PURPOSE: This descriptive study was done to identify factors that influence stress related to clinical practice for nursing students. METHODS: Structured questionnaires were used to collect data from 278 students from two nursing colleges located in G metropolitan city and one nursing college in C region. RESULTS: The factors that most influenced stress for the nursing students during their clinical practice were critical thinking disposition, clinical competence, year, and gender. Especially, the result showed that higher critical thinking disposition and clinical competence correlated with lower stress in clinical practice. CONCLUSION: The results indicate that improving nursing students' critical thinking ability and clinical competence would help to relieve stress during clinical practice and increase the ability to cope with stress efficiently. The development of a variety of teaching and learning strategies and education in both theoretical and clinical practice education would be necessary to achieve this goal.
Clinical Competence ; Education ; Humans ; Learning ; Nursing ; Surveys and Questionnaires ; Students, Nursing* ; Thinking

No abstract available.

Cerebral infarction in cancer patients is often caused by thrombosis due to hypercoagulability, and in some cases, caused by direct tumor embolism. We report the case of cerebral infarction due to direct tumor embolism mixed with thrombus. Biopsy of blood clots obtained during thrombectomy is important for diagnosis. If there is a high risk of thrombosis among cancer patients with cerebral infarction, the use of appropriate antithrombotic agents along with maintaining a certain level of platelets should be considered.

The leading cause of morbidity and mortality in patients with acromegaly is cardiovascular complications. Myocardial exposure to excessive growth hormone can cause ventricular hypertrophy, hypertension, arrhythmia, and diastolic dysfunction. However, congestive heart failure as a result of systolic dysfunction is observed only rarely in patients with acromegaly. Most cases of acromegaly exhibit high levels of serum insulin-like growth factor-1 (IGF-1). Acromegaly with normal IGF-1 levels is rare and difficult to diagnose. Here, we report a rare case of an acromegalic patient whose first clinical manifestation was severe congestive heart failure, despite normal IGF-1 levels. We diagnosed acromegaly using a glucose-loading growth hormone suppression test. Cardiac function and myocardial hypertrophy improved 6 months after transsphenoidal resection of a pituitary adenoma.
Acromegaly* ; Arrhythmias, Cardiac ; Estrogens, Conjugated (USP)* ; Growth Hormone ; Heart Failure* ; Humans ; Hypertension ; Hypertrophy ; Insulin-Like Growth Factor I ; Mortality ; Pituitary Neoplasms

Thyroid dysfunction is one of the more prevalent clinical situations encountered by primary care physicians. Thyroid storm is defined as a life-threatening exacerbation of the hyperthyroid state in which there is evidence of decompensation of one or more organ systems. Common precipitants include infection, surgery, diabetic ketoacidosis, vascular accidents, non-compliance with antithyroid medication, and emotional stress, but rarely develop in invasive molar pregnancy. An 18-year-old woman presented to the emergency department complaining of lower abdominal pain and vaginal spotting. She had no previous history of hyperthyroidism. Under the diagnosis of invasive molar pregnancy, dilatation and curettage was performed. However, right after the procedure the patient developed a semi-coma metal status, high grade fever, and tachycardia. Prompt diagnosis of thyroid storm was made and treatment followed immediately. We present a case of thyroid storm and a review of thyroid storm precipitated by invasive molar pregnancy.
Abdominal Pain ; Adolescent ; Diabetic Ketoacidosis ; Diagnosis ; Dilatation and Curettage* ; Dilatation* ; Emergency Service, Hospital ; Female ; Fever ; Humans ; Hydatidiform Mole* ; Hyperthyroidism ; Metrorrhagia ; Molar* ; Physicians, Primary Care ; Pregnancy ; Stress, Psychological ; Tachycardia ; Thyroid Crisis* ; Thyroid Gland*

Background: Postpartum depression (PPD) can negatively affect infant well-being and child development. Although the frequency and risk factors of PPD symptoms might vary depending on the country and culture, there is limited research on these risk factors among Korean women. This study aimed to elucidate the potential risk factors of PPD throughout pregnancy to help improve PPD screening and prevention in Korean women. Methods: The pregnant women at 12 gestational weeks (GW) were enrolled from two obstetric specialized hospitals from March 2013 to November 2017. A questionnaire survey was administered at 12 GW, 24 GW, 36 GW, and 4 weeks postpartum. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale, and PPD was defined as a score of ≥ 10. Results: PPD was prevalent in 16.3% (410/2,512) of the participants. Depressive feeling at 12 GW and postpartum factors of stress, relationship with children, depressive feeling, fear, sadness, and neonatal intensive care unit admission of baby were significantly associated with a higher risk of PPD. Meanwhile, high postpartum quality of life and marital satisfaction at postpartum period were significantly associated with a lower risk of PPD. We developed a model for predicting PPD using factors as mentioned above and it had an area under the curve of 0.871. Conclusion Depressive feeling at 12 GW and postpartum stress, fear, sadness, relationship with children, low quality of life, and low marital satisfaction increased the risk of PPD. A risk model that comprises significant factors can effectively predict PPD and can be helpful for its prevention and appropriate treatment.