This systematic review aimed to investigate the effects of periodontal treatment on glycated hemoglobin A (HbA1c) levels in patients with type 2 diabetes who develop periodontal disease. The search of the MEDLINE, Embase, CINAHL, and Cochrane Library databases was completed on April 8, 2018. The study design was based on randomized clinical trials. Scaling and root planing was performed for the test group, whereas no periodontal treatment or simple oral training was performed for the control group. The main outcome variable was the change in HbA1c levels. We used the Review Manager statistical analysis software for the quantitative analysis of selected documents. Meta-analysis was performed using the inverse variance estimation method of the fixed-effect model to estimate the effects of periodontal treatment on HbA1c levels in patients with type 2 diabetes. A total of 1,011 documents were searched using search strategies, and 10 documents were included in the meta-analysis. The meta-analysis of the selected literature showed that periodontal treatment significantly reduced the HbA1c levels in patients with type 2 diabetes who develop periodontal disease (mean difference, −0.34; 95% confidence interval, −0.43 to −0.26; p<0.001). This study aimed to investigate the effects of periodontal treatment on HbA1c levels, which can be used as a basis for the increasing management of diabetic complications. To improve the quality of life and reduce the burden of medical expenses for patients with diabetes, periodontal disease management through nonsurgical periodontal treatment, such as scaling and root planing, is necessary.
Dental Scaling ; Diabetes Complications ; Diabetes Mellitus, Type 2 ; Hemoglobin A, Glycosylated* ; Humans ; Methods ; Periodontal Diseases ; Quality of Life ; Root Planing

Purpose: Nursing students are susceptible to medication safety incidents in the neonatal intensive care unit (NICU) related to a lack of communication experience. The purpose of the present study was to investigate the impact of a NICU medication safety simulation (NMSS) focusing on communication clarity, patient hand-off confidence, and patient safety competency in senior-year nursing students. Methods: The study utilized a nonequivalent control group pretest-posttest design. In total, 60 nursing students were assigned to two groups. The experimental group participated in the NMSS, which included three medication error scenarios. Pairs of students completed the scenarios together in 10 to 20 minutes. Data were analyzed using the chi-squared test, independent t test, and ANCOVA. Results: The experimental group showed significant improvements in communication clarity (p=.015), and patient safety competency (p<.001) compared to the control group. Using the pretest values as covariates, patient hand-off confidence scores significantly increased (p=.027). Conclusion Implementing the NMSS focusing on communication in the pediatric nursing curriculum helped students to communicate clearly and concisely about medication errors, and its use is recommended to promote patient safety competency in the NICU.

A 71-yr-old male patient with three vessel coronary artery disease underwent a coronary artery bypass graft. The patient was found to have a large pericardial defect at the apex of the heart that measured approximately 18 cm in circumference. The edge of the pericardial defect impinged on the epicardial coronary arteries. The left phrenic nerve descended via the dorsal boundary of the pericardial defect. Following coronary artery bypass grafting, the pericardial defect was repaired with a polytetrafluorethylene patch. The patient had an uncomplicated postoperative course.
Aged ; Coronary Angiography ; *Coronary Artery Bypass ; Coronary Artery Disease/radiography/*surgery ; Humans ; Male ; Pericardium/*abnormalities ; Phrenic Nerve ; Polytetrafluoroethylene/therapeutic use

PURPOSE: This study is a comparative evaluation of the incidence of parenteral nutrition-associated liver disease (PNALD) when administering intravenous fat emulsions containing fish oil. METHODS: The medical records of patients who were in the neonatal intensive care unit at Severance Hospital from January, 2012 to December 2015, were reviewed retrospectively. Patients who were administered either soybean oil (SO) or SMOF (containing soybean oil, medium chain triglycerides, olive oil, and fish oil) more than 14 days were included. The patients were excluded if they were administered both agents or had underlying hepatic disease. An increase in bilirubin to 2 mg/dL was defined as PNALD. RESULTS: PNALD occurred in only 8 out of a total of 77 patients: 6 out of 31 (19.4%) in the SO group and 2 out of 46 (4.3%) in the SMOF group (P=0.055). The number of patients, whose lab values, such as direct bilirubin, total bilirubin, asparate aminotransferase (AST), alanine amino-transferase, gamma-glutamyl transpeptidase, C-reactive protein, serum triglyceride, and alkaline phosphate, exceeded the normal range, were similar in both groups. The gestational age, birth body weight, and APGAR score at 1 min and 5 min were significantly higher in the SO group and the PN duration was significantly long in the SMOF group. Considering only term infants, there were no significant differences in baseline characteristics and incidence of PNALD. The number of patients whose AST exceeded the normal range was significantly higher in the SO group (P=0.034). CONCLUSION: The incidence of PNALD was similar in both groups. On the other hand, considering the tendency, there was a high correlation between the type of lipid emulsion and an increased direct bilirubin level in the SO group.
Alanine ; Apgar Score ; Bilirubin ; Body Weight ; C-Reactive Protein ; Emulsions* ; Fat Emulsions, Intravenous ; Fish Oils ; gamma-Glutamyltransferase ; Gestational Age ; Hand ; Humans ; Incidence ; Infant ; Infant, Newborn* ; Intensive Care, Neonatal ; Liver Diseases* ; Liver* ; Medical Records ; Olive Oil ; Parenteral Nutrition ; Parturition ; Reference Values ; Retrospective Studies ; Soybean Oil ; Triglycerides

