• Title/Summary/Keyword: Adverse Factors

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Arthralgia and Myalgia Associated with the Use of Bisphosphonate: An Active Monitoring Study (비스포스포네이트 제제 관련 관절통 및 근육통에 대한 지역 약국 약사 및 환자 능동적 모니터링)

  • Song, Jung-woo;Park, So-Hee;Yoon, Dongwon;Lee, Mo-Se;Lee, Jung-Min;Kim, Na-Young;Kim, Young-Wook;Lee, Ju-Yeun;Shin, Ju-Young
    • Korean Journal of Clinical Pharmacy
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    • v.31 no.3
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    • pp.180-187
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    • 2021
  • Objective: We investigated arthralgia and myalgia associated with the use of oral bisphosphonate (BP) by conducting a survey of patient. Methods: The pharmacists conducted a survey between 1 Oct 2019 and 30 Sep 2020 among patients who were dispensed BP in community pharmacies to assess their demographic and medical characteristics, and their experiences with, and process for pain. Logistic regression analyses were performed to find the risk factors associated with the pain, and the odds ratios (OR) and 95% confidence intervals (CI) were determined. Results: A total of 160 patients who used BP participated in the survey (74 [46.3%] used risedronate; 61 [38.1%] used alendronate; 23 [14.4%] used ibandronate), and 20 (12.5%) of them experienced pain. Significant statistical differences of the characteristics between patients who experienced pain or not were observed regarding menopause, and parity. Compared with women who had one or two parity, women who had more than three parity were associated with the decreased risk of pain (OR, 0.24; 95% CI, 0.04-0.98). Moreover, steady exercise was associated with the decreased risk of pain compared to less exercise (OR, 0.37; 95% CI, 0.14-0.98). Conclusion: Our findings suggest that the risk of pain in BP-treated patients might be different regarding the different ingredients of BP, and dosing frequency. This survey highlights a need for a further safety research to understand the factors influencing the pain associated with the BP treatment.

Factors affecting on Perceived Medication Administration Competence in Senior Nursing Students (졸업 예정 간호대학생의 주관적 투약수행역량 영향요인)

  • Kim, Jeong-Hee;Kang, Kyung-Ja
    • Journal of Digital Convergence
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    • v.17 no.7
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    • pp.215-224
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    • 2019
  • The objective of study was to identify perceived medication administration Competence of senior nursing students. A total of 128 students were recruited. The instruments for this study were self-efficacy for drug dosage calculation, anxiety for drug dosage calculation and perceived medication administration competence. The data were collected from November 2018 to January 2019, analyzed by descriptive analysis, chi-square, t-test, Scheffe test, correlation coefficients, and multiple regression using the SPSS 25.0 program. The main predictors of perceived medication administration competence were identified as confidence in drug dosage calculation (${\beta}=.463$, p<.001), Attitude of participation at clinical practice (${\beta}=.168$, p=.040). These two factors explained about 29% of variance in perceived medication administration competence (F=26.93, p<.001). It can contribute to improve their ability to administrate medication in practice, with the accuracy of prescription, recalculation of prescribed drug dose, and observation of adverse reactions in clinical practice and simulation with collaborative approach.

Evaluation of Stent Apposition in the LVIS Blue Stent-Assisted Coiling of Distal Internal Carotid Artery Aneurysms : Correlation with Clinical and Angiographic Outcomes

