Delirium is a common but serious complication in critically ill patients. Family visitation has been shown to reduce delirium; however, during the coronavirus disease 2019 (COVID-19) pandemic, intensive care units (ICUs) restricted regular visitation to prevent the spread of infection. This study aimed to evaluate the association between visitation policies and incidence of delirium in the ICUs. Methods: This was a retrospective before-and-after study conducted in medical and surgical ICUs at a tertiary hospital. Adult patients admitted to an ICU during one of two periods were included: before the COVID-19 pandemic (June 2017 to May 2019) with regular visitation and during the pandemic (June 2020 to May 2022) with prohibited visitation. Delirium was assessed using the Confusion Assessment Method for the ICU. The primary outcome was association between delirium incidence and visitation policy. Results: Totals of 1,566 patients from the pre-COVID-19 period and 1,404 patients from the COVID-19 period were analyzed. The incidence of delirium was higher during the COVID-19 period (48.1% vs. 38.4%, P<0.001). After adjusting for relevant variables, the restricted visitation policy during COVID-19 remained a risk factor for delirium (odds ratio, 1.37; 95% CI, 1.13–1.65; P=0.001). Conclusions: Complete restriction of ICU visitations during the COVID-19 pandemic was associated with a significant increase in delirium incidence. These findings suggest the importance of visitation policies on patient outcomes and suggest the need for alternative strategies, such as video visitation, to mitigate the adverse effects of visitation restrictions during pandemics.

Background: As the global population ages, medical professionals are also aging. This study investigates the status of Korean anesthesiologists over the age of 60. Methods: Anesthesiologists aged 60 and older, residing and working in Korea, were invited to participate in this study via e-mail from February to March 2021 and by mail from June to August 2021. The survey consisted of 40 questions covering 10 topics, including health status, residence, work style, and economic status. Depending on the type of question, answers were ranked on a scale of 1, 2, and 3, with the most preferred response being selected. Results: A total of 63 responses were received, resulting in a response rate of 26.5%. Among the respondents, 56 were currently practicing as anesthesiologists and reported satisfaction with their clinical practice and life status. On average, they treated 24 patients per day without experiencing significant discomfort or inconvenience in their roles as senior physicians. Twenty-four respondents acknowledged physical discomfort related to aging, and nine expressed cautions regarding age-related changes. Fifty-two respondents indicated that reeducation for advanced medical practice as anesthesiologists was necessary. Conclusions Senior anesthesiologists in Korea are primarily working in secondary and tertiary hospitals and are satisfied with their current life status. A comprehensive evaluation of reeducation programs for advanced clinical practice and retirement strategies for senior anesthesiologists is needed to address the growing number of aging physicians in the workforce.

Background: An increased incidence of hair loss disorders has been noted among patients with coronavirus disease 2019 (COVID-19) and individuals vaccinated against COVID-19. However, research involving large populations on this topic is lacking. Objective: To investigate the risks associated with developing hair loss disorders in patients with COVID-19 and individuals vaccinated against COVID-19. Methods: This nationwide, population-based, cross-sectional study included patients diagnosed with COVID-19 and healthy individuals without a history of COVID-19 infection registered in the Korean National Health Insurance Service (NHIS) database between January 1, 2021, and December 31, 2021. COVID-19 infection and vaccine databases were integrated using this NHIS database. The odds ratios of hair loss disorders were compared using multivariate logistic regression models. Results: COVID-19 infection was associated with an increased risk of total alopecia (adjusted odds ratio [aOR], 1.076; 95% confidence interval [CI], 1.002–1.156), although this association was not significant after propensity score matching. No significant associations were found between COVID-19 infection and alopecia areata or telogen effluvium. However, COVID-19 vaccination was positively correlated with total alopecia (aOR, 1.266; 95% CI, 1.191–1.346), alopecia areata (aOR, 1.243; 95% CI, 1.154–1.339), and telogen effluvium (aOR, 1.495; 95% CI, 1.133–1.974). Conclusion COVID-19 vaccination was positively correlated with hair loss disorders but not COVID-19 infection. However, given the advantages of vaccines in reducing COVID-19 mortality and morbidity, alopecia may be relatively reversible and less severe. Physicians need to understand the benefits and possible side effects of the COVID-19 vaccine.

