Heart failure (HF) is a major cause of mortality and morbidity in South Korea, imposing substantial physical, emotional, and financial burdens on patients and society. Despite the high burden of symptom and complex care needs of HF patients, palliative care and hospice services remain underutilized in South Korea due to cultural, institutional, and knowledge-related barriers. This position statement from the Korean Society of Heart Failure emphasizes the need for integrating palliative and hospice care into HF management to improve quality of life and support holistic care for patients and their families. By clarifying the role of palliative care in HF and proposing practical referral criteria, this position statement aims to bridge the gap between HF and palliative care services in South Korea, ultimately improving patient-centered outcomes and aligning treatment with the goals and values of HF patients.

Varicose veins are consistent with physically dilated superficial veins ≥3 mm. Physiologically, chronic venous insufficiency is an advanced chronic venous disease with functional abnormalities. Essentially, the shape of the vein is directly influenced by hydrostatic pressure. Ambulatory venous pressure is increased as shunt formation and vein will be dilated by the connection with deep venous refluxes. Hydrostatic parodox in varicose veins is that the ambulatory venous pressure is not directly related with vein diameter but with shunt formation with valve insufficiency. Mean ambulatory venous pressure of 10–30 mmHg is considered as normal, 31–45 mmHg as intermediate and >45 mmHg as severe venous hypertension. Diameter measurement is used in the diagnosis of varicose veins, but treatment need to be more focused to remove hydrostatic pressure rather than diameter of vein in respect to improve symptoms related with varicose veins. Nevertheless, there are some concerns for the treatment of large veins. From the guidelines endothermal ablation is recommended than non-thermal ablation for >10 mm large varicose vein. Large veins might increase the incidence of endothermal heat induced thrombosis. Caprini score more than 7 will be benefited from chemoprophylaxis for large vein. For the compression therapy, inelastic compression is recommended than elastic compression to improve the function of calf muscle pump.

With advancements in both pharmacologic and non-pharmacologic treatments, significant changes have occurred in heart failure (HF) management. The previous Korean HF registries, namely the Korea Heart Failure Registry (KorHF-registry) and Korean Acute Heart Failure Registry (KorAHF-registry), no longer accurately reflect contemporary acute heart failure (AHF) patients. Our objective is to assess contemporary AHF patients through a nationwide registry encompassing various aspects, such as clinical characteristics, management approaches, hospital course, and long-term outcomes of individuals hospitalized for AHF in Korea. This prospective observational multicenter cohort study (KorHF III) is organized by the Korean Society of Heart Failure. We aim to prospectively enroll 7,000 or more patients hospitalized for AHF at 47 tertiary hospitals in Korea starting from March 2018. Eligible patients exhibit signs and symptoms of HF and demonstrate either lung congestion or objective evidence of structural or functional cardiac abnormalities in echocardiography, or isolated right-sided HF. Patients will be followed up for up to 5 years after enrollment in the registry to evaluate long-term clinical outcomes. KorHF III represents the nationwide AHF registry that will elucidate the clinical characteristics, management strategies, and outcomes of contemporary AHF patients in Korea.

Purpose: This study aims to develop a tool to systematically assess the risk of collapse in the delivery infrastructure and apply it to 42 districts in Gyeonggi Province. The ultimate goal is to provide data for preventive and improvement strategies tailored to regional needs. Methods: Hospitals performing over 50 deliveries annually were identified. Regions were categorized as 'none,' 'one,' or 'more than two' delivery hospitals, with further subdivision by annual delivery volume. Regions were then classified into 5 categories: 'relatively stable,' 'low-risk,' 'moderate-risk,' 'high-risk,' and 'collapsed.' Results: Of the 42 districts, 23 were classified as relatively stable, 3 as low-risk, 1 as moderate-risk, 4 as highrisk, and 11 as collapsed. Notably, areas where the delivery infrastructure has collapsed or is at high risk of collapse accounted for approximately 36% of the total. Conclusion Tailored strategies and urgent policy support are required for high-risk regions. While perinatal regionalization may be a future direction, stable infrastructure must be maintained until the maternal care delivery system is established.

