• 제목/요약/키워드: Chronic disease patients

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Clinical Features and Prognosis of Corneal Ulcers in Dogs with Chronic Kidney Disease

  • Choi, Heeyeon;Kim, Se Eun;Kim, Taehyun;Jang, Jaeyoung;Hwang, Sun Young;Seo, Kangmoon
    • 한국임상수의학회지
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    • 제38권3호
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    • pp.115-119
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    • 2021
  • This study was designed to investigate the characteristics of corneal ulcers in dogs with chronic kidney disease (CKD). Medical records of dogs that had been diagnosed with corneal ulcers and chronic kidney disease at Haemaru Referral Animal Hospital between April 1, 2011 and March 31, 2016 were investigated. A control group was randomly selected during the same time period. This group included patients with corneal ulcers but no evidence of systemic disease. The mean healing time of superficial corneal ulcers in the CKD group was 21.0 ± 15.0 days. This was a significantly longer healing time than was observed in the control group (11.0 ± 6.6 days, p = 0.019). The incidence rates of uveitis and keratoconjunctivitis sicca in the CKD group were significantly higher than in the control group (p = 0.000 and p = 0.026, respectively). Additionally, non-healing ulcers had significantly elevated white blood cell counts, while those with healing ulcers had WBC counts within the normal range in CKD group (p = 0.000). This study revealed that corneal ulcers in CKD patients would be delayed epithelial healing process and accompanied by ocular disease which affected to corneal healing compared to non-CKD patients.

만성질환 진단이 노인의 우울수준에 미치는 영향: 주요 5대 만성질환의 초기 진단기를 중심으로 (The Effect of Transition to Living with Chronic Diseases on Depressive Symptoms)

  • 박민경;조규영
    • 한국산학기술학회논문지
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    • 제22권2호
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    • pp.354-361
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    • 2021
  • 본 연구는 노인인구의 급속한 증가에 따른 만성질환자 증가 추이를 고려하여, 만성질환에 의한 정신건강 악화에 대해 다루고자 하였다. 이를 위해, 한국인의 사망원인 중에서 상위를 차지하는 5가지의 주요 만성질환(당뇨병, 암, 만성폐질환, 심장질환, 뇌혈관 질환)을 선정하였다. 1-2차년도 고령화연구패널조사(KLoSA)에 참여한 45세 이상의 중고령자를 대상으로, 만성질환 진단자로의 전이와 우울 수준이 어떠한 관계가 있는지 살펴보았다. 연구방법은 SPSS 25.0을 사용한 다중회귀분석을 실시하여, 만성질환자로 전이한 경우 및 5가지 각 질환별 전이한 경우가 우울에 어떠한 영향을 미치는지 분석하였다. 본 연구결과에 따르면, 만성질환 진단자로 전이는 우울수준을 유의미하게 증가시키는 것으로 나타났다. 질환별로 살펴보았을 때, 암, 만성 폐질환, 뇌혈관 질환이 진단된 중고령자는 우울 수준이 높아졌으나, 당뇨병과 심장질환이 진단된 경우는 우울에 유의한 영향을 미친다는 증거가 발견되지 않았다. 본 연구결과를 바탕으로 만성질환자로의 전이와 우울관리에 대한 논의가 이루어졌다.

Phenotype of Chronic Obstructive Pulmonary Disease Based on Computed Tomography-Defined Underlying Pathology

  • Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • 제85권4호
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    • pp.302-312
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    • 2022
  • Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous disease. Not all patients with COPD respond to available drugs. Identifying respondents to therapy is critical to delivering the most appropriate treatment and avoiding unnecessary medication. Recognition of individual patients' dominant characteristics by phenotype is a useful tool to better understand their disease and tailor treatment accordingly. To look for a suitable phenotype, it is important to understand what makes COPD complex and heterogeneous. The pathology of COPD includes small airway disease and/or emphysema. Thus, COPD is not a single disease entity. In addition, there are two types (panlobular and centrilobular) of emphysema in COPD. The coexistence of different pathological subtypes could be the reason for the complexity and heterogeneity of COPD. Thus, it is necessary to look for the phenotype based on the difference in the underlying pathology. Review of the literature has shown that clinical manifestation and therapeutic response to pharmacological therapy are different depending on the presence of computed tomography-defined airway wall thickening in COPD patients. Defining the phenotype of COPD based on the underlying pathology is encouraging as most clinical manifestations can be distinguished by the presence of increased airway wall thickness. Pharmacological therapy has shown significant effect on COPD with airway wall thickening. However, it has limited use in COPD without an airway disease. The phenotype of COPD based on the underlying pathology can be a useful tool to better understand the disease and adjust treatment accordingly.

