Purpose: The purpose of this study was to investigate polypharmacy and potentially inappropriate medication (PIM) use in elderly patients admitted to hospitals after falls. Methods: The study surveyed 283 patients 65 or older admitted January 1-December 31, 2016. Data were collected from electronic medical records, and medications administered immediately prior to admission were examined. PIM use for patients was investigated using the Beers criteria, and data were analyzed by Chi-square test and independent test. Results: The average age of participants was 79.42 ± 8.16, and the study included 226 women (79.9%) and 57 men (20.1%). The average number of self-administered medications daily was 4.94 ± 3.68, and 55.1% took five or more medications. PIM use was found in 107 patients (37.8%). There was a significant difference in polypharmacy according to age, and the proportion of medical aid beneficiaries and prevalence of cardiocerebrovascular, endocrine, and other chronic diseases were higher in the polypharmacy and PIM use patients than in the non-polypharmacy and non-PIM use patients. The number of chronic diseases and medications taken were significantly high among polypharmacy and PIM use patients. Conclusion It is necessary to minimize polypharmacy and PIM use, and establish a system for systematically evaluating and managing medication use to prevent falls in the elderly.

PURPOSE: The aim of this study was to explore the relationship between perfectionism dimensions and postpartum depression among parturient women between 2 weeks to 12 months, using the Frost Multidimensional Perfectionism Scale (FMPS). METHODS: Participants were 150 women who had their infants examined for health in two public health centers in a city. The participants completed a self-administered questionnaire, which included the FMPS, Postpartum Depression Predictors Inventory-Revised and the Korean version of the Edinburgh Postpartum Depression Scale (K-EPDS). The data were analyzed using independent t-tests and a multiple linear regression. RESULTS: The prevalence of postpartum depression was 43.3% (K-EPDS≥9.5). Multiple regression analysis showed that postpartum depression was significantly associated with parental criticism (β=.21), concern over mistakes (β=.19), postnatal maternal blues (β=.22), history of depression (β=.20), social support (β=.13), marital relationship/satisfaction (β=.14), prenatal anxiety (β=.17), and self-esteem (β=.15, all p values < .05). These variables explained 57.2% of the variance in postpartum depression. CONCLUSION: Parental criticism and concern over mistakes are personality dimensions that can be exhibited by participants and are therefore associated with the development of postpartum depression in parents of infants. The perfectionism assessment is needed to detect postpartum depression and develop strategies to provide effective and preventive interventions.
Anxiety ; Depression ; Depression, Postpartum ; Female ; Humans ; Infant ; Linear Models ; Parents ; Postpartum Period ; Prevalence ; Public Health

PURPOSE: This study systematically reviewed research on behavioral interventions based on the information-motivation-behavioral skills (IMB) model to investigate specific intervention strategies that focus on information, motivation, and behavioral skills and to evaluate their effectiveness for people with chronic diseases. METHODS: A systematic review was conducted in accordance with the guidelines of both the National Evidence-based Healthcare Collaborating Agency and Im and Chang. A literature search was conducted using electronic databases. Randomized controlled trials that tested behavioral interventions based on the IMB model for promoting health behaviors among people with chronic diseases were included. Four investigators independently reviewed the studies and assessed the quality of each study. A narrative synthesis was used. RESULTS: A total of 12 studies were included in the review.Nine studies investigated patients with HIV/AIDS. The most frequently used intervention strategies were instructional pamphlets for the information construct, motivational interviewing techniques for the motivation construct, and instruction or role playing for the behavioral skills construct. Ten studies reported significant behavior changes at the first post-intervention assessment. CONCLUSION: This review indicates the potential strength of the IMB model as a theoretical framework to develop behavioral interventions. The specific integration strategies delineated for each construct of the model can be utilized to design model-based interventions.
Behavioral Research ; Chronic Disease ; Delivery of Health Care ; Health Behavior* ; Humans ; Motivation ; Motivational Interviewing ; Pamphlets ; Research Personnel ; Role Playing

