Background: Mycoplasma pneumoniae is a major cause of community-acquired pneumonia (CAP) in children, with a rising incidence of macrolide resistance. Early diagnosis is crucial for reducing the disease burden; however, current diagnostic tools have limitations.We evaluated the diagnostic accuracy of serological assays and their performance based on symptom onset in children with CAP. Methods: From September 2023 to September 2024, we prospectively enrolled children with CAP, classified as M. pneumoniae pneumonia (MPP) or non-MPP, from 16 hospitals in Korea. Serological testing included chemiluminescence immunoassay (CLIA) and ELISA for detecting IgM and IgG, along with particle agglutination (PA) for total antibody measurements. Serological responses were analyzed at different times after symptom onset (0–4, 5–9, and 10–21 days). Results: Among 472 children with CAP (362 MPP, 110 non-MPP), 138 (29.2%) underwent PA testing, and 334 (70.8%) underwent IgM testing. PA at a 1:640 cutoff showed 48.0% sensitivity and 100% specificity. CLIA and ELISA showed comparable sensitivities (69.1% vs. 69.2%) and specificities (76.9% vs. 66.7%) for IgM testing. Seropositivity increased significantly with time since symptom onset (P for trend < 0.001), reaching 97.9% for IgM, 62.5% for IgG, and 94.7% for PA at 10–21 days. Conclusions The time post-symptom onset significantly influenced the diagnostic utility of serological tests for pediatric MPP, which showed limited value during the early stage of illness. These findings emphasize the importance of symptom onset-based interpretation of serological test results and their utility in complementing PCR when optimizing MPP diagnosis in children.

Objective: To investigate the associations between T2-weighted imaging (T2WI) features and clinicopathologic characteristics in invasive breast cancer, as well as their relationship with treatment response to neoadjuvant chemotherapy (NAC). Materials and Methods: This retrospective study included 179 women with invasive breast cancer who underwent preoperative 3T breast MRI between November 2020 and February 2021. Intratumoral T2 signal intensity (SI) and peritumoral edema were graded on T2WI, and T2 relaxation times were calculated both including and excluding necrotic or cystic areas. T2 relaxation times were compared across T2 SI grades using the Kruskal–Wallis test. Associations between T2 features and clinicopathologic factors were assessed using chi-square tests and logistic regression analyses. In patients who received NAC (n = 68), associations between T2 features and NAC outcomes were also evaluated. Results: Higher intratumoral T2 SI and peritumoral edema grades were significantly associated with longer T2 relaxation times (P < 0.001). Intratumoral T2 SI grades were associated with higher clinical T category, axillary lymph node metastasis, and tumor multiplicity (all P < 0.05). Longer intratumoral T2 relaxation times were associated with higher clinical T category, hormone receptor (HR) negativity, and the triple-negative subtype (all P < 0.05), even after excluding necrotic or cystic areas.Higher peritumoral edema grades were associated with advanced clinical T category, HR negativity, and the triple-negative subtype (all P < 0.05). T2 relaxation times of peritumoral edema showed no significant associations, except with higher clinical T category (P = 0.005) and estrogen receptor status (P = 0.030). In the NAC subgroup, higher intratumoral T2 SI grades and longer T2 relaxation times were significantly associated with disease progression during NAC (P < 0.05), but not with non-pathologic complete response. Peritumoral edema showed no significant association with NAC outcomes (P > 0.05). Conclusion T2-weighted MRI features were associated with clinicopathologic factors, including clinical T category, HR status, triple-negative subtype, and disease progression during NAC.

Delirium is a common acute neuropsychiatric syndrome, and its early detection may improve clinical outcomes. This narrative review synthesized findings from 11 original studies and two systematic reviews that employed wearable sensors (actigraphy) to predict or detect delirium. In surgical, intensive care unit, and geriatric populations, delirium has consistently been associated with disrupted rest–activity rhythms, including lower daytime activity, increased nighttime activity, and fragmented sleep–wake cycles. Characteristic motor patterns also differed based on the motor subtype (hyperactive vs. hypoactive). Several studies have demonstrated that continuous wrist accelerometry can objectively detect the onset of delirium and classify motor subtypes. Notably, one machine learning model showed improved prediction accuracy, increasing from approximately 62% to 74% when motion features were included. Overall, continuous motion monitoring appears feasible and may serve as a promising non-invasive tool for early delirium detection and risk stratification. However, the findings remain heterogeneous, and motion-based algorithms alone show only moderate sensitivity. Further validation in larger and more diverse cohorts, as well as integration with clinical risk factors, is required before clinical implementation.

