Background: Proximal humerus fractures account for 2% of all pediatric fractures. A nonoperative approach is the treatment of choice for most of these fractures; however, debates continue regarding the treatment of displaced fractures, especially in adolescents. In this study, we aimed to examine demographic data and treatment strategies for proximal humerus fractures in the pediatric population by conducting a meta-analysis. Additionally, we investigated the preferred surgical technique for operative treatment. Methods: A systematic online search of databases, including Embase, Medline, PubMed, and Cochrane Library, was conducted to identify studies that matched our search criteria. Data collection was completed on May 1, 2022. Age, sex, degree of angulation, Neer-Horwitz classification, Salter-Harris classification, treatment method (operative vs. nonoperative), and instrument used for internal fixation were classified and documented. Effect size analysis was performed using odds ratios (ORs) or weighted mean differences (WMDs) with 95% confidence intervals (CIs), based on data types. Results: Eight studies met our inclusion criteria. Overall, 33% of the patients (n = 195) underwent operative treatment, whereas 67% of them (n = 392) received nonoperative treatment. Among the demographic risk factors, severely displaced fracture type (OR, 10.00; 95% CI, 1.56−64.22; p = 0.020) and older age (WMD, 3.26; 95% CI, 2.29−4.23; p < 0.001) were significantly associated with operative treatment. There was no significant difference in the preference for percutaneous pinning or intramedullary nailing, the most frequently employed surgical techniques (OR, 5.09; 95% CI, 0.65−39.58; p = 0.120). Conclusions The operative treatment rate in pediatric proximal humerus fractures was 33%, which increased to 60% in severely displaced fractures (Neer-Horwitz grade III/IV). Severely displaced fractures and older age significantly contributed to the establishment of a treatment strategy for operative treatment. The choice of surgical technique may seem to be based on the anatomical location of the fracture rather than the surgeon’s preference.

No abstract available.
Disseminated Intravascular Coagulation* ; Fibrinogen*

BACKGROUND: Thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS) is a disease entity defined by the presence of thrombocytopenia and microangiopathic hemolytic anemia with or without fever, neurologic and renal symptoms. Therapeutic plasma exchange (TPE) has proven to be an effective treatment for TTP/HUS and has decreased mortality. We evaluated the effectiveness of TPE for TTP/HUS at the Department of Clinical Pathology, Samsung Medical Center during the last 6 years. METHODS: We assessed retrospectively the chief complaints, the clinical course, the treatment and the outcome in 17 TTP/HUS patients treated with TPE from December 1994 to May 2001. Minimal diagnostic criteria for TTP/HUS were unexplained thrombocytopenia and microangiopathic hemolytic anemia, with or without fever, neurologic, and renal symptoms. The range of ages of the patients was 15 to 63 years and the female to male ratio was 2:1. RESULTS: The most frequent clinical presentation was a renal problem (71%), followed by fever (53%) and neurologic symptoms (24%). The causes of TTP/HUS followed in the order of frequency: idiopathic (41%), suspicious for Escherichia coli O157: H7 infection (24%), systemic lupus erythematosus (18%), mitomycin C induced (12%), and preeclampsia (6%). A total of 229 TPE procedures were performed for 17 patients (mean: 13 procedures). The replacement fluids for TPE were fresh frozen plasma (59%) and cryosupernatant (41%). Thirteen patients (76%) survived and three of them relapsed (23%); however, they responded to further treatment. In comparing the laboratory results between pre and post TPE, significant changes were found in the white blood cells and platelet counts, creatinine, total bilirubin, and lactic dehydrogenase. The initial symptoms did not indicate a recurrence rate and a variety of drugs were used, except for corticosteroid administration. CONCLUSIONS: TTP/HUS patients responded well to TPE. The overall efficacy of TPE for TTP/HUS was 76%. The causes of TTP/HUS, the administered drugs and the replacement fluid did not affect the patient's prognosis.
Anemia, Hemolytic ; Bilirubin ; Creatinine ; Escherichia coli O157 ; Female ; Fever ; Hemolytic-Uremic Syndrome ; Humans ; Leukocytes ; Lupus Erythematosus, Systemic ; Male ; Mitomycin ; Mortality ; Neurologic Manifestations ; Oxidoreductases ; Pathology, Clinical ; Plasma Exchange* ; Plasma* ; Platelet Count ; Pre-Eclampsia ; Prognosis ; Recurrence ; Retrospective Studies ; Thrombocytopenia

