• Tuberculosis and Respiratory Diseases
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• 제86권2호
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• pp.102-110
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• 2023

Coronavirus disease 2019 (COVID-19) has become a major health burden worldwide, with over 600 million confirmed cases and 6 million deaths by 15 December 2022. Although the acute phase of COVID-19 management has been established, the long-term clinical course and complications due to the relatively short outbreak is yet to be assessed. The current COVID-19 pandemic is causing significant morbidity and mortality around the world. Interestingly, epidemiological studies have shown that fatality rates vary considerably across different countries, and men and elderly patients are at higher risk of developing severe diseases. There is increasing evidence that COVID-19 infection causes neurological deficits in a substantial proportion to patients suffering from acute respiratory distress syndrome. Furthermore, lack of physical activity and smoking are associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) susceptibility. We should therefore explore why lack of physical activity, smoking, etc causing a population more susceptible to SARS-CoV-2 infection, and mechanism involved. Thus, in this review article, we summarize epidemiological evidence related to risk factors and lifestyle that affect COVID-19 severity and the mechanism involved. These risk factors or lifestyle interventions include smoking, cardiovascular health, obesity, exercise, environmental pollution, psychosocial social stress, and diet.

• 대한한의학회지
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• 제28권3호통권71호
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• pp.207-215
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• 2007

Objectives : The objective of this study was to assess whether there were sex differences in stroke types, risk factors, warning signs, and stroke complications among patients with first-ever stroke. Methods : Six-hundred seventy six patients with first-ever stroke were recruited at the Department Cardiovascular and Neurologic Diseases (Stroke center) of KyungHee University Oriental Hospital, DongGuk University International Hospital, and Kyungwon University In-cheon Oriental Medical Hospital from September 2005 to June 2007. Patients were hospitalized within 28 days after the onset of stroke. We investigated their stroke types, ischemic stroke subtypes by TOAST classification, risk factors, warning signs, stroke complications, general characteristics such as age, sex, etc. Results : Overall, 347 patients were male and 279 female. Compared with males, female patients were significantly older (mean age 67.3${\pm}$1.1 versus 62.4${\pm}$1.6 years) (P=0.000). We did not find significant sex differences in stroke types or ischemic stroke subtypes by TOAST classification. History of hypertension was significantly more frequent in female than male patients (P=0.000). Among stroke complications, urinary tract infection was significantly more frequent in female than male patients (P=0.003). Among warning signs, blepharospasm was significantly more frequent in female than male patients (P=0.006). Conclusions : Knowledge of sex differences of stroke patients can help us gain better insights on the characteristics of stroke patients. We need further and larger scale research to acquire more concrete conclusions on this theme.

• Environmental Analysis Health and Toxicology
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• 제31권
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• pp.18.1-18.8
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• 2016

Objectives This study aimed to evaluate the risk factors associated with depression and suicidal ideation in a rural population. Methods A survey was conducted with 543 farmers from Chungcheongnam-do Province using the Center for Epidemiologic Studies Depression Scale (CES-D) for depression, Lubben Social Network Scale (LSNS) for social support, Swedish Q16 for neurotoxicity symptoms and a survey tool for farmer's syndrome. Results After adjusting for socioeconomic factors using logistic regression analysis, poor self-rated health, low social support and neurotoxicity were positively associated with the risk of depression (odds ratio [OR], 15.96; 95% confidence interval [CI], 3.11 to 81.97; OR, 3.14; 95% CI, 1.26 to 7.82; and OR, 3.68; 95% CI, 1.08 to 12.57, respectively). The risk of suicidal ideation significantly increased with low social support, neurotoxicity and farmer's syndrome (OR, 2.28; 95% CI, 1.18 to 4.40; OR, 6.17; 95% CI, 2.85 to 13.34; and OR, 3.70; 95% CI, 1.51 to 9.07, respectively). Conclusions Given the overall results of this study, there is a need to establish programs which can improve the health and social relationships of farmers. Also, when farmers have neurological symptoms from pesticide exposure and characteristic symptoms of farmer's syndrome, a monitoring system for depression and suicide must be made available.

