Purpose: s: Sepsis is a critical condition in which nurses should detect clinical manifestations and provide early intervention to prevent unwanted serious conditions in the patients. The initial occurrence and management of sepsis take place in general units, but there is a lack of knowledge in nurses. The purpose of this study was to examine the effects of a case-based sepsis education program and compare the case-based education program with and without smartphone applications. Methods: A quasi-experimental pre-testpost-test design with a control group was used. We provided a case-based education program with and without smartphone applications to the nurses and tested the effects of the program on knowledge, the accuracy of sepsis assessment, and self-efficacy as outcome variables. A total of 60 nurses in general units participated. To test differences in knowledge, the accuracy of sepsis assessment, and self-efficacy regarding sepsis between the groups over time, a mixed-design ANCOVA was used for parametric analysis, and generalized estimating equations (GEE) were used for nonparametric analysis. Results: There were significant differences in knowledge, the accuracy of sepsis assessment, and self-efficacy between the groups and within the groups over time. The intervention groups treated with the case-based education program showed improved outcome variables compared to the control group. There was no difference between case-based education with the smartphone application or without the application. Conclusions The case-based education improved knowledge, the accuracy of sepsis assessment, and self-efficacy in the care of sepsis by nurses working in the general wards. The results suggest that the case-based education program for nurses was effective and eventually improved patient health outcomes.

Purpose: The objectives of this study were to categorize the conflict management types of preceptor nurses and determine the effects of these types on preceptors’ role perception and core competencies. Methods: Data was collected from 192 preceptor nurses with at least two years experiences in general hospitals, from July 1 to July 31, 2022. Conflict management type, preceptor role perception, and core competency were investigated using structured instruments. The data was analyzed using K-means cluster analysis, Independent samples t-test, One-way ANOVA with Scheffé‘s test, and multiple regression analysis. Results: The conflict management types were categorized into four types; comprehensive type (cluster 1), integrating, obliging, compromising type (cluster 2), undifferentiated type (cluster 3) and obliging, avoiding type (cluster 4). The effect of conflict management types on preceptors’ role recognition occurred in the following order of cluster 2 (integrating/obliging/compromising type), cluster 1 (comprehensive type), and cluster 4 (obliging/avoiding type). Next, cluster 1 (comprehensive type), cluster 2 (integrating/obliging/compromising type), and cluster 4 (obliging/avoiding type) were shown in the order of the impact on the core competencies of the preceptor. Conclusion When preceptor nurses use a mixture of various attributes of conflict management evenly, they have been shown to demonstrate effective preceptor role recognition and core competencies. Therefore, it is proposed that future development of conflict management training programs for preceptor nurses should begin with identifying their conflict management type, followed by creating a program that addresses any deficiencies.

Purpose: This study aimed to analyze the differences in medical care use and patient outcomes between patient groups in the general ward (GW) and integrated nursing care ward (INCW). Methods: Among all patients admitted from January 1 to December 31, 2020, 430 patients (total 860) were selected in the GW and INCW using propensity score matching. The differences in the two groups were analyzed using t-test and x 2 test. Multiple and logistic regression were used to investigate the effect of admission to the INCW or GW on medical use and patient outcomes. Results: The total medical expenses, urinary tract infection rate, and pneumonia rate of the two groups did not show significant differences; however, the length of stay for the INCW group was approximately 3 days longer and unplanned readmissions were 5.4% lower for the INCW group than that for the GW group. Multiple and logistic regression analysis showed similar results. Conclusion Patients in the INCW group had longer hospitalization days and lower rates of unplanned readmission than those in GW group. Additional studies related to longer hospital stays are needed, and measures should be taken to prevent social hospitalization.

Purpose: This study aimed to analyze the differences in medical care use and patient outcomes between patient groups in the general ward (GW) and integrated nursing care ward (INCW). Methods: Among all patients admitted from January 1 to December 31, 2020, 430 patients (total 860) were selected in the GW and INCW using propensity score matching. The differences in the two groups were analyzed using t-test and x 2 test. Multiple and logistic regression were used to investigate the effect of admission to the INCW or GW on medical use and patient outcomes. Results: The total medical expenses, urinary tract infection rate, and pneumonia rate of the two groups did not show significant differences; however, the length of stay for the INCW group was approximately 3 days longer and unplanned readmissions were 5.4% lower for the INCW group than that for the GW group. Multiple and logistic regression analysis showed similar results. Conclusion Patients in the INCW group had longer hospitalization days and lower rates of unplanned readmission than those in GW group. Additional studies related to longer hospital stays are needed, and measures should be taken to prevent social hospitalization.

