• 제목/요약/키워드: Ambulatory care

검색결과 138건 처리시간 0.029초

국내 아스페르길루스증에 대한 항진균제 처방 현황 (Real-world Prescribing Patterns of Antifungal drugs in Patients with Aspergillosis)

  • 염상수;천부순
    • 한국임상약학회지
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    • 제33권2호
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    • pp.113-121
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    • 2023
  • Background: Globally, the number of patients with aspergillosis is increasing, and the mortality rate remains high. This study aimed to investigate prescribing patterns of antifungal drugs for patients with aspergillosis in South Korea using real-world data. Methods: This retrospective cross-sectional study was performed using National Patient Sample (NPS) data collected by the Health Insurance Review and Assessment Service (HIRA) during 2011-2020. The use of antifungal drugs in patients with aspergillosis was investigated. Results:A total of 1374 patients were identified: 333 patients with invasive pulmonary aspergillosis (IPA) (24.2%), 436 patients with other PA (31.7%), 73 patients with other forms of aspergillosis (5.3%), and 532 patients with unspecified aspergillosis (38.7%). The odds of receiving an antifungal prescription were higher for IPA than for other PA (aOR, 0.233; p<0.001), and higher for hematologic malignancies than for respiratory disorders other than cancer or infections (aOR, 10.018; p<0.001). During each hospitalization period, 56.1% (97/173) and 6.4% (11/173) of IPA hospitalizations received voriconazole and itraconazole monotherapy, respectively, whereas 44.3% (27/61) and 27.9% (17/61) of other PA hospitalizations received itraconazole and voriconazole monotherapy, respectively. Among outpatients with IPA, 67.5% (85/126) and 26.2% (33/126) received voriconazole and itraconazole alone, respectively, whereas among outpatients with other PA, 86.1% (68/79) and 12.7% (10/79) received itraconazole and voriconazole alone, respectively, during the year. Conclusion: In Korea, voriconazole monotherapy was preferred in IPA inpatients, and itraconazole monotherapy was preferred in other PA inpatients. In the ambulatory care settings for IPA and other PA, itraconazole monotherapy was preferred.

암환자의 통증치료에 대한 $Ultracet^{(R)}$의 유효성과 안전성 (Efficacy and Safety of $Ultracet^{(R)}$ in Ambulatory Patients with Cancer Pain)

  • 이효진;진선아;윤각원;양영준;박남환;천재민;박남숙;윤환중;조덕연;김삼용
    • Journal of Hospice and Palliative Care
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    • 제9권2호
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    • pp.101-105
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    • 2006
  • 목적: 외래에 내원하는 암환자들을 대상으로 암성통증의 조절에 있어서 $Ultracet^{(R)}$의 효과와 안전성에 대해 알아보고자 하였다. 방법: 암으로 진단을 받고 통증 조절을 목적으로 $Ultracet^{(R)}$을 투여한 61명의 환자를 대상으로 통증조절의 정도와 통증이 환자의 삶의 질에 미치는 영향에 대한 평가를 위해 Korean version of Brief Pain Inventory를 이용하였다. 약물의 안전성은 복용 후 나타나는 부작용 정도에 의하여 평가하였다. 결과: 대상환자의 평균연령은 59.9세였고 성별분포는 남자가 34명, 여자가 27명이었다. 환자의 진단은 폐암, 위암, 육종, 대장암, 췌장암, 자궁 경부암, 두경부암, 그리고 림프종 등의 순이었다. 대상환자에서 가장 심했을 때의 통증 정도는 $Ultracet^{(R)}$을 사용하기 전후에 유의한 감소를 보이지 않았으나($5.18{\pm}1.41\;vs.\;4.82{\pm}1.94$; P=0.113), 가장 약했을 때의 통증 정도($1.2{\pm}1.05\;vs.\;0.87{\pm}1.35$; P=0.038), 환자가 느끼는 통증의 평균 정도($3.65{\pm}1.01\;vs.\;3.13{\pm}1.73$: P=0.022)와 바로 지금 느끼는 통증정도($3.63{\pm}1.25\;vs.\;2.85{\pm}1.94$; P=0.003)는 유의하게 감소되었다. $Ultracet^{(R)}$의 사용으로 인한 부작용은 전반적으로 경미하여 2도의 오심과 구토 각 1예와 1도의 변비, 소양증, 안면 홍조가 각각 1예씩 관찰되었으나 3도나 4도의 독성은 관찰되지 않았다. 결론: $Ultracet^{(R)}$은 외래환경에서 암환자의 통증조절에 있어서 안전하게 사용할 수 있는 비교적 효과적인 약물로 생각된다.

