• Title/Summary/Keyword: Emergency room visit

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Case of Acute Hemolytic Transfusion Reaction due to Anti-Fya Alloantibody in a Patient with Autoimmune Hemolytic Anemia (자가면역용혈환자에서 항-Fya 동종항체에 의한 급성용혈성수혈반응 1예)

  • Choi, Seung Jun;Nah, Hyunjin;Kim, Yundeok;Kim, Sinyoung;Kim, Hyun Ok
    • The Korean Journal of Blood Transfusion
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    • v.29 no.3
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    • pp.320-327
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    • 2018
  • A 72-year-old man with general weakness visited the outpatient clinic of the hematology department. The patient had been treated under the diagnosis of autoimmune hemolytic anemia for 2 years. His hemoglobin level at the time of the visit was 6.3 g/dL, and a blood transfusion was requested to treat his anemia. The patient's blood type was A, RhD positive. Antibody screening and identification test showed agglutination in all reagent cells with a positive reaction to autologous red blood cells (RBCs). He had a prior transfusion history with three least incompatible RBCs. The patient returned home after receiving one unit of leukoreduced filtered RBC, which was the least incompatible blood in the crossmatching test. After approximately five hours, however, fever, chills, dyspnea, abdominal pain, and hematuria appeared and the patient returned to the emergency room next day after the transfusion. The $anti-Fy^a$ antibody, which was masked by the autoantibody, was identified after autoadsorption using polyethylene glycol. He was diagnosed with an acute hemolytic transfusion reaction due to $anti-Fy^a$ that had not been detected before the transfusion. In this setting, it is necessary to consider the identification of coexisting alloantibodies in patients with autoantibodies and to become more familiar with the method of autoantibody adsorption.

Prevalence of and Coping Patterns for Allergic Diseases in Preschool and School-age Children in Nam-gu, Ulsan (울산광역시 남구 지역의 미취학 및 학령기 아동의 알레르기질환 유병률 및 대처 양상)

  • Im, Dasom;Pyo, Jeehee;Ock, Minsu
    • Journal of the Korean Society of School Health
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    • v.34 no.3
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    • pp.133-150
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    • 2021
  • Purpose: The epidemiologic understanding of allergic diseases, including prevalence and risk factors, is needed for allergy management. This study identified the prevalence of and coping patterns for various types of allergies, such as asthma, allergic rhinitis (AR), atopic dermatitis (AD), allergic conjunctivitis (AC), food allergy (FA), and drug allergy (DA), in Nam-gu, Ulsan, one of the most industrialized districts in Korea. Methods: A cross-sectional study was performed using a self-report multiple choice questionnaire. The International Study of Asthma and Allergies in Childhood (ISAAC) and other measures were reviewed to develop the questionnaire. Data was collected from May 9th to November 30th of 2018. Descriptive and frequency analyses were performed to apprehend the prevalence of symptoms, diagnostic rates, diagnosis dates, treatment history, and others. Results: By randomized sampling, 9,102 children from 25 nurseries, 25 kindergartens, and 15 elementary schools participated in the study. The prevalence of asthma, AR, AD, AC, FA, and DA were 11.1%, 48.7%, 15.5%, 17.6%, 15.1%, and 2.0%, respectively. The respective rate of ever being diagnosed with asthma, AR, AD, AC, FA, and DA were 4.2%, 38.4%, 25.5%, 23.3%, 9.7%, and 1.1%, respectively. Last year's allergy related school absenteeism rates were 10.8%, 4.1%, and 1.3% for asthma, AR, and AD, respectively. Lastly, 59.2% of the participants considered air pollution as the most challenging factor in allergy management. Conclusion: This study comprehensively investigated the current state of various allergic diseases in Nam-gu, Ulsan. The study's findings are expected to be applied to strategies for decreasing the socioeconomic burden of allergic diseases.

