• Title/Summary/Keyword: Adverse Factors

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Effect of remifentanil on intraoperative fluid balance: a retrospective statistical examination of factors contributing to fluid balance

  • Ohara, Sayaka;Nishimura, Akiko;Tachikawa, Satoshi;Iijima, Takehiko
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.3
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    • pp.129-135
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    • 2020
  • Background: Postoperative fluid retention is a factor that causes delay in recovery and unexpected adverse events. It is important to prevent intraoperative fluid retention, which is putatively caused by intraoperative release of stress hormones, such as ADH (anti-diuretic hormone) or others. We hypothesized that intraoperative analgesia may prevent pathological fluid retention. We retrospectively explored the relationship between analgesics and in-out balance in surgical patients from anesthesia records. Methods: Anesthetic records of 80 patients who had undergone orthognathic surgery were checked in this study. Patients were anesthetized with either TIVA (propofol and remifentanil) or inhalational anesthesia (sevoflurane and remifentanil). During surgery, acetated Ringer's solution was infused for maintenance at a rate of 3-5 ml/kg/h at the discretion of the anesthetist. The perioperative parameters, including the amount of crystalloid and colloid infused, and the amount of urine and bleeding were checked. Furthermore, we checked the amount and administration rate of remifentanil during the surgical procedure. The correlation coefficient between the remifentanil dose and the in-out balance or the urinary output was analyzed using the Pearson correlation coefficient. The contributing factor to fluid retention, including urinary output, was statistically examined by means of multivariate logistic regression analysis. Results: A significant positive correlation was found between remifentanil dose and urinary output. Urinary output less than 0.04 ml/kg/min was suggested to cause positive fluid balance. Although in-out balance approaches zero balance with increase in remifentanil administration rate, no contributing factor for near-zero fluid balance was statistically picked up. The remifentanil administration rate was statistically picked up as the significant factor for higher urinary output (> 0.04 ml/kg/min) (OR, 2,644; 95% CI, 3.2-2.2 × 106) among perioperative parameters. Conclusions: In conclusion, remifentanil contributes in maintaining the urinary output during general anesthesia. Although further prospective study is needed to confirm this hypothesis, it was suggested that fluid retention could be avoided through suppressing intraoperative stress response by means of appropriate maintenance of remifentanil infusion rate.

Risk Assessment Tools for Invasive Alien Species in Japan and Europe (일본과 유럽의 침입외래생물 생태계위해성평가 기법)

  • Kil, Jihyon;Mun, Saeromi;Kim, Chang-Gi
    • Ecology and Resilient Infrastructure
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    • v.2 no.3
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    • pp.191-197
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    • 2015
  • Invasive alien species are considered to be one of the main factors that cause biodiversity loss. Establishment of management strategies through continuous monitoring and risk assessment is a key element for invasive alien species management policy. In the present study, we introduce examples of ecological risk assessment tools developed in Japan, Germany-Austria and Belgium. Invasive alien species have been designated in Japan based on the assessment of risks to ecosystems, human health and primary industry. German-Austrian Black List Information System categorized alien species into Black List, White List and Grey List according to their risks to biodiversity. In the Harmonia Information System developed in Belgium, invasiveness, adverse impacts on native species and ecosystem functions and invasion stages were assessed and alien species were categorized into Black List, Watch List and Alert List. These international risk assessment tools may be helpful to improve our national risk assessment protocol for the prioritization of invasive alien species management.

[ $CO_2$ ] Sequestration in Geological Structures in the Maritime Area: A Preliminary Review (이산화탄소 해저 지질 구조 격리: 기술 현황과 제도 예비검토)

  • Hong, Gi-Hoon;Park, Chan-Ho;Kim, Han-Joon
    • Journal of the Korean Society for Marine Environment & Energy
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    • v.8 no.4
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    • pp.203-212
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    • 2005
  • Anthropogenic emissions of greenhouse gases, particularly carbon dioxide($CO_2$) which arises mainly as wastes from the fossil fuel burning processes, are causing global warming. The effects of global warming become increasingly felt all over the world including sea level rise and extreme weather. The more direct consequences of the elevated atmospheric $CO_2$ on the ocean is the acidification of the surface ocean which brings a far reaching adverse impact on the life at sea and probably on the whole ecosystem of the planet. Improvement in energy efficiency and use of alternative energy sources are being made to reduce $CO_2$ emissions. However, a rapid transition to alternatives seems unachievable within a few decades due to the constraints on the associated technology and socio-economic factors in the world, since fossil fuels make up approximately 85% of the world's commercial energy demands. It has now been recognized that capture and geological sequestration of $CO_2$ could significantly reduce its emissions from fossil fuel utilization and therefore provides the means to rapidly achieve large reductions in $CO_2$ emissions(excerpts from London Convention, LC/SG 28, 2005). In Korea, well-developed sedimentary basins are spread over the vast continental shelf and slope regions, whereas, the land is densely populated and limited in area. Consequently, the offshore area is preferred to the land for the sites for geological sequestration. The utilization of the offshore area, however, may be subject to international agreements including London Convention. In this paper, the recent trends in technologies and regulations for $CO_2$ capture and geological sequestration are described to encourage its applications in Korea.