Objective: To develop an evidence-based guideline for the diagnosis and treatment of antipsychotic-induced hyperprolactinemia by adapting existing high-quality clinical guidelines with a view to improve the clinical symptoms and long-term quality of life of patients by providing appropriate management. Methods: This guideline was developed according to the ADAPTE methodology. The adaptation process included determining key health questions, systematically searching and screening guidelines, evaluating the quality and contents of these guidelines, deriving recommendations for key questions, and performing a peer review. The selection criteria for the guideline search were (1) evidence-based guidelines, (2) published within the last 5 years, and (3) written in English or Korean. Results: After evaluating the quality and content, we finally selected three guidelines for adaptation. The final output of the development process was 25 recommendations for 10 key questions. We adopted the Agency for Health Research Quality methodology and presented the level of evidence from levels I to IV. In addition, we defined the recommendation grades from grade A (strongly recommended) to D (no recommendation) based on the level of evidence and clinical significance of the recommendation. Conclusion The development and dissemination of the adapted guideline is expected to increase the certainty of medical decision making and improve the quality of medical care. Further studies on the effectiveness and applicability of the developed guideline are necessary.

Background: Dermatophyte infection is one of the most common skin diseases affecting the skin, hair, and nails. Despite widespread recognition of the disease, missing details and misperceptions are commonplace in the general population. Objective: This study aimed to investigate the public perception and behavior regarding dermatophytosis of the hands and feet. Methods: This results from an online survey conducted between July 2022 and August 2022. The survey included 1,000 Korean participants aged 20 to 69 years, of whom 60% experienced symptoms of tinea pedis or onychomycosis. The questionnaire focused on the awareness and personal experience of tinea pedis and perception of the treatment of dermatophytosis. Results: Of the 1,000 participants, nearly 80% regarded tinea pedis as a common skin condition by which anyone can be affected. Furthermore, 88.4% had heard that the treatment of tinea pedis could be harmful, causing skin rash (60.4%) and worsening liver function (48.5%). Among 896 participants who noticed suspicious symptoms, 81.2% did not visit the clinic because it was not severe (50.1%) and seemed easily manageable (25.7%). Of the respondents, 84.4% preferred to meet dermatologists rather than non-dermatologist doctors regarding skin diseases, mainly because of trust in experts and belief in a faster cure. Conclusion Providing accurate and detailed information via online media, educational campaigns, and medical papers can rectify misconceptions and improve patient appliance, contributing to public skin health.

Purpose: We examined the effects of the 8-week moderate-intensity Pilates exercise program on body composition, balance ability, metabolic parameters, arterial condition, and eating habits among overweight and obese women. Methods: From the general sample of overweight or obese Korean women (body mass index ≥ 23 kg/m2 ), those who had not been diagnosed with any chronic degenerative diseases were enrolled in the study (n = 39). After 8 weeks of the Pilates exercise program, the participants were subdivided into adherence and non-adherence groups. Among the study participants, 24 women were matched for age and menopausal status to reduce the bias, and then finally included for the comparison (Pilates-adherence, n = 12; Pilates-non-adherence, n = 12). Results: The body balance measured by the Y-balance test, body mass index, and subcutaneous fat areas were significantly improved in both groups. However, the Pilatesadherence group showed more positive changes in body balance and had significant improvement in body composition parameters such as waist size, visceral fat area, systolic blood pressure, arterial aging index, fasting blood glucose, and glycated hemoglobin than the Pilates-non-adherence group. In addition, the nutrition quotient for Korean adults (balance,moderation, and behavior except diversity) were significantly improved in both groups after dietary education. However, the participants did not show dramatic improvement in the metabolic parameters, because all the study subjects were in relatively good health and did not have any diagnosed diseases. Conclusion This study demonstrated that higher adherence to the Pilates exercise program together with a modification of eating habits may effectively improve body balance, body composition, and obesity-related parameters among overweight and obese women.