만성폐쇄성폐질환자의 건강 관련 삶의 질에 영향을 미치는 요인 (Factors Influencing Health-related Quality of Life of Patients with Chronic Obstructive Pulmonary Disease)

  • 김나현;박진희
    • 근관절건강학회지
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    • 제23권3호
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    • pp.159-168
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    • 2016
  • Purpose: The purpose of this study was to identify the factors influencing health-related quality of life (HRQOL) of patients with chronic obstructive pulmonary disease (COPD). Methods: A sample of 108 Patients diagnosed with COPD was recruited from outpatients, at a university hospital. Data were collected from February to April in 2016 using the St. George's Respiratory Questionnaire, the Hospital Anxiety-Depression Scale, and the COPD Self-efficacy scale. Results: The average score of HRQOL was 47.56 in patients with COPD. Results of the regression analysis showed that dyspnea phase (${\beta}$=.34, p<.001) and presence or absence of oxygen (${\beta}$=.20, p=.009), anxiety (${\beta}$=.29, p<.001), $FEV_1$ % predicted (${\beta}$=-.15, p=.014) were statistically significant in patients' HRQOL. Conclusion: The research findings show that dyspnea phase and anxiety among psychological factors were the most powerful factors that explain the HRQOL of COPD patients when the demographic and disease characteristics were controlled. Identification of quality of life-related factors should be used to inform targeted interventions, in order to improve HRQOL and help patients' cope.

급·만성 기관지염과 알레르기성 비염의 국내 의료 이용 현황 분석 (Analysis of Korean Medical status of Acute Bronchitis, Chronic Bronchitis and Allergic Rhinitis patients)

  • 정유진;양웅모
    • 대한한의학회지
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    • 제40권3호
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    • pp.87-98
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    • 2019
  • Objectives: Patients with respiratory diseases are increasing as air pollution due to fine dust gets worse. Diseases that occupy a large proportion of respiratory diseases in medical institutions are acute bronchitis, chronic bronchitis and Allergic rhinitis. The number of patients with all three diseases is gradually increasing. This study was to suggest assignment of medicine policy for improving accessibility to Korean medical treatment of respiratory diseases analyzing the current treatment status of acute bronchitis, Chronic bronchitis and Allergic rhinitis patients in Western medical and Korean medical institutes in this situation. Methods: This study used 2017 National patient sample data from the Korean Health Insurance Review and Assessment Service for research. Acute bronchitis, Chronic bronchitis, Allergic rhinitis was according to KCD code. This research contains Socio-demographic analysis classified by sex and age, the number of three disease's patients. Also the number of medical treatment, the expense of recuperation cost, medical practices were analyzed compare with Western and Korean medicine. Results: The incidence of three diseases is higher among female than male. There are many patients under the age of 10 in the case of acute bronchitis and allergic rhinitis, while there are many patients over 50 years of age in chronic bronchitis. Western medical treatment take up a larger proportion than Korean medical treatment in part of the number of three disease's patients, the number of medical treatment, the expense of recuperation cost. Conclusions: Much more patients of these diseases visit in Western medical clinic and hospital than Korean medical clinic and hospital for treatment. There are many parts of Korean medical treatment that are not covered by Health insurance benefits like herbal decoction, pharmacopuncture, etc. Korean medicine need to do the efforts for expanding medical field in variety. Also it is demanded for institutional support for reduction of the cost burden and improving on accessibility of Korean medical treatment in order to treat with the increase in respiratory diseases due to fine dust.

Small Airway Disease in Patients with Chronic Obstructive Pulmonary Disease

  • Singh, Dave
    • Tuberculosis and Respiratory Diseases
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    • 제80권4호
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    • pp.317-324
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    • 2017
  • Small airway disease (SAD) has been recognized for many years as a central feature of chronic obstructive pulmonary disease (COPD). Histopathology studies have shown that the narrowing and destruction of small airways in COPD combined with inflammatory cell infiltration in the submucosa increases the severity of the disease. SAD is present in the early stages of COPD and becomes more widespread over time as the disease progresses to more severe COPD. The development of inhalers containing extra-fine particles allows the small airways to be pharmacologically targeted. Recent clinical trials have shown the efficacy of extra-fine triple therapy that targets the small airways in patients with COPD. This article reviews the importance and treatment of SAD in COPD.

만성질환자의 특성에 따른 생애말기치료 선호도 (Preferences for Care near the End of Life according to Chronic Patients' Characteristics)

  • 윤선영;강지연
    • 성인간호학회지
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    • 제25권2호
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    • pp.207-218
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    • 2013
  • Purpose: The purpose of this study was to explore the chronic patients' preferences for care near the end of life. Methods: This is a descriptive survey research, with subjects of 161 outpatients with hypertension, diabetes mellitus or chronic renal failure. Results: The majority of the subjects do not want meaningless life sustaining treatment and they report thinking positively about family or health care professional to participate in their end of life decision making process. Subjects reported preferring adequate pain management and spiritual support at the end of life. In regard to advance directives (ADs), those subjects with chronic disease report thinking positively about the necessity of ADs and its institutionalization. However, the subjects report not having the detailed information on the proper time and method of writing their ADs. Conclusion: Based on these results, educational programs on end of life decision making for chronic patients need to be developed. Also, the nurse should try to reflect the opinion of chronic patients as much as possible when make an end-of-life decision.