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A Study on the Stress and Dietary Life of Office Workers in Seoul (서울시내 직장인의 스트레스와 식생활관리)

  • 김종군;김정미;최미경
    • Korean journal of food and cookery science
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    • v.19 no.4
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    • pp.413-422
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    • 2003
  • The purpose of this study was to investigate the relationship between the dietary attitude and health on the stress status of office - workers in Seoul. This research was conducted on 389 office workers (224 males and 165 female). In relation to stress, it was found that the degree of stress as an office workers was ′slight′ and much for 45.2% and 40.6%, respectively, of the study population. Consequently, most office workers were found to be under stress. The amount of food intake under stress was found to be ′reduced′, unchanged and increased in 38.3, 37.0 and 24.7%, respectively, of those surveyed. The preferred foods when under stress were found to be alcoholic and non-alcoholic beverages, in 57.6% of cases, which was the highest proportion regardless of age, sex, marital status, occupation and educational level. The desired taste when under stress was found to be ′hot′ and sweet in 34.7 and 26.0%, respectively. As to the feeling after food intake, 51.7% responded that food intake was not useful for the relief of stress, which was the highest proportion and many salaried females worried about weight gain. With regard to the relationship between stress, health and nutrition, 69.9% of office workers responded that they thought the relationship of these factors was very high. As for the greatest cause triggering stress, 50.3% responded "due to workplace and job". The best method for relieving stress was to do exercise, with a 30.1 % response, The average score for the degree of stress and tension was 7.2, with 64.0% of office workers having an average level between 6- and 9. The degree of stress was higher for females than males, for unmarried salaried and hot-tempered persons. Those not doing exercise were subject to the highest levels of stress, and those a having sufficient sleep were found to be subject to less stress. Those interested in their health were found to have a good condition and lower levels of stress. In correlation with eating habits, stress, the degree of tension and personality, the F-value was found to be 43.505 (p<0.01), with an explanatory power of 0.294 (29.4%), indicating significant differences. This means that office workers with higher degrees of stress and tension tended to have poorer eating habits. Since bad eating habits have an adverse effect on both the state of physical health and individuals emotional development, for the purpose of correctly managing stress, office workers should make efforts to practice good eating habits.

Efficacy of Nab-Paclitaxel Plus Gemcitabine and Prognostic Value of Peripheral Neuropathy in Patients with Metastatic Pancreatic Cancer

  • You, Min Su;Ryu, Ji Kon;Choi, Young Hoon;Choi, Jin Ho;Huh, Gunn;Paik, Woo Hyun;Lee, Sang Hyub;Kim, Yong-Tae
    • Gut and Liver
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    • v.12 no.6
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    • pp.728-735
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    • 2018
  • Background/Aims: The combination of nab-paclitaxel and gemcitabine (nab-P/Gem) is widely used for treating metastatic pancreatic cancer (MPC). We aimed to evaluate the therapeutic outcomes and prognostic role of treatment-related peripheral neuropathy in patients with MPC treated with nab-P/Gem in clinical practice. Methods: MPC patients treated with nab-P/Gem as the first-line chemotherapy were included. All 88 Korean patients underwent at least two cycles of nab-P/Gem combination chemotherapy (125 and $1,000mg/m^2$, respectively). Treatment-related adverse events were monitored through periodic follow-ups. Overall survival and progression-free survival were estimated by the Kaplan-Meier method, and the Cox proportional hazards regression linear model was applied to assess prognostic factors. To evaluate the prognostic value of treatment-related peripheral neuropathy, the landmark point analysis was used. Results: Patients underwent a mean of $6.7{\pm}4.2$ cycles during $6.3{\pm}4.4$ months. The median overall survival and progression-free survival rates were 14.2 months (95% confidence interval [CI], 11.8 to 20.3 months) and 8.4 months (95% CI, 7.1 to 13.2 months), respectively. The disease control rate was 84.1%; a partial response and stable disease were achieved in 30 (34.1%) and 44 (50.0%) patients, respectively. Treatment-related peripheral neuropathy developed in 52 patients (59.1%), and 13 (14.8%) and 16 (18.2%) patients experienced grades 2 and 3 neuropathy, respectively. In the landmark model, at 6 months, treatment-related peripheral neuropathy did not have a significant correlation with survival (p=0.089). Conclusions: Nab-P/Gem is a reasonable choice for treating MPC, as it shows a considerable disease control rate while the treatment-related peripheral neuropathy was tolerable. The prognostic role of treatment-related neuropathy was limited.

