Urogenital Tract Infection

Hong Wook Kim

9 Articles

Impact of the Timing of Percutaneous Nephrostomy on the Prognosis of Obstructive Urolithiasis With Sepsis: A Retrospective Cohort Study: Ji Eun Yu, Hyung Joon Kim, Hong Wook Kim, Young Seop Chang, Jin Bum Kim, Dong Hoon Koh; Urogenit Tract Infect 2024;19(3):89-96. Published online December 31, 2024; DOI: https://doi.org/10.14777/uti.2448018009

Abstract PDF PubReader ePub: Purpose
The aim of this study was to investigate the prognostic impact of time to percutaneous nephrostomy (PCN) insertion on obstructive ureteral stones with sepsis. Materials and Methods: Data were collected on patients who presented at our Emergency Department between 2017 and 2021 with obstructive uropathy due to urinary stones and underwent PCN insertion. Patients were stratified into 4 groups in accordance with the quick sepsis-related organ failure (qSOFA) score at presentation (<2 or ≥2) and time to PCN insertion (<4 hours or ≥4 hours) as follows: group 1, qSOFA < 2 and time to PCN insertion < 4 hours; group 2, qSOFA < 2 and time to PCN insertion ≥ 4 hours; group 3, qSOFA ≥ 2 and time to PCN insertion < 4 hours; group 4, qSOFA ≥ 2 and time to PCN insertion ≥ 4 hours. The prognostic impacts of the time to PCN insertion were compared between these groups
Results
The total cohort consisted of 96 patients, of whom 70 were classified as either group 1 or 2 (qSOFA < 2). Overall, 37 patients had a positive urine culture. The median time to PCN insertion was 218 minutes, and the median length of stay was 14 days. The hospitalization period was significantly shorter in group 3 than in group 4 (p=0.041).
Conclusions
A shorter length of stay was associated with more rapid PCN insertion in patients with obstructive uropathy and a high risk of sepsis.

51 View
2 Download

Does Music Have a Calming Effect on Pain and Anxiety in Patients Undergoing Cystoscopy?: Ye Chan Joo, Ji Eun Yu, Jae Hyun Baik, Young Seop Chang, Jin Bum Kim, Hyung Joon Kim, Dong Hoon Koh, Hong Wook Kim; Urogenit Tract Infect 2024;19(1):3-9. Published online April 30, 2024; DOI: https://doi.org/10.14777/uti.2024.19.1.3

Abstract PDF Supplementary Material PubReader ePub: Purpose: Cystoscopy is a diagnostic test performed frequently in urology outpatient clinics. Despite the large number of inspections, the associated pain, discomfort, or anxiety can markedly affect patient compliance and adherence to subsequent surveillance protocols. This study conducted a prospective, randomized study to investigate the potential efficacy of music and pyuria on pain or anxiety during outpatient cystoscopy.
Materials and Methods: In this single-institution, randomized study, the participants were assigned to a music-intervention or non-music control group. The music-intervention group underwent an identical procedure with the addition of Johann Sebastian Bach’s “Air on the G String” from Suite No. 3 in D major, BWV 1068. Urinalysis was performed to determine if pyuria affects pain during the procedure.
Results: The patient-reported outcomes, encompassing the changes in the STAI-X-1 (State-Trait Anxiety Inventory-X-1) scores, subjective levels of discomfort, embarrassment, satisfaction, and pain, were similar in the two groups. In contrast, the surgeons reported statistically significant differences in their evaluations of the same items as patient-reported outcomes of the two groups. The patient-reported pain showed no significant differences between the pyuria-negative group (0-2 and 3-5 WBC/HPF) and pyuria-positive group (>5 WBC/HPF).
Conclusions: The data from this study do not support the hypothesis that musical intervention during cystoscopy alleviates pain or anxiety to any significant extent. In addition, pyuria did not affect the patient’s reported pain. Nevertheless, a notable impact was observed in the surgeons’ assessments, suggesting that the musical accompaniment may alter the surgeons’ perception of patient pain and anxiety levels throughout the procedure.

