Purpose: : This retrospective study aims to provide basic data for intervention to improve clinical outcomes and identify the characteristics of the rebound hyperthermia (RHG) and non-rebound hyperthermia (NRHG) groups by checking body temperature in patients with post-cardiac arrest syndrome.Method : The study involved 118 patients who completed target temperature management (TTM) in an acute-care unit. Data were analyzed for frequency, percentages, mean, standard deviation, median, and quartiles, and compared using the chi-squared test and Mann–Whitney U-test. Results: : Rebound hyperthermia (RH) was observed in 74 (62.7%) patients, predominantly male (69.5%), with an average age of 64.54 ± 15.98, and a body mass index of 23.22 ± 4.75kg/m2 (overweight). Hypertension (50%) was the most common co-morbidity, followed by diabetes and heart disease (33.1%). Neuron-specific enolase levels were higher in the NRHG 24, 48, and 72 hours after recovery of spontaneous circulation (p = .037, p＜ .001, p= .008). The APHCHE Ⅳ was also higher in the NRHG (p＜ .001). RH occurred 25.49 (7.28–52.96) hours after TTM completion, lasting for 2 (1–3) hours. Temperature reduction strategies included notifying doctors, administering antipyretics, and nursing intervention, with the latter being the most common at 94.6%. Half of the subjects in the RHG and 77.3% in the NRHG fell into cerebral performance categories 3, 4, and 5 (p= .003). Conclusion : RH is more likely a body mechanism related to CPR and TTM than a result of pathogenic infection. Therefore, we require an active intervention for hyperthermia, and a patient-specific nursing intervention protocol.

Background: Hypotension following spinal anesthesia of Cesarean section is mainly caused by peripheral vasodilation and venous pooling due to sympathetic blockade. The degree of sympathetic blockade is known to affect the occurrence of hypotension after spinal anesthesia. The perfusion index (PI) and plethysmographic variability index (PVI) are non-invasive tools for measuring the vasomotor tone and volume status, respectively. The purpose of this study is to compare the trends of PI and PVI values between hypotension and normotension groups during Cesarean section following spinal anesthesia. Methods: Fifty-one parturients were divided into two groups whether they developed hypotension or maintained normotension after spinal anesthesia. Spinal anesthesia was performed with 0.5% hyperbaric bupivacaine (10 mg) and fentanyl (15 μg) at the L3-4 intervertebral space. The data of blood pressure, heart rate, PI and PVI were recorded every minute until delivery of baby. Results: Hypotension occurred in 61% of parturients during Cesarean section. The overall PI and PVI value after spinal anesthesia have gradually increased and decreased, respectively. The degree of increase and decrease in PI (p = 0.31) and PVI value (p = 0.35) was not significant between hypotension and normotension groups. Conclusions The trend of PI value has gradually increased while the PVI value has decreased, regardless of whether the parturient has experienced hypotension or not.

Background: Hypotension following spinal anesthesia of Cesarean section is mainly caused by peripheral vasodilation and venous pooling due to sympathetic blockade. The degree of sympathetic blockade is known to affect the occurrence of hypotension after spinal anesthesia. The perfusion index (PI) and plethysmographic variability index (PVI) are non-invasive tools for measuring the vasomotor tone and volume status, respectively. The purpose of this study is to compare the trends of PI and PVI values between hypotension and normotension groups during Cesarean section following spinal anesthesia. Methods: Fifty-one parturients were divided into two groups whether they developed hypotension or maintained normotension after spinal anesthesia. Spinal anesthesia was performed with 0.5% hyperbaric bupivacaine (10 mg) and fentanyl (15 μg) at the L3-4 intervertebral space. The data of blood pressure, heart rate, PI and PVI were recorded every minute until delivery of baby. Results: Hypotension occurred in 61% of parturients during Cesarean section. The overall PI and PVI value after spinal anesthesia have gradually increased and decreased, respectively. The degree of increase and decrease in PI (p = 0.31) and PVI value (p = 0.35) was not significant between hypotension and normotension groups. Conclusions The trend of PI value has gradually increased while the PVI value has decreased, regardless of whether the parturient has experienced hypotension or not.

Purpose: As the number of older adults with dual sensory declines is increasing, they face a higher risk of malnutrition compared to those without these declines. Although social determinants of health can influence malnutrition, there has been limited research on this population. This study aimed to explore the association between malnutrition risk and social determinants of health among older adults with dual sensory declines. Methods: The study is a cross-sectional analysis using data from the 2020 National Survey of Older Koreans. Binomial logistic regression analysis was conducted to examine the association between malnutrition risk and social determinants of health. These determinants include structural determinants, social capital, and intermediary determinants among older adults with dual sensory declines. Results: 1,771 with dual sensory declines were included in the analysis. Among the structural determinants, women (odds ratio [OR]=1.75, 95% confidential interval [CI] 1.19~2.57) and national basic livelihood security system recipients (OR=1.87, 95% CI 1.13~3.07) were significantly associated with malnutrition risk. In social capital, social non-participation (OR=1.33, 95% CI 1.03~1.73) and social network size (OR=0.95, 95% CI 0.92~0.98), Among intermediary determinants, living dissatisfaction (OR=1.61, 95% CI 1.16~2.23), environmental satisfaction (OR=0.95, 95% CI 0.92~0.99), household debt (OR=1.59, 95% CI 1.02~2.49) and comorbidity (OR=3.85, 95% CI 2.98~4.97) were significantly related to malnutrition risk. Conclusion These findings highlight the critical need to address key social determinants of health to enhance nutritional outcomes for older adults with dual sensory declines.

