1.Comparison of Clinical Outcomes between Rebound Hyperthermia and Non-Rebound Hypertherma Groups in Postcardiac Arrest Syndrome Patients Undergoing Targeted Temperature Management
Journal of Korean Critical Care Nursing 2023;16(3):99-108
Purpose:
: This retrospective study aims to provide basic data for intervention to improve clinical outcomes and identify the characteristics of the rebound hyperthermia (RHG) and non-rebound hyperthermia (NRHG) groups by checking body temperature in patients with post-cardiac arrest syndrome.Method : The study involved 118 patients who completed target temperature management (TTM) in an acute-care unit. Data were analyzed for frequency, percentages, mean, standard deviation, median, and quartiles, and compared using the chi-squared test and Mann–Whitney U-test.
Results:
: Rebound hyperthermia (RH) was observed in 74 (62.7%) patients, predominantly male (69.5%), with an average age of 64.54 ± 15.98, and a body mass index of 23.22 ± 4.75kg/m2 (overweight). Hypertension (50%) was the most common co-morbidity, followed by diabetes and heart disease (33.1%). Neuron-specific enolase levels were higher in the NRHG 24, 48, and 72 hours after recovery of spontaneous circulation (p = .037, p< .001, p= .008). The APHCHE Ⅳ was also higher in the NRHG (p< .001). RH occurred 25.49 (7.28–52.96) hours after TTM completion, lasting for 2 (1–3) hours. Temperature reduction strategies included notifying doctors, administering antipyretics, and nursing intervention, with the latter being the most common at 94.6%. Half of the subjects in the RHG and 77.3% in the NRHG fell into cerebral performance categories 3, 4, and 5 (p= .003).
Conclusion
: RH is more likely a body mechanism related to CPR and TTM than a result of pathogenic infection. Therefore, we require an active intervention for hyperthermia, and a patient-specific nursing intervention protocol.
2.The Analysis of Perfusion Index and Plethysmographic Variability Index During Elective Cesarean Section
Keimyung Medical Journal 2021;40(1):19-25
Background:
Hypotension following spinal anesthesia of Cesarean section is mainly caused by peripheral vasodilation and venous pooling due to sympathetic blockade. The degree of sympathetic blockade is known to affect the occurrence of hypotension after spinal anesthesia. The perfusion index (PI) and plethysmographic variability index (PVI) are non-invasive tools for measuring the vasomotor tone and volume status, respectively. The purpose of this study is to compare the trends of PI and PVI values between hypotension and normotension groups during Cesarean section following spinal anesthesia.
Methods:
Fifty-one parturients were divided into two groups whether they developed hypotension or maintained normotension after spinal anesthesia. Spinal anesthesia was performed with 0.5% hyperbaric bupivacaine (10 mg) and fentanyl (15 μg) at the L3-4 intervertebral space. The data of blood pressure, heart rate, PI and PVI were recorded every minute until delivery of baby.
Results:
Hypotension occurred in 61% of parturients during Cesarean section. The overall PI and PVI value after spinal anesthesia have gradually increased and decreased, respectively. The degree of increase and decrease in PI (p = 0.31) and PVI value (p = 0.35) was not significant between hypotension and normotension groups.
Conclusions
The trend of PI value has gradually increased while the PVI value has decreased, regardless of whether the parturient has experienced hypotension or not.
3.The Analysis of Perfusion Index and Plethysmographic Variability Index During Elective Cesarean Section
Keimyung Medical Journal 2021;40(1):19-25
Background:
Hypotension following spinal anesthesia of Cesarean section is mainly caused by peripheral vasodilation and venous pooling due to sympathetic blockade. The degree of sympathetic blockade is known to affect the occurrence of hypotension after spinal anesthesia. The perfusion index (PI) and plethysmographic variability index (PVI) are non-invasive tools for measuring the vasomotor tone and volume status, respectively. The purpose of this study is to compare the trends of PI and PVI values between hypotension and normotension groups during Cesarean section following spinal anesthesia.
Methods:
Fifty-one parturients were divided into two groups whether they developed hypotension or maintained normotension after spinal anesthesia. Spinal anesthesia was performed with 0.5% hyperbaric bupivacaine (10 mg) and fentanyl (15 μg) at the L3-4 intervertebral space. The data of blood pressure, heart rate, PI and PVI were recorded every minute until delivery of baby.
