Background: This study investigates changes in infection control organizations and the roles of infection control nurses in healthcare institutions during the prolonged COVID-19 pandemic. It aims to provide evidence for preparing effective responses to future emerging infectious diseases. Methods: A survey was conducted from August 9 to 27, 2021, targeting infection control nurses working in infection control departments of general hospitals in South Korea with more than 100 beds. Results: A total of 118 (38.3%) healthcare institutions responded, and 113 questionnaires ultimately analyzed. Changes in infection control organizations observed during the COVID-19 pandemic included alterations in infection control department staffing (34.5%), work arrangements (92.0%), IT systems development (45.1%), facilities and equipment (92.9%), and systems for responding to emerging infectious diseases (99.1%). Over 50% of infection control tasks were performed either frequently or daily during the pandemic, with the most significant workload increase observed in epidemiological investigations (77.9%). The most challenging task for infection control nurses was establishing and operating epidemic management systems (82.3%). Among personal factors hindering their work, a sense of responsibility for their duties scored the highest (mean 4.73/5 points). The primary structural and environmental barrier was insufficient staffing (mean 4.36/5 points). The most critical need for improving infection control efforts was increased staffing in infection control departments and enhanced administrative support (mean 4.63/5 points). Conclusion The COVID-19 pandemic brought significant changes to infection control organizations and the roles of infection control nurses. Based on the lessons learned, healthcare institutions must systematically restructure infection control organizations and enhance the expertise of infection control nurses to respond effectively to future outbreaks of emerging infectious diseases.

Background: This study investigates changes in infection control organizations and the roles of infection control nurses in healthcare institutions during the prolonged COVID-19 pandemic. It aims to provide evidence for preparing effective responses to future emerging infectious diseases. Methods: A survey was conducted from August 9 to 27, 2021, targeting infection control nurses working in infection control departments of general hospitals in South Korea with more than 100 beds. Results: A total of 118 (38.3%) healthcare institutions responded, and 113 questionnaires ultimately analyzed. Changes in infection control organizations observed during the COVID-19 pandemic included alterations in infection control department staffing (34.5%), work arrangements (92.0%), IT systems development (45.1%), facilities and equipment (92.9%), and systems for responding to emerging infectious diseases (99.1%). Over 50% of infection control tasks were performed either frequently or daily during the pandemic, with the most significant workload increase observed in epidemiological investigations (77.9%). The most challenging task for infection control nurses was establishing and operating epidemic management systems (82.3%). Among personal factors hindering their work, a sense of responsibility for their duties scored the highest (mean 4.73/5 points). The primary structural and environmental barrier was insufficient staffing (mean 4.36/5 points). The most critical need for improving infection control efforts was increased staffing in infection control departments and enhanced administrative support (mean 4.63/5 points). Conclusion The COVID-19 pandemic brought significant changes to infection control organizations and the roles of infection control nurses. Based on the lessons learned, healthcare institutions must systematically restructure infection control organizations and enhance the expertise of infection control nurses to respond effectively to future outbreaks of emerging infectious diseases.

Background: This study investigates changes in infection control organizations and the roles of infection control nurses in healthcare institutions during the prolonged COVID-19 pandemic. It aims to provide evidence for preparing effective responses to future emerging infectious diseases. Methods: A survey was conducted from August 9 to 27, 2021, targeting infection control nurses working in infection control departments of general hospitals in South Korea with more than 100 beds. Results: A total of 118 (38.3%) healthcare institutions responded, and 113 questionnaires ultimately analyzed. Changes in infection control organizations observed during the COVID-19 pandemic included alterations in infection control department staffing (34.5%), work arrangements (92.0%), IT systems development (45.1%), facilities and equipment (92.9%), and systems for responding to emerging infectious diseases (99.1%). Over 50% of infection control tasks were performed either frequently or daily during the pandemic, with the most significant workload increase observed in epidemiological investigations (77.9%). The most challenging task for infection control nurses was establishing and operating epidemic management systems (82.3%). Among personal factors hindering their work, a sense of responsibility for their duties scored the highest (mean 4.73/5 points). The primary structural and environmental barrier was insufficient staffing (mean 4.36/5 points). The most critical need for improving infection control efforts was increased staffing in infection control departments and enhanced administrative support (mean 4.63/5 points). Conclusion The COVID-19 pandemic brought significant changes to infection control organizations and the roles of infection control nurses. Based on the lessons learned, healthcare institutions must systematically restructure infection control organizations and enhance the expertise of infection control nurses to respond effectively to future outbreaks of emerging infectious diseases.