Purpose: As the number of older adults with dual sensory declines is increasing, they face a higher risk of malnutrition compared to those without these declines. Although social determinants of health can influence malnutrition, there has been limited research on this population. This study aimed to explore the association between malnutrition risk and social determinants of health among older adults with dual sensory declines. Methods: The study is a cross-sectional analysis using data from the 2020 National Survey of Older Koreans. Binomial logistic regression analysis was conducted to examine the association between malnutrition risk and social determinants of health. These determinants include structural determinants, social capital, and intermediary determinants among older adults with dual sensory declines. Results: 1,771 with dual sensory declines were included in the analysis. Among the structural determinants, women (odds ratio [OR]=1.75, 95% confidential interval [CI] 1.19~2.57) and national basic livelihood security system recipients (OR=1.87, 95% CI 1.13~3.07) were significantly associated with malnutrition risk. In social capital, social non-participation (OR=1.33, 95% CI 1.03~1.73) and social network size (OR=0.95, 95% CI 0.92~0.98), Among intermediary determinants, living dissatisfaction (OR=1.61, 95% CI 1.16~2.23), environmental satisfaction (OR=0.95, 95% CI 0.92~0.99), household debt (OR=1.59, 95% CI 1.02~2.49) and comorbidity (OR=3.85, 95% CI 2.98~4.97) were significantly related to malnutrition risk. Conclusion These findings highlight the critical need to address key social determinants of health to enhance nutritional outcomes for older adults with dual sensory declines.

Purpose: As the number of older adults with dual sensory declines is increasing, they face a higher risk of malnutrition compared to those without these declines. Although social determinants of health can influence malnutrition, there has been limited research on this population. This study aimed to explore the association between malnutrition risk and social determinants of health among older adults with dual sensory declines. Methods: The study is a cross-sectional analysis using data from the 2020 National Survey of Older Koreans. Binomial logistic regression analysis was conducted to examine the association between malnutrition risk and social determinants of health. These determinants include structural determinants, social capital, and intermediary determinants among older adults with dual sensory declines. Results: 1,771 with dual sensory declines were included in the analysis. Among the structural determinants, women (odds ratio [OR]=1.75, 95% confidential interval [CI] 1.19~2.57) and national basic livelihood security system recipients (OR=1.87, 95% CI 1.13~3.07) were significantly associated with malnutrition risk. In social capital, social non-participation (OR=1.33, 95% CI 1.03~1.73) and social network size (OR=0.95, 95% CI 0.92~0.98), Among intermediary determinants, living dissatisfaction (OR=1.61, 95% CI 1.16~2.23), environmental satisfaction (OR=0.95, 95% CI 0.92~0.99), household debt (OR=1.59, 95% CI 1.02~2.49) and comorbidity (OR=3.85, 95% CI 2.98~4.97) were significantly related to malnutrition risk. Conclusion These findings highlight the critical need to address key social determinants of health to enhance nutritional outcomes for older adults with dual sensory declines.

Purpose: As the number of older adults with dual sensory declines is increasing, they face a higher risk of malnutrition compared to those without these declines. Although social determinants of health can influence malnutrition, there has been limited research on this population. This study aimed to explore the association between malnutrition risk and social determinants of health among older adults with dual sensory declines. Methods: The study is a cross-sectional analysis using data from the 2020 National Survey of Older Koreans. Binomial logistic regression analysis was conducted to examine the association between malnutrition risk and social determinants of health. These determinants include structural determinants, social capital, and intermediary determinants among older adults with dual sensory declines. Results: 1,771 with dual sensory declines were included in the analysis. Among the structural determinants, women (odds ratio [OR]=1.75, 95% confidential interval [CI] 1.19~2.57) and national basic livelihood security system recipients (OR=1.87, 95% CI 1.13~3.07) were significantly associated with malnutrition risk. In social capital, social non-participation (OR=1.33, 95% CI 1.03~1.73) and social network size (OR=0.95, 95% CI 0.92~0.98), Among intermediary determinants, living dissatisfaction (OR=1.61, 95% CI 1.16~2.23), environmental satisfaction (OR=0.95, 95% CI 0.92~0.99), household debt (OR=1.59, 95% CI 1.02~2.49) and comorbidity (OR=3.85, 95% CI 2.98~4.97) were significantly related to malnutrition risk. Conclusion These findings highlight the critical need to address key social determinants of health to enhance nutritional outcomes for older adults with dual sensory declines.