40 View
4 Download

Korean Translation of the GRADE Series Published in the BMJ, ‘Use of GRADE Grid to Reach Decisions on Clinical Practice Guidelines When Consensus Is Elusive’ (A Secondary Publication): Hyun Jin Jung, Eu Chang Hwang, Do Kyung Kim, Ho Won Kang, Ja Yoon Ku, Hong Wook Kim, Jae Hung Jung, Guideline Development Committee in the Korean Association of Urogenital Tract Infection and Inflammation; Urogenit Tract Infect 2020;15(3):83-89. Published online December 31, 2020; DOI: https://doi.org/10.14777/uti.2020.15.3.83

Abstract PDF Supplementary Material PubReader ePub: This article is the last of a series providing guidance for the use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system for rating the quality of evidence and grading the strength of recommendations in systematic reviews and clinical practice guidelines. Formulating recommendations with the applicable evidence can be difficult due to the large and diverse nature of guideline committees. This article describes a simple technique called the GRADE grid for clarifying the opinions from guideline panels, dealing with disagreement, and achieving consensus among guideline panels. The grid may be helpful for any guideline groups who want to use GRADE to develop their guidelines and achieve consensus or understand the patterns of uncertainty that surround the interpretation of scientific evidence.

22 View
0 Download

Korean Translation of the GRADE Series Published in the BMJ, ‘GRADE: Incorporating Considerations of Resources Use into Grading Recommendations’ (A Secondary Publication): Hong Wook Kim, Jae Hung Jung, Do Kyung Kim, Ho Won Kang, Ja Yoon Ku, Hyun Jin Jung, Eu Chang Hwang, Guideline Development Committee in the Korean Association of Urogenital Tract Infection and Inflammation; Urogenit Tract Infect 2020;15(2):57-62. Published online August 31, 2020; DOI: https://doi.org/10.14777/uti.2020.15.2.57

Abstract PDF Supplementary Material PubReader ePub: This article is the fifth translation of a GRADE series published in the BMJ for incorporating the considerations of resources use into grading recommendations. Clinical recommendations inevitably involve judgments about the allocation of resources use (costs). Although costs differ from typical healthcare outcomes, such as mortality, morbidity, and quality of life, costs are another potentially important outcome that differs across and within a jurisdiction. A balance sheet is a useful method for determining if the net benefits are worth the incremental costs. Resource use, not just monetary values, should always be presented in an evidence profile. Formal economic modeling may or may not help judge the certainty of the evidence for resource use.

12 View
0 Download

Korean Translation of the GRADE Series Published in the BMJ, ‘GRADE: Grading Quality of Evidence and Strength of Recommendations for Diagnostic Tests and Strategies’ (A Secondary Publication): Jae Hung Jung, Do Kyung Kim, Ho Won Kang, Ja Yoon Ku, Hyun Jin Jung, Hong Wook Kim, Eu Chang Hwang, Guideline Development Committee in the Korean Association of Urogenital Tract Infection and Inflammation; Urogenit Tract Infect 2020;15(1):16-25. Published online April 30, 2020; DOI: https://doi.org/10.14777/uti.2020.15.1.16

Abstract PDF Supplementary Material PubReader ePub: This article is the fourth translation of a GRADE series published in the BMJ, which graded the quality of evidence and strength of recommendations for diagnostic tests or strategies, as a comprehensive and transparent approach for developing recommendations. Randomized trials for diagnostic approaches represent the ideal study design for intervention studies. On the other hand, cross-sectional or cohort studies with a direct comparison of the test results with an appropriate reference standard can provide high-quality evidence. The guideline panel must be reminded that the test accuracy is a surrogate for patient-important outcomes, so such studies often provide a low quality of evidence for recommendations regarding diagnostic tests, even when the studies do not have serious limitations. Diagnostic accuracy studies showing that a diagnostic test or strategy improves important patient outcomes will require the availability of effective treatment, reduction of test-related adverse effects or anxiety, or improvement of the patients’ well-being from prognostic information. Therefore, it is important to assess the directness of the test results regarding the consequences of diagnostic recommendations that are important to patients.

