Background: Providing optimal nutrition to patients with acute respiratory failure is difficult because nutritional requirements vary according to disease severity and comorbidities. In 2021, the National Medical Center initiated a protocol for screening upon admission and regular monitoring by a multidisciplinary nutritional support team (NST), for all patients in the medical intensive care unit (ICU). This study aimed to evaluate the effects of routine NST monitoring and active intervention on the clinical outcomes of patients with acute respiratory failure. Methods: Patients with acute respiratory failure requiring high-flow nasal cannula, non-invasive ventilation, or mechanical ventilation were included. The primary outcome was 28-day mortality after ICU admission. Secondary outcomes included the supplied/target calorie ratio, supplied/target protein ratio on day 7, and complications. Results: In total, 152 patients were included in the analysis. The patients were divided into a pre-monitoring (n=96) and post-monitoring groups (n=56). More patients in the post-monitoring group received NST intervention and had earlier initiation of enteral feeding. In survival analysis, 28-day mortality was significantly lower in post-monitoring group (adjusted hazard ratio, 0.42; 95% CI, 0.24–0.74). The ratio of achievement for required calories and protein on day 7 was higher, but not significantly, in the post-monitoring group. No significant differences were observed in the incidence of complications. Conclusions Regular NST monitoring in the ICU could have contributed to a reduced risk of 28-day mortality in critically ill patients with acute respiratory failure.

Purpose: This meta-analysis was conducted to determine the effect size of anxiety and psychological outcomes of virtual reality interventions in patients with anxiety disorders. Methods: A total of 835 studies were initially identified, of which six were found to be suitable according to the PICO (P: Patients with social phobia, I: VR technology, C: non VR technology, O: Variables related to mental health). criteria. Results: An analysis of the effect size of these studies confirmed that virtual reality interventions were not statistically significantly effective for generalized anxiety disorder (standardized mean difference [SMD]=0.16, 95% confidence interval [CI]=-0.84 to 1.15), but exhibited statistically significant effects for social anxiety (SMD=-0.56, 95% CI=-0.87 to -0.25) disorder and relational anxiety disorder (SMD -0.83, 95% CI=-1.49 to -0.16). Although these interventions were not statistically significantly effective for depression (SMD=-0.40, 95% CI=-0.84 to 0.04), they were effective in reducing negative emotions (SMD=-0.75, 95% CI=-1.20 to -0.31). Conclusion Virtual reality interventions based on the desensitization effect may be considered a viable option for reducing anxiety disorders.

Purpose: This meta-analysis was conducted to determine the effect size of anxiety and psychological outcomes of virtual reality interventions in patients with anxiety disorders. Methods: A total of 835 studies were initially identified, of which six were found to be suitable according to the PICO (P: Patients with social phobia, I: VR technology, C: non VR technology, O: Variables related to mental health). criteria. Results: An analysis of the effect size of these studies confirmed that virtual reality interventions were not statistically significantly effective for generalized anxiety disorder (standardized mean difference [SMD]=0.16, 95% confidence interval [CI]=-0.84 to 1.15), but exhibited statistically significant effects for social anxiety (SMD=-0.56, 95% CI=-0.87 to -0.25) disorder and relational anxiety disorder (SMD -0.83, 95% CI=-1.49 to -0.16). Although these interventions were not statistically significantly effective for depression (SMD=-0.40, 95% CI=-0.84 to 0.04), they were effective in reducing negative emotions (SMD=-0.75, 95% CI=-1.20 to -0.31). Conclusion Virtual reality interventions based on the desensitization effect may be considered a viable option for reducing anxiety disorders.

Purpose: This meta-analysis was conducted to determine the effect size of anxiety and psychological outcomes of virtual reality interventions in patients with anxiety disorders. Methods: A total of 835 studies were initially identified, of which six were found to be suitable according to the PICO (P: Patients with social phobia, I: VR technology, C: non VR technology, O: Variables related to mental health). criteria. Results: An analysis of the effect size of these studies confirmed that virtual reality interventions were not statistically significantly effective for generalized anxiety disorder (standardized mean difference [SMD]=0.16, 95% confidence interval [CI]=-0.84 to 1.15), but exhibited statistically significant effects for social anxiety (SMD=-0.56, 95% CI=-0.87 to -0.25) disorder and relational anxiety disorder (SMD -0.83, 95% CI=-1.49 to -0.16). Although these interventions were not statistically significantly effective for depression (SMD=-0.40, 95% CI=-0.84 to 0.04), they were effective in reducing negative emotions (SMD=-0.75, 95% CI=-1.20 to -0.31). Conclusion Virtual reality interventions based on the desensitization effect may be considered a viable option for reducing anxiety disorders.

Leiomyoma is a common benign tumor of smooth muscle cells that rarely occurs in the retroperitoneum. Here, we report a retroperitoneal leiomyoma with exophytic growing into the lesser sac incidentally diagnosed in a 69-year-old woman. In this case, the retroperitoneal leiomyoma presented as a well-circumscribed mass with heterogeneous signal intensity and mild progressive enhancement on magnetic resonance imaging. Differential image diagnosis of this retroperitoneal leiomyoma from other retroperitoneal tumors was difficult due to an overlap in imaging appearances with other retroperitoneal tumors.

