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Transition from homelessness to becoming housed: A qualitative study
No full textAIM: To explore the transitional experiences of becoming housed from homelessness. DESIGN: A qualitative descriptive study. METHODS: Data were collected during 2017 and 2018 using a semi-structured interview method with 10 former homeless people who became housed at the time of the study. The grounded theory method was used to analyse qualitative data. RESULTS: 'Desire to keep a place to stretch out and lie down' was the basic social problem participants suffered during the transition from homeless to becoming housed. In addition, 'returning to the social world as a person living an ordinary life' was the basic social process that emerged as a core category. The process was divided into four phases: (1) being discarded from everyday life in the social world, (2) struggling to reconnect with society and (3) returning to the social world as a person living an ordinary life. CONCLUSION: The transition from homelessness to becoming housed is a significant experience for individuals that involves holistic changes. Community health nurses should consider their practical needs based on client views. IMPACT: What problem did the study address? This study explored the experiences of transitioning from homelessness to becoming housed among post-homeless individuals. What were the main findings? While moving from homelessness to becoming housed, homeless people experienced returning to the social world as a person living an ordinary life. They were also shown to go through the process of four stages. Where and on whom will the research have an impact? This study will contribute to suggesting a direction for self-reliance-based interventions among people who are homeless. Additionally, the findings will provide primary data to develop a program for social integration. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution
18F-FDG PET/CT in Inflammation and Infection: Procedural Guideline by the Korean Society of Nuclear Medicine
No full textThis guideline outlines the use of (18)F-fluoro-2-deoxyglucose positron emission tomography / computed tomography for the diagnosis and management of infectious and inflammatory diseases. It provides detailed recommendations for healthcare providers on patient preparation, imaging procedures, and the interpretation of results. Adapted from international standards and tailored to local clinical practices, the guideline emphasizes safety, quality control, and effective use of the technology in various conditions, including spinal infections, diabetic foot, osteomyelitis, vasculitis, and cardiac inflammation. The aim is to assist nuclear medicine professionals in delivering accurate diagnoses and improving patient outcomes while allowing flexibility to adapt to individual patient needs, technological advancements, and evolving medical knowledge. This document is a comprehensive resource for enhancing the quality and safety of (18)F-fluoro-2-deoxyglucose positron emission tomography / computed tomography for the evaluation of infectious and inflammatory diseases. PREAMBLE: The Korean Society of Nuclear Medicine (KSNM) was established in 1961 to promote the clinical and technological advancement of nuclear medicine in South Korea, with members that include nuclear medicine physicians and associated scientists. The KSNM regularly formulates and revises procedural guidelines for nuclear medicine examinations to enhance the field and improve the quality of patient care. These guidelines are designed to support healthcare professionals in providing appropriate medical care to patients. However, they are not immutable rules or mandatory requirements for conducting examinations.Therefore, KSNM states that these guidelines should not be used in legal actions challenging a healthcare professional's medical decisions. The ultimate judgment regarding specific procedures or appropriate measures should be made by nuclear medicine physicians, considering the unique circumstances of each case. Deviation from these guidelines does not imply substandard medical practice. Rather, reasonable judgments differing from the guidelines can be made based on the patient's condition, available resources, and advancements in knowledge or technology. Due to the diversity and complexity of patients, it is often challenging to predict the most appropriate diagnostic and accurate therapeutic responses. Thus, adherence to these guidelines does not always guarantee an exact diagnosis or successful outcomes.The purpose of this guideline is to assist healthcare providers in making reasonable decisions and conducting effective and safe examinations based on current medical knowledge, available resources, and patient needs when performing 18F-fluoro-2-deoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) examinations for infectious/inflammatory diseases
Immunosuppressive State May Lead to Brain Metastases in Lung Squamous Cell Carcinoma: Gene Expression and Immunohistochemical Analysis
