Purpose: This study examined longitudinal changes in interstitial lung abnormalities (ILAs) and predictors of clinically significant interstitial lung diseases (ILDs) in a screening population with ILAs. Materials and Methods: We retrieved 36891 low-dose chest CT records from screenings between January 2003 and May 2021. After identifying 101 patients with ILAs, the clinical findings, spirometry results, and initial and follow-up CT findings, including visual and artificial intelligence-based quantitative analyses, were compared between patients diagnosed with ILD (n = 23, 23%) and those who were not (n = 78, 77%). Logistic regression analysis was used to identify significant parameters for the clinical diagnosis of ILD. Results: Twenty-three patients (n = 23, 23%) were subsequently diagnosed with clinically significant ILDs at follow-up (mean, 8.7 years). Subpleural fibrotic ILAs on initial CT and signs of progression on follow-up CT were common in the ILD group (both p < 0.05). Logistic regression analysis revealed that emerging respiratory symptoms (odds ratio [OR], 5.56; 95% confidence interval [CI], 1.28–24.21; p = 0.022) and progression of ILAs at follow-up chest CT (OR, 4.07; 95% CI, 1.00–16.54; p = 0.050) were significant parameters for clinical diagnosis of ILD. Conclusion Clinically significant ILD was subsequently diagnosed in approximately one-quarter of the screened population with ILAs. Emerging respiratory symptoms and progression of ILAs at followup chest CT can be predictors of clinically significant ILDs.

Purpose: This study examined longitudinal changes in interstitial lung abnormalities (ILAs) and predictors of clinically significant interstitial lung diseases (ILDs) in a screening population with ILAs. Materials and Methods: We retrieved 36891 low-dose chest CT records from screenings between January 2003 and May 2021. After identifying 101 patients with ILAs, the clinical findings, spirometry results, and initial and follow-up CT findings, including visual and artificial intelligence-based quantitative analyses, were compared between patients diagnosed with ILD (n = 23, 23%) and those who were not (n = 78, 77%). Logistic regression analysis was used to identify significant parameters for the clinical diagnosis of ILD. Results: Twenty-three patients (n = 23, 23%) were subsequently diagnosed with clinically significant ILDs at follow-up (mean, 8.7 years). Subpleural fibrotic ILAs on initial CT and signs of progression on follow-up CT were common in the ILD group (both p < 0.05). Logistic regression analysis revealed that emerging respiratory symptoms (odds ratio [OR], 5.56; 95% confidence interval [CI], 1.28–24.21; p = 0.022) and progression of ILAs at follow-up chest CT (OR, 4.07; 95% CI, 1.00–16.54; p = 0.050) were significant parameters for clinical diagnosis of ILD. Conclusion Clinically significant ILD was subsequently diagnosed in approximately one-quarter of the screened population with ILAs. Emerging respiratory symptoms and progression of ILAs at followup chest CT can be predictors of clinically significant ILDs.

Purpose: This study examined longitudinal changes in interstitial lung abnormalities (ILAs) and predictors of clinically significant interstitial lung diseases (ILDs) in a screening population with ILAs. Materials and Methods: We retrieved 36891 low-dose chest CT records from screenings between January 2003 and May 2021. After identifying 101 patients with ILAs, the clinical findings, spirometry results, and initial and follow-up CT findings, including visual and artificial intelligence-based quantitative analyses, were compared between patients diagnosed with ILD (n = 23, 23%) and those who were not (n = 78, 77%). Logistic regression analysis was used to identify significant parameters for the clinical diagnosis of ILD. Results: Twenty-three patients (n = 23, 23%) were subsequently diagnosed with clinically significant ILDs at follow-up (mean, 8.7 years). Subpleural fibrotic ILAs on initial CT and signs of progression on follow-up CT were common in the ILD group (both p < 0.05). Logistic regression analysis revealed that emerging respiratory symptoms (odds ratio [OR], 5.56; 95% confidence interval [CI], 1.28–24.21; p = 0.022) and progression of ILAs at follow-up chest CT (OR, 4.07; 95% CI, 1.00–16.54; p = 0.050) were significant parameters for clinical diagnosis of ILD. Conclusion Clinically significant ILD was subsequently diagnosed in approximately one-quarter of the screened population with ILAs. Emerging respiratory symptoms and progression of ILAs at followup chest CT can be predictors of clinically significant ILDs.

