Background: Population-level data on emergency department (ED) utilization in patients with neuromuscular diseases (NMDs) receiving home mechanical ventilation (HMV) remain limited. This study investigated the frequency, outcomes, and associated factors of ED visits using a nationwide administrative database. Methods: Using the Health Insurance Review and Assessment Service database, we identified patients with NMDs who received HMV between January 2016 and October 2021, based on diagnostic codes and the MM441 procedure code. ED visits and outcomes were analyzed using claims data. Associations between ED visits and tracheostomy or gastrostomy were evaluated using the chi-square test. Results: A total of 1,569 patients were identified; amyotrophic lateral sclerosis (39.7%) and muscular dystrophy (31.0%) were the most common diagnoses. During the study period, 1,009 patients (64.3%) visited the ED at least once, accounting for 5,159 visits (mean 5.1 visits per patient). Among these visits, 35.9% resulted in hospitalization and 3.4% resulted in death in the ED. ED visits were more frequent among patients with tracheostomy than in those without tracheostomy (76.6% vs. 59.0%; relative risk [RR], 1.30; 95% confidence interval [CI], 1.21–1.39; p<0.001). In contrast, patients with gastrostomy had a lower proportion of ED visits than those without gastrostomy (22.6% vs. 55.1%; RR, 0.41; 95% CI, 0.35–0.48; p<0.001). Conclusion ED utilization is common among patients with NMDs receiving HMV and is frequently associated with hospitalization, highlighting a substantial acute healthcare burden. These findings highlight the need for improved long-term respiratory care and outpatient management.

Purpose: This study systematically reviewed and analyzed the effects of non-pharmacological interventions on internalized stigma among people with severe mental illness. Methods: A systematic review and meta-analysis were conducted following the Cochrane Intervention Research Systematic Review Manual and Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. This study targeted people with severe mental illness as the population, interventions aimed at reducing internalized stigma, comparisons with control groups, and internalized stigma as the outcome. A literature search was performed across multiple databases, including PubMed, EMBASE, the Cochrane Library, CINAHL, PsycArticles, RISS, KMbase, and KoreaMed. The risk of bias was evaluated using the Cochrane Risk of Bias 2.0 tool. Effect sizes were computed using Hedges’s g, and subgroup analyses were conducted with Comprehensive Meta-Analysis software version 4.0. Results: Of 2,388 papers, 15 were included in the meta-analysis. The overall effect size (Hedges’s g) of the intervention was –0.60 (95% confidence interval, –1.01 to –0.19), indicating a statistically significant reduction in internalized stigma (Z=–2.88, p=.004). Subgroup analyses revealed that the intervention type (p=.008) and session length (p=.011) were significant moderators influencing the effectiveness of the interventions. Conclusion Tailoring interventions by considering variables such as the intervention type and session length could enhance the effectiveness of non-pharmacological interventions for reducing internalized stigma among people with severe mental illness (PROSPERO: CRD42023418561).

Purpose: This study systematically reviewed and analyzed the effects of non-pharmacological interventions on internalized stigma among people with severe mental illness. Methods: A systematic review and meta-analysis were conducted following the Cochrane Intervention Research Systematic Review Manual and Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. This study targeted people with severe mental illness as the population, interventions aimed at reducing internalized stigma, comparisons with control groups, and internalized stigma as the outcome. A literature search was performed across multiple databases, including PubMed, EMBASE, the Cochrane Library, CINAHL, PsycArticles, RISS, KMbase, and KoreaMed. The risk of bias was evaluated using the Cochrane Risk of Bias 2.0 tool. Effect sizes were computed using Hedges’s g, and subgroup analyses were conducted with Comprehensive Meta-Analysis software version 4.0. Results: Of 2,388 papers, 15 were included in the meta-analysis. The overall effect size (Hedges’s g) of the intervention was –0.60 (95% confidence interval, –1.01 to –0.19), indicating a statistically significant reduction in internalized stigma (Z=–2.88, p=.004). Subgroup analyses revealed that the intervention type (p=.008) and session length (p=.011) were significant moderators influencing the effectiveness of the interventions. Conclusion Tailoring interventions by considering variables such as the intervention type and session length could enhance the effectiveness of non-pharmacological interventions for reducing internalized stigma among people with severe mental illness (PROSPERO: CRD42023418561).

Purpose: This study systematically reviewed and analyzed the effects of non-pharmacological interventions on internalized stigma among people with severe mental illness. Methods: A systematic review and meta-analysis were conducted following the Cochrane Intervention Research Systematic Review Manual and Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. This study targeted people with severe mental illness as the population, interventions aimed at reducing internalized stigma, comparisons with control groups, and internalized stigma as the outcome. A literature search was performed across multiple databases, including PubMed, EMBASE, the Cochrane Library, CINAHL, PsycArticles, RISS, KMbase, and KoreaMed. The risk of bias was evaluated using the Cochrane Risk of Bias 2.0 tool. Effect sizes were computed using Hedges’s g, and subgroup analyses were conducted with Comprehensive Meta-Analysis software version 4.0. Results: Of 2,388 papers, 15 were included in the meta-analysis. The overall effect size (Hedges’s g) of the intervention was –0.60 (95% confidence interval, –1.01 to –0.19), indicating a statistically significant reduction in internalized stigma (Z=–2.88, p=.004). Subgroup analyses revealed that the intervention type (p=.008) and session length (p=.011) were significant moderators influencing the effectiveness of the interventions. Conclusion Tailoring interventions by considering variables such as the intervention type and session length could enhance the effectiveness of non-pharmacological interventions for reducing internalized stigma among people with severe mental illness (PROSPERO: CRD42023418561).

