Background: Deep vein thrombosis (DVT) is a common complication in orthopedic surgery and has the potential to lead to fatal complications such as pulmonary thromboembolism. However, the precise incidence and risk factors for DVT in the foot and ankle fields remain unclear. This study aimed to analyze the prevalence of DVT and identify its risk factors after foot and ankle surgery. Methods: Between September 2020 and July 2023, screening duplex ultrasonography was performed on 278 patients who underwent foot and ankle surgery and required immobilization. The findings from screening duplex ultrasonography were assessed in conjunction with the symptoms present at the time of diagnosis. Heterogeneous demographic data that could serve as potential risk factors for DVT, including diagnosis, body mass index, and other medical histories, were examined alongside pertinent surgeryrelated data, such as tourniquet time. Results: Among the 278 individuals, DVT occurred in 41 patients (14.7%). Among these, 92.7% originated at the calf level and the majority were asymptomatic. The cases originating above the calf accounted for 3 cases, representing 7.3% of patients diagnosed with DVT (1.1% of the entire screened population). Acute trauma, history of previous DVT, and old age were identified as statistically significant risk factors for DVT occurrence, with odds ratios of 2.44 (p = 0.04), 6.40 (p = 0.02), and 1.16 (p = 0.03), respectively. Conclusions After foot and ankle surgery, DVT occurred in 14.7% of cases. Acute trauma, history of DVT, and old age were identified as risk factors for DVT. These findings highlight the necessity of careful monitoring and appropriate prophylactic interventions for high-risk patients. Further investigation is required to determine effective prophylactic strategies for this patient population.

Background: Deep vein thrombosis (DVT) is a common complication in orthopedic surgery and has the potential to lead to fatal complications such as pulmonary thromboembolism. However, the precise incidence and risk factors for DVT in the foot and ankle fields remain unclear. This study aimed to analyze the prevalence of DVT and identify its risk factors after foot and ankle surgery. Methods: Between September 2020 and July 2023, screening duplex ultrasonography was performed on 278 patients who underwent foot and ankle surgery and required immobilization. The findings from screening duplex ultrasonography were assessed in conjunction with the symptoms present at the time of diagnosis. Heterogeneous demographic data that could serve as potential risk factors for DVT, including diagnosis, body mass index, and other medical histories, were examined alongside pertinent surgeryrelated data, such as tourniquet time. Results: Among the 278 individuals, DVT occurred in 41 patients (14.7%). Among these, 92.7% originated at the calf level and the majority were asymptomatic. The cases originating above the calf accounted for 3 cases, representing 7.3% of patients diagnosed with DVT (1.1% of the entire screened population). Acute trauma, history of previous DVT, and old age were identified as statistically significant risk factors for DVT occurrence, with odds ratios of 2.44 (p = 0.04), 6.40 (p = 0.02), and 1.16 (p = 0.03), respectively. Conclusions After foot and ankle surgery, DVT occurred in 14.7% of cases. Acute trauma, history of DVT, and old age were identified as risk factors for DVT. These findings highlight the necessity of careful monitoring and appropriate prophylactic interventions for high-risk patients. Further investigation is required to determine effective prophylactic strategies for this patient population.

Background: Deep vein thrombosis (DVT) is a common complication in orthopedic surgery and has the potential to lead to fatal complications such as pulmonary thromboembolism. However, the precise incidence and risk factors for DVT in the foot and ankle fields remain unclear. This study aimed to analyze the prevalence of DVT and identify its risk factors after foot and ankle surgery. Methods: Between September 2020 and July 2023, screening duplex ultrasonography was performed on 278 patients who underwent foot and ankle surgery and required immobilization. The findings from screening duplex ultrasonography were assessed in conjunction with the symptoms present at the time of diagnosis. Heterogeneous demographic data that could serve as potential risk factors for DVT, including diagnosis, body mass index, and other medical histories, were examined alongside pertinent surgeryrelated data, such as tourniquet time. Results: Among the 278 individuals, DVT occurred in 41 patients (14.7%). Among these, 92.7% originated at the calf level and the majority were asymptomatic. The cases originating above the calf accounted for 3 cases, representing 7.3% of patients diagnosed with DVT (1.1% of the entire screened population). Acute trauma, history of previous DVT, and old age were identified as statistically significant risk factors for DVT occurrence, with odds ratios of 2.44 (p = 0.04), 6.40 (p = 0.02), and 1.16 (p = 0.03), respectively. Conclusions After foot and ankle surgery, DVT occurred in 14.7% of cases. Acute trauma, history of DVT, and old age were identified as risk factors for DVT. These findings highlight the necessity of careful monitoring and appropriate prophylactic interventions for high-risk patients. Further investigation is required to determine effective prophylactic strategies for this patient population.

