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Clinical Investigation and Follow-up Monitoring of Fatigue Patients Visiting the Oriental Medical Hospital (한방병원 보양클리닉에 내원하는 피로환자의 임상적 분석 및 치료경과 관찰)

  • 이종훈;이지현;박신명;김영철;이장훈;우홍정
    • The Journal of Korean Medicine
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    • v.21 no.4
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    • pp.55-63
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    • 2000
  • Objectives : Fatigue is a common symptom experienced by everyone. Nevertheless, clinicians have a tendency of ignoring it since fatigue itself is not considered a distinct disease. Actually, some limited research about chronic fatigue syndrome has been made within the country, but in reality, the probability of getting this syndrome is still considered very low due to the strict diagnosis standard. Therefore, there are tremendous numbers of patients who do not get enough attention from clinicians for their fatigue symptoms only because technically they do not belong to the syndrome. Therefore, a basic statistical database must be compiled and patient management programs must be developed. To accomplish this, we conducted this study by measuring degree of fatigue, clinical characteristics and processes of Oriental medical treatment of fatigue patients. Methods : The objects of this study were selected from the new patients who entered the tonification Clinic in Kynnghee Oriental Medical Center between August 11, 2000 and October 7, 2000. Their main complaint was fatigue and they did not suffer from any physical or mental problem either historically or at the time of the study. The objects were divided into two groups based on duration of fatigue; fatigue under 6 months is considered as acute fatigue and fatigue for longer than 6 months is chronic fatigue. The prepared survey sheet for measuring fatigue degree was distributed to the patients with their consent. The patients were divided again into three subgroups : the fIrst group went through 1st test and constitution test after tonification clinic; the second one went into constitution test skipping Ist measuring test; the third one went into only tonification clinic with neither 1st measuring test nor constitution test. Results : The total number of object patients was 47 and 80% of them were considered as 'fatigue patients' by the Chalder scale. Among all patients, 29.5% requested treatment for chronic fatigue, which is over 6 months. The average of scale II for all patients was 14.8, which indicates moderate fatigue. The averages of scale II-1, II-2, II-3 were respectively 7.5, 5.9, and 3.7 so the most common complaint was physical fatigue. When compared scale II based on occupations, student group scored 6.9 and office man group scored 8.5 in scale II-1, physical fatigue, but it was not significant. Conclusions : Numerous number of patients have come to Oriental medical centers or hospitals in Korea. Therefore, deeper statistical research and follow-up-monitoring are reqnired in the Oriental medical academic world. In this study, among all patients who entered the tonification Clinic in Kyunghee Oriental Medical Center, 29.5% requested treatment for chronic fatigue, which is over 6 months. This kind of statistical report is the first time trial in the Oriental medical academy world. Through these steps, more objective treatment can be made and standards of prognosis assessment can be established.tablished.

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Young Women with Breast Cancer in the United States and South Korea: Comparison of Demographics, Pathology and Management

  • Son, Byung Ho;Dominici, Laura S;Aydogan, Fatih;Shulman, Lawrence N;Ahn, Sei Hyn;Cho, Ja Young;Coopey, Suzanne B;Kim, Sung Bae;Min, H Elise;Valero, Monica;Wang, Jiping;Caragacianu, Diana;Gong, Gyung-yub;Hevelone, Nathanael D;Baek, Seunghee;Golshan, Mehra
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2531-2535
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    • 2015
  • Background: Breast cancer diagnosed in young women may be more aggressive, with higher rates of local and distant recurrence compared to the disease in older women. Epidemiologic evidence suggests that Korean women have a lower incidence of breast cancer than women in the United States, but that they present at a younger age than their American counterparts. We sought to compare risk factors and management of young women with breast cancer in Boston, Massachusetts (US) with those in Seoul, South Korea (KR). Materials and Methods: A retrospective review was performed of consecutive patients less than 35 years old with a diagnosis of breast cancer at academic cancer centers in the US and KR from 2000-2005. Patient data were obtained by chart review. Demographic, tumor and treatment characteristics were compared utilizing Pearson's chisquare or Wilcoxon rank-sum tests where appropriate. All differences were assessed as significant at the 0.05 level. Results: 205 patients from the US and 309 from KR were analyzed. Patients in US were more likely to have hormone receptor positive breast cancer, while patients in KR had a higher rate of triple negative lesions. Patients in US had a higher mean body mass index and more often reported use of birth control pills, while those in the KR were less likely to have a sentinel node procedure performed or to receive post mastectomy radiation. Conclusions: Patients under 35 diagnosed with breast cancer in the US and KR differ with respect to demographics, tumor characteristics and management. Although rates of breast conservation and mastectomy were similar, US patients were more likely to receive post mastectomy radiation. The lower use of sentinel node biopsy is explained by the later adoption of the technique in KR. Further evaluation is necessary to evaluate recurrence rates and survival in the setting of differing disease subtypes in these patients.