Background: Chromosomal alterations serve as diagnostic and prognostic markers in acute leukemia. Given the evolving landscape of chromosomal abnormalities in acute leukemia, we previously studied these over two periods. In this study, we investigated the frequency of these abnormalities and clinical trends in acute leukemia in Korea across three time periods. Methods: We retrospectively analyzed data from 1,787 patients with acute leukemia (319 children and 1,468 adults) diagnosed between 2006 and 2020. Conventional cytogenetics, FISH, and multiplex quantitative PCR were used for analysis. The patient groups were divided according to the following three study periods: 2006–2009 (I), 2010–2015 (II), and 2016–2020 (III). Results: Chromosomal aberrations were detected in 92% of patients. The PML::RARA translocation was the most frequent. Over the 15-yr period, chromosomal aberrations showed minimal changes, with specific fusion transcripts being common among patients.ALL was more prevalent in children than in adults and correlated significantly with the ETV6::RUNX1 and RUNX1::RUNX1T1 aberrations. The incidence of ALL increased during the three periods, with PML::RARA remaining common. Conclusions The frequency of chromosomal abnormalities in acute leukemia has changed subtly over time. Notably, the age of onset of adult AML has continuously increased. Our results may help in establishing diagnoses and clinical treatment strategies and developing various molecular diagnostic platforms.

The LabGenius C-CT/NG-BMX assay (LabGenius CT/NG; BIOMEDUX, Gyeonggi, Republic of Korea) is a recently developed real-time PCR assay that can simultaneously detect the sexually transmitted pathogens Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) in genitourinary specimens. We evaluated the analytical performance of this assay in comparison with BD MAX CT/GC/TV (Becton Dickinson, Franklin Lakes, NJ, USA). The results of both assays were in nearly perfect agreement for the detection of CT and NG. LabGenius CT/NG demonstrated acceptable analytical performance, comparable with that of another commercially available kit, and provides a cost-effective option for detecting sexually transmitted pathogens in routine and follow-up testing.

Background: Genetic alterations play a pivotal role in multiple myeloma (MM) development and therapeutic resistance. Traditionally, the genetic profiling of MM requires invasive bone marrow (BM) procedures; however, these procedures are associated with patient discomfort and cannot fully capture the spatial and temporal heterogeneity of the disease.Therefore, we investigated the clinical implications of liquid biopsy using targeted deep sequencing. Methods: We analyzed the genetic profiles of circulating tumor DNA (ctDNA) by targeted deep sequencing from 102 patients, including those with monoclonal gammopathy of undetermined significance (MGUS, N = 7), smoldering MM (N = 6), and symptomatic MM (N = 89). Results: The number of ctDNA mutations increased with disease progression from MGUS to MM, with averages of 1.0 mutations in MGUS, 1.8 mutations in smoldering MM, and 1.9 mutations in MM, respectively. Shared mutations between BM and ctDNA were more prevalent in MM (68.9%) than in MGUS (25.0%). RAS/RAF and TP53 mutations were significantly enriched in MM ctDNA. Specific mutations were associated with clinical features in patients with MM: hypercalcemia and TET2 (P = 0.006), renal insufficiency and NRAS (P = 0.012), paramedullary myeloma and TP53(P = 0.02), and extramedullary myeloma and NRAS (P = 0.007). TET2 mutations significantly affected 2-yr progression-free survival (hazard ratio = 7.11, P = 0.003). Serial ctDNA profiling accurately predicted treatment response in patients with MM. Conclusions Our findings highlight the potential of liquid biopsy for understanding MM progression and prognosis utilizing a minimally invasive approach, paving the way for its integration into personalized treatment strategies and real-time disease monitoring.