PURPOSE: To compare the effect of breast milk containing fortifier with preterm formula on bone mineral metabolism in premature infants, we evaluated the state of bone mineralization, biochemical alteration and the frequency of rickets during the first five months of life. METHODS: Fourteen fortified breast milk-fed infants and eleven preterm formula-fed infants who were born at Il-Sin Christian Hospital from August, 1996 through July, 1997, were studied. The breast milk-fed group received human milk fortifier. The intake of Ca, P, Mg, protein, and fat was calculated at one month of age. Birth weight and weight at one, two and five months of age were measured. Serum Ca, P, alkaline phosphatase and 25-hydroxyvitamine D were measured at one month of age, and the wrist received X-ray examinations monthly. Total body bone mineral content was measured by Dual energy X-ray absorptiometry (Lunar WI) at two and five months of age. RESULTS: The two groups were similar in birth weight, gestational age, and weight at one, two and five months of age. Enteral Ca, P, protein, Mg, and fat intake, and urinary excretion of Ca, P were similar among the two groups. Serum Ca, P, ALP and 25-hydroxyvitamin D were not different. Occurrence of rickets and bone mineral content were similar among the two groups. CONCLUSION: Fortified breast milk-fed infants and preterm formula-fed infants showed no difference in total body bone mineral content and occurrence of rickets. Ultimately, we could enhance the advantage of breast milk fed to premature infants by adding fortifier.
Absorptiometry, Photon ; Alkaline Phosphatase ; Birth Weight ; Bone Density ; Breast ; Calcification, Physiologic ; Gestational Age ; Humans* ; Infant ; Infant, Newborn ; Infant, Premature ; Metabolism* ; Milk, Human* ; Rickets* ; Wrist

No abstract available.
Humans ; Liver Cirrhosis* ; Liver* ; Sepsis* ; Vibrio cholerae* ; Vibrio*

BACKGROUND: The usage of appropriate disinfectants is essential for infection control in a hospital. Inadequate use of disinfectants is the cause of human or environmental toxicity and is a waste of cost. The objective of this study was to describe the status of the usage of disinfectants in Korean hospitals. METHOD: One hundred and eighty three hospitals of over 300 beds were investigated by a questionnaire distributed by mall. Data collection was done on November 1999. The questionnaire was made by the Association of Infection Control Nurses in Korea, based on references and protocols of the Korean Society of Nosocomial Infection Control. Numerical and percentage data were analyzed by SPSS. RESULTS: The collection rate of the questionnaire was 43.7% (80/300). Thirty five hospitals (46.7%) had an official process in selecting disinfectants in their hospitals. Regarding skin antiseptics, 10% povidone iodine and 70% alcohol were commonly used in skin preparation for intravenous catheterization or pre-operative skin disinfection, For disinfection of mucosal membranes such as mouth and periurethral area, 3% boric acid solution or 3% H202 were used. Most of the hospitals decontaminated contaminated medical instruments manually with dodecyl diamino ethyl glycine (20.8%). glutaraldehyde (15.6%). quaternary ammonium compounds (13.8%), virkon (12.3%) and sodium hypochlorites (11.7%). Glutaraldehyde and virkon were frequently used for disinfection of endoscopes. Sodium hypochlorites (48.9%) and quaternary ammonium compounds (19.8%) were the most commonly used environmental disinfectants. Some noticeable problems in disinfectants were as follows. First, for mouth care, many hospitals (41.7%) over-used boric acid, which has cumulative toxicity for humans. Second, many hospitals had an incorrect protocol of disinfecting endoscopes. Third, for environmental decontamination and instrument cleaning, some hospitals used high level disinfectants such as glutaraldehyde, which is too costly and provides unnecessary safety problems. Fourth, after patient discharge, many hospitals did not use disinfectants at all. Considering the specific Korean medical environment of high incidence of multi-drug resistant microorganisms, use of disinfectants for discharged environments may be warranted. CONCLUSION: This study included only hospitals of over 300 beds, which has a limitation in representing the status of disinfectants usage in a country. However, significant problems from misunderstanding the basic principles of disinfectants and misusages of disinfectants were observed in this investigation. These observations will provide useful information for designing a guideline for the appropriate uses and for efficient education of disinfectants, and also for planning a national control program for proper disinfectants usage in this country.
Anti-Infective Agents, Local ; Catheterization ; Catheters ; Cross Infection ; Data Collection ; Decontamination ; Disinfectants* ; Disinfection ; Education ; Endoscopes ; Glutaral ; Glycine ; Humans ; Incidence ; Infection Control ; Korea* ; Membranes ; Mouth ; Patient Discharge ; Povidone-Iodine ; Quaternary Ammonium Compounds ; Skin ; Sodium ; Surveys and Questionnaires

