Explore the vast range of titles available.

Sepsis is a life-threatening condition, especially for patients in the intensive care unit (ICU), where early identification of the prognosis is critical. This study aimed to evaluate the prognostic value of inflammatory markers, clinical scores, and specific laboratory findings for predicting ICU and in-hospital mortality in sepsis patients. A retrospective cohort study was conducted on adult patients with sepsis who were admitted to the ICU of a university hospital between September 2019 and December 2022. To minimize selection bias, all eligible patients during the study period were consecutively included. Data were extracted from electronic medical records and included demographics, clinical characteristics, inflammatory markers, and clinical scores such as the Charlson Comorbidity Index (CCI), Clinical Frailty Scale (CFS), Eastern Cooperative Oncology Group (ECOG) performance status, Simplified Acute Physiology Score 3 (SAPS 3), and Sequential Organ Failure Assessment (SOFA). The primary outcomes were ICU and in-hospital mortality. Univariate and multivariate Cox regression analyses were performed to identify predictors of mortality. A total of 213 ICU patients with sepsis were included in the study. The patients were 62.0% male with a mean age of 73.1 ± 12.6 years. The ICU and in-hospital mortality rates were 29.6% and 36.6%, respectively. Non-survivors had higher clinical severity scores and poorer nutritional and perfusion profiles than survivors. Multivariate analysis revealed that elevated lactate levels (a marker of tissue hypoperfusion) and higher SAPS 3 scores were independently associated with ICU mortality. For in-hospital mortality, lower albumin levels and higher SAPS 3 scores were significant predictors. High lactate and SAPS 3 scores were independent predictors of mortality, while higher albumin levels showed a potential protective effect. Early identification of these factors may aid in the management of sepsis.

There are many types of disabilities, and each type has a variety related to socioeconomic factors. Such factors affect to many health problems of the disabled. However, surveys of the oral health status of the disabled in Korea are rare. The purpose of this study was to estimate oral health disparity through comparing oral health status of the disabled to the non-disabled, adjusted for the net effect of the disability on oral health status. A cross-sectional study was conducted among the disabled in urban and suburban areas in Korea from June to September 2016. People with physical, mental, and multiple disabilities took part in this survey. The clinical examinations were carried out by trained dentists. Statistical analysis was performed to quantify the association between oral health and socioeconomic status after restricting the analysis using a propensity score matching method. The disabled had more DMFT, DT, and MT, fewer FT, and fewer teeth than the non-disabled based on entire groups (P<0.01). No difference in the ratio of periodontitis was observed. The subjects with mental disabilities (MD) scored 3.09 (95% CI, 1.07-8.97), and those with multiple disabilities scored 4.37 (95% CI, 1.16-16.37) for edentulous status. The MD had an odds ratio of 1.34 (95% CI, 1.03-1.74), and those with multiple disabilities had an odds ratio of 1.75 (95% CI, 1.11-2.76) for the DMFT index. These results represent poor oral health status of the disabled compared to the non-disabled. Consequentially, we can verify that not only the existence of disability but also the type of disability has a decisive effect on oral health condition. This comparison is necessary to widen our approach to evaluate the actual status condition of the disabled.

