We present the case of a 78-year-old female who experienced acute mental deterioration after vomiting. She showed severe hypercapnia without definite lung disease and hypoxic injury on brain image. After the acute period, she still had excessive daytime sleepiness, and the hypercapnia aggravated during the night. Polysomnography revealed severe obstructive sleep apnea, a sleep-related breathing disorder with a high apneahypopnea index of 60.2/h (mainly a hypopnea index of 59.0/h). She was diagnosed with combined obesity hypoventilation syndrome (OHS) and sleep-related breathing disorder, as the cause of daytime hypercapnia and excessive daytime sleepiness. Three months of successful bi-level positive airway pressure (BiPAP) therapy dramatically improved her daytime sleepiness and cognition. This case suggests that patients with OHS can be susceptible to hypoxic brain damage, and emphasizes the importance of the recognition and diagnosis of OHS and appropriate treatment with BiPAP therapy.

Oxygen therapy (OT) can relieve head pain in certain primary headache disorders, including cluster headache (CH). The exact underlying mechanism is currently uncertain, but suggested mechanisms include inhibition of the trigeminoautonomic reflex, modulation of neurotransmitters, and cerebral vasoconstriction. OT is the standard for acute treatment of CH, but patients with CH often experience considerable difficulties accessing home OT due to problems with insurance coverage. Inhalation of 100% oxygen at 6–12 L/min for 15–30 min using a non-rebreather face mask is one of the most effective acute therapies for CH, but several trials have indicated the superiority of higher oxygen flow rates of up to 15 L/min and/or using a demand-valve oxygen mask that can produce very high flow rates. Two randomized controlled trials have demonstrated the efficacy of OT in migraine, but obtaining reliable evidence is considered difficult because of different inhalation protocols, varying outcome measures, and small samples. There are some reports on the efficacy of OT as an adjuvant therapy in hypnic headache, primary headache in the emergency department, and even postdural puncture headache. The goal of this review article is to expand the knowledge regarding the use of oxygen in the treatment of headache disorders.

We present a case report indicating that the administration of phentermine, an appetite suppressant with sympathomimetic activity, can provoke an intracerebral hemorrhage. A 48-year-old woman with no previously established cerebrovascular risk fa ctors and who had taken phentermine for 30 days developed sudden-onset left hemiparesis. Brain magnetic resonance imaging revealed an acute intracerebral hemorrhage involving the right thalamus. This case indicates that physicians should be aware of the relevant cause of medication history including appetite suppressants in young patients with an acute intracerebral hemorrhage.
Appetite Depressants ; Appetite* ; Brain ; Cerebral Hemorrhage* ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Paresis ; Phentermine* ; Thalamus

No abstract available.
Infarction* ; Sarcoma*

PURPOSE: The aim of the study is to evaluate the current and prospective status of nursing in Korea and develop a strategic framework and plan to accommodate the increased demands on nurses in the changing health-care system. METHODS: This study used a mixed-methods approach including a literature review, an online survey with health-care consumers, expert panel interviews, and an analysis of strengths, weaknesses, opportunities, and threats to develop the strategic plans and framework. RESULTS: The vision of the strategic framework involved improving health and quality of life, and its mission was to elevate the status of Korea's nursing sector as a key health-care profession through high-quality and innovative nursing education, research, and practice. The five values in accordance with the mission and vision were innovation, creation, collaboration, excellence, and authenticity. Three strategic goals, namely, education, research, and practice, were identified, and 31 related strategic tasks were developed. CONCLUSION: In response to the rising social demand for a paradigm shift in nursing care services, there is a need for advancements in nursing education, research, and practice in Korea. This study provide some recommendations to achieve these aims.
Cooperative Behavior ; Education ; Education, Nursing ; Health Policy ; Korea ; Nurse's Role ; Nursing Care ; Nursing ; Prospective Studies ; Quality of Life

Purpose: This study examines the association between child maltreatment and the perpetration and victimization of intimate partner violence (IPV) in adulthood, exploring the moderating effects of gender, age, and household income level. Methods: This cross-sectional study analyzed secondary data from the 2016 Domestic Violence Survey in South Korea, including 1,765 married individuals aged 65 or younger who responded to key variables. Structural equation modeling was used to analyze associations among the variables. Results: The paths from child maltreatment to IPV perpetration (β=.22, p<.001) and victimization (β=.22, p<.001) were statistically significant. Gender, age, and household income level significantly moderated this relationship. Women under 40 were more likely to be IPV victims than perpetrators. Low-income level increased the likelihood of being both perpetrators and victims. Women under 40 who had experienced child maltreatment and had a low-income level showed different probabilities of being victims or perpetrators of IPV. Conclusion Our findings highlight the need to mitigate the negative impact of child maltreatment in adulthood by designing specific interventions for vulnerable groups, such as women, younger individuals, and those with low-income levels. Ensuring lifelong prevention of child maltreatment and establishing tailored programs for IPV is crucial.

BACKGROUND: Linkage of public healthcare data is useful in stroke research because patients may visit different sectors of the health system before, during, and after stroke. Therefore, we aimed to establish high-quality big data on stroke in Korea by linking acute stroke registry and national health claim databases. METHODS: Acute stroke patients (n = 65,311) with claim data suitable for linkage were included in the Clinical Research Center for Stroke (CRCS) registry during 2006–2014. We linked the CRCS registry with national health claim databases in the Health Insurance Review and Assessment Service (HIRA). Linkage was performed using 6 common variables: birth date, gender, provider identification, receiving year and number, and statement serial number in the benefit claim statement. For matched records, linkage accuracy was evaluated using differences between hospital visiting date in the CRCS registry and the commencement date for health insurance care in HIRA. RESULTS: Of 65,311 CRCS cases, 64,634 were matched to HIRA cases (match rate, 99.0%). The proportion of true matches was 94.4% (n = 61,017) in the matched data. Among true matches (mean age 66.4 years; men 58.4%), the median National Institutes of Health Stroke Scale score was 3 (interquartile range 1–7). When comparing baseline characteristics between true matches and false matches, no substantial difference was observed for any variable. CONCLUSION: We could establish big data on stroke by linking CRCS registry and HIRA records, using claims data without personal identifiers. We plan to conduct national stroke research and improve stroke care using the linked big database.
Delivery of Health Care ; Humans ; Information Storage and Retrieval ; Insurance, Health ; Korea* ; Male ; National Health Programs* ; National Institutes of Health (U.S.) ; Parturition ; Stroke*