Purpose: The purpose of our study was to identify the bleeding risk factors and to validate the safety of shortening the bed rest time after bone marrow examination in pediatric hemato-oncologic patients. Methods: From July 2019 to September 2020, 145 patients were enrolled from a single center. Medical records were reviewed retrospectively. Descriptive statistics were presented, and the data were analyzed using x2 -test, Fisher’s exact test, and a logistic regression. Results: After two hours of bed rest, most of the patients (91.7%) did not have bleeding complications, and only 8.3% of the patients had a minor bleeding. The rate of major bleeding complications, including hematoma, retroperitoneal hemorrhage rate was zero. The bleeding complications was frequently found on bilateral procedures than unilateral procedures and the difference were statistically significant (p<.05). Conclusion Two hours of bed rest time after bone marrow examination could be safe and adequate in pediatric hemato-oncologic patients.

Background: Patient-centered management is becoming increasingly important in gout, but there are limited studies exploring patients' perspectives and preferences. We aimed to investigate patients' perspectives and preferences regarding gout and gout management, and their impacts on adherence to urate lowering therapy (ULT). Methods: A paper-based survey was performed in patients with gout seen at the rheumatology outpatient clinics of 16 tertiary hospitals. The survey included questions regarding demographics, comorbidities, gout attacks, current treatment and adherence, and patients' perspectives and preferences regarding gout and gout management. Multivariate regression analysis was performed to determine the factors associated with ULT adherence. Results: Of 809 surveyed patients with gout, 755 (94.5%) were using ULT. Among those using ULT, 89.1% had ≥ 80% adherence to ULT. Majority of the patients knew management strategies to some extent (94.8%), perceived gout as a life-long disease (91.2%), and were making efforts toward practicing at least one lifestyle modification (89.2%). Most patients (71.9%) obtained information about gout management during their clinic visits.Approximately half of the patients (53.6%) preferred managing their disease with both ULT and lifestyle modification, 28.4% preferred ULT only, and 17.4% preferred lifestyle modification only. Adherence was better in patients with older age (odds ratio [OR], 1.03), those with better knowledge of gout management strategies (OR, 3.56), and those who had preference for ULT (OR, 2.07). Conclusion Patients' perspectives and management preferences had high impacts on adherence to ULT in gout. Consideration of patients' perspectives and preferences is important for achieving the desired clinical outcome in gout.

Purpose: The purpose of our study was to identify the bleeding risk factors and to validate the safety of shortening the bed rest time after bone marrow examination in pediatric hemato-oncologic patients. Methods: From July 2019 to September 2020, 145 patients were enrolled from a single center. Medical records were reviewed retrospectively. Descriptive statistics were presented, and the data were analyzed using x2 -test, Fisher’s exact test, and a logistic regression. Results: After two hours of bed rest, most of the patients (91.7%) did not have bleeding complications, and only 8.3% of the patients had a minor bleeding. The rate of major bleeding complications, including hematoma, retroperitoneal hemorrhage rate was zero. The bleeding complications was frequently found on bilateral procedures than unilateral procedures and the difference were statistically significant (p<.05). Conclusion Two hours of bed rest time after bone marrow examination could be safe and adequate in pediatric hemato-oncologic patients.