Purpose: As the number of older adults with dual sensory declines is increasing, they face a higher risk of malnutrition compared to those without these declines. Although social determinants of health can influence malnutrition, there has been limited research on this population. This study aimed to explore the association between malnutrition risk and social determinants of health among older adults with dual sensory declines. Methods: The study is a cross-sectional analysis using data from the 2020 National Survey of Older Koreans. Binomial logistic regression analysis was conducted to examine the association between malnutrition risk and social determinants of health. These determinants include structural determinants, social capital, and intermediary determinants among older adults with dual sensory declines. Results: 1,771 with dual sensory declines were included in the analysis. Among the structural determinants, women (odds ratio [OR]=1.75, 95% confidential interval [CI] 1.19~2.57) and national basic livelihood security system recipients (OR=1.87, 95% CI 1.13~3.07) were significantly associated with malnutrition risk. In social capital, social non-participation (OR=1.33, 95% CI 1.03~1.73) and social network size (OR=0.95, 95% CI 0.92~0.98), Among intermediary determinants, living dissatisfaction (OR=1.61, 95% CI 1.16~2.23), environmental satisfaction (OR=0.95, 95% CI 0.92~0.99), household debt (OR=1.59, 95% CI 1.02~2.49) and comorbidity (OR=3.85, 95% CI 2.98~4.97) were significantly related to malnutrition risk. Conclusion These findings highlight the critical need to address key social determinants of health to enhance nutritional outcomes for older adults with dual sensory declines.

PURPOSE: Cystoscopy is very common and is one of the major office based procedures used in urologic clinics. However, a majority of patients complain of fear, pain, and discomfort when performing the procedure in an alert state. Routine administration of sedative and analgesic drugs is widely provided for gastorintestinal endoscopy to prevent patient discomfort and increase tolerance. Based on this, we investigated the safety and efficacy of midazolam induced sedative cystoscopy. MATERIALS AND METHODS: One hundred and twenty patients were enrolled in this study. They were divided into two groups; group I (n=80) consisted of patients who were sedated by midazolam 2.5mg IV before cystoscopy, and group II (n=40) consisted of patients who were not sedated and diclopenac 90mg was injected in them intramuscularly before cystoscopy to prevent pain. All patients in group I were reversed from the sedative state by flumazenil 0.5mg IV right after the completion of the cystoscopic procedure. The two groups were not significantly different in their age, sex, and weight distribution (p>0.05). Blood pressure, pulse, and respiratory rates were monitored pre-, intra-, and post procedure. The status of consciousness was monitored every three minutes by the OAA/S (Observer's Assessment of Alertness/Sedation) scale. Pain scale, anxiety scale, satisfaction score from patients and operators were measured using a specified questionnaire. RESULTS: In group I, the pain scale and anxiety scale were significantly reduced compared to group II (p<0.001). There were temporary changes in blood pressure and pulse rate in group I, but they were not clinically significant and no specific management was required. Group I patients were significantly more satisfied with their procedures compared to the patients of group II (p<0.001). CONCLUSIONS: Midazolam induced sedative cystoscopy can be applied safely and effectively as an outpatient base procedure. Further, we expect to apply this sedative procedure to other urologic procedures.
Analgesics ; Anxiety ; Blood Pressure ; Conscious Sedation ; Consciousness ; Cystoscopy* ; Endoscopy ; Flumazenil ; Heart Rate ; Humans ; Midazolam* ; Outpatients ; Surveys and Questionnaires ; Respiratory Rate

A 44-year-old man was cutting an outer plate of a ship, at a depth of 25 m below sea level. Following a sudden explosion, he was discovered unconscious and was carried to the surface by other divers. There was no evidence of vital signs upon arrival at the hospital. Postmortem computed tomography, which was performed prior to autopsy, revealed massive pneumocephalus in the brain, pneumohemothorax, diffuse lung contusions with multiple traumatic lung cysts, air-fluid level in the cardiac chamber of the chest, and pneumoperitoneum in the abdomen. Postmortem external examination showed a circular abrasion on the jaw, diffuse subcutaneous emphysema, and contusion in the right upper arm. An internal examination revealed intravascular air bubbles in all four chambers of the heart, and diffuse pulmonary trauma including contusion, laceration, and multiple traumatic cysts. Blast injury to the chest, and air embolism due to the underwater explosion were established as the underlying cause of death.
Abdomen ; Adult ; Arm ; Autopsy ; Blast Injuries ; Brain ; Cause of Death ; Contusions ; Diving ; Embolism, Air ; Explosions* ; Heart ; Humans ; Jaw ; Lacerations ; Lung ; Pneumocephalus ; Pneumoperitoneum ; Ships ; Subcutaneous Emphysema ; Thorax ; Vital Signs