Multiple autoimmune syndrome (MAS) refers to the occurrence of three or more autoimmune diseases in a patient. This case describes a 12-year-old neutered male Shih Tzu with fever and neutropenia, previously diagnosed with immune-mediated thrombocytopenia, immune-mediated hemolytic anemia, and inflammatory bowel disease. Blood tests revealed leukopenia and neutropenia, and immune-mediated neutropenia was suspected after ruling out other causes of neutropenia. The dog showed no response to antibiotics, but treatment with prednisolone (2 mg/kg q24h) led to improvement. This case highlights the potential for MASs to occur in dogs and underscores the importance of their recognition in the diagnosis and management of immune-mediated diseases.

Purpose: This study was conducted to deeply explore the work experiences of nurses in COVID-19 isolation wards. Methods: Data were collected through one-on-one in-depth interviews with 11 nurses working in COVID-19 isolation wards from November 3 to November 23, 2023. The data were analyzed using Braun and Clarke's inductive thematic analysis. Results: The study identified three categories, seven themes, and 16 sub-themes. The categories were: ‘the reality of unprepared COVID-19 isolation wards’, ‘the ongoing process of change and coordination’, and ‘experiencing confusion in the process of returning to normal’. A common experience among nurses was ‘confusion due to changes’. Initially, there was confusion caused by the unfamiliar environment and lack of a work manual. Subsequently, confusion arose due to changes in the direction of the COVID-19 response. Finally, they experienced confusion in the process of returning to normal life, continually facing uncertainty. Conclusion Strategies are needed to improve the work environment of nurses in isolation wards for future infectious diseases and pandemics. Allocating nursing staff considering infection control tasks and patient care demands, and addressing communication problems in isolation wards is necessary. Routine education on infection control and preparation for emerging infectious diseases should be implemented, and an operational manual for duties in isolation ward should be prepared. Additionally, promoting psychological support systems for disaster response personnel and developing policies to alleviate physical difficulties are needed.

Purpose: This study was conducted to deeply explore the work experiences of nurses in COVID-19 isolation wards. Methods: Data were collected through one-on-one in-depth interviews with 11 nurses working in COVID-19 isolation wards from November 3 to November 23, 2023. The data were analyzed using Braun and Clarke's inductive thematic analysis. Results: The study identified three categories, seven themes, and 16 sub-themes. The categories were: ‘the reality of unprepared COVID-19 isolation wards’, ‘the ongoing process of change and coordination’, and ‘experiencing confusion in the process of returning to normal’. A common experience among nurses was ‘confusion due to changes’. Initially, there was confusion caused by the unfamiliar environment and lack of a work manual. Subsequently, confusion arose due to changes in the direction of the COVID-19 response. Finally, they experienced confusion in the process of returning to normal life, continually facing uncertainty. Conclusion Strategies are needed to improve the work environment of nurses in isolation wards for future infectious diseases and pandemics. Allocating nursing staff considering infection control tasks and patient care demands, and addressing communication problems in isolation wards is necessary. Routine education on infection control and preparation for emerging infectious diseases should be implemented, and an operational manual for duties in isolation ward should be prepared. Additionally, promoting psychological support systems for disaster response personnel and developing policies to alleviate physical difficulties are needed.

Purpose: This study was conducted to deeply explore the work experiences of nurses in COVID-19 isolation wards. Methods: Data were collected through one-on-one in-depth interviews with 11 nurses working in COVID-19 isolation wards from November 3 to November 23, 2023. The data were analyzed using Braun and Clarke's inductive thematic analysis. Results: The study identified three categories, seven themes, and 16 sub-themes. The categories were: ‘the reality of unprepared COVID-19 isolation wards’, ‘the ongoing process of change and coordination’, and ‘experiencing confusion in the process of returning to normal’. A common experience among nurses was ‘confusion due to changes’. Initially, there was confusion caused by the unfamiliar environment and lack of a work manual. Subsequently, confusion arose due to changes in the direction of the COVID-19 response. Finally, they experienced confusion in the process of returning to normal life, continually facing uncertainty. Conclusion Strategies are needed to improve the work environment of nurses in isolation wards for future infectious diseases and pandemics. Allocating nursing staff considering infection control tasks and patient care demands, and addressing communication problems in isolation wards is necessary. Routine education on infection control and preparation for emerging infectious diseases should be implemented, and an operational manual for duties in isolation ward should be prepared. Additionally, promoting psychological support systems for disaster response personnel and developing policies to alleviate physical difficulties are needed.

Purpose: This study was conducted to deeply explore the work experiences of nurses in COVID-19 isolation wards. Methods: Data were collected through one-on-one in-depth interviews with 11 nurses working in COVID-19 isolation wards from November 3 to November 23, 2023. The data were analyzed using Braun and Clarke's inductive thematic analysis. Results: The study identified three categories, seven themes, and 16 sub-themes. The categories were: ‘the reality of unprepared COVID-19 isolation wards’, ‘the ongoing process of change and coordination’, and ‘experiencing confusion in the process of returning to normal’. A common experience among nurses was ‘confusion due to changes’. Initially, there was confusion caused by the unfamiliar environment and lack of a work manual. Subsequently, confusion arose due to changes in the direction of the COVID-19 response. Finally, they experienced confusion in the process of returning to normal life, continually facing uncertainty. Conclusion Strategies are needed to improve the work environment of nurses in isolation wards for future infectious diseases and pandemics. Allocating nursing staff considering infection control tasks and patient care demands, and addressing communication problems in isolation wards is necessary. Routine education on infection control and preparation for emerging infectious diseases should be implemented, and an operational manual for duties in isolation ward should be prepared. Additionally, promoting psychological support systems for disaster response personnel and developing policies to alleviate physical difficulties are needed.