Background: This study investigates changes in infection control organizations and the roles of infection control nurses in healthcare institutions during the prolonged COVID-19 pandemic. It aims to provide evidence for preparing effective responses to future emerging infectious diseases. Methods: A survey was conducted from August 9 to 27, 2021, targeting infection control nurses working in infection control departments of general hospitals in South Korea with more than 100 beds. Results: A total of 118 (38.3%) healthcare institutions responded, and 113 questionnaires ultimately analyzed. Changes in infection control organizations observed during the COVID-19 pandemic included alterations in infection control department staffing (34.5%), work arrangements (92.0%), IT systems development (45.1%), facilities and equipment (92.9%), and systems for responding to emerging infectious diseases (99.1%). Over 50% of infection control tasks were performed either frequently or daily during the pandemic, with the most significant workload increase observed in epidemiological investigations (77.9%). The most challenging task for infection control nurses was establishing and operating epidemic management systems (82.3%). Among personal factors hindering their work, a sense of responsibility for their duties scored the highest (mean 4.73/5 points). The primary structural and environmental barrier was insufficient staffing (mean 4.36/5 points). The most critical need for improving infection control efforts was increased staffing in infection control departments and enhanced administrative support (mean 4.63/5 points). Conclusion The COVID-19 pandemic brought significant changes to infection control organizations and the roles of infection control nurses. Based on the lessons learned, healthcare institutions must systematically restructure infection control organizations and enhance the expertise of infection control nurses to respond effectively to future outbreaks of emerging infectious diseases.

Two open-label, randomized, two-period crossover studies were conducted to investigate the pharmacokinetic (PK) properties, safety, and bioequivalence of the test formulation (KD4004), a new fixed-dose combination (FDC) formulation of dapagliflozin and metformin extended release (XR) tablets, relative to the reference formulation (10 mg dapagliflozin/1,000 mg metformin XR FDC tablet) in healthy subjects under fasting (Part A) and fed (Part B) conditions. After giving the dose, serial blood samples were collected for a period of 48 hours. Primary PK parameters (AUC 0-t and C max ) were used to assess bioequivalence between two dapagliflozin/metformin XR (10/1,000 mg) FDC formulations under fed and fasting conditions. Safety and tolerability were also evaluated. Part A and Part B were completed by 32 and 37 subjects, respectively. Bioequivalence of the two FDC formulations of dapagliflozin and metformin XR tablets was established in both the fasted and the fed conditions as the 90% confidence interval of the ratios of adjusted geometric means for AUC 0-t and C max were contained within the predefined range of 0.800–1.250 bioequivalence criteria. Single-dose administration of dapagliflozin and metformin XR was safe and well tolerated as the two FDC formulations. In conclusion, both FDC formulations of dapagliflozin and metformin XR tablets were bioequivalent in fed and fasted subjects. All treatments were well tolerated.

A new fixed-dose combination (FDC) formulation of raloxifene 60 mg and cholecalciferol 800 IU was developed to improve the medication compliance and overall efficacy of raloxifene treatment in postmenopausal osteoporosis patients. The aim of this study was to compare the pharmacokinetics between two tablets of FDC formulation of raloxifene/cholecalciferol and the two products administered concomitantly at respective doses. This randomized, open-label, single-dose, two-treatment, two-way crossover study included 46 volunteers. During each treatment period, subjects received the test formulation (FDC formulation containing raloxifene and cholecalciferol) or the reference formulation (co-administration of raloxifene and cholecalciferol), with a 14-d washout period. Serial blood samples were collected periodically over 96 hours after drug intake. In total, 46 subjects completed the study. The geometric mean ratios and its 90% confidence intervals of the FDC to the single agents for the area under the concentration-time curve from zero to the last quantifiable time point and the maximum plasma concentration met the regulatory criteria for bioequivalence: 1.1364 (1.0584–1.2201) and 1.1010 (0.9945–1.2188) for raloxifene and 1.0266 (0.9591–1.0989) and 1.0354 (0.9816–1.0921) for baseline-corrected cholecalciferol, respectively. Both formulations were well tolerated. No significant differences was observed in the incidence of adverse events between the two treatments. It was concluded that two tablets of the newly developed FDC formulation of raloxifene and cholecalciferol and the corresponding two agents administered concomitantly at respective doses were bioequivalent.

β-Lapachone has been reported to have anticancer and various other therapeutic effects, but is limited in clinical applications by its low bioavailability. pH-Dependent isomerization can be suggested as one plausible factor influencing its low bioavailability. Since it is known that β-lapachone is converted to its isomer, α-lapachone in hydrochloric acid (HCl) solution, isomerization in the human body may be driven by HCl in the gastric fluid. The purpose of this study was to evaluate the possibility of isomerization of β-lapachone in the human body. Chemical reactions were conducted using simulated gastric fluid (SGF, pH 1.2) and simulated intestinal fluid (SIF, pH 7.5) at 37°C. β-Lapachone was observed in SGF at 37°C for 1 hour and SIF for 3 hours. In addition, biofluid analysis was performed on plasma samples 1 hour and 4 hours, and on urine sample 12 hours after oral administration of 100 mg MB12066, a synthetic β-lapachone, in healthy adult male. All samples were analyzed using liquid chromatography-tandem mass spectrometry. Only β-lapachone peaks existed in the spectra obtained from SGF and SIF. No isomerization of β-lapachone was observed in the analysis of any of the human samples. In the current study, the possibility of pH-dependent isomerization of β-lapachone in the human body was not confirmed.

