• 제목/요약/키워드: Adverse Factors

검색결과 630건 처리시간 0.022초

Mycophenolate Mofetil 부작용 발생에 미치는 요인 분석 (Factors Affecting the Adverse Drug Reactions of Mycophenolate Mofetil)

  • 김금희;이주연;박경호;손인자;이혜숙
    • 한국임상약학회지
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    • 제20권2호
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    • pp.151-158
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    • 2010
  • Therapeutic drug monitoring of Mycophenolate mofetil(MMF) has been suggested in some clinical trials, but has not been widely adopted in Korea. The purpose of this study was to analyze the withdrawal rates of MMF and determine the characteristics of the patients who experienced adverse reactions with MMF therapy and to suggest the criteria for selecting patients who need monitoring of MMF levels. We retrospectively collected data of patients who started MMF between July 2007 and June 2008. A total of 154 adult patients were included in our study. Among them, ninety seven patients discontinued MMF with 59 cases being due to adverse drug reactions. Thirty one patients required dosage reduction of MMF with twenty three cases being due to adverse reactions. Twenty six patients continued the MMF without or with mild adverse reactions. Of the 82 adverse reaction cases, hematologic adverse reactions accounted for 38 cases (46%) and gastrointestinal (GI) adverse reactions accounted for 28 cases (34%). Older age and lower serum albumin levels were significantly different characteristics between the patients who withdraw MMF due to hematological adverse reactions and those who were able to continue therapy. The group who experienced GI adverse reactions had higher MMF dosages based on body weight and lower serum albumin levels. In conclusion, the factors affecting the adverse reactions of MMF were age, serum albumin level and higher dosage, therefore therapeutic drug monitoring of MMF should be considered in these patients.

자발적 약물 이상반응 보고 분석을 통한 수술 후 통증 조절에 사용된 Fentanyl의 약물사용적정성 (Fentanyl PCA Monotherapy and Fentanyl TTS Combination Therapy in Post-Operative Pain Management: Analyses of Spontaneous Adverse Drug Reaction Reports)

  • 박수정;정경혜;김은영
    • 한국임상약학회지
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    • 제28권2호
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    • pp.81-87
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    • 2018
  • Objective: There have been many cases of spontaneous adverse drug reactions to fentanyl at a regional pharmacovigilance center in the hospital. To assess the factors causing the adverse drug reactions reported in patients receiving fentanyl patient-controlled analgesia (PCA) monotherapy or in combination with fentanyl transdermal therapeutic system (TTS) for acute post-operative pain management. Methods: We conducted a retrospective cohort study with all patients prescribed fentanyl PCA for pain management after orthopedic surgery at a single university hospital from June 2012 to May 2013. We analysed the factors causing adverse drug reactions reported by a spontaneous reporting system in patients receiving fentanyl PCA monotherapy and those receiving fentanyl TTS in combination with fentanyl PCA. Results: Based on the spontaneous adverse drug reaction reporting, the risk ratio for the incidence rate of adverse drug reaction in the fentanyl TTS combination therapy group was 3.04 (95 % CI: 2.4-4.00, P < 0.0001), which was approximately 3-fold higher than that reported for fentanyl PCA monotherapy. Only 60 % of the adverse drug reactions were reported. Conclusion: It is inappropriate to add fentanyl TTS to fentanyl PCA to manage post-operative acute pain. There is a need to improve adverse drug reaction reporting. We expect that regular analysis of adverse drug reactions reported at regional pharmacovigilance centre would aid in appropriate drug utilization by patients.

침도 침술시 부작용과 예방법에 관한 연구 (Clinical Characteristics of Poor Responders to Acupotomy and Safety Pretreatment Management)

  • 김성철
    • Journal of Acupuncture Research
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    • 제25권4호
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    • pp.117-125
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    • 2008
  • Objectives : Analyze according to types of event causing the adverse outcome due to acupotomy, and discuss problems and safety reqirements to using this therapy in Korea. Methods : Based upon the indication, contraindication, treatment procedures, clinical obsevations, acupotomy-related adverse outcome case reports, the factors of damaging event were classified. Results : The main factors of adverse outcome by acupotomy were anatomical ignorance, contamination of device or hospital staff, failure to notice preexisting disease(cardiovascular disease, hypertension, renal failure, hemophilia, chronic Liver Disease, etc.), unskilled treatment procedures(massive bleeding) and techniques(nerve injury, hepatic and splenic injury, Pneumothorax). Conclusions : It is mandatory to prepare adequate sterilie aseptic technique. The clinician should ensure understand genernal health state of patient and anatomical direction.