• Journal of Korean Neurosurgical Society
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• 제50권6호
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• pp.492-496
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• 2011

Objective : Direct revascularization surgery is regarded as the most effective method of treatment of adults with moyamoya disease. These patients, however, have a higher risk of perioperative ischemic complications than do patients with atherosclerotic stroke, and are at risk for ischemic complications in the hemisphere contralateral to the one operated on. We investigated the incidence and risk factors for ischemic stroke in the contralateral hemisphere after surgical treatment of adults with moyamoya disease. Methods : We retrospectively reviewed the medical records and results of neuroimaging studies on 79 hemispheres of 73 consecutive patients with adult moyamoya disease ($mean{\pm}SD$ age, $37.96{\pm}11.27$ years; range, 18-62 years) who underwent direct bypass surgery over 6 years. Results : Ischemic complications occurred in 4 of 79 (5.1%) contralateral hemispheres, one with Suzuki stage 3 and three with Suzuki stage 4. Three patients showed posterior cerebral artery (PCA) involvement by moyamoya vessels. Advanced stage of moyamoya disease (Suzuki stages 4/5/6; $p$=0.001), PCA involvement ($p$=0.001) and postoperative hypotension (mean arterial blood pressure <80% of preoperative mean arterial blood pressure) on the first ($p$<0.0001) and second ($p$=0.003) days after surgery were significantly correlated with postoperative contralateral ischemic complications. Conclusion : In patients with advanced moyamoya disease and involvement of the PCA, intentional hypotension can result in ischemic stroke in the hemisphere contralateral to the one operated on. Careful control of perioperative blood pressure is crucial for good surgical results.

• 임상간호연구
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• 제23권3호
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• pp.350-360
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• 2017

Purpose: The purpose of this study was to investigate the present status of falls among inpatients in general hospitals and to identify the fall risk factors that reflect the characteristics of domestic hospitals. Methods: Data were collected between December 15, 2016 and January 15, 2017 from 32 Korean hospitals having 500 or more beds. First, 42 risk factors were extracted based on literature review and expert opinions. Then the importance of each factor was evaluated by 223 nurses from medical and surgical adult ward and intensive care units in 40 hospitals. Results: The incidence rate of falls in 18 hospitals was 3.87 per 1,000 total discharged patients and 0.55 per 1,000 patient-days, and the rate of injury-related falls was 40.5%. Major risk factors for falling were identified as the following: being over 65 years of age, history of falls during admission, physical mobility disorders requiring assistance, physical factors (dizziness or vertigo, unstable gait, general weakness, walking aids, visual problems), cognitive factors (delirium, lack of understanding on limitations), neurological disease, CNS medications Conclusion: The findings provide information that can be in the development of a fall risk assessment tool for inpatients in general hospitals in Korea.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제7권1호
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• pp.92-109
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• 1996

