• 제목/요약/키워드: Clinical Severity

검색결과 1,687건 처리시간 0.031초

APACHE Ⅲ를 이용한 중환자 분류도구의 타당도 검증 (Patient Severity Classification in a Medical ICU using APACHE Ⅲ and Patient Severity Classification Tool)

  • 이경옥;신현주;박현애;정현명;이미혜;최은하;이정미;김유자;심윤경;박귀주
    • 대한간호학회지
    • /
    • 제30권5호
    • /
    • pp.1243-1253
    • /
    • 2000
  • The purpose of this study was to verify the validity of the Patient Severity Classification Tool by examining the correlations between the APACHE Ⅲ and the Patient Severity Classification Tool and to propose admission criteria to the ICU. The instruments used for this study were the APACHE Ⅲ developed by Knaus and the Patient Severity Classification Tool developed by Korean Clinical Nurses Association. Data was collected from the 156 Medical ICU patients during their first 24 hours of admission at the Seoul National University Hospital by three trained Medical ICU nurses from April 20 to August 31 1999. Data were analyzed using the frequency, $x^2$, Wilcoxon rank sum test, and Spearman rho. There was statistically significant correlations between the scores of the APACHE III and the Patient Severity Classification Tool. Mortality rate was increased as patients classification of severity in both the APACHE III and the Patient Severity Classification Tool scored higher. The Patient Severity Classification Tool was proved to be a valid and reliable tool, and a useful tool as one of the severity predicting factors, ICU admission criteria, information sharing between ICUs, quality evaluations of ICUs, and ICU nurse staffing.

  • PDF

아토피 피부염의 동물 모델인 NC/Nga Mice에서의 우묵사스레피의 면역조절 효과 (Immunomodulatory Effects of Eurya emarginata on NC/Nga Mice as Models for Atopic Dermatitis)

  • 이승헌
    • 생명과학회지
    • /
    • 제24권4호
    • /
    • pp.447-453
    • /
    • 2014
  • 본 연구에서는 1-chloro-2,4-dinitrobenzene (DNCB)로 유도한 아토피 피부염 동물 모델인 NC/Nga mice에 대한 Eurya emarginata 에탄올 추출물(EE-70E)의 면역 조절 효능을 확인하고자 하였다. DNCB를 5주간 도포하여 유도한 아토피 동물 모델인 NC/Nga mice에 EE-70E를 3주간 경구 투여한 후 scratching behavior 및 clinical skin severity score, 혈청 면역지표(IL-4, IL-13, IL-17, histamine, IgG1, IgE)의 농도를 측정하였다. DNCB를 도포하여 3주동안 경구 투여한 결과, EE-70E의 200 및 400mg/kg 용량에서 clinical skin severity의 감소, scratching behavior의 감소 및 혈중 IL-4 및 IL-13, IL-17, histamine, IgE의 농도가 대조군과 비교하여 유의성 있게 농도의존적으로 감소하는 결과가 관찰되었다(p<0.05). EE-70E의 경구투여는 NC/Nga mice 아토피 피부염 동물모델에서 면역조절 작용 및 아토피 피부염의 개선 효과를 가짐을 나타냈다. 따라서 EE-70E은 아토피 피부염에 유용한 천연자원으로서 기대된다.

코골이가 수면무호흡증의 중증도를 예측할 수 있을까? (Has Snoring Significance for Predicting Obstructive Sleep Apnea Severity?)

  • 김시은;박봉수;박시형;신경진;하삼열;박진세;박강민
    • Annals of Clinical Neurophysiology
    • /
    • 제17권2호
    • /
    • pp.61-67
    • /
    • 2015
  • Background: The aim of this study was to investigate the predictive value of snoring frequency in the diagnosis and severity of obstructive sleep apnea. Methods: Patients who underwent polysomnography with one or more of the following characteristics were included: 1) sleepiness, non-restorative sleep, fatigue, or insomnia symptoms; 2) arousal due to cessation of breathing or the occurrence of gasping or choking when waking up; and 3) habitual snoring, breathing interruptions, or both, noted by a bed partner or other observer. We analyzed the differences in clinical and polysomnographic variables between patients with and without obstructive sleep apnea and investigated the associations of those variables with obstructive sleep apnea severity. Results: One hundred ninety-three patients met the inclusion criteria, and 145 of the 193 patients were diagnosed with obstructive sleep apnea. Multiple logistic regression analysis showed that large neck circumference (p = 0.0054) and high snoring index (p = 0.0119) were independent predictors for obstructive sleep apnea. Moreover, between the obstructive sleep apnea severity groups, there was a strong tendency of difference in body mass index (p = 0.0441) and neck circumference (p = 0.0846). However, there was no significant difference in snoring frequency according to obstructive sleep apnea severity (p = 0.4914). Conclusions: We confirmed that snoring frequency is a predictor of obstructive sleep apnea. In addition, we showed for the first time that snoring frequency is not associated with obstructive sleep apnea severity, thus it is not a valuable marker for predicting obstructive sleep apnea severity.