No full textBACKGROUND/AIM: Brain metastases (BMs) are rare in lung squamous cell carcinoma (LUSC). Therefore, research on biomarkers or mechanisms that can be used to predict them is limited. To verify whether mRNA profiles can accurately predict BMs, we used a machine learning approach on 20 TNM-matched LUSC tissue samples. MATERIALS AND METHODS: We conducted pathway and immunohistochemical analyses to investigate the underlying mechanisms of BM. RESULTS: A total of 15 mRNAs linked to BM were identified. The 15-mRNA signature was highly accurate in predicting BM, with an area under the curve and accuracy of 0.940 and 0.9, respectively. The pathway analysis revealed that immune-related pathways (leukocyte transendothelial migration, Fc gamma R-mediated phagocytosis, and natural killer cell-mediated cytotoxicity) were suppressed, suggesting that an immunosuppressive state may be involved in the development of BM. In the validation set confirmed by immunohistochemical staining, the BM group exhibited significantly lower levels of CD4+ T cells or CD8+ T cells than the group without BM. BM in patients with LUSC was associated with an immunosuppressive state. CONCLUSION: Immunotherapy may be effective in preventing BM in patients with LUSC
Effectiveness of adding glucagon-like peptide-1 receptor agonist on diabetes complications and mortality among basal insulin-treated people with type 2 diabetes: A real-world Korean study
No full textAIMS: To compare the effectiveness of adding a glucagon-like peptide-1 receptor agonist (GLP-1RA) on composite of diabetes-related complications and mortality with that of adding short-acting insulin (SAI) or shifting to premixed insulin among basal insulin (BI)-treated individuals with type 2 diabetes mellitus (T2DM) in South Korea. METHODS: From the Health Insurance Review and Assessment Service database, individuals with T2DM who initiated BI treatment and had advanced their treatment regimen from July 1, 2012, to December 31, 2018. RESULTS: A total of 38,634 individuals with T2DM were included in this study. Compared to adding SAI to BI, adding GLP-1RA was associated with decreased risks of cardiovascular complications (hazard ratio 0.56; 95 % confidence interval 0.43-0.72), severe microvascular complications (0.30; 0.19-0.48), diabetes-related hospitalization (0.62; 0.53-0.73), and all-cause mortality (0.27; 0.13-0.57). Compared to switching to premixed insulin, adding GLP-1RA was also associated with lower risk of cardiovascular complications (0.65; 0.51-0.84), severe microvascular complications (0.36; 0.22-0.58), diabetes-related hospitalization (0.62; 0.53-0.73), and all-cause mortality (0.32; 0.15-0.67). CONCLUSIONS: In this real-world Korean study, adding GLP-1RA to BI reduced risks of diabetes complications and all-cause mortality than adding SAI or shifting to premixed insulin
Sodium-glucose cotransporter-2 inhibitors and dipeptidyl peptidase-4 inhibitors on diabetic macular edema and the need for intravitreal injection
No full textAIM: To investigate the effects of dipeptidyl peptidase-4 inhibitors (DPP4i) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) on diabetic macular edema (DME) and the need for intravitreal injections (IVT) in patients with type 2 diabetes. METHODS: Data were retrospectively collected from the medical records of patients with diabetic retinopathy (DR) taking either DPP4i or SGLT2i as secondary oral hypoglycemic agents in addition to metformin between January 2019 and July 2022. We compared the prevalence of DME and the need for IVT among patients treated with DPP4i or SGLT2i. Propensity score matching was performed using the following variables: age, duration of diabetes, blood glucose control (HbA1c) level, and severity of DR. RESULTS: A total of 268 patients with DR were included in this study. More DPP4i users needed IVT than SGLT2i users (35.3% vs 18.0%, P=0.011), while the prevalence of DME was not different. The use of SGLT2i was associated with a lower need for IVT than DPP4i [odds ratio (OR) 0.404, 95% confidence interval (CI) 0.198-0.823], and similar trends were observed after propensity score matching (OR 0.419, 95%CI 0.181-0.970). However, this tendency was not significant in multiple logistic regressions. For DME, the use of DPP4i was not a significant risk factor compared to SGLT2i. CONCLUSION: The use of SGLT2i may be associated with a lower need for IVT for overall DR complications, while other factors may contribute to this effect. The effect of SGLT2i on the prevention of DME is not evident
Distinct Roles Between Eotaxin 1 and Eotaxin 2 in Asthmatic Airways
No full textBACKGROUND: Eotaxins (EOTs), primarily expressed in airway epithelial cells (AECs), act as chemoattractants for eosinophils in asthma pathogenesis. Recent studies have suggested that EOTs have additional functions beyond chemotaxis. However, the distinct roles of EOTs remain incompletely understood. METHODS: Serum EOT1, EOT2, myeloperoxidase (MPO), matrix metalloproteinase-9 (MMP-9), and tissue inhibitor of metalloproteinase-1 (TIMP-1) levels were evaluated by ELISA and serum eosinophil cationic protein (ECP) levels were measured by ImmunoCAP in 79 adult asthmatics. Clinical characteristics were analyzed by inflammatory phenotype, disease severity, and serum EOT1/EOT2 levels. The functions of EOTs were investigated in vitro and ex vivo. For in vivo, EOT1 and EOT2 were intranasally administered to ovalbumin/lipopolysaccharide-induced asthmatic mice (BALB/c). To assess neutralization effects, anti-EOT1 or anti-EOT2 antibodies were intranasally administered. RESULTS: Serum EOT1 and EOT2 levels were higher in patients with severe asthma (SA) than in those with non-SA. Serum EOT1 levels were associated with increased blood/sputum eosinophil counts and serum ECP levels, but not significantly correlated with FEV(1) (%) values. In contrast, serum EOT2 levels are correlated with higher serum MPO, MMP-9, and TIMP-1 levels but lower FEV(1) (%). In asthmatic mice, EOT1 increased eosinophil counts and IL-5 production, whereas EOT2 induced CXCL1 and MMP-9 production, junctional dysfunction and epithelial-to-mesenchymal transition in the lungs, which were attenuated by neutralizing EOTs using each antibody. CONCLUSION: EOT1 promotes T2/eosinophilic inflammation, whereas EOT2 accelerates airway remodeling and lung function decline by activating neutrophils, providing a new insight into the distinct roles of EOTs in the pathogenesis of SA
