• 제목/요약/키워드: Clinical Severity

검색결과 1,687건 처리시간 0.027초

응급실에 내원한 발열 환자에서 암 진단 유무에 따른 임상증상의 중증도에 대한 후향적 조사 연구 (The severity of clinical symptoms according to cancer diagnosis in fever patients visiting the emergency department: a retrospective analysis)

  • 이은샘;강푸름;신유경;설근희
    • Journal of Korean Biological Nursing Science
    • /
    • 제25권2호
    • /
    • pp.105-112
    • /
    • 2023
  • Purpose: This study aimed to understand the general characteristics and biomarkers of inflammation in adult patients who visited the emergency department with fever and to determine whether the severity of clinical symptoms varies according to cancer diagnosis. Methods: Data were collected retrospectively from 4,002 adult patients with fever who visited the emergency department at a tertiary hospital from January 2018 to December 2018 using medical records. Results: On average, cancer patients were older than non-cancer patients (p < .001), and differences were observed between cancer and non-cancer patients in the origin of fever and biomarkers associated with inflammation. A higher proportion of cancer patients than non-cancer patients had a Korean Triage and Acuity Scale level of 1 to 3 (p < .001), and more cancer patients than non-cancer patients met two or more criteria for systemic inflammatory response syndrome (p = .001). More life-saving interventions in the emergency department were required in cancer patients than in non-cancer patients (p < .001), and cancer patients spent more time in the emergency department than non-cancer patients (p < .001). Conclusion: This study showed that the general characteristics and biomarkers of inflammation differed among adult patients with fever depending on cancer diagnosis. Furthermore, among adult patients with fever, cancer patients had more severe clinical symptoms than non-cancer patients. The results of this study are hoped to be helpful as a basis of nursing knowledge for adult patients with fever in the emergency department and as evidence for the classification of severity in patients with fever according to cancer diagnosis.

원발성(原發性) 월경곤난증(月經困難症)과 어혈(瘀血)의 상관성 연구 (A study on the Correlation between Primary dysmenorrhea and Blood stasis)

  • 윤영진;조정훈;장준복;이진무;이창훈;이경섭
    • 대한한방부인과학회지
    • /
    • 제22권1호
    • /
    • pp.148-160
    • /
    • 2009
  • Purpose: We intended to observe the correlations between Primary dysmenorrhea severity and Questionnaires for Blood Stasis Pattern. Methods: After initial approval by Kyung-Hee University Oriental Medical Hospital Institutional Review Board of Clinical Trials, volunteers for the clinical trial were recruited. We selected the 52 primary dysmenorrhea patients by the screening tests (clinical examination and inquiry). The severity of dysmenorrhea was evaluated by VAS (Visual Analog Scale), VRS (Verbal Rating Scale) & MVRS (Multidimensional Verbal Rating Scale). The severity of Blood Stasis was evaluated by Questionnaires for Blood Stasis Pattern. For statistics, we used Spearman's rho correlations, SPSS 13.0 for windows. Results: In case of VAS, though two items (眼瞼下靑紫, 便黑) of Questionnaires for Blood Stasis Pattern were correlated, total score & discriminant function score of Questionnaires for Blood Stasis Pattern were not correlated. In case of VRS, though two items (小腹痛, 夜間痛) of Questionnaires for Blood Stasis Pattern were correlated, total score & discriminant function score of Questionnaires for Blood Stasis Pattern were not correlated. In case of MVRS, though one items (久痺症) of Questionnaires for Blood Stasis Pattern were correlated, total score & discriminant function score of Questionnaires for Blood Stasis Pattern were not correlated. Conclusion: Though the results showed partial correlation of Primary dysmenorrhea severity and Questionnaires for Blood Stasis Pattern, we need further study after improvement and complementation of Questionnaires for Blood Stasis Pattern.