PURPOSE: The purpose of this study was to analyze the prevalence of allergic disease among elementary school students in rural and urban areas. METHODS: In this study, 1,513 elementary students (1,163 in urban areas, 350 in rural areas) were surveyed. Data were analyzed using frequency, percentage of allergic symptoms and chi2 test was used to identify differences in the prevalence of allergic symptoms between urban and rural area students. The SAS program was used in the data analysis. RESULTS: There were significant differences in the prevalence of allergic disease according to whether there was a family member with a prior history of allergy symptoms. 48.7% of surveyed students (49.4% in urban, 46.3% in rural) had allergic symptoms. Allergic rhinitis was the most frequent allergic symptom in both urban and rural students. CONCLUSION: These results suggest that there is a need to prevent and manage allergies among elementary students. The family history should be considered an important factor when a program for allergy prevention and management is developed. Interventions are needed in both areas, especially for students with allergic rhinitis.
Humans ; Hypersensitivity ; Phenothiazines ; Prevalence ; Rhinitis ; Rhinitis, Allergic, Perennial ; Child Health

PURPOSE: This study was to identify the relationship among clinical nurse's job overload, self-efficacy, emotional exhaust and turnover intention. METHODS: The study was conducted through a survey on 537 clinical nurses in five general hospitals. The data were collected by self-reporting questionnaires and analysed by the SPSS/WIN 17.0 program using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient and stepwise multiple regression. RESULTS: The mean score of turnover intention was 3.04. Turnover intention according to age, total career, job objective, and work off showed significant differences. The significant positive correlations between emotional exhaust and turnover intention (r=.531, p<.001), job overload and turnover intention (r=.514, p<.001) were found. The significant factors influencing turnover intention were emotional exhaust (beta=.488, p<.001), career (beta=.175, p<.001), job overload (beta=.119, p=.003), and number of night (beta=.117, p=.002), which accounted for 40.3% of the variance. CONCLUSION: Thought this result, nursing managers should analyze the reasons for high turnover intention, focusing on the main factors affecting turnover intention and consider the solutions to decrease the turnover intention.
Hospitals, General ; Intention ; Personnel Turnover ; Surveys and Questionnaires

Anaphylaxis is one of major causes of morbidity and mortality during anesthesia. Even when treated appropriately, these reactions are usually unpredictable and potentially life-threatening. A 26-year-old male patient, who had previously undergone surgery under general and spinal anesthesia twice without any problems, was scheduled for a reconstruction of the anterior cruciate ligament. Lidocaine, thiopental sodium and rocuronium were injected sequentially to induce general anesthesia. Two minutes after the rocuronium injection, severe hypotension, tachycardia and bronchospasm developed, and delayed skin rashes appeared. These unexpected events resulted in the operation being aborted. The patient recovered without any significant complications under immediate proper intensive care.
Adult ; Anaphylaxis* ; Anesthesia ; Anesthesia, General ; Anesthesia, Spinal ; Anterior Cruciate Ligament ; Bronchial Spasm ; Exanthema ; Humans ; Hypotension ; Critical Care ; Lidocaine ; Male ; Mortality ; Tachycardia ; Thiopental

PURPOSE: Women's weight perception and obesity-related quality of life were analyzed according to BMI (Body Mass Index). METHODS: A survey was conducted using self-report questionnaires from 178 participants. The data analysis included descriptive statistics, frequency, percentage, t-test, ANOVA, Fisher's exact test and Kendall's tau using the SPSS version 14.0. RESULTS: There were significant differences in BMI according to age (F=8.037, p=<.001), weight perception (F=60.71, p<.001), weight control experience (F=2.504, p=.013), weight control method (F=5.839, p=.001) and weight control success (F=-2.451, p=.016). There was a significant difference in obesity-related quality of life according to weight perception in the low weight group (F=5.587, p=.021) and in the obesity group (t=3.419, p=.003). Higher correlations were found between the women's BMI group, weight perception and obesity-related quality of life. CONCLUSION: A program to provide appropriate information for weight perception is needed for the low weight group. There is a need for a program about weight reduction as well as weight perception for the obesity group.
Body Mass Index ; Obesity ; Quality of Life ; Surveys and Questionnaires ; Statistics as Topic ; Weight Loss ; Weight Perception

