Background/Aims: Despite numerous global changes in Helicobacter pylori treatment guidelines over the past decade, no comprehensive nationwide trend analysis has been conducted.We aimed to investigate the annual trends in the use of H. pylori treatment regimens on the basis of hospital type and region to identify whether changes in prescription patterns aligned with the Korean guidelines updated in 2013 and 2020. Methods: Using data from Korean Health Insurance Review and Assessment database spanning from January 2010 to December 2022, we extracted the performance code for H. pylori diagnosis along with the drug combination code for H. pylori treatment. Results: We analyzed the annual trends in standard triple therapy (STT; n=664,748), bismuth quadruple therapy (BQT; n=151,828), concomitant therapy (CT; n=3,034), sequential therapy (SEQ; n=1,612), and salvage treatment. Overall, STT use declined, with the use of 7-day STT decreasing but the use of 10- and 14-day STT increasing. The use of BQT as a first-line treatment consistently increased, and non-BQT (i.e., CT and SEQ) use also increased sharply since 2019.The tendency to adhere to the guideline changes was more pronounced in primary care clinics.Salvage treatment with BQT after STT failure exhibited a declining trend from 2010 to 2017, followed by an increase since 2018. Salvage treatment with levofloxacin triple therapy after BQT failure increased over time. Conclusions This long-term nationwide trend analysis revealed that real-world prescriptions for H. pylori treatment generally corresponded to the updated guidelines. Efforts are needed to disseminate the revised guidelines to achieve higher compliance rates.

This study aimed to evaluate the effect of the TouchCare system, a digital health management system utilizing the internet of things (IoT), based on the usage levels of older adults. Methods: This is a secondary analysis of data from a quasi-experimental study examining the effects of an IoT-based digital healthcare system. Participants were equipped with the TouchCare application, a touch-tag, and context-aware artificial intelligence. Data on cognitive function, frailty, depressive symptoms, nutritional status, and fall efficacy were collected at baseline and after six months of using the system. The participants were divided into a high-engagement group (n = 22) and a low-engagement group (n = 24) based on how many days they used the application during the study. We used descriptive statistics, the paired t-test, the independent-samples t-test, and two-way mixed analysis of variance. Results: In total, 46 participants completed the evaluations (mean age, 76.6 years). Two-way mixed analysis of variance revealed no significant group-by-time interaction for cognitive function (p = .184), frailty (p = .338), depressive symptoms (p = .543), and nutritional status (p = .589). There was no significant difference in fall efficacy between the two groups (p = .091). The high-engagement group exhibited significant improvements in visuospatial and executive functions on the Montreal Cognitive Assessment (p = .029). Conclusion: The IoT-based mobile health management application demonstrated benefits in improving cognitive health among older adults. The findings suggest that active engagement with healthcare technology can positively affect health in this population, emphasizing the need for continuous support from nurses as health providers.

This study aimed to evaluate the effect of the TouchCare system, a digital health management system utilizing the internet of things (IoT), based on the usage levels of older adults. Methods: This is a secondary analysis of data from a quasi-experimental study examining the effects of an IoT-based digital healthcare system. Participants were equipped with the TouchCare application, a touch-tag, and context-aware artificial intelligence. Data on cognitive function, frailty, depressive symptoms, nutritional status, and fall efficacy were collected at baseline and after six months of using the system. The participants were divided into a high-engagement group (n = 22) and a low-engagement group (n = 24) based on how many days they used the application during the study. We used descriptive statistics, the paired t-test, the independent-samples t-test, and two-way mixed analysis of variance. Results: In total, 46 participants completed the evaluations (mean age, 76.6 years). Two-way mixed analysis of variance revealed no significant group-by-time interaction for cognitive function (p = .184), frailty (p = .338), depressive symptoms (p = .543), and nutritional status (p = .589). There was no significant difference in fall efficacy between the two groups (p = .091). The high-engagement group exhibited significant improvements in visuospatial and executive functions on the Montreal Cognitive Assessment (p = .029). Conclusion: The IoT-based mobile health management application demonstrated benefits in improving cognitive health among older adults. The findings suggest that active engagement with healthcare technology can positively affect health in this population, emphasizing the need for continuous support from nurses as health providers.

This study aimed to evaluate the effect of the TouchCare system, a digital health management system utilizing the internet of things (IoT), based on the usage levels of older adults. Methods: This is a secondary analysis of data from a quasi-experimental study examining the effects of an IoT-based digital healthcare system. Participants were equipped with the TouchCare application, a touch-tag, and context-aware artificial intelligence. Data on cognitive function, frailty, depressive symptoms, nutritional status, and fall efficacy were collected at baseline and after six months of using the system. The participants were divided into a high-engagement group (n = 22) and a low-engagement group (n = 24) based on how many days they used the application during the study. We used descriptive statistics, the paired t-test, the independent-samples t-test, and two-way mixed analysis of variance. Results: In total, 46 participants completed the evaluations (mean age, 76.6 years). Two-way mixed analysis of variance revealed no significant group-by-time interaction for cognitive function (p = .184), frailty (p = .338), depressive symptoms (p = .543), and nutritional status (p = .589). There was no significant difference in fall efficacy between the two groups (p = .091). The high-engagement group exhibited significant improvements in visuospatial and executive functions on the Montreal Cognitive Assessment (p = .029). Conclusion: The IoT-based mobile health management application demonstrated benefits in improving cognitive health among older adults. The findings suggest that active engagement with healthcare technology can positively affect health in this population, emphasizing the need for continuous support from nurses as health providers.