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일상식이섭취상태와 신체계측 및 혈액화학적 영양지표에 의한 혈액투석 환자의 영양결핍상태 평가 (Evaluation of Nutritional Deficit Status in Hemodialysis Patients' Based on Usual Dietary Intake, Anthropometric and Biochemical Parameters)

  • 송경애
    • 기본간호학회지
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    • 제3권1호
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    • pp.68-80
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    • 1996
  • Long-term hemodialysis(HD) patients manifest various signs of protein and caloric malutrition due to poor intake of nutrients and other causes. Poor nutritional status increases the mortality and morbidity rates in HD patients. Thus, mataintnance of adequate nutritional status has been a major task in taking care of patients receiving HD. This study was to evaluate the nutritional status of HD patients and to clarify the degree of nutritional deficit based on usual dietary intake, anthropometric and biochemical indicators. Sixty HD patients comprised a HD group, while the control group consisted of 60 healthy adults whose age and sex matched those of the HD group. Nutritional status was evaluated by dietrary intake using instant nutritional scale, anthropometric measures, serum protein concentrations and the number of lymphocytes. The data were analyzed by using Chi-square test and unpaired t-test. The results are as follows. 1. Regarding usual dietary intake of HD group. 1) Estimated caloric intake was significantly lower than the recommended daily allowance(RDA) and among them, 35% were taking calories less than 85% of the RDA. 2) Estimated protein intake was significantly higher than the RDA and among them 40% were taking protein more than 115% of the RDA. 3) Estimated fat intake was lower than the RDA. 4) Vitamin A, B, $B_1,\;B_2$, C and niacin in take was lower than the RDA respectively. 5) Estimated ferrous intake was within the normal limit the RDA while estimated calcium intake was higher than the RDA. 6) Both calorie and protein intake were higher for the 10 patients who had been under continuous ambulatory peritoneal dialysis than for the patients under HD from the beginning. 2. Regarding anthropometric measures : 1) Body mass index(BMI), midarm circumference(MAC), and triceps skinfold thickness(TSF) were lower in the HD group than in the control group. 2) Among HD group, 47.1% were within the normal limit of BMI, while 86.7% were within the same limit in the control group. 3) Among HD group, 35.0% were within the normal limit of MAC, while 83.3% were within the same limit in the control group. 4) Among HD group, only 8.3% were normal, 30.3% were mild deficit status of TSF, while 50% were normal and 48.3% were mild deficit status in the control group. 3. Regarding biochemical laboratory tests 1) Albumin, transferrin concentrations and the number of lymphocytes were lower in HD group than in the control group. 2) Among HD group, 98.3% were within the normal limit of albumin concentration and all were within the same limit in the control group. 3) Among HD group, only 11.7% were within the normal limit of transferrin concentration, while 81.7% were within the same limit in the control group. 4) Among HD group, 25% were within the normal limit, while 93.3% were within the same limit in the control group. The above findings suggest that HD patients were in nutritional deficit status. Adequate diet therapy and periodical evaluation of the nutritional status in HD patients are needed. Accordingly, it turned out that anthropometric measures were very reliable parameters and easy to use to evaluate nutritional status. So nurses are encouraged to adopt anthropometric measures to examine nutritional deficit status of HD patients.

