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JYMS : Journal of Yeungnam Medical Science

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Original articles
Clinical investigation on acute pyelonephritis without pyuria: a retrospective observational study
Hyung Keun Song, Dong Hyuk Shin, Ji Ung Na, Sang Kuk Han, Pil Cho Choi, Jang Hee Lee
J Yeungnam Med Sci. 2022;39(1):39-45.   Published online August 11, 2021
DOI: https://doi.org/10.12701/yujm.2021.01207
  • 6,052 View
  • 183 Download
AbstractAbstract PDF
Background
The current guidelines for the diagnosis of acute pyelonephritis (APN) recommend that APN be diagnosed based on the clinical features and the presence of pyuria. However, we observed that some of the patients who are diagnosed with APN do not have characteristic clinical features or pyuria at the initial examination. We performed this study to investigate the characteristics of APN without pyuria.
Methods
A retrospective, cross-sectional study was conducted on 391 patients diagnosed with APN based on clinical and radiologic findings, between 2015 and 2019. The clinical features, laboratory results, and computed tomography (CT) findings were compared between patients with normal white blood cell (WBC) counts and those with abnormal WBC counts (WBC of 0–5/high power field [HPF] vs. >5/HPF) in urine.
Results
More than 50% of patients with APN had no typical urinary tract symptoms and one-third of them had no costovertebral angle (CVA) tenderness. Eighty-eight patients (22.5%) had normal WBC counts (0–5/HPF) on urine microscopy. There was a negative correlation between pyuria (WBC of >5/HPF) and previous antibiotic use (odds ratio, 0.249; 95% confidence interval, 0.140–0.441; p<0.001), and the probability of pyuria was reduced by 75.1% in patients who took antibiotics before visiting the emergency room.
Conclusion
The diagnosis of APN should not be overlooked even if there are no typical clinical features, or urine microscopic examination is normal. If a patient has already taken antibiotics at the time of diagnosis, imaging studies such as CT should be performed more actively, regardless of the urinalysis results.
Impact of an emergency department resident strike during the coronavirus disease 2019 (COVID-19) pandemic in Daegu, South Korea: a retrospective cross-sectional study
Yo Han Cho, Jae Wan Cho, Hyun Wook Ryoo, Sungbae Moon, Jung Ho Kim, Sang-Hun Lee, Tae Chang Jang, Dong Eun Lee
J Yeungnam Med Sci. 2022;39(1):31-38.   Published online August 10, 2021
DOI: https://doi.org/10.12701/yujm.2021.01130
  • 4,548 View
  • 96 Download
  • 5 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Background
To prepare for future work stoppages in the medical industry, this study aimed to identify the effects of healthcare worker strikes on the mortality rate of patients visiting the emergency department (ED) at six training hospitals in Daegu, Korea.
Methods
We used a retrospective, cross-sectional, multicenter design to analyze the medical records of patients who visited six training hospitals in Daegu (August 21–September 8, 2020). For comparison, control period 1 was set as the same period in the previous year (August 21–September 8, 2019) and control period 2 was set as July 1–19, 2020. Patient characteristics including age, sex, and time of ED visit were investigated along with mode of arrival, length of ED stay, and in-hospital mortality. The experimental and control groups were compared using t-tests, and Mann-Whitney U-test, chi-square test, and Fisher exact tests, as appropriate. Univariate logistic regression was performed to identify significant factors, followed by multivariate logistic regression analysis.
Results
During the study period, 31,357 patients visited the ED, of which 7,749 belonged to the experimental group. Control periods 1 and 2 included 13,100 and 10,243 patients, respectively. No significant in-hospital mortality differences were found between study periods; however, the results showed statistically significant differences in the length of ED stay.
Conclusion
The ED resident strike did not influence the mortality rate of patients who visited the EDs of six training hospitals in Daegu. Furthermore, the number of patients admitted and the length of ED stay decreased during the strike period.

Citations

Citations to this article as recorded by  
  • Impact of junior doctor strikes on patient flow in the emergency department: a cross-sectional analysis
    Svenja Ravioli, Raeesa Jina, Omar Risk, Fleur Cantle
    European Journal of Emergency Medicine.2024; 31(1): 53.     CrossRef
  • What Do Trainees Want? The Rise of House Staff Unions
    Debra Malina, Lisa Rosenbaum
    New England Journal of Medicine.2024; 390(3): 279.     CrossRef
  • Experience of operating a medical humanities course at one medical school during the COVID-19: a retrospective study
    Yu Ra Kim, Hye-won Shin, Young Hwan Lee, Seong-Yong Kim
    Journal of Yeungnam Medical Science.2023; 40(2): 179.     CrossRef
  • A deliberative framework to assess the justifiability of strike action in healthcare
    Ryan Essex
    Nursing Ethics.2023;[Epub]     CrossRef
  • Study on the Learning Environment of Medical Students in the COVID-19
    Yu Ra Kim, Hye Jin Park, Saeyoon Kim
    Keimyung Medical Journal.2023; 42(2): 80.     CrossRef
JYMS : Journal of Yeungnam Medical Science
© Yeungnam University College of Medicine, Yeungnam University Institute of Medical Science.