Anxiety Hastened Depressive Recurrence in Bipolar Disorder : An Interim Analysis of Prospective Follow-Up Study (양극성 장애 환자에서 불안이 질병 경과에 미치는 영향 : 전향적 추적관찰에 대한 중간분석)

  • Kim, Soojeong;Kim, So Jeong;Song, Hye Hyun;Lee, Wonhye;Chon, Myong-Wuk;Nam, Yoon Young;Park, Dong Yeon
    • Korean Journal of Biological Psychiatry
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    • v.28 no.1
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    • pp.13-22
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    • 2021
  • Objectives Despite growing attention to anxiety in bipolar disorder (BD), little research has assessed anxiety symptoms in the course of BD. The current prospective follow-up study examines the influence of subjectively and objectively measured anxiety symptoms on the course of BD. Methods A total of 49 patients with BD were followed-up prospectively for average of one year at an average of four months interval. The Korean version of the Beck Anxiety Inventory (K-BAI), the Hamilton Anxiety Rating Scale, heart rate variability (HRV) were used to measure anxiety subjectively, objectively and physiologically. Participants were divided into high and low anxiety groups based on their K-BAI scores. Kaplan-Meier survival analysis was performed to compare the recurrence of mood episode, suicide attempt, emergency room visit, and psychiatric hospitalization between two groups. Mediators were investigated with Cox proportional hazards models. Results Compared to the low anxiety group, the high anxiety group reported significantly higher impulsiveness (p = 0.016) and lower high frequency component on HRV (p = 0.007) after controlling for severity of BD. Regarding survival analysis, the high anxiety group showed hastened depressive episode recurrence (p = 0.048) and suicidal ideation was the mediator of the hazard ratio (HR) 1.089 (p = 0.029) in the Cox model. Moreover, the high anxiety group showed a tendency of accelerated suicide attempt (p = 0.12) and impulsivity was the risk factor of suicide attempt (HR = 1.089, p = 0.036). Conclusions This interim analysis of prospective study suggests that high anxiety level in BD may anticipate unfavorable course. Further studies are needed to understand the multifactorial mechanism of anxious bipolar patients.

Perceptions of Quality Nursing care of Patients and Families (질적 간호에 대한 환자와 가족의 지각)