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심박변이도 측정을 통한 두한증(頭汗證) 환자의 자율신경계 기능 평가 (Evaluation of Autonomic Function in Patients with Head-Hyperhidrosis by Power Spectral Analysis of Heart Rate Variability)

  • 이건영;황준호;이성헌;정승연;이형구;정승기;정희재
    • 대한한방내과학회지
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    • 제27권4호
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    • pp.822-826
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    • 2006
  • Objectives : Essential hyperhidrosis is a socially and occupationally disabling disorder. There are many suggestions that hyperhidrosis is associated with the autonomic nervous system, especiallythe sympathetic system. This study was designed to investigate the autonomic nerve system in patients with essential hyperhidrosis and healthy controls by the frequency domain analysis of heart rate variability (HRV). Methods : 17 head-hyperhidrosis patients in the ambulatory care were investigated. All were inspected at the first medical examination. using the PSA of HRV. HRV was measured for minutes after 5 minutes bed rest. We checked the frequency domain analysis of HRV (i.e. TP, VLF, LF, HF) which were transformed into natural logarithm of patients against the standard measures of the HRV components. Then we compared the values of patients with means of normal Korean subjects. Results : The values of natural logarithmic measure of HRV (LnTP, LnHF, LnLF, LnVLF) of patients With head-hyperhidrosis we examined were $6.85{\pm}1.61$, $4.93{\pm}$2.00, $5.40{\pm}1.83$, and $6.13{\pm}1.37$, respectively. None of these values were higher than means of normal subjects. Conclusions : This study suggests that the function of the autonomic nervous system does not increase in patients with head-hyperhidrosis.

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심박변이도(Heart Rate Variability) 측정을 통한 다한증(多汗症)환자의 자율신경계(自律神經系)기능 평가 (Evaluation of Autonomic Function in Patients with Hyperhidrosis by Power Spectral Analysis of Heart Rate Variability)

  • 이건영;이형구;정승기;정희재
    • 대한한방내과학회지
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    • 제29권1호
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    • pp.1-11
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    • 2008
  • Objectives : Essential hyperhidrosis is a socially and occupationally disabling disorder. There are many suggestions that hyperhidrosis is associated with the autonomic nervous system. This study was designed to investigate the autonomic nerve system the patients with hyperhidrosis. Methods : 348 palmar and plantar hyperhidrosis patients and 20 systemic hyperhidrosis patients in the ambulatory care were investigated. All patients were inspected at the first medical examination, using the PSA of HRV. HRV was measured for 5 minutes after 5 minutes' bed rest. We checked the frequency domain analysis of HRV (i.e. TP, VLF, LF, HF and LF/HF) which were transformed into natural logarithm of patients against the standard measures of the HRV components. Then, we compared the means of patients with means and highest values of in the normal range of Koreans 1) between the patients with palmar and plantar hyperhidrosis and the healthy controls and 2) between the patients with the systemic hyperhidrosis and healthy controls, by the frequency domain analysis of heart rate variability (HRV), respectively. We then compared the results between 1) and 2). Results : The values of natural logarithmic measures of LF/HF ratio in the patients with palmar and plantar hyperhidrosis we examined were significantly higher than the values of healthy controls, but those in the patients with systemic hyperhidrosis were not higher. Conclusion : This study suggests that the autonomic nervous function did not simply increase but that the balance between sympathetic and parasympathetic nervous function did matter in patients with palmar and plantar hyperhidrosis. This balance included that the sympathetic nervous function aggravated comparatively with parasympathetic nervous function. On the other hand, we couldn't find any significance of the patients with the systemic hyperhidrosis as for the autonomic nervous function.

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수족냉증 환자의 실태 및 HRV(Heart Rate Variability)를 이용한 자율신경계 기능 평가 연구 (A clinical study on patients with Cold Hypersensitivity on hands and feet and their autonomic nervous system function using of Heart Rate Variability(HRV))

