; Medical Errors ; Noise* ; Patient Satisfaction ; Prevalence ; Prostheses and Implants

Fulminant type 1 diabetes is a distinct subtype of type 1 diabetes mellitus that is characterized by sudden, complete destruction of pancreatic beta cells at the disease onset. Since the disease was first described in 2000 in Japan, a number of case reports have also been published in Korea. However, this disease entity is still not well defined. A 48-year old man with no medical history was admitted with diabetic ketoacidosis. Fulminant type 1 diabetes was diagnosed and he was discharged with multiple insulin injections. His serum glucose level was well controlled in the outpatient clinic. A month later, diabetic ketoacidosis occurred again following a diagnostic colonoscopy. This case suggests that fulminant type 1 diabetes is an aggressive disease in which small stimuli can provoke ketoacidosis. Therefore, for tests that require fasting, close observation by medical staff and patient education about the disease is essential.
Ambulatory Care Facilities ; Blood Glucose ; Colonoscopy* ; Diabetes Mellitus, Type 1 ; Diabetic Ketoacidosis* ; Fasting ; Humans ; Insulin ; Insulin-Secreting Cells ; Japan ; Ketosis ; Korea ; Medical Staff ; Patient Education as Topic

OBJECTIVE: Emergency department (ED) visits by nonurgent patients are controversial because they are considered one of the causes of ED overcrowding and an example of the improper use of medical resources. On the other hand, some non-urgent patients do require hospitalization. The purpose of this study was to compare hospitalized and discharged patients who were classified as nonurgent upon their initial ED visit and identify the predictive factors associated with hospitalization in nonurgent patients visiting an ED. METHODS: Among a nonurgent patient group visiting an urban university hospital ED in 2016, the hospitalized and discharged patients were compared. RESULTS: A total of 13,988 nonurgent patients were analyzed, of which 773 (5.5%) were hospitalized. The predictive factors related to hospitalization for nonurgent patients were as follows: male, age 65 years or older, ED visits during outpatient clinic availability, and in the evening, heart rate greater than 100 per minute, respiration rate greater than 20 per minute and body temperature over 38℃ CONCLUSION: Among nonurgent patients, there are patients who require hospitalization. If these predictive factors are considered in the initial ED triage, it should improve the safe treatment of nonurgent patients and improve the efficiency of the use of limited resources.
Ambulatory Care Facilities ; Body Temperature ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Hand ; Heart Rate ; Hospitalization* ; Hospitals ; Humans ; Male ; Respiratory Rate ; Triage

BACKGROUND: With the rising patients dissatisfying experiences and poor patient satisfaction rate accounted in the Emergency Department (ED) of Manila Doctors Hospital, the researcher was determined to alleviate these upsetting experiences without making huge and costly renovation on the part of the hospital management by educating the patients and guardians of pediatric patients of the ED processes and scenarios while at the triage.

METHODS: This study was randomized,controlled trial in which 70 acute care adult patients and guardians of pediatric patients that came in the afternoon shift (2-10pm) were enrolled and randomized to experimental and control groups, where the experimental group was educated of the ED processes and scenarios at the triage area and the control group was given no information. At the end of ED visit, participants were asked to give a patient satisfaction rating using a scale where 6 domains are rated (triage, patient safety, security, non-medical and medical staffs, facility and payments). 

RESULTS: The results showed no statistically significant differences between the experimental and the control groups. There was not enough power to detect a statistically significant difference between the two groups as to the level of satisfaction.

CONCLUSION: The experimental and control groups were comparable as to the level of patient satisfaction. Patient education in the triage is not an effective strategy in improving the patient satisfaction in the ED of Manila Doctors Hospital.

Human ; Male ; Female ; Triage ; Patient Satisfaction ; Patient Safety ; Personal Satisfaction ; Emergency Service, Hospital ; Hospitals ; Medical Staff ; Health Facilities

OBJECTIVE: As increasing the size of the geriatric population, the number of elderly patients, who need the surgery for painful degenerative spinal stenosis has been increasing. The geriatric population may be relatively high complications, because of age and age-associated medical conditions. However, there is a lack of studies addressing the perioperative complications and outcomes in elderly patients with posterior lumbar inter body fusion with screw augmentation (PLIF). METHODS: We retrospectively reviewed the medical records and radiographic studies of geriatric patients who had spine surgery of PLIF due to spinal stenosis for 11 years. We divided into 2 groups (A; 70–75 years, B; over then 76 years) according to the age. Surgical level of each groups, hospital day and postoperative day, co-morbidities, complications, clinical outcomes were analyzed. Operative reports, hospital and outpatient clinic charts, and radiographic studies were reviewed. RESULTS: Group A was composed of 80 patients, their mean age was 72.21 and female dominant (n=46), and their mean surgically fused level was 1.52 level. Group B was 36 patients, their mean age was 78.83 and female dominant (n=20), and their mean surgically fused level was 1.36 level. Comparing between two groups, complications, postoperative hospital stay were slightly increase in group B and co-morbidity was statistically high in group B, however clinical outcomes were similar between two groups. CONCLUSION: Increasing age might be an important risk factor for complications in patients undergoing PLIF, however, we would like to recommend that if the situation of spine of extreme geriatric patients need PLIF, it should be in the surgeon’s consideration after careful selection and clinical judgement.
Aged ; Ambulatory Care Facilities ; Female ; Geriatrics ; Humans ; Length of Stay ; Lumbar Vertebrae ; Medical Records ; Postoperative Complications ; Retrospective Studies ; Risk Factors ; Spinal Stenosis* ; Spine