• Title/Summary/Keyword: Clinical adjustment

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Pediatric Inflammatory Bowel Disease: A Multicenter Study of Changing Trends in Argentina Over the Past 30 Years

  • Arcucci, Maria Soledad;Contreras, Monica Beatriz;Gallo, Julieta;Antoniska, Mariela Andrea;Busoni, Veronica;Tennina, Cecilia;D’Agostino, Daniel;Kakisu, Maria Hisae;Weyersberg, Christian;Orsi, Marina
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.3
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    • pp.218-227
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    • 2022
  • Purpose: To analyze the characteristics of pediatric inflammatory bowel disease (IBD) over the past three decades in Argentina and determine if there are differences between the first two decades and the past decade. Methods: We conducted a retrospective multicenter analytical study in children with IBD between 0 and 18 years of age diagnosed between 1987 and 2017 in three tertiary health centers in Argentina. The evaluation included clinical characterization, endoscopy, histology, and imaging data together with therapeutic strategies. The patients were divided into two groups: Group 1, diagnosed between 1987 and 2007, and Group 2, diagnosed between 2008 and 2017. Results: Of the 756 patients included, 409 (54%) had ulcerative colitis (UC), 250 (33%) had Crohn's disease (CD), and 97 (13%) had IBD-unclassified (IBD-U). The positive family history was 3.8%, which was more frequent among children under two years of age (6.7%). There were no significant differences in clinical presentation and extraintestinal manifestations between periods, with hepatic manifestations being the most frequent. In the last decade, we found an upward trend in CD, a downward trend in UC/IBD-U, even after adjustment for socioeconomic status, and a decrease of 50% in surgical treatments coinciding with the advent of biological therapy. Conclusion: This is the first multicenter cohort study in a Latin American country to describe clinical, endoscopic, and therapeutic data across the past 30-year period. Although CD was responsible for the overall increase in incidence, UC was still prevalent in this region.

Usability test of pulling cable exercise machine in the spinal cord injury disabled: Focusing on deriving improvement (척수 손상 장애인 대상 장애인용 풀링 케이블 운동기구의 사용성 평가: 개선점 도출을 중심으로)

  • Sung Shin Kim;Myo Jung Choi;Hyosun Kweon;Kwang Ok An;Young-Hyeon Bae
    • Journal of Korean Physical Therapy Science
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    • v.31 no.1
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    • pp.16-32
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    • 2024
  • Background: Exercise equipments and assistive devices for the disabled are being developed, but improvements for usability are still needed. The purpose of this study was to improve and utilize the developed exercise equipment and assistance devices by conducting usability test for people with spinal cord injury. Design: Cross-sectional Study. Methods: Scenarios and usability indicators were derived by conducting a preliminary usability test, 5 non-disabled men and women aged 19 or older. In the scenario, a total of 9 tasks were sequentially performed, including 2 tasks of entry and exit, 5 tasks of assistance devices and weight stack adjustment, and 2 tasks of pre exercise and exercise. The usability indicators were task success (success or fail), execution time (sec), safety, and convenience. For safety, 7 questions (Likert scale, 1~5 point) related to safety, stability and hazard were derived, and for convenience, the system usability scale (SUS score) was used (range: 0~100, 50 percentile rank is 68 point). Results: As a result of the usability test of people with spinal cord injury, there was a large variation among subjects in the task of adjusting the position of the pulley and support in the execution time (11.64~25.44 seconds), and one person failed to adjust the pulley. The safety level showed a lower score (score = 3 points) than other items in the item of entrapment or skin pressure, and in the case of SUS, the average score was 64.5 points, which was close to the acceptable level. Conclusion: Through the usability test, it was confirmed that exercise equipment for the disabled needs improvement in operability, pinching, and pressure, and that it is necessary to develop an assistive device that provides unrestrained posture information (biofeedback) to maintain correct posture during exercise.