Background: Deep vein thrombosis (DVT) is a common complication in orthopedic surgery and has the potential to lead to fatal complications such as pulmonary thromboembolism. However, the precise incidence and risk factors for DVT in the foot and ankle fields remain unclear. This study aimed to analyze the prevalence of DVT and identify its risk factors after foot and ankle surgery. Methods: Between September 2020 and July 2023, screening duplex ultrasonography was performed on 278 patients who underwent foot and ankle surgery and required immobilization. The findings from screening duplex ultrasonography were assessed in conjunction with the symptoms present at the time of diagnosis. Heterogeneous demographic data that could serve as potential risk factors for DVT, including diagnosis, body mass index, and other medical histories, were examined alongside pertinent surgeryrelated data, such as tourniquet time. Results: Among the 278 individuals, DVT occurred in 41 patients (14.7%). Among these, 92.7% originated at the calf level and the majority were asymptomatic. The cases originating above the calf accounted for 3 cases, representing 7.3% of patients diagnosed with DVT (1.1% of the entire screened population). Acute trauma, history of previous DVT, and old age were identified as statistically significant risk factors for DVT occurrence, with odds ratios of 2.44 (p = 0.04), 6.40 (p = 0.02), and 1.16 (p = 0.03), respectively. Conclusions After foot and ankle surgery, DVT occurred in 14.7% of cases. Acute trauma, history of DVT, and old age were identified as risk factors for DVT. These findings highlight the necessity of careful monitoring and appropriate prophylactic interventions for high-risk patients. Further investigation is required to determine effective prophylactic strategies for this patient population.

Background: Infectious disease (ID) specialists are skilled facilitators of medical consultation who promote better outcomes in patient survival, antibiotic stewardship as well as healthcare safety in pandemic response. This study aimed to assess the working status of ID specialists and identify problems faced by ID professionals in Korea. Methods: This was a nationwide cross-sectional study in Korea. An online-based survey was conducted over 11 days (from December 17–27, 2020), targeting all active adult (n = 281) and pediatric (n = 71) ID specialists in Korea (N = 352). Questions regarding the practice areas of the specialists were divided into five categories: 1) clinical practices of outpatient care, inpatient care, and consultations; 2) infection control; 3) antibiotic stewardship; 4) research; and 5) education and training. We investigated the weekly time-use patterns for these areas of practice. Results: Of the 352 ID specialists, 195 (55.4%; 51.2% [144/281] adult and 71.8% [51/71] pediatric ID specialists) responded in the survey. Moreover, 144 (73.8%) of the total respondents were involved in all practice categories investigated. The most common practice area was outpatient service (93.8%), followed by consultation (91.3%) and inpatient service (87.7%). Specialists worked a median of 61 (interquartile range: 54–71) hours weekly: patient care, 29 (14–37) hours; research 11 (5–19) hours; infection control 4 (2–10) hours; antibiotic stewardship, 3 (1–5) hours; and education/training, 2 (2–6) hours. Conclusion ID specialists in Korea simultaneously undertake multiple tasks and work long hours, highlighting the need for training and employing more ID specialists.

Background: Proteinuria is a significant risk factor for progression of IgA nephropathy (IgAN) and has a positive correlation with severity of foot process effacement (FPE). We evaluated the relationship of FPE with proteinuria and histologic characteristics, including the Oxford classification. Methods: Patients who underwent renal biopsy and were diagnosed with IgAN at a single center were retrospectively reviewed. Patients aged less than 18 years and those with the possibility of secondary causes were excluded from the study. Subsequently, we evaluated the association between degree of proteinuria, severity of FPE, and histologic characteristics, including the Oxford classification and other immunofluorescence stains. Results: A total of 805 cases of renal biopsy was performed at our institution, and 327 patients were diagnosed with IgAN. Among them, 82 patients were excluded. Severity of FPE had an impact on the degree of proteinuria. Notably, the group with diffuse FPE had more than about 1.3 g/day of urine protein compared to those with rare FPE. Among the histologic characteristics, M1 score and immune deposition of IgG affected severity of FPE (hazard ratios [95% confidence interval], 1.90 [1.10 to 3.26], and 3.77 [1.66 to 8.54], respectively). Conclusion Severity of FPE had an impact on the degree of proteinuria and may be associated with the pathogenesis of IgAN.