This study aimed to evaluate the effect of the TouchCare system, a digital health management system utilizing the internet of things (IoT), based on the usage levels of older adults. Methods: This is a secondary analysis of data from a quasi-experimental study examining the effects of an IoT-based digital healthcare system. Participants were equipped with the TouchCare application, a touch-tag, and context-aware artificial intelligence. Data on cognitive function, frailty, depressive symptoms, nutritional status, and fall efficacy were collected at baseline and after six months of using the system. The participants were divided into a high-engagement group (n = 22) and a low-engagement group (n = 24) based on how many days they used the application during the study. We used descriptive statistics, the paired t-test, the independent-samples t-test, and two-way mixed analysis of variance. Results: In total, 46 participants completed the evaluations (mean age, 76.6 years). Two-way mixed analysis of variance revealed no significant group-by-time interaction for cognitive function (p = .184), frailty (p = .338), depressive symptoms (p = .543), and nutritional status (p = .589). There was no significant difference in fall efficacy between the two groups (p = .091). The high-engagement group exhibited significant improvements in visuospatial and executive functions on the Montreal Cognitive Assessment (p = .029). Conclusion: The IoT-based mobile health management application demonstrated benefits in improving cognitive health among older adults. The findings suggest that active engagement with healthcare technology can positively affect health in this population, emphasizing the need for continuous support from nurses as health providers.

OBJECTIVES: This study investigated whether adherence to the overall lifestyle recommendations in the American Cancer Society (ACS) guidelines on nutrition and physical activity for cancer survivors was associated with inflammation in breast cancer survivors. METHODS: The study included 409 women who had undergone breast cancer surgery at least 1 year before enrollment. A generalized linear model was used to estimate the least square means and 95% confidence intervals of plasma levels of inflammatory markers according to lifestyle factors defined in terms of adherence to the ACS guidelines. RESULTS: Higher overall adherence scores were associated with lower levels of high-sensitivity C-reactive protein (hs-CRP) (p for trend=0.015) and higher levels of adiponectin (p for trend=0.009). Similar significant associations of hs-CRP (p for trend= 0.004) and adiponectin (p for trend=0.010) levels were observed with the score for the body mass index (BMI) component of the adherence score. A higher diet component score was associated with a higher adiponectin level (p for trend=0.020), but there was no significant association for the physical activity component score. CONCLUSIONS The present study’s findings suggest that maintaining a healthy lifestyle according to the ACS guidelines was associated with beneficial effects on inflammatory marker levels, especially hs-CRP and adiponectin, among breast cancer survivors. Among the 3 components of lifestyle guidelines, the BMI component exhibited the most similar tendency to the overall adherence score in relation to inflammatory indicators. Further prospective and intervention studies are needed to investigate longitudinal associations between lifestyle factors and inflammatory markers among breast cancer survivors.

Background: and Purpose Myokines include cytokines secreted by muscle fibers, which are the final targets of myasthenia gravis (MG). This pilot study investigated whether myokine plasma concentrations are altered in patients with MG and assessed the association between the concentration of each myokine and disease severity. Methods: We compared the plasma concentrations of 15 myokines in 63 patients with acetylcholine receptor antibody (Ab)-positive MG and 14 with muscle-specific tyrosine kinase Ab-positive MG (MuSK MG) with those in 15 healthy controls. Plasma myokine concentrations were measured using a Luminex multiplex assay kit with magnetic beads that contained Abs for 15 myokines. Correlations between myokine concentration and clinical scale results were analyzed. Results: The concentration of fractalkine in plasma was higher in MG (median [interquartile range]=419.6 [38.7–732.5] pg/mL) than in controls (158.5 [0.0–313.2] pg/mL, p=0.034).The leukemia inhibitory factor concentration was also found to be higher in MuSK MG (29.9 [8.7–40.1] pg/mL) than in healthy controls (7.6 [0.0–15.6] pg/mL, p=0.013). Fatty-acid-binding protein 3 (FABP3) concentrations in plasma were positively associated with clinical parameters for MG severity, including scores on the Quantitative Myasthenia Gravis score (p= 0.008), Myasthenia Gravis Activities of Daily Living (p=0.003), and Myasthenia Gravis Composite (p=0.024) scales. FABP3 concentration in plasma tended to decrease after treatment in patients without additional relapse but increased in those with further relapse. Conclusions The plasma myokine profile was significantly altered in patients with MG.FABP3 concentration may be useful in assessing disease severity and predicting the treatment response.