Immunotherapy has revolutionized and opened a new paradigm for cancer treatment. In the era of immunotherapy and molecular targeted therapy, precision medicine has gained emphasis, and an early response assessment is a key element of this approach. Treatment response assessment for immunotherapy is challenging for radiologists because of the rapid development of immunotherapeutic agents, from immune checkpoint inhibitors to chimeric antigen receptor-T cells, with which many radiologists may not be familiar, and the atypical responses to therapy, such as pseudoprogression and hyperprogression.Therefore, new response assessment methods such as immune response assessment, functional/molecular imaging biomarkers, and artificial intelligence (including radiomics and machine learning approaches) have been developed and investigated.Radiologists should be aware of recent trends in immunotherapy development and new response assessment methods.

Pancreatic pseudocyst can fistulize to adjacent organs such as stomach, duodenum, colon, and esophagus. Fistula formation with bile duct is rare. Reported cases of biliary involvement of pancreatic pseudocyst include fistula formation between the pancreatic pseudocyst and common bile duct. Intrahepatic bile duct dilatation caused by fistula formation with pancreatic pseudocyst is extremely rare. There are no published reports to the best of our knowledge. Herein, we report a case of intrahepatic bile duct dilatation caused by fistulous communication with a pancreatic pseudocyst. The peripheral intrahepatic bile duct surrounding the pseudocyst was dilated without involving the common bile duct. Magnetic resonance cholangiopancreatography image showed a connection between the pancreatic pseudocyst and dilated intrahepatic bile ducts with a multifocal cystic and beaded appearance.

PURPOSE: The aim of this study was to identify the relationships between the difficulty of end-of-life care and moral distress, burnout and job satisfaction of nurses working in intensive care units (ICUs). METHODS: This descriptive study was conducted using self-report questionnaires. Participants were nurses who had more than one year of ICU experience and were recruited from three university hospitals (N=168). RESULTS: The mean scores for ICU nurses' difficulty in end-of-life care, moral distress, burnout and job satisfaction were 3.42, 113.88, 3.16 and 2.58 points, respectively. Difficulty in end-of-life care was positively correlated with moral distress (r=.48, p < .001) and burnout (r=.26, p=.001) and was negatively correlated with job satisfaction (r=−.17, p=.024). Difficulties in end-of-life was identified as a predictor of moral distress (β=.44, p < .001), burnout (β=.26, p=.001) and job satisfaction (β=−.18, p=.024). CONCLUSION: The results of this study suggest the following: it is important to have a deep understanding of ICU nurses who experience various difficulties in end-of-life care and to provide realist support for these nurses. And practical efforts by nursing organizations are needed, including support systems and education programs to alleviate ICU nurses' difficulties in end-of-life care.
Education ; Hospitals, University ; Intensive Care Units ; Job Satisfaction ; Nursing ; Terminal Care

OBJECTIVES: This study developed an information and communication technology (ICT)-based comprehensive health and social-needs assessment (CHSNA) system based on the International Classification of Functioning, Disability, and Health (ICF) with the aim of enhancing person-centered community care for community residents and supporting healthcare professionals and social workers who provide healthcare and social services in the community. METHODS: Items related to a CHSNA tool were developed and mapped with ICF codes. Experts validated the CHSNA system design and process using the Delphi method, and a pilot test of the initial version of the system was conducted. RESULTS: The following three steps of CHSNA were embedded in the system, which had a user-friendly screen and images: basic health assessment, life and activity assessment, and in-depth health assessment. The assessment results for the community residents were presented with visualized health profiles, including images, graphs, and an ICF model. CONCLUSIONS: The developed CHSNA system can be used by healthcare professionals, social workers, and community residents to evaluate the reasoning underlying health and social needs, to facilitate the identification of more appropriate healthcare plans, and to guide community residents to receive the best healthcare services. A CHSNA system can improve the implementation of standardized terminology utilizing the ICF and the accuracy of needs assessments of community residents.
Classification ; Community Health Services ; Decision Support Techniques ; Delivery of Health Care ; Methods ; Needs Assessment ; Patient-Centered Care ; Social Work ; Social Workers

STUDY DESIGN: A cross-sectional, case-control study. PURPOSE: To investigate associations between physical fitness measures and disabilities related to back pain and quality of life (QOL) by the presence of symptomatic lumbar spinal stenosis (LSS) in elderly Korean women. OVERVIEW OF LITERATURE: LSS leads to decreased functioning and reduced QOL. However, correlations among physical fitness, disability, and QOL have not been investigated in elderly women with LSS. METHODS: Participants included women aged 65 years and older (n=192), divided into a study group (n=38) and a control group (n=154) based on the presence/absence of LSS. All participants underwent physical function and fitness tests. Oswestry disability index (ODI) scores and EuroQol five-dimensional questionnaire (EQ-5D-5L) scores were used to assess disability and health-related QOL. RESULTS: The results for the handgrip strength, sit-and-reach, functional reach, and timed up and go (TUG) tests were significantly higher in the control group than the LSS group. ODI scores were significantly higher and EQ-5D-5L scores significantly lower in the LSS group. TUG and functional reach test scores were significantly correlated with ODI scores, and handgrip strength was strongly interrelated with ODI and EQ-5D-5L scores in the LSS group. No other physical fitness measures showed statistically significant relationships with ODI or EQ-5D-5L scores. CONCLUSIONS: In elderly Korean women with LSS, back pain-related disability and QOL are significantly associated with some physical fitness parameters such as handgrip strength. Handgrip strength reflects general muscle strength, which is significantly interrelated with the level of disability and QOL. Our results suggest that enhancing generalized muscle strength helps to reduce disability due to back pain and improve QOL in patients with LSS.
Aged* ; Back Pain ; Case-Control Studies ; Female ; Humans ; Lumbar Vertebrae ; Muscle Strength ; Physical Fitness* ; Quality of Life* ; Spinal Stenosis*