This guideline aims to promote the prudent use of antibacterial agents for managing carbapenem-resistant Enterobacterales (CRE) infections in clinical practice in Korea. The general section encompasses recommendations for the management of common CRE infections and diagnostics, whereas each specific section is structured with key questions that are focused on antibacterial agents and disease-specific approaches. This guideline covers both currently available and upcoming antibacterial agents in Korea.

This guideline aims to promote the prudent use of antibacterial agents for managing carbapenem-resistant Enterobacterales (CRE) infections in clinical practice in Korea. The general section encompasses recommendations for the management of common CRE infections and diagnostics, whereas each specific section is structured with key questions that are focused on antibacterial agents and disease-specific approaches. This guideline covers both currently available and upcoming antibacterial agents in Korea.

This guideline aims to promote the prudent use of antibacterial agents for managing carbapenem-resistant Enterobacterales (CRE) infections in clinical practice in Korea. The general section encompasses recommendations for the management of common CRE infections and diagnostics, whereas each specific section is structured with key questions that are focused on antibacterial agents and disease-specific approaches. This guideline covers both currently available and upcoming antibacterial agents in Korea.

Background: The aim of this study was to capture multifaceted clinical characteristics of congenital cytomegalovirus (CMV) infection from diagnosis to treatment using a multidisciplinary approach including obstetrics, pediatrics, pathology, and otorhinolaryngology-head and neck surgery. Methods: This is a retrospective study including 30 consecutive cases of congenital CMV infection that were diagnosed at a single tertiary hospital located in Seoul, Korea from January 2009 to December 2020. Congenital CMV infection was defined as a positive result by polymerase chain reaction from urine, saliva or cerebrospinal fluid or positive CMV IgM from neonatal blood sampled within 3 weeks after birth. All cases were analyzed with respect to whole clinical characteristics from diagnosis to treatment of congenital CMV by a multidisciplinary approach including prenatal sonographic findings, maternal immune status regarding CMV infection, detailed placental pathology, neonatal clinical manifestation, auditory brainstem response test, and antiviral treatment (ganciclovir or valganciclovir). Long-term outcomes including developmental delay and hearing loss were also investigated. Results: The total number of births during the study period in our institution was 19,385, with the prevalence of congenital infection estimated to be 0.15%. Among 30 cases of congenital CMV, the median gestational age at delivery was 32.2 weeks [range, 22.6–40.0] and 66.7% of these infants were delivered preterm at less than 37 weeks. Suspected fetal growth restriction was the most common prenatal ultrasound finding (50%) followed by ventriculomegaly (17.9%) and abnormal placenta (17.9%), defined as thick placenta with calcification. No abnormal findings on ultrasound examination were observed in one-third of births. Maternal CMV serology tests were conducted in only 8 cases, and one case each of positive and equivocal IgM were found. The most common placental pathologic findings were chronic villitis (66.7%) and calcification (63.0%), whereas viral inclusions were identified in only 22.2%. The most common neonatal manifestations were jaundice (58.6%) followed by elevation of aspartate aminotransferase (55.2%) and thrombocytopenia (51.7%). After excluding cases for which long-term outcomes were unavailable due to death (n = 4) or subsequent follow up loss (n = 3), developmental delay was confirmed in 43.5% of infants (10/23), and hearing loss was confirmed in 42.9% (9/21) during the follow-up period. In our cohort, 56.7% (17/30) of neonates were treated for congenital CMV with ganciclovir or valganciclovir. Conclusion Our data show that prenatal findings including maternal serologic tests and ultrasound have limited ability to detect congenital CMV in Korea. Given that CMV is associated with high rates of developmental delay and hearing loss in infants, there is an urgent need to develop specific strategies for the definite diagnosis of congenital CMV infection during the perinatal period by a multidisciplinary approach to decrease the risks of neurologic impairment and hearing loss through early antiviral treatment.