틱 장애 아동의 인지행동치료 증례: 5회기 습관뒤집기 훈련과 호흡훈련을 중심으로 (Cognitive Behavioral Therapy in Childhood Tic Disorder : A Case of Report)

  • 송정림;홍종우;도진아;김현우;임명호
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
    • /
    • 제22권1호
    • /
    • pp.38-43
    • /
    • 2011
  • Chronic tic disorder or Tourette syndrome is known to be a chronic neuro-behavioral disease for which cognitive behavioral therapy (CBT) strategies have recently been introduced. Here, we report the effectiveness of CBT in a case of childhood chronic tic disorder, which is very common in clinical settings. The DSM-IV clinical diagnosis was applied by a child psychiatrist. The Yale Global Tic Severity Scale, Kovac's children's depression inventory, Spielberger State-Trait Anxiety Inventory, Abbreviated Conners' Rating Scales, and the Dupaul ADHD Rating Scales were used. This case involved a pharmacological treatment-refractory patient over the previous year. Thus, psychiatric consultation was undertaken. Subsequently, we administered five sessions of CBT for four weeks, consisting of symptom evaluation and planning, habit reversal training, and ventilation training. Following four weeks of CBT administration, there were improvements in the scores of the Yale Global Tic Severity Scale and the Clinical Global Improvement scale. Our observations indicate that CBT may be effective in the treatment of childhood tic disorder.

폐쇄성 수면무호흡 환자의 안면 및 혀의 크기에 대한 연구 (A size analysis in obstructive sleep apnea patients)

  • 배응권;;박영철
    • 대한치과교정학회지
    • /
    • 제27권6호
    • /
    • pp.865-870
    • /
    • 1997
  • 폐쇄성 수면무호흡(이하 OSA)환자의 일반적 특징의 하나로 다소 비대한 Submental부위를 든다. 따라서 근간에는 경부 주위의 측정을 임상적 진단의 한 보조방법으로 채택하는 경우도 있다. 본 연구는 80명의 환자로 부터 직접위와 앙와위의 두 자세에서 각각 두 장의 측모두부방서선사진을 채득하여 OSA환자의 안면과 혀의 크기를 일반인의 그것과 비교 하였다. 채득된 실험자료는 각각 증상의 심한 정도에 따라 무증상군, 경미군 중증군 그리고 중중근으로 나누었다. 크기 측정의 방법으로는 각각의 두 계측점간의 거리를 측정하여 모든 계측치의 합으로 해부학적 크기를 대신하였다. 결과로서, 안면의 크기가 혀의 크기보다 체중과 더 높은 상관관계를 보였으나, 증상의 심한 정도와는 혀의 크기가 더 중요한 측정치 임을 알수 있었다. 혀의 크기가 증상의 정도에 비례함에 있어서 $1\%$의 유의차를 보였다.

  • PDF

병용금기, 연령금기 경고 등급화 방안과 DUR 처방변경률 분석 (Tiering 'Drug Combinations to Avoid' and 'Drug-age Precaution' DUR Alerts by Severity Level and its Application)

  • 이수옥;제남경;김동숙;천방옥;황인옥
    • 약학회지
    • /
    • 제59권6호
    • /
    • pp.278-283
    • /
    • 2015
  • The computerized prospective Drug Utilization Review (DUR) program supported by the Korean government has provided alerts to physicians and pharmacists since December 2010. This study aims to propose and apply the tiering system in "drug combinations to avoid (DCA)" and "age-precaution" alerts based on severity to improve the compliance of users. To propose the severity and clinical importance of 647 DCA alerts and 140 age precautions, a Delphi evaluation survey was conducted. An expert panel comprising 5 clinical pharmacists and 5 physicians were participated in mail surveys. Based on the results of Delphi survey, DCA pairs were classified into 3 groups; group 1 (70.6%), 2 (26.9%), and 3 (2.8%). Drug-age precaution ingredients were also classified into three groups; group 1 (53.6%), group 2 (40.7%), and group 3 (5.7%). When this grouping was applied to claim data from 2011 to 2013, the majority of alerts had occurred in the groups of high severity. Presenting DUR alerts with severity level is expected to improve the compliance of clinicians. The implementation of tiering system in DUR criteria should be considered.