Health promotion services of health care center at some universities in California, the U.S. (미국 대학보건실의 건강증진 서비스 제공체계 - 캘리포니아 주에 소재한 일부 대학의 운영사례를 중심으로 -)

  • Kim, Young-Bok;Park, Chun-Man
    • The Journal of Korean Society for School & Community Health Education
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    • v.12 no.2
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    • pp.113-127
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    • 2011
  • Background: University health services have provided comprehensive medical care, counseling, health promotion, and public health services to their students and several other local institutions. To their faculty and staff, university health care centers have served occupational health services and employee assistant program. Purpose: We performed this study to review the health promotion services on two kinds of health care center with different style of university formate. Methods: We tried to collect the data by literature review and interview with executive and provider at health care center in University of California at Berkeley and San Jose State University. Results: Our results were as followed. First, students could use the medical services just as they would their regular doctor's office and urgent care center. Second, the health promotion unit offered programs and services for keeping students healthy and safe, including many opportunities for students to get involved in shaping the public health of the campus. Third, the health promotion recommendation offered from ACHA was useful guideline to improve health status of their member in university campus. Finally, the student satisfaction surveys were used for evaluation and quality improvement. Conclusions: The systematic approach to improve health status of students, faculty and staff can use to maintain a state of optimum health among the diverse student community in support of academic excellence. Coupled with health promotion and public health programs, university health service have to reach all segments of the healthy campus community. To achieve study goals in university, the health care center contributes to promote accountability and responsibility for the health and well being of the members in their campus.

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Evaluation of online video content related to reverse shoulder arthroplasty: a YouTube-based study

  • Mohamad Y. Fares;Jonathan Koa;Peter Boufadel;Jaspal Singh;Amar S. Vadhera;Joseph A. Abboud
    • Clinics in Shoulder and Elbow
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    • v.26 no.2
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    • pp.162-168
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    • 2023
  • Background: Reverse shoulder arthroplasty (RSA) has evolved continuously over recent years, with expanded indications and better outcomes. YouTube is one of the most popular sources globally for health-related information available to patients. Evaluating the reliability of YouTube videos concerning RSA is important to ensure proper patient education. Methods: YouTube was queried for the term "reverse shoulder replacement." The first 50 videos were evaluated using three different scores: Journal of the American Medical Association (JAMA) benchmark criteria, the global quality score (GQS), and the reverse shoulder arthroplasty-specific score (RSAS). Multivariate linear regression analyses were conducted to determine the presence of a relationship between video characteristics and quality scores. Results: The average number of views was 64,645.78±264,160.9 per video, and the average number of likes was 414 per video. Mean JAMA, GQS, and RSAS scores were 2.32±0.64, 2.31±0.82, and 5.53±2.43, respectively. Academic centers uploaded the highest number of videos, and surgical techniques/approach videos was the most common video content. Videos with lecture content predicted higher JAMA scores whereas videos uploaded by industry predicted lower RSAS scores. Conclusions: Despite its massive popularity, YouTube videos provide a low quality of information on RSA. Introducing a new editorial review process or developing a new platform for patients' medical education may be necessary. Level of evidence: Not applicable.