Background: This study aimed to evaluate the prevalence of dysmenorrhea and to investigate the effect of weight changes or unhealthy weight control behaviors on dysmenorrhea in young Korean women. Methods: We used large-scale data of women, aged 14 to 44 years, who participated in the Korean Study of Women’s Health-Related Issues. Dysmenorrhea was measured using a visual analog scale and was categorized as none, mild, moderate, and severe according to the severity. Weight changes and unhealthy weight control behaviors (any of the behaviors, fasting/meal skipping, drugs, the use of unapproved dietary supplements, and one-food diets) over the past year were self-reported. We used multinomial logistic regression to investigate the association between weight changes or unhealthy weight control behaviors and dysmenorrhea. Results: Of the 5,829 young women participating in the study, 5,245 (90.0%) participants experienced dysmenorrhea [2,184 (37.5%) had moderate and 1,358 (23.3%) had severe].After adjusting for confounders, the odds ratios for moderate and severe dysmenorrhea in participants with weight changes ≥ 3 kg (vs. < 3 kg) were 1.19 (95% confidence interval:1.05–1.35) and 1.25 (95% confidence interval: 1.08–1.45), respectively. The odds ratios in participants with any unhealthy weight control behaviors were 1.22 (95% confidence interval:1.04–1.42) and 1.41 (95% confidence interval: 1.19–1.67) for those with moderate and severe dysmenorrhea, respectively. Conclusion Weight changes (≥ 3 kg) or unhealthy weight control behaviors are common among young women, which may adversely affect dysmenorrhea. Therefore, attention needs to be paid to excessive weight changes and unhealthy weight control behaviors to improve dysmenorrhea in young women.

The aim of this study was to develop evidence-based recommendations for determining the surgical extent in patients with locally invasive differentiated thyroid cancer (DTC). Locally invasive DTC with gross extrathyroidal extension invading surrounding anatomical structures may lead to several functional deficits and poor oncological outcomes. At present, the optimal extent of surgery in locally invasive DTC remains a matter of debate, and there are no adequate guidelines. On October 8, 2021, four experts searched the PubMed, Embase, and Cochrane Library databases; the identified papers were reviewed by 39 experts in thyroid and head and neck surgery. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the quality of evidence, and to develop and report recommendations. The strength of a recommendation reflects the confidence of a guideline panel that the desirable effects of an intervention outweigh any undesirable effects, across all patients for whom the recommendation is applicable. After completing the draft guidelines, Delphi questionnaires were completed by members of the Korean Society of Head and Neck Surgery. Twenty-seven evidence-based recommendations were made for several factors, including the preoperative workup; surgical extent of thyroidectomy; surgery for cancer invading the strap muscles, recurrent laryngeal nerve, laryngeal framework, trachea, or esophagus; and surgery for patients with central and lateral cervical lymph node involvement. Evidence-based guidelines were devised to help clinicians make safer and more efficient clinical decisions for the optimal surgical treatment of patients with locally invasive DTC.

Osteoporosis and osteoporotic fractures cause socioeconomic concerns, and medical system and policies appear insufficient to prepare for these issues in Korea, where the older adult population is rapidly increasing. Many countries around the world are already responding to osteoporosis and osteoporotic fractures by adopting fracture liaison service (FLS), and such an attempt has only begun in Korea. In this article, we introduce the operation methods for institutions implementing FLS and characteristics of services, and activities of the FLS Committee for FLS implementation in the Korean Society for Bone and Mineral Research. In addition, we hope that the current position statement will contribute to the implementation of FLS in Korea and impel policy changes to enable a multidisciplinary and integrated FLS operated under the medical system.