Spontaneous Resolution Rate and Predictive Factors of Resolution in Children with Primary Vesicoureteral Reflux (소아에서 일차성 방광요관역류의 자연소실율 및 관련 인자)

  • Kang, Eun-Young;Kim, Min-Sun;Kwon, Keun-Sang;Park, Eun-Hye;Lee, Dae-Yeol
    • Childhood Kidney Diseases
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    • v.11 no.1
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    • pp.74-82
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    • 2007
  • Purpose : To analyze the clinical characteristics, spontaneous resolution rate and predictive factors of resolution in children with primary vesicoureteral reflux(VUR). Methods : Between October 1991 and July 2003, 149 children diagnosed with primary VUR at Chonbuk National University Hospital were reviewed retrospectively. All of the patients were maintained on low-dose antibiotic prophylaxis and underwent radionuclide cystograms at 1 year intervals over 3 years after the initial diagnosis of VUR by voiding cystourethrogram was made. Results : The median time to resolution of VUR was 24 months and the total 3 year-cumulative resolution rate of VUR was 61.7%. The following variables were associated with resolution of VUR according to univariate analysis-; age<1 year, male gender, mild grade of reflux, unilateral reflux, congenital hydronephrosis as clinical presentation at time of diagnosis of VUR, absence of focal defects in the renal scan at diagnosis, absence of recurrent UTI, renal scars and small kidney during follow-up. After adjustment by Cox regression model, five variables remained as independent predictors of VUR resolution; age<1 yew, relative risk 1.77(P<0.05), VUR grade I+II 2.98(P<0.05), absence of renal scars 2.23(P<0.05), and absence of small kidney 5.20(P<0.01) during follow-up. Conclusion : In this study, spontaneous resolution rate of VUR, even high grade reflux, is high in infants during medical management, and it was related to age, reflux grade at diagnosis, absence of renal scars and small kidney during follow-up. Therefore early surgical intervention should be avoided and reserved for the selected groups.

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Prosthetic rehabilitation for a glossectomy patient - a clinical report (혀절제술을 시행한 환자의 보철적 수복 증례)

  • Yoon, Jiyoung;Lee, Siho;Lee, Jiyoen;Oh, Namsik
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.4
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    • pp.347-352
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    • 2013
  • Malignant tumours of the oral cavity that require resection of the tongue result in severe deficiencies in speech and deglutition. In such patients, improvements in mastication, swallowing, and speech may be reasonable goals for treatment. The viability of a prosthodontic approach to treatment depends on the type and extent of surgery. In a total glossectomy, a mandibular tongue prosthesis is the treatment of choice. Mandibular tongue prosthesis occupies the space in the floor of the oral cavity. It provides the patients with a platform for directing food into the esophagus and aids in speaking. This type of prosthesis can achieve that protection of the underlying fragile tissue and improvement in appearance and psychosocial adjustment. This case report describes the technical steps involved in prosthetic rehabilitation for a glossectomy patient.

Ileal Endogenous Amino Acid Flow Response to Nitrogen-free Diets with Differing Ratios of Corn Starch to Dextrose in Pigs

  • Kong, C.;Ragland, D.;Adeola, O.
    • Asian-Australasian Journal of Animal Sciences
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    • v.27 no.8
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    • pp.1124-1130
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    • 2014
  • The objective of this study was to determine the responses in the digestibility of dry matter (DM) and amino acid (AA) composition of ileal endogenous flow (IEF) of pigs (initial body weight, $69.1{\pm}6.46$ kg) fed N-free diets (NFD) formulated with different ratios of corn starch to dextrose. Fifteen pigs fitted with a T-cannula at the distal ileum were fed 5 diets according to a triplicated $5{\times}2$ incomplete Latin-square design. Each period consisted of a 5-d adjustment period and 2 d of ileal digesta collection for 12 h on each of d 6 and 7 and between each period, there was a 5-d recovery period to avoid abnormal weight loss. The ratios of corn starch to dextrose investigated were 0:879, 293:586, 586:293, 779:100, and 879:0 for diet numbers 1, 2, 3, 4 and 5, respectively, and chromic oxide (5 g/kg) was used as an indigestible index. Ileal DM digestibility was greater in Diet 1 than that in Diet 4 (89.5% vs 87.3%, p<0.01) but they were not different from Diet 2, 3, or 5. The IEF for most of indispensable AA were not different among diets with the exception of Met, in which a lack of corn starch or dextrose gave lower (p = 0.028) IEF of Met than diets containing corn starch and dextrose. Likewise, the dispensable AA and total AA in the IEF did not differ among diets. The respective IEF of AA (mg/kg of dry matter intake) in pigs fed Diets 1, 2, 3, 4, or 5 were 301, 434, 377, 477,or 365 for Lys, 61, 89, 71, 87, or 61 for Met, and 477, 590, 472, 520, or 436 for Thr. Proline was the most abundant AA in the IEF followed by Gly, Glu, and Asp and together accounted for approximately 50% of the total ileal AA flows of pigs fed NFD. In conclusion, the variation in proportion of corn starch and dextrose in a NFD does not largely affect estimates of IEF of N and AA for growing-finishing pigs.

