• Title/Summary/Keyword: Clinical Management

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Trends of Market and Approval Management System for in vitro Diagnostic Veterinary Medical Reagents in Korea

  • Kang, Kyoung-Mook;Kang, Min-Hee;Suh, Tae-Young;Kang, Hwan-Goo;Moon, Jin-San
    • Journal of Veterinary Clinics
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    • v.35 no.4
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    • pp.119-125
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    • 2018
  • In vitro diagnostic veterinary medical reagents (IVDVMRs) were diverted the medical devices from medicine by the revision of the pharmaceutical affairs act enforcement regulations in 2015 in Korea. It classified into class I-IV according to risks of individual and public health. However, good manufacturing practices requirements on IVDVMRs were exempted from the current system. The registration of IVDVMRs by the Animal and Plant Quarantine Agency has gradually increased since 2012, and total of 584 products from 68 companies were registered from 1978 to 2017. Most of these items are clinical immunochemistry (infection disease), clinical immunochemistry (non-infection disease), molecular genetics, endocrinology, blood gas analysis, clinical microbiology, toxin, heavy metal and drug of abuse, other etc. The market size of IVDVMRs reported from the Korea Animal Health Products Association was estimated to be approximately 51.9 billion won in 2017. The domestic consumption and the export sales were approximately 31.2 and 20.7 billion won, respectively. They are increasing 23.9% (CAGR) in domestic consumption and 40.4% (CAGR) in export from 2011 to 2017.

Knowledge and Performance of Cancer Pain Management of Nurses and Nurses' aides in Long-term Care Hospitals (요양병원 간호사와 간호조무사의 암성 통증관리에 대한 지식 및 수행)

  • Jeong, Sunjin;Kim, Kyeha
    • The Journal of the Korea Contents Association
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    • v.14 no.10
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    • pp.649-660
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    • 2014
  • The purpose of this study was to assess knowledge and performance of cancer pain management of nurses and nurses' aides in long-term care hospitals. Subjects were 84 nurses and 72 nurses' aides recruited from seven long-term care hospitals in Gwangju city and Jeonranam-do. SPSS/WIN 21.0 was used for data analysis by descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation coefficients, and stepwise multiple regression. The mean scores of knowledge of cancer pain management were 16.84, and the score for performance was 2.88. There were significant differences in the knowledge of cancer pain management according to education level, job, and cancer pain management guidelines. Significant differences in performance of cancer pain management were observed according to education level, job, number of beds, cognition of cancer pain management guidelines, and clinical practice guideline for cancer pain management. Knowledge, number of beds, and clinical practice guideline for cancer pain management affected in performance of cancer pain management. Education program for cancer pain management and clinical practice guideline for cancer pain management are needed to improve performance of cancer pain management of nurses and nurses' aides in long-term care hospitals.

Management of Recurrent Vestibular Schwannomas

  • Kim, Wook-Ha;Park, Chul-Kee;Kim, Dong-Gyu;Jung, Hee-Won
    • Journal of Korean Neurosurgical Society
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    • v.39 no.2
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    • pp.87-91
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    • 2006
  • Objective : Management of recurrent vestibular schwannomas[VS] after microsurgery or radiosurgery is a complicated subject. However, few studies have documented the outcome of recurrent VS. The authorsreviewclinicalexperience of recurrent VS management and analyzed the efficacy of treatment modalities. Methods : Between 1990 and 2002, 293 patients harboring unilateral VS underwent, microsurgery, radiosurgery, microsurgery followed by radiosurgery. Of these, 26 procedures [in 20 patients] were performed to assessed from an increased tumor size by magnetic resonance imaging[MRI]. The mean age of patients with recurred VS was 46.9 years and the mean follow-up period was 68 months. Radiological characteristics were investigated and growth rates of recurred tumors were calculated by measuring changes in tumor diameter on MRI after treatment. Results : MRI characteristics revealed a lobulated contour in 75% and a cyst in 60% of the patients. Only 1 patient showed neither lobulation nor a cyst. The average diameter of the recurrent tumors were 36.9mm. The overall tumor control rate for initial management was 87.4%, 94.7%, and 98.5% for microsurgery, radiosurgery, and microsurgery plus radiosurgery, respectively. However, control rates for recurrent tumors were lower at 85%, 63%, and 80%, respectively. Conclusion : A cystic nature and a lobulated tumor contour are frequent clinical characteristics of recurrent VS. Microsurgery or microsurgery followed by radiosurgery shows little difference in tumor control rate for primary and recurrent VS. However, radiosurgery alone appears to be less beneficial for recurrent VS.

