Background: Transfusion reactions are major considerations in transfusions. Appropriate transfusion practices are essential to minimize the risk of transfusion reactions, such as using irradiated and leukoreduced blood components for indicated patients. This study examined the effectiveness of an electronic prescription system modification in promoting the appropriate use of these blood components. Methods: The blood component prescription data from seven years (Jan 2016∼Dec 2022) were analyzed retrospectively. The proportion of irradiated units was calculated for each half-year. Each transfusion was categorized by cancer diagnosis, blood component type, and visit type. Statistical comparisons were performed to assess the changes in the use of irradiated blood units and leukoreduced red cell components before and after the system modification. Results: This study analyzed 33,701 blood component prescriptions. The average number of irradiated units per prescription increased significantly from 0.21 to 0.77 after system modification. All patient groups, excluding transfusion in the operating room, showed a significant increase in irradiated unit use (P≤0.001). In addition, the percentage of leukoreduced red cell components increased significantly after the intervention (P<0.001). Conclusion Modification of the electronic prescription system was effective in promoting the appropriate use of irradiated blood components among clinicians. This intervention can reduce transfusion reactions and improve patient outcomes by ensuring the correct selection of blood components for the indicated patients.

Background: Transfusion reactions are major considerations in transfusions. Appropriate transfusion practices are essential to minimize the risk of transfusion reactions, such as using irradiated and leukoreduced blood components for indicated patients. This study examined the effectiveness of an electronic prescription system modification in promoting the appropriate use of these blood components. Methods: The blood component prescription data from seven years (Jan 2016∼Dec 2022) were analyzed retrospectively. The proportion of irradiated units was calculated for each half-year. Each transfusion was categorized by cancer diagnosis, blood component type, and visit type. Statistical comparisons were performed to assess the changes in the use of irradiated blood units and leukoreduced red cell components before and after the system modification. Results: This study analyzed 33,701 blood component prescriptions. The average number of irradiated units per prescription increased significantly from 0.21 to 0.77 after system modification. All patient groups, excluding transfusion in the operating room, showed a significant increase in irradiated unit use (P≤0.001). In addition, the percentage of leukoreduced red cell components increased significantly after the intervention (P<0.001). Conclusion Modification of the electronic prescription system was effective in promoting the appropriate use of irradiated blood components among clinicians. This intervention can reduce transfusion reactions and improve patient outcomes by ensuring the correct selection of blood components for the indicated patients.

Background/Aims: The gut microbiome has emerged as a key player that mechanistically links various risk factors to colorectal cancer (CRC) etiology. However, the role of the gut microbiome in CRC pathogenesis remains unclear. This study aimed to characterize the gut microbiota in healthy controls (HCs) and patients with colorectal adenoma (AD) and CRC in subgroups based on sex and age. Methods: Study participants who visited the hospital for surveillance of CRC or gastrointestinal symptoms were prospectively enrolled, and the gut microbiome was analyzed based on fecal samples. Results: In terms of HC-AD-CRC sequence, commensal bacteria, including lactate-producing (Streptococcus salivarius) and butyrate-producing (Faecalibacterium prausnitzii, Anaerostipes hadrus, and Eubacterium hallii) bacteria, were more abundant in the HC group than in the AD and CRC groups. In the sex comparison, the female HC group had more lactate-producing bacteria (Bifidobacterium adolescentis, Bifidobacterium catenulatum, and Lactobacillus ruminis) than the male HC group. In age comparison, younger subjects had more butyrate-producing bacteria (Agathobaculum butyriciproducens and Blautia faecis) than the older subjects in the HC group.Interestingly, lactate-producing bacteria (B. catenulatum) were more abundant in females than males among younger HC group subjects. However, these sex- and age-dependent differences were not observed in the AD and CRC groups. Conclusions The gut microbiome, specifically lactate- and butyrate-producing bacteria, which were found to be abundant in the HC group, may play a role in preventing the progression of CRC. In particular, lactate-producing bacteria, which were found to be less abundant in healthy male controls may contribute to the higher incidence of CRC in males.

