Rapid integration of information technology into health care systems has included the use of highly portable systems-in particular, personal digital assistants (PDAs). With their large built-in memories, fast processors, wireless connectivity, multimedia capacity, and large library of applications, PDAs have been widely adopted by physicians and nurses for patient tracking, disease management, medical references and drug information, enhancing a quality of health care. Many health-related PDA applications are available to both dietetics professionals and clients. Dietetics professionals can effectively use PDAs for client tracking and support, accessing to hospital database or information, and providing better self-monitoring tools to clients. Internship programs for dietetics professionals should include training in the use of PDAs and their dietetics applications, so that new practitioners can stay abreast of this rapidly evolving technology. Several considerations to keep in mind in selecting a PDA and its applications are discussed.
Delivery of Health Care ; Dietetics* ; Disease Management ; Humans ; Internship and Residency ; Multimedia ; Patient Identification Systems ; Quality of Health Care

Purpose: : Developing infection control capabilities during the COVID-19 pandemic was critical. This study aimed to develop a simulation program to control patients with COVID-19 in nursing students and examine the effects on COVID-19 knowledge, COVID-19 nursing intention, self-efficacy learning, and clinical performance. Methods: : The study used nonequivalent control group pretest-posttest design. Sixty nursing students were recruited from two different colleges using purposive sampling. For the intervention group(n=30), the pretest was administered before the simulation program, involving six sessions of online lectures and simulation practices. Immediately, the posttest was conducted following the program. Results: : COVID-19 knowledge (t=9.87, p ＜.001), COVID-19 nursing intention (t=4.45, p ＜.001), learning self-efficacy (t=6.49, p ＜.001), and clinical performance (t=6.77, p ＜.001) increased significantly after the program, revealing the positive effect of the COVID-19 infection control simulation program in nursing students. Conclusion : The results of the study and the curriculum may be used as practical evidence for COVID-19 infection control in nursing schools and medical institutions.

BACKGROUND: The use of several biochemical markers has improved the diagnosis of neonatal bacterial infection, which remains an important cause of morbidity and mortality. Recently, serum procalcitonin (PCT) has been investigated as a new marker for the detection of bacterial infection. The aim of this study was to assess the usefulness of PCT in early neonatal bacterial infection and compare the diagnostic utility of PCT with that of C-reactive protein (CRP). METHODS: We retrospectively studied 216 neonates (109 full term, 107 preterm) whose PCT was measured 24 hr after birth. Thirty-five were clinically classified into an infected group, of which 17.4% had positive cultures. Clinical data, PCT, CRP, leukocyte, and neutrophil counts were evaluated. The diagnostic performance of PCT and CRP was studied using receiver operating characteristic analysis. RESULTS: Compared to the non-infected group, the infected group displayed significantly higher median PCT (0.82 vs. 12.29 ng/mL, P<0.0001) and CRP (1.0 vs. 5.0 mg/L, P<0.0001) values, but similar leukocyte and neutrophil counts. The thresholds for PCT and CRP were 2.75 ng/mL (sensitivity, 97.1%; specificity, 76.7%) and 3.1 mg/L (sensitivity, 68.6%; specificity, 83.3%), respectively. The area under the curve for PCT was 0.937 (95% confidence interval [CI], 0.896-0.965) and 0.781 for CRP (95% CI, 0.720-0.834). CONCLUSIONS: During the first 24 hr after birth, PCT is a more sensitive marker than CRP for bacterial infection and has predictive value for early neonatal bacterial infection.
Bacterial Infections* ; Biomarkers ; C-Reactive Protein ; Diagnosis* ; Humans ; Infant, Newborn ; Leukocytes ; Mortality ; Neutrophils ; Parturition ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity

