PURPOSE: The purpose of this study was to identify the factors influencing parenting stress in primiparas. METHOD: The participants in this study were 198 primiparas of infants aged 1-6 months who visited well baby clinics in 5 hospitals. The data were collected from April 15 to June 15, 2003. RESULTS: The mean score for parenting stress was 2.4 of a possible 5 and thus considered average. The score for parenting stress was significantly correlated with the level of maternal perception of the infant and the level of social support. The score for parenting stress was significantly different according to the education level of the primiparas and prenatal management. For the primiparas, social support(20%) and maternal perception of the infant(9%) were significant predictors explaining parenting stress. CONCLUSIONS: Nursing interventions to improve maternal perception of the infant and increase social support should be provided for primiparas in order to reduce parenting stress.
Education ; Humans ; Infant ; Nursing ; Parenting* ; Parents* ; Child Health

BACKGROUND: Interest in pharmacist participation in the multidisciplinary intensive care team is increasing. However, studies examining pharmacist interventions in the medical intensive care unit (MICU) are limited in Korea. The aim of this study was to describe the current status of pharmacist interventions and to identify common pharmacologic problems requiring pharmacist intervention in the MICU. METHODS: Between September 2013 and August 2014, a retrospective, observational study was conducted in the 22-bed MICU at a university hospital. Data were obtained from two trained pharmacists who participated in MICU rounds three times a week. In addition to patient characteristics, data on the cause, type, related drug, and acceptance rate of interventions were collected. RESULTS: In 340 patients, a total of 1211 pharmacologic interventions were performed. The majority of pharmacologic interventions were suggested by pharmacists at multidisciplinary rounds in the MICU. The most common pharmacologic interventions were adjustment of dosage and administration (n = 328, 26.0%), followed by parenteral/enteral nutritional support (n = 228, 18.1%), the provision of drug information (n = 228, 18.1%), and advice regarding pharmacokinetics (n = 118, 9.3%). Antimicrobial agents (n = 516, 42.6%) were the most frequent type of drug associated with pharmacist interventions. The acceptance rate of interventions was 84.1% with most accepted by physicians within 24 hours (n = 602, 92.8%). CONCLUSIONS: Medication and nutritional problems are frequently encountered pharmacotherapeutic problems in the MICU. Pharmacist interventions play an important role in the management of these problems.
Anti-Infective Agents ; Humans ; Critical Care ; Intensive Care Units* ; Korea ; Nutritional Support ; Observational Study ; Pharmacists* ; Pharmacokinetics ; Retrospective Studies

Eosinophilic pancreatitis is a rare disorder that frequently accompanies peripheral eosinophilia and/or eosinophilic gastroenteritis. Eosinophilic pancreatitis can mimic a pancreatic neoplasm by forming a pancreatic mass with focal pancreatic eosinophilic infiltration. Because eosinophilic pancreatitis responds well to steroid treatment, it is important to distinguish eosinophilic pancreatitis from pancreatic neoplasm. Thus, fine needle aspiration biopsy (FNAB) should be considered in patients with a pancreatic mass accompanied by peripheral eosinophilia and/or eosinophilic gastroenteritis. We describe a case of eosinophilic pancreatitis with annular pancreas that was diagnosed by FNAB. This is the first reported case of eosinophilic pancreatitis with annular pancreas diagnosed by FNAB.
Biopsy ; Biopsy, Fine-Needle ; Enteritis ; Eosinophilia ; Eosinophils* ; Gastritis ; Gastroenteritis ; Humans ; Pancreas* ; Pancreatic Diseases ; Pancreatic Neoplasms ; Pancreatitis*

Eosinophilic pancreatitis is a rare disorder that frequently accompanies peripheral eosinophilia and/or eosinophilic gastroenteritis. Eosinophilic pancreatitis can mimic a pancreatic neoplasm by forming a pancreatic mass with focal pancreatic eosinophilic infiltration. Because eosinophilic pancreatitis responds well to steroid treatment, it is important to distinguish eosinophilic pancreatitis from pancreatic neoplasm. Thus, fine needle aspiration biopsy (FNAB) should be considered in patients with a pancreatic mass accompanied by peripheral eosinophilia and/or eosinophilic gastroenteritis. We describe a case of eosinophilic pancreatitis with annular pancreas that was diagnosed by FNAB. This is the first reported case of eosinophilic pancreatitis with annular pancreas diagnosed by FNAB.
Biopsy ; Biopsy, Fine-Needle ; Enteritis ; Eosinophilia ; Eosinophils* ; Gastritis ; Gastroenteritis ; Humans ; Pancreas* ; Pancreatic Diseases ; Pancreatic Neoplasms ; Pancreatitis*