A Study on the Home Care Nurses' Perception of the Complementary & Alternative Therapy (가정전문간호사의 대체요법에 대한 인식)

  • Jang, Kyoung-Ja;Kim, Hyun-Li
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.13 no.1
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    • pp.24-32
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    • 2006
  • The purpose of this study is to predict the degree of taking the complementary & alternative therapy in the home care nursing service and provide basic data for the application of it. To accomplish this, degree of general recognition of the complementary & alternative therapy, experiences, degree of concern, applicability of the therapy, and educational need should be studied. This study is a descriptive research survey on the home care nurses working at 73 medical centers out of 125 nationwide who provide hospital based home nursing care. The data was collected from Sep. 20, to Oct. 20, 2004 by ChoiHeyran's questionaries (2002). The data was analyzed by the frequency and the percentage. The results of this study are as follows ; 1. The degree of pre-cognition on the complementary & alternative therapy is very high. Information about the therapy was mostly obtained through medias. Home care nurses understand that he desirable treatment is to practice medical treatment and complementary & alternative therapy simultaneously. While 50% of them have already practiced complementary & alternative therapy among their patients. The most commonly used therapy is Acupressure. And Home care nurses have open and positive attitudes about the complementary & alternative therapy as to answer they aye ready to recommend it to their patients. 2. Over half of the Home care nurses met patients taking complementary & alternative therapy. 94.5% of them think scientific diagnosis on the effect of the therapy. advice from the doctor. and the special working staff is required to apply it on to the home care nursing. 3. 68.5% of the Home care nurses have taken education on the therapy through general comprehensive instructions and supplementary. Most of them want to have a opportunity education on the therapy because they want to provide comprehensive nursing and diversified nursing service. The preferred educations are Hand acupuncture, Acupressure & Massage and Aromatherapy, in that order. Based on the above results, the followings are recommended. 1. A study that stipulates the types, applications, and efficiency assessment of the complementary & alternative therapy practiced by Home care nurses in the home care nursing care procedure. And systematic and scientific nursing intervention be developed.

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Clinical and Imaging Characteristics of SARS-CoV-2 Breakthrough Infection in Hospitalized Immunocompromised Patients

  • Jong Eun Lee;Jinwoo Kim;Minhee Hwang;Yun-Hyeon Kim;Myung Jin Chung;Won Gi Jeong;Yeon Joo Jeong
    • Korean Journal of Radiology
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    • v.25 no.5
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    • pp.481-492
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    • 2024
  • Objective: To evaluate the clinical and imaging characteristics of SARS-CoV-2 breakthrough infection in hospitalized immunocompromised patients in comparison with immunocompetent patients. Materials and Methods: This retrospective study analyzed consecutive adult patients hospitalized for COVID-19 who received at least one dose of the SARS-CoV-2 vaccine at two academic medical centers between June 2021 and December 2022. Immunocompromised patients (with active solid organ cancer, active hematologic cancer, active immune-mediated inflammatory disease, status post solid organ transplantation, or acquired immune deficiency syndrome) were compared with immunocompetent patients. Multivariable logistic regression analysis was performed to evaluate the effect of immune status on severe clinical outcomes (in-hospital death, mechanical ventilation, or intensive care unit admission), severe radiologic pneumonia (≥ 25% of lung involvement), and typical CT pneumonia. Results: Of 2218 patients (mean age, 69.5 ± 16.1 years), 274 (12.4%), and 1944 (87.6%) were immunocompromised an immunocompetent, respectively. Patients with active solid organ cancer and patients status post solid organ transplantation had significantly higher risks for severe clinical outcomes (adjusted odds ratio = 1.58 [95% confidence interval {CI}, 1.01-2.47], P = 0.042; and 3.12 [95% CI, 1.47-6.60], P = 0.003, respectively). Patient status post solid organ transplantation and patients with active hematologic cancer were associated with increased risks for severe pneumonia based on chest radiographs (2.96 [95% CI, 1.54-5.67], P = 0.001; and 2.87 [95% CI, 1.50-5.49], P = 0.001, respectively) and for typical CT pneumonia (9.03 [95% CI, 2.49-32.66], P < 0.001; and 4.18 [95% CI, 1.70-10.25], P = 0.002, respectively). Conclusion: Immunocompromised patients with COVID-19 breakthrough infection showed an increased risk of severe clinical outcome, severe pneumonia based on chest radiographs, and typical CT pneumonia. In particular, patients status post solid organ transplantation was specifically found to be associated with a higher risk of all three outcomes than hospitalized immunocompetent patients.