Results:
Hypotension occurred in 61% of parturients during Cesarean section. The overall PI and PVI value after spinal anesthesia have gradually increased and decreased, respectively. The degree of increase and decrease in PI (p = 0.31) and PVI value (p = 0.35) was not significant between hypotension and normotension groups.
Conclusions
The trend of PI value has gradually increased while the PVI value has decreased, regardless of whether the parturient has experienced hypotension or not.
4.Malnutrition Risk in Community-Dwelling Older Adults with Dual Sensory Declines: Focusing on Social Determinants of Health
Journal of Korean Academy of Community Health Nursing 2024;35(4):325-338
Purpose:
As the number of older adults with dual sensory declines is increasing, they face a higher risk of malnutrition compared to those without these declines. Although social determinants of health can influence malnutrition, there has been limited research on this population. This study aimed to explore the association between malnutrition risk and social determinants of health among older adults with dual sensory declines.
Methods:
The study is a cross-sectional analysis using data from the 2020 National Survey of Older Koreans. Binomial logistic regression analysis was conducted to examine the association between malnutrition risk and social determinants of health. These determinants include structural determinants, social capital, and intermediary determinants among older adults with dual sensory declines.
Results:
1,771 with dual sensory declines were included in the analysis. Among the structural determinants, women (odds ratio [OR]=1.75, 95% confidential interval [CI] 1.19~2.57) and national basic livelihood security system recipients (OR=1.87, 95% CI 1.13~3.07) were significantly associated with malnutrition risk. In social capital, social non-participation (OR=1.33, 95% CI 1.03~1.73) and social network size (OR=0.95, 95% CI 0.92~0.98), Among intermediary determinants, living dissatisfaction (OR=1.61, 95% CI 1.16~2.23), environmental satisfaction (OR=0.95, 95% CI 0.92~0.99), household debt (OR=1.59, 95% CI 1.02~2.49) and comorbidity (OR=3.85, 95% CI 2.98~4.97) were significantly related to malnutrition risk.
Conclusion
These findings highlight the critical need to address key social determinants of health to enhance nutritional outcomes for older adults with dual sensory declines.
5.Malnutrition Risk in Community-Dwelling Older Adults with Dual Sensory Declines: Focusing on Social Determinants of Health
Journal of Korean Academy of Community Health Nursing 2024;35(4):325-338
Purpose:
As the number of older adults with dual sensory declines is increasing, they face a higher risk of malnutrition compared to those without these declines. Although social determinants of health can influence malnutrition, there has been limited research on this population. This study aimed to explore the association between malnutrition risk and social determinants of health among older adults with dual sensory declines.
Methods:
The study is a cross-sectional analysis using data from the 2020 National Survey of Older Koreans. Binomial logistic regression analysis was conducted to examine the association between malnutrition risk and social determinants of health. These determinants include structural determinants, social capital, and intermediary determinants among older adults with dual sensory declines.
Results:
1,771 with dual sensory declines were included in the analysis. Among the structural determinants, women (odds ratio [OR]=1.75, 95% confidential interval [CI] 1.19~2.57) and national basic livelihood security system recipients (OR=1.87, 95% CI 1.13~3.07) were significantly associated with malnutrition risk. In social capital, social non-participation (OR=1.33, 95% CI 1.03~1.73) and social network size (OR=0.95, 95% CI 0.92~0.98), Among intermediary determinants, living dissatisfaction (OR=1.61, 95% CI 1.16~2.23), environmental satisfaction (OR=0.95, 95% CI 0.92~0.99), household debt (OR=1.59, 95% CI 1.02~2.49) and comorbidity (OR=3.85, 95% CI 2.98~4.97) were significantly related to malnutrition risk.
Conclusion
These findings highlight the critical need to address key social determinants of health to enhance nutritional outcomes for older adults with dual sensory declines.
6.Malnutrition Risk in Community-Dwelling Older Adults with Dual Sensory Declines: Focusing on Social Determinants of Health
Journal of Korean Academy of Community Health Nursing 2024;35(4):325-338
Purpose:
As the number of older adults with dual sensory declines is increasing, they face a higher risk of malnutrition compared to those without these declines. Although social determinants of health can influence malnutrition, there has been limited research on this population. This study aimed to explore the association between malnutrition risk and social determinants of health among older adults with dual sensory declines.
Methods:
The study is a cross-sectional analysis using data from the 2020 National Survey of Older Koreans. Binomial logistic regression analysis was conducted to examine the association between malnutrition risk and social determinants of health. These determinants include structural determinants, social capital, and intermediary determinants among older adults with dual sensory declines.