Purpose: This study investigated hand-washing practice among community-dwelling older adults during the coronavirus disease 2019 (COVID-19) pandemic and aimed to identify the impact of COVID-19-related concerns and depression on hand-washing practice. Methods: This was a secondary analysis of data extracted from the 2020 Community Health Survey. The primary data were collected through self-reporting from August 10 to September 8, 2020 in a cross-sectional study. The subjects consisted of 1,350 adults aged 65 or older living in J Province who participated in the 2020 Community Health Survey. Results: The factors affecting hand-washing practice among older adults were male gender (β = –.18, p < .001), age (β = –.07, p = .001), no education (β = –.20, p < .001) and elementary, middle, and high school graduation (β = –.15, p < .001) compared to a college or higher education, poor health perception (β = –.13, p < .001), COVID-19-related concerns (β = .08, p = .005), and depression (β = –.07, p = .001). To summarize, the factors negatively affecting hand-washing practice included male gender, lower education level, poor health perception, and depression, while the factors positively associated with hand-washing practice included COVID-19-related concerns. Conclusion These findings show the importance of considering these multifaceted determinants when designing targeted interventions and educational programs aimed at promoting hand-washing among older adults. Additionally, based on the relationship between hand-washing practice and COVID-19-related concerns and depression, interventions that can alleviate mental problems along with providing proper education are required.

The pro-inflammatory cytokines tumor necrosis factor-alpha (TNFalpha) and interleukin (IL)-1beta are crucial mediators involved in chronic inflammatory diseases. Inflammatory signal pathways regulate inflammatory cytokine expression-mediated by p38 mitogen activated protein kinase (p38MAPK). Therefore, considerable attention has been given to p38MAPK as a target molecule for the development of a novel anti-inflammatory therapeutics. BIRB 796, one of p38MAPK inhibitor, is a candidate of therapeutic drug for chronic inflammatory diseases. In this study, we investigated the effect of BIRB 796 on inflammatory cytokine productions by lipopolysaccharide (LPS) in different immune cell types. BIRB 796 reduced LPS-mediated IL-8 production in THP-1 cells but not in Raw 264.7 cells. Further analysis of signal molecules by western blot revealed that BIRB 796 sufficiently suppressed LPS-mediated phosphorylation of p38MAPK in both cell types whereas it failed to block inhibitor of kappa B (I-kappaB) degradation in Raw 264.7 cells. Taken together, these results suggest that the anti-inflammatory function of BIRB 796 depends on cell types.
Blotting, Western ; Cytokines ; Interleukin-8 ; Interleukins ; Phosphorylation ; Protein Kinases ; Signal Transduction ; Tumor Necrosis Factor-alpha

PURPOSE: The purpose of this study was to compare the diagnostic performance of ultrasound (US) elastography and conventional B-mode US for discrimination between benign and malignant breast lesions. MATERIALS AND METHODS: During a 13-month period, 277 women with 335 sonographically visible breast lesions who were scheduled to undergo biopsy were examined with US elastography. Elastographic findings were classified as benign or malignant based on the area ratio, with 1.00 as the threshold. Findings on conventional B-mode US were classified according to the BI-RADS category, as follows: lesions of BI-RADS categories 2 and 3 were considered benign, while those in categories 4 and 5 were considered malignant. Statistical analysis included sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and ROC curve analysis for comparison of the diagnostic performance of US elastography and conventional B-mode US. RESULTS: Of the 335 breast lesions, 85 (25.4%) showed malignancy on pathology. Findings on B-mode US showed malignancy in 264 (78.8%) and elastographic findings showed malignancy in 102 (30.4%). The sensitivity, specificity, PPV, NPV, and accuracy of B-mode US and elastography were 98.8%, 28.0%, 31.8%, 98.6%, and 79.4% and 69.4%, 81.2%, 57.8%, 88.8%, and 79.4%, respectively. Elastography showed significantly higher specificity and PPV and lower sensitivity and NPV, compared with B-mode US (p < 0.001). The area under the ROC curve (AUC value) was 0.761 for elastography, and 0.634 for B-mode US (p < 0.001). CONCLUSIONS: US elastography can improve specificity and PPV of B-mode US, but with significant sacrifice of sensitivity and NPV. Therefore, US elastography may complement B-mode US for differentiation of breast masses.
Biopsy ; Breast ; Complement System Proteins ; Discrimination (Psychology) ; Elasticity Imaging Techniques ; Female ; Humans ; ROC Curve ; Sensitivity and Specificity