Ocean ventilation is a key mechanism for transporting anthropogenic CO2 (CANTH) from the ocean surface toward its interior. We investigated the link between ocean ventilation and CANTH increase in the East Sea using data from surveys conducted in 1992, 1999, 2007, and 2019. Between 1992 and 1999, the East Sea Intermediate Water (300−1,500 m) accumulated CANTH at a rate of 0.3 ± 0.1 mol C m−2 yr−1. However, in the subsequent period (1999−2007) this rate decreased to <0.1 ± 0.1 mol C m−2 yr−1. There was a resurgence in the CANTH increase rate between 2007 and 2019, reaching 0.4 ± 0.1 mol C m−2 yr−1. The East Sea Intermediate Water ventilation changes, inferred from the changes in water column O2 level and the Arctic Oscillation‐driven winter surface temperature in the deep water formation region, were responsible for the periodic decline and recovery in CANTH increase. Plain Language Summary Ocean ventilation plays a crucial role in transporting anthropogenic CO2 from the surface toward the deep ocean interior. In the East Sea, demonstrating a direct causal relationship between ocean ventilation and anthropogenic CO2 uptake has remained elusive because of limited observational evidence. To address this knowledge gap, we conducted direct measurements of carbon parameters during four surveys in the East Sea that together spanned nearly three decades (1992, 1999, 2007, and 2019). Our investigation revealed a cyclical pattern of waxing and waning in the rate of anthropogenic CO2 increase within the East Sea over the past three decades. Significantly, we demonstrated that fluctuations in the ventilation of the East Sea were the primary driving force behind the decadal changes in anthropogenic CO2 increase. Furthermore, our research unveiled a potential connection between the periodic fluctuations in surface temperature linked to the Arctic Oscillation and variations in East Sea ventilation. Our findings shed light on the intricate dynamics between ocean ventilation, winter sea surface temperature patterns, and CO2 uptake in the East Sea. Key Points The rate of anthropogenic CO2 increase in the East Sea showed cyclic trends The cyclic trends of anthropogenic CO2 increase were linked to the Arctic Oscillation Our findings shed light on changes in anthropogenic CO2 uptake and transport by the global ocean in response to climate variations

Wearable human interaction devices are technologies with various applications for improving human comfort, convenience and security and for monitoring health conditions. Healthcare monitoring includes caring for the welfare of every person, which includes early diagnosis of diseases, real-time monitoring of the effects of treatment, therapy, and the general monitoring of the conditions of people’s health. As a result, wearable electronic devices are receiving greater attention because of their facile interaction with the human body, such as monitoring heart rate, wrist pulse, motion, blood pressure, intraocular pressure, and other health-related conditions. In this paper, various smart sensors and wireless systems are reviewed, the current state of research related to such systems is reported, and their detection mechanisms are compared. Our focus was limited to wearable and attachable sensors. Section 1 presents the various smart sensors. In Section 2, we describe multiplexed sensors that can monitor several physiological signals simultaneously. Section 3 provides a discussion about short-range wireless systems including bluetooth, near field communication (NFC), and resonance antenna systems for wearable electronic devices.

Background Behçet’s disease (BD) is a multisystem inflammatory disorder that can affect various organs, including the lungs. Pulmonary manifestations are rare and typically present as pulmonary artery aneurysms. Case presentation We report the case of a 56-year-old East Asian male with a 27-year history of BD, who had no respiratory symptoms, such as hemoptysis, cough, or fever. Chest imaging revealed lymph node enlargement and a lung mass, initially raising concerns of malignancy. Despite the suspicious radiological findings, three biopsies, including a surgical biopsy, were all negative for malignancy. Remarkably, over the course of 2 years, these pulmonary manifestations spontaneously regressed without any specific treatment for lung involvement, and the patient remained in a stable BD state. Conclusions BD patients are at an increased risk for malignancy compared to healthy controls, making it crucial to differentiate between malignancy and BD-related pulmonary abnormalities. This case highlights that, in the absence of active BD symptoms, lymphadenopathy and lung masses can occur and may resolve spontaneously. Accurate diagnosis and vigilant monitoring are essential in BD patients but BD-related lung involvement should be considered in similar cases.