Background: Patient-centered management is becoming increasingly important in gout, but there are limited studies exploring patients' perspectives and preferences. We aimed to investigate patients' perspectives and preferences regarding gout and gout management, and their impacts on adherence to urate lowering therapy (ULT). Methods: A paper-based survey was performed in patients with gout seen at the rheumatology outpatient clinics of 16 tertiary hospitals. The survey included questions regarding demographics, comorbidities, gout attacks, current treatment and adherence, and patients' perspectives and preferences regarding gout and gout management. Multivariate regression analysis was performed to determine the factors associated with ULT adherence. Results: Of 809 surveyed patients with gout, 755 (94.5%) were using ULT. Among those using ULT, 89.1% had ≥ 80% adherence to ULT. Majority of the patients knew management strategies to some extent (94.8%), perceived gout as a life-long disease (91.2%), and were making efforts toward practicing at least one lifestyle modification (89.2%). Most patients (71.9%) obtained information about gout management during their clinic visits.Approximately half of the patients (53.6%) preferred managing their disease with both ULT and lifestyle modification, 28.4% preferred ULT only, and 17.4% preferred lifestyle modification only. Adherence was better in patients with older age (odds ratio [OR], 1.03), those with better knowledge of gout management strategies (OR, 3.56), and those who had preference for ULT (OR, 2.07). Conclusion Patients' perspectives and management preferences had high impacts on adherence to ULT in gout. Consideration of patients' perspectives and preferences is important for achieving the desired clinical outcome in gout.

Respiratory syncytial virus (RSV) is common cause of acute respiratory infection in infants and young children. Group life in postpartum care centers is easily exposed to infectious diseases in neonates and puerperds immediately after giving birth, and the harm caused by exposure to them is much greater. In particular, respiratory diseases are highly infectious and infections occur in a short period of time. among them, RSV infections are very serious in children under 5 years of age, leading to death. This paper studied an infection of RSV in outbreaks at postpartum care center in Busan. In 4 postpartum care centers, a total of 877 people (390 neonates, 386 puerperds, 106 others) were exposed to RSV outbreak. Of these, there were 73 RSV-positive patients; most of them had cough and runny nose and no fever. We were collected from neonates and puerperds with acute respiratory tract a total of 146 samples (throat swabs). In 51 samples, RSV (43 cases), human rhinovirus (6 cases), human coronavirus NL63 (1 case), and human coronavirus 229E (1 case) were found to be positive and the rest were negative. All 43 RSV positive samples were identified as RSV B. Sequence analysis of the detected strains was performed to confirm the molecular genetic information of RSV. Out of 43 RSV positive samples, 38 samples were successfully sequenced using the G gene, resulting in all of the same genotype BA9. This study provides a better understanding of RSV prevalence patterns and genetic characteristics. It also contributes to the accumulation of epidemiological data and the development of public health and hygiene.

BACKGROUND/AIMS: This study compared the efficacy, compliance, and safety of bowel preparation between sodium picosulfate with magnesium citrate (SPMC) and oral sulfate solution (OSS). METHODS: A prospective randomized multicenter study was performed. Split preparation methods were performed in both groups; the SPMC group, 2 sachets on the day before, and 1 sachet on the day of the procedure, the OSS group, half of the OSS with 1 L of water on both the day before and the day of the procedure. The adenoma detection rate (ADR), adequacy of bowel preparation using the Boston Bowel Preparation Scale (BBPS) score, patient satisfaction on a visual analog scale (VAS), and safety were compared between the 2 groups. RESULTS: This study analyzed 229 patients (121 in the SPMC group and 108 in the OSS group). ADR showed no differences between 2 groups (51.7% vs. 41.7%, P>0.05). The mean total BBPS score (7.95 vs. 8.11, P>0.05) and adequate bowel preparation rate (94.9% vs. 96.3%, P>0.05) were similar between the 2 groups. The mean VAS score for taste (7.62 vs. 6.87, P=0.006) was significantly higher in the SPMC group than in the OSS group. There were no significant differences in any other safety variables between the 2 groups except nausea symptom (36.1% vs. 20.3%, P=0.008). CONCLUSIONS: Bowel preparation for colonoscopy using low volume OSS and SPMC yielded similar ADRs and levels of efficacy. SPMC had higher levels of satisfaction for taste and feeling than did OSS.
Adenoma ; Citric Acid ; Colonoscopy ; Compliance ; Humans ; Magnesium ; Nausea ; Patient Satisfaction ; Prospective Studies ; Sodium ; Visual Analog Scale ; Water