경정영양과 중심정맥영양을 공급받는 환자에서 질병의 상태(APACHEIII Score), 과대사 정도가 영양상태 및 임상적 결과에 미치는 영향 (Effects of the APACHEIII Score, Hypermetabolic Score on the Nutrition Status and Clinical Outcome of the Patients Administered with Total Parenteral Nutrition and Enteral Nutrition)

  • 라미용;김은미;조영연;서정민;최혜미
    • 대한지역사회영양학회지
    • /
    • 제11권1호
    • /
    • pp.124-132
    • /
    • 2006
  • The aim of this study is to evaluate the clinical outcome. Between January 1,2002 to September 30, 2002, we prospectively and retrospectively recruited III hospitalized patients who received Enteral Nutrition (EN group n = 52) and Total Parenteral Nutrition (TPNgroup n = 59) for more than seven days. The factors of clinical outcomes are costs, incidences of infection, lengths of hospital stay, and changes in weight. The characteristics of patients were investigated, which included nutritional status, disease severity CAP ACHE III score) and hypermetabolic severity Chypermetabolic score). Hypermeta-bolic scores were determined by high fever (> $38^{\circ}C$), rapid breathing (> 30 breaths/min) , rapid pulse rate (> 100 beats/min), leukocytosis (WBC > 12000 $mm^{3}$), leukocytopenia (WBC > 3000 $mm^{3}$), status of infection, inflammatory bowel disease, surgery and trauma. There was a positive correlation between hypermetabolic score and length of hospital stay (ICU), medical cost, weight loss, antibiotics adjusted by age while APACHEIII score did not show correlation to clinical outcome. Medical cost was higher by $18.2\%$ in the TPN group than the EN group. In conclusion, there was a strong negative correlation between the clinical outcome (cost, incidence of infection, hospital stay) and hypermetabolic score. Higher metabolic stress caused more malnutrition and complications. For nutritional management of patients with malnutrition, multiple factors, including nutritional assessment, and evaluation of hypermetabolic severity are needed to provide nutritional support for critically ill patients.

파킨슨병의 중증도에 따른 수면 장애 (Sleep Disturbances in Patients with Parkinson's Disease according to Disease Severity)

  • 이수윤;천상명;김재우
    • Annals of Clinical Neurophysiology
    • /
    • 제17권1호
    • /
    • pp.17-23
    • /
    • 2015
  • Background: Sleep-related disturbances and sleep disorders are common in Parkinson's disease (PD) and have a great impact on daily life of PD patients. This study was done to find the sleep characteristics and sleep disturbing factors in PD patients according to disease severity through clinical interview and polysomnographic (PSG) study. Methods: Fifty patients with PD (22 males, age $60.6{\pm}6.4$, Hoehn and Yahr (HY) stage $2.7{\pm}1.0$) were recruited and thoroughly interviewed about their sleep. PSG was performed on the patients taking routine antiparkinsonian medications. Patients were grouped into mild and moderate/severe group according to HY stage, and the results were compared between each group. Results: Ninety-four percent of total patients had one or more sleep-related disturbances based on the interview or PSG. On interview, the moderate/severe group complained more insomnia and REM sleep behavior disorder (RBD) than mild group. In PSG findings, the moderate/severe group showed lower sleep efficiency, longer sleep latency, REM sleep latency, waking time after sleep onset, and higher prevalence of RBD. Conclusions: In this study, most patients with PD had sleep disturbances. Clinical interview and PSG findings revealed deterioration of sleep quality along the disease severity. Our results suggest that sleep disturbances in PD patients are prevalent and warrant clinical attention, especially to the patients with advanced disease.