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재난 대응 활동 시 노출가능 유해인자 종합분석 -화재 현장을 중심으로- (Comprehensive Analysis of Exposed Adverse Factors in Disaster Response Activities - Focused on Fire -)

  • Park, Chanseok
    • 한국재난정보학회 논문집
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    • 제10권3호
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    • pp.420-430
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    • 2014
  • 화재와 같은 재난현장에서 재난대응활동을 수행하는 소방공무원은 진압 구조 구급활동을 하는 동안 열, 연기, 유독가스에 노출되며 정신적인 스트레스, 생물학적 유해인자, 그리고 화재 진압 시 요구되는 인체공학적으로 부자연스러운 자세로 인한 육체적 과부하 등의 다양한 유해인자에 노출되고 있다. 그러나 지금까지 이에 대한 연구는 개별적 수준에서는 일부 존재해 왔지만 화재현장에서 소방관에게 노출되는 유해인자를 종합적으로 정리하고 그 대책까지 제안한 연구는 존재하지 않았다. 본 연구의 목적은 재난현장에서의 안전 및 유해인자를 종합적으로 도출하고 그 대응방안까지 제시함으로써 소방공무원의 노출로 인한 건강장애 및 사고 예방에 기여하는 데 의미가 있다고 할 수 있다. 이에 소방업무환경별로 화재진압분야, 구조 및 구급분야, 생활환경분야로 나누어 환경분석을 하고 물리적 화학적 생물학적 심리적 측면으로 구분하여 화재현장의 유해인자를 도출하고 노출현황을 제시하였다. 그리고, 물리적 유해인자 중에는 특수건강검진 결과 가장 많은 케이이스수를 차지하는 소음분야에 대하여 대처방안을 모색하였다. 화학적 유해인자는 보호장비와 클린룸 운영방안을, 생물학적 유해인자는 감염예방교육과 예방접종, 주기적 관리점검 체계확립을, 심리적 유해인자는 PTSD 경감 부스 설치와 멘토링제도의 도입을 제시하였다.

효과적인 정보화 역기능 해소를 위한 인터넷 중독 유발 요인 분석 (Analysis of Causal Factors of Internet Addiction to Resolve Adverse Effects of the Informatization)

  • 한옥영;김재현
    • 컴퓨터교육학회논문지
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    • 제16권2호
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    • pp.19-27
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    • 2013
  • 정보화 역기능 문제 중에서 인터넷 중독이 매우 심각한 사회 문제로 대두되고 있다. 본 논문은 인터넷 중독을 유발하는 요인 가운데 대학생들에게 가장 큰 영향력을 미치는 요인을 분석하여 효과적 정보화 역기능 해소 방안을 모색하고자 하는 목적으로 수행되었다. 인터넷 중독 유발 요인 분석을 위하여 개인적 요인, 가족적 요인, 사회 환경적 요인을 인터넷 중독 유발 2차 확인 요인으로 정의한 후 각 요인에 대한 1차 확인 요인을 선정하여 인터넷 중독 유발에 미치는 영향력을 고찰하였다. 대학생의 경우에는 인터넷 중독 유발 2차 확인 요인 가운데 개인적 요인이 가장 큰 영향력을 미치는 것으로 나타났으며, 개인적 요인의 1차 확인 요인 중에서 자기 통제력, 자기 효능감이 중요 변수임이 나타났다. 이는 대학생의 인터넷 중독 예방을 위하여서는 개인적 요인 중에 자기 통제력과 자기 효능감에 대한 대응책을 제시하는 것이 가장 효과적 정보화 역기능 해소 방안이 될 수 있음을 의미한다.

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Interpregnancy Interval and Adverse Birth Outcome in Term Premature Rupture of Membrane, 2017

  • Workineh, Yinager;Ayalew, Emiru;Debalkie, Megbaru
    • 식품보건융합연구
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    • 제5권2호
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    • pp.1-11
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    • 2019
  • The objective of this study is to assess the effect of interpregnancy interval on fetal outcome among women with term premature rupture of membrane in public hospitals, Ethiopia, 2017. Facility based follow up study was conducted in Southern Ethiopia public hospitals from February 30, 2017 to August 20, 2017. Among 150 observed mothers with interpregnancy interval of less two years, 46.67 % (95% CI: (7.170, 29.93) of them experienced adverse birth outcome, but among 173 women with interpregnancy interval of two and above years, 5.78% (95% CI: (7.170, 29.93) of them experienced adverse birth outcome. The odds of adverse birth outcome were more among women with interpregnancy interval of less than two years (AOR=17.899, 95%CI: [6.425, 49.859]. The effect of interbirth interval of less than two years on adverse birth outcome of newborn was increased by length labor of >=24 hours, induction of labour and cesarean section delivery. Interpregnancy interval of less than two years, in collaboration with other risk factors, is the main predictor of adverse birth outcome. Therefore especial attention should be given to mothers with birth spacing by using family planning methods to reduce adverse birth outcome.

Is ginseng free from adverse effects?

  • Xie, Jing-Tian;Mehendale, Sangeeta R.;Maleckar, Spring A.;Yuan, Chun-Su
    • Advances in Traditional Medicine
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    • 제2권2호
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    • pp.80-86
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    • 2002
  • Ginseng is a perennial herb widely used in China, Japan, and Korea. It is also one of the most commonly used herbal medicines in the U.S. Although it is generally considered safe to use, adverse effects associated with ginseng use have been reported. Inappropriate ginseng use, such as high dose administration, may cause insomnia, headaches, diarrhea, as well as cardiovascular and endocrine disorders. Other factors that may contribute to adverse effects of ginseng include the variety of ginseng species, variability in commercial ginseng preparations, and potential ginseng-drug interactions. To minimize adverse effects of ginseng, consumers should be advised to use it appropriately, and the herbal industry should try to provide standardized ginseng preparations.