Effect of Preexisting Musculoskeletal Diseases on the 1-Year Incidence of Fall-related Injuries

  • Lee, Won-Kyung;Kong, Kyoung-Ae;Park, Hye-Sook
    • Journal of Preventive Medicine and Public Health
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    • v.45 no.5
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    • pp.283-290
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    • 2012
  • Objectives: People who have chronic diseases, as well as gait imbalance or psychiatric drug use, may be susceptible to injuries from falls and slips. The purpose of this study was to evaluate the effect of musculoskeletal diseases on incidental fall-related injuries among adults in Korea. Methods: We analyzed data from the 4th Korea National Health and Nutrition Examination Survey (2007-2009), which are national data obtained by a rolling survey sampling method. The 1-year incidence of fall-related injuries was defined by health service utilization within the last year due to injury occurring after a slip and fall, and musculoskeletal diseases included osteoarthritis, rheumatoid arthritis, osteoporosis, and back pain. To evaluate the effects of preexisting musculoskeletal diseases, adults diagnosed before the last year were considered the exposed group, and adults who had never been diagnosed were the unexposed group. Results: The weighted lifetime prevalence of musculoskeletal disease was 32 540 per 100 000 persons. Musculoskeletal diseases were associated with a higher risk of fall-related injury after adjustment for sex, age, residence, household income, education, occupation, visual disturbance, paralysis due to stroke, and medication for depression (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.03 to 1.93). As the number of comorbid musculoskeletal diseases increased, the risk of fall-induced injuries increased (p-value for trend <0.001). In particular, patients who had any musculoskeletal condition were at much higher risk of recurrent fall-related injuries (OR, 6.20; 95% CI, 1.06 to 36.08). Conclusions: One must take into account the risk of fall-related injuries and provide prevention strategies among adults who have musculoskeletal diseases.

ADHESIVE PROPERTY OF POLYSULFIDE IMPRESS10N MATERIAL ON THE TRAY RESIN AND BORDER HOLDING MATERIALS (타액오염이 트레이 레진 및 변연 형성재와 Polysulfide 인상재의 접착력에 미치는 영향)

  • Kim, Yong-Hak;Yang, Hong-Seo
    • The Journal of Korean Academy of Prosthodontics
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    • v.38 no.5
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    • pp.650-658
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    • 2000
  • This study was investigated to compare the bond strength of polysulfide adhesive between tray resin and border molding materials and to evaluate the effect of saliva contamination on them. We made the 135 resin tray secimens with a dimension of $1{\times}1{\times}1cm$ and divided them into 3 groups by the materials 1) Quicky group, 2) Compound group, and 3) Impregum group Each group was subdivided by saliva contimination. Group S1 : applied adhesive without saliva contamination Group S2 : applied adhesive after drying 15seconds after saliva contamination Group S3 : applied adhesive no after saliva contamination. Tensile tests were performed with a Universal Load testing machine. Results showed Impregum group significantly higher bond strength than Quicky group, but there was no significant difference in adhesive bond strength between Compound group and Quicky group in experimental group by materials In experimental group by saliva contamination, S1 group is significantly higher bond strength than S2 group and S2 group is significantly higher bond strength than S3 group in Quicky group and S1, S2 group is significantly higher bond strength than S3 group in Compound group and Impregum group. Impression compound and Impregum F which are usually used as an individual tray border mold-ing material can be said to be satisfied in adhesive bond strength to polysulfide impression materials. After try-in and clinical adjustment are performed, a custom tray should be properly rinsed and air dried before tray adhesive was placed.

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Association of Serum Lipids and Dietary Intakes with Serum Adiponectin Level in Overweight and Obese Korean Women (과체중 및 비만 여성의 혈청지질 및 식이섭취실태와 혈청 Adiponectin 농도와의 상관성 연구)

