Pub Date : 2023-06-01DOI: 10.3904/kjm.2023.98.3.125
Seung Hun Lee, Min Chul Kim, D. Sim, Y. Hong, Ju Han Kim, Youngkeun Ahn, M. Jeong
Acute chest pain is a frequent cause of visits to emergency departments. As the major etiologies of such pain include life-threatening acute myocardial infarction, aortic dissection, and pulmonary embolism, prompt diagnosis and management are essential. After exclusion of coronary artery disease, other cardiac causes must be considered. In this review, we discuss the diagnosis of acute chest pain with a focus on clinical symptoms and the initial examination.
{"title":"Evaluation and Diagnosis of Acute Chest Pain","authors":"Seung Hun Lee, Min Chul Kim, D. Sim, Y. Hong, Ju Han Kim, Youngkeun Ahn, M. Jeong","doi":"10.3904/kjm.2023.98.3.125","DOIUrl":"https://doi.org/10.3904/kjm.2023.98.3.125","url":null,"abstract":"Acute chest pain is a frequent cause of visits to emergency departments. As the major etiologies of such pain include life-threatening acute myocardial infarction, aortic dissection, and pulmonary embolism, prompt diagnosis and management are essential. After exclusion of coronary artery disease, other cardiac causes must be considered. In this review, we discuss the diagnosis of acute chest pain with a focus on clinical symptoms and the initial examination.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"151 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76885824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.3904/kjm.2023.98.3.144
Joohee Jeon, Dongyeong Lee, Jae-Sung Ahn, C. H. Baek, Hyosang Kim
Tyrosine kinase inhibitors (TKIs), such as imatinib, dasatinib, and nilotinib, have been used to treat chronic myelogenous leukemia (CML). The adverse effects of these TKIs vary according to the site of signaling pathway inhibition. Here, we report a case of dasatinib- induced proteinuria. A 56-year-old Korean woman was diagnosed with CML and treated with dasatinib. However, 3 years later, the patient developed hypertension and microalbuminuria. Losartan was ineffective, so a kidney biopsy was performed, which revealed dasatinib-associated glomerular changes. Subsequently, dasatinib was switched to nilotinib. After 1 month, the spot urine protein/creatinine ratio decreased from 2,985.0 mg/g to 237.8 mg/g. This case of heavy proteinuria developed after long-term TKI treatment and improved rapidly after switching to another TKI. The proposed strategy is important because it eliminates the need to discontinue the medication or use immunosuppressive drugs to treat proteinuria.
{"title":"Improvement in Dasatinib-Induced Proteinuria after Switching to Nilotinib: A Case Report","authors":"Joohee Jeon, Dongyeong Lee, Jae-Sung Ahn, C. H. Baek, Hyosang Kim","doi":"10.3904/kjm.2023.98.3.144","DOIUrl":"https://doi.org/10.3904/kjm.2023.98.3.144","url":null,"abstract":"Tyrosine kinase inhibitors (TKIs), such as imatinib, dasatinib, and nilotinib, have been used to treat chronic myelogenous leukemia (CML). The adverse effects of these TKIs vary according to the site of signaling pathway inhibition. Here, we report a case of dasatinib- induced proteinuria. A 56-year-old Korean woman was diagnosed with CML and treated with dasatinib. However, 3 years later, the patient developed hypertension and microalbuminuria. Losartan was ineffective, so a kidney biopsy was performed, which revealed dasatinib-associated glomerular changes. Subsequently, dasatinib was switched to nilotinib. After 1 month, the spot urine protein/creatinine ratio decreased from 2,985.0 mg/g to 237.8 mg/g. This case of heavy proteinuria developed after long-term TKI treatment and improved rapidly after switching to another TKI. The proposed strategy is important because it eliminates the need to discontinue the medication or use immunosuppressive drugs to treat proteinuria.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79239069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.3904/kjm.2023.98.3.102
S. Y. Kim
The risk of developing metachronous advanced neoplasia is associated with the presence of polyps in index colonoscopy. Therefore, it is essential to establish the optimal colonoscopy surveillance period following polypectomy. In the 2020s, international guidelines published by the US Multi-Society Task Force, European Society of Gastrointestinal Endoscopy, and British Society of Gastroenterology were revised. In 2022, the Korean postpolypectomy colonoscopic surveillance guidelines were revised to recommend surveillance for adenoma size ≥ 10 mm, ≥ 3 adenomas, tubulovillous or villous adenoma, adenoma with high-grade dysplasia, traditional serrated adenoma, sessile serrated lesion (SSL) with dysplasia, serrated polyp with size ≥ 10 mm, and ≥ 3 SSLs.