Diabetes in pregnancy is associated with higher rates of miscarriage, pre-eclampsia, preterm labor, and fetal malformation. To prevent these obstetric and perinatal complications, women with diabetes have to control levels of blood sugar, both prior to and during pregnancy. Thus, individualized medical nutrition therapy for each stage of pregnancy is essential. We provided in-depth medical nutrition therapy to a 38-year-old pregnant woman with diabetes at all stages of pregnancy up to delivery. She underwent radiation therapy after surgery for breast cancer and was diagnosed with diabetes. At the time of diagnosis, her glycated hemoglobin level was 8.3% and she was planning her pregnancy. She started taking an oral hypoglycemic agent and received education regarding the management of diabetes and preconception care. She became pregnant while maintaining a glycated hemoglobin level of less than 6%. We provided education program for diabetes management during the pregnancy, together with insulin therapy. She experienced weight loss and ketones were detected; furthermore, she was taking in less than the recommended amount of foods for the regulation of blood sugar levels. By giving emotional support, we continued the counseling and achieved not only glycemic control but also instilled an appreciation of the importance of appropriate weight gain and coping with difficulties. Through careful diabetes management, the woman had a successful outcome for her pregnancy, other than entering preterm labor at 34 weeks. This study implicated that the important things in medical nutrition therapy for pregnant women with diabetes are frequent follow-up care and emotional approach through the pregnancy process.
Abortion, Spontaneous ; Adult ; Blood Glucose ; Breast Neoplasms ; Counseling ; Diagnosis ; Education ; Female ; Follow-Up Studies ; Hemoglobin A, Glycosylated ; Humans ; Insulin ; Ketones ; Nutrition Therapy* ; Obstetric Labor, Premature ; Pre-Eclampsia ; Preconception Care ; Pregnancy* ; Pregnant Women ; Weight Gain ; Weight Loss

To raise traditional medicine to a higher level of scientific research, a mathematical model has been proposed using symbolic notations and operators to describe several disease symptoms generally recognized in traditional medicine. Even though this model to a certain degree offers a mathematical approach to identify the relationships between yin-yang and the five viscera, it is not an efficient means of explaining the pathology in traditional medicine due to its use of superfluous notations and definitions. In this paper, we introduce two concise operators, a self-development operator and an action operator: the former describes the effect of a viscus in the unbalanced state on other viscera: the latter explains the engendering and restraining relationships between the two viscera. These tools are useful to elucidate the interactions among the states of the five viscera based on yin-yang and the five elements theory. Our mathematical model with these two operators facilitates description for the scheme of deficiency-excess of yin-yang in the five viscera. Accordingly, we have mathematically refined the existing results and shown clinical applications as well.
Heart ; physiopathology ; Humans ; Liver ; pathology ; Lung ; pathology ; Models, Theoretical ; Viscera ; pathology ; Yin-Yang

PURPOSE: Elevated circulating oxidized low density lipoprotein (Ox-LDL) levels are associated with increased risk of atherosclerosis, which may be due to high plasma homocysteine (Hcy) and low intakes of antioxidants. We investigated the contribution of dietary intakes of antioxidants to Hcy-induced LDL oxidation in atherosclerotic patients (AP) and controls. MATERIALS AND METHODS: Male AP (n = 101) who were confirmed by coronary angiography and 91 controls were evaluated by blood biochemistry and dietary intakes. To determine whether homocysteine is an independent risk factor for atherosclerosis, subjects were divided into three groups; low- (< or = 6.9 uM/L), normal- (7 uM-12 uM/L) and high- (> or = 12.1 uM/L) Hcy. RESULTS: Plasm levels of homocysteine and LDL were higher, but plasma apo A-I in HDL and folate were lower in the AP group. The odds ratio (OR) for the risk of atherosclerosis was 3.002 [95% confidence interval (CI), 1.27-7.09] for patients in the highest tertile with homocysteine > or = 12.1 uM/L. AP having high homocysteine levels had low intakes of vitamin A, beta-carotene and vitamin C. By logistic regression analysis, age, body mass index (BMI), plasma LDL, plasma folate, and low intakes of vitamin A and beta-carotene were found to be risk factors for atherosclerosis in patients with high-Hcy, but dietary B vitamins including folate were not. CONCLUSION: A high-Hcy level was a risk factor for atherosclerosis in patients with high Ox-LDL levels. High intakes of antioxidants appeared to be a protective factor for atherosclerosis, perhaps exerting a pro-oxidative effect on LDL when combined with high levels of Hcy and LDL. However, more evidence for the benefits of B vitamins as a homocysteine-lowering therapy is needed.