  • Kwon, Min-Yong;Ko, Young San;Kwon, Sae Min;Kim, Chang-Hyun;Lee, Chang-Young
    • Journal of Korean Neurosurgical Society
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    • v.65 no.6
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    • pp.801-815
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    • 2022
  • Objective : To evaluate the stent apposition of a low-profile visualized intraluminal support (LVIS) device in distal internal carotid artery (ICA) aneurysms, examine its correlation with clinical and angiographic outcomes, and determine the predictive factors of ischemic adverse events (IAEs) related to stent-assisted coiling. Methods : We retrospectively analyzed a prospectively maintained database of 183 patients between January 2017 and February 2020. The carotid siphon from the cavernous ICA to the ICA terminus was divided into posterior, anterior, and superior bends. The anterior bends were categorized into angled (V) and non-angled (C, U, and S) types depending on the morphology and measured angles. Complete stent apposition (CSA) and incomplete stent apposition (ISA) were evaluated using unsubtracted angiography and flat-panel detector computed tomography. Dual antiplatelet therapy with aspirin 200 mg and clopidogrel 75 mg was administered. Clopidogrel resistance was defined as fewer responders (≥10%, <40%) and non-responders (<10%) based on the percent inhibition (%INH) of the VerifyNow system. These were counteracted by a dose escalation to 150 mg for fewer responders or substitution with cilostazol 200 mg for non-responders. IAEs included intraoperative in-stent thrombosis, transient ischemic attack, cerebral infarction, and delayed in-stent stenosis. A multivariate logistic regression analysis was used to determine the predictive factors for ISA and IAEs. Results : There were 33 ISAs (18.0%) and 27 IAEs (14.8%). The anterior bend angle was narrower in ISA (-4.16°±25.18°) than in CSA (23.52°±23.13°) (p<0.001). The V- and S-types were independently correlated with the ISA (p<0.001). However, treatment outcomes, including IAEs (15.3% vs. 12.1%), aneurysmal complete occlusion (91.3% vs. 88.6%), and recanalization (none of them), did not differ between CSA and ISA (p>0.05). The %INH of 27 IAEs (13.78%±14.78%) was significantly lower than that of 156 non-IAEs (26.82%±20.23%) (p<0.001). Non-responders to clopidogrel were the only significant predictive factor for IAEs (p=0.001). Conclusion : The angled and tortuous anatomical peculiarity of the carotid siphon caused ISA of the LVIS device; however, it did not affect clinical and angiographic outcomes, while the non-responders to clopidogrel affected the IAEs related to stent-assisted coiling.

Cone-beam computed tomographic evaluation of mandibular incisor alveolar bone changes for the intrusion arch technique: A retrospective cohort research

  • Lin Lu;Jiaping Si;Zhikang Wang;Xiaoyan Chen
    • The korean journal of orthodontics
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    • v.54 no.2
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    • pp.79-88
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    • 2024
  • Objective: Alveolar bone loss is a common adverse effect of intrusion treatment. Mandibular incisors are prone to dehiscence and fenestrations as they suffer from thinner alveolar bone thickness. Methods: Thirty skeletal class II patients treated with mandibular intrusion arch therapy were included in this study. Lateral cephalograms and cone-beam computed tomography images were taken before treatment (T1) and immediately after intrusion arch removal (T2) to evaluate the tooth displacement and the alveolar bone changes. Pearson's and Spearman's correlation was used to identify risk factors of alveolar bone loss during the intrusion treatment. Results: Deep overbite was successfully corrected (P < 0.05), accompanied by mandibular incisor proclination (P < 0.05). There were no statistically significant change in the true incisor intrusion (P > 0.05). The labial and lingual vertical alveolar bone levels showed a significant decrease (P < 0.05). The alveolar bone is thinning in the labial crestal area and lingual apical area (P < 0.05); accompanied by thickening in the labial apical area (P < 0.05). Proclined incisors, non-extraction treatment, and increased A point-nasion-B point (ANB) degree were positively correlated with alveolar bone loss. Conclusions: While the mandibular intrusion arch effectively corrected the deep overbite, it did cause some unwanted incisor labial tipping/flaring. During the intrusion treatment, the alveolar bone underwent corresponding changes, which was thinning in the labial crestal area and thickening in the labial apical area vice versa. And increased axis change of incisors, non-extraction treatment, and increased ANB were identified as risk factors for alveolar bone loss in patients with mandibular intrusion therapy.

