Background: Differentiating between asymptomatic bacteriuria (ASB) and urinary tract infection (UTI) is difficult in patients who have difficulty communicating their symptoms.This study aimed to evaluate the diagnostic accuracy of urine leukocytes in distinguishing between UTI and ASB, and the clinical outcomes of patients with UTI according to the degree of pyuria. Methods: This retrospective cohort study included patients with positive urine cultures between July 2022 and June 2023 at two hospitals. UTI and ASB were diagnosed through a comprehensive review of medical records. We evaluated the differences in urine leukocyte counts between patients with UTI and ASB. The diagnostic performance of urine leukocytes to differentiate between UTI and ASB was evaluated. To investigate the clinical outcomes based on the degree of pyuria, we classified patients with upper UTI according to their urine leukocyte counts. Results: Of the 1,793 eligible patients with bacteriuria included, 1,464 had UTI and 329 had ASB. Patients with UTI had higher urinary leukocytes than patients with ASB did (490.4 vs.123.5 cells/µL; P < 0.001). The area under the receiver operating characteristic curve was 0.702 for discriminating between ASB and UTI. The optimal urine leukocyte cutoff was 195.35 cells/µL, with a sensitivity and specificity of 0.70 and 0.60, respectively. A sequential rise in secondary bacteremia rate was observed according to an increase in urine leukocytes in patients with upper UTI, whereas in-hospital mortality showed no corresponding trend. Conclusion Urine leukocyte counts could be used to predict UTI occurrence and bacteremia secondary to UTI. Higher degrees of pyuria were associated with bacteremia but not with mortality. Urine leukocyte counts can provide additive information for patients with bacteriuria with vague symptoms.

Background: Differentiating between asymptomatic bacteriuria (ASB) and urinary tract infection (UTI) is difficult in patients who have difficulty communicating their symptoms.This study aimed to evaluate the diagnostic accuracy of urine leukocytes in distinguishing between UTI and ASB, and the clinical outcomes of patients with UTI according to the degree of pyuria. Methods: This retrospective cohort study included patients with positive urine cultures between July 2022 and June 2023 at two hospitals. UTI and ASB were diagnosed through a comprehensive review of medical records. We evaluated the differences in urine leukocyte counts between patients with UTI and ASB. The diagnostic performance of urine leukocytes to differentiate between UTI and ASB was evaluated. To investigate the clinical outcomes based on the degree of pyuria, we classified patients with upper UTI according to their urine leukocyte counts. Results: Of the 1,793 eligible patients with bacteriuria included, 1,464 had UTI and 329 had ASB. Patients with UTI had higher urinary leukocytes than patients with ASB did (490.4 vs.123.5 cells/µL; P < 0.001). The area under the receiver operating characteristic curve was 0.702 for discriminating between ASB and UTI. The optimal urine leukocyte cutoff was 195.35 cells/µL, with a sensitivity and specificity of 0.70 and 0.60, respectively. A sequential rise in secondary bacteremia rate was observed according to an increase in urine leukocytes in patients with upper UTI, whereas in-hospital mortality showed no corresponding trend. Conclusion Urine leukocyte counts could be used to predict UTI occurrence and bacteremia secondary to UTI. Higher degrees of pyuria were associated with bacteremia but not with mortality. Urine leukocyte counts can provide additive information for patients with bacteriuria with vague symptoms.

Background: Differentiating between asymptomatic bacteriuria (ASB) and urinary tract infection (UTI) is difficult in patients who have difficulty communicating their symptoms.This study aimed to evaluate the diagnostic accuracy of urine leukocytes in distinguishing between UTI and ASB, and the clinical outcomes of patients with UTI according to the degree of pyuria. Methods: This retrospective cohort study included patients with positive urine cultures between July 2022 and June 2023 at two hospitals. UTI and ASB were diagnosed through a comprehensive review of medical records. We evaluated the differences in urine leukocyte counts between patients with UTI and ASB. The diagnostic performance of urine leukocytes to differentiate between UTI and ASB was evaluated. To investigate the clinical outcomes based on the degree of pyuria, we classified patients with upper UTI according to their urine leukocyte counts. Results: Of the 1,793 eligible patients with bacteriuria included, 1,464 had UTI and 329 had ASB. Patients with UTI had higher urinary leukocytes than patients with ASB did (490.4 vs.123.5 cells/µL; P < 0.001). The area under the receiver operating characteristic curve was 0.702 for discriminating between ASB and UTI. The optimal urine leukocyte cutoff was 195.35 cells/µL, with a sensitivity and specificity of 0.70 and 0.60, respectively. A sequential rise in secondary bacteremia rate was observed according to an increase in urine leukocytes in patients with upper UTI, whereas in-hospital mortality showed no corresponding trend. Conclusion Urine leukocyte counts could be used to predict UTI occurrence and bacteremia secondary to UTI. Higher degrees of pyuria were associated with bacteremia but not with mortality. Urine leukocyte counts can provide additive information for patients with bacteriuria with vague symptoms.