{"title":"Korean Guidelines for Postpolypectomy Colonoscopic Surveillance: 2022 Revision","authors":"S. Y. Kim","doi":"10.3904/kjm.2023.98.3.102","DOIUrl":"https://doi.org/10.3904/kjm.2023.98.3.102","url":null,"abstract":"The risk of developing metachronous advanced neoplasia is associated with the presence of polyps in index colonoscopy. Therefore, it is essential to establish the optimal colonoscopy surveillance period following polypectomy. In the 2020s, international guidelines published by the US Multi-Society Task Force, European Society of Gastrointestinal Endoscopy, and British Society of Gastroenterology were revised. In 2022, the Korean postpolypectomy colonoscopic surveillance guidelines were revised to recommend surveillance for adenoma size ≥ 10 mm, ≥ 3 adenomas, tubulovillous or villous adenoma, adenoma with high-grade dysplasia, traditional serrated adenoma, sessile serrated lesion (SSL) with dysplasia, serrated polyp with size ≥ 10 mm, and ≥ 3 SSLs.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72917659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.3904/kjm.2023.98.3.132
Han-sang Baek, D. Lim
Thyrotoxicosis is a clinical state with a variety of various etiologies that results from excess thyroid hormones, including hyperthyroidism and thyroiditis. Graves' disease (GD) is a well-known autoimmune thyroid disease that causes hyperthyroidism, and its pathogenesis is mainly driven by the thyroid-stimulating hormone receptor antibody (TSHRAb), which is highly specific for GD. Measuring the TSHRAb is a fast and accurate diagnostic tool for GD and has been used to monitor disease activity and the treatment response. However, conventional TSH-binding inhibitory immunoglobulin (TBII) does not differentiate between stimulating, blocking, or neutral antibodies. In contrast, thyroid stimulatory immunoglobulin bioassays differentiate between stimulating and blocking antibodies and have comparably high sensitivity and specificity to TBII for GD. We also discuss the role of thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) in thyrotoxicosis, although they are less specific than TSHRAb for GD. TPOAb is associated with autoimmune thyroiditis, while TgAb appears with TPOAb in patients with autoimmune thyroid disease. In addition, TPOAb or TgAb may be associated with a low recurrence of GD after discontinuing anti-thyroid drugs. Clinicians should interpret thyroid autoantibodies in the context of the patient's clinical presentation and consider their implications to manage and monitor thyrotoxicosis.
甲状腺毒症是一种由甲状腺激素过多引起的多种病因的临床状态，包括甲状腺功能亢进和甲状腺炎。Graves' s disease (GD)是一种众所周知的甲状腺功能亢进的自身免疫性疾病，其发病机制主要由促甲状腺激素受体抗体(TSHRAb)驱动，该抗体对GD具有高度特异性。测量TSHRAb是一种快速准确的GD诊断工具，已被用于监测疾病活动性和治疗反应。然而，传统的tsh结合抑制性免疫球蛋白(TBII)不能区分刺激、阻断或中性抗体。相比之下，甲状腺刺激免疫球蛋白生物测定法区分刺激抗体和阻断抗体，对GD的TBII具有相当高的敏感性和特异性。我们还讨论了甲状腺过氧化物酶抗体(TPOAb)和甲状腺球蛋白抗体(TgAb)在甲状腺毒症中的作用，尽管它们对GD的特异性不如TSHRAb。TPOAb与自身免疫性甲状腺炎相关，而TgAb在自身免疫性甲状腺疾病患者中与TPOAb一起出现。此外，TPOAb或TgAb可能与停用抗甲状腺药物后GD复发率低有关。临床医生应该在患者临床表现的背景下解释甲状腺自身抗体，并考虑其对管理和监测甲状腺毒症的影响。
{"title":"Interpretation of Thyroid Autoantibodies in Hyperthyroidism","authors":"Han-sang Baek, D. Lim","doi":"10.3904/kjm.2023.98.3.132","DOIUrl":"https://doi.org/10.3904/kjm.2023.98.3.132","url":null,"abstract":"Thyrotoxicosis is a clinical state with a variety of various etiologies that results from excess thyroid hormones, including hyperthyroidism and thyroiditis. Graves' disease (GD) is a well-known autoimmune thyroid disease that causes hyperthyroidism, and its pathogenesis is mainly driven by the thyroid-stimulating hormone receptor antibody (TSHRAb), which is highly specific for GD. Measuring the TSHRAb is a fast and accurate diagnostic tool for GD and has been used to monitor disease activity and the treatment response. However, conventional TSH-binding inhibitory immunoglobulin (TBII) does not differentiate between stimulating, blocking, or neutral antibodies. In contrast, thyroid stimulatory immunoglobulin bioassays differentiate between stimulating and blocking antibodies and have comparably high sensitivity and specificity to TBII for GD. We also discuss the role of thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) in thyrotoxicosis, although they are less specific than TSHRAb for GD. TPOAb is associated with autoimmune thyroiditis, while TgAb appears with TPOAb in patients with autoimmune thyroid disease. In addition, TPOAb or TgAb may be associated with a low recurrence of GD after discontinuing anti-thyroid drugs. Clinicians should interpret thyroid autoantibodies in the context of the patient's clinical presentation and consider their implications to manage and monitor thyrotoxicosis.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90987068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.3904/kjm.2023.98.2.88