Background: There are various reports on the effects of the anesthetic method on neurologic complications. A population-based study was conducted to estimate the effect of anesthetic method on the incidence of postoperative delirium in patients that underwent total hip replacement arthroplasty in South Korea. Methods: The Korean National Health Insurance claims database was used to retrospectively identify and analyze 24,379 cases of total hip replacement arthroplasty, defined as patients having a claim record with the operation code ‘N0711,’ from January 2008 to December 2017. Patients were divided into two groups, a general anesthesia group (n = 9,921) and a regional anesthesia group (n = 14,458). The incidence of delirium was assessed in cases when patients used medications for delirium, such as haloperidol, chlorpromazine, olanzapine, and risperidone. Results: Of the 9,921 patients receiving general anesthesia and 14,458 receiving regional anesthesia, 142 (1.43%) and 209 (0.86%) experienced postoperative delirium after total hip replacement arthroplasty, respectively. There was no significant difference between the groups (P = 0.92). In logistic regression analysis, sex (P = 0.038) and patients with acquired immune deficiency syndrome (P = 0.008) were predictors of postoperative delirium. Conclusions Our results revealed that the anesthetic method was not associated with the incidence of postoperative delirium. In addition, the results suggest that male patients and patients with acquired immune deficiency syndrome undergoing total hip replacement arthroplasty carefully managed for postoperative delirium after surgery.

Purpose: The aim of this study was to investigate celiac plexus neurolysis (CPN) for the treatment of cancerous upper abdominal pain in a tertiary university hospital in Korea. Methods: At the tertiary university hospital in Korea, electronic medical records of cancer patients who underwent CPN and died in the hospital from November 2009 to June 2018 were retrospectively analyzed. Results: The total number of subjects was 51. The 17 patients were from the Department of Gastroenterology (33.0%), followed by 11 patients from the Department of Hemato-oncology (21.6%), 11 patients from the Department of Anesthesia and Pain Medicine (21.6%), 9 patients from the Department of General Surgery (17.6%). The diagnosis was pancreatic cancer in 15 patients (29.4%), stomach cancer in 8 patients (15.7%), hepatobiliary cancer in 20 patients (39.2%), colon cancer in 1 patient (2.0%), esophageal cancer in 2 patient (3.9%) and intra-abdominal metastasis in 5 patients (9.8%). The mean survival time after the surgery was 66.4±55.0 days. The pain intensity before and 1 week after the procedure significantly decreased, but the amounts of opioids consumed before and 1 week after the procedure were not statistically significant. Side effects occurred after the procedure including temporary localized pain in 24 patients (47.0%), hypotension in 12 (23.5%), and diarrhea in 6 (11.8%). Conclusion CPN is an effective and safe procedure for reducing upper abdominal pain caused by cancer, and it is necessary to perform CPN within the appropriate time by establishing a system of interdepartmental cooperation.

This study compared the pharmacokinetics of a fixed-dose combination (FDC) of candesartan (16 mg) and amlodipine (10 mg) versus coadministration of individual formulations to clarify the bioequivalence of the FDC. In this randomized, open-label, single-dose, 2-treatment, 2-way crossover study, healthy Korean volunteers received a single dose of candesartan (16 mg) with amlodipine (10 mg) as either an FDC or single agents concomitantly administered, with a 2-week washout period. Serial blood samples were collected up to 72 hours after dosing for each treatment period, and plasma concentrations of candesartan and amlodipine were measured using a validated liquid chromatography-tandem mass spectrometry method. A total of 39 subjects completed the study. The geometric mean ratios (GMRs) and 90% confidence intervals (CIs) for the area under the plasma concentration-time curve from time 0 to the last measurement (AUC0-t) and the peak plasma concentration (Cmax) for candesartan were 1.0182 (0.9562–1.0841) and 0.9492 (0.8726–1.0324), respectively. The GMR and 90% CI for the AUC0-t and Cmax for amlodipine were 1.0552 (1.0255–1.0857) and 1.0668 (1.0259–1.1094), respectively. In conclusion, the new FDC formulation of candesartan (16 mg) and amlodipine (10 mg) was bioequivalent to the concomitant administration of single agents. A single dose of candesartan/amlodipine as the FDC or as single agents was well tolerated.