• Title/Summary/Keyword: Adult patient

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Increased Prevalence of Chronic Disease in Back Pain Patients Living in Car-dependent Neighbourhoods in Canada: A Cross-sectional Analysis

  • Zeglinski-Spinney, Amy;Wai, Denise C.;Phan, Philippe;Tsai, Eve C.;Stratton, Alexandra;Kingwell, Stephen P.;Roffey, Darren M.;Wai, Eugene K.
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.5
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    • pp.227-233
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    • 2018
  • Objectives: Chronic diseases, including back pain, result in significant patient morbidity and societal burden. Overall improvement in physical fitness is recommended for prevention and treatment. Walking is a convenient modality for achieving initial gains. Our objective was to determine whether neighbourhood walkability, acting as a surrogate measure of physical fitness, was associated with the presence of chronic disease. Methods: We conducted a cross-sectional study of prospectively collected data from a prior randomized cohort study of 227 patients referred for tertiary assessment of chronic back pain in Ottawa, ON, Canada. The Charlson Comorbidity Index (CCI) was calculated from patient-completed questionnaires and medical record review. Using patients' postal codes, neighbourhood walkability was determined using the Walk Score, which awards points based on the distance to the closest amenities, yielding a score from 0 to 100 (0-50: car-dependent; 50-100: walkable). Results: Based on the Walk Score, 134 patients lived in car-dependent neighborhoods and 93 lived in walkable neighborhoods. A multivariate logistic regression model, adjusted for age, gender, rural postal code, body mass index, smoking, median household income, percent employment, pain, and disability, demonstrated an adjusted odds ratio of 2.75 (95% confidence interval, 1.16 to 6.53) times higher prevalence for having a chronic disease for patients living in a car-dependent neighborhood. There was also a significant dose-related association (p=0.01; Mantel-Haenszel chi-square=6.4) between living in car-dependent neighbourhoods and more severe CCI scores. Conclusions: Our findings suggest that advocating for improved neighbourhood planning to permit greater walkability may help offset the burden of chronic disease.

Comprehensive Orthodontic Treatment in a Middle-Aged Patient with Missing Maxillary Left First Premolar: A Case Report

  • Kwon, Sun-Mi;Baik, Hyoung-Seon;Choi, Sung-Hwan
    • Journal of Korean Dental Science
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    • v.11 no.1
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    • pp.32-41
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    • 2018
  • As the adult population continues to increase, orthodontic treatment for adult patients is becoming more common. This case report describes comprehensive orthodontic treatment of a middle-aged patient with closure of the extraction space without prosthetic restoration. A 55-year-old woman with her maxillary left first premolar extracted because of a periodontal problem, wanted to close the space with orthodontic treatment. Since she had generalized crowding and mild skeletal discrepancy, we planned comprehensive orthodontic treatment, including closure of the extraction space by protraction of the left maxillary molars using miniscrews and aesthetic alignment of anterior teeth. The total treatment period was 28 months. As a result of these treatments, the extraction space was successfully closed, good tooth alignment and satisfactory occlusion were achieved.

Langerhans Cell Histiocytosis of the Rib of an Adult Female Patient: a Case Report

  • Oh, Chang Hoon;Kang, Woo Young;Lee, Ok-Jun
    • Investigative Magnetic Resonance Imaging
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    • v.24 no.1
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    • pp.61-65
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    • 2020
  • Langerhans cell histiocytosis (LCH) is generally considered a childhood disease that exhibits various nonspecific clinical and radiological manifestations that mimic infection or malignancy. Here, we present a case of LCH involving the rib in an adult patient. CT and MRI revealed an expansile lytic lesion with periosteal reaction on the left 8th rib, suggesting a malignant bone tumor. Surgical resection was performed and histopathological examination was consistent with LCH. Owing to its rare occurrence in adults and nonspecific aggressive features, LCH should be included in the differential diagnosis of an aggressive-appearing rib lesion in both adults and children.

The orthodontic strategies for adult patients of cleft lip and palate (성인 구순구개열환자의 교정치료 전략)

  • Kim, Jae-Hoon
    • The Journal of the Korean dental association
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    • v.53 no.7
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    • pp.450-456
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    • 2015
  • Even the adult cleft lip and palate patient who has not had timely treatment during the growth period, can be treated with orthodontic treatment without the necessity of orthognathic surgery if only the patient is treated under correct diagnosis and fitting appliances. Initially, maxillary arch form is established by constructing trifocal circles. Posterior region can be expanded and derotated laterally with pentahelix and anterior teeth are aligned with Tiggle brackets and "ㄷ"-shaped spring. Thereafter, anterior and posterior regions are consolidated. Mandibular intercanine width should be adjusted to maxillary intercanine width which was unavoidably reduced. Mandibular anterior tooth extraction will be helpful to attain proper mandibular intercanine width and better anterior dental showing.