Results:
1,771 with dual sensory declines were included in the analysis. Among the structural determinants, women (odds ratio [OR]=1.75, 95% confidential interval [CI] 1.19~2.57) and national basic livelihood security system recipients (OR=1.87, 95% CI 1.13~3.07) were significantly associated with malnutrition risk. In social capital, social non-participation (OR=1.33, 95% CI 1.03~1.73) and social network size (OR=0.95, 95% CI 0.92~0.98), Among intermediary determinants, living dissatisfaction (OR=1.61, 95% CI 1.16~2.23), environmental satisfaction (OR=0.95, 95% CI 0.92~0.99), household debt (OR=1.59, 95% CI 1.02~2.49) and comorbidity (OR=3.85, 95% CI 2.98~4.97) were significantly related to malnutrition risk.
Conclusion
These findings highlight the critical need to address key social determinants of health to enhance nutritional outcomes for older adults with dual sensory declines.
7.Malnutrition Risk in Community-Dwelling Older Adults with Dual Sensory Declines: Focusing on Social Determinants of Health
Journal of Korean Academy of Community Health Nursing 2024;35(4):325-338
Purpose:
As the number of older adults with dual sensory declines is increasing, they face a higher risk of malnutrition compared to those without these declines. Although social determinants of health can influence malnutrition, there has been limited research on this population. This study aimed to explore the association between malnutrition risk and social determinants of health among older adults with dual sensory declines.
Methods:
The study is a cross-sectional analysis using data from the 2020 National Survey of Older Koreans. Binomial logistic regression analysis was conducted to examine the association between malnutrition risk and social determinants of health. These determinants include structural determinants, social capital, and intermediary determinants among older adults with dual sensory declines.
Results:
1,771 with dual sensory declines were included in the analysis. Among the structural determinants, women (odds ratio [OR]=1.75, 95% confidential interval [CI] 1.19~2.57) and national basic livelihood security system recipients (OR=1.87, 95% CI 1.13~3.07) were significantly associated with malnutrition risk. In social capital, social non-participation (OR=1.33, 95% CI 1.03~1.73) and social network size (OR=0.95, 95% CI 0.92~0.98), Among intermediary determinants, living dissatisfaction (OR=1.61, 95% CI 1.16~2.23), environmental satisfaction (OR=0.95, 95% CI 0.92~0.99), household debt (OR=1.59, 95% CI 1.02~2.49) and comorbidity (OR=3.85, 95% CI 2.98~4.97) were significantly related to malnutrition risk.
Conclusion
These findings highlight the critical need to address key social determinants of health to enhance nutritional outcomes for older adults with dual sensory declines.
8.Malnutrition Risk in Community-Dwelling Older Adults with Dual Sensory Declines: Focusing on Social Determinants of Health
Journal of Korean Academy of Community Health Nursing 2024;35(4):325-338
Purpose:
As the number of older adults with dual sensory declines is increasing, they face a higher risk of malnutrition compared to those without these declines. Although social determinants of health can influence malnutrition, there has been limited research on this population. This study aimed to explore the association between malnutrition risk and social determinants of health among older adults with dual sensory declines.
Methods:
The study is a cross-sectional analysis using data from the 2020 National Survey of Older Koreans. Binomial logistic regression analysis was conducted to examine the association between malnutrition risk and social determinants of health. These determinants include structural determinants, social capital, and intermediary determinants among older adults with dual sensory declines.
Results:
1,771 with dual sensory declines were included in the analysis. Among the structural determinants, women (odds ratio [OR]=1.75, 95% confidential interval [CI] 1.19~2.57) and national basic livelihood security system recipients (OR=1.87, 95% CI 1.13~3.07) were significantly associated with malnutrition risk. In social capital, social non-participation (OR=1.33, 95% CI 1.03~1.73) and social network size (OR=0.95, 95% CI 0.92~0.98), Among intermediary determinants, living dissatisfaction (OR=1.61, 95% CI 1.16~2.23), environmental satisfaction (OR=0.95, 95% CI 0.92~0.99), household debt (OR=1.59, 95% CI 1.02~2.49) and comorbidity (OR=3.85, 95% CI 2.98~4.97) were significantly related to malnutrition risk.
Conclusion
These findings highlight the critical need to address key social determinants of health to enhance nutritional outcomes for older adults with dual sensory declines.
9.The inhibitory effect of lactic acid bacteria to periodontal pathogens.