The relationship between perceived subjective socioeconomic status and physical health among late school-aged children -A psychosocial perspective- (학령후기 아동이 인지한 주관적 사회경제적 지위와 신체건강과의 관계 -심리사회적 관점-)

  • Kim, Sue-Lynn;Yoo, P. Joan
    • Journal of the Korean Society of Child Welfare
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    • no.57
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    • pp.43-82
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    • 2017
  • As material perspective that stresses absolute income has limitations in explaining socioeconomic gradients in health, research on the relationship between an individual's subjective socioeconomic status(SSS) and health has emerged in recent years. Although previous research has been conducted mostly on adults, late school-aged children, who frequently evaluate themselves using social comparisons, are likely to subjectively perceive their socioeconomic status and be affected by their perception. Accordingly, this study examined the relationship between late school-aged children's SSS and their physical health, and its underlying path based on a psychosocial perspective. For this purpose, data from the first year survey of the Seoul Education and Health Welfare Panel (2014), which consisted of responses from 394 children ($4^{th}$ graders in elementary school) and their parents, were analyzed utilizing structural equation modeling. The results showed an indirect but significant relationship between late school-aged children's SSS and their physical health, via stress, self-efficacy, and health behaviors, which are mediating variables grounded on a psychosocial perspective. No direct relationship was found between late school-aged children's SSS and physical health. Based on these findings, we suggested several implications to improving children's health, including efforts to prevent adverse effects of low SSS on physical health through psychosocial factors.

Effects of vocational roles on the perceived prejudice of people with psychiatric disabilities (직업적 역할은 정신장애인이 지각한 편견을 감소시키는가?)

  • Kim, Moon-Geun
    • Korean Journal of Social Welfare Studies
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    • v.40 no.3
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    • pp.299-326
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    • 2009
  • The purpose of this study was to find out some factors affecting the social prejudice perceived by people with psychiatric disability(PPD) and to present some useful explanations for those effects based on theories from symbolic interactionism. The hypotheses were as follow. First, the higher the symptoms, the higher will be the perceived social prejudice of PPD. Second, if PPD have vocational roles, the perceived prejudice will be lower. Third, if PPD want more services or supports for vocational rehabilitation, the perceived prejudice will be higher. Fourth, the higher the perceived prejudice of family members, the higher will be the perceived prejudice of PPD. The results show that the major hypotheses were supported. Based on the results some theoretical and clinical implications are discussed. First, this study made a little contribution to the study of perceived social prejudice of PPD providing some useful theoretical basis and empirical evidences. Secondly, due to the limitation of the data and cross-sectional research the results of this study need to be duplicated under more rigorous experimental or quasi-experimental study. Concerning the clinical intervention, it should be stressed to provide valued social roles to help PPD protect themselves from social prejudices. Secondly, rehabilitation professionals need to help PPD cope with increasing perceived prejudice while pursuing valued social roles such as employee. Third, rehabilitation professionals should assess the perceived prejudice of family members and to help them resist social prejudices through education, self-help groups, and other advocating strategies. Lastly, professionals should be carful not to blame family members for the adverse effects of their perceived prejudice on PPD.

Prognostic impact of chromogranin A in patients with acute heart failure

  • Kim, Hong Nyun;Yang, Dong Heon;Park, Bo Eun;Park, Yoon Jung;Kim, Hyeon Jeong;Jang, Se Yong;Bae, Myung Hwan;Lee, Jang Hoon;Park, Hun Sik;Cho, Yongkeun;Chae, Shung Chull
    • Journal of Yeungnam Medical Science
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    • v.38 no.4
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    • pp.337-343
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    • 2021
  • Background: Chromogranin A (CgA) levels have been reported to predict mortality in patients with heart failure. However, information on the prognostic value and clinical availability of CgA is limited. We compared the prognostic value of CgA to that of previously proven natriuretic peptide biomarkers in patients with acute heart failure. Methods: We retrospectively evaluated 272 patients (mean age, 68.5±15.6 years; 62.9% male) who underwent CgA test in the acute stage of heart failure hospitalization between June 2017 and June 2018. The median follow-up period was 348 days. Prognosis was assessed using the composite events of 1-year death and heart failure hospitalization. Results: In-hospital mortality rate during index admission was 7.0% (n=19). During the 1-year follow-up, a composite event rate was observed in 12.1% (n=33) of the patients. The areas under the receiver-operating characteristic curves for predicting 1-year adverse events were 0.737 and 0.697 for N-terminal pro-B-type natriuretic peptide (NT-proBNP) and CgA, respectively. During follow-up, patients with high CgA levels (>158 pmol/L) had worse outcomes than those with low CgA levels (≤158 pmol/L) (85.2% vs. 58.6%, p<0.001). When stratifying the patients into four subgroups based on CgA and NT-proBNP levels, patients with high NT-proBNP and high CgA had the worst outcome. CgA had an incremental prognostic value when added to the combination of NT-proBNP and clinically relevant risk factors. Conclusion: The prognostic power of CgA was comparable to that of NT-proBNP in patients with acute heart failure. The combination of CgA and NT-proBNP can improve prognosis prediction in these patients.