Won-Young Kim, Sung Jin Park, Moon Seong Baek, K. Kim, Dae-yong Lee, Byoung-Whui Choi
Myasthenic crisis, which can be life-threatening due to severe respiratory failure, occurs in 15-20% of patients with myasthenia gravis. However, the crisis often develops within 1-2 years after diagnosis and is very rare as a first symptom of myasthenia gravis; isolated sudden-onset hypercapnic respiratory failure without other symptoms of myasthenia gravis is even rarer. A 63-year-old woman presented to the emergency department with fever and dizziness. Chest computed tomography showed multifocal peribronchial ground-glass opacities, and a diagnosis of pneumonia was made. Initially, the patient did not have dyspnea. However, she developed acute hypercapnic respiratory failure and was intubated. After mechanical ventilation, her hypercapnia improved initially, but worsened on initiation of weaning from the ventilator. As she had a high acetylcholine receptor antibody titer, myasthenia gravis was diagnosed. Her hypercapnia improved after treatment with pyridostigmine and methylprednisolone.
{"title":"Myasthenia Gravis Presenting as Sudden–onset Isolated Hypercapnic Respiratory Failure","authors":"Won-Young Kim, Sung Jin Park, Moon Seong Baek, K. Kim, Dae-yong Lee, Byoung-Whui Choi","doi":"10.3904/kjm.2023.98.2.88","DOIUrl":"https://doi.org/10.3904/kjm.2023.98.2.88","url":null,"abstract":"Myasthenic crisis, which can be life-threatening due to severe respiratory failure, occurs in 15-20% of patients with myasthenia gravis. However, the crisis often develops within 1-2 years after diagnosis and is very rare as a first symptom of myasthenia gravis; isolated sudden-onset hypercapnic respiratory failure without other symptoms of myasthenia gravis is even rarer. A 63-year-old woman presented to the emergency department with fever and dizziness. Chest computed tomography showed multifocal peribronchial ground-glass opacities, and a diagnosis of pneumonia was made. Initially, the patient did not have dyspnea. However, she developed acute hypercapnic respiratory failure and was intubated. After mechanical ventilation, her hypercapnia improved initially, but worsened on initiation of weaning from the ventilator. As she had a high acetylcholine receptor antibody titer, myasthenia gravis was diagnosed. Her hypercapnia improved after treatment with pyridostigmine and methylprednisolone.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"94 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80332474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.3904/kjm.2023.98.2.93
Won Myung Kim, Mun Su Park, Dong Hyun Seo, Jung Yun Lee, J. Pyo
COVID-19 vaccination is essential in cancer patients. However, there is limited evidence of the prognosis of these patients, especially for those taking immune checkpoint inhibitors (ICIs). We present a patient on pembrolizumab for advanced endometrioid adenocarcinoma experiencing continuous diarrhea and subsequent episodes of fever with pain in multiple joints following a second dose of the BNT162b2 mRNA COVID-19 vaccine. An ICI-induced immune-related adverse effect (irAE) was the main diagnosis; cytokine release syndrome and rheumatoid arthritis were also considered. Notably, the novel irAE occurred after the 19th pembrolizumab trial, highlighting the potential effect of changes in systemic immunogenicity after BNT162b2 vaccination. Ultimately, the patient was treated with steroid, which alleviated her symptoms. Here, we report a rare adverse effect after COVID-19 vaccination in an endometrioid carcinoma patient on ICI therapy. This report shows that there is a need to consider and investigate vaccine-related adverse events.