Objective: In somatic symptom disorder (SSD), cognitive dysfunction is related to perceptive distortion that excessively amplifies bodily sensations. The association between high body mass index (BMI) and cognitive dysfunction could be attributed to underlying systemic inflammation. We aimed to evaluate whether patients with SSD and high BMI exhibit increased somatic symptom severity and whether this is mediated by cognitive dysfunction. Methods: This retrospective, cross-sectional study was conducted on 54 patients with SSD (20 males/34 females, mean age ± standard deviation: 40.65 ± 13.23 years). Participants’ BMI, laboratory data including complete blood count and lipid profile, results from the Korean Wechsler Adult Intelligence Scale-IV, and scores of the Korean-Symptom Checklist 95-Somatization (SCL95-SOM) were analyzed. We performed a path analysis to evaluate BMI as a predictor of somatic symptoms. Results: In a path analysis, the SCL95-SOM score was directly influenced by working memory (b = −0.326, p = 0.032), which was significantly influenced by BMI (b = −0.338, p = 0.009), although there was no direct effect of BMI on the SCL95-SOM score. The path analytic model showed a close fit to the data with the following values: χ2 (df) = 0.918 (1), p = 0.338, root mean square error of approximation = 0.000 (＜ 0.001), and comparative fit index = 1.00. Conclusion Patients with SSD and high BMI may exhibit increased somatic symptom severity, and this is mediated by working memory dysfunction. Weight management may help improve symptoms in patients with SSD and high BMI.

Background and Objectives: A mobile application (app)-based electrocardiogram (ECG) consultation system (InterMD Co., Ltd., Seoul, Korea) using the collective intelligence (CI) and the availability of large-scale digitized ECG data would extend the utility of ECGs beyond their current limitations, while at the same time preserving interpretability that remains critical to medical decision-making. Methods: We developed a new mobile app-based ECG consultation system by CI for general practitioners. We compared the responses of ECG reading between the mobile app-based CI system and the conventional system in a tertiary referring hospital. Results: We analyzed 376 consecutive ECGs between December 2017 and May 2019. Of these, 159 ECGs (42.3%) were interpreted by CI through the mobile app-based ECG consultation system and 217 ECGs (57.7%) were analyzed by cardiologists in the conventional systems based on electronic medical record data in a tertiary hospital. All ECG readings were confirmed by an electrophysiologist (EP). The time to an initial response by the CI system was faster than that of the conventional system (6.6 hours vs. 35.8 hours, p<0.0001). The number of responses of each ECG in CI system outnumbered those of the conventional system in the tertiary hospital (3.1 vs. 1.2, p<0.0001). The consensus of the ECG readings with EP was similar in both systems (98.6% vs. 100%, p=0.158). Conclusions The mobile app-based ECG consultation system by CI is as reliable method as the conventional referral system. It would expand the app of the 12-lead ECG with the collaboration of physicians in clinics and hospitals without time and space constraints.

Objective: In somatic symptom disorder (SSD), cognitive dysfunction is related to perceptive distortion that excessively amplifies bodily sensations. The association between high body mass index (BMI) and cognitive dysfunction could be attributed to underlying systemic inflammation. We aimed to evaluate whether patients with SSD and high BMI exhibit increased somatic symptom severity and whether this is mediated by cognitive dysfunction. Methods: This retrospective, cross-sectional study was conducted on 54 patients with SSD (20 males/34 females, mean age ± standard deviation: 40.65 ± 13.23 years). Participants’ BMI, laboratory data including complete blood count and lipid profile, results from the Korean Wechsler Adult Intelligence Scale-IV, and scores of the Korean-Symptom Checklist 95-Somatization (SCL95-SOM) were analyzed. We performed a path analysis to evaluate BMI as a predictor of somatic symptoms. Results: In a path analysis, the SCL95-SOM score was directly influenced by working memory (b = −0.326, p = 0.032), which was significantly influenced by BMI (b = −0.338, p = 0.009), although there was no direct effect of BMI on the SCL95-SOM score. The path analytic model showed a close fit to the data with the following values: χ2 (df) = 0.918 (1), p = 0.338, root mean square error of approximation = 0.000 (＜ 0.001), and comparative fit index = 1.00. Conclusion Patients with SSD and high BMI may exhibit increased somatic symptom severity, and this is mediated by working memory dysfunction. Weight management may help improve symptoms in patients with SSD and high BMI.