Objectives: This paper provides evidence for the improvement of the local and national longterm psychiatric emergency response system by analyzing emergency response cases for psychiatric crisis intervention conducted over three years at the Jeonbuk State Mental Health Welfare Center. Methods: From August 1, 2020, to December 31, 2023, 314 cases of emergency response for psychiatric crisis intervention were analyzed. The analysis included factors such as gender, age, marital status, location, classification of psychiatric crises, referral pathways, intervention response time, counseling history, location of intervention, types of mental health issues, types of suicidal issues, psychiatric treatment history, suicide plans and attempts, outcomes of major interventions, levels of depression, alcohol consumption, and suicidal behavior. Results: The emergency response for psychiatric crisis intervention had a higher proportion of suicide counseling compared to general mental health emergencies, and most cases were referred through administrative agencies such as the police and fire department. The majority of intervention targets were first-time counselees, classified as high-risk individuals because of depression, alcohol consumption, and suicidal behavior, and either discontinued or were maintaining medication treatment. Conclusion This study illustrated the major role of emergency response in psychiatric crisis intervention and the need for strengthening networks with police, fire departments, and relevant agencies, and improving the treatment of care staff and public awareness. In addition, this study provides evidence for predicting risk factors and offering preventive and preemptive measures.

Objectives: This paper provides evidence for the improvement of the local and national longterm psychiatric emergency response system by analyzing emergency response cases for psychiatric crisis intervention conducted over three years at the Jeonbuk State Mental Health Welfare Center. Methods: From August 1, 2020, to December 31, 2023, 314 cases of emergency response for psychiatric crisis intervention were analyzed. The analysis included factors such as gender, age, marital status, location, classification of psychiatric crises, referral pathways, intervention response time, counseling history, location of intervention, types of mental health issues, types of suicidal issues, psychiatric treatment history, suicide plans and attempts, outcomes of major interventions, levels of depression, alcohol consumption, and suicidal behavior. Results: The emergency response for psychiatric crisis intervention had a higher proportion of suicide counseling compared to general mental health emergencies, and most cases were referred through administrative agencies such as the police and fire department. The majority of intervention targets were first-time counselees, classified as high-risk individuals because of depression, alcohol consumption, and suicidal behavior, and either discontinued or were maintaining medication treatment. Conclusion This study illustrated the major role of emergency response in psychiatric crisis intervention and the need for strengthening networks with police, fire departments, and relevant agencies, and improving the treatment of care staff and public awareness. In addition, this study provides evidence for predicting risk factors and offering preventive and preemptive measures.

Objectives: This paper provides evidence for the improvement of the local and national longterm psychiatric emergency response system by analyzing emergency response cases for psychiatric crisis intervention conducted over three years at the Jeonbuk State Mental Health Welfare Center. Methods: From August 1, 2020, to December 31, 2023, 314 cases of emergency response for psychiatric crisis intervention were analyzed. The analysis included factors such as gender, age, marital status, location, classification of psychiatric crises, referral pathways, intervention response time, counseling history, location of intervention, types of mental health issues, types of suicidal issues, psychiatric treatment history, suicide plans and attempts, outcomes of major interventions, levels of depression, alcohol consumption, and suicidal behavior. Results: The emergency response for psychiatric crisis intervention had a higher proportion of suicide counseling compared to general mental health emergencies, and most cases were referred through administrative agencies such as the police and fire department. The majority of intervention targets were first-time counselees, classified as high-risk individuals because of depression, alcohol consumption, and suicidal behavior, and either discontinued or were maintaining medication treatment. Conclusion This study illustrated the major role of emergency response in psychiatric crisis intervention and the need for strengthening networks with police, fire departments, and relevant agencies, and improving the treatment of care staff and public awareness. In addition, this study provides evidence for predicting risk factors and offering preventive and preemptive measures.

