Purpose: To analyze the frequency and clinical characteristics of ocular injuries in patients with prior blowout fractures who experience new blunt trauma, and to assess whether old orbital fractures provide a protective effect against subsequent ocular trauma. Methods: The medical records of 1,315 ocular trauma patients were reviewed. A total of 927 patients who had orbital or facial computed tomography scans and ophthalmologist evaluations were considered. After applying exclusion criteria, 568 patients with 581 affected eyes were included in the final analysis. The patients were divided into two groups based on the presence of old blowout fractures, identified on computed tomography scan. The clinical characteristics and the frequency of ocular injuries were compared between the two groups. The risk of ocular injury according to the presence of old blowout fracture ware studied using multiple logistic regression after controlling age and sex. Results: Among the 581 eyes examined, 140 (24.1%) had old blowout fractures. The incidence of intraocular complications was significantly higher in the no orbital fracture group compared to the old blowout fracture group (20.4% vs. 2.1%, p < 0.001). Specifically, the incidence of complications such as gross hyphema (p = 0.001), globe rupture (p = 0.006), and vitreous hemorrhage (p = 0.027) was significantly greater in the group without old blowout fractures than in those with them. Multiple logistic regression showed that the presence of old blowout fractures was significantly associated with reduced risk of ocular injury (p < 0.001). Conclusions The patients with old blowout fractures had a lower risk of ocular injuries following subsequent blunt trauma. The findings suggest that old fractures may provide protective effect. These results may have important implications for the clinical management of patients at risk of recurrent orbital trauma.

Purpose: To analyze the frequency and clinical characteristics of ocular injuries in patients with prior blowout fractures who experience new blunt trauma, and to assess whether old orbital fractures provide a protective effect against subsequent ocular trauma. Methods: The medical records of 1,315 ocular trauma patients were reviewed. A total of 927 patients who had orbital or facial computed tomography scans and ophthalmologist evaluations were considered. After applying exclusion criteria, 568 patients with 581 affected eyes were included in the final analysis. The patients were divided into two groups based on the presence of old blowout fractures, identified on computed tomography scan. The clinical characteristics and the frequency of ocular injuries were compared between the two groups. The risk of ocular injury according to the presence of old blowout fracture ware studied using multiple logistic regression after controlling age and sex. Results: Among the 581 eyes examined, 140 (24.1%) had old blowout fractures. The incidence of intraocular complications was significantly higher in the no orbital fracture group compared to the old blowout fracture group (20.4% vs. 2.1%, p < 0.001). Specifically, the incidence of complications such as gross hyphema (p = 0.001), globe rupture (p = 0.006), and vitreous hemorrhage (p = 0.027) was significantly greater in the group without old blowout fractures than in those with them. Multiple logistic regression showed that the presence of old blowout fractures was significantly associated with reduced risk of ocular injury (p < 0.001). Conclusions The patients with old blowout fractures had a lower risk of ocular injuries following subsequent blunt trauma. The findings suggest that old fractures may provide protective effect. These results may have important implications for the clinical management of patients at risk of recurrent orbital trauma.

Connective tissue disease (CTD), comprising a range of autoimmune disorders, is often accompanied by lung involvement, which can lead to life-threatening complications. The primary types of CTDs that manifest as interstitial lung disease (ILD) include rheumatoid arthritis, systemic sclerosis, Sjögren’s syndrome, mixed CTD, idiopathic inflammatory myopathies, and systemic lupus erythematosus. CTD-ILD presents a significant challenge in clinical diagnosis and management due to its heterogeneous nature and variable prognosis. Early diagnosis through clinical, serological, and radiographic assessments is crucial for distinguishing CTD-ILD from idiopathic forms and for implementing appropriate therapeutic strategies. Hence, we have reviewed the multiple clinical manifestations and diagnostic approaches for each type of CTD-ILD, acknowledging the diversity and complexity of the disease. The importance of a multidisciplinary approach in optimizing the management of CTD-ILD is emphasized by recent therapeutic advancements, which include immunosuppressive agents, antifibrotic therapies, and newer biological agents targeting specific pathways involved in the pathogenesis. Therapeutic strategies should be customized according to the type of CTD, the extent of lung involvement, and the presence of extrapulmonary manifestations. Additionally, we aimed to provide clinical guidance, including therapeutic recommendations, for the effective management of CTD-ILD, based on patient, intervention, comparison, outcome (PICO) analysis.