  • Lee, Mi-Young;Kim, Jung-Hee
    • Korean Journal of Community Nutrition
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    • v.15 no.1
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    • pp.27-35
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    • 2010
  • This study was done to investigate the association of blood clinical parameters and dietary intakes with serum adiponectin level. Athropometric measurement, dietary intakes, serum lipids and adiponectin levels were examined in 160 overweight and obese women. The subjects were divided into 5 groups by quintile according to serum adiponectin level. Weight, BMI, waist circumferences and waist/hip ratio of the highest quintile group were significantly lower than those of the lowest quintile group. Serum lipid analysis showed a significant higher level of TG, LDL-cholesterol, LDL/HDL ratio, AI, and serum hs-CRP in the lowest quintile group. Similarly, correlation data also showed that serum adiponectin level was positively correlated with serum HDL-cholesterol level (p < 0.01) and was negatively correlated with BMI (p < 0.01), waist circumferences (p < 0.01), waist/hip ratio (p<0.01), systolic (p < 0.01) and diastolic blood pressure (p < 0.05), TG (p < 0.01), LDL-cholesterol (p < 0.05), LDL/HDL ratio (p < 0.05), AI (p < 0.01), Homa-IR (p < 0.01), hs-CRP (p < 0.05) and leptin (p < 0.05). Dietary intake data showed that protein intake was significantly lower in the highest quintile group compared to the lower quintile groups while intakes of vitamin C was significantly higher in highest quintile group after adjustment by BMI, waist and energy intake, In addition, the highest quintile group had higher fiber intakes than the lower quintile groups. These results might suggest that a diet high in fiber and vitamin C and low in protein for obese patients would better be recommended to improve adiponectin level. However, further research is needed to elucidate the association of dietary intakes or dietary patterns and serum adiponectin level.

The Variation Factors of Severity-Adjusted Length of Stay in CABG (관상동맥우회술 시행환자의 중증도 보정 재원일수 변이에 관한 연구)

  • Kim, Sun-Ja;Kang, Sung-Hong;Kim, Won-Joong;Kim, Yoo-Mi
    • Journal of Korean Society for Quality Management
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    • v.39 no.3
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    • pp.391-399
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    • 2011
  • Our study was carried out to analyze the variation factors of severity-adjusted length of stay(LOS) in coronary artery bypass graft(CABG). The subjects were 932 CABG inpatients of the Korean National Hospital Discharge In-depth Injury Survey from 2004 through 2008. The data were analyzed using $x^2$ test and the severity-adjusted model was developed using data mining technique. The results of the study were as follows: male(71.1%), older than 61 years of age(61.6%), more than 500 beds(92.8%) and admitting via ambulatory care(70.0%) appeared to have higher rate than otherwise. In-hospital mortality of CABG inpatients was 2.8%. In addition, 46.4% of the patients received their care in other residence. The angina pectoris(45.6%) was found to be the highest in principle diagnosis, followed by chronic ischemic heart disease(36.9%) and acute myocardial infarction(12.0%). We developed severity-adjusted LOS model using the variables such as gender, age and comorbidity. Comparison of adjusted values in predicted LOS revealed that there were significant variations in LOS by location of hospital, bed size, and whether patients received the care in their residences. The variations of LOS can be explained as the indirect indicator for quality variation of medical process. It is suggested that the severity-adjusted LOS model developed in this study should be utilized as a useful method for benchmarking in hospital and it is necessary that national standard clinical practice guideline should be developed.

5-FU or capecitabine based chronomodulated chemotherapy for advanced colorectal cancer: mata-analysis and systematic review (진행성 대장직장암 환자군에 있어서 5-FU 혹은 capecitabine의 최적 시간 치료법에 대한 체계적 고찰 : 메타분석)

  • Lee, Jee Young;Oh, Hye Kyung;Ryu, Han Sung;Yoon, Seong Woo
    • Journal of Korean Traditional Oncology
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    • v.20 no.1
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    • pp.31-44
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    • 2015
  • Background : The purpose of this study is to investigate the efficacy and safety of the circadian delivery schedule of fluorouracil or capecitabine based chemotherapy for advanced colorectal cancer. Patients and methods : A meta-analysis was performed using individual data from eight international randomized clinical trials, especially phase II or III trials, comparing 5-fluorouracil, or capeticabine in chronomodulated or conventional schedule. The data from 8 studies was composed of 692 patients receiving chronomodulated chemotheray and 684 patients receiving conventional chemotherapy. The main end point was response rate. Results : Response rate was insignificantly different from each group (RR 1.14, 95%CI 0.74-1.74, p=0.55). Overall survival and progresseion-free survival were not significant either. Chemotherapy induced anemia, diarrhea, and nausea/vomiting were worse in the chronotherapy group, with statistic significance respectively. On the other hand, chemotherapy induced thrombocytopenia, stomatitis, peripheral neuropathy, and dermatotoxicity were better but they were not statistically significant results. Conclusions : Patients lived longer but not significantly on chronomodulated chemotherapy rather than on conventional chemotherapy. Patients on chronomodulated chemotherapy experienced adverse events more. The chronomodulated chemotherapy schedule needs adjustment of its delivery schedule and further research is required.