Physiological Characteristics Related to Cold Injury in Rice (수도 냉해에 관련된 생리적 특성 고찰)

  • 석순종;허일봉;임정남
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.36 no.5
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    • pp.429-444
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    • 1991
  • Cold stress influence plant growth through a wide range of growth characters. Adverse effects of low temperature to plant growth come from results of colligative and complex physiological responses to cold stress. To evaluate more exactly cold tolerance of crop plant, it is needed to observe physiological changes induced by cold stress and to analyze relationships between intraspecific variations in physiological factors related to cold tolerance and the extent of cold tolerance in the field. Therefore, the composition and unsaturation ratio of fatty acids in phospholipid, a constituent of membrane, the transition-temperature in respiratory activity of mitochodria, the chlorophyll fluorescence as a factor related to photosynthesis were investigated in rice plant and data on these factors were compared with the degree of cold tolerance obtained in the field experiment. Also, effects of hardening and Mn++ treatment were evaluated as a method to reduce chilling injuries. The unsaturation ratio of fatty acids, whether rice plants were grown in a natural condition or under the chilling stress, was higher in the cold- tolerant varieties and was significantly correlated with the degree of cold tolerance (1-9) observed in the field experiment. And it was also increased by chilling treatment or hardening treatment, due to a reduction in palmitic acid content and an increase in linolenic acid content. The transition-temperature of respiratory activity of mitochodria isolated from etiolated rice seedlings ($25^{\circ}C$, two week-grown in the dark), was correlated with the degree of cold tolerance in the field, cold -tolerant varieties showing a lower transition-temperature. It was not influenced by growth stages. The intensity of chlorophyll fluorescence was highly correlated with the degree of cold tolerance, cold-tolerant varieties having a higher fluorescence intensity. By foliar application of Mn, the transition-temperature of respiratory activity was lowered as much as 0-2$^{\circ}C$ in all tested varieties. Soil application of Mn induced more significant effect in cold-susceptible varieties with a possibility of reducing chilling injuries. On the whole, there were high correlationships among the degree of cold tolerance, the unsaturation ratio of fatty acids in phospholipid, the transition- temperature of respiratory activity and chlorophyll fluorescence except for a few varieties. The transition- temperature of respiratory activity appeared to be negatively correlated with the unsaturation ratio of fatty acids. and the chlorophyll fluorescence to be positively correlated with the unsaturation ratio. This implies that these physical and physiological factors were very closely related to cold tolerance and can be used as an effective index of the evaluation of cold tolerance of crop plant. But other factors as well as three factors discussed above are needed to be considered colligatively and altogether with a systematic analysis for the more exact evaluation of cold tolerance. in rice cultivars. in rice cultivars.

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A Study on Ecological Variables that Affect Runaway Youths at Risk in Preparation for a Independent Life - Centering on Youths at Shelters (가출위기청소년의 자립생활 준비에 영향을 미치는 생태 체계적 변인연구 - 쉼터 청소년을 중심으로 -)

  • Oh, Soo-Saing;Byun, Sang-Hae
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.7 no.2
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    • pp.195-205
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    • 2012
  • This study examines runaway youths at risk in a youths' shelter who are preparing for an independent life and both the facilitating and adverse factors to personal characteristics and independence of runaway youths at risk with the aim to grasp their recognition of independence and level of desire for it and find out necessary factors for a successful independence in multidimensional perspectives including the economic independence, educational independence, psychological independence, and social independence for their sound growth. This will provide the basis for desirable interventions for youths runaway youths at risk to prepare for an independent life. The findings of this study on the factors that affect the preparation for an independent life are as follows: First, as a result of analyzing the effect of micro-systematic factors on the preparation for an independent life, it turned out that problem-solving abilities and self-efficacy had influence on the preparation for a career Second, as a result of analyzing the effect of mesoscopic-systematic variables on the preparation for an independent life, it turned out that the preparation for a career were affected by whether to participate in independence preparation programs and institutional supports, and that career maturity of runaway youths at risk were affected only by the relationship with teachers and participation in independence preparation programs. Third, as a result of analyzing the effect of macro systematic variables on the preparation for an independent life, it turned out that the preparation for a career were affected by participation of the local community and service network, and that participation of the local community was an predictor variable that would affect a career maturity of runaway youths at risk. Fourth, as a result of analyzing ecological systematic variables that might affect the preparation for a career, it turned out that intervening variables and macro systematic variables had the most powerful influence on the preparation for a career among runaway youths at risk. It is necessary, therefore, to provide education programs organized by policies in order to develop problem-solving abilities and vocational capabilities so that runaway youths at risk, and to train and appoint more professional teachers at shelters. Programs for independence preparation need to be developed actively and practically in consideration of the characteristics of shelters, and the network with the local community for support also need to be established in utilization of the human resources and service programs of the community. With the understanding of leaving home of runaway youths at risk as the previous stage of an independence, there should be a housing support for their stable settlement in the perspective of housing welfare until become adults. In addition, there should be education specialized programs for occupation and careers to train runaway youths at risk as professionals including such areas as health, mentality, learning, and voluntary work for their sound growth.