Ha Na JEONG ; Jong Suk OH ; Young Jun KIM ; Hyun Ju CHUNG
The Journal of the Korean Academy of Periodontology 1999;29(1):265-276
This study was performed to evaluate the effect of hydrogen peroxide-producing Lactobacillus acidophilus V-2Oonthe replication of periodontal pathogens, Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. When A. actinomycetemcomitam and P. gingivalis were incubated alone and in the combination with L. acidophilus V-20, the viable cell numbers of A. actinomycetemcomitans and P. gingivalis were compared between those cultures. The effect of S. mutans, E. durans, and L. lactis on the replication of A. actinomycetemcomitans and P. gingivalis was also evaluated. The change of periodontal indexes(probine depth, gingival index, GCF volume) and the viable cell numbers of A. actinomycetemcomitans and black pigmented bdcteroides in subgingival plaque sample were evaluated following gargling of fermented milk made from L. acidophilus V-20 for 1 month on patients with periodontal disease in maintenance phase. In the mixed culture of L. acidophilus V-20 and A. actinomycetemcomitans or P. gingivalis, the replication of A. adinomycetemcomitam or P. gingivalis was completely inhibited. But in the mixed culture of P. gingivalis and hydrogen peroxide-nonproducing Lactobacillus casei, the viable cell numbers of P. gingivalis was not decreased when compared with the numbers in the mixed culture of P. gingivalis and L. acidophilus V-20. In the mixed culture of A. actinomycetemcomitam and S. mutans, E. durans, or L. lactis, the viable cell number of A. adinomycetemcomitans was not almost changed when compared with the numbers in the culture of A. actinomycetemcomitans alone. And in the mixed culture of P. gingivalis and E. durans or L. lactis, the viable cell numbers of P. gingivalis was not almost changed compared with the counts in the culture of P. gingivalis alone. But the replication of P. gingivalis was completely inhibited in the mixed culture of P. gingivalis and S. mutans. When the change of periodontal indexes following gargling of fermented milk was compared with baseline, probing depth and gingival index were not changed, but GCF volume was significantly dcreased(p (0.05). And when the viable cell numbers of microorganisms in subgingival plaque sample were compared with baseline, total viable cell number was almost unchanged and the viable cell numbers of A. actinomycetemcomitans and black pigmented bdcteroides were significantly decreased(p<0.05). These results suggest that L. acidophilus V-20 inhibit the replication of A. actinomycetemcomitans and black pigmented bacteroides by the formation of hydrogen peroxide.
Aggregatibacter actinomycetemcomitans
;
Bacteria*
;
Bacteroides
;
Cell Count
;
Gingival Crevicular Fluid
;
Humans
;
Hydrogen
;
Hydrogen Peroxide
;
Lactic Acid*
;
Lactobacillus acidophilus
;
Lactobacillus casei
;
Milk
;
Periodontal Diseases
;
Periodontal Index
;
Porphyromonas gingivalis
10.Diver Death due to Underwater Explosion.
Joo Young NA ; Jeong Woo PARK ; Seok Hyun YOON ; Jong Shin PARK ; Byung Ha CHOI ; Youn Shin KIM
Korean Journal of Legal Medicine 2014;38(4):171-174
A 44-year-old man was cutting an outer plate of a ship, at a depth of 25 m below sea level. Following a sudden explosion, he was discovered unconscious and was carried to the surface by other divers. There was no evidence of vital signs upon arrival at the hospital. Postmortem computed tomography, which was performed prior to autopsy, revealed massive pneumocephalus in the brain, pneumohemothorax, diffuse lung contusions with multiple traumatic lung cysts, air-fluid level in the cardiac chamber of the chest, and pneumoperitoneum in the abdomen. Postmortem external examination showed a circular abrasion on the jaw, diffuse subcutaneous emphysema, and contusion in the right upper arm. An internal examination revealed intravascular air bubbles in all four chambers of the heart, and diffuse pulmonary trauma including contusion, laceration, and multiple traumatic cysts. Blast injury to the chest, and air embolism due to the underwater explosion were established as the underlying cause of death.
Abdomen
;
Adult
;
Arm
;
Autopsy
;
Blast Injuries
;
Brain
;
Cause of Death
;
Contusions
;
Diving
;
Embolism, Air
;
Explosions*
;
Heart
;
Humans
;
Jaw
;
Lacerations
;
Lung
;
Pneumocephalus
;
Pneumoperitoneum
;
Ships
;
Subcutaneous Emphysema
;
Thorax
;
Vital Signs