Development of Health Assessment Tools and Tailored Home Visiting Nursing Service Model for Children in Poverty (신생아-학령전기 대상자의 맞춤형 방문건강관리 기록지 및 모형 개발)

  • Kim, Hee-Ja;Yoo, Jae-Soon;Kim, Hyun-Sook;Tak, Yang-Ju;Bang, Kyung-Sook;Huh, Bo-Yun
    • Korean Parent-Child Health Journal
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    • v.13 no.2
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    • pp.63-77
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    • 2010
  • Purpose: The purpose of this study was to develop child's health assessment tools and tailored home visiting nursing service model in a community. Methods: Based on the literature review and several types of workshops participated with the child health nursing professors and visiting nurses in public health centers from May to December 2009, the standards of child health assessment tools, service model and education materials for visiting nurses were developed. Results: Some record forms were newly developed, including neonatal assessment, breast feeding, mother-infant interaction, oral care, vaccination and safety, and appropriate developmental screening tests in the community were selected. For systematic health care management in the community, problem list, problem criteria, health care plan, outcome criteria were also developed. Conclusion: On the demand of growing need for health promotion and early intervention for children and their association with parenting and socioeconomic status, assessment and control measures are indispensable to the promotion of child health for vulnerable population. Children's health and developmental problems, and safe circumstances can be assessed using this assessment tools, and can be used for tailored home visiting nursing care for children.

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Clinical predictors of therapeutic laparotomy in anterior abdominal stab injuries: a multicenter study from low-income institutions in Ethiopia

  • Segni Kejela;Abel Hedato;Yeabsera Mekonnen Duguma;Meklit Solomon Gebremariam
    • Journal of Trauma and Injury
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    • v.37 no.2
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    • pp.140-146
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    • 2024
  • Purpose: Despite the high incidence of abdominal stab injuries, the rate of nontherapeutic laparotomies and the predictors of therapeutic laparotomies have rarely been studied in low-income settings. Methods: This multicenter retrospective study involved three of the largest academic medical centers in central Ethiopia. All patients who sustained an anterior abdominal stab injury and underwent exploratory laparotomy, regardless of the intraoperative findings, were included over the 3-year course of the study. Results: Of the 117 patients who underwent exploratory laparotomy, 35 patients (29.9%) underwent nontherapeutic laparotomies. Three factors predicted therapeutic laparotomy: hollow viscus evisceration (adjusted odds ratio [AOR], 5.77; 95% confidence interval [CI], 1.16-28.64; P=0.032), localized and generalized peritonitis (AOR, 4.77; 95% CI, 1.90-11.93; P=0.001), and white blood cell count ≥11,500/mm3 (AOR, 2.77; 95% CI, 1.002-7.650; P=0.049). The overall positive predictive value of the therapeutic predictors was 80.2%, while the negative predictive value of all predictor-negative patients was 58.1%. The predictors would have prevented 51.4% of the nontherapeutic laparotomies. Conclusions: Close to one-third of the patients had a nontherapeutic laparotomy. The clinical predictors of therapeutic laparotomy were shown to have a high positive predictive value despite a lower negative predictive value. Further prospective studies that involve all patients who sustain anterior abdominal stab injuries are needed to potentially improve on the negative predictive value of the predictors suggested by our study.

The Preliminary Study on Music?Movement Program developed for Stroke Patients (뇌졸중환자의 음악.동작 프로그램 적용을 위한 예비연구)