Purpose: This study aimed to analyze the differences in medical care use and patient outcomes between patient groups in the general ward (GW) and integrated nursing care ward (INCW). Methods: Among all patients admitted from January 1 to December 31, 2020, 430 patients (total 860) were selected in the GW and INCW using propensity score matching. The differences in the two groups were analyzed using t-test and x 2 test. Multiple and logistic regression were used to investigate the effect of admission to the INCW or GW on medical use and patient outcomes. Results: The total medical expenses, urinary tract infection rate, and pneumonia rate of the two groups did not show significant differences; however, the length of stay for the INCW group was approximately 3 days longer and unplanned readmissions were 5.4% lower for the INCW group than that for the GW group. Multiple and logistic regression analysis showed similar results. Conclusion Patients in the INCW group had longer hospitalization days and lower rates of unplanned readmission than those in GW group. Additional studies related to longer hospital stays are needed, and measures should be taken to prevent social hospitalization.

Purpose: This study aimed to analyze the differences in medical care use and patient outcomes between patient groups in the general ward (GW) and integrated nursing care ward (INCW). Methods: Among all patients admitted from January 1 to December 31, 2020, 430 patients (total 860) were selected in the GW and INCW using propensity score matching. The differences in the two groups were analyzed using t-test and x 2 test. Multiple and logistic regression were used to investigate the effect of admission to the INCW or GW on medical use and patient outcomes. Results: The total medical expenses, urinary tract infection rate, and pneumonia rate of the two groups did not show significant differences; however, the length of stay for the INCW group was approximately 3 days longer and unplanned readmissions were 5.4% lower for the INCW group than that for the GW group. Multiple and logistic regression analysis showed similar results. Conclusion Patients in the INCW group had longer hospitalization days and lower rates of unplanned readmission than those in GW group. Additional studies related to longer hospital stays are needed, and measures should be taken to prevent social hospitalization.

Tuberculosis (TB) is an old disease caused by Mycobacterium tuberculosis. Although it has been known for humans for thousands of years, the treatment of this disease still requires a lengthy therapy with multiple antibiotics. Also, the emergence of multidrug-resistant strains made it more difficult to treat TB, calling for a novel treatment approach. In Photodynamic therapy (PDT), a photosensitizer, such as methylene blue (MB), is irradiated by a laser, generating reactive oxygen species and killing microorganisms. Here, using M. smegmatis as a model mycobacterium, we examined the utility of PDT in TB treatment. The photosensitizer MB alone showed weak antimicrobial activity; however, when irradiated by a laser, it efficiently killed M. smegmatis (> 97% killing with 30 mg/ml MB and 54 J/cm2 irradiation). Surprisingly, PDT showed more efficient killing activity toward drug-resistant strains of M. smegmatis than the drug-sensitive wild-type strain. In PDT, when the irradiation step alone (Intermittent PDT) or the entire PDT process was repeated (Repeated PDT), the bactericidal activity was significantly enhanced. Since PDT can be applied locally in a short period of time and kills mycobacterium irrespective of its antibiotic resistance status, we conclude that PDT can be a viable option for TB treatment.

OBJECTIVE: To determine the usefulness of tissue harmonic imaging (THI) and pulse-inversion harmonic imaging (PIHI) in the evaluation of normal and abnormal fetuses. MATERIALS AND METHODS: Forty-one pregnant women who bore a total of 31 normal and ten abnormal fetuses underwent conventional ultrasonography (CUS), and then THI and PIHI. US images of six organ systems, namely the brain, spine, heart, abdomen, extremities and face were compared between the three techniques in terms of overall conspicuity and the definition of borders and internal structures. RESULTS: For the brain, heart, abdomen and face, overall conspicuity at THI and PIHI was significantly better than at CUS (p < 0.05). There was, though, no significant difference between THI and PIHI. Affected organs in abnormal fetuses were more clearly depicted at THI and PIHI than at CUS. CONCLUSION: Both THI and PIHI appear to be superior to CUS for the evaluation of normal or abnormal structures, particularly the brain, heart, abdomen and face.