BACKGROUND/AIMS: The aim of this study was to investigate the value of colonoscopy for Salmonella-Shigella culture of biopsy specimen and intraluminal fluid during colonoscopy in patients with acute diarrhea. METHODS: From March 2001 to August 2001, sixty-six patients with watery or bloody diarrhea lasting less than 15 days were participated after exclusion of the patients with previous history or presumption of inflammatory bowel disease, radiation colitis, ischemic colitis, or pseudomembranous colitis. The biopsy specimen was taken and colonic luminal fluid was aspirated during colonoscopy for Salmonella-Shigella cultures. RESULTS: Male and female ratio was 1:1.3 and mean age was 45 17 years. The normal colonoscopic finding was showed in twelve cases (18.2%). The severity of acute colitis was mild in 25 cases (25/54, 46.3%), moderate in 9 cases (9/54, 16.7%), and severe in 20 cases (20/54, 37.0%). The extent of acute colitis was as followed: involvement of one segment in 9 cases (16.7%), involvement of two or more segments in 26 cases (48.1%), pancolitis in 7 cases (13.0%), and pancolitis with involved terminal ileum in 12 cases (22.2%). In culture study, identification of Salmonella species was in 11 cases (16.7%). Salmonella species were identified in 6.0% (3/50) with stool specimen, 18.0% (9/50) with biopsy specimen, and 4.0% (2/50) with intraluminal fluid, but without statistical significance. CONCLUSION: The culture using biopsy specimens and intraluminal fluid obtained during colonoscopy may be helpful in diagnosis of cases of suggesting Salmonella-Shigella infection.
Biopsy* ; Colitis ; Colitis, Ischemic ; Colon ; Colonoscopy* ; Diagnosis ; Diarrhea* ; Enterocolitis, Pseudomembranous ; Female ; Humans ; Ileum ; Inflammatory Bowel Diseases ; Male ; Phenobarbital ; Salmonella

BACKGROUND: Interest in pharmacist participation in the multidisciplinary intensive care team is increasing. However, studies examining pharmacist interventions in the medical intensive care unit (MICU) are limited in Korea. The aim of this study was to describe the current status of pharmacist interventions and to identify common pharmacologic problems requiring pharmacist intervention in the MICU. METHODS: Between September 2013 and August 2014, a retrospective, observational study was conducted in the 22-bed MICU at a university hospital. Data were obtained from two trained pharmacists who participated in MICU rounds three times a week. In addition to patient characteristics, data on the cause, type, related drug, and acceptance rate of interventions were collected. RESULTS: In 340 patients, a total of 1211 pharmacologic interventions were performed. The majority of pharmacologic interventions were suggested by pharmacists at multidisciplinary rounds in the MICU. The most common pharmacologic interventions were adjustment of dosage and administration (n = 328, 26.0%), followed by parenteral/enteral nutritional support (n = 228, 18.1%), the provision of drug information (n = 228, 18.1%), and advice regarding pharmacokinetics (n = 118, 9.3%). Antimicrobial agents (n = 516, 42.6%) were the most frequent type of drug associated with pharmacist interventions. The acceptance rate of interventions was 84.1% with most accepted by physicians within 24 hours (n = 602, 92.8%). CONCLUSIONS: Medication and nutritional problems are frequently encountered pharmacotherapeutic problems in the MICU. Pharmacist interventions play an important role in the management of these problems.
Anti-Infective Agents ; Humans ; Critical Care ; Intensive Care Units ; Korea ; Nutritional Support ; Observational Study ; Pharmacists ; Pharmacokinetics ; Retrospective Studies