불안장애, 우울장애, 외상 및 스트레스 관련 장애의 심박변이지표 비교 연구 (Comparisons of HRV Parameters Among Anxiety Disorder, Depressive Disorder and Trauma·Stressor Related Disorder)

  • 김지은;박도원;한지연;이정현
    • 정신신체의학
    • /
    • 제28권1호
    • /
    • pp.81-88
    • /
    • 2020
  • 연구목적 이 연구는 심박변이도(Heart rate variability, HRV) 지표를 이용하여, 불안장애, 우울장애, 외상 및 스트레스 관련 장애의 차이를 비교하고 증상 심각도와의 연관성을 보고자 한다. 방 법 2017년부터 2018년까지 국립정신건강센터 스트레스 클리닉 내원 환자의 후향적 의무기록을 분석하였다. 총 473명 환자(불안장애 166명, 우울장애 184명, 외상 및 스트레스 관련 장애 123명)의 HRV 지표의 진단 군간 차이를 비교하였다. 또한 지표와 전반적 임상 인상 심각도(Clinical Global Impression-Severity Scale, CGI-S)의 연관성이 진단군에 따른 차이를 보이는지 분석하였다. 결 과 세 군에서 HRV 지표는 유의한 차이를 보이지 않았다. 그러나, 심박도 간격(normal-to-normal, NN)의 표준 편차(standard deviation of normal RR intervals, SDNN)와 연속된 NN 간격들의 변이의 제곱 평균값의 루트 값(the square root of the mean squared differences of successive NN intervals, RMSSD)의 CGI-S와의 관련성은 그룹 간 유의한 차이가 나타났다(SDNN, p=0.017 ; RMSSD, p=0.034). 불안장애와 우울장애에서는 CGI-S에 따른 SDNN, RMSSD가 음의 관련성을 보였지만, 외상 및 스트레스 관련 장애에서는 양의 관련성을 보였다. 결 론 본 연구에서 세 군의 HRV 지표는 차이를 보이지 않았지만, 각 군에서 지표와 임상적 심각도와의 연관성은 다른 양상을 보였다. 본 연구 결과는 외상 및 스트레스 관련 장애군은 HRV의 특징 및 임상적 활용이 불안 및 우울장애와 다를 수 있음을 시사한다.

폐쇄성 수면무호흡 증후군과 목둘레 및 체질량 지수와의 상관성 연구 (Correlation of Body Mass Index and Neck Circumference in Patients with Obstructive Sleep Apnea-Hypopnea Syndrome)

  • 김천식;김대식
    • 대한임상검사과학회지
    • /
    • 제39권2호
    • /
    • pp.141-146
    • /
    • 2007
  • Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a disorder characterized by the repetitive collapse of the pharyngeal airway during sleep, which leads to oxygen desaturation, sleep fragmentation, daytime sleepiness, and increased risk for hypertension and stroke. We investigated the clinical factors related to the severity of OSAHS. Polysomnography was performed in three hundred and ninety five consecutive adult patients with clinical symptoms of obstructive sleep apnea syndrome. All patients completed the sleep questionnaire and the Epworth Sleepiness Scale before polysomnography. Patients were classified into four groups based on the severity of their polysomnographic data: Non-OSA group, characterized by Apnea-Hypopnea Index (AHI) < 5; mild OSA group, by AHI 5-15; moderate OSA group, by AHI 16-30; and severe OSA group, by AHI > 30. Neck circumference was also measured at the cricothyroid level. A total of 395 patients (336 men and 59 women) were studied. In the non-OSA group, there were 55 patients; their mean neck circumference was $39.63{\pm}4.24cm$ and mean BMI was $24.48{\pm}3.53$. In the mild group, there were 101 patients; their mean neck circumference was $41.93{\pm}3.75cm$ and mean BMI was $25.33{\pm}2.94$. In the moderated group, there were 93 patients; their mean neck circumference was $43.27{\pm}3.50cm$ and BMI was $25.90{\pm}2.88$. In the severe group, there were 146 patients; their mean neck circumference was $44.94{\pm}3.93cm$ and mean BMI was $26.81{\pm}3.76$. Men had significantly larger neck circumference than women ($Mean{\pm}SD$, $43.72{\pm}3.83$ vs $39.17{\pm}4.30$, p < 0.001), and higher AHI than women ($29.12{\pm}22.65$ vs $14.63{\pm}14.11$, p < 0.001). Multiple regression analysis revealed that neck circumference was the most significant predictor of AHI. Neck circumference and BMI were positively correlated with the severity of OSAHS. The severity of OSAHS was greater in men than in women.