The Korean Society of Infectious Diseases has been regularly developing guidelines for adult immunization since 2007. In 2023, the guidelines for the following seven vaccines were revised: influenza, herpes zoster, pneumococcal, tetanus-diphtheria-pertussis (Tdap), human papillomavirus (HPV), meningococcal, and rabies vaccines. For the influenza vaccine, a recommendation for enhanced vaccines for the elderly was added. For the herpes zoster vaccine, a recommendation for the recombinant zoster vaccine was added. For the pneumococcal vaccine, the current status of the 15-valent pneumococcal conjugate vaccine and 20-valent PCV was described. For the Tdap vaccine, the possibility of using Tdap instead of tetanus-diphtheria vaccine was described. For the HPV vaccine, the expansion of the eligible age for vaccination was described. For the meningococcal vaccine, a recommendation for the meningococcal B vaccine was added. For the rabies vaccine, the number of pre-exposure prophylaxis doses was changed. This manuscript documents the summary and rationale of the revisions for the seven vaccines. For the vaccines not mentioned in this manuscript, the recommendations in the 3rd edition of the Vaccinations for Adults textbook shall remain in effect.

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: Transfusion reactions are major considerations in transfusions. Appropriate transfusion practices are essential to minimize the risk of transfusion reactions, such as using irradiated and leukoreduced blood components for indicated patients. This study examined the effectiveness of an electronic prescription system modification in promoting the appropriate use of these blood components. Methods: The blood component prescription data from seven years (Jan 2016∼Dec 2022) were analyzed retrospectively. The proportion of irradiated units was calculated for each half-year. Each transfusion was categorized by cancer diagnosis, blood component type, and visit type. Statistical comparisons were performed to assess the changes in the use of irradiated blood units and leukoreduced red cell components before and after the system modification. Results: This study analyzed 33,701 blood component prescriptions. The average number of irradiated units per prescription increased significantly from 0.21 to 0.77 after system modification. All patient groups, excluding transfusion in the operating room, showed a significant increase in irradiated unit use (P≤0.001). In addition, the percentage of leukoreduced red cell components increased significantly after the intervention (P<0.001). Conclusion Modification of the electronic prescription system was effective in promoting the appropriate use of irradiated blood components among clinicians. This intervention can reduce transfusion reactions and improve patient outcomes by ensuring the correct selection of blood components for the indicated patients.

Background: Transfusion reactions are major considerations in transfusions. Appropriate transfusion practices are essential to minimize the risk of transfusion reactions, such as using irradiated and leukoreduced blood components for indicated patients. This study examined the effectiveness of an electronic prescription system modification in promoting the appropriate use of these blood components. Methods: The blood component prescription data from seven years (Jan 2016∼Dec 2022) were analyzed retrospectively. The proportion of irradiated units was calculated for each half-year. Each transfusion was categorized by cancer diagnosis, blood component type, and visit type. Statistical comparisons were performed to assess the changes in the use of irradiated blood units and leukoreduced red cell components before and after the system modification. Results: This study analyzed 33,701 blood component prescriptions. The average number of irradiated units per prescription increased significantly from 0.21 to 0.77 after system modification. All patient groups, excluding transfusion in the operating room, showed a significant increase in irradiated unit use (P≤0.001). In addition, the percentage of leukoreduced red cell components increased significantly after the intervention (P<0.001). Conclusion Modification of the electronic prescription system was effective in promoting the appropriate use of irradiated blood components among clinicians. This intervention can reduce transfusion reactions and improve patient outcomes by ensuring the correct selection of blood components for the indicated patients.