The objective of this study was to compare the efficacy of cardiopulmonary resuscitation (CPR) with 120 compressions per minute (CPM) to CPR with 100 CPM in patients with non-traumatic out-of-hospital cardiac arrest. We randomly assigned patients with non-traumatic out-of-hospital cardiac arrest into two groups upon arrival to the emergency department (ED). The patients received manual CPR either with 100 CPM (CPR-100 group) or 120 CPM (CPR-120 group). The primary outcome measure was sustained restoration of spontaneous circulation (ROSC). The secondary outcome measures were survival discharge from the hospital, one-month survival, and one-month survival with good functional status. Of 470 patients with cardiac arrest, 136 patients in the CPR-100 group and 156 patients in the CPR-120 group were included in the final analysis. A total of 69 patients (50.7%) in the CPR-100 group and 67 patients (42.9%) in the CPR-120 group had ROSC (absolute difference, 7.8% points; 95% confidence interval [CI], -3.7 to 19.2%; P = 0.183). The rates of survival discharge from the hospital, one-month survival, and one-month survival with good functional status were not different between the two groups (16.9% vs. 12.8%, P = 0.325; 12.5% vs. 6.4%, P = 0.073; 5.9% vs. 2.6%, P = 0.154, respectively). We did not find differences in the resuscitation outcomes between those who received CPR with 100 CPM and those with 120 CPM. However, a large trial is warranted, with adequate power to confirm a statistically non-significant trend toward superiority of CPR with 100 CPM. (Clinical Trial Registration Information: www.cris.nih.go.kr, cris.nih.go.kr number, KCT0000231)
Cardiopulmonary Resuscitation* ; Emergency Service, Hospital ; Heart Arrest ; Humans ; Out-of-Hospital Cardiac Arrest ; Outcome Assessment (Health Care) ; Resuscitation

Liver cancer is the 2nd most common cause of cancer related death in Korea. Especially, patients who present extrahepatic spread of hepatocellular carcinoma (HCC) have a shorter life expectancy (50% survival at 1 year and less than 4 months of median overall survival). Molecular target agent like sorafenib was usually mentioned as a treatment for them, but that was still not firmly established. We present a 75 year-old who had expanding nodular type of HCC. The mass was removed by resection and radiofrequency ablation. However, lung metastasis were revealed shortly after surgery. That lesions were treated with lenvatinib and systemic chemotherapy.
Carcinoma, Hepatocellular* ; Catheter Ablation ; Drug Therapy ; Humans ; Korea ; Life Expectancy ; Liver Neoplasms ; Lung* ; Molecular Targeted Therapy ; Neoplasm Metastasis*

PURPOSE: Trauma is one of the leading causes of death, especially among young people. Life-threatening conditions are very common in multiple-traumatized patients due to concurrent multi-organ injuries. Treating such severely injured patients is time critical. However, in Korea, the transfer of severely injured patients is not uncommon due to the lack of a mature trauma care system. In developed countries, the preventable trauma death rate is very low, but the rate is still very high in Korea. This study's objective was to demonstrate the current serious state in which severely injured patients have to be transferred from a Regional Emergency Medical Center even though it actually serves as a trauma center. METHODS: Ajou University Medical Center is a tertiary hospital that serves as a trauma center in Gyeonggi-do. The medical records at Ajou University Medical Center for a 1-year period from January 1, 2008, to December 31, 2008, were retrospectively reviewed. A severely injured patient was defined as a patient who showed more than 15 point on the ISS (injury severity score) scale. We investigated the clinical characteristics of such patients and the causes of transfer. RESULTS: Out of 81,718 patients who visited the Regional Emergency Medical Center, 19,731 (24.1%) were injured patients. Among them, 108 severely-injured patients were transferred from one Regional Emergency Medical Center to other hospitals. The male-to-female ratio was about 3.5:1, and the mean ISS was 23.08. The most common mechanism of injury was traffic accidents (41.7%). A major cause of transfer was the shortage of intensive care units (44.4%); another was for emergent operation (27.8%). Most of the hospitals that received the severely-injured patients were secondary hospitals (86.1%). CONCLUSION: Although the Regional Emergency Medical Center played a role as a trauma center, actually, severely-injured patients had to be transferred to other hospitals for several reasons. Most reasons were related with the deficiencies in the trauma care system. If a mature trauma care system is well-organized, the numbers of transfer of severely injured patients will be reduced significantly.
Academic Medical Centers ; Accidents, Traffic ; Cause of Death ; Developed Countries ; Emergencies ; Humans ; Injury Severity Score ; Intensive Care Units ; Korea ; Medical Records ; Retrospective Studies ; Tertiary Care Centers ; Trauma Centers