No abstract available.
Anemia, Iron-Deficiency* ; Erythropoietin* ; Iron* ; Tumor Necrosis Factor-alpha*

Purpose: This study aimed to identify relationships among knowledge and skills about suicide prevention, attitudes toward suicide, and burnout of suicide prevention work of nurses at mental health welfare centers. Methods: An explanatory sequential mixed-method research was conducted. For the quantitative study, the subjects (nurses) were 133 nurses executing suicide prevention work. The data were analyzed using the SPSS 25.0 program. For the qualitative research, 13 nurses with high burnout scores were interviewed. The data were analyzed using theme analysis method. Results: Quantitative results showed the average burnout of suicide prevention work was 54.62 ± 12.51. The burnout of suicide prevention work had significant correlations with attitudes toward suicide (r = .30, p < .001) and suicide prevention skills (r = - .18,p = .037). Qualitative results showed six themes related to burnout of suicide prevention work. They were ‘feeling a lack of confidence in one’s suicide counselling skills’, ‘feeling of the limits of one’s ability to cope with a suicide crisis’, ‘feeling regret for not being able to help the clients’, ‘being over-empathetic to the clients’, ‘Not being able to understand the clients because the subjects (nurses) opposes committing suicide’, and ‘thinking that the suicidal thoughts of suicide attempters do not improve’. Conclusion To reduce burnout of nurses’ suicide prevention work at mental health welfare centers, there is a need to develop an educational program considering nurses' attitudes toward suicide and one to enhance their confidence in suicide prevention skills.

Purpose: The purpose of this study was to understand the experience of using community mental health services from the perspective of people with severe mental illness. Methods: The key research question was, "How was the experience of people with severe mental illnesses using community mental health services in studies using photovoice?" A systematic search was performed using seven core electronic databases (PubMed, EMBASE, CINAHL, Cochrane Library, RISS, KISS, and DBpia). Results: A total of nine studies out of 3,041 were included in the review. Seven central themes were identified through the thematic analysis: "growing hope," "continuing treatment with insight into the illness," "feeling a sense of achievement and improving self-esteem," "feeling joy, stability and connectedness," "pursuing a proactive life," "wanting to live a life that helps others," and "experiencing frustration." Conclusion The experience of using community mental health services by people with severe mental illness was similar to the experience of recovery. The use of community mental health services and the expansion of the peer support program and supported housing services are needed to promote recovery and improve the quality of life of people with severe mental illness.

No abstract available.
Humans ; Neutrophils* ; Phagocytosis* ; Stomach Neoplasms*

BACKGROUND: The analgesic efficacy and safety of transdermal fentanyl patch(TDFP) combined with intravenous ketorolac administration were evaluated. METHODS: TDFP releasing 75 mcg/h (Group 1) or 50 mcg/h (Group 2) or placebo (Group 3) were applied to 60 women at 2 hours before abdominal gynecologic surgery. Postoperatively, patients self-administered intravenous ketorolac as required using patient controlled analgesia. Each group was assessed following 48 hours with respect to vital signs, VAS pain score, satisfaction score, side effects, and cumulative ketorolac use. RESULTS: After operation, pain score and ketorolac demand were significantly lower and satisfaction score and side effects were significantly higher in TDFP group (Group 1, 2) than control group (Group 3). CONCLUSIONS: If TDFP is applied 2 hour before surgery, combined with a bolus dose of 200 mcg i.v. fentanyl at induction of anesthesia and ketorolac i.v. infusion in the postoperative period, it provides a significant degree of background analgesia without respiratory depression.
Analgesia ; Analgesia, Patient-Controlled* ; Anesthesia ; Female ; Fentanyl* ; Gynecologic Surgical Procedures ; Humans ; Hysterectomy* ; Ketorolac* ; Postoperative Period ; Respiratory Insufficiency ; Vital Signs

BACKGROUND: The purpose of this study was to evaluate the effect of different doses of fentanyl and morphine on the spread of spinal analgesia produced by bupivacaine. METHODS: 40 patients undergoing arthroscopy or transurethral resection under spinal anesthesia were randomly assigned to receive intravenous 50 or 100 g of fentanyl(F-50, F-100) or 5, 10 mg of morphine(M-5, M-10). 10 min after, we assessed the new levels of analgesia and administered intravenous naloxone 0.4 mg. The levels of sensory analgesia was reassessed 10 min after naloxone. RESULTS: 10 minutes after intravenous opioids, the level of analgesia increased significantly in M-10 group compared with F-50, M-5 group. Naloxone antagonized the effect of opioids on spinal analgesia. CONCLUSIONS: We conclude that systemic opioids enhance the spread of analgesia in a dose dependent manner, and this enhancement was antagonized by naloxone.
Analgesia* ; Analgesics, Opioid ; Anesthesia ; Anesthesia, Spinal ; Anesthetics ; Arthroscopy ; Bupivacaine ; Fentanyl* ; Humans ; Morphine* ; Naloxone