PURPOSE: To investigate the usefulness of the serum Creatine kinase(CK), especially brain typical creatine kinase(CK-BB) as an indicator of brain damage extent, mortality and long term nurologic sequelae, the study was done. METHODS: CK and CK isoenzyme activites were measured at 6-10 hours after birth in 160 asphyxiated newborn infants who admitted in Eulji General Hospital from August 1990 to July 1994. Infants were followed up for 1 years after birth to evaluate survival and neurologic outcome. RESULTS: 1) There was low correlation between CK-BB and 5 minute Apgar score(r=0.245, p=0.0026). 2) There was intermediate correlation between CK-BB and Lactic dehydrogenase (LDH)(r=0.470, p<0.0001). 3) Infants who died within 24 hours after birth had significantly higher CK-BB activity(144.9+/-98.5U/L) than survivors(82.2+/-159U/L), (p=0.0160). Infants who died within 72 hours after birth had significantly higher CK-BB activity(130.2+/-108.4U/L) than survivors(80.5+/-161.1U/L), (p=0.0209) 4) Infants who died within 24 hours after birth had significantly higher CK-BB%(23.4+/-17.4%) than survivors(9.6+/-11.9%), (p=0.0042). Infants who died within 72 hours after birth had significantly higher CK-BB%(20.0+/-15.4%) than survivors(9.3+/-11.8%), (p= 0.0027). Infants who died within 28 days after birth had significantly higher CK-BB% (12.7+/-13.4%) than survivors(9.7+/-12.3%), (p=0.0500). 5) In the cases of neonatal seizure in 24-48 hours after birth, CK-BB was higher than in the cases of no seizure or seizure in 48 hours after birth. 6) CK-BB was well correlated to the grade of hypoxic ischemic encephalopathy. 7) CK-BB, CK-BB% and 5 minute Apgar score showed similar positive and negative predictive values for survival rate, abnormal findings of imaging studies and neurologic outcomes. CONCLUSIONS: CK-BB is a good predictive value for the death within 24 and 72 hours after birth and the neonatal seizure in 24-48 hours after birth. CK-BB% is a good predictive value of the death within 24, 72 hours and 28 days after birth. CK-BB, CK-BB% and 5 minute Apgar score showed similar predictivity for neurologic outcomes during 1 years after birth.
Apgar Score ; Asphyxia* ; Brain ; Creatine Kinase* ; Creatine* ; Hospitals, General ; Humans ; Hypoxia-Ischemia, Brain ; Infant ; Infant, Newborn ; Isoenzymes* ; Mortality ; Oxidoreductases ; Parturition ; Seizures ; Survival Rate

PURPOSE: This study develop a Video Recording-Based Standardized Handoff (VRSH) program at shift change for ward nurses.METHOD: The study was conducted in five medical, three surgical, and one comprehensive nursing care service wards affiliated with a secondary general hospital. In this methodological study, the VRSH program was developed between April and December, 2017. It is noted that 65 nurses who were involved in the VRSH program participated in this study.RESULTS: In line with the modified Situation, Background, Assessment, Recommendation tool, the VRSH program consisted of three phases. In the VRSH program, the average time for handoff duration was 3–5 minutes per patient. More than 90% of the ward nurses were satisfied with the VRSH program since it benefited them by reducing overtime work and improving the performance, as well as effective communication, of nurses. The content analysis of nurses' VRSH program experience, revealed three categories and eight sub-categories.CONCLUSION: This study provides evidence that the VRSH program improves effective nursing performance and, the handoff communication and relationships between nurses. Future studies on large sample sizes and multiple settings are required to substantially evaluate the impact of the VRSH program on clinical outcomes.
Feasibility Studies ; Hospitals, General ; Humans ; Methods ; Nursing ; Nursing Care ; Patient Handoff ; Pilot Projects ; Sample Size ; Video Recording

Background: The purpose of this study was to investigate the conditional effect of school support between learning agility and academic burnout in nursing students. Methods: A cross-sectional descriptive study design was used. A total of 213 participants was surveyed using a self-report questionnaires including general characteristics, a learning agility, academic burnout and school support scale. The descriptive statistics, independent t-test, one-way ANOVA, Pearson’s correlation, and PROCESS Macro (Model 7) and bootstrapping method. Results: Educational environment support had a significant mediating effect between the learning agility and academic burnout. Professor support had a significant moderating mediation effect in the Educational environment support between the learning agility and academic burnout. And friend and senior support had only direct effect to learning agility and academic burnout. Conclusion These results highlight the importance of school support and can be used as meaningful data for intervention research to reduce the academic burnout and to learning agility for nursing students.