Objective: The Daegu region experienced the first wave of the pandemic at the beginning of the coronavirus disease 2019 (COVID-19) outbreak in Korea. Other non-COVID-19-related treatments during a community outbreak, such as cardiovascular diseases, were expected to impact emergency departments. In acute myocardial infarctions, time is an important factor affecting the patient outcome. This study examined how community COVID-19 outbreak affected STsegment elevated myocardial infarction (STEMI) care in emergency departments. Methods: A retrospective analysis was performed on patients visiting five emergency departments in the Daegu area who were diagnosed with STEMI from February 18 to April 17 each year from 2018 to 2020. The demographic characteristics, prehospital variables, in-hospital time variables, and treatment results were collected. The cases were divided into the pre-COVID period and the COVID period for comparison. Results: The study included 254 patients (194 pre-COVID, 60 during COVID). The symptom-to-door time did not differ. Although the door-to-first doctor time was shortened (4 min vs. 2 min, P=0.01), the rate of coronary angiogram along with the door-to-angiogram time and the door-to-balloon time did not change. The length of stay in the emergency department was delayed during COVID-19 (median, 136 min vs. 404 min; P<0.01). The in-hospital length of stay and mortality were similar in both groups. Conclusion The time to treat STEMI was not delayed significantly during the first wave of the COVID-19 outbreak in the Daegu area compared with the pre-pandemic period. Mortality did not change. The length of stay was elongated significantly in the emergency department but not in the hospital.

Objective: The Daegu region experienced the first wave of the pandemic at the beginning of the coronavirus disease 2019 (COVID-19) outbreak in Korea. Other non-COVID-19-related treatments during a community outbreak, such as cardiovascular diseases, were expected to impact emergency departments. In acute myocardial infarctions, time is an important factor affecting the patient outcome. This study examined how community COVID-19 outbreak affected STsegment elevated myocardial infarction (STEMI) care in emergency departments. Methods: A retrospective analysis was performed on patients visiting five emergency departments in the Daegu area who were diagnosed with STEMI from February 18 to April 17 each year from 2018 to 2020. The demographic characteristics, prehospital variables, in-hospital time variables, and treatment results were collected. The cases were divided into the pre-COVID period and the COVID period for comparison. Results: The study included 254 patients (194 pre-COVID, 60 during COVID). The symptom-to-door time did not differ. Although the door-to-first doctor time was shortened (4 min vs. 2 min, P=0.01), the rate of coronary angiogram along with the door-to-angiogram time and the door-to-balloon time did not change. The length of stay in the emergency department was delayed during COVID-19 (median, 136 min vs. 404 min; P<0.01). The in-hospital length of stay and mortality were similar in both groups. Conclusion The time to treat STEMI was not delayed significantly during the first wave of the COVID-19 outbreak in the Daegu area compared with the pre-pandemic period. Mortality did not change. The length of stay was elongated significantly in the emergency department but not in the hospital.

Connective tissue disease (CTD), comprising a range of autoimmune disorders, is often accompanied by lung involvement, which can lead to life-threatening complications. The primary types of CTDs that manifest as interstitial lung disease (ILD) include rheumatoid arthritis, systemic sclerosis, Sjögren’s syndrome, mixed CTD, idiopathic inflammatory myopathies, and systemic lupus erythematosus. CTD-ILD presents a significant challenge in clinical diagnosis and management due to its heterogeneous nature and variable prognosis. Early diagnosis through clinical, serological, and radiographic assessments is crucial for distinguishing CTD-ILD from idiopathic forms and for implementing appropriate therapeutic strategies. Hence, we have reviewed the multiple clinical manifestations and diagnostic approaches for each type of CTD-ILD, acknowledging the diversity and complexity of the disease. The importance of a multidisciplinary approach in optimizing the management of CTD-ILD is emphasized by recent therapeutic advancements, which include immunosuppressive agents, antifibrotic therapies, and newer biological agents targeting specific pathways involved in the pathogenesis. Therapeutic strategies should be customized according to the type of CTD, the extent of lung involvement, and the presence of extrapulmonary manifestations. Additionally, we aimed to provide clinical guidance, including therapeutic recommendations, for the effective management of CTD-ILD, based on patient, intervention, comparison, outcome (PICO) analysis.

Purpose: To analyze the frequency and clinical characteristics of ocular injuries in patients with prior blowout fractures who experience new blunt trauma, and to assess whether old orbital fractures provide a protective effect against subsequent ocular trauma. Methods: The medical records of 1,315 ocular trauma patients were reviewed. A total of 927 patients who had orbital or facial computed tomography scans and ophthalmologist evaluations were considered. After applying exclusion criteria, 568 patients with 581 affected eyes were included in the final analysis. The patients were divided into two groups based on the presence of old blowout fractures, identified on computed tomography scan. The clinical characteristics and the frequency of ocular injuries were compared between the two groups. The risk of ocular injury according to the presence of old blowout fracture ware studied using multiple logistic regression after controlling age and sex. Results: Among the 581 eyes examined, 140 (24.1%) had old blowout fractures. The incidence of intraocular complications was significantly higher in the no orbital fracture group compared to the old blowout fracture group (20.4% vs. 2.1%, p < 0.001). Specifically, the incidence of complications such as gross hyphema (p = 0.001), globe rupture (p = 0.006), and vitreous hemorrhage (p = 0.027) was significantly greater in the group without old blowout fractures than in those with them. Multiple logistic regression showed that the presence of old blowout fractures was significantly associated with reduced risk of ocular injury (p < 0.001). Conclusions The patients with old blowout fractures had a lower risk of ocular injuries following subsequent blunt trauma. The findings suggest that old fractures may provide protective effect. These results may have important implications for the clinical management of patients at risk of recurrent orbital trauma.