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Effects of Ishige okamurae Extract Supplement on Blood Glucose and Antioxidant Systems in Type 2 Diabetic Patients (패 추출물이 제2형 당뇨병 환자의 혈당 및 항산화 체계에 미치는 영향)

  • Kang, Yeon-Ju;Kim, Hak-Ju;Han, Ji-Sook
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.40 no.12
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    • pp.1726-1733
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    • 2011
  • We performed a randomized placebo-controlled trial to determine whether or not Ishige okamurae extract supplements modulate blood glucose and antioxidant systems in type 2 diabetic patients. A total of 46 patients were randomized to either an Ishige okamurae extract group or a placebo group. The patients consumed either 1,600 mg of Ishige okamurae extract or cornstarch supplement per day for 10 weeks. The lifestyle factors and dietary intake of patients were not altered during the 10 week trial period. After 10 weeks, the fasting blood glucose level was slightly decreased in the Ishige okamurae extract group, but a significant decrease was not observed. Also, glycosylated hemoglobin was significantly (p<0.01) decreased. Especially, low-glycosylated hemoglobin ($7.12{\pm}0.38%$ to $6.56{\pm}0.53%$) was significantly decreased compared to high-glycosylated hemoglobin ($8.65{\pm}0.92%$ to $8.60{\pm}0.85%$) in that group. The superoxide dismutase, catalase, and glutathione peroxidase levels were increased in the Ishige okamurae extract group compared to the placebo group. The increase of these enzymes was associated with the decrease of MDA concentration in the Ishige okamurae extract group, but a significant decrease was not observed. The Ishige okamurae extract supplement showed no adverse effects on liver and kidney functions. Findings from this study suggest that an Ishige okamurae extract supplement can help blood glucose status in type 2 diabetic patients without adverse effects.

Discontinuation Rate of Doxepin in Insomnia Patients (불면증 환자의 Doxepin 치료 중단율)

  • Lee, Ji Hyeon;Kim, Sung-Min;Hong, Seung-Chul;Seo, Ho-Jun;Kim, Tae-Won;Um, Yoo-Hyun;Jeong, Jong-Hyun
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.1
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    • pp.51-58
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    • 2018
  • Objectives : We aimed to investigate the discontinuation rate and reasons of doxepin base prescription pattern in insomnia outpatients of psychiatry department of a university hospital. Methods : 534 patients prescribed doxepin were screened. 201 patients were included and reviewed for their medical records retrospectively. The discontinuation rate and reasons of doxepin after 2 months of prescription were investigated. Patients were divided into three groups according to the prescription patterns. The initial group, prescribed doxepin as the first hypnotic, the add-on group, prescribed doxepin while maintaining existing hypnotics, and the switching group, prescribed doxepin after discontinuation of existing hypnotics. Results : The discontinuation rate after 2 months of prescription of doxepin was 56.2%. There were significant differences in the discontinuation rate among three groups. The initial group had the highest while the add-on group had the lowest (p=0.018). In reasons for discontinuation of doxepin among three groups, lack of efficacy (p<0.001) and adverse events (p<0.001) were significantly higher in the add-on group. In the initial group, patient's refusal (p=0.022) and unknown or loss to follow up (p<0.001) were significantly higher. Conclusions : The results of this study suggested that add-on is superior than switching method and gradual reduction of existing hypnotics is necessary to maintain doxepin treatment and prevent adverse events. Additional large scale prospective studies are needed to evaluate various factors and risks of discontinuation of doxepin.