Prediction of Pulmonary Function in Patients with Chronic Obstructive Pulmonary Disease: Correlation with Quantitative CT Parameters

  • Hyun Jung Koo;Sang Min Lee;Joon Beom Seo;Sang Min Lee;Namkug Kim;Sang Young Oh;Jae Seung Lee;Yeon-Mok Oh
    • Korean Journal of Radiology
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    • 제20권4호
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    • pp.683-692
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    • 2019
  • Objective: We aimed to evaluate correlations between computed tomography (CT) parameters and pulmonary function test (PFT) parameters according to disease severity in patients with chronic obstructive pulmonary disease (COPD), and to determine whether CT parameters can be used to predict PFT indices. Materials and Methods: A total of 370 patients with COPD were grouped based on disease severity according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) I-IV criteria. Emphysema index (EI), air-trapping index, and airway parameters such as the square root of wall area of a hypothetical airway with an internal perimeter of 10 mm (Pi10) were measured using automatic segmentation software. Clinical characteristics including PFT results and quantitative CT parameters according to GOLD criteria were compared using ANOVA. The correlations between CT parameters and PFT indices, including the ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) and FEV1, were assessed. To evaluate whether CT parameters can be used to predict PFT indices, multiple linear regression analyses were performed for all patients, Group 1 (GOLD I and II), and Group 2 (GOLD III and IV). Results: Pulmonary function deteriorated with increase in disease severity according to the GOLD criteria (p < 0.001). Parenchymal attenuation parameters were significantly worse in patients with higher GOLD stages (P < 0.001), and Pi10 was highest for patients with GOLD III (4.41 ± 0.94 mm). Airway parameters were nonlinearly correlated with PFT results, and Pi10 demonstrated mild correlation with FEV1/FVC in patients with GOLD II and III (r = 0.16, p = 0.06 and r = 0.21, p = 0.04, respectively). Parenchymal attenuation parameters, airway parameters, EI, and Pi10 were identified as predictors of FEV1/FVC for the entire study sample and for Group 1 (R2 = 0.38 and 0.22, respectively; p < 0.001). However, only parenchymal attenuation parameter, EI, was identified as a predictor of FEV1/FVC for Group 2 (R2 = 0.37, p < 0.001). Similar results were obtained for FEV1. Conclusion: Airway and parenchymal attenuation parameters are independent predictors of pulmonary function in patients with mild COPD, whereas parenchymal attenuation parameters are dominant independent predictors of pulmonary function in patients with severe COPD.

만성질환자의 한방의료기관 재방문 및 추천의사에 영향을 미치는 요인 (Factors influencing the intention of Chronic Disease Patients to revisit and recommend the Korean medicine clinics)

  • 김재우;강정규;김성호
    • 대한예방한의학회지
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    • 제27권3호
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    • pp.83-95
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    • 2023
  • Objectives : The purpose of this study is to analyze the factors affecting the intention of chronic disease patients on revisiting and recommending those clinics to others. Methods : This study conducted the frequency analysis, Rao-scott chi-square test, and logistic regression analysis on 927 people, who answered that they had been diagnosed with a chronic disease, using data from the 2020 Korean Medicine Utilization and Herbal Medicine Consumption Survey. Results : The results of analyses revealed that the attitude of medical staff, and the treatment results were the significant influencing factors on the intention to revisit and to recommend to others. Other than the above factors, the medical expenses were found to be important influencing factors on the intention to recommend to others. Conclusions : In order to increase the intention to revisit and to recommend to others a Korean Medicine clinics, the top priority lies in both proving high-quality medical services and promoting friendly attitudes of medical staff. In addition, it is necessary to actively utilize korean medicine to guarantee patients' medical options.

뇌혈관(腦血管) 질환(疾患) 환자(患者)에 대한 임상적(臨床的) 고찰(考察) (A Clinical Study on 106 cases of CVA)

  • 정현지;유재연;한창호;신동은;주입산
    • 대한한방내과학회지
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    • 제21권5호
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    • pp.791-797
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    • 2000
  • Objectives : C V A(Cerebral Vascular Attack) is the severest and most important disease that makes doctors difficult in treating, also makes patients difficult to recover. I intended to research for imformations and standards of C V A patients of Sasang Constitutional Medicine through this clinical study. Methods : 106 C V A patients(61 men and 45 women) who had been inpatients from October 19, 1996 to August 19, 1999 in Conmaul Oriental Hospital were investigated and analysed the characteristics, past histories, symtoms, progress, relationship with other diseases for example DM and HTN, efficacy of oriental medical treatments. Results and Conclusions : The results of constitutional analysis showed 51 Taeumin(48.1%) 13 Soyangin(12.3%) 12 Soeumin(11.3%) 7 Taeyangin(6.6%). In the frequency of C V A, age of $60{\sim}69(43.4%)$ is major, both $50{\sim}59\;and\;70{\sim}79$ (17.9%) are next. and in pre-disease on the past, C V A is major, digestive disease and musuloskeletal disease are next. In chief complaint, kinetic disorder is major dyslogia is next. In efficacy of treatments, Slightly Improved(52.9%) is the most occupied part of that.

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