19 View
0 Download

Korean Translation of the GRADE Series Published in the BMJ, ‘GRADE: Going from Evidence to Recommendations’ (A Secondary Publication): Eu Chang Hwang, Do Kyung Kim, Ho Won Kang, Ja Yoon Ku, Hyun Jin Jung, Hong Wook Kim, Jae Hung Jung, Guideline Development Committee in the Korean Association of Urogenital Tract Infection and Inflammation; Urogenit Tract Infect 2019;14(3):99-103. Published online December 31, 2019; DOI: https://doi.org/10.14777/uti.2019.14.3.99

Abstract PDF: This article is the third translation of a GRADE series published in the BMJ for developing and presenting recommendations for managing patients. The strength of a recommendation reflects the extent to which we can be confident that desirable effects of an intervention outweigh any undesirable effects. GRADE classifies the strength of recommendations as strong or weak. The strength of recommendation is determined by the balance between desirable and undesirable consequences of alternative management strategies, quality of the evidence, variability in values and preferences, and the appropriate usage of resources.

4 View
0 Download

Korean Translation of the GRADE Series Published in the BMJ, ‘GRADE: What Is “Quality of Evidence” and Why Is It Important to Clinicians?’ (A Secondary Publication): Ho Won Kang, Jae Hung Jung, Do Kyung Kim, Ja Yoon Ku, Hyun Jin Jung, Hong Wook Kim, Eu Chang Hwang, Guideline Development Committee in the Korean Association of Urogenital Tract Infection and Inflammation; Urogenit Tract Infect 2019;14(2):64-70. Published online August 30, 2019; DOI: https://doi.org/10.14777/uti.2019.14.2.64

Abstract PDF: This article is second translation of a GRADE series published in the BMJ to create a highly structured, transparent, and informative system for rating quality of evidence for developing recommendations. The process to develop a guideline, we should formulate a clear question with specification of all outcomes of importance to patients. Grading of Recommendations, Assessment, Development and Evaluation (GRADE) offers four levels of evidence quality: high, moderate, low, and very low for these patient-important outcomes. Randomized trials begin as high quality evidence and observational studies as low quality evidence. Although randomized trials begin as high quality evidence, quality may be downgraded as a result of study limitations (risk of bias), inconsistency (variability in results), indirectness, imprecision (wide confidence intervals), or publication bias. While the quality of evidence derived from observational studies starts at ‘low’ but may be upgraded based on a very large magnitude of effect, a dose-response gradient, and if all plausible biases would reduce an apparent treatment effect.

5 View
0 Download

Korean Translation of the GRADE Series Published in the BMJ, ‘GRADE: An Emerging Consensus on Rating Quality of Evidence and Strength of Recommendations’ (A Secondary Publication): Do Kyung Kim, Eu Chang Hwang, Ho Won Kang, Ja Yoon Ku, Hyun Jin Jung, Hong Wook Kim, Jae Hung Jung, Guideline Development Committee in the Korean Association of Urogenital Tract Infection and Inflammation; Urogenit Tract Infect 2019;14(1):28-32. Published online April 30, 2019; DOI: https://doi.org/10.14777/uti.2019.14.1.28

Abstract PDF: Clinical practice guidelines are statements that include recommendations intended to optimize patient care based on a systematic review of the evidence assessing the benefits and harm of alternative care options. Guideline developers should use an explicit, judicious, and transparent methodology to make trustworthy guidelines. Although there are a variety of frameworks that can help translate enormous medical knowledge into recommendations, the most widely adopted tool for grading the quality of evidence and making recommendations is GRADE (Grading of Recommendations, Assessment, Development and Evaluations). This article is the first translation of a series published in the BMJ with regard to the GRADE Approach for Evidence Based Clinical Practice Guideline Development to provide informative knowledge for moving from evidence to recommendations to Korean guideline developers.

6 View
0 Download

Primary Repair of Erosion after Artificial Urinary Sphincter Implantation: Yong Seung Lee, Hong Wook Kim, Jang hwan Kim; Korean J Urogenit Tract Infect Inflamm 2010;5(2):211-213. Published online October 31, 2010

Abstract PDF: Erosion is a common complication after artificial urinary sphincter implantation and a major cause of sphincter removal. A 73-year old man presented with exposure of artificial urinary sphincter connector and tube through the scrotal skin 13 months after implantation. He had taken radical prostatectomy for prostate cancer. After 10 days of aseptic dressing, the exposed connector was changed and the exposed wound was closed. After a 5-month follow-up period, there has been no complication in both wound and the functions of the artificial urinary sphincter. In conclusion, the small exposure of implantation device through erosion without active infection can be managed with primary repair, rather than initial removal of the device.

6 View
0 Download

Author Index