급성 아세트아닐라이드계 제초제 중독의 임상 분석 (Clinical Features of Acute Acetanilide Herbicide Poisoning)

  • 박철상;이미진;박성수;정원준;김현진
    • 대한임상독성학회지
    • /
    • 제9권2호
    • /
    • pp.49-55
    • /
    • 2011
  • Purpose: Acetanilide has been in widespread use as an amide herbicide compound. However, available data regarding acute human poisoning is scarce. The aim of this study was to analyze the clinical characteristics of acetanilide poisoning in order to identify the risk factors associated with severity. Methods: We conducted a retrospective observational study encompassing the period January 2005 to December 2010, including adult ED patients suffering from acetanilide intoxication. Toxicological history, symptoms observed, clinical signs of toxicity, and laboratory test results were collected for each patient. The patients were classified into two groups for analysis, according their poisoning severity score (PSS). Resulting clinical data and prognostic variables were compared between mild-to-moderate poisoning (PSS 1/2 grades), and severe poisonings and fatalities (PSS 3/4 grades). Results: There were a total of 37 patients, including 26 alachlor, 6 s-metolachlor, 4 mefenacet, and 1 butachlor cases. The majority of patients (81.1%) were assigned PSS 1/2 grades. Changes in mental status and observation of adverse neurologic symptoms were more common in the PSS 3/4 group. The median ingested volume of amide herbicide compound was 250 ml (IQR 200-300 ml) in the PSS 3/4 group, and 80 ml (IQR 50-138 ml) in the PSS 1/2 group. Also, the median GCS observed in the PSS 3/4 group was 13 (IQR 10-14), which was markedly low as compared to a median GCS of 15 in the PSS 1/2 group. Overall mortality rate was 5.4%, and profound cardiogenic shock was observed prior to death in all fatalities. Conclusion: When compared to previous reports, acute acetanilide poisoning resulted in relatively moderate severity. The presence of neurologic manifestations, hypotension, lower GCS score, and larger ingested volumes was associated with more serious effects and mortalities.

  • PDF

Associations of periodontal status in periodontitis and rheumatoid arthritis patients

  • Rovas, Adomas;Puriene, Alina;Punceviciene, Egle;Butrimiene, Irena;Stuopelyte, Kristina;Jarmalaite, Sonata
    • Journal of Periodontal and Implant Science
    • /
    • 제51권2호
    • /
    • pp.124-134
    • /
    • 2021
  • Purpose: The aim of this study was to assess the association between the clinical status of rheumatoid arthritis (RA) and periodontitis (PD) in patients diagnosed with PD and to evaluate the impact of RA treatment on the severity of PD. Methods: The study included 148 participants with PD, of whom 64 were also diagnosed with RA (PD+RA group), while 84 age-matched participants were rheumatologically healthy (PD-only group). PD severity was assessed by the following periodontal parameters: clinical attachment loss, probing pocket depth (PPD), bleeding on probing (BOP), alveolar bone loss, and number of missing teeth. RA disease characteristics and impact of disease were evaluated by the Disease Activity Score 28 using C-reactive protein, disease duration, RA treatment, the RA Impact of Disease tool, and the Health Assessment Questionnaire. Outcome variables were compared using parametric and non-parametric tests and associations were evaluated using regression analysis with the calculation of odds ratios (ORs). Results: Participants in the PD+RA group had higher mean PPD values (2.81 ± 0.59 mm vs. 2.58 ± 0.49 mm, P=0.009) and number of missing teeth (6.27±4.79 vs. 3.93±4.08, P=0.001) than those in the PD-only group. A significant association was found between mean PPD and RA (OR, 2.22; 95% CI, 1.16-4.31; P=0.016). Within the PD+RA group, moderate to severe periodontal disease was significantly more prevalent among participants with higher RA disease activity (P=0.042). The use of biologic disease-modifying antirheumatic drugs (bDMARDs) was associated with a lower BOP percentage (P=0.016). Conclusions: In patients with PD, RA was associated with a higher mean PPD and number of missing teeth. The severity of PD was affected by the RA disease clinical activity and by treatment with bDMARDs, which were associated with a significantly lower mean BOP percentage.

