6.Effect of Paxlovid in COVID-19 treatment during the periods of SARS-CoV-2 Omicron BA.5 and BN.1 subvariant dominance in the Republic of Korea: a retrospective cohort study
Dong-Hwi KIM ; Min-Gyu YOO ; Na-Young KIM ; So Young CHOI ; Minjeong JANG ; Misuk AN ; Se-Jin JEONG ; Jungyeon KIM
Osong Public Health and Research Perspectives 2024;15(2):137-149
Objectives:
This study was conducted to assess the efficacy of nirmatrelvir/ritonavir treatment in patients with coronavirus disease 2019 (COVID-19), particularly those aged 60 years and older. Using real-world data, the period during which the BN.1 Omicron variant was dominant was compared to the period dominated by the BA.5 variant.
Methods:
In this retrospective cohort study, data were collected regarding 2,665,281 patients infected with severe acute respiratory syndrome coronavirus 2 between July 24, 2022, and March 31, 2023. Propensity score matching was utilized to match patients who received nirmatrelvir/ritonavir in a 1:4 ratio between BN.1 and BA.5 variant groups. Multivariable logistic regression analysis was employed to assess the effects of nirmatrelvir/ritonavir within these groups.
Results:
Compared to the prior period, the efficacy of nirmatrelvir/ritonavir did not significantly differ during the interval of Omicron BN.1 variant dominance in the Republic of Korea. Among patients treated with nirmatrelvir/ritonavir, a significantly lower risk of mortality was observed in the BN.1 group (odds ratio [OR], 0.698; 95% confidence interval [CI], 0.557–0.875) compared to the BA.5 group. However, this treatment did not significantly reduce the risk of severe or critical illness, including death, for those in the BN.1 group (OR, 0.856; 95% CI, 0.728–1.007).
Conclusion
Nirmatrelvir/ritonavir has maintained its effectiveness against COVID-19, even with the emergence of the BN.1 Omicron subvariant. Consequently, we strongly recommend the administration of nirmatrelvir/ritonavir to patients exhibiting COVID-19-related symptoms, irrespective of the dominant Omicron variant or their vaccination status, to mitigate disease severity and decrease the risk of mortality.
7.Comprehensive Analysis of the Contributing Factors to the Hearing Abilities of Patients With Vestibular Schwannoma
Jung Ho CHOI ; Yong-Hwi AN ; Ra Gyoung YOON ; Hyun Joon SHIM
Korean Journal of Otolaryngology - Head and Neck Surgery 2024;67(10):525-531
Background and Objectives:
This study aimed to comprehensively assess the factors influencing hearing ability in patients with vestibular schwannoma, focusing on tumor size, location, primary complaint, and contralateral hearing threshold.Subjects and Method This was a retrospective analysis of 50 patients diagnosed with vestibular schwannoma by magnetic resonance imaging (MRI) at Nowon Eulji Medical Center. Tumor size and location were evaluated using a 3-T MRI system, and pure-tone threshold and speech discrimination were retrieved. To investigate the relationship between tumor size and hearing, we conducted a multiple regression analysis with several variables, including tumor size, tumor location, patient age, and gender.
Results:
When patients were categorized into groups according to their primary complaint at initial presentation, no significant differences were observed in pure tone thresholds but different speech discrimination were detected among the groups. When patients were classified according to the tumor location, the extrameatal group exhibited lower pure-tone thresholds and higher speech discrimination scores than the intrameatal group. Multiple regression analysis indicated that differences in pure tone thresholds and speech discrimination scores between affected and unaffected sides were more pronounced in cases with smaller tumor sizes and extrameatal tumor locations, emphasizing the greater impact of location over size.
Conclusion
Using both tumor size and location, it is possible to predict the differences in pure-tone thresholds and speech discrimination between the affected and unaffected sides. Extrameatal invasion of the tumor appears to be the most important factor among them.
