• Title/Summary/Keyword: CPI

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Clinical usefulness of Clinical Pulmonary Infection Scare of ICU Patients with Sputum Culture positive for Multi-drug resistant Acinetobacter baumannii (객담에서 Multi-drug Resistant Acinetobacter baumannii가 동정된 중환자실 환자에서 Clinical Pulmonary Infection Score의 임상적 유용성)

  • Lee, Ji Hyun;Cheon, Seok Cheol;Jung, Sun Hye;Phyun, Lae Hyun;Jang, Moon Zu;Lee, Stephen Yonggu;Hong, Sung Kwan;Hong, Seong Geun;Hong, Sang Bum
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.6
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    • pp.579-588
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    • 2003
  • Background : The hospital-acquired pneumonia is the most common nosocomial infection. Recently, the Acinetobacter baummannii infections are rapidly increasing, especially the frequency of Multi-drug resistant A. baumannii. Therefore we assessed clinical features and prognosis of patients in the ICU with Multi-drug resistant A. baumannii from the sputum culture using the Clinical Pulmonary Infection Score(CPIS). Method : The medical records of 43 patients with Multi-drug resistant A. baumannii from sputum culture who were suspected had clinically pneumonia and admitted to the ICU from January 2000 to July 2002 were retrospectively analyzed. Results : 19 patients were CPIS greater than 6 and 24 patients were CPIS less than or equal to 6. Mean age for the former was $71{\pm}11$ years old, and the latter was $61{\pm}19$ years old. The mean APACHE II score on admission and on sputum study was not different between two groups($17.4{\pm}5.7$ vs $18.5{\pm}6.1$, p=0.553, $20{\pm}6$ vs $17{\pm}8$, p=0.078). But the mortality rate was 73.7% for the former, and 16.7% for the latter(p<0.001). Conclusion : In ICU patients who had clinically suspected pneumonia with sputum culture positive for Multi-drug resistant A. baumannii, the mortality was significantly higher if CPIS was greater than 6.

Halitosis and Related Factors among Rural Residents (농촌지역 주민들의 구취실태와 유발요인)

  • Lee, Young-Ok;Hong, Jung-Pyo;Lee, Tae-Yong
    • Journal of Oral Medicine and Pain
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    • v.32 no.2
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    • pp.157-175
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    • 2007
  • This study was conducted through an interview process in which questionnaires were administered to 293 people. The questionnaires related to the behaviors of oral hygiene care, and disease history related to halitosis, and status of halitosis, halitosis measurement, oral examination, and caries activity tests such as the snyder test, Salivary flow rate test, and Salivary buffering capacity test. Our sample was taken from 293 rural residents within the period from 4th to 21st of January 2006. This was done in order to provide basic data to prepare both policies of halitosis prevention and a device to efficiently measure halitosis status and investigate the factors related therein. The major findings of this study results are as follows: 1. As for frequency of tooth brushing, twice a day occupied the greatest portion at 46.1 % Women exceeded men in frequency of tooth brushing. Tongue brushing everyday produced a 25.6 % result among subjects and The use of auxiliary oral hygiene devices occupied 9.2 %. 2. As for degree of usual self-awareness of halitosis: 62.5 %. This result also demonstrate that the severest time of self-awareness in regards to halitosis is wake up time in the morning. The time period produced the highest portion of 72.7 % in times of self-awareness. In terms of the area in which halitosis was observed, gum resulted in 23.0 %. As for types of halitosis, fetid smell was the most frequent at 37.2 %. 3. As for the result of halitosis measurement, values of OG less than 50 ppm occupied 54.3 % and $50{\sim}100ppm$ occupied 41.6 %. As for $NH_3$ values, $20{\sim}60ppm$ showed the highest value range of 52.6 %. 4. As for OG per disease history related to halitosis, values of OG were significantly high in the ranges of $50{\sim}100ppm$ within family history groups of food impaction by dental caries, diabetes mellitus and halitosis. As for values of $NH_3$, there showed a significant difference in respiratory system disease groups. 5 Value range of OG per ordinary halitosis self-awareness degree: values ranging less than 50 ppm were recorded at 55.9 % from the group realizing not aware of smell. 57.5 % from groups only realizing sometimes, while values range of $50{\sim}100ppm$ were recorded at 52.0 % from groups always aware of smell. 63.6 % from groups always strongly aware of smell. Meanwhile as for the values ranges of $NH_3$, $20{\sim}60ppm$. they occupied high portions for all groups of exams. 6. Values of OG per oral examination: the more pulp-exposed teeth and food impaction and the higher the tongue plaque index, values of OG increased within the range of $50{\sim}100ppm$. As for values of $NH_3$, the more prosthetic teeth and the higher the tongue plaque index, this value increased significantly, and the values increased up to no less than 60 ppm for groups of mandibular partial denture. 7. Within the realm of caries activity test: as for the Snyder test, high activity was highest by 43.0 % wherewith the higher the activity of acidogenic bacteria the higher the OG values. As for the salivary flow rate test, the number of cases below 8.0 ml showed the highest tendency by 62.5 %. The larger the salivary flow rate the more decreased OG values distribution. As for the salivary buffering capacity test, $6{\sim}10$ drops of 0.1N lactic acid showed the overwhelming trend by 58.7 % whereby the higher the salivary buffering capacity the greater distribution occupancy ratio of OG values below 50 ppm which is scentless to on ordinary person. 8. As for the correlation between oral environment and halitosis, OG showed the positive correlation with pulp exposed teeth, filled teeth, present teeth, tongue plaque index, and food impaction, while the negative correlation with salivary flow rate and prosthetic teeth. $NH_3$ showed a positive correlation with prosthetic teeth and frequency of tooth brushing, while decayed teeth was negative correlation. 9. As for the multiple regression analysis result, there have been selected female, pulp exposed teeth, prosthetic teeth, food impaction, salivary flow rate, tongue plaque index and severe activities in the Snyder test as factors affecting OG wherein explanatory power on it was 45.1 %. There have been selected females, pulp exposed teeth, tongue plaque index, and prosthetic teeth as factors affecting on $NH_3$ wherein explanatory power on it was 6.6 %. With the aforementioned results in mind, the status of halitosis among rural residents is considered to bare a close relation with oral environments and other factors related to halitosis such as the Snyder test from caries activity test, and salivary flow rate test. For the prevention of halitosis of residents in rural areas, we have to focus on correct tooth brushing methods and tongue brushing, with using auxiliary oral hygiene devices to remove fur of tongue plaque and food impaction. Also, when the cause and ingredients of halitosis are diverse and complex, in order to analyze exactly the factors of individual halitosis development, we need continuous and systematic study in order to provide rural residents with programs of oral hygiene education and encourage the use of dental hygienists in public health centers.