  • Chi, Sung-Ai;Kwon, Sung-Bok;Park, Eun-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.4 no.1
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    • pp.247-275
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    • 1998
  • The purpose of this study was to offer the results of content analysis and qualitative study that explored the perceptions about quality nursing care of patients and families as consumers and to identify the implications of this study for quality nursing care management and research. The data was collected from 12 adult patients and 9 families who were admmitted at medical and surgical nursing unit of one university hospital in Seoul from October, 1996 to January, 1997. Research participants were asked to response "what do you think quality nursing care?" and similar questions during the interviews was performed. Data were analyzed using open coding and content analysis with frequencies and percents of attributes of quality nursing care. Attributes of quality nursing care and meaning of quality nursing care that patients and families perceived were explored. 1. The attributes of quality nursing care that patient and families perceived were categorized into 56 attributes. The highest response rate among the attributes was 'one's heart at ease' (76.2%), and the next high response rates were ranked in order 'consideration' , 'care about' (each 61.9% 'expert skill' (57.1%), 'deal with problem promptly' , 'information offer' (42.9%), 'intimate feeling' (38.1%), 'smile' 'service spirit' , 'do one's best' (each 33.3%), 'frequent visit' (23.8%), 'observe the time' (23.8%), 'direct nursing care' , 'speaking warmly' , give a hope' , 'address kindly' , 'a sense of duty' , 'good facilities' (each 19.0%), 'inquire after a patient health' , 'patient-centered nursing care' , 'showing an example' , 'professional knowledge' , 'careless moraly patient' , 'give encourage to patients' , 'good answer a question' (each 14.3%), 'do not imprudently' , 'do not disregard' , 'broad knowledge' , 'emergency treatment skill' , 'dependability' ,'consolation' giving a sense of security' , 'a self sacrificing spirit' , 'a sense of responsibility' 'hard - working', 'enough disposition of nursing staff (each 9.5%), 'improve patient's pride' and the rest attributes exhibited 4.7%, respectively. 2. The attributes that were identified in patients' data only were 8 categories, 'service sprit' (58.3 %) 'expert knowledge' , 'good answer a question' (each 25.0%), 'hard working' (16.7%), 'a warm character', 'professional attainments', 'do without reserve', 'satisfaction' (each 8.3%), 3. The attributes were identified to families' data only were 31 categories, 'speaking warmly' , 'direct nursing care', 'adress kindly', 'patientcentered nursing care', 'showing an example' (each 33.3%). 'do not imprudently' , 'do not disregard' , 'consolation', 'giving a sense of security', 'broad knowledge' , 'emergency treatment skill', 'dependability' ,'a self - sacrificing spirit', 'a sense of responsibility' (each 22.2%), 'improve patient's pride' , 'without discrimination' , 'show kindness' , 'individual nursing care', 'being with patient' , 'helping' , 'accuracy' , 'without any mistake' , 'love' , 'self - confidence', 'self possession', 'a self - denying spirit' , 'a sense of duty' , 'tighten discipline' , 'disposed room with similar patient to diagnosis', 'compensatory relationship between me dical team' , 'role of connection' (each 11.1 %). 4. The attributes of quality nursing care were integrated into 11 categories that they were 'patientcentered nursing care' (25.1%), 'expertise' (22.1%), 'caring'(18.1%), 'kindness'(11.1%L 'nurse attainments(10.1%), 'sincerity' (7.5%), 'good environment' (2.0%), 'effective organizational management', 'coordination', 'enough nursing staff' ( each 1.0%), 'satisfaction' (0.5%) were showed in the order of the highest rate. 5. The concept of quality nursing care were defined as 'give a satisfaction to patients by patientcentered care based on professional skill and caring with kindness and sincerity'. The description of the meaning of quality nursing care provided by this research participants, patients and families can provide important information for quality nursing care management, medical marketing, education and researches of this field. On the basis of the above findings the following recommendations are made: to suggest to utilize this results for patient care in practice setting, development of quality assessment tool in nursing care, repeat study by the same subjects and method, and to a comparative study by the same method to nurse.

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Factors Affecting Self-efficacy of Cardiopulmonary Resuscitation(CPR) in Adults (일반 성인들의 심폐소생술 자기효능감에 미치는 영향 요인)

  • Jeon, So Youn
    • Journal of agricultural medicine and community health
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    • v.44 no.3
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    • pp.124-137
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    • 2019
  • Objectives: The purpose of this study was factors affecting self-efficacy of cardiopulmonary resuscitation (CPR) in adults. Therefore, the provide basic data for strategy development to improve the performance rate of bystander CPR. Methods: The data were collected from 164,165 adults of the 2016 Korean Community Health Survey. The survey method was 1:1 interview with households, and the survey period was from August 16, 2016 to October 31, 2016. The survey variables were as follows: self-efficacy of CPR, awareness of CPR, training experience of CPR, demographic characteristics, medical characteristics, health promoting behaviors, and safety practices. Results: The rate of self-efficacy of CPR in adults was 60.6%. Factors affecting self-efficacy of CPR were age, sex, residence, education level, occupation, marital status, any CPR training, CPR training within the last 2 years, CPR training with manikin within the last 2 years, emergency room visit within the last 1 year, physical activity status, drive a bicycle, seat belts on rear seat, seat belts when riding a bus were statistically significant. Conclusions: In conclusion, in order to improve the self-efficacy of CPR in adults, the recent experience rate of CPR education, the practice rate of health promotion behavior, and the practice rate of safety behavior should be improved. The government should expand the provision of education programs to improve the self-efficacy of CPR and actively prepare national-level public advertisements strategies.