Syndesmotic injury can either be isolated or associated with bony or ligamentous ankle injury. When it is not associated with an ankle fracture, it may not be easy to diagnose, especially when there is no franck diastasis on a plain radiograph. Without proper treatment, syndesmotic injury can lead to chronic pain due to impingement of scar tissues and instability. It may further lead to ankle arthritis. Early diagnosis with appropriate management is a prerequisite to avoid these problems. Herein, we review and discuss the mechanism of injury, classification, diagnosis, and treatment of isolated syndesmotic injury.
Ankle ; Ankle Fractures ; Ankle Injuries* ; Arthritis ; Chronic Pain ; Cicatrix ; Classification ; Diagnosis ; Early Diagnosis ; Ligaments ; Sports

BACKGROUND: The Korean Society for Nosocomial Infection Control (KOSNIC) ran a surveillance system, called as Korean Nosocomial Infections Surveillance (KONIS), since July 2006. Here, we report the annual data of the intensive care unit (ICU) module of the system from July 2012 through June 2013. METHODS: This is a prospective surveillance of nosocomial urinary tract infections (UTI), bloodstream infections (BSI), and pneumonia (PNEU) at 161 ICUs in 91 hospitals using the KONIS system. The nosocomial infection (NI) rate was calculated as the number of infections per 1,000 patient days or device days. RESULTS: A total of 3,042 NIs were reported during the study period: 877 UTIs (854 cases were urinary catheter-associated), 1,272 BSIs (1,096 were central line-associated), and 893 PNEUs (526 cases were ventilator-associated). The rate of urinary catheter-associated UTIs (CAUTIs) was 1.26 cases per 1,000 device days (95% confidence interval; 1.18-1.34) and urinary catheter utilization ratio was 0.78 (0.779-0.781). The rate of central line-associated BSIs was 2.57 (2.42-2.72) and the utilization ratio was 0.49 (0.489-0.491). The rate of ventilator-associated PNEUs was 1.64 (1.50-1.78) and the utilization ratio was 0.37 (0.369-0.371). The urinary catheter utilization ratio was lower in the ICUs of hospitals with 400-699 beds than in those of hospitals with more than 900 beds; nevertheless, CAUTIs were more common in the hospitals with 400-699 beds. The central line-associated BSI (CLABSI) rate was lower in the study period than in the previous period of July 2011-June 2012 [2.57 (2.42-2.72) vs. 3.01 (2.84-3.19)]. CONCLUSION: The CLABSI rates were lower in the study period than those in the previous years. CAUTIs were more common in the ICUs of hospitals with 400-699 beds than in those of larger hospitals.
Cross Infection* ; Humans ; Intensive Care Units* ; Critical Care* ; Pneumonia ; Prospective Studies ; Urinary Catheters ; Urinary Tract Infections

Antipsychotics are the drug of choice for patients with schizophrenia, but they can induce hyperprolactinemia and growth of pituitary adenomas by blocking dopamine 2 receptors in the pituitary gland. In contrast, the medical treatment for a prolactinoma is a dopamine agonist. Therefore, managing a patient concurrently diagnosed with a prolactinoma and psychosis is challenging. We describe a patient with schizophrenia who was diagnosed with a prolactinoma. We changed his neuroleptic to quetiapine and prescribed bromocriptine for the prolactinoma. As a result, the patient was successfully treated with a dopamine agonist and antipsychotic without psychotic exacerbation. Our case suggests that dopamine agonists can be administrated to patients with schizophrenia and a prolactinoma without adversely affecting their psychopathological status.
Antipsychotic Agents ; Bromocriptine ; Dopamine ; Dopamine Agonists ; Humans ; Hyperprolactinemia ; Pituitary Gland ; Pituitary Neoplasms ; Prolactinoma ; Psychotic Disorders ; Schizophrenia ; Quetiapine Fumarate