Echocardiography Core Laboratory Validation of a Novel Vendor-Independent Web-Based Software for the Assessment of Left Ventricular Global Longitudinal Strain

  • Ernest Spitzer;Benjamin Camacho;Blaz Mrevlje;Hans-Jelle Brandendburg;Claire B. Ren
    • Journal of Cardiovascular Imaging
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    • v.31 no.3
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    • pp.135-141
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    • 2023
  • BACKGROUND: Global longitudinal strain (GLS) is an accurate and reproducible parameter of left ventricular (LV) systolic function which has shown meaningful prognostic value. Fast, user-friendly, and accurate tools are required for its widespread implementation. We aim to compare a novel web-based tool with two established algorithms for strain analysis and test its reproducibility. METHODS: Thirty echocardiographic datasets with focused LV acquisitions were analyzed using three different semi-automated endocardial GLS algorithms by two readers. Analyses were repeated by one reader for the purpose of intra-observer variability. CAAS Qardia (Pie Medical Imaging) was compared with 2DCPA and AutoLV (TomTec). RESULTS: Mean GLS values were -15.0 ± 3.5% from Qardia, -15.3 ± 4.0% from 2DCPA, and -15.2 ± 3.8% from AutoLV. Mean GLS between Qardia and 2DCPA were not statistically different (p = 0.359), with a bias of -0.3%, limits of agreement (LOA) of 3.7%, and an intraclass correlation coefficient (ICC) of 0.88. Mean GLS between Qardia and AutoLV were not statistically different (p = 0.637), with a bias of -0.2%, LOA of 3.4%, and an ICC of 0.89. The coefficient of variation (CV) for intra-observer variability was 4.4% for Qardia, 8.4% 2DCPA, and 7.7% AutoLV. The CV for inter-observer variability was 4.5%, 8.1%, and 8.0%, respectively. CONCLUSIONS: In echocardiographic datasets of good image quality analyzed at an independent core laboratory using a standardized annotation method, a novel web-based tool for GLS analysis showed consistent results when compared with two algorithms of an established platform. Moreover, inter- and intra-observer reproducibility results were excellent.

An Analysis of the Role of Nurse Specialists in the General Hospital (일 종합전문병원의 전문간호사 업무 분석)

  • Park, Kwang-Ok;Kim, Jong-Kyung;Jeong, Jae-Sim
    • The Journal of Korean Academic Society of Nursing Education
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    • v.13 no.2
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    • pp.246-256
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    • 2007
  • Purpose: The purpose of this study was to explore the role of nurse specialist in the general hospital, and to provide basic data for the role management of nurse specialist. Method: The subjects were 38 staff nurses who worked in a medical, surgical, or other department in one general hospital. Survey tools were developed with criteria for a clinical nurse specialist by American Nurses Association(1986), Korean Nurses Association(2001), Kim(2005)'s research, and the nurse specialists' self job description. Validity of the tool was examined by 5 clinical nursing experts and nurse specialists. Data analysis was done by using SPSS Win 12.0 program. Result: The results of domains for the job of nurse specialists were 61.6% for direct clinical practice, 21.7% for education, 5.7% for consultation, 5.2% for management, 5.2% for research, and 1.1% for other domains. The results for the large classifications in nurse specialists domains were 57.6% for direct nursing practice in direct clinical practice domain, 89.1% for patient education in education domain, 57.5% for medical consultation in consultation domain, 57.5% for medical research in research domain, and 39.2% for documentation in management domain. Conclusion: This research revealed that direct clinical practice domain was higher than the other domains of research, education, and management. Discussion and development about the nurse specialist's various roles needs to be addressed on a continual basis.

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Initial Management of Radiation Injuries

  • Linnemann Roger E.
    • Journal of Radiation Protection and Research
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    • v.5 no.1
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    • pp.11-25
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    • 1980
  • The increasing utilization of radioactive isotopes in industry, medicine and research has raised the question, 'How should hospitals deal with radiation injuries when they occur?' A system for initial management of radiation injuries has been developed by Radiation Management Corporation. Radiation injuries are classified and a treatment plan outlined for each at the emergency and short term medical care phase. This system includes clinical prognosis as well as a detailed plan for quick set up or a Radiation Emergency Area in any hospital. Procedures for patient admission, preparation of the facility, general decontamination, sample taking, and wound decontamination are included.

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Esophageal perforation in children: etiology and management, with special reference to endoscopic esophageal perforation

  • Govindarajan, Krishna Kumar
    • Clinical and Experimental Pediatrics
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    • v.61 no.6
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    • pp.175-179
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    • 2018
  • Perforation of the esophagus is an uncommon problem with significant morbidity and mortality. In children undergoing endoscopy, the risk of perforation is higher when interventional endoscopy is performed. The clinical features depend upon the site of esophageal perforation. Opinions vary regarding the optimal treatment protocol, and the role of conservative management in this context is not well established. Esophageal perforation that occurs as a consequence of endoscopy in children requires careful evaluation and management, as outlined in this article.