PURPOSE: The purpose of this study was to explore and describe the distress of the patients with ostomy. METHODS: A descriptive research design was adopted for data collection and analysis. Six patients with ostomy participated in the study. The consent from the participants was obtained for ethical protection. Data were collected from July 31, 2009 to January 10, 2010 using in-depth interview technique. Krippendorff's content analysis method was utilized for data analysis. RESULTS: Eight categories and 26 themes were extracted from the data which illustrated the lived distress of the patients with ostomy. The categories were "do not have any freedom to eat whatever I wish to eat", "uncontrolled defecation", "have to live through tough situation", "keep stoma in suspense", "disgusting ostomy", "can not live with comfort", "easily take a pessimistic view", and "see how the wind blows in daily family life". CONCLUSION: Ostomates were affected by the distress of having an ostomy in their physical, psychological, social and spiritual life. Individualized and continued nursing education program has to be developed in hospital and community settings in order to improve the quality of life of the ostomates.
Data Collection ; Education, Nursing ; Freedom ; Humans ; Ostomy ; Quality of Life ; Research Design ; Wind

PURPOSE: To examine the effect of tooth-brushing education on the oral health of preschoolers. METHODS: A quasi-experimental design with a non-equivalent control group was used. Two kindergartens were selected and 39 preschoolers from one kindergarten were assigned to the experimental group with tooth-brushing education and 39 from the other kindergarten to the control group. The tooth-brushing education program included 1 session on oral health education, individual tooth-brushing instruction for 1 week and supervised tooth-brushing after lunch for 4 weeks. Oral health behavior including use of tooth paste, tooth-brushing time and method of tooth-brushing, plague, streptococcus mutans, lactobacillus and dental caries were measured before and after the education. Fisher's exact test, t-test and paired t-test with the Window SAS 9.1 program were used to analyze the data. RESULTS: A significant increase in the use of tooth paste, tooth-brushing time and the practice of correct tooth-brushing and a decrease in plague and development of dental caries were observed in the experimental group. CONCLUSION: This tooth-brushing education was partially effective in improving oral health of preschoolers.
Child, Preschool ; DMF Index ; Dental Caries/prevention & control ; Dental Plaque/prevention & control ; Female ; *Health Education, Dental ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; *Oral Health ; Oral Hygiene ; Toothbrushing/*utilization

PURPOSE: This study was done to develop and examine the effects of a self-management program (SMP) on physical, psychological functions, and symptoms in patients with Parkinson's disease(PD). METHODS: In a two-group pre-and post-test design, a total of 40 patients were assigned to the experimental group(21) or the control group (19). The experimental group received eight weekly 2-hour sessions for 10-15 literate adults of all ages, while the control group did not receive any intervention. RESULTS: The experimental group showed significant improvements in muscle strength, balance, self-efficacy, depression, quality of life(QL), quality of sleep, and discomfort of constipation. It also reduced the number of participants using assistive walking devices. There were no significant changes in fear of falling and duration of sleep. CONCLUSION: The eight week SMP in patients with PD was found to be significantly effective in enhancing muscle strength, balance, self-efficacy, QL, and quality of sleep. It also decreased depression, discomfort of constipation, and assistive walking devices. These results suggest that a SMP can have effects on physical, psychological functions and symptoms in patients with PD. Further research with a larger sample and for a longer follow up period is needed to expand our understanding of the effects of a SMP for patients with PD.
Aged ; Chi-Square Distribution ; Female ; Humans ; Male ; Middle Aged ; Parkinson Disease/psychology/*therapy ; Patient Education as Topic ; Quality of Life ; Self Care/*methods ; Self Efficacy ; Walking