  • 김은숙;황재호;이진무;이창훈;조정훈;장준복;이경섭;최재호
    • 대한한방체열의학회지
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    • 제5권1호
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    • pp.1-13
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    • 2006
  • Objectives : This study was designed to analyze basic data for cold hypersensitivity patients with a questionnaire and investigate correlation between cold hypersensitivity and Heart Rate Variability(HRV). Methods : 49 patients who complain of cold hypersensitivity on hands and feet in ambulatory care were investigated in Oriental Gynecology, Kyunghee Oriental Medical Center and Women medical center, Kangnam Koreana hospital from May 1, 2006 to October 20, 2006. All patients were asked to answer a questionnaire. After careful I examination to rule out other disease which may affect Digital Infrared Thermal Imaging(DITI) and HRV data, patients were taken thermography for the diagnosis of cold hypersensitivity Based on the result of thermography, the patients were divided into two groups(Objective cold hypersensitivity and Subjective cold hypersensitivity). Then, these two groups were compared using HRV data which was measured in the supine position for 5 minutes. Results: 1. For most patients, cold hypersensitivity first developed during puberty. 2. The parts of the body that felt cold first time were hands and feet. 3. The cold sensation was increased in winter or at bedtime Showing that the sensation can be changed according to the level of coldness. 4. Among women who sufferfrom cold hypersensitivity, very few of them were treated. 5. More than half of cold hypersensitivity patients's family member also had a cold hypersensitivity. 6. The decrease in mean values of LF/HF ratio was observed in objective cold hypersensitivity group than subjective cold hypersensitivity group and the decrease was significant(P=0.014) when examined by Student t-test. Conclusions : It is necessary that the cold hypersensitivity patients should be treated carefully considering the facts mentioned above. And it can be suggested that dysautinomia be related with cold hypersensitivity and be evaluated by HRV.

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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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    • 제45권5호
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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;

사상체질진단검사(QSCC II) 설문지 간소화 연구 (A Study on the Simplification of Questionnaire for Sasang Constitution Classification(QSCC II))

  • 박지원;김정아;왕명자
    • 지역사회간호학회지
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    • 제14권2호
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    • pp.334-350
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    • 2003
  • The purpose of this descriptive study was to evaluate the clinical validity of QSCCII (Questionnaire for the Sasang Constitution Classification), whose high accuracy as a constitutional diagnostic tool has been recognized by medical professionals. The subjects of this study were 568 clients from an A university hospital in Suwon. Of the subjects, 259 were health center visitors and 292 were ambulatory clinic visitors. Data were collected using self-reported questionnaire and were analyzed by $X^2$-test and one-way ANOVA. The results of this study as follows: 1. In 4 types of constitution, Soeumin type was found in 41.5% of the subjects. Taeumin type in 39.2%.,and Soyangin type in 19.2%, respectively. There was no Tayangin type found in this study. There were no significant differences on types of constitution by demographic characteristics such as age, sex, marital status, education, religion, and economic status. 2. As for 15 item-selective questionnaire, there were statistically significant differences on the response rate of the 12 items, except items such as A4, A11 and A14, by the types of constitution. When the subjects' own criteria on their constitution were compared to the given constitutional criteria on each item, 4 items such as A6, A11, A13 and A14 were advisable to be excluded from the questionnaire or to be reunited to the other criteria. In the meanwhile, 3 items such as A7, A18 and A15 were desirable to be re-categorized to the other constitutional types and reconstructed to the QSCC II questionnaire. 3. In terms of 106 true-false questionnaire, there were statistically significant differences on the response rate of 46 items by the types of constitution. The 46 items include 15 items (32.6%) of the domain of 'handling something/strength and weakness', 4 items (8.7%) of the domain of 'interpersonal relationship', 9 items (19.6%) of the domain of 'state of mind at ordinary times', 2 items (4.3%) of the domain of 'distinctive emotional characteristics' area, 11 items (23.9%) of the domain of 'specific behavioral trait' and 5 items (10.9%) of the domain of 'physical characteristics'. Therefore, the areas of 'handling something/strength and weakness' and' specific behavioral trait' mainly contributed to the classification of constitutional type. 4. When the 106 true-false items were simplified to the 46 items, statistically significant differences were found on the rate of items allocated to the 3 types of constitution. The rate of selection assigned to the 3 constitutional types of the simplified 46-item questionnaire was higher than that of the original 106-item questionnaire. Conclusions; It was concluded that the rate of selection of each lay person about his own constitutional type would be still higher even though the simplified items of QSCC II questionnaire were applied. If more replicated studies are conducted on the diverse population using the simplifying QSCC II questionnaire in the future, a more simplified standardized Sasang Constitution Questionnaire that is available to the public rather than to medical staffs in the clinical settings could be developed. Moreover, the simplified scale will help nurses deliver more efficient nursing care by providing a more rapid way of health assessment.

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