Yonsei medical journal
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Yonsei medical journal · Dec 2024
Case ReportsPercutaneous Coronary Intervention and Long-Term Management of Acute Myocardial Infarction in a Hemophilia Patient: Overcoming Bleeding Challenges.
A 55-year-old male with hemophilia A came to the outpatient clinic with chest pain for several days after overdose injection of coagulation factor. He was a heavy smoker and a chronic alcoholic. An electrocardiogram (ECG) showed no specific change. ⋯ A bare metal stent was deployed and dual antiplatelet therapy including aspirin and clopidogrel had been maintained for 6 months under the conventional hemophilia management. The patient did not develop any coronary events just with single clopidogrel therapy for 5 years until he passed away from pancreatic cancer. Our case implicates that the invasive coronary intervention and post-procedural management could be safely performed with conventional standards of care while maintaining the usual dose of coagulation factors in a hemophilia patient with acute coronary syndrome.
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Yonsei medical journal · Dec 2024
Observational StudyRisk Factors for Intravenous Acetaminophen-Induced Hypotension in Patients with Repeated Acetaminophen Administration.
Intravenous (IV) acetaminophen-induced hypotension is a clinically significant issue that remains difficult to predict. Therefore, this study aimed to identify the factors associated with hypotension in patients with repeated IV acetaminophen administration. ⋯ Severe infections, heart failure, and the use of beta-blockers are associated with IV acetaminophen-induced hypotension. However, IV acetaminophen-induced hypotension is inconsistent and depends on the patient's condition.
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Yonsei medical journal · Dec 2024
Thirty-Day Mortality of Persistent Methicillin-Resistant Staphylococcus aureus Bacteremia: Insights from a Retrospective Cohort Study.
Although glycopeptides remain the preferred treatment for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia, the treatment of persistent MRSA bacteremia has been challenging. We investigated real-world treatment strategies for persistent MRSA bacteremia, with a specific emphasis on the use of antimicrobial agents and the frequency of changes during the treatment course. We retrospectively identified patients with persistent MRSA bacteremia in four university-affiliated hospitals between 2017 and 2021. ⋯ Meanwhile, the factors associated with antimicrobial switching were the duration of bacteremia, the initial use of teicoplanin, echocardiogram, and Charlson comorbidity index. This study showed that while over one-third of persistent MRSA bacteremia patients experience changes in antimicrobial agents during treatment, this practice does not significantly improve the 30-day mortality. Our study suggests the need for more effective treatment strategies in managing persistent MRSA bacteremia.
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Yonsei medical journal · Dec 2024
Triglyceride to High-Density Lipoprotein Cholesterol Ratio and Sensorineural Hearing Loss in Community-Dwelling Adults: an NHANES Analysis.
Sensorineural hearing loss (SNHL) is prevalent among older adults in the United States. Recent studies suggest the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio as a potential marker for metabolic and cardiovascular conditions. Our research investigates the association between the TG/HDL-C ratio and SNHL using a comprehensive national dataset. ⋯ A higher TG/HDL-C ratio was significantly associated with SNHL in US adults aged 50-69 years, especially in those free from diabetes or obesity. These findings support considering TG/HDL-C as a useful marker for SNHL risk, highlighting the importance of combined metabolic and auditory health assessments.
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Yonsei medical journal · Dec 2024
Survival Is Just the Beginning of Recovery: A Qualitative Study of Survivors' Experiences after Severe Injury.
Patients experience severe physical trauma every year. However, studies on survivors' experiences after severe injury are limited. Previous studies have mainly focused on time spans of trauma treatment. This study aimed to comprehensively explore survivors' experiences to improve the current quality of trauma treatment and highlight the importance of patient-centered care. ⋯ Increased efforts focusing on enabling survivors of severe injury to return to society and improve their quality of life are needed, including the establishment of patient-centered care in the trauma field, extended care for the survivors' families, multidisciplinary treatment, and the collection of quantitative post-discharge data.