  • Suh, Moon-Ja;Jeong, Seong-Hee
    • The Korean Journal of Rehabilitation Nursing
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    • v.6 no.1
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    • pp.79-89
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    • 2003
  • Purpose: This research with one group pre-post design was carried out to test the practical feasibility to administrate the Music Movement program developed for the stroke patients. Subjects: 12 stroke survivors at "J" Public Health Center in Seoul. were participated in. The average age was 68 years old, the ratio of sex was almost 5.8:4.2, the duration of was almost over 1 year. Method: Music Movement program was conducted for 2 hours ${\times}$ 1day ${\times}$ 6 weeks. The contents of Music Movement program were consisted of the preparatory activities, main activities and the wrap up activities. The preparatory activities are ice braking, greeting, explanation of the aims of music movement program, and introduction of stroke disease and ROM exercise. The main activities are the body motions with singing and playing musical instruments. The wrap up activities are stretching and joints and discussion of home activities. Data Collection: The outcome variables are muscle strength, finger pinch power, ROMs, flexibility, depression, and life satisfaction. Depression was measured by CES-D(Kim, I. J., 1999), life satisfaction by ladder scale(McDowell & Newell, 1996), and ADL state(Holbrook & Skilbeck, 1983). Data Analysis: SPSS/PC 10.0 for Window was used. Wilcoxon Signed Ranks Test was used to analyze outcome measures. The level of statistical significance was set at p<.05. Results: This program was effective to decrease the depression level of subjects(p<.05). The muscle strength, hand grip power, ROMs, life satisfaction, and rehabilitation state of the subjects were slightly increased but no significant differences were found between the pre and post test. Additionally every patient replied that they were very satisfied and expressed their appreciation for this program very much. Of course they strongly want to continue to participate in and meet the peer group again. Conclusion: Considering these results, the practical feasibility of Music Movement program can be supported. Therefore, this Music Movement program can be examined with the quasi-experimental design with control group and ongoing reviews. After that, this program would be applied in public health centers, medical institutes, and welfare centers for the rehabilitation of stroke patients.

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A Survey on Clients' Home Care Satisfaction in Taejon City in Korea (일개 시지역의 가정간호 수혜자들의 만족도 조사)

  • Kim, Sun-Sook;So, Hee-Young;Lee, Tae-Yong
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.5
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    • pp.73-83
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    • 1998
  • This study enrolled one thousand five hundred twenty one clients that were receiving home care services at five health centers and a home care services center in the city of Taejon from November 17 through December 7, 1997. The purpose of this study was to analyze satisfaction levels, general characteristics and efficacies, of the client served home care. The main results were as follows; The age group of most of the subjects was 70-79 years: 76.9% of them were female and 87.3% were over 65 years. In education variables, over 90% of the clients were below primary school. In marital status variables, 63.4% of them had no spouse, 57.5% of them were widows and widowers. In living arrangement variables, alone(35.8%) was the most. In insurance status variables, medical aid(69.9%) was the most. In household income variables, below 000 won(72.6%) was the most. In hospitalization variables, 53% of the clients had no hospitalization. The satisfaction level of home care service of male and female was similar. The older the age, the higher the satisfaction level. The satisfaction level of the group having religion was higher than the group having no religion and the Christianity group had the highest satisfaction level(p<0.001). In education variables, the over high school group was the highest satisfaction level(p<0.01). In living arrangement variables, the other (sisters or neighbors etc.) group indicated the highest satisfaction level(p<0.001). In insurance status variables, the other group(except for medical aid) was the highest satisfaction level(p<0.001). In household income variables, below 390,000 won was the highest satisfaction level(p<0.001). In hospitalization variables, 'over 4 times' group indicated the highest satisfaction level (p<0.01). Home care took place more in health centers than in home care services center. In frequency of home care per month three times was the most. In opinion of home care frequency per month 82.8% of the people answered 'proper'. A lot of present illness was neuralgia, arthritis, digestive disease, hypertension & CVA. In contents of home care services variables, education & counselling was the most and medication was second. In duration of illness variables, over 10 years was the most. In place of treatment before home care service variables, hospital(57%) was the most. In illness condition after home care variables, 'moderate' was the most and 'much better'(85.5%) was second. In help of home care variables, 'much help'(71.5%) was the most and 'moderate'(28.1%) was second. In contents of counselling variables, treatment method of illness was the most. Home care services center indicated higher level of satisfaction than health center(p<0.001). In opinion of home care frequency per month variables, 'less' was the highest satisfaction level (p<0.001). In duration of illness variables, below one year was the highest and over 10 years was second(p<0.001). In place of treatment before home care service variables, health center was the highest (p<0.001). In illness condition after home care variables 'much better' was the highest and 'worse' was second (p<0.001). I n help of home care variables, 'much help' was the highest (p<0.001). In contents of counselling variables, cause of illness was the highest(p<0.001). According to the 14 items which consisted of 3 point scales the total level of satisfaction of home care service was very high, with total mean score 36. According to the above results, most clients taking home care services are satisfied. However, organization and a fund are required to support high quality home care services to those who need them. Furthermore, a follow-up survey should be accomplished to evaluate the status of clients.

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