RESUMEN
BACKGROUND: Little is known about patients with sudden cardiac arrest in the emergency department (ED). This study aimed to identify factors affecting the prognosis of patients with cardiac arrest in the ED. METHODS: This retrospective study analyzed patients with sudden cardiac arrest admitted to the ED of a general hospital between January 2016 and July 2020. A total of 153 patients with sudden cardiac arrest were identified, and 149 patients for whom all data could be confirmed were included in the statistical analysis of this study. A good neurological outcome was defined as a Cerebral Performance Category (CPC) scale score of 1 or 2, assessed 6 months after discharge. RESULTS: In the univariate analysis, the characteristics of patients included in the good neurological outcomes group were younger (t = 3.553, p < .001), had shorter low flow time (t = 3.31, p = .019), and had more shockable initial rhythms (χ2 = 28.038, p = < .001). As a result of multivariate binary logistic regression analysis, among 43 patients alive 6 months after discharge, age 60 years or younger (odds ratio = 32.703, p = .005), low flow time 6 min or less (odds ratio = 38.418, p = .006), and initial shockable rhythm (odds ratio = 31.214, p < .001) were identified as predictors that had a significant impact on good neurological outcomes. CONCLUSIONS: Young age, short low-flow-time, and initial shockable rhythm are predictors of good neurological outcomes in patients with acute cardiac arrest in the ED.
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Servicio de Urgencia en Hospital , Humanos , Masculino , Femenino , Persona de Mediana Edad , Estudios Retrospectivos , Anciano , Pronóstico , Muerte Súbita Cardíaca , Reanimación Cardiopulmonar , Adulto , Factores de EdadRESUMEN
PURPOSE: The purpose of the study was to understand and explain the essences and structures of the experience of Korean women who have had a spinal cord injury. METHODS: The data were collected in 2010 through individual in-depth interviews using open-ended questions. A total of 9 women with spinal cord injuries participated in the study. Each interview lasted about 2 hours. Verbatim transcripts were analyzed using phenomenological analysis. RESULTS: Five theme clusters emerged from the analysis using Colaizzi's method: frozen mind with rigid body; shame due to restrictions of physical function and dependency; struggle to go back to the previous normal body; disabilities that are noticeable in everyday family life; rebirth by discarding the obsessions of the past. These theme clusters illustrate that although most participants faced very strange and unbearable situations in most aspects of life after the injury, they were empowered finally by finding their hope and by giving new meanings to the current existence. CONCLUSION: This study provides deep understanding of women with spinal cord injuries who are relatively alienated from society. Based on the results of the study, health professionals could develop effective nursing interventions to improve quality of life of these women.
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Traumatismos de la Médula Espinal/psicología , Adaptación Psicológica , Adulto , Pueblo Asiatico , Personas con Discapacidad , Familia , Femenino , Humanos , Entrevistas como Asunto , Persona de Mediana Edad , Investigación Cualitativa , Calidad de Vida , República de Corea , Estrés Psicológico , Encuestas y CuestionariosRESUMEN
PURPOSE: The purpose of the study was to understand and describe the hospital workers' experience related to the hospital evaluation program implemented in Korea between 2004 and 2009. METHODS: During 2010, data were collected using focus group interviews. Four focus group interviews were held with a total of 28 hospital workers participating. All interviews were recorded and transcribed as they were spoken, and data were analyzed using qualitative content analysis. RESULTS: Nine themes emerged from the analysis: 1) Positive change in the necessity of the evaluation; 2) Improvement in the hospital system, facilities, and human resources; 3) Unity through cooperation among departments; 4) Nursing work overload; 5) Lack of physicians' awareness and responsibilities; 6) Unfair and unrealistic evaluation items; 7) Lack of credibility of the outcome; 8) Shifting responsibility for negative outcomes to the workers; 9) Lack of pragmatic utility. CONCLUSION: The results of the study demonstrate that the hospital evaluation program played a key role in improving some work environments and communication among departments. At the same time, they show various negative themes resulting from the context of very authoritarian hospital systems and a connection-oriented society in Korea.
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Hospitales/estadística & datos numéricos , Hospitales/normas , Personal de Enfermería en Hospital/estadística & datos numéricos , Adulto , Actitud del Personal de Salud , Femenino , Grupos Focales , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Grabación en CintaRESUMEN
Lactoferrin (Lf) has been shown to control the proliferation of a variety of mammalian cells. Recently, we reported that human Lf induces apoptosis via a c-Jun N-terminal kinases (JNK)-associated Bcl-2 pathway that stimulates programmed cell death. In order to gain insight into the mechanism underlying Lf-triggered apoptotic features, we attempted to determine the mechanisms whereby the Lf-induced Bcl-2 family proteins exert their pro- or anti-apoptotic effects in Jurkat leukemia T lymphocytes. Treatment of the cells with high concentrations of Lf resulted in a significant reduction in in vitro growth and cell viability. As the levels of Lf increased, greater quantities of CDK6 and hyper-phosphorylated retinoblastoma protein were produced, resulting in the induction of E2F1-dependent apoptosis. Simultaneously, PARP and caspases were efficiently cleaved during Lf-induced apoptosis. The E2F1-induced apoptotic process occurred preferentially in p53-deficient Jurkat leukemia cells. Therefore, we attempted to determine whether E2F1-regulated Bcl-2 family proteins involved in the apoptotic process were relevant to Lf-induced apoptosis. We found that Lf increased the interaction of Bcl-2 with the pro-apoptotic protein Bad, whereas the total protein levels did not change significantly. Our results, collectively, suggest that Lf exploits the control mechanism of E2F1-regulated target genes or Bcl-2 family gene networks involved in the apoptotic process in Jurkat human leukemia T lymphocytes.