Background/Aims: We aimed to compare the effectiveness and safety of Janus kinase inhibitors (JAKi) vs. biologic disease- modifying antirheumatic drugs (bDMARD) in Korean patients with rheumatoid arthritis (RA) who had an inadequate response to conventional synthetic DMARDs. Methods: A quasi-experimental, multi-center, prospective, non-randomized study was conducted to compare response rates between JAKi and bDMARDs in patients with RA naïve to targeted therapy. An interim analysis was performed to estimate the proportion of patients achieving low disease activity (LDA) based on disease activity score (DAS)–28– erythroid sedimentation rate (ESR) (DAS28-ESR) at 24 weeks after treatment initiation and to evaluate the development of adverse events (AEs). Results: Among 506 patients enrolled from 17 institutions between April 2020 and August 2022, 346 (196 JAKi group and 150 bDMARD group) were included in the analysis. After 24 weeks of treatment, 49.0% of JAKi users and 48.7% of bDMARD users achieved LDA (p = 0.954). DAS28-ESR remission rates were also comparable between JAKi and bDMARD users (30.1% and 31.3%, respectively; p = 0.806). The frequency of AEs reported in the JAKi group was numerically higher than that in the bDMARDs group, but the frequencies of serious and severe AEs were comparable between the groups. Conclusions Our interim findings reveal JAKi have comparable effectiveness and safety to bDMARDs at 24 weeks after treatment initiation.

Background: Pharmacists communicate with a variety of healthcare experts to prevent medication errors. Situation-BackgroundAssessment-Recommendation (SBAR) is a tool used for concise and accurate communication. In 2018, we developed the pharmacy-SBAR (P-SBAR) to deliver pharmacists intervention more quickly and effectively through quality improvement activities. Objectives: This study evaluates the efficacy of P-SBAR on pharmacists’ intervention activities before and after the implementation of P-SBAR applications. We assessed the impact of P-SBAR on reducing the burden of intervention work, promoting pharmacists’ participation, and enhancing the acceptance rate. Methods: This is a retrospective study of the two groups before and after P-SBAR implementation. All pharmacists’ intervention records during two periods (2016-2017 and 2019-2020) were extracted from the data warehouse system at Kyunghee University Hospital at Gangdong, Seoul. The outcome was the number of inpatients and pharmacists who participated in the prescription monitoring activity, the number of interventions, and the physicians’ acceptance rate. Results: Although the total number of inpatients decreased (364,753 vs. 348,229), the number of pharmacists who participated in intervention activity increased (monthly mean: 15.8 vs. 18.0, p=0.001). The total number of interventions (2,767 vs. 4,389), the frequency of full acceptance (2,018 vs. 3,710), and the monthly acceptance rate increased significantly (73.8% vs. 83.8%, p<0.001). Conclusion P-SBAR improved accessibility and convenience by digitalizing the intervention activities performed in an offline environment. Improvement in work burden and acceptance rate using P-SBAR is expected to contribute toward reducing medication errors.

Background: We analyzed the differences between clinical characteristics and computed tomography (CT) findings in patients with coronavirus disease 2019 (COVID-19) to establish potential relationships with mediastinal lymphadenopathy and clinical outcomes. Methods: We compared the clinical characteristics and CT findings of COVID-19 patients from a nationwide multicenter cohort who were grouped based on the presence or absence of mediastinal lymphadenopathy. Differences between clinical characteristics and CT findings in these groups were analyzed. Univariate and multivariate analyses were performed to determine the impact of mediastinal lymphadenopathy on clinical outcomes. Results: Of the 344 patients included in this study, 53 (15.4%) presented with mediastinal lymphadenopathy. The rate of diffuse alveolar damage pattern pneumonia and the visual CT scores were significantly higher in patients with mediastinal lymphadenopathy than in those without (P < 0.05). A positive correlation between the number of enlarged mediastinal lymph nodes and visual CT scores was noted in patients with mediastinal lymphadenopathy (Spearman’s ρ = 0.334, P < 0.001). Multivariate analysis showed that mediastinal lymphadenopathy was independently associated with a higher risk of intensive care unit (ICU) admission (odds ratio, 95% confidence interval; 3.25, 1.06-9.95) but was not significantly associated with an increased risk of in-hospital death in patients with COVID-19. Conclusion COVID-19 patients with mediastinal lymphadenopathy had a larger extent of pneumonia than those without. Multivariate analysis adjusted for clinical characteristics and CT findings revealed that the presence of mediastinal lymphadenopathy was significantly associated with ICU admission.