  • PDF

Study of pathogenicity and severity of Lactococcus garvieae isolated from rainbow trout (Oncorhynchus mykiss) farms in Kohkilooieh and Boyerahmad province

  • Karami, Esmaeil;Alishahi, Mojtaba;Molayemraftar, Taravat;Ghorbanpour, Masoud;Tabandeh, Mohammad Reza;Mohammadian, Takavar
    • Fisheries and Aquatic Sciences
    • /
    • 제22권10호
    • /
    • pp.21.1-21.7
    • /
    • 2019
  • Background: Lactococcus garvieae is one of the most important risk factors in the rainbow trout culture. Therefore, the purpose of this study was to identify and detect strains isolated from rainbow trout suspected of having Lactococcus garvieae using biochemical characteristics and PCR and determination of the degree of severity of isolated strains. Methods: In this study, the cause of lactococcosis in selected rainbow trout farms in Kohkilooieh and Boyerahmad province was assayed. Gram-positive and catalase-negative bacterial isolates were first obtained from selected trout fish farms using conventional biochemical tests and PCR assay. The 10-day LD50 method (concentration causing 50% mortality in 10 days) was used to determine the severity of the isolated bacteria. Results: One bacterial isolate was detected from all sampled fish which confirmed as Lactococcus garvieae using a specific PCR assay based on the 16S rDNA gene by producing a single band of 1107 bp. Analysis of the rate of mortality showed that the 10-day LD50 was 4.6 × 105 CFU/fish. The results of this study showed that isolated bacteria had high severity for rainbow trout. The presence of bacteria in internal organs of suspected fish showed a severe systemic infection in challenged fish. Antibiogram assay also indicated that the isolated Lactococcus garvieae were resistant to some mostly used antibiotics in rainbow trout. Conclusions: According to current research, it can be concluded that the condition of lactococcosis in the studied area is not suitable, and despite the presence of disease, there is no proper action to control and prevent the disease. Unfortunately, isolated bacteria from the studied area have a very high severity compared to bacteria isolated from other regions of the country or other countries. Therefore, further investigation is needed to determine the cause of this difference and possibly in the design of the vaccine.

구강건조증 환자의 임상적 특징에 관한 연구 (A Study on the Clinical Characteristics of Patients with Dry Mouth)