Increase of α-Synuclein in the Peripheral Blood of Subjects with Methamphetamine Use Disorder
No full textOBJECTIVE: Methamphetamine (MA) use has created significant public health problems worldwide. Its chronic abuse causes neurotoxicity resulting in disruption of neural plasticity and early onset of neurodegenerative diseases. Therefore, there is need for a biomarker to evaluate the neurotoxicity caused by MA. This study investigates the expression levels of alpha-synuclein (alpha-Syn), brain-derived neurotrophic factor (BDNF), and neuron-specific enolase (NSE) in the blood of patients with MA use disorder to identify potential biomarkers. METHODS: We collected blood samples from 60 subjects (30 normal healthy controls and 30 patients with MA use disorder [MA group]). We used multiplex assay kits to analyze the expression levels of alpha-Syn, BDNF, and NSE in the blood of these subjects. RESULTS: Beck Depression Inventory and Beck Anxiety Inventory scale scores were significantly different between the control and MA groups. The expression level of alpha-Syn in the MA group was significantly increased compared to that in the control group (z value=-1.986, p=0.0473). In contrast, BDNF in the MA group tended to increase as the duration of MA use increased (r=0.323, p=0.082). CONCLUSION: We identified an increase of alpha-Syn in the blood of the MA group. This finding suggests that the alpha-Syn level increases in the brain after exposure to MA by passing through the blood brain barrier. This result provides useful information for potential biomarkers in diagnosis of neurodegenerative diseases caused by MA abuse
Effect of tissue adhesive application on central line-associated bloodstream infections: a multi-centre retrospective study
No full textBACKGROUND: Use of central venous access devices (CVADs) has been plagued by various adverse events, including central line-associated bloodstream infection (CLABSI), inadvertent dislocation, exit-site haemorrhage, and local infection. AIM: To investigate whether tissue adhesive (TA, 2-octyl blended with n-butyl cyanoacrylate) application to centrally/femorally inserted central catheter (CICC/FICC) exit sites could reduce the occurrence of CLABSI. METHODS: This retrospective review with historical controls was conducted in three tertiary care institutions. The TA group was established from December 2021 to July 2022 with the simultaneous initiation of TA application to the exit site of CICCs/FICCs. Patients in the control group received CICCs/FICCs before TA application between February 2021 and November 2021. Adverse event rates, including CLABSI, oozing, dislocation, and skin problems, were compared between groups. Risk factors were analysed using inverse probability of treatment weighting (IPTW)-adjusted Cox analysis. FINDINGS: The TA group comprised 1061 patients; the control group included 1049 patients. The CLABSI rate was significantly lower in the TA group (1.84 per 1000 catheter-days) compared with the control group (3.66 per 1000 catheter-days), with a rate ratio of 0.5 (95% confidence interval: 0.28-0.87; P = 0.01). The oozing rate was significantly lower (TA: 120; control: 158; P = 0.01). IPTW-adjusted analysis revealed TA as risk-reducing factor (P = 0.003), while age (P = 0.04) and triple-lumen (P = 0.04) were significant risk factors for CLABSI. CONCLUSION: TA application at CICCs/FICCs exit sites could significantly lower CLABSI rates without serious adverse events
Association of Preoperative Imaging and Surgical Delay with Hemorrhagic Mortality in Abdominal Trauma: A Retrospective Multicenter Study
No full textBackground: Surgical delay in abdominal trauma with hemorrhage is a leading cause of preventable death, yet the precise time threshold for adverse outcomes remains uncertain. This study examined the association between emergency department (ED)-to-operating room (OR) time and hemorrhagic mortality and evaluated the impact of preoperative computed tomography (CT). Methods: We retrospectively analyzed patients >/=15 years old who underwent emergency laparotomy for abdominal trauma at two Level I trauma centers in South Korea (2016-2023). The primary outcome was hemorrhagic death, adjudicated by a multidisciplinary review panel. Multivariable and segmented logistic regression was used to assess the association between ED-to-OR time and mortality. The effect of preoperative CT was evaluated using inverse probability of treatment weighting (IPTW). Results: Among 414 patients, 71 (17.1%) died from hemorrhage. Each 1-min increase in ED-to-OR time was associated with 1.8% higher odds of hemorrhagic death (adjusted OR = 1.018; 95% CI, 1.007-1.030). Segmented regression identified a changepoint at 91 min (bootstrap 95% CI, 62.0-97.6), beyond which mortality risk rose sharply. Preoperative CT was performed in 27.5% of patients and was associated with a mean surgical delay of over 30 min. After IPTW adjustment, CT use was not significantly associated with hemorrhagic death (14.3% vs. 10.3%, p = 0.542). Conclusions: Longer ED-to-OR intervals were associated with increased hemorrhagic mortality, particularly beyond approximately 90 min. Although preoperative CT contributed to procedural delay, it was not independently associated with worse outcomes when selectively used in stable patients. These findings represent observational associations in current practice rather than causal effects, underscoring the importance of minimizing surgical delay while cautiously considering CT in appropriate patients