Nonbacterial thrombotic endocarditis (NBTE) is a rare condition; sterile vegetations attach to heart valves. NBTE is typically found in patients with malignancies or autoimmune disorders. Although surgical interventions are sometimes performed, the appropriate indication and timing are still unclear. Here, we describe a 72‐year‐old woman diagnosed with adenosquamous carcinoma of the lung. She was initially diagnosed as pT2aN0M0 and underwent RUL lobectomy. After nine months, lung cancer recurred, and she underwent treatment with cytotoxic chemotherapy. However, images showed progression after only one month. Rebiopsy revealed she had comutation of de novo EGFR L858R and T790M. Treatment was changed to gefitinib. After one month, she experienced loss of consciousness. Brain magnetic resonance imaging (MRI) showed multiple lesions resembling infarctions or metastases. Chest computed tomography (CT) revealed progression. Osimertinib was prescribed and she underwent echocardiography to rule out the possibility of a cardiogenic embolism. Surprisingly, severe mitral regurgitation and a massive vegetation on the mitral valve were found. Cardiologists recommended surgery due to the severity of the embolic event and valve dysfunction, but it was decided to continue antibiotics, osimertinib, and anticoagulants instead of surgery due to the patient's poor general condition and the possibility of NBTE. Six weeks later, the patient's condition markedly improved and echocardiography revealed a marked reduction in vegetation size. Clinicians should be aware that targeted therapy can be effective in treating severe cancer complications, such as NBTE, as evidenced by the successful treatment of lung cancer with osimertinib. This option should be considered, particularly for elderly lung cancer patients, before resorting to surgery as a first‐line treatment for NBTE. We report a patient with lung adenosquamous carcinoma harboring de novo EGFR L858R and T790M comutation and huge nonbacterial vegetation. Because of her condition and the possibility of nonbacterial thrombotic endocarditis (NBTE), we prescribed antibiotics, anticoagulants, and osimertinib instead of heart surgery. The size of the vegetation decreased over time while taking targeted therapy. Clinicians should be aware that targeted therapy can be effective at treating severe cancer complications, such as NBTE.

Cancer‐associated dermatomyositis (CAD), a paraneoplastic syndrome characterized by dermatomyositis (DM), frequently presents in association with small cell lung cancer (SCLC). Although the advent of immune checkpoint inhibitors (ICIs) has revolutionized cancer treatment, their efficacy and safety in patients with concurrent autoimmune diseases (AD) and malignancies remains uncertain. Several studies have suggested the safe administration of ICIs in patients with AD, indicating that successful cancer therapy can alleviate CAD symptoms. Conversely, other studies have raised concerns about the potential for ICIs to exacerbate AD flares or immune‐related adverse events (irAEs). A comparative analysis of two cases from our institution emphasizes the variability in ICI responses among SCLC patients with CAD. One patient, previously reported as a case study, exhibited significant clinical improvement in DM symptoms after ICI administration, whereas the other developed severe exfoliative skin changes and experienced an unfavorable prognosis. This variability emphasizes the need for careful patient selection and close monitoring during ICI treatment. We hypothesized that overweight or obese individuals and those with severe initial skin lesions and elevated lactate dehydrogenase levels are more susceptible to developing irAEs following ICI therapy. Therefore, caution is advised when considering immunotherapy in these patients. When considering the use of immune checkpoint inhibitors in Small Cell Lung Cancer (SCLC) with accompanying Dermatomyositis (DM), it's essential to evaluate the anticancer effect, the risk of immune‐related adverse effects (irAEs), and the potential for worsening of DM. Additionally, factors such as the patient's overweight status, the severity of the initial skin lesions, and the Lactate Dehydrogenase (LDH) levels should be taken into account.

Background Severe acute respiratory infections (SARIs) are a critical public health concern due to their substantial morbidity and mortality rates across age groups. The objective of this study was to investigate the epidemiological characteristics, pathogen distribution, and clinical outcomes of SARIs in South Korea by analyzing nationwide surveillance data. Methods We conducted a prospective, multicenter surveillance study from January 2017 to January 2023 across sentinel hospitals nationwide, coordinated by the Korea Disease Control and Prevention Agency (KDCA). Respiratory specimens were collected and tested for a panel of viral and bacterial pathogens. Clinical data and outcomes were analyzed according to pathogen detection status. Results A total of 47,857 hospitalized patients with SARIs were enrolled based on standardized criteria: fever (≥ 38 °C), cough, and symptom onset within 10 days prior to hospitalization. Pathogens were identified in 52.5% of enrolled patients. The group that tested positive for pathogens was significantly younger (median age of 4.0 years) than the group that tested negative (median age of 59.0 years). Viral pathogens were more prevalent in children, whereas bacterial pathogens, such as Streptococcus pneumoniae, were more prevalent in older adults. Seasonal trends were observed: influenza and respiratory syncytial virus (RSV) peaked in winter; rhinovirus circulated year-round; and SARS-CoV-2 showed irregular peaks. Patients with confirmed pathogens had higher rates of pneumonia and mortality, as well as longer hospital stays ( P  < 0.001), compared to patients without confirmed pathogens. Antivirals were more commonly used in the pathogen-positive group, while antibiotics were predominantly prescribed to patients without confirmed pathogens. Geographic and sex-specific variations in pathogen distribution were also identified. Conclusions This study provides a thorough examination of the epidemiology of SARIs in South Korea over a six-year period. The findings reveal notable differences in pathogen prevalence and related clinical outcomes by age, season, and region. These results underscore the importance of sustained nationwide surveillance and the development of targeted, seasonally adaptive public health strategies to mitigate the impact of SARIs on vulnerable populations.