{"title":"Immune-related Adverse Effect after BNT162b2 Vaccination with Parallel Immune Checkpoint Inhibitor Therapy: A Case Report","authors":"Won Myung Kim, Mun Su Park, Dong Hyun Seo, Jung Yun Lee, J. Pyo","doi":"10.3904/kjm.2023.98.2.93","DOIUrl":"https://doi.org/10.3904/kjm.2023.98.2.93","url":null,"abstract":"COVID-19 vaccination is essential in cancer patients. However, there is limited evidence of the prognosis of these patients, especially for those taking immune checkpoint inhibitors (ICIs). We present a patient on pembrolizumab for advanced endometrioid adenocarcinoma experiencing continuous diarrhea and subsequent episodes of fever with pain in multiple joints following a second dose of the BNT162b2 mRNA COVID-19 vaccine. An ICI-induced immune-related adverse effect (irAE) was the main diagnosis; cytokine release syndrome and rheumatoid arthritis were also considered. Notably, the novel irAE occurred after the 19th pembrolizumab trial, highlighting the potential effect of changes in systemic immunogenicity after BNT162b2 vaccination. Ultimately, the patient was treated with steroid, which alleviated her symptoms. Here, we report a rare adverse effect after COVID-19 vaccination in an endometrioid carcinoma patient on ICI therapy. This report shows that there is a need to consider and investigate vaccine-related adverse events.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78844145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.3904/kjm.2023.98.2.64
H. Yoo
Idiopathic pulmonary fibrosis (IPF) is the most common and fatal idiopathic interstitial pneumonia and is characterized by chronic progressive pulmonary fibrosis of indeterminate etiology. In 2018, the American Thoracic Society, European Respiratory Society, Japanese Respiratory Society, and Latin American Thoracic Society published joint clinical practice guidelines for IPF. The guidelines require exclusion of known causes of interstitial lung disease and identification of a radiological and/or pathologic pattern of usual interstitial pneumonia (UIP). The diagnosis of IPF is a multidisciplinary process, involving pulmonologists, radiologists, pathologists and, if necessary, experts in other medical fields. The 2022 guidelines for IPF revisit and clarify the radiological and pathological features of UIP. In addition, recommendations regarding transbronchial lung cryobiopsy, antacid medication, and antireflux surgery are revised or established based on up-to-date evidence in the 2022 guidelines. The new guidelines also encompass the definition and treatment of progressive pulmonary fibrosis (PPF). PPF comprises diverse fibrotic interstitial lung diseases other than IPF, which progress despite standard treatment. The diagnosis of PPF is based on symptoms, physiologic evidence, and radiologic evidence of progression. The use of nintedanib was suggested for patients with PPF other than IPF who are unresponsive to standard treatment. This review introduces and discusses the recommendations for the diagnosis and treatment of IPF and PPF in the new international guidelines.
{"title":"New Guidelines for Idiopathic Pulmonary Fibrosis and Progressive Pulmonary Fibrosis","authors":"H. Yoo","doi":"10.3904/kjm.2023.98.2.64","DOIUrl":"https://doi.org/10.3904/kjm.2023.98.2.64","url":null,"abstract":"Idiopathic pulmonary fibrosis (IPF) is the most common and fatal idiopathic interstitial pneumonia and is characterized by chronic progressive pulmonary fibrosis of indeterminate etiology. In 2018, the American Thoracic Society, European Respiratory Society, Japanese Respiratory Society, and Latin American Thoracic Society published joint clinical practice guidelines for IPF. The guidelines require exclusion of known causes of interstitial lung disease and identification of a radiological and/or pathologic pattern of usual interstitial pneumonia (UIP). The diagnosis of IPF is a multidisciplinary process, involving pulmonologists, radiologists, pathologists and, if necessary, experts in other medical fields. The 2022 guidelines for IPF revisit and clarify the radiological and pathological features of UIP. In addition, recommendations regarding transbronchial lung cryobiopsy, antacid medication, and antireflux surgery are revised or established based on up-to-date evidence in the 2022 guidelines. The new guidelines also encompass the definition and treatment of progressive pulmonary fibrosis (PPF). PPF comprises diverse fibrotic interstitial lung diseases other than IPF, which progress despite standard treatment. The diagnosis of PPF is based on symptoms, physiologic evidence, and radiologic evidence of progression. The use of nintedanib was suggested for patients with PPF other than IPF who are unresponsive to standard treatment. This review introduces and discusses the recommendations for the diagnosis and treatment of IPF and PPF in the new international guidelines.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82474380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.3904/kjm.2023.98.2.59
D. Cho
Sodium-glucose cotransporter 2 (SGLT2) inhibitors constitute a class of diabetes medications that have demonstrated the potential to improve outcomes for heart failure (HF) patients. Although they were originally developed to treat diabetes, clinical trials have demonstrated their ability to both reduce the risk and improve the prognosis of HF. SGLT2 inhibitors have unique mechanisms of action, including improvement of water retention and promotion of lipolysis, which contribute to their effectiveness in treating HF. They are considered essential primary treatment options for patients with HF, regardless of diabetes status and ejection fraction. Overall, the use of SGLT2 inhibitors in patients with HF is expected to increase in the future and may further improve treatment outcomes for HF patients.