Objective: This study aimed to assess the outcomes of outpatient day-care management of unruptured intracranial aneurysm (UIA), and to present the risks associated with different management strategies by comparing the outcomes and adverse events between outpatient day-care management and management with longer admission periods. Materials and Methods: This retrospective cohort study used prospectively registered data and was approved by a local institutional review board. We enrolled 956 UIAs from 811 consecutive patients (mean age ± standard deviation, 57 ± 10.7 years; male:female = 247:564) from 2017 to 2020. We compared the outcomes after embolization among the different admission-length groups (1, 2, and ≥ 3 days). The outcomes included pre- and post-modified Rankin Scale (mRS) scores and rates of adverse events, cure, recurrence, and reprocedure. Events were defined as any cerebrovascular problems, including minor and major stroke, death, or hemorrhage. Results: The mean admission period was 2 days, and 175 patients (191 aneurysms), 551 patients (664 aneurysms), and 85 patients (101 aneurysms) were discharged on the day of the procedure, day 2, and day 3 or later, respectively. During the mean 17-month follow-up period (range 6–53 months; 2757 patient years), no change in post-mRS was observed compared to pre-mRS in 99.6% of patients. Cure was achieved in 95.6% patients; minimal recurrence that did not require re-procedure occurred in 3.5% patients, and re-procedure was required in 2.3% (22 of 956) patients due to progressive enlargement of the recurrent sac during follow up (mean 17 months, range, 6–53 months). There were eight adverse events (0.8%), including five cerebrovascular (two major stroke, two minor strokes and one transient ischemic stroke), and three non-cerebrovascular events. Statistical comparison between groups with different admission lengths (1, 2, and ≥ 3 days) revealed no difference in the outcomes. Conclusion This study revealed no difference in outcomes and adverse events according to the admission period, and suggested that UIA could be managed by outpatient day-care embolization.

Kaposi's sarcoma (KS) is a multicentric human immunodeficiency virus-associated neoplasm characterized by multiple vascular nodules in the skin, mucous membranes, and viscera. Gastrointestinal acquired immunodeficiency syndrome (AIDS)-related KS is the most common visceral involvement reported in disseminated disease. Here, we present the findings of a rare case of KS involving multiple organs with abdominal pain and active bleeding in the colon. Multiple intraluminal lesions were found in the terminal ileum, sigmoid colon, and rectum by ileocolonoscopy, and in the jejunum and ileum by fluoroscopy. Abdominopelvic CT revealed multiple enhanced flat lesions in the ileum and enlarged lymph nodes. The diagnosis was confirmed by histopathology, and antiretroviral therapy was initiated as the treatment of choice for KS. Owing to the increasing number of AIDS patients, it is essential for radiologists and clinicians to be aware of the imaging characteristics of KS to protect physicians from indiscriminate exposure to AIDS.

The global crisis caused by the coronavirus disease 2019 (COVID-19) led to the most significant economic loss and human deaths after World War II. The pathogen causing this disease is a novel virus called the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2). As of December 2020, there have been 80.2 million confirmed patients, and the mortality rate is known as 2.16% globally. A strategy to protect a host from SARS-CoV-2 is by suppressing intracellular viral replication or preventing viral entry. We focused on the spike glycoprotein that is responsible for the entry of SARS-CoV-2 into the host cell. Recently, the US Food and Drug Administration/EU Medicines Agency authorized a vaccine and antibody to treat COVID-19 patients by emergency use approval in the absence of long-term clinical trials. Both commercial and academic efforts to develop preventive and therapeutic agents continue all over the world. In this review, we present a perspective on current reports about the spike glycoprotein of SARS-CoV-2 as a therapeutic target.