Understanding and managing patients with adult rare diseases

  • Jangsup Moon
    • Journal of Genetic Medicine
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    • v.21 no.1
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    • pp.1-5
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    • 2024
  • Despite advances in the diagnosis and management of rare diseases (RDs), there remains a tendency to overlook adult RD patients. In addition to the considerable number of adult-onset RDs, advances in the diagnosis and management of pediatric RDs have led to an increase in the survival of these patients into adulthood. Adult RDs exhibit distinct features from pediatric counterparts, necessitating careful consideration during medical assessments. Given the extended life expectancy of adult RD patients, precise diagnosis and management strategies can significantly enhance patient outcomes. This review aims to provide an in-depth exploration of the characteristics unique to adult RDs. Special emphasis will be placed on the importance of cascade screening and prenatal genetic testing in the context of adult RDs, highlighting the need for a comprehensive understanding of these aspects in clinical practice.

Atlantoaxial Rotatory Fixation in Adults Patient

  • Jeon, Sei-Woong;Jeong, Je-Hoon;Moon, Seung-Myung;Choi, Sun-Kil
    • Journal of Korean Neurosurgical Society
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    • v.45 no.4
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    • pp.246-248
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    • 2009
  • Atlantoaxial rotatory fixation (AARF) in adult is a rare disorder that occurs followed by a trauma. The patients were presented with painful torticollis and a typical 'cock robin' position of the head. The clinical diagnosis is generally difficult and often made in the late stage. In some cases, an irreducible or chronic fixation develops. We reported a case of AARF in adult patient which was treated by immobilization with conservative treatment. A 25-year-old female was presented with a posterior neck pain and limitation of motion of cervical spine after a traffic accident. She had no neurological deficit but suffered from severe defect on the scalp and multiple thoracic compression fractures. Plain radiographs demonstrated torticollis, lateral shift of odontoid process to one side and widening of one side of C1-C2 joint space. Immobilization with a Holter traction were performed and analgesics and muscle relaxants were given. Posterior neck pain and limitation of the cervical spine' motion were resolved. Plain cervical radiographs taken at one month after the injury showed that torticollis disappeared and the dens were in the midline position. The authors reported a case of type I post-traumatic AARF that was successfully treated by immobilization alone.

Study on Family Caregiving Burden Scale of Dementia-Korea(FCBSD-K) (치매환자 가족부담감의 한국형 도구개발)

  • Cho, Nam Ok
    • Korean Journal of Adult Nursing
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    • v.12 no.4
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    • pp.629-640
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    • 2000
  • The purpose of this study was to develop and validate the scale to measure dementia patient's caregiver burden of Korea. In the first phase of the study, 15 caregivers of dementia patients were interviewed to provide narrative data from which items were developed. Initially 65 items were generated from the interview data of 15 caregivers. Content validity was judged by two separate panels of experts with 27 professionals and 30 family caregivers. These items were analyzed through the Index of Content Validity and 33 items were selected which met .80 or more of the CVI. This preliminary FCBSD-K was tested with 207 adult caregivers for reliability and construct validity including item analysis and orthogonal(Varimax) factor analysis. Eight items were deleted because of high or low item-item correlation. The result of the second factor analysis produced six factors that coincided with the conceptual framework posed for the scale developed. The six factors were labeled as 'physio social factor' 'emotional factor' 'family cultural factor' 'role obligation' 'guilt feeling' and 'financial & supportive system factor'. The alpha coefficient relating to internal consistency was .9264 for reliability. In conclusion, cultural factor is related to dementia patient's caregiver burden and FCBSD-K was useful in assessing the dementia patient's caregiver burden in Korea.

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Palatal Fistula of a Healthy Adult after an Infectious Disease: A Case Report (건강한 성인에서 감염성 질환 후 발생한 구개누공 치험례)

  • Choi, Hyun Nam;Park, Jin Hyung;Han, Yea Sik
    • Archives of Craniofacial Surgery
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    • v.13 no.1
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    • pp.80-83
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    • 2012
  • Purpose: In rare cases, infectious disease can become the cause of palatal fistula as it usually occurs in immunocompromised patients. We are reporting this case because we have successfully reconstructed palatal fistula occurring due to infectious disease in a healthy adult. Methods: A 62-year-old female patient had visited our hospital with a palatal hole that had occurred after suffering from a severe febrile disease. An oro-nasal fistula measuring $1.5{\times}1.3cm$ has been observed in the junction of the soft palate and hard palate, and is presumed to be caused by an infectious disease according to the patient's history. It was reconstructed using a hinge flap and a mucoperiosteal flap. Results: For 6 months, no recurrence or complications had been observed. The post operative patient was satisfied with the improvement in nasal speech and fluid regurgitation. Conclusion: We reported this case since we had obtained a functionally satisfactory result by reconstructing the palatal fistula due to infectious disease in a healthy adult.