Hypertensive Retinopathy and the Risk of Hemorrhagic Stroke

  • Thiagarajah, Ramani;Kandasamy, Regunath;Sellamuthu, Pulivendhan
    • Journal of Korean Neurosurgical Society
    • /
    • 제64권4호
    • /
    • pp.543-551
    • /
    • 2021
  • Objective : Hemorrhagic stroke (HS) and hypertensive retinopathy are known end organ damage of the brain and eye respectively, with HS having deleterious consequence to the patients. This study is to correlate between hypertensive retinopathy and HS in hypertensive disease. Methods : A control group of hypertensive patients only, and an investigated group of hypertensive HS patients. Fundoscopic examination to determine the grade of retinopathy was performed and then divided into low or high severity hypertensive retinopathy. Clinical and radiological parameter included are demography, vital signs, Glasgow coma scale (GCS) on admission, clot volume, site of clot, Intracerebral hemorrhage (ICH) score and Glasgow outcome scale (GOS). Data were correlated with the severity of hypertensive retinopathy. Results : Fifty patient in the control group and 51 patients in the investigated group were recruited. In the hypertensive HS group, 21 had low severity retinopathy (no or mild retinopathy) accounting for 41.2% and 30 patients had high severity (moderate or severe retinopathy). In the hypertensive patients 49 had low severity and one had high severity (p-value of 0.001). In HS group low severity showed better GCS score of 9-15 on admission (p-value of 0.003), clot volume less than 30 mL (p-value 0.001), and also a better 30 days mortality rate by using the ICH score (p-value 0.006), GOS score of 4 and 5 the low severity retinopathy fair better than the high severity retinopathy (p-value of 0.001), and the relative risk to develop HS in low severity and high severity retinopathy was 0.42 and 29.4, respectively. Conclusion : Hypertensive retinopathy screening could be used as an indicator in hypertensive patient, to evaluate the risk of developing hypertensive HS in the future.

乾癬患者 臨床報告 (A Clinical Reports on Psoriasis)

  • 오은영;박혜선;구덕모;지선영
    • 한방안이비인후피부과학회지
    • /
    • 제14권2호
    • /
    • pp.278-285
    • /
    • 2001
  • A Reports were done on proriasis which were treated bv medications of Sasang Constitution and Constitution-Acupunture in Dept. surgery, opthalmology & otolaryngology, college of Oriental Medicine, Kyungsan University, Pohang, Korea, from May 30. 2000 to JUN 30 2001. we gave score and checked involvement, plaque, erythematous popules, invasiveness according to psoriasis area and severity index. The results were as follows: 1. Sasang Constitution classification was Soyanggin 11($93.33\%$), Taeumgin 1($6.67\%$) in the 15 cases, Hyungbangsabaeksan is used in 9 cases($60\%$), Yanggeuksanhoatang is used in 3cases($13.11\%$), Geopungchunggisan is used in 3 cases($20\%$), Hyungbangdojucksan is used in 1 case($6.57\%$) 2. In the 9 cases, we checked for over 4 weeks, clinical severity of involvement, plaque, total score(psoriasis area and severity index) was siginificantly decreased(p <0.05), clinical severity of erythematous popules, itching was decreased but It is not siginificant(p>0.05). 3. The mean duration of treatmemt was 73.3 days, result of Excellent or Good improvement was showed on over 120 days. These results indicate that Sasang Constitution and Constitution-Acupuncture treatment is effective on psoriasis and the more study is needed.

  • PDF

30-40대 여성의 미병상태에 따른 월경양상 비교연구 (A Study on comparison of menstrual pattern according to Mibyeong Index of Korean women in their thirties and forties)

  • 박민영;오현주;황민우
    • 대한예방한의학회지
    • /
    • 제23권1호
    • /
    • pp.61-72
    • /
    • 2019
  • Introduction : The aim of this study was to investigate menstrual pattern according to Mibyeong Index(MBI) and compare Mibyeong symptom score according to severity of menstrual pain. Mibyeong Index was designed to measure inconvenience and resilience of subject's complains including four physical symptoms(fatigue, pain, low sleep quality, indigestion) and mental distress including anxiety, anger, depression. Method : We used the clinical data of Korean medicine Date Center(KDC) for subjects who participated in the study of 'Clinical research for collecting of clinical cases based on the personal type of Mibyeng' conducted in Seoul, from June 26, 2015 to June 26, 2017. A total of 566 fertile women aged 30 to 50 who completed the questionnaires were included in this study. In this study, we used items of Mibyeong Index and the menstrual pattern by self-report questionnaires. The date were analyzed through Kruskal Wallis test, Pearson's chi-square test, and one-way ANOVA using SPSS statistics 19.0. Results : Mibyeong status was significantly associated with severity of menstrual pain(p<0.001), worst day of menstrual pain(p<0.05), and type of menstrual pain(low back pain, nausea, depression, and none (respectively, p<0.05)). In addition, The 7-subtype score (fatigue (p<0.001), pain(p<0.001), low sleep quality(p<0.001), indigestion(p<0.001), anxiety(p<0.05), anger(p<0.05) and depression(p<0.05)) of Mibyeong index and total score of Mibyeong Index (p<0.001) showed significant difference for severity of menstrual pain. Conclusion : This result indicates that a close relationship between Mibyeong status and severity of menstrual pain. Further studies are needed but, we hope that this results will be used as the basic data to improve mibyeong status through health care to alleviate dysmenorrhea.