Background: Differentiating between asymptomatic bacteriuria (ASB) and urinary tract infection (UTI) is difficult in patients who have difficulty communicating their symptoms.This study aimed to evaluate the diagnostic accuracy of urine leukocytes in distinguishing between UTI and ASB, and the clinical outcomes of patients with UTI according to the degree of pyuria. Methods: This retrospective cohort study included patients with positive urine cultures between July 2022 and June 2023 at two hospitals. UTI and ASB were diagnosed through a comprehensive review of medical records. We evaluated the differences in urine leukocyte counts between patients with UTI and ASB. The diagnostic performance of urine leukocytes to differentiate between UTI and ASB was evaluated. To investigate the clinical outcomes based on the degree of pyuria, we classified patients with upper UTI according to their urine leukocyte counts. Results: Of the 1,793 eligible patients with bacteriuria included, 1,464 had UTI and 329 had ASB. Patients with UTI had higher urinary leukocytes than patients with ASB did (490.4 vs.123.5 cells/µL; P < 0.001). The area under the receiver operating characteristic curve was 0.702 for discriminating between ASB and UTI. The optimal urine leukocyte cutoff was 195.35 cells/µL, with a sensitivity and specificity of 0.70 and 0.60, respectively. A sequential rise in secondary bacteremia rate was observed according to an increase in urine leukocytes in patients with upper UTI, whereas in-hospital mortality showed no corresponding trend. Conclusion Urine leukocyte counts could be used to predict UTI occurrence and bacteremia secondary to UTI. Higher degrees of pyuria were associated with bacteremia but not with mortality. Urine leukocyte counts can provide additive information for patients with bacteriuria with vague symptoms.

Background: Previous studies showed that the prognosis for severe trauma patients is better after transport to trauma centers compared to non-trauma centers. However, the benefit from transport to trauma centers may differ according to age group. The aim of this study was to compare the effects of transport to trauma centers on survival outcomes in different age groups among severe trauma patients in Korea. Methods: Cross-sectional study using Korean national emergency medical service (EMS) based severe trauma registry in 2018–2019 was conducted. EMS-treated trauma patients whose injury severity score was above or equal to 16, and who were not out-of-hospital cardiac arrest or death on arrival were included. Patients were classified into 3 groups:pediatrics (age < 19), working age (age 19–65), and elderly (age > 65). The primary outcome was in-hospital mortality. Multivariable logistic regression analysis was conducted to evaluate the effect of trauma center transport on outcome after adjusting of age, sex, comorbidity, mechanism of injury, Revised Trauma Score, and Injury Severity Score. All analysis was stratified according to the age group, and subgroup analysis for traumatic brain injury was also conducted. Results: Overall, total of 10,511 patients were included in the study, and the number of patients in each age group were 488 in pediatrics, 6,812 in working age, and 3,211 in elderly, respectively. The adjusted odds ratio (95% confidence interval [CI]) of trauma center transport on in-hospital mortality from were 0.76 (95% CI, 0.43–1.32) in pediatrics, 0.78 (95% CI, 0.68–0.90) in working age, 0.71(95% CI, 0.60–0.85) in elderly, respectively. In subgroup analysis of traumatic brain injury, the benefit from trauma center transport was observed only in elderly group. Conclusion We found out trauma centers showed better clinical outcomes for adult and elderly groups, excluding the pediatric group than non-trauma centers. Further research is warranted to evaluate and develop the response system for pediatric severe trauma patients in Korea.

Objective: This study evaluated the efficacy and effectiveness of a new patient handover system developed for better handover in a metropolitan emergency department (ED). Methods: A retrospective observational study was designed to evaluate the appropriateness and satisfaction level of the new ED handover system. The participants were pre-hospital emergency medical service (EMS) providers with patient transport experience before and after the pilot of the new handover system. Results: A questionnaire was completed by 37 pre-hospital EMS providers who transported patients to the emergency department. Based on the results, pre-hospital EMS providers felt an increased level of kindness from the ED healthcare professionals during patient handover (P<0.001), from 3.19±1.05 points before the introduction of the system to 3.97±0.96 points after its introduction, and the activeness of ED healthcare professionals also increased, from 3.35±1.03 to 4.14±0.86 points (P<0.001). The sufficiency of contents of patient handover information to explain a patient’s condition increased from 3.59±0.76 to 4.08±0.72 points (P<0.003). The score for overall satisfaction felt by the EMS providers during patient handover increased from 3.46±0.96 to 3.76±0.86 points, which was not statistically significant (P=0.020). Conclusion Our findings suggest that the introduction of a new patient handover system between EMS providers and the ED staff is effective for both pre-hospital EMS providers and ED staff.