Approximately half of the patients with sepsis require intensive care unit (ICU) management and their mortality rate remains high. The concept of withholding and withdrawal life-sustaining treatment (WWLST) issue was introduced to limit the suffering of critically ill patients. However, little is known about the characteristics and outcomes of WWLST in patients with sepsis. We conducted a nationwide cohort study of adult patients with sepsis prospectively collected from the Korean Sepsis Alliance Database of 20 tertiary referral or university-affiliated hospitals in South Korea between September 2019 and December 2021. Patients were classified according to WWLST issues and characteristics, and their prognoses were compared. Among the 11,981 patients with sepsis included in the study, 4430 (37.0%) had WWLST issues. The WWLST group was older, frailer, and had higher Sequential Organ Failure Assessment (SOFA) scores than the no-WWLST group. The WWLST group had more underlying diseases, including solid tumors (45.2% vs. 30.6%, p  < 0.001) and hematologic malignancies (8.0% vs. 5.2%, p  < 0.001), than the no-WWLST group. Regarding patient outcomes and interventions in the ICU, the WWLST group used vasopressors (35.4% vs. 32.8%, p  = 0.003) more frequently; invasive mechanical ventilation (62.9% vs. 41.9%, p  < 0.001) and continuous renal replacement therapy (40.8% vs. 17.6%, p  < 0.001) were applied more frequently in the WWLST group than in the no-WWLST group. Logistic regression analysis revealed the factors associated with WWLST group to be old age, low body mass index, higher Charlson comorbidity index, clinical frailty scale, SOFA score, underlying diseases such as solid tumors and hematologic malignancies, invasive mechanical ventilation, and continuous renal replacement therapy. We predicted that the WWLST group would have a fewer ICU admissions and less invasive treatment. However, the admission rate was equivalent, and the percentage of invasive treatment, length of ICU stays, and mortality rate were higher and longer in the WWLST group. In patients with sepsis who have factors related to WWLST, appropriate communication with the patient and their family about WWLST can improve the quality of life and quality of death.

Background Tongue necrosis is a rare and relatively uncommon condition, usually caused by vasculitis, thrombosis, severe hypotension due to septic or cardiogenic shock, vasopressor use, or intubation. Following damage such as necrosis, dystrophic calcification, a type of soft tissue calcification, can occur. Case presentation: Herein, we present a unique case of bilateral tongue necrosis in a patient with nonintubated septic shock. A 70-year-old East Asian man with no significant medical history presented to the emergency department with postprandial epigastric pain. The patient was admitted to the intensive care unit with hypotension due to septic shock and disseminated intravascular coagulation. After a short course of vasopressors, the patient developed tongue discoloration and swelling without limb ischemia. Computed tomography was performed to observe the tongue necrosis, and calcification of the tongue was found. The patient was successfully treated by wiping the area with a hexamidine-soaked gauze. Conclusion Tongue necrosis remains a rare finding, and its occurrence as a complication of vasopressor use is even rarer. Therefore, even with relatively short courses of vasopressors in the intensive care unit, daily visualization of the tongue to check for discoloration, along with daily inspection and pulse checks of the limbs, can help identify vasospasms. These measures allow for prompt intervention, minimizing permanent damage and shortening the recovery time.