Background: Meniscal tears are commonly observed in patients with knee osteoarthritis (OA), however, clinical significance of such lesions detected by magnetic resonance imaging is in many cases unclear. This study aimed to determine the clinical effectiveness of arthroscopic partial meniscectomy (APM) compared with non-operative care in patients with knee OA.Method: We used existing systematic reviews with updates of latest studies. Three randomized controlled studies were selected, where two studies compared the effects of APM plus physical therapy (PT) with PT alone and one compared APM alone and PT alone. While 1 study exclusively included OA patients, 2 studies included 21.1 and 12% of patients with no radiographic OA. Patients with knee locking were unanimously excluded. Results: Upon comparison of APM plus PT and PT alone, there was no significant difference observed in knee function, physical activity, or adverse events. Knee pain was observed to be significantly lower in the APM plus PT group at 6 months, but there was no difference between the two groups at 12 and 24 months. With respect to the comparison between APM alone and PT alone, PT was non-inferior based on the criteria for knee function during 24 months; however, knee pain was significantly reduced in the APM alone group. Conclusions Our study showed that knee pain was significantly improved in the APM group compared to non-operative care group at 6 months and over 24 months. Our result was based on only 3 randomized controlled trials (RCTs) revealing a significant knowledge gap, hence demanding more high-quality RCTs in OA patients.

Panax ginseng, also known as Korean ginseng, has long been used as a broad tonic in Oriental medicine to augment vitality, health, and longevity, particularly in older people. This study investigated the effects of Korean red ginseng (RG) on bone loss in ovariectomized (OVX) mice. C3H/HeN mice (10-weeks-old) were divided into sham and OVX groups. OVX mice were treated with vehicle, 17beta-estradiol (E2), RG (oral administration, 250 mg/kg/day), or RG (intraperitoneal administration, 50 mg/kg/every other day) for 6 weeks. Serum E2 concentration and alkaline phosphatase (ALP) activity were measured. Tibiae were analyzed using microcomputed tomography. Biomechanical properties and osteoclast surface level were measured. There was no significant difference in the degree of grip strength, body weight, uterine weight, mechanical property, tibiae length, or tibiae weight between the OVX and RG-treated groups. Compared with the OVX group, the serum ALP level was significantly lower in the RG-treated groups. Serum E2 levels and osteoclast surface levels did not change between the OVX and RG-treated groups. RG could not preserve trabecular bone volume, trabecular bone number, trabecular separation, trabecular thickness, structure model index, or bone mineral density of the proximal tibiae metaphysic. In conclusion, there was no definite effect of RG on OVX-induced bone loss in C3H/HeN mice.
Alkaline Phosphatase ; Animals ; Body Weight ; Bone Density ; Female ; Hand Strength ; Longevity ; Medicine, East Asian Traditional ; Metaphysics ; Mice* ; Osteoclasts ; Osteoporosis ; Ovariectomy ; Panax* ; Tibia ; X-Ray Microtomography

Bone changes are common sequela of radiation therapy for cancer. The purpose of this study was to establish an experimental model of radiation-induced bone loss in adult mice using micro-computed tomography (microCT). The extent of changes following 2 Gy gamma irradiation (2 Gy/min) was studied at 4, 8, 12 or 16 weeks after exposure. Adult mice that received 1, 2, 4 or 6 Gy of gamma-rays were examined 12 weeks after irradiation. Tibiae were analyzed using microCT. Serum markers and biomechanical properties were measured and the osteoclast surface was examined. A significant loss of trabecular bone in tibiae was evident 12 weeks after exposure. Measurements performed after irradiation showed a dose-related decrease in trabecular bone volume fraction (BV/TV) and bone mineral density (BMD), respectively. The best-fitting dose-response curves were linear-quadratic. Taking the controls into accounts, the lines of best fit were as follows: BV/TV (%)= -0.071D2-1.799D+18.835 (r2=0.968, D=dose in Gy) and BMD (mg/cm3) = -3.547D2-14.8D+359.07 (r2=0.986, D=dose in Gy). Grip strength and body weight did not differ among the groups. No dose-dependent differences were apparent among the groups with regard to mechanical and anatomical properties of tibia, serum biochemical markers and osteoclast activity. The findings provide the basis required for better understanding of the results that will be obtained in any further studies of radiation-induced bone responses.
Adult ; Animals ; Biomarkers ; Body Weight ; Bone Density ; Hand Strength ; Humans ; Mice ; Models, Theoretical ; Osteoclasts ; Tibia ; X-Ray Microtomography