본 연구에서는 정상 지능 범위의 만성 특발성 경련 질환으로 치료중인 40명의 환아군과, 나이, 성별, 학업 성적, 지능 지수를 일치시킨 30명의 대조군을 대상으로, 국내외를 통해 신뢰도 및 타당도가 확인된 평가 도구들인, 부모용 아동 행동 조사표(Child Behavior Checklist)의 한국판, DSM-III-R에 따른 파탄적 행동 장애 척도(Disruptive behavior disorders scale according to DBM-III-R)의 한국판, 예일 아동 평가표(Yale children's inventory)의 한국판, 소아 우울 척도(Children's Depression Inventory)의 한국촌, 소아용 상태 및 특성불안 척도(State-Trait Anxiety Inventory for children)의 한국판, 피어스-해리스 자기 개념 척도(Piers-Harris self-concept questionnaire)의 한국판. 가정 환경 척도(Family environment Scale)의 한국판, 간이 정신진단 검사(Symptom check-list-90)의 한국판, 경련질환에 대한 부모태도 척도(Parent's attitude to epilepsy questionnaire)의 한국판, 아동 의존척도(self-administered dependency questionnaire)의 한국판을 사용하였고, 이들 결과로 부터 얻은 자료의 일부인 환아의 정신병리 부분과 경련 질환의 신경과적인 변수들인 환아의 성별 및 나이, 경련 질환 발병시 나이와 유병기간, 경련질환의 임상적 유형, 뇌파의 유형 최근 6개월간의 경련 빈도, 항경련 약물 치료력과 그 반응등과의 관련성을 평가하였다. 위에서 얻은 자료들을 토대로 분석하여 다음과 같은 연구 결과를 얻었다. 환아의 우울과 관계된 위험 요인은, 조기 발병(early onset), 복합성 부분 간질(complex partial seizure), 뇌파상 편측성 측두엽 이상(lateralized temporal focal abnormality in EEG), 약물 병합 투여(drug polypharmacy), 고 빈도 경련(high seizure frequency)임을 알 수 있었고, 이들 위험요인들은 상호 연관되어 있었다. 불안에 영향을 미치는 요인은 높은 연령. 뇌파상 편측성 측두엽 이상, 고 빈도 경련이었고, 학습 및 언어적 문제와 관련이 있는 위험 요인은 환아의 어린나이, 조기 발병, 복합성 부분 간질, 고빈도 경련 등이었다. 주의력 결핍 과잉행동 장애와 반항 및 품행장애에 영향을 미치는 위험 요인은 남성, 어린 나이, 조기 발병, 뇌파상 편측성 측두엽 이상, 고 빈도 경련등이었다. 위의 결과를 종합하면, 우울, 불안, 품행장애 및 주의력 결핍 과잉 행동장애에 공통적으로 관계되는 위험요인은, 뇌파상 편측성 측두엽 이상, 고 빈도 경련이라는 겻을 알 수 있었다. 향후 연구를 통해서는 신경학적 요인이외에 가족 및 사회-인구학적 위험 요인을 찾는 연구가 지속되어야 하며, 이를 통해 종합적 위험 요인 평가 작업과 치료적 대안을 제시하는 후속 작업이 지속 되어야 할 것 이다.

• Asian Spine Journal
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• 제12권6호
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• pp.1100-1105
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• 2018

Study Design: Prospective observational study. Purpose: To determine the incidence of postoperative urinary retention (POUR) in patients undergoing elective posterior lumbar spine surgery and identify the risk factors associated with the development of POUR. Overview of Literature: POUR following surgery can lead to detrusor dysfunction, urinary tract infections, prolonged hospital stay, and a higher treatment cost; however, the risk factors for POUR in spine surgery remain unclear. Methods: A prospective, consecutive analysis was conducted on patients undergoing elective posterior lumbar surgery in the form of lumbar discectomy, lumbar decompression, and single-level lumbar fusions during a 6-month period. Patients with spine trauma, preoperative neurological deficit, previous urinary disturbance/symptoms, multiple-level fusion, and preoperative catheterization were excluded from the study. Potential patient- and surgery-dependent risk factors for the development of POUR were assessed. Univariate analysis and a multiple logistical regression analysis were performed. Results: A total of 687 patients underwent posterior lumbar spine surgery during the study period; among these, 370 patients were included in the final analysis. Sixty-one patients developed POUR, with an incidence of 16.48%. Significant risk factors for POUR were older age, higher body mass index (BMI), surgery duration, intraoperative fluid administration, lumbar fusion versus discectomy/decompression, and higher postoperative pain scores (p<0.05 for all). Sex, diabetes, and the type of inhalational agent used during anesthesia were not significantly associated with POUR. Multiple logistical regression analysis, including age, BMI, surgery duration, intraoperative fluid administration, fusion surgery, and postoperative pain scores demonstrated a predictive value of 92% for the study population and 97% for the POUR group. Conclusions: POUR was associated with older age, higher BMI, longer surgery duration, a larger volume of intraoperative fluid administration, and higher postoperative pain scores. The contribution of postoperative pain scores in the multiple regression analysis was a significant predictor of POUR.