Rituximab 주입관련 부작용발생 및 위험인자 분석 (Rituximab Infusion-related Adverse Events and Risk Factors)

  • 이은정;김영주;이정연
    • 한국임상약학회지
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    • 제23권3호
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    • pp.223-231
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    • 2013
  • Objective: This study aimed to identify the status and risk factors of rituximab infusion-related adverse events (ADE) in rituximab-na$\ddot{i}$ve patients with cancer diseases. Method: A retrospective analysis using electronic medical records review was conducted. Inclusions were patients with a diagnosis of cancer disease with the initiation of rituximab-included treatment who were na$\ddot{i}$ve to rituximab during January 2011 to March 2013 at National Cancer Center (NCC) in Korea. Result: Total 110 patients, 582 cases of rituximab administrations, were reported in the study. About 57.2% of patients were 51-70 years old and evenly distributed between two genders and 72.7% were BMI less than $25kg/m^2$. All of study patients were diagnosed with non-Hodgkin lymphoma. Fifty patients (45.4%) and 54 cases (9.3%) were experienced rituximab infusion-related AEs even with conservative administration protocol at NCC. The most frequently occurring AEs were shivering followed by rash and itching. In single variant analysis, we found that the early stage of NHL, low exposure to rituximab administrations, high white blood cell counts, high lymphocyte counts, high absolute neutrophil count and low lactate dehydrogenase were associated with infusion-related AEs (p<0.05). The early stage of disease, high lymphocyte counts, low exposure to rituximab administrations were also related significantly with AEs in multiple variants analysis (p<0.05). Conclusion: Rituximab infusion-related AEs for patients who were na$\ddot{i}$ve to rituximab were still a concern with conservative administration protocol. The adverse drug reactions were significantly associated with early stage of NHL, higher lymphocyte counts and low exposure to rituximab administrations. The factors need to be considered with close monitoring to prevent rituximab infusion-related AE.

Clinical Determinants of Weight Loss in Patients with Esophageal Carcinoma During Radiotherapy: a Prospective Longitudinal View

  • Jiang, Nan;Zhao, Jin-Zhi;Chen, Xiao-Cen;Li, Li-Ya;Zhang, Li-Juan;Zhao, Yue
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권5호
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    • pp.1943-1948
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    • 2014
  • Purpose: The prevalence of weight loss in esophageal carcinoma patients is high and associated with impairment of physical function, increased psychological distress and low quality of life. It is not known which factors may contribute to weight loss in patients with esophageal carcinoma during radiotherapy in China. The objective of this study was to identify the associated demographic and clinical factors influencing weight loss. Methods: We evaluated 159 esophageal carcinoma patients between August 2010 and August 2013 in a crosssectional, descriptive study. Patient characteristics, tumor and treatment details, psychological status, adverse effects, and dietary intake were evaluated at baseline and during radiotherapy. A multivariate logistic regression analyss was performed to identify the potential factors leading to weight loss. Results: 64 (40.3%) patients had weight loss ${\geq}5%$ during radiotherapy. According to logistic regression analysis, depression, esophagitis, and loss of appetite were adverse factors linked to weight loss. Dietary counseling, early stage disease and total energy intake ${\geq}1441.3$ (kcal/d) were protective factors. Conclusions It was found that dietary counseling, TNM stage, total energy intake, depression, esophagitis, and loss of appetite were the most important factors for weight loss. The results underline the importance of maintaining energy intake and providing dietary advice in EC patients during RT. At the same time, by identifying associated factors, medical staff can provide appropriate medical care to reduce weight loss. Further studies should determine the effect of these factors on weight loss and propose a predictive model.

황천 시 최소추진출력 관련 IMO 잠정 가이드라인의 진행 현황과 적용 결과 검토 (Progress of the 2013 Interim Guidelines for Determining Minimum Propulsion Power to Maintain the Manoeuvrability of Ships in Adverse Conditions)

  • 성영재;옥유빈
    • 대한조선학회논문집
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    • 제56권6호
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    • pp.497-506
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    • 2019
  • Literature survey was conducted on the 2013 Interim Guidelines for determining the minimum propulsion power to maintain the manoeuvrability of ships in adverse conditions. The International Maritime Organization (IMO) Marine Environment Protection Committee (MEPC) documents related with the Guidelines were reviewed. Compatibility of the present Guidelines can be checked by two different levels: (Level 1) minimum power lines assessment and (Level 2) simplified assessment. The IHS (Information Handling Services) sea-web data on the bulk carriers and the tankers, which were built after 2000, were used to examine the Level 1 assessment. KVLCC2 was used to examine the Level 2 assessment. Regarding the Level 2 assessment, effects of the adverse weather conditions, the added resistance due to waves, the wake fractions and the thrust deduction factors were discussed.