Purpose: This study systematically reviewed and analyzed the effects of non-pharmacological interventions on internalized stigma among people with severe mental illness. Methods: A systematic review and meta-analysis were conducted following the Cochrane Intervention Research Systematic Review Manual and Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. This study targeted people with severe mental illness as the population, interventions aimed at reducing internalized stigma, comparisons with control groups, and internalized stigma as the outcome. A literature search was performed across multiple databases, including PubMed, EMBASE, the Cochrane Library, CINAHL, PsycArticles, RISS, KMbase, and KoreaMed. The risk of bias was evaluated using the Cochrane Risk of Bias 2.0 tool. Effect sizes were computed using Hedges’s g, and subgroup analyses were conducted with Comprehensive Meta-Analysis software version 4.0. Results: Of 2,388 papers, 15 were included in the meta-analysis. The overall effect size (Hedges’s g) of the intervention was –0.60 (95% confidence interval, –1.01 to –0.19), indicating a statistically significant reduction in internalized stigma (Z=–2.88, p=.004). Subgroup analyses revealed that the intervention type (p=.008) and session length (p=.011) were significant moderators influencing the effectiveness of the interventions. Conclusion Tailoring interventions by considering variables such as the intervention type and session length could enhance the effectiveness of non-pharmacological interventions for reducing internalized stigma among people with severe mental illness (PROSPERO: CRD42023418561).

This case report aimed to describe successful pain management and maintenance of pregnancy in a woman with a herniated intervertebral disc using ultrasound-guided epidural steroid injections (US ESI). A 43-year-old pregnant woman at 23 weeks’ gestation presented with severe radiating pain extending from the hip to the thigh and calf. Magnetic resonance imaging revealed a herniated disc at the L5–S1 level with severe compromise of the thecal sac. Multiple rounds of US ESI were performed that reduced her pain from a numerical rating scale score of 9–10 to approximately 6.The patient underwent a cesarean section at 36 weeks and 6 days’ gestation. Following delivery, the patient underwent a discectomy and has since experienced no recurrence of pain or complications.Pregnant women with herniated intervertebral discs may experience severe radicular pain but have limited treatment options. This case demonstrates that US ESI can be beneficial when appropriate.

This case report aimed to describe successful pain management and maintenance of pregnancy in a woman with a herniated intervertebral disc using ultrasound-guided epidural steroid injections (US ESI). A 43-year-old pregnant woman at 23 weeks’ gestation presented with severe radiating pain extending from the hip to the thigh and calf. Magnetic resonance imaging revealed a herniated disc at the L5–S1 level with severe compromise of the thecal sac. Multiple rounds of US ESI were performed that reduced her pain from a numerical rating scale score of 9–10 to approximately 6.The patient underwent a cesarean section at 36 weeks and 6 days’ gestation. Following delivery, the patient underwent a discectomy and has since experienced no recurrence of pain or complications.Pregnant women with herniated intervertebral discs may experience severe radicular pain but have limited treatment options. This case demonstrates that US ESI can be beneficial when appropriate.

This case report aimed to describe successful pain management and maintenance of pregnancy in a woman with a herniated intervertebral disc using ultrasound-guided epidural steroid injections (US ESI). A 43-year-old pregnant woman at 23 weeks’ gestation presented with severe radiating pain extending from the hip to the thigh and calf. Magnetic resonance imaging revealed a herniated disc at the L5–S1 level with severe compromise of the thecal sac. Multiple rounds of US ESI were performed that reduced her pain from a numerical rating scale score of 9–10 to approximately 6.The patient underwent a cesarean section at 36 weeks and 6 days’ gestation. Following delivery, the patient underwent a discectomy and has since experienced no recurrence of pain or complications.Pregnant women with herniated intervertebral discs may experience severe radicular pain but have limited treatment options. This case demonstrates that US ESI can be beneficial when appropriate.

This case report aimed to describe successful pain management and maintenance of pregnancy in a woman with a herniated intervertebral disc using ultrasound-guided epidural steroid injections (US ESI). A 43-year-old pregnant woman at 23 weeks’ gestation presented with severe radiating pain extending from the hip to the thigh and calf. Magnetic resonance imaging revealed a herniated disc at the L5–S1 level with severe compromise of the thecal sac. Multiple rounds of US ESI were performed that reduced her pain from a numerical rating scale score of 9–10 to approximately 6.The patient underwent a cesarean section at 36 weeks and 6 days’ gestation. Following delivery, the patient underwent a discectomy and has since experienced no recurrence of pain or complications.Pregnant women with herniated intervertebral discs may experience severe radicular pain but have limited treatment options. This case demonstrates that US ESI can be beneficial when appropriate.

This case report aimed to describe successful pain management and maintenance of pregnancy in a woman with a herniated intervertebral disc using ultrasound-guided epidural steroid injections (US ESI). A 43-year-old pregnant woman at 23 weeks’ gestation presented with severe radiating pain extending from the hip to the thigh and calf. Magnetic resonance imaging revealed a herniated disc at the L5–S1 level with severe compromise of the thecal sac. Multiple rounds of US ESI were performed that reduced her pain from a numerical rating scale score of 9–10 to approximately 6.The patient underwent a cesarean section at 36 weeks and 6 days’ gestation. Following delivery, the patient underwent a discectomy and has since experienced no recurrence of pain or complications.Pregnant women with herniated intervertebral discs may experience severe radicular pain but have limited treatment options. This case demonstrates that US ESI can be beneficial when appropriate.