• 대한간호학회지
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• 제44권5호
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• pp.573-580
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• 2014

Purpose: This study was conducted to analyze intubation survival rates according to characteristics and to identify the risk factors affecting deliberate self-extubation. Methods: Data were collected from patients' electronic medical reports from one hospital in B city. Participants were 450 patients with endotracheal intubation being treated in intensive care units. The collected data were analyzed using Kaplan-Meier estimation, Log rank test, and Cox's proportional hazards model. Results: Over 15 months thirty-two (7.1%) of the 450 intubation patients intentionally extubated themselves. The patients who had experienced high level of consciousness, agitation. use of sedative, application of restraints, and day and night shift had significantly lower intubation survival rates. Risk factors for deliberate self-extubation were age (60 years and over), unit (neurological intensive care), level of consciousness (higher), agitation, application of restraints, shift (night), and nurse-to-patient ratio (one nurse caring for two or more patients). Conclusion: Appropriate use of sedative drugs, effective treatment to reduce agitation, sufficient nurse-to-patient ratio, and no restraints for patients should be the focus to diminish the number of deliberate self-extubations.

• Journal of Korean Neurosurgical Society
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• 제41권4호
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• pp.236-240
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• 2007

Objective : The aim of this study is to analyze on the external ventricular drainage [EVD] related ventriculitis, especially on their risk factors, management, and prevention. Methods : From January 2003 to December 2005, a total of 174 EVD catheters were placed in 112 patients at our institution. Of these patients, EVD-related ventriculitis were developed in 15 cases. Clinical variables such as age, sex, prior clinical diagnosis, placement of EVD insertion, duration of EVD, total numbers of EVD per person, and outcome were analyzed in theses cases to verify the risk factors, causative agents and outcomes. Results : Fifteen cases of EVD related ventriculitis were noted presenting infection incidence of 13.39 % per patient and 8.62% per procedure. Of these, five patients died from sepsis, seven patients were recovered from infection but neurological complications remained and three patients were recovered without any complications. Microbes were obtained from cerebrospinal fluid only in six patients. Acinetobactoer baumanii was the most common pathogen in our study [4 cases]. Among the various risk factors, only the prior clinical diagnosis showed the statistical significance. Patients who underwent decompressive craniectomy after severe brain trauma showed unfavorable outcome because of possible contaminative environment compared with other cases. Conclusion : EVD is considered as a safe procedure with good control of intracranial pressure if meticulous care is provided for EVD procedure and maintenance. With regards to risk factors and prevention, the higher incidence and unfavorable outcome was seen especially in patients with severe head trauma. Thus, special attention is required in these clinical settings.

• 중환자간호학회지
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• 제13권3호
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• pp.62-74
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• 2020

Purpose : This study aimed to investigate the prevalence and risk factors of mental health problems in patients discharged from the intensive care unit (ICU). Methods : This was a secondary analysis study using data from a multicenter prospective cohort of post-ICU patients. We analyzed data of 311 patients enrolled in the primary cohort study who responded to the mental health questionnaire three months after the discharge. Anxiety and depression were measured on the Hospital Anxiety-Depression Scale, and post-traumatic stress disorder (PTSD) was measured on the Posttraumatic Diagnostic Scale. Results : The prevalence of anxiety, depression, and PTSD in patients at three months after ICU discharge were 25.7%, 17.4%, and 18.0%, respectively, and 7.7% of them experienced all three problems. Unemployment (OR=1.99, p=.033) and unplanned ICU admission (OR=2.28, p=.017) were risk factors for depression, while women gender (OR=2.34, p=.009), comorbid diseases (OR=2.88, p=.004), non-surgical ICUs (trauma ICU: OR=7.31, p=.002, medical ICU: OR=3.72, p=.007, neurological ICU: OR=2.95, p=.019) and delirium (OR=2.89, p=.009) were risk factors for PTSD. Conclusion : ICU nurses should proactively monitor risk factors for post-ICU mental health problems. In particular, guidelines on the detection and management of delirium in critically ill patients should be observed.