Clinical Characteristics of Neonatal Status Epilepticus (신생아 간질 중첩증의 임상 특성)

  • Jung, Kyeong Hun;Kim, Yun Hee;Kwon, Young Se;Jun, Yong Hoon;Kim, Soon Ki;Son, Byong Kwan
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1342-1347
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    • 2005
  • Purpose : Among perinatal risk factors, neonatal seizures are one of the strongest independent discriminators of adverse outcome, representing high risks of mortality and neurologic morbidity. This study was undertaken to evaluate the neurologic outcome of neonatal status epilepticus according to underlying etiology, seizure pattern, onset time, and duration. Methods : We reviewed retrospectively 36 neonates(19 males, 17 females) with status epilepticus who were admitted to the neonatal intensive care unit, Inha Hospital between July, 1988 and June, 2003. They were evaluated with neurologic examination, laboratory data, EEG findings, and neuroimaging studies etc. Results : The mean gestational period of the patients was $37.0{\pm}3.6$ weeks and birth weight was $2.70{\pm}0.82$ kilogram. Fifty two point eight percent of the neonates were male and 66.7 percent were born at term. The most common cause of neonatal status epilepticus was hypoxic-ischemic encephalopathy. In preterm babies, intracranial hemorrhages showed an especially high frequency(P=0.034). Gestational age and birth weight did not show a correlation with neurologic complications. The incidence of neurological sequelae were significantly related to prolonged seizures lasting more than 1 hour(P=0.002). Neonates with seizures within the first 72 hours tended to be more frequent among those who developed adverse outcomes(P=0.016). Generalized tonic seizures had the worst prognosis, whereas those children who had subtle seizures had better outcomes than any other type(P<0.05). Generalized tonic seizures were primarily represented on EEG by abnormal background, whereas subtle seizure showed a significantly more normal EEG than any other seizures(P<0.05). Conclusion : Our results indicate that neonatal status epilepticus with early onsets, prolonged durations. And generalized tonic types can predict an increased risk for neurologic sequelae. So, those seizures must be perceived as medical emergencies and treated aggressively with antiepileptic drugs.

Analysis of Effect and Prognostic Factors Associated with Catheter Intervention on Ascites in Terminal Cancer Patient (복수가 있는 말기 암환자에서 복수 배액관 시술의 효과와 예후요인 분석)

  • Jang, Mungsun;Kim, Chul-Min;Yoon, Johi;Nah, Jung-Ran;Chang, Seung-Nam;Kim, Myung Ok;Lee, Ja Young
    • Journal of Hospice and Palliative Care
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    • v.19 no.4
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    • pp.303-309
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    • 2016
  • Purpose: Malignant ascites is a common complication in terminal cancer patients. Less-invasive pigtail catheter insertion is the most frequent procedure in patients who need repeated ascites drainage. This study investigated effects and adverse events associated with catheter insertion for ascites drainage and evaluated prognostic outcomes. Methods: We reviewed medical records between 2010 and 2013 of hospice and palliative care institutions in Seoul, South Korea. Among 2,608 inpatients, 67 patients received ascites pigtail catheter drainage. We reviewed demographic data, palliative performance scale, laboratory data, duration of catheter insertion, prevalence and type of complications, use and duration of antibiotics, and survival time. Univariate and multivariate Cox regression models were used to evaluate prognostic outcomes related with catheter insertion. Results: Ascites drainage was performed most commonly in hepatobiliary and gastric cancer patients. Ascites symptoms improved in 55 patients after the catheter drainage. Adverse events included pain (19.4%), leakage (14.9%), disconnection (7.5%), catheter occlusion (6%) and fever (4.5%). In Cox regression analysis, survival time from the catheter insertion was significantly associated with Palliative Performance Scale (PPS) (HR 0.73; P value 0.045) and serum sodium level (HR 2.77; P value 0.003) in a multivariate model. Conclusion: Patients' PPS and serum sodium level should be considered before making a decision of pigtail catheter insertion.