PURPOSE: The purpose of this study was to analyze the effects of a health education program to improve knowledge about environmental health and allergy symptoms among elementary school students. METHODS: This study has nonequivalent control group pre-post test design. Participants of this study were 60 elementary students (30 experimental and 30 control) who agreed to participate in the study. The education program consisted of information on environmental health and allergies, the atmosphere, indoor environments, food and allergies, and activities with parents. The program was carried out one time (50 minutes) per week during 6 weeks. Knowledge and symptoms of allergies were recorded before and after the program among both groups. The collected data were analyzed by ANCOVA and t-test using SAS program. RESULTS: There was a significant increase in knowledge about allergies in the experimental group compared to the control group, but allergic symptoms were similar in the two groups. CONCLUSION: These findings suggest that environmental health education programs are effective in the area of school health nursing for increasing knowledge about environmental health and allergies. Further research is needed to develop programs for reducing allergic symptoms as an environment health problem among children.
Atmosphere ; Child ; Environmental Health ; Evaluation Studies as Topic ; Health Education ; Humans ; Hypersensitivity ; Parents ; Phenothiazines ; School Health Services

Objectives: The aim of this retrospective cohort study was to investigate whether non-alcoholic fatty liver disease (NAFLD) was associated with incident bone mineral density (BMD) decrease. Methods: This study included 4536 subjects with normal BMD at baseline. NAFLD was defined as the presence of fatty liver on abdominal ultrasonography without significant alcohol consumption or other causes. Decreased BMD was defined as a diagnosis of osteopenia, osteoporosis, or BMD below the expected range for the patient’s age based on dual-energy X-ray absorptiometry. Cox proportional hazards models were used to estimate the hazard ratio of incident BMD decrease in subjects with or without NAFLD. Subgroup analyses were conducted according to the relevant factors. Results: Across 13 354 person-years of total follow-up, decreased BMD was observed in 606 subjects, corresponding to an incidence of 45.4 cases per 1000 person-years (median follow-up duration, 2.1 years). In the model adjusted for age and sex, the hazard ratio was 0.65 (95% confidence interval, 0.51 to 0.82), and statistical significance disappeared after adjustment for body mass index (BMI) and cardiometabolic factors. In the subgroup analyses, NAFLD was associated with a lower risk of incident BMD decrease in females even after adjustment for confounders. The direction of the effect of NAFLD on the risk of BMD decrease changed depending on BMI category and body fat percentage, although the impact was statistically insignificant. Conclusions NAFLD had a significant protective effect on BMD in females. However, the effects may vary depending on BMI category or body fat percentage.

PURPOSE: Food intake of COPD patients decreases because of appetite loss, depression, and breathing problems while eating, which increase the likelihood of patients becoming malnourished. This study investigated the nutrient intake and dietary quality of people with and without COPD in Korea. METHODS: There were 2,160 adults aged 50 and over who participated in the 5~6th Korea National Health and Nutrition Examination Survey. The subjects were divided into the COPD group and non-COPD group according to the rate of forced expiratory volume at 1 second (FEV1) against forced vital capacity (FVC). Consumption of food and nutrients were calculated based on the nutrition examination survey. Statistical analyses were conducted using SPSS 19.0. RESULTS: Among individuals in their 50s, intake of vitamin B1 in the COPD group was significantly less than the NCOPD group, while intake of sodium in the COPD group was significantly greater than the NCOPD group. Among individuals in their 60s, the energy intake of the COPD group was significantly less than that of the NCOPD group. The COPD group showed significantly less intake of vitamin B1 and vitamin C, but greater intake of sodium than the NCOPD group. In the group aged 70 and over, The COPD group had significantly less intake of vitamin B1 than the NCOPD group and showed lower nutrient adequacy ratio values in protein, vitamin B1, vitamin B2, and iron than the NCOPD group. CONCLUSION: The COPD group consumed less energy and certain nutrients, and their dietary quality was poor compared to the NCOPD group. Thus, more detailed research is required to understand the concrete relationship between COPD and malnutrition.
Adult* ; Appetite ; Ascorbic Acid ; Depression ; Eating ; Energy Intake ; Forced Expiratory Volume ; Humans ; Iron ; Korea* ; Malnutrition ; Nutrition Surveys* ; Nutritional Status ; Pulmonary Disease, Chronic Obstructive* ; Respiration ; Riboflavin ; Sodium ; Thiamine ; Vital Capacity