Objectives: This paper provides evidence for the improvement of the local and national longterm psychiatric emergency response system by analyzing emergency response cases for psychiatric crisis intervention conducted over three years at the Jeonbuk State Mental Health Welfare Center. Methods: From August 1, 2020, to December 31, 2023, 314 cases of emergency response for psychiatric crisis intervention were analyzed. The analysis included factors such as gender, age, marital status, location, classification of psychiatric crises, referral pathways, intervention response time, counseling history, location of intervention, types of mental health issues, types of suicidal issues, psychiatric treatment history, suicide plans and attempts, outcomes of major interventions, levels of depression, alcohol consumption, and suicidal behavior. Results: The emergency response for psychiatric crisis intervention had a higher proportion of suicide counseling compared to general mental health emergencies, and most cases were referred through administrative agencies such as the police and fire department. The majority of intervention targets were first-time counselees, classified as high-risk individuals because of depression, alcohol consumption, and suicidal behavior, and either discontinued or were maintaining medication treatment. Conclusion This study illustrated the major role of emergency response in psychiatric crisis intervention and the need for strengthening networks with police, fire departments, and relevant agencies, and improving the treatment of care staff and public awareness. In addition, this study provides evidence for predicting risk factors and offering preventive and preemptive measures.

Background: and Purpose Patients with cluster headache (CH) exhibit impaired health-related quality of life (HRQoL). However, there have been few studies related to the HRQoL of patients with CH from Asian backgrounds. This study aimed to determine the impact of CH on HRQoL and to identify the factors affecting HRQoL in patients with CH during cluster periods. Methods: This prospective study enrolled patients with CH from 17 headache clinics in South Korea between September 2016 and February 2021. The study aimed to determine HRQoL in patients with CH using the EuroQol 5 Dimensions (EQ-5D) index and the time trade-off (TTO) method. Age- and sex-matched headache-free participants were recruited as a control group. Results: The study included 423 patients with CH who experienced a cluster period at the time. EQ-5D scores were lower in patients with CH (0.88±0.43, mean±standard deviation) than in the controls (0.99±0.33, p<0.001). The TTO method indicated that 58 (13.6%) patients with CH exhibited moderate-to-severe HRQoL deterioration. The HRQoL states in patients with CH were associated with current smoking patterns, headache severity, frequency, and duration, and scores on the Generalized Anxiety Disorder 7-item scale (GAD-7), Patient Health Questionnaire 9-item scale (PHQ-9), 6-item Headache Impact Test, and 12-item Allodynia Symptom Checklist. Multivariable logistic regression analyses demonstrated that the HRQoL states in patients with CH were negatively correlated with the daily frequency of headaches, cluster period duration, and GAD-7 and PHQ-9 scores. Conclusions Patients with CH experienced a worse quality of life during cluster periods compared with the headache-free controls, but the degree of HRQoL deterioration varied among them. The daily frequency of headaches, cluster period duration, anxiety, and depression were factors associated with HRQoL deterioration severity in patients with CH.

Background: Remimazolam is a new ultra short-acting benzodiazepine originally developed as an improved version of midazolam. Recent studies have demonstrated non-inferiority of remimazolam to propofol in general anesthesia. However, to date, few studies have investigated the induction bolus dose of remimazolam required to achieve general anesthesia. We aimed to determine the 95% effective dose (ED95) of remimazolam bolus required to achieve loss of consciousness (LOC) and the appropriate doses for different age groups. Methods: Patients aged 20–79 years with the American Society of Anesthesiologists physical status of I or II were enrolled in this study. A total of 120 patients were included representing young, middle-aged, and elderly groups. Loss of eyelash reflex and verbal response after the administration of remimazolam was considered successful LOC. The ED95 of remimazolam was determined using a biased coin up-and-down design with sequential allocation and the isotonic regression method. Results: The ED95 of remimazolam for induction of general anesthesia was 0.367 mg/kg (95% CI [0.277, 0.392]) in the young group, 0.369 mg/kg (95% CI [0.266, 0.394]) in the middle-aged group, and 0.249 mg/kg (95% CI [0.199, 0.288]) in the elderly group. During the study period, none of the patients required rescue medications for hypotension or bradycardia. Conclusions This study investigated the ED95 of remimazolam bolus for anesthesia induction. The precise dosing of the ED95 can help maintain hemodynamic stability during the induction of anesthesia.

As a technique mainly hiring in forensic investigation field to identify the descents, craniofacial reconstruction (CFR) is also used in archaeology to create the faces from ancient or medieval human remains, when there is little information about his/her appearance. Eung-Cheok Ko (1531–1605) was a writer and scholar in the mid Joseon period. In January of 2019, His mummified body was found at Gumi, Kyeonsangbuk-do, Korea. The remains were anthropologically examined, and archaeological CFR was also requested for this case. This report reveals the case’s facial reconstruction process and his portrait that is drawn based on the 3-dimensional CFR result.

