Purpose: Few meta-analyses of head-to-head comparisons between subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) for perennial allergic rhinitis (AR) have been performed so far. This study aimed to compare the efficacy, safety, and adherence of SCIT and SLIT in patients with house dust mite (HDM)-sensitized AR through a meta-analysis of head-to-head comparative studies. Methods: A meta-analysis based on direct comparisons of SCIT and SLIT in HDM-sensitized AR was performed, using randomized controlled trials (RCTs) and nonrandomized studies (NRSs), on efficacy, safety, and adherence, which had been published until April 30, 2021. Treatment efficacy was calculated as the standardized mean difference in symptoms and medication scores after treatment between SCIT and SLIT. Safety and adherence to treatment were compared with the relative risk (RR) of SCIT and SLIT. Results: Six RCTs and 3 NRS scores were analyzed. No statistically significant difference was noticed in improvement in symptoms and medication scores between SCIT and SLIT groups. Systemic adverse events occurred more frequently in SCIT than in SLIT in both RCT (RR, 3.97; 95% confidence interval [CI], 0.50–31.57) and NRS (RR, 5.48; 95% CI, 1.94–15.50). SCIT showed significantly higher adherence than did SLIT (RR, 1.16; 95% CI, 0.92–1.47). Conclusion No significant difference in efficacy was noticed between the 2 modalities for HDM-sensitized AR. However, SLIT had significantly lower number of systemic adverse reactions, and SCIT had more preferable adherence.

Background: An epidural blood patch (EBP) is a procedure to treat intracranial hypotension that does not respond to conservative treatment. EBPs are commonly repeated when the symptoms persist. In this study, we used a large single-center retrospective cohort and evaluated the factors associated with repeated EBPs. Methods: From January 2010 to December 2020, a total of 596 patients were treated with EBPs for intracranial hypotension. We evaluated the factors associated with repeated EBPs in the entire population, in patients with spontaneous intracranial hypotension (SIH), and in those with available myelographies. Results: In a total of 596 patients, 125 (21.1%) patients required repeated EBPs, and 96/278 (34.5%) in SIH and 29/314 (9.2%) in iatrogenic population. In patients with SIH, international normalized ratio (INR) and cerebrospinal fluid (CSF) leakage on myelographies consistently exhibited significant associations (odds ratio [OR], 1.38; 95% confidence interval [CI], 1.02–1.87; P = 0.043 and OR, 2.18; 95% CI, 1.28–3.69; P = 0.004). In patients with iatrogenic injury, INR and CSF leakage on myelogram did not show difference in repeated EBPs. Conclusions Repeated EBPs may be more frequently required in patients with SIH.Prolonged INR and CSF leakage were associated with repeated EBPs in patient with SIH. Further studies are needed to determine factors associated with repeated EBP requirements.

Hypernatremia is a common electrolyte disorder in children and elderly people and has high short-term mortality. However, no high-quality studies have examined the correction rate of hypernatremia and the amount of fluid required for correction. Therefore, in this study, we will compare the efficacy and safety of rapid intermittent bolus (RIB) and slow continuous infusion (SCI) of electrolyte-free solution in hypernatremia treatment. Methods: This is a prospective, investigator-initiated, multicenter, open-label, randomized controlled study with two experimental groups. A total of 166 participants with severe hypernatremia will be enrolled and divided into two randomized groups; both the RIB and SCI groups will be managed with electrolyte-free water. We plan to infuse the same amount of fluid to both groups, for 1 hour in the RIB group and continuously in the SCI group. The primary outcome is a rapid decrease in serum sodium levels within 24 hours. The secondary outcomes will further compare the efficacy and safety of the two treatment protocols. Conclusion: This is the first randomized controlled trial to evaluate the efficacy and safety of RIB correction compared with SCI in adult patients with severe hypernatremia.

Purpose: Social distancing and strict visitor restrictions at hospitals have been national policies since the onset of the coronavirus disease 2019 (COVID-19) pandemic. This has challenged the concept of a good death in comfort with the opportunity to say goodbye.Little is known about how these measures have influenced end-of-life (EOL) care among cancer patients who die in acute care hospitals. This study examined changes in the EOL care of cancer patients during the COVID-19 pandemic. Methods: We retrospectively analyzed 1,456 adult cancer patients who died in 2019 (n=752) and 2020 (n=704) at a tertiary hospital. Data on EOL care—symptom control and comfort care in an imminently dying state, preparation for death, place of death, and aggressive care in the last month— were reviewed. Results: The 1,456 patients had a median age of 67 years, and 62.5% were men. Patients who died in 2020 were more likely to experience agitation or delirium before death (17.2% vs. 10.9%), to use inotropes/vasopressors near death (59.2% vs. 52.3%), and to receive cardiopulmonary resuscitation in their last months (16.3% vs. 12.5%) than those who died in 2019. Additionally, the number of deaths in the emergency room doubled in 2020 compared to 2019 (from 7.1% to 14.1%). Conclusion This study suggests that EOL care for cancer patients who died in a tertiary hospital deteriorated during the COVID-19 pandemic. The implementation of medical care at the EOL and the preferred place of death should be discussed carefully in advance for high-quality EOL care.