Consensus on definition and quality standard of clinical practice guideline using RAND method (RAND 방법으로 합의한 임상진료지침의 정의와 질 평가 기준)

  • Ji, Seon-Mi;Kim, Soo-Young;Sheen, Seung-Soo;Heo, Dae-Seog;Kim, Nam-Soon
    • Health Policy and Management
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    • v.20 no.2
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    • pp.1-16
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    • 2010
  • Background : Clinical practice guidelines are an increasingly familiar part of clinical practice. Moreover, rigorously developed evidence based guidelines has been widely used. However, in Korea, some of published documents as clinical practice guidelines have shown considerable disparity in structure, contents and quality. This is mainly because there is no consensus on the definition and quality standard of clinical practice guidelines. The purpose of this study was to draw consensus on the definition and the quality standard about clinical practice guidelines. Method : We developed a questionnaire about the definition of clinical practice guidelines with inclusion criteria(23 items) and the quality standard(30 items). We selected 9 experts who had prior experience in developing and implementing guidelines. Rating methods for appropriateness of items were adopted from the RAND method. Consensus was drawn in three rounds. Results : Of the 47 items agreed, 40 items were determined to be appropriate. Clinical practice guidelines were defined as "scientifically and systematically developed statements to assist practitioners and patients on making decisions about appropriate health care for specific clinical circumstances." Narrative reviews, systematic reviews or health technology assessment without recommendations, translation of foreign guidelines, guidelines for patients only and training manuals were not considered as clinical practice guidelines. For the quality standard of clinical practice guidelines, 27 items were deemed necessary. Conclusions : The consensus on the definition with inclusion criteria and the quality standard of clinical practice guidelines carries an important meaning as the first attempt to draw a general agreement in our society. The unique achievement of the consensus reflects the current status of clinical practice guidelines that there has been a high tendency to adapt foreign guidelines. We hope efforts of this kind will continue to bring improvement in clinical practice guidelines.

The Clinical Characteristic and Management of Patients with Nocardiosis in a Tertiary Hospital in China

  • Peilin Liu;Zhiqian Wang;Zijuan Jian;Xuan Liu;Yanming Li;Qun Yan;Baiyun Zhong;Mengting Liao;Xianghui Liang;Wenen Liu
    • Journal of Microbiology and Biotechnology
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    • v.33 no.5
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    • pp.574-581
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    • 2023
  • Nocardiosis is an uncommon opportunistic bacterial infection which becomes a significant health problem due to its increasing incidence and high mortality rate. However, many nocardiosis patients are underdiagnosed by physicians. To summarize the clinical characteristics and management of nocardiosis would help with better diagnosis and prognosis of nocardiosis. This retrospective study was conducted based on the medical records of nocardiosis patients between January 2015 and December 2021 in a tertiary hospital in China. Overall, 44 nocardiosis patients with 54 specimens were included. The patients consisted of 26 males and 18 females with a mean age of 50.4 ± 13.2 years. Among 44 patients, 26 (59.1%) were previously given immunosuppressive therapy. Connective tissue diseases (CTDs) were the most common underlying disease (16/44). The most frequent infection sites were the lungs (17/44) and skin or soft tissues (8/44). Common symptoms included cough (23/44), expectoration (18/44), fever (15/44), and subcutaneous abscesses (15/44). Forty-five out of 54 specimens (83.3%) required over 48 hours of culture time for nocardiosis detection. Thirty-six patients were cured or improved, 5 patients were discharged from the hospital due to poor prognosis, and 1 patient died. The average diagnosis time of poor prognosis cases was 19.7 days, which was significantly longer than those of improved or cured patients (7.3 days). Immunosuppressed patients comprise a large part of nocardiosis cases, which is worth attention in clinical practice. Early diagnosis, specifically through prolonged cultivation time of specimen, could help achieve better prognosis of nocardiosis patients.

Job Analysis for Role Identification of Clinical Nurses with Expanded Role - Clinical Nurse with Education and Clinical Nurse with Coordination - (진료협력간호사의 역할규명을 위한 직무분석 - 교육상담간호사와 진료코디네이터간호사 중심 -)

  • Sung, Young Hee;Lim, Nan Young;Park, Kwang Ok;Jung, Jung Hee;Kwon, In Gak;Kim, Ul Soon;Hwang, Moon Sook
    • Journal of Korean Clinical Nursing Research
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    • v.15 no.2
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    • pp.139-155
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    • 2009
  • Purpose: The purpose of this study was to identify role through job analysis (duties and tasks) of nurses who work as clinical nurses with education and clinical nurse with patient coordination within the hospital. Methods: The DACUM committee was organized with 8 nurses each, clinical nurses with education and clinical nurses with coordination. The committee derived the duties and tasks of the two groups of clinical nurses from their actual work in the hospital through a DACUM workshop. Validity of the derived duties and tasks was tested by 12 nurses at each of 3 hospital. Results: For clinical nurse with education, 8 duties and 45 tasks were identified, which included patient education and consultation, patient advocacy, management of the therapeutic process, direct nursing care, activities work directed at improvement, management of health promotion events, administration work, and self-improvement. For clinical nurse with coordination, 10 duties and 54 tasks were identified, and included client consultation, client education, direct nursing care, coordination of therapeutic flow, employee education, public relations with the community, planning and operation of meetings, administration work, work directed at improvement, and self-improvement. Conclusion: The results of this study contribute to not only the work of the participants but also basic data for human resource management in the hospital.