8.Comprehensive Analysis of the Contributing Factors to the Hearing Abilities of Patients With Vestibular Schwannoma
Jung Ho CHOI ; Yong-Hwi AN ; Ra Gyoung YOON ; Hyun Joon SHIM
Korean Journal of Otolaryngology - Head and Neck Surgery 2024;67(10):525-531
Background and Objectives:
This study aimed to comprehensively assess the factors influencing hearing ability in patients with vestibular schwannoma, focusing on tumor size, location, primary complaint, and contralateral hearing threshold.Subjects and Method This was a retrospective analysis of 50 patients diagnosed with vestibular schwannoma by magnetic resonance imaging (MRI) at Nowon Eulji Medical Center. Tumor size and location were evaluated using a 3-T MRI system, and pure-tone threshold and speech discrimination were retrieved. To investigate the relationship between tumor size and hearing, we conducted a multiple regression analysis with several variables, including tumor size, tumor location, patient age, and gender.
Results:
When patients were categorized into groups according to their primary complaint at initial presentation, no significant differences were observed in pure tone thresholds but different speech discrimination were detected among the groups. When patients were classified according to the tumor location, the extrameatal group exhibited lower pure-tone thresholds and higher speech discrimination scores than the intrameatal group. Multiple regression analysis indicated that differences in pure tone thresholds and speech discrimination scores between affected and unaffected sides were more pronounced in cases with smaller tumor sizes and extrameatal tumor locations, emphasizing the greater impact of location over size.
Conclusion
Using both tumor size and location, it is possible to predict the differences in pure-tone thresholds and speech discrimination between the affected and unaffected sides. Extrameatal invasion of the tumor appears to be the most important factor among them.
9.Klebsiella pneumoniae-Induced Emphysematous Prostatic Abscess Accompanied by a Spinal Cord Infarction: Case Report
Seong Uk JEH ; Min Sung CHOI ; Chang Seok KANG ; Dae Hyun KIM ; Jae Hwi CHOI ; See Min CHOI ; Sung Chul KAM ; Jeong Seok HWA ; Jae Seog HYUN
Urogenital Tract Infection 2024;19(3):104-108
Various strains can be found in emphysematous prostatic abscesses (EPAs), but the most frequent causative organism is Klebsiella pneumoniae . Hypervirulent K. pneumoniae can disseminate to distant sites by forming a muco-polysaccharide network outside the capsule. Here, we present the first case of K. pneumoniae in an EPA accompanied by a spinal cord infarction. A 65-year-old man was referred to our hospital due to sudden-onset paraplegia after a 5-day history of fever, myalgia, and voiding difficulty. Abdominal computed tomography revealed a collection of air pockets in the prostate, and diffusion-weighted magnetic resonance imaging showed high signal intensity in the thoracic spinal cord. The patient was initially treated with antibiotics and surgical drainage. On the third hospital day, therapeutic heparin was added after discussion with a neurologist. The patient had no inflammatory symptoms, experienced some improvement in paraplegia, and was discharged on the 14th hospital day. This study adhered to the case report guidelines.
10.Klebsiella pneumoniae-Induced Emphysematous Prostatic Abscess Accompanied by a Spinal Cord Infarction: Case Report
Seong Uk JEH ; Min Sung CHOI ; Chang Seok KANG ; Dae Hyun KIM ; Jae Hwi CHOI ; See Min CHOI ; Sung Chul KAM ; Jeong Seok HWA ; Jae Seog HYUN
Urogenital Tract Infection 2024;19(3):104-108
Various strains can be found in emphysematous prostatic abscesses (EPAs), but the most frequent causative organism is Klebsiella pneumoniae . Hypervirulent K. pneumoniae can disseminate to distant sites by forming a muco-polysaccharide network outside the capsule. Here, we present the first case of K. pneumoniae in an EPA accompanied by a spinal cord infarction. A 65-year-old man was referred to our hospital due to sudden-onset paraplegia after a 5-day history of fever, myalgia, and voiding difficulty. Abdominal computed tomography revealed a collection of air pockets in the prostate, and diffusion-weighted magnetic resonance imaging showed high signal intensity in the thoracic spinal cord. The patient was initially treated with antibiotics and surgical drainage. On the third hospital day, therapeutic heparin was added after discussion with a neurologist. The patient had no inflammatory symptoms, experienced some improvement in paraplegia, and was discharged on the 14th hospital day. This study adhered to the case report guidelines.

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