Enterococcus faecium, particularly in its multidrug-resistant forms, causes invasive nosocomial infections. Given the limited data comparing the effectiveness of the European Committee on Antimicrobial Susceptibility Testing (EUCAST) and the CLSI clinical breakpoints (CBPs) for quinupristin–dalfopristin (QD) resistance and the need to evaluate their practical application, we retrospectively investigated the susceptibility patterns of 287 E.faecium bloodstream isolates from Korean hospitals to QD using the updated EUCAST and CLSI CBPs and two antimicrobial susceptibility testing methods: disk diffusion (DD) and Sensititre broth microdilution (Sensititre). QD resistance rates were 5.9% (CLSI) and 18.8% (EUCAST) for DD and 22.6% (CLSI) and 28.2% (EUCAST) for Sensititre. The most prevalent QD resistance gene types among QD-resistant isolates were ermB+msrC+ or ermB– msrC+. Categorical agreement between DD and Sensititre ranged from 77.7% to 90.7%, depending on the testing method and CBPs applied. The EUCAST zone diameter CBPs more effectively help identify QD-resistant E. faecium isolates using the DD method than the CLSI zone diameter CBPs. In comparison, the CLSI minimum inhibitory concentration (MIC) CBPs provide more reliable results for resistance classification in the Sensititre method than EUCAST MIC CBPs. These findings would help improve clinical decision-making for treating multidrug-resistant E. faecium infections.

Background: Polycyclic aromatic hydrocarbons are generated from the incomplete combustion of organic materials such as fossil fuels and wood. These compounds, often inhaled, cause respiratory issues like asthma and chronic obstructive pulmonary disease due to oxidative stress and inflammation. Pohang, South Korea’s iron and steel hub, experiences significant polycyclic aromatic hydrocarbons emissions from extensive industrial activities and heavy truck movements. This study investigates the link between urinary polycyclic aromatic hydrocarbons metabolites and respiratory diseases among Pohang residents, considering their cumulative exposure and duration of residency. Methods: Utilizing data from the National Environmental Research Institute’s health impact assessment conducted between 2012 and 2015, this study included 1,189 participants from Pohang. Urinary concentrations of polycyclic aromatic hydrocarbons metabolites served as exposure indicators. The study assessed the correlation between these metabolite levels and self-reported respiratory diseases, considering variables such as duration of residence, smoking status, and occupational exposures. Statistical analyses involved logistic regression and fixed-effect meta-analysis. Results: The findings indicate a significant association between elevated levels of polycyclic aromatic hydrocarbons metabolites and an increased risk of respiratory diseases, particularly among those in the highest exposure quartile. The study also found a notable dose-response relationship, emphasizing the heightened risk with longer residency durations near the industrial complex. Despite yearly fluctuations, the trend suggests a persistent risk associated with high polycyclic aromatic hydrocarbons exposure. Conclusions Elevated exposure to polycyclic aromatic hydrocarbons near industrial areas such as the Pohang Industrial Complex is significantly associated with an increased prevalence of respiratory diseases. The study underscores the importance of implementing public health strategies to reduce polycyclic aromatic hydrocarbons exposure, especially in industrial regions. Future research should broaden the scope of polycyclic aromatic hydrocarbons metabolites analyzed and consider comprehensive exposure histories to better understand the relationship between polycyclic aromatic hydrocarbons exposure and respiratory health outcomes.

Background: In Malaysia, occupational allergic contact dermatitis (ACD) is often under-reported. This case report describes a chemical engineer who developed possible ACD, likely due to workplace allergen exposure.Case presentation: He presented with a 4-month history of intensely itchy rashes on both hands, which improved during work breaks. A dermatological examination revealed lichenified, pruritic papules with well-defined borders on the palmar surfaces of both hands. A skin patch test identified reactions to five allergens, including ‘fragrance mix,’ ‘methyldibromo glutaronitrile,’ ‘clioquinol,’ ‘epoxy resin,’ and ‘textile dye mix.’ However, among these, only ‘bisphenol A diglycidyl ether,’ a component of ‘epoxy resin,’ was listed in the safety data sheet as a confirmed occupational exposure. In accordance with local regulations, this case was reported as ‘occupational dermatitis’ to the Department of Occupational Safety and Health. The patient was prescribed symptomatic topical treatments, including emollients and topical corticosteroids. Additionally, he was advised to switch to hypoallergenic products. On follow-up, his chronic inflammatory skin lesions showed improvement. Conclusions Thorough occupational history-taking and patch testing are essential for diagnosing ACD. Personalized health education and regular follow-ups, is crucial in monitoring lesion resolution and evaluating the effectiveness of preventive measures in workplace settings.