Objective: The incidence of hip fractures is increasing worldwide with the aging population, causing a challenge to healthcare systems due to the associated morbidities and high risk of mortality. After hip fractures in frail geriatric patients, existing comorbidities worsen and new complications are prone to occur. Comprehensive rehabilitation is essential for promoting physical function recovery and minimizing complications, which can be achieved through a multidisciplinary approach. Recommendations are required to assist healthcare providers in making decisions on rehabilitation post-surgery. Clinical practice guidelines regarding rehabilitation (physical and occupational therapies) and management of comorbidities/complications in the postoperative phase of hip fractures have not been developed. This guideline aimed to provide evidence-based recommendations for various treatment items required for proper recovery after hip fracture surgeries. Methods Reflecting the complex perspectives associated with rehabilitation post-hip surgeries, 15 key questions (KQs) reflecting the complex perspectives associated with post-hip surgery rehabilitation were categorized into four areas: multidisciplinary, rehabilitation, community-care, and comorbidities/complications. Relevant literature from four databases (PubMed, EMBASE, Cochrane Library, and KoreaMed) was searched for articles published up to February 2020. The evidence level and recommended grade were determined according to the grade of recommendation assessment, development, and evaluation method. Results A multidisciplinary approach, progressive resistance exercises, and balance training are strongly recommended. Early ambulation, weigh-bearing exercises, activities of daily living training, community-level rehabilitation, management of comorbidities/complication prevention, and nutritional support were also suggested. This multidisciplinary approach reduced the total healthcare cost. Conclusion This guideline presents comprehensive recommendations for the rehabilitation of adult patients after hip fracture surgery.

Background: and Purpose Epidemiologic data suggest that cluster headache (CH) is significantly associated with cigarette smoking. The aim of this study was to determine differences in features between patients with a smoking history and those who are never-smokers, using data from a prospective multicenter registry. Methods: Data used in this study were obtained from the Korean Cluster Headache Registry that collected data from consecutive patients diagnosed with CH. We compared clinical and demographic features between ever-smokers (current or former smokers) and never-smokers. Results: This study enrolled 250 patients who were diagnosed with CH, of which 152 (60.8%) were ever-smokers and 98 (39.2%) were never-smokers. The age at CH onset was significantly lower in the never-smoker group than in the ever-smoker group [27.1±12.9 years vs. 30.6± 10.9 years (mean±standard deviation), p=0.024]. Seasonal rhythmicity (58.1% vs. 44.7%, p= 0.038) and triptan responsiveness (100% vs. 85.1%, p=0.001) were higher in never-smokers, while other clinical features such as pain severity, duration, attack frequency, and associated autonomic symptoms did not differ significantly between the groups. The male-to-female ratio was markedly higher in ever-smokers (29.4:1) than in never-smokers (1.7:1). Conclusions Most of the clinical features did not differ significantly between patients with a smoking history and never-smokers. However, the age at CH onset, sex ratio, and seasonal rhythmicity were significantly associated with smoking history.

Objective: The incidence of hip fractures is increasing worldwide with the aging population, causing a challenge to healthcare systems due to the associated morbidities and high risk of mortality. After hip fractures in frail geriatric patients, existing comorbidities worsen and new complications are prone to occur. Comprehensive rehabilitation is essential for promoting physical function recovery and minimizing complications, which can be achieved through a multidisciplinary approach. Recommendations are required to assist healthcare providers in making decisions on rehabilitation post-surgery. Clinical practice guidelines regarding rehabilitation (physical and occupational therapies) and management of comorbidities/complications in the postoperative phase of hip fractures have not been developed. This guideline aimed to provide evidence-based recommendations for various treatment items required for proper recovery after hip fracture surgeries. Methods Reflecting the complex perspectives associated with rehabilitation post-hip surgeries, 15 key questions (KQs) reflecting the complex perspectives associated with post-hip surgery rehabilitation were categorized into four areas: multidisciplinary, rehabilitation, community-care, and comorbidities/complications. Relevant literature from four databases (PubMed, EMBASE, Cochrane Library, and KoreaMed) was searched for articles published up to February 2020. The evidence level and recommended grade were determined according to the grade of recommendation assessment, development, and evaluation method. Results A multidisciplinary approach, progressive resistance exercises, and balance training are strongly recommended. Early ambulation, weigh-bearing exercises, activities of daily living training, community-level rehabilitation, management of comorbidities/complication prevention, and nutritional support were also suggested. This multidisciplinary approach reduced the total healthcare cost. Conclusion This guideline presents comprehensive recommendations for the rehabilitation of adult patients after hip fracture surgery.