Objectives: This study developed a battery test that allows a comprehensive evaluation of depressive symptoms and related protective-vulnerable factors to screen for depression and mental health and examined the reliability and validity of the test. Methods: PROtective and Vulnerable factors battEry test (PROVE) consisting of five sub-sections was developed: depressive symptomatology (PROVE-DS), suicide risk (PROVE-SR), and three protective-vulnerable factors, which were adult attachment type (PROVE-ATT), adverse childhood experience (PROVE-ACE), and mentalization capacity (PROVE-MC). Two hundred and thirteen subjects completed the PROVE test and other comparative scales, and the analysis was carried out based on the data. Results: The PROVE test showed good convergent, discriminant, and concurrent validity as well as adequate internal consistency. In addition, five sub-sections of the PROVE test showed significant relevance to each other. Conclusion The results of this study indicate that the PROVE test is a reliable and valid test, which will be useful for the prevention, evaluation, and treatment of depression in various clinical settings.

Background: People face many obstacles to overcoming crisis in life and proactively manage life crises. This study aimed to evaluate the association of self-management strategy with subjective health and well-being for the general South Korean population. Methods: We recruited 1,200 respondents using an equal-probability sampling method from March to May 2018. A questionnaire including life version of the Smart Management Strategy for Health Assessment Tool (SAT-Life), the five Health Status Questionnaire, Short Form-12, McGill Quality of Life Questionnaire (MQOL), Patient Health Questionnaire-9 (PHQ-9), and Satisfaction With Life Scale (SWLS) was administered to participants. Results: In multiple stepwise logistic regression model adjusted with basic demographic variables (age, sex, region, education and monthly income level), core strategy was independently associated with physical, mental, social, spiritual, and general health status (adjusted odds ratios [aORs], 1.97–2.92). Preparation strategy was independently associated with physical, mental, spiritual, and general health status (aORs, 2.36–3.31). Implementation strategy was independently associated with physical, social, spiritual, and general health status (aORs, 2.22–2.42). Core strategy and implementation strategy were independently associated with higher Physical Component Score (aORs, 2.21–2.29) and higher Mental Component Score (aORs, 1.68–1.76). Core strategy and preparation strategy were independently associated with lower PHQ-9 (aORs, 2.63–3.74). Pearson's correlation coefficients between scores on SAT-Life and the other factors (MQOL social support, MQOL spiritual well-being, and SWLS) explain having significant correlations ranging from 0.41–0.43. Conclusion Self-management strategies of health might be encouraged to manage subjective health and well-being outcomes.

Objectives: This study developed a battery test that allows a comprehensive evaluation of depressive symptoms and related protective-vulnerable factors to screen for depression and mental health and examined the reliability and validity of the test. Methods: PROtective and Vulnerable factors battEry test (PROVE) consisting of five sub-sections was developed: depressive symptomatology (PROVE-DS), suicide risk (PROVE-SR), and three protective-vulnerable factors, which were adult attachment type (PROVE-ATT), adverse childhood experience (PROVE-ACE), and mentalization capacity (PROVE-MC). Two hundred and thirteen subjects completed the PROVE test and other comparative scales, and the analysis was carried out based on the data. Results: The PROVE test showed good convergent, discriminant, and concurrent validity as well as adequate internal consistency. In addition, five sub-sections of the PROVE test showed significant relevance to each other. Conclusion The results of this study indicate that the PROVE test is a reliable and valid test, which will be useful for the prevention, evaluation, and treatment of depression in various clinical settings.

While recently extending that research, however, the authors discovered that 236 members of the general population were mistakenly to be duplicated by the investigating agency (Word Research) and 1,241 were reported rather than 1,005. The authors present corrections and discuss the relevant data. The authors wish to apologize to the publisher and readers of Journal of Korean Medical Science for these errors.

0.05). The area under the receiver operating characteristics curve (AUC) was 0.922 [95% confidence interval (CI) 0.89–0.95]. In external validation, the discrimination was good, with an AUC value of 0.833 (95% CI 0.70–0.92) for this model. Nomogram calibration plots indicated good agreement between the predicted and observed outcomes, exhibiting close approximation between the predicted and observed probability.CONCLUSION: We constructed a scoring model for predicting massive transfusion during cesarean section in women with placenta previa. This model may help in determining the need to prepare an appropriate amount of blood products and the optimal timing of blood transfusion.]]>
Area Under Curve ; Blood Transfusion ; Calibration ; Cesarean Section ; Cohort Studies ; Discrimination (Psychology) ; Early Intervention (Education) ; Erythrocytes ; Female ; Humans ; Logistic Models ; Maternal Age ; Nomograms ; Placenta Previa ; Placenta ; Placentation ; Postpartum Hemorrhage ; Pregnancy ; ROC Curve ; Ultrasonography

While recently extending that research, however, the authors discovered that 236 members of the general population were mistakenly to be duplicated by the investigating agency (Word Research) and 1,241 were reported rather than 1,005. The authors present corrections and discuss the relevant data. The authors wish to apologize to the publisher and readers of Journal of Korean Medical Science for these errors.