Objectives: This study analyzed the decline in quality of life according to age in the chronic disease patient group, quantified it as a quantitative index, and compared it by sex and chronic disease. Methods: In the 2017-2019 Korea National Health and Nutrition Examination Survey database, 11,473 adults aged 19 years or older, excluding cancer patients, were analyzed for age-specific changes in the EQ-5D Index by chronic disease. The decline in quality of life according to age in patients with chronic diseases was analyzed by linear regression analysis while controlling for general characteristics. Then, linear regression analysis was performed according to sex. Results: In the case of the control group, the quality of life decreased by 0.0004 for every 1-year increase in age(P<0.001). By chronic disease, asthma(β=0.0019, P<0.001), arthritis(β=0.0017, P=0.002), thyroid disease(β=0.0016, P=0.015), dyslipidemia(β=0.0011, P=0.020), and hypertension(β=0.0009, P=0.027) mostly showed a greater decrease in quality of life than the control group. In addition, when divided into two groups by sex, hypertension(β=0.0012, P=0.029), thyroid disease(β=0.0041, P=0.038), and arthritis(β=0.0022, P<0.001) showed a significant decrease in quality of life only in male. Diabetes(β=0.0056, P=0.038), dyslipidemia(β=0.0022, P=0.001) significantly decreased quality of life only in female. Conclusions Chronic disease had a negative impact on patients perception of quality of life, and the more severe the pain and activity limitation due to the chronic disease, the more severe it was. It also showed different patterns according to sex. Therefore, it is necessary to allocate more medical resources and provide policy support to prevent chronic diseases, which are serious social problems.

Donor–recipient size mismatching is commonly occurs in pediatric kidney transplantation (KT). However, its effect on graft survival remains unknown. This study aimed to determine the effect of donor–recipient size mismatch on the long-term survival rate of transplant kidneys in pediatric KT. Methods: A total of 241 pediatric patients who received KT were enrolled. The medical records of all patients were retrospectively reviewed, and the correlation between donor–recipient size mismatch and graft function and long-term graft outcome was analyzed according to donor–recipient size mismatch. Results: Recipients and donors’ mean body weight at the time of KT were 34.31 ± 16.85 and 56.53 ± 16.73 kg, respectively. The mean follow-up duration was 96.49 ± 52.98 months. A significant positive correlation was observed between donor–recipient body weight ratio (DRBWR) or donor–recipient body surface area ratio (DRBSR) and graft function until 1 year after KT. However, this correlation could not be confirmed at the last follow-up. The results of long-term survival analysis using Fine and Gray’s subdistribution hazard model showed no significant difference of the survival rate of the transplant kidney according to DRBWR or DRBSR. Conclusion: Donor–recipient size mismatch in pediatric KT is not an important factor in determining the long-term prognosis of transplant kidneys.

Regdanvimab is the only monoclonal antibody available in Korea that targets severe acute respiratory syndrome coronavirus 2. We retrospectively evaluated the clinical characteristics of 374 adults hospitalized with coronavirus disease 2019 (COVID-19) who were treated with regdanvimab from September through December 2021. In total, 322 (86.1%) patients exhibited risk factors for disease progression. Most patients (91.4%) improved without additional treatment. No patient died or was transferred to intensive care. This study shows that regdanvimab prevented disease progression in high-risk patients with mild to moderate COVID-19 infections during Delta variant predominance.

Plasmodium vivax exhibits dormant liver-stage parasites, called hypnozoites, which can cause relapse of malaria. The only drug currently used for eliminating hypnozoites is primaquine. The antimalarial properties of primaquine are dependent on the production of oxidized metabolites by the cytochrome P450 isoenzyme 2D6 (CYP2D6). Reduced primaquine metabolism may be related to P. vivax relapses. We describe a case of 4 episodes of recurrence of vivax malaria in a patient with decreased CYP2D6 function. The patient was 52-year-old male with body weight of 52 kg. He received total gastrectomy and splenectomy 7 months before the first episode and was under chemotherapy for the gastric cancer. The first episode occurred in March 2019 and each episode had intervals of 34, 41, and 97 days, respectively. At the first and second episodes, primaquine was administered as 15 mg for 14 days. The primaquine dose was increased with 30 mg for 14 days at the third and fourth episodes. Seven gene sequences of P. vivax were analyzed and revealed totally identical for all the 4 samples. The CYP2D6 genotype was analyzed and intermediate metabolizer phenotype with decreased function was identified.