OBJECTIVE: To assess the utility of hysterosonography (HS) as a screening method in patients with abnormal uterine bleeding. MATERIALS AND METHODS: We retrospectively reviewed transvaginal ultrasonography (TVS) and HS for 105 patients whose diagnosis was confirmed pathologically. All 105 patients were initially evaluated on the same day with both TVS and HS. On TVS and HS examination, endometrial cavitary lesions were classified as diffuse hyperplasia, endometrial polyp, endometrial cancer, uterine synechia and submucosal leiomyoma. Hysteroscopy with biopsy (n=35), curettage (n=60) or hysterectomy (n=10) was performed, and the results of TVS and HS examination were correlated with the pathological findings. RESULTS: The sensitivity and specificity were 79.0% and 45.8% for TVS, and 95.1% and 83.3% for HS, respectively. The positive and negative predictive values were 83.0% and 39.3% for TVS, and 95.1% and 83.3% for HS, respectively. Twenty-seven showed a discrepancy between the TVS and HS, and eight cases showed a discrepancy between HS and the pathologic diagnosis. CONCLUSION: TVS is a sensitive method to evaluate the endometrial cavitary lesions, but it often does not provide the physician with sufficient diagnostic information. With its higher sensitivities, specificities and positive and negative predictive values, HS can be better used than TVS in evaluating those patients with abnormal uterine bleeding.
Adult ; Aged ; Comparative Study ; *Endosonography/methods ; Female ; Human ; Middle Aged ; Retrospective Studies ; Sensitivity and Specificity ; Uterine Hemorrhage/etiology/*ultrasonography

BACKGROUND/AIMS: Hepatic damage during transarterial chemoembolization (TACE) is a critical complication in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Apart from its role in preventing HBV reactivation, there is some evidence for the benefits of preemptive antiviral therapy in TACE. This study evaluated the effect of preemptive antiviral therapy on acute hepatic deterioration following TACE. METHODS: This retrospective observational study included a prospectively collected cohort of 108 patients with HBV-related HCC who underwent TACE between January 2007 and January 2013. Acute hepatic deterioration following TACE was evaluated. Treatment-related hepatic decompensation was defined as newly developed encephalopathy, ascites, variceal bleeding, elevation of the bilirubin level, prolongation of prothrombin time, or elevation of the Child-Pugh score by ≥2 within 2 weeks following TACE. Univariate and multivariate analyses were conducted to identify factors influencing treatment-related decompensation. Preemptive antiviral therapy involves directing prophylaxis only toward high-risk chronic hepatitis B patients in an attempt to prevent the progression of liver disease. We regarded at least 6 months as a significant duration of preemptive antiviral treatment before diagnosis of HCC. RESULTS: Of the 108 patients, 30 (27.8%) patients received preemptive antiviral therapy. Treatment-related decompensation was observed in 25 (23.1%) patients during the follow-up period. Treatment-related decompensation following TACE was observed more frequently in the nonpreemptive group than in the preemptive group (29.5% vs. 6.7%, P=0.008). In the multivariate analysis, higher serum total bilirubin (Hazard ratio [HR] =3.425, P=0.013), hypoalbuminemia (HR=3.990, P=0.015), and absence of antiviral therapy (HR=7.597, P=0.006) were significantly associated with treatment-related hepatic decompensation. CONCLUSIONS: Our findings suggest that preemptive antiviral therapy significantly reduces the risk of acute hepatic deterioration. Preventing hepatic deterioration during TACE by applying such a preemptive approach may facilitate the continuation of anticancer therapy and thus improve long-term outcomes.
Aged ; Antiviral Agents/*therapeutic use ; Bilirubin/blood ; Carcinoma, Hepatocellular/*therapy ; Chemoembolization, Therapeutic/*adverse effects ; Female ; Gastrointestinal Hemorrhage/etiology ; Guanine/*analogs & derivatives/therapeutic use ; Hepatitis B/complications/*drug therapy ; Humans ; Hypoalbuminemia/etiology ; Incidence ; Liver/physiopathology ; Liver Diseases/epidemiology/*etiology ; Liver Neoplasms/*therapy ; Male ; Middle Aged ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Treatment Outcome