Development of a Protocol for Nursing Care after Death for Adult Patients in Hospitals (병원 성인 환자의 사후 간호 프로토콜 개발)

  • Kim, Ki Kyong;Kim, Aeng Do;Ahn, Kyung Ah;Cheon, Jooyoung
    • Journal of Korean Clinical Nursing Research
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    • v.29 no.1
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    • pp.75-84
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    • 2023
  • Purpose: This study developed a protocol for nursing care after death for adult patients in hospitals. Methods: This was a methodological study to develop a care after death protocol. The preliminary protocol was developed based on a literature review, guidelines, and practice recommendations from groups of experts and clinical nurses. Content validity was evaluated by a group of experts (n=6) and nurses (n=30) in two hospitals. Results: The preliminary protocol recommendations were modified by validation and the open-question analysis results. The final protocol comprised three general recommendations and 43 recommendations in five steps that are verification and notification of a death, personal care of the body, viewing the patient, patient transfer, and documentation and self-care. Conclusion: This study result provides nurses with a consensus information on patient care after death and family support in a hospital setting. This nursing protocol is expected to improve the quality of care after death for adult patients and their families, and can be used for developing educational and emotional support for nurses to accomplish their important role.

The Correlation Among Health Status, Burden and Quality of Life of the Adult Stroke Patient's Family and the Elderly Stroke Patient's Family (노인층과 청·장년층 뇌졸중 환자가족의 건강상태·부담감 및 삶의 질과의 관계)

  • Kim, Kwuy-Bun;Lee, Kyung-Ho
    • Korean Journal of Adult Nursing
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    • v.13 no.2
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    • pp.262-276
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    • 2001
  • The purpose of this study is to investigate the correlation among the stroke patient family's health, burden and quality of life which is based upon the comparative appreciation of the adult stroke patient's family and elderly stroke patient's family. For this purpose, data were collected from the family care-givers for two groups of stroke patients under sixty years old and over sixty years of age, admitted at K Hospital and H Hospital in Seoul. The instruments for this research are based on the tool for measuring physical health and psychological health developed by Yang, Young-hee(1992), the tool for measuring the sense of burden by Seo, Mee-hae and Oh, Ga-sil(1993), and the tool for the quality of life by Noh, Yoo-ja(1988). The sampling for this study was done from December, 2000 until February, 2001. Questionnaire data were drawn up by personal interviews aided by the staff nurses. The analysis of collected data are based on general characteristics calculated at the rate of 100 percent of the average, t-test, ANOVA(some difference on a level with p<.05 being subsquently confirmed by DMR) for Health Status, Burden, Quality of Life and Pearson Correlation to verify the hypothetical correlation among the subjects. The results of this study are as follows: 1. In the adult stroke patient family, the factors influencing the physical health proved to be age, present occupation and family-formation. Here, the factors influencing psychological health turned out to be age, matrimonial status, present occupation and family-formation. In the elderly stroke patient family, the factors influencing physical health proved to be age, gender, final academic status, matrimonial status, present occupation, and relation with the patient. Here, the factors influencing the psychological health were age, final academic status, matrimonial status, present occupation, relation with the patient and family-formation. In the former case, the influencing factors upon the burden were shown to be age, final academic status, matrimonial status, relation with the patient and family-formation. In the latter case, the influences upon the burden were age, gender, final academic status, matrimonial status, present occupation and relation with the patient. In the former case, the influences on the quality of life were gender, and economic situation. In the later case, the influencing factors on the quality of life were age, final academic status, matrimonial status, present occupation, and relation with the patient. 2. The rate of the physical condition in the former case turned out to be 2.83, and the psychological condition 2.37. The physical condition of the latter case was 2.76, and the psychological condition 2.46. The rate of the burden in the former case was 3.14, and that of the latter case was 3.04. The rate of quality of life in the former case proved to be 2.46, and that of the latter case 2.55. 3. The rate of correlation between the burden and the quality of life appeared to be the high counter-correlation (r= -.573). The rate of correlation between the psychological health and the burden of a simialr (r= -.565). The rate of correlation between the physical health and the psychological health proved to be a moderate correlation (r= .372), The rate of correlation between physical health and the burden turned out to be a low counter-correlation (r= -.276). According to this study, there proved to be a very close correlation among the stroke patient family's health, the burden and quality of life. Thus, it would be necessary to find out various nursing interventions in order to mitigate the stroke patient family's burden in the process of caring for the patients.

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