Objective: The aim of this study was to investigate the association between blood levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) and cognitive impairments among elderly individuals. Methods: Peripheral concentration of TNF-α and IL-6 were measured in all subjects. To assess individual cognitive function, the Consortium to Establish a Registry for Alzheimer’s Disease Neuropsychological Assessment Battery (CERAD-NP) was used, and standardized scores (z-scores) were calculated for each test. Cytokine levels were compared between the diagnostic groups, and correlations between blood inflammatory factor levels and z-scores were analyzed. Results: The 37 participants included 8 patients with Alzheimer’s disease (AD), 15 subjects with mild cognitive impairment (MCI), and 14 cognitively healthy controls. TNF-α and IL-6 levels were higher in patients with AD than in healthy controls. TNF-α levels were higher in the AD group than in the MCI group. However, after adjusting for age, the associations between diagnosis and TNF-α and IL-6 were not significant. The higher the plasma IL-6 level, the lower the z-scores on the Boston Naming Test, Word List Learning, Word List Recognition, and Constructional Recall. The higher the serum TNF-α level, the lower the z-scores on the Word List Learning and Constructional Recall. Negative correlation between serum TNF-α level and the z-score on Word List Learning remained significant when age was adjusted. Conclusion The difference in the blood levels of TNF-α and IL-6 between the diagnostic groups may be associated with aging. However, elevated TNF-α levels were associated with worse immediate memory performance, even after adjusting for age.

Thyroid hormone plays an important role in the process of implantation of a fertilized egg in the endometrium, as well as in the division and development of the fertilized egg. In addition, maternal thyroid hormone is essential for the formation and development of the fetal brain, nervous system, and bones. Therefore, when maternal thyroid hormone is insufficient, complications such as miscarriage, stillbirth, low birth weight and preeclampsia increase. Guidelines for the diagnosis and treatment of thyroid dysfunction during pregnancy were established and published by the American Endocrine Society, the American Thyroid Association, and the European Thyroid Society. The Korean Thyroid Society also published recommendations for diagnosis and treatment of thyroid disease during pregnancy and postpartum in 2014. However, since the revised guidelines of the American Thyroid Association were published in 2017, many studies, including large-scale randomized controlled trials, have been published in relation to thyroid and pregnancy, and the need to revise the existing recommendations has emerged in Korea.The main revisions of this recommendation are changes in the normal range of TSH during pregnancy, detailed description of treatment policies according to pregnant women’s autoantibodies and thyroid function status. Also, a description of the effect of thyroid autoantibodies on assisted reproductive procedures has been added.

Subclinical hypothyroidism (SCH), characterized by elevated serum thyroid-stimulating hormone (TSH) levels and normal free thyroxine levels, usually presents without symptoms, and is often discovered incidentally during routine blood test. The Task Force of the Korean Thyroid Association Committee of Clinical Practice Guidelines has established a guideline to evaluate and manage SCH; the guideline emphasizes the implementation of diagnostic criteria based on the TSH reference range for Koreans and focuses on the proven health benefits of levothyroxine (LT4) treatment. Based on the Korea National Health and Nutrition Examination Survey (2013-2015), serum TSH level of 6.8 mIU/L is considered the reference value for SCH. SCH can be categorized as mild (TSH 6.8-10.0 mIU/L) or severe (TSH ＞10.0 mIU/L), and patients are classified as adults (age ＜70 years) or elderly patients (age ≥70years) depending on the health effects of LT4 treatment. An initial increase in serum TSH levels should be reassessed with a subsequent measurement, along with the thyroid peroxidase antibody test, preferably 2-3 months after the initial evaluation. Usually, LT4 treatment is not recommended for mild SCH in adults; however, treatment is necessary for severe SCH in patients with underlying coronary artery disease or heart failure and can be considered for coexisting dyslipidemia. LT4 treatment is not recommended for mild or even severe SCH in elderly patients, in general. Patients with SCH who receive LT4 treatment, the LT4 dosage should be personalized, and serum TSH levels should be monitored to ensure optimal LT4 dosage (dosage that is neither excessive nor insufficient). Patients with SCH who do not receive LT4 treatment require periodic follow-up at appropriate testing intervals determined by disease severity. The guideline also provides several educational points applicable in clinical settings.