{"title":"SGLT2 Inhibitors: Emerging Drugs in Heart Failure","authors":"D. Cho","doi":"10.3904/kjm.2023.98.2.59","DOIUrl":"https://doi.org/10.3904/kjm.2023.98.2.59","url":null,"abstract":"Sodium-glucose cotransporter 2 (SGLT2) inhibitors constitute a class of diabetes medications that have demonstrated the potential to improve outcomes for heart failure (HF) patients. Although they were originally developed to treat diabetes, clinical trials have demonstrated their ability to both reduce the risk and improve the prognosis of HF. SGLT2 inhibitors have unique mechanisms of action, including improvement of water retention and promotion of lipolysis, which contribute to their effectiveness in treating HF. They are considered essential primary treatment options for patients with HF, regardless of diabetes status and ejection fraction. Overall, the use of SGLT2 inhibitors in patients with HF is expected to increase in the future and may further improve treatment outcomes for HF patients.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88323798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.3904/kjm.2023.98.2.73
S. Han
The hospitalist system has recently been implemented in Korea. Claims against hospitalists may become a new medicolegal issue, as the number of medical malpractice claims is increasing. Hospitalist medical malpractice cases frequently involve more severe patient injuries than those involving claims against other physicians, and these cases frequently involve errors in clinical judgment and communication. Doctor-patient relationship issues, poor communication skills, and physicians at high risk of malpractice claims are risk factors for medical malpractice claims against hospitalists. Strategies to lower the risk of medical malpractice claims against hospitalists include empathetic communication with patients, standardized handoffs or discharge summaries, direct and close communication with outpatient physicians, and timely referral and consultation. Hospitalists will soon have a significant impact on inpatient care in Korea.
{"title":"Strategies to Reduce the Risk of Medical Malpractice Claims against Hospitalists","authors":"S. Han","doi":"10.3904/kjm.2023.98.2.73","DOIUrl":"https://doi.org/10.3904/kjm.2023.98.2.73","url":null,"abstract":"The hospitalist system has recently been implemented in Korea. Claims against hospitalists may become a new medicolegal issue, as the number of medical malpractice claims is increasing. Hospitalist medical malpractice cases frequently involve more severe patient injuries than those involving claims against other physicians, and these cases frequently involve errors in clinical judgment and communication. Doctor-patient relationship issues, poor communication skills, and physicians at high risk of malpractice claims are risk factors for medical malpractice claims against hospitalists. Strategies to lower the risk of medical malpractice claims against hospitalists include empathetic communication with patients, standardized handoffs or discharge summaries, direct and close communication with outpatient physicians, and timely referral and consultation. Hospitalists will soon have a significant impact on inpatient care in Korea.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79157058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.3904/kjm.2023.98.2.78
S. H. Kim, Hong Ki Min, Sang-Heon Lee, Hae-Rim Kim
Low back pain, categorized as nociceptive, neuropathic, or nociplastic, is the leading cause of disability in terms of years lived among young people. The lumbar spine may produce specific or non-specific pain. Treatment depends on the underlying cause of low back pain. This review discusses the classification, prevalence, diagnosis, and treatment of low back pain in young adults.
{"title":"A 22-year-old Woman with Chronic Back Pain","authors":"S. H. Kim, Hong Ki Min, Sang-Heon Lee, Hae-Rim Kim","doi":"10.3904/kjm.2023.98.2.78","DOIUrl":"https://doi.org/10.3904/kjm.2023.98.2.78","url":null,"abstract":"Low back pain, categorized as nociceptive, neuropathic, or nociplastic, is the leading cause of disability in terms of years lived among young people. The lumbar spine may produce specific or non-specific pain. Treatment depends on the underlying cause of low back pain. This review discusses the classification, prevalence, diagnosis, and treatment of low back pain in young adults.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85247112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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