A 10-year-old spayed female Maltese presented with purpura and hematemesis. Initial laboratory evaluation revealed immune-mediated thrombocytopenia, but evidence of hemolytic anemia was not identified. Three milligrams of human intravenous immunoglobulin (hIVIG) was administered for 3 hours following prednisolone and mycophenolate mofetil. A pale mucous membrane was identified, and the packed cell volume decreased by 3%. Blood film examination revealed significant spherocytosis with auto-agglutination. Blood transfusions and immunosuppression were continued for 4 days, and hIVIG was discontinued. This report describes a case of increased immune-mediated hemolysis after hIVIG administration, possibly due to new-onset immune-mediated hemolytic anemia or enhanced immunogenicity.

Peritoneal lymphomatosis (PL) is a rare lymphoid neoplasm in dogs. A nine-year-old spayed female Labrador retriever presented with pleural and peritoneal effusions. Diagnostic imaging revealed diffuse nodular to massive lesions in the mesentery, particularly in the caudal abdomen. While the superficial lymph nodes did not show significant changes, enlargement was observed in the intra-abdominal and intra-thoracic lymph nodes. Cytological and flow cytometric analyses of the effusion indicated the presence of large B-cell lymphocytes expressing CD3-/CD5-/CD14-/CD21-/CD34+/CD45+/CD79a+. PL was diagnosed using diagnostic imaging and fluid analysis. This case report highlights the clinical and diagnostic features of canine PL.

Objective: This study investigated whether sleep and stress mutually interact to induce changes in white matter integrity. Methods: Diffusion tensor imaging (DTI) was conducted on 36 participants (male=22, female=14; mean age=38.33±12.78 years). Participants were divided into three groups depending on their sleep quality and stress levels: poor sleepers with stress, poor sleepers without stress, and good sleepers. Sleep quality and stress level were evaluated using the Pittsburgh Sleep Quality Index and the Life Experiences Survey, respectively. Fractional anisotropy (FA) values were calculated employing DTI tractography. Results: After controlling for age and sex, poor sleepers with stress exhibited a lower FA of the left inferior cerebellar peduncle (ICP) than did poor sleepers without stress (t=2.81, p=0.02). Poor sleepers without stress showed a higher FA of the right middle longitudinal fasciculus (MdLF) than did good sleepers (t=3.35, p=0.006). Conclusion The current study reports the effects of sleep, stress, and their interaction on the white matter integrities of the ICP and MdLF. ICP change seems to be associated with sleep disturbances related to stress, while MdLF change would be associated with sleep disturbances unrelated to stress.

Purpose: The aim of this study was to longitudinally compare novice nurses’ sleep disturbance, sleep hygiene, and physical activity and analyze factors affecting sleep disturbance. Methods: Data were obtained from three follow-up surveys of 178 novice nurses. The data were analyzed using SPSS 25.0 to calculate descriptive statistics. A repeated measures ANOVA and Cochran’s Q test were performed, and a logistic regression analysis was conducted using generalized estimation equations. Results: The sleep disturbance rate increased significantly over time in the following order: before the start of shift work, after six months of shift work, and after 18 months of shift work (T=98.67, p<.001). Sleep hygiene significantly deteriorated over time after the start of shift work (F=127.95, p<.001). Arousal behavior (OR=10.34, p<.001) and the sleep environment (OR=1.54, p=.005) in sleep hygiene, significantly influenced sleep disturbance. Stretching exercises were an influencing factor in sleep disturbance (OR=1.71, p=.039). Conclusion Sleep disturbance among novice nurses increased after the start of shift work. Sleep hygiene and stretching were influencing factors. Therefore, to prevent and reduce sleep disturbance in novice nurses, efforts are needed to improve sleep hygiene and promote stretching exercises.

Purpose: The purpose of this study was to identify the quality of sleep in novice and experienced shift work nurses and compare the factors associated with their quality of sleep. Methods: We analyzed the data of 192 and 256 novice and experienced nurses, respectively. The quality of sleep, sleep hygiene, job stress, and fatigue were measured using Insomnia Severity Index, Sleep Hygiene Practice Scale, the Korean Occupational Stress Scale, and Fatigue Severity Scale. Data were analyzed using SPSS 25.0 to calculate descriptive statistics and logistic regression. Results: Sleep quality was lower in experienced nurses (12.55 ± 5.71) than in novice nurses (11.18 ± 5.78). Fatigue was more severe in experienced nurses (4.47 ± 1.13) than in novice nurses (4.23 ± 1.12). In the logistic regression, factors related to sleep quality in novice nurses were sleep hygiene (odds ratio; OR = 1.06, p < .001) and fatigue (OR = 2.49, p < .001). Factors related to sleep quality in the experienced nurses were also sleep hygiene (OR = 1.04, p = .001) and fatigue (OR = 1.53, p = .012). Conclusion Sleep quality of experienced nurses is lower than those of novice nurses. Factors associated with sleep quality in novice and experienced nurses are equally identified as sleep hygiene and fatigue. Therefore, personal efforts to improve sleep hygiene, such as providing comfortable sleep environment, are needed. Furthermore, organized efforts to decrease fatigue, such as constructing a working environment with a bright light at night and providing a fatigue-decreasing program that includes meditation, are required.