OBJECTIVE: To study the neonatal outcomes of pregnancies complicated with preterm premature rupture of the membranes (PPROM) and to assess the prognostic factors for poor neonatal outcomes. METHODS: We performed a retrospective study of pregnancies registered and managed in Korea from Jan 1st, 2000 to Dec 31st, 2005. The 217 women with preterm premature rupture of membranes in singleton pregnancies from 16 to 36 gestational weeks were enrolled in this study. We investigated respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), and neonatal infection for poor neonatal outcomes. Prognostic variables included for analysis were age, BMI, parity, history of PPROM, history of preterm labor, preterm labor, amniotic fluid index, tocolysis, antibiotics, antenatal steroid, hemoglobin, WBC, CRP, gestational age at PPROM, interval from PPROM to delivery, gestational age at delivery, placental findings, and etc. We compared the characteristics of those who developed neonatal morbidity (n=144) with those who did not (n=65) using the Student t test for continuous variables, and the Pearson's chi-square or the Fisher exact test for categorical variables. RESULTS: Total of 217 cases of PPROM were registered and treated expectantly during the study period. The majority of cases were delivered within 48 hours of PPROM. There were 64 cases diagnosed with RDS, 21 with IVH, 3 with NEC, 117 with neonatal infection and 8 neonatal mortalities. The gestational age at PPROM (p<0.000), interval from PPROM to delivery (p<0.036), gestational age at delivery (p<0.000), decreased amniotic fluid index (p<0.048), and high level of WBC, CRP (p<0.010, p<0.049) were significantly correlated with poor neonatal outcomes. Birth weight (p<0.000) and APGAR (p<0.000) score at 5 minute were significantly lower in cases resulting in neonatal morbidity. CONCLUSION: Neonatal outcomes of pregnancies with preterm premature rupture of membranes are related to gestational age at PPROM, interval from PPROM to delivery, and gestational age at delivery. The decreased amniotic fluid index, and high level of WBC, CRP presented before delivery are significantly correlated with poor neonatal outcomes. Birth weight and APGAR scores at 5 minute are significantly lower in cases resulting in neonatal morbidity.
Amniotic Fluid ; Anti-Bacterial Agents ; Birth Weight ; Enterocolitis, Necrotizing ; Female ; Gestational Age ; Hemorrhage ; Humans ; Infant ; Infant Mortality ; Korea ; Membranes* ; Obstetric Labor, Premature ; Parity ; Pregnancy* ; Retrospective Studies ; Rupture* ; Tocolysis

PURPOSE: To develop & to examine the effect of a Tailored Exercise Program (TEP) on physical fitness in patients with Parkinson's disease (PD). METHOD: In a two-group pre-and post-test design, from a total 41 participants. 21 were assigned th the experimental group and the remainder to the control group. The experimental group participated in a 4-day a week, 8 week program in which one session a week was by direct instruction with the self-help group and two sessions a week were by videotaped instruction at home by themselves. The control group did not receive any intervention. RESULTS: The eight week TEP in patients with PD was found to be significantly effective in enhancing muscle strength, ankle flexibility, and balance. However instrumental activities of daily living was not changed by the intervention. CONCLUSION: These results suggest that TEP can have an effect on physical fitness in patients with PD. Further research with a larger sample and for a longer follow up period is needed to expand our understanding of the effects of TEP for patients with PD.
Activities of Daily Living ; Ankle ; Follow-Up Studies ; Humans ; Muscle Strength ; Parkinson Disease* ; Physical Fitness* ; Pliability ; Self-Help Groups

PURPOSE: To investigate the status of health education courses in elementary schools. METHOD: From September to December in 2003, 607 school nurses were surveyed by questionnaires. RESULTS: 1) Of the schools, 32.1% had health education programs as part of the school health service. A higher proportion was found in schools in suburban and rural areas. Mass media in health education was used by 75% of school nurses. Regular classes were more frequently utilized in schools in rural areas, while the classes in health-related subjects were utilized in urban areas. For 20.6% of school nurses, there was a substitute person to provide health care while the nurse was in health education classed, but 94.2% of school nurses found they had to give up health education due to pressure from other health services. 2) Of the nurses, 97.0% felt the need to provide health education courses, but 60.6% insisted that their work load needed to be modified and supplemental personnel were necessary if health education courses were to be provided. 3) More than 30% school nurses responded that educational materials and media, and concern by teachers and administrators were insufficient. 4) School nurses suggested that the content for health education courses should include healthy life and dental health care for students in lower grades, dental health care, sex education and safety for students in middle grades, and sex education and drug abuse prevention for students in higher grades. CONCLUSION: There is an urgent need to provide health education courses in elementary schools but conditions in the schools are not satisfactory. For successful school health services, personnel supplement, modified work loads and sufficient educational materials and media should be in place before health education courses are provided.
Administrative Personnel ; Delivery of Health Care ; Health Education* ; Health Services ; Humans ; Mass Media ; Surveys and Questionnaires ; School Health Services ; Sex Education ; Substance-Related Disorders