Background: The PLASMIC score is a convenient tool for predicting ADAMTS13 activity of ＜10%.Lactate dehydrogenase (LDH) is widely used as a marker of haemolysis in thrombotic thrombocytopenic purpura (TTP) monitoring, and could be used as a replacement marker for lysis. We aimed to validate the PLASMIC score in a multi-centre Asia Pacific region, and to explore whether LDH could be used as a replacement marker for lysis. Methods: Records of patients with thrombotic microangiopathy (TMA) were reviewed. Patients’ ADAMTS13 activity levels were obtained, along with clinical/laboratory findings relevant to the PLASMIC score. Both PLASMIC scores and PLASMIC-LDH scores, in which LDH replaced traditional lysis markers, were calculated. We generated a receiver operator characteristics (ROC) curve and compared the area under the curve values (AUC) to determine the predictive ability of each score. Results: 46 patients fulfilled the inclusion criteria, of which 34 had ADAMTS13 activity levels of ＜10%. When the patients were divided into intermediate-to-high risk (scores 5‒7) and low risk (scores 0‒4), the PLASMIC score showed a sensitivity of 97.1% and specificity of 58.3%, with a positive predictive value (PPV) of 86.8% and negative predictive value (NPV) of 87.5%. The PLASMIC-LDH score had a sensitivity of 97.1% and specificity of 33.3%, with a PPV of 80.5% and NPV of 80.0%. Conclusion Our study validated the utility of the PLASMIC score, and demonstrated PLASMIC-LDH as a reasonable alternative in the absence of traditional lysis markers, to help identify high-risk patients for treatment via plasma exchange.

Purpose: Sex hormones are known to affect the gut microbiota. Previously, we reported that endogenous and exogenous testosterone are associated with colorectal cancer (CRC) development and submucosal invasion. In the present study, we investigated whether the gut microbiota is affected by orchiectomy (ORX) and testosterone propionate (TP) administration using an azoxymethane/dextran sulfate sodium (AOM/DSS)-induced CRC mouse model. Materials and Methods: Gut microbiota was evaluated by means of 16S rRNA gene sequencing of stool DNA extracted from feces that were obtained at 13 weeks after AOM injection (from 22-week-old animals) and stored in a gas-generating pouch. Results: The increase in microbial diversity (Chao1 and Phylogenetic Diversity index) and Firmicutes/Bacteroidetes (F/B) ratio upon AOM/DSS treatment in ORX mice was significantly decreased by TP supplementation. The ratio of commensal bacteria to opportunistic pathogens was lower in the TP-administered females and ORX mice than in the AOM/DSS group. Opportunistic pathogens (Mucispirillum schaedleri or Akkermansia muciniphila) were identified only in the TP group. In addition, microbial diversity and F/B ratio were higher in male controls than in female and ORX controls. Flintibacter butyricus, Ruminococcus bromii, and Romboutsia timonensis showed similar changes in the male control group as those in the female and ORX controls. Conclusion In conclusion, testosterone determines the dysbiosis of gut microbiota, which suggests that it plays a role in the sex-related differences in colorectal carcinogenesis.

Background: Respiratory pathogen infections and air pollution are main causes of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Air pollution has a direct effect on the airway epithelial barrier and the immune system, which can have an influence on infection. However, studies on the relationship between respiratory infections and air pollutants in severe AECOPD are limited. Thus, the objective of this study was to investigate the correlation between air pollution and respiratory pathogen in severe AECOPD. Methods: This multicenter observational study was conducted by reviewing electronic medical records of patients with AECOPD at 28 hospitals in South Korea. Patients were divided into four groups according to the comprehensive air-quality index (CAI) used in Korea. Identification rates of bacteria and viruses of each group were analyzed. Results: Viral pathogens were identified in 270 (36.7%) of 735 patients. Viral identification rate was different (P = 0.012) according to air pollution. Specifically, the virus detection rate was 55.9% in the group of CAI ‘D’ with the highest air pollution. It was 24.4% in the group of CAI ‘A’ with the lowest air pollution. This pattern was clearly seen for influenza virus A (P = 0.042). When further analysis was performed with particulate matter (PM), the higher/lower the PM level, the higher/lower the virus detection rate. However, no significant difference was found in the analysis related to bacteria. Conclusion Air pollution may make COPD patients more susceptible to respiratory viral infections, especially influenza virus A. Thus, on days with poor air quality, COPD patients need to be more careful about respiratory infections.