  • 오정규;김연중;고홍섭
    • Journal of Oral Medicine and Pain
    • /
    • 제26권4호
    • /
    • pp.331-343
    • /
    • 2001
  • Advances in medical procedures and utilization of medication have resulted in expanding aged population, which leads to increased aged patients with salivary hypofunction and its associated symptoms in dental clinic. The purpose of this study was to investigate clinical characteristics of patients with dry mouth and its correlation with their salivary flow rate. Forty dry mouth patients (7 males, 33 females, mean age 42.0 years) whose flow rate of unstimulated whole saliva was less than 0.15 ml/min were included and their gender- and age-matched controls (7 males, 33 females, mean age 42.9 years) who did not report any complaints, suggestive of salivary gland dysfunction and had the flow rate of greater than 0.20 ml/min were included for comparison. The salivary flow rate was measured in both unstimulated and stimulated conditions. Dry mouth-related clinical information including history, dry mouth associated symptoms, exacerbating and relieving factors, drugs, systemic diseases, and family history was investigated using questionnaires. The differences in distribution of patients and control subjects to each question and their relation to the salivary flow rate were analyzed and we came to following conclusions. 1. There were statistically significant differences in the distribution of patients and controls to the following questions: the period and frequency of suffering from dry mouth; severity of dry feeling during a meal; severity of discomfort during swallowing; necessity of sipping liquids during swallowing dry foods, severity of discomfort in usual life due to dry feeling; self-assessment of residual salivary volume; taking medications. 2. The patients had more stress-related medical histories including indigestion, insomnia, and gastritis compared with controls. The patients took many kinds of medications to control their systemic diseases. 3. There were statistically significant differences in the salivary flow rate between different groups of patients to following questions: severity of dry feeling during a meal; severity of discomfort during swallowing; necessity of sipping liquids during swallowing dry foods. The difference was more significant in the case of stimulated salivary flow rate rather than unstimulated one. 4. The salivary flow rate of patients taking medications was significantly less than that of patients who did not take medications. The difference was more significant in the case of stimulated salivary flow rate rather than unstimulated one.

  • PDF

CT Quantitative Analysis and Its Relationship with Clinical Features for Assessing the Severity of Patients with COVID-19

  • Dong Sun;Xiang Li;Dajing Guo;Lan Wu;Ting Chen;Zheng Fang;Linli Chen;Wenbing Zeng;Ran Yang
    • Korean Journal of Radiology
    • /
    • 제21권7호
    • /
    • pp.859-868
    • /
    • 2020
  • Objective: To investigate the value of initial CT quantitative analysis of ground-glass opacity (GGO), consolidation, and total lesion volume and its relationship with clinical features for assessing the severity of coronavirus disease 2019 (COVID-19). Materials and Methods: A total of 84 patients with COVID-19 were retrospectively reviewed from January 23, 2020 to February 19, 2020. Patients were divided into two groups: severe group (n = 23) and non-severe group (n = 61). Clinical symptoms, laboratory data, and CT findings on admission were analyzed. CT quantitative parameters, including GGO, consolidation, total lesion score, percentage GGO, and percentage consolidation (both relative to total lesion volume) were calculated. Relationships between the CT findings and laboratory data were estimated. Finally, a discrimination model was established to assess the severity of COVID-19. Results: Patients in the severe group had higher baseline neutrophil percentage, increased high-sensitivity C-reactive protein (hs-CRP) and procalcitonin levels, and lower baseline lymphocyte count and lymphocyte percentage (p < 0.001). The severe group also had higher GGO score (p < 0.001), consolidation score (p < 0.001), total lesion score (p < 0.001), and percentage consolidation (p = 0.002), but had a lower percentage GGO (p = 0.008). These CT quantitative parameters were significantly correlated with laboratory inflammatory marker levels, including neutrophil percentage, lymphocyte count, lymphocyte percentage, hs-CRP level, and procalcitonin level (p < 0.05). The total lesion score demonstrated the best performance when the data cut-off was 8.2%. Furthermore, the area under the curve, sensitivity, and specificity were 93.8% (confidence interval [CI]: 86.8-100%), 91.3% (CI: 69.6-100%), and 91.8% (CI: 23.0-98.4%), respectively. Conclusion: CT quantitative parameters showed strong correlations with laboratory inflammatory markers, suggesting that CT quantitative analysis might be an effective and important method for assessing the severity of COVID-19, and may provide additional guidance for planning clinical treatment strategies.