The importance of the results of some large, randomized controlled trials on hormone therapy (HT) has changed the perceived risk or benefit of HT. It is now recommended that the dose and regimen of HT should be individualized based on the principle of choosing the lowest appropriate dose in relation to the severity of symptoms and age of menopause. The effectiveness of low and ultra-low dose HT has been demonstrated for the treatment of vasomotor symptoms, genital atrophy and the prevention of bone loss with fewer side-effects than the standard dose HT. Although accumulating evidence demonstrates the efficacy and tolerability of low-dose HT, data about the use are limited by a lack of long-term, randomized studies. Further research is needed to determine the effect on fractures, as well as cardiovascular and breast disease.
Atrophy ; Breast Diseases ; Female ; Humans ; Menopause

The importance of the results of some large, randomized controlled trials on hormone therapy (HT) has changed the perceived risk or benefit of HT. It is now recommended that the dose and regimen of HT should be individualized based on the principle of choosing the lowest appropriate dose in relation to the severity of symptoms and age of menopause. The effectiveness of low and ultra-low dose HT has been demonstrated for the treatment of vasomotor symptoms, genital atrophy and the prevention of bone loss with fewer side-effects than the standard dose HT. Although accumulating evidence demonstrates the efficacy and tolerability of low-dose HT, data about the use are limited by a lack of long-term, randomized studies. Further research is needed to determine the effect on fractures, as well as cardiovascular and breast disease.
Atrophy ; Breast Diseases ; Female ; Humans ; Menopause

Sleep disorder has been portrayed as merely a common dissatisfaction with sleep quality and quantity. However, sleep disorder is actually a medical condition characterized by inconsistent sleep patterns that interfere with emotional dynamics, cognitive functioning, and even physical performance. This is consistent with sleep abnormalities being more common in patients with autonomic dysfunction than in the general population. The autonomic nervous system coordinates various visceral functions ranging from respiration to neuroendocrine secretion in order to maintain homeostasis of the body. Because the cell population and efferent signals involved in autonomic regulation are spatially adjacent to those that regulate the sleep-wake system, sleep architecture and autonomic coordination exert effects on each other, suggesting the presence of a bidirectional relationship in addition to shared pathology.The primary goal of this review is to highlight the bidirectional and shared relationship between sleep and autonomic regulation. It also introduces the effects of autonomic dysfunction on insomnia, breathing disorders, central disorders of hypersomnolence, parasomnias, and movement disorders. This information will assist clinicians in determining how neuromodulation can have the greatest therapeutic effects in patients with sleep disorders.

Purpose: The sonographic differential diagnosis of umbilical polyps and granulomas in children based on correlations with pathologic findings. Methods: We retrospectively analyzed the ultrasonographic findings of twenty-two umbilical masses in children that were pathologically confirmed as umbilical polyps or umbilical granulomas by surgery. We analyzed size, depth, echogenicity, internal content, intralesional vascularity, and the presence of unobliterated medial umbilical ligament. Pathologic correlation was performed for all of the umbilical masses. Results: Twenty-two masses consisted of eight umbilical polyps and fourteen umbilical granulomas. The mean age of the children with umbilical polyps was 30.13 months (range, 2 to 108 months) and it was 1.33 months (range, 0.6 to 3 months) for the children with umbilical granulomas. The average mass sizes were 10.25 mm (range, 5 to 35 mm) for umbilical polyps and 6.21 mm (range, 3 to 10 mm) for umbilical granulomas. The umbilical polyps were manifested as cystic lesions with thick echogenic walls in five patients (62.5%), which were associated with the intestinal mucosa (four lesions) and ectopic pancreatic tissue (one lesion) on pathology. Umbilical granulomas were superficially located in 13 (92.9%) and solid in thirteen (92.9%), which correlated with prominent granulation tissues on pathology. Seven (87.5%) of the eight umbilical granulomas were hypervascular and correlated with neovascularization on pathologic examination. Conclusion The umbilical polyps revealed deep-seated, hypovascular nodules with cyst formation surrounded by thick echogenic walls. In contrast, the umbilical granulomas revealed superficially located hypervascular hypoechoic solid nodules in young infants.