Effect of coadministration of enriched Korean Red Ginseng (Panax ginseng) and American ginseng (Panax quinquefolius L) on cardiometabolic outcomes in type-2 diabetes: A randomized controlled trial

  • Jovanovski, Elena;Smircic-Duvnjak, Lea;Komishon, Allison;Au-Yeung, Fei (Rodney);Sievenpiper, John L.;Zurbau, Andreea;Jenkins, Alexandra L.;Sung, Mi-Kyung;Josse, Robert;Li, Dandan;Vuksan, Vladimir
    • Journal of Ginseng Research
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    • v.45 no.5
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    • pp.546-554
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    • 2021
  • Background: Diabetes mellitus and hypertension often occur together, amplifying cardiovascular disease (CVD) risk and emphasizing the need for a multitargeted treatment approach. American ginseng (AG) and Korean Red Ginseng (KRG) species could improve glycemic control via complementary mechanisms. Additionally, a KRG-inherent component, ginsenoside Rg3, may moderate blood pressure (BP). Our objective was to investigate the therapeutic potential of coadministration of Rg3-enriched Korean Red Ginseng (Rg3-KRG) and AG, added to standard of care therapy, in the management of hypertension and cardiometabolic risk factors in type-2 diabetes. Methods: Within a randomized controlled, parallel design of 80 participants with type-2 diabetes (HbA1c: 6.5-8%) and hypertension (systolic BP: 140-160 mmHg or treated), supplementation with either 2.25 g/day of combined Rg3-KRG + AG or wheat-bran control was assessed over a 12-wk intervention period. The primary endpoint was ambulatory 24-h systolic BP. Additional endpoints included further hemodynamic assessment, glycemic control, plasma lipids and safety monitoring. Results: Combined ginseng intervention generated a mean ± SE decrease in primary endpoint of 24-h systolic BP (-3.98 ± 2.0 mmHg, p = 0.04). Additionally, there was a greater reduction in HbA1c (-0.35 ± 0.1% [-3.8 ± 1.1 mmol/mol], p = 0.02), and change in blood lipids: total cholesterol (-0.50 ± 0.2 mmol/l, p = 0.01), non-HDL-C (-0.54 ± 0.2 mmol/l, p = 0.01), triglycerides (-0.40 ± 0.2 mmol/l, p = 0.02) and LDL-C (-0.35 ± 0.2 mmol/l, p = 0.06) at 12 wks, relative to control. No adverse safety outcomes were observed. Conclusion: Coadministration of Rg3-KRG + AG is an effective addon for improving BP along with attaining favorable cardiometabolic outcomes in individuals with type 2 diabetes. Ginseng derivatives may offer clinical utility when included in the polypharmacy and lifestyle treatment of diabetes. Clinical trial registration: Clinicaltrials.gov identifier, NCT01578837;

Incidence Rate and Characteristics of Falls in Patients Using Comprehensive Nursing Care Service (간호·간병통합서비스 이용환자의 낙상발생률과 낙상의 특성)

  • Son, Jaei;Park, Byung Kyu;Lee, Chan Hee;Ahn, Keum Hui;Kim, Jung Nam;Park, Min Hyun;Choi, Eun Young;Boo, Eun Hui;Kang, Min Jin;Hong, Jung Hwa
    • Health Policy and Management
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    • v.29 no.2
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    • pp.172-183
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    • 2019
  • Background: Falls are the most frequent adverse events reported in hospitals. The aim of this study was to investigate the incidence rate and characteristics of falls in patients who used comprehensive nursing care service in National Health Insurance Service Ilsan Hospital. Methods: Incidence rate of falls was investigated in patients using comprehensive nursing care service, from July 2013 to Jun 2017 and compared with those not using this service. The characteristics and risk factors for falls, and fall-related injuries were obtained. Results: Among the 62,445 patients who used the comprehensive nursing care service for 4 years, total of 672 falls were reported. The incidence rate of falls per 1,000 patients-day was 1.15. The percentage of fall-related injuries was 26.9% and that of major injury was 2.2%. Although the incidence rate of all falls was slightly higher in patients using comprehensive nursing care service than those not using this service, falls-related injuries were not correlated with the implementation of this service. Conclusion: The falls could be more frequently detected and reported in comprehensive nursing care service, but there was no difference in fall-related injuries.