• 제목/요약/키워드: Clinical factor

검색결과 3,668건 처리시간 0.032초

A comparison of the implant stability among various implant systems: clinical study

  • Kim, Jae-Min;Kim, Sun-Jong;Han, In-Ho;Shin, Sang-Wan;Ryu, Jae-Jun
    • The Journal of Advanced Prosthodontics
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    • 제1권1호
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    • pp.31-36
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    • 2009
  • PURPOSE. To determine the change in stability of single-stage, three different design of implant systems in humans utilizing resonance frequency analysis for early healing period(24 weeks), without loading. MATERIAL AND METHODS. Twenty-five patients were included into this study. A total of 45 implants, three different design of implant systems(group A,C,R) were placed in the posterior maxilla or mandible. The specific transducer for each implant system was used. ISQ(implant stability quotient) reading were obtained for each implant at the time of surgery, 3, 6, 8, 10, 12, 24 weeks postoperatively. Data were analyzed for different implant type, bone type, healing time, anatomical locations. RESULTS. For each implant system, a two-factor mixed-model ANOVA demonstrated that a significant effect on ISQ values(group A=0.0022, C=0.017, R=0.0018). For each implant system, in a two-factor mixed model ANOVA, and two-sample t-test, the main effect of jaw position(P > .005) on ISQ values were not significant. CONCLUSIONS. All the implant groups A, C and R, the change patterns of ISQ over time differed by bone type. Implant stability increased greatly between week 0 and week six and showed slow increase between week six and six months(plateau effect).

투여 항생제군과 Clostridium Difficile-Associated Diarrhea의 위험인자 분석 (Risk Factor Analysis of Clostridium Difficile Associated Diarrhea and Antibiotics Administration)

  • 오경선;이숙향
    • 한국임상약학회지
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    • 제20권1호
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    • pp.78-84
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    • 2010
  • Background: Clostridium difficile is the primary reason of the nosocomial diarrhea. The antimicrobial therapy plays a central role in the pathogenesis of Clostridium difficile associated diarrhea (CDAD). Although nearly all classes of antimicrobial agents have been associated with CDAD, clindamycin and the third-generation cephalosporins have traditionally been considered to the greatest risk factor. Recent studies have also implicated fluoroquinolones as high-risk agents due to increasing use of the agents. This study was to determine the incidence and the risk factors of CDAD related to the administered antibiotics and to assess the therapeutic regimen of metronidazole or vancomycin based on the C. difficile toxin assay Methods: A retrospective study was performed in patients with Clostridium difficile toxin assay at I Hospital (Incheon, South Korea) during the period from January 2007 through December 2007. Administrative, laboratory, and pharmacy data were collected from Electronic Medical Databases. Results: The analysis included 129 reported C.difficile toxin assay results, with 42 positive cases and 87 negative cases. Significant antibiotic risk factors for CDAD included the use of the fourth-generation cephalosporinse (OR=5.97, 95% CI 1.37-25.98, P=0.017). Administration of metronidazole was protective against CDAD (OR=0.30, 95% CI 0.12-0.74, P=0.009). Prolonged antimicrobial therapy has been associated with an increased risk of CDAD. The third-generation cephalosporins (OR=3.81, 95% CI 1.08-13.41, P=0.037) and aminoglycoside (OR=5.50, 95% CI 1.43-21.10, P=0.013) demonstrated greater risk for CDAD over 15 days than 8days or less days of treatment duration. Conclusions: The fourth and third generation cephalosporin, aminglycoside were the significant risk factors compared with other antibiotics, whereas metronidazole appears to be protective. The longer duration of antiobiotic use increased CDAD.

Use of adipose-derived stem cells in lymphatic tissue engineering and regeneration

  • Forte, Antonio Jorge;Boczar, Daniel;Sarabia-Estrada, Rachel;Huayllani, Maria T.;Avila, Francisco R.;Torres, Ricardo A.;Guliyeva, Gunel;Aung, Thiha;Quinones-Hinojosa, Alfredo
    • Archives of Plastic Surgery
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    • 제48권5호
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    • pp.559-567
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    • 2021
  • The potential to differentiate into different cell lines, added to the easy and cost-effective method of extraction, makes adipose-derived stem cells (ADSCs) an object of interest in lymphedema treatment. Our study's goal was to conduct a comprehensive systematic review of the use of ADSCs in lymphatic tissue engineering and regeneration. On July 23, 2019, using PubMed/MEDLINE, Cochrane Clinical Answers, Cochrane Central Register of Controlled Trials, and Embase databases, we conducted a systematic review of published literature on the use of ADSCs in lymphatic tissue engineering and regeneration. There were no language or time frame limitations, and the following search strategy was applied: ((Adipose stem cell) OR Adipose-derived stem cell)) AND ((Lymphedema) OR Breast Cancer Lymphedema). Only original research manuscripts were included. Fourteen studies fulfilled the inclusion criteria. Eleven studies were experimental (in vitro or in vivo in animals), and only three were clinical. Publications on the topic demonstrated that ADSCs promote lymphangiogenesis, and its effect could be enhanced by modulation of vascular endothelial growth factor-C, interleukin-7, prospero homeobox protein 1, and transforming growth factor-β1. Pilot clinical studies included 11 patients with breast cancer-related lymphedema, and no significant side effects were present at 12-month follow-up. Literature on the use of ADSCs in lymphatic tissue engineering and regeneration demonstrated promising data. Clinical evidence is still in its infancy, but the scientific community agrees that ADSCs can be useful in regenerative lymphangiogenesis. Data collected in this review indicate that unprecedented advances in lymphedema treatment can be anticipated in the upcoming years.

응급실 실습을 경험한 응급구조학 전공 학생의 5요인 성격특성, 스트레스 대처방식이 임상실습스트레스에 미치는 영향 (The Impact of Five Personality Traits and Stress Coping Methods of Paramedic Students Who Experienced Emergency Room Practice on Clinical Practice Stress)

  • 정준호
    • 한국응급구조학회지
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    • 제27권3호
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    • pp.71-83
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    • 2023
  • Purpose: The purpose of this study is to investigate the impact of paramedic students' five-factor personality characteristics and stress coping behavior on the stress of emergency room practice. Methods: This study conducted a survey targeting 2 grade - 4 grade paramedic students who had experience practice at emergency room at N University and B University located in Cheonan, South Chungcheong Province. Results: 'Agreeableness' was the highest at 33.88±6.31 and 'Neuroticism' was the lowest at 27.82±7.43. Among stress coping methods, 'active coping' was higher at 3.39 than 'passive coping' at 3.21, and the subarea with the highest score was 'wishful coping'. When looking at clinical practice stress by sub-domain, 'practical training environment' was the highest at 2.96, and 'interpersonal conflict' was the lowest at 2.14. There was a negative correlation between clinical practice stress and friendliness (r=-.220, p=.014) and a positive correlation with active coping (r=.210, p=.019). The influential factors were friendliness (β=-.267) and active coping (β=.258). Conclusion: The paramedic students who participated in this study showed a high level of agreeableness among the five personality traits and used a active coping style to cope with stress. Agreeableness has been shown to lower clinical practice stress, and active coping is classified as the most appropriate coping style, so research is needed to guide people to utilize friendliness and active coping well.

Panax ginseng exerts antidepressant-like effects by suppressing neuroinflammatory response and upregulating nuclear factor erythroid 2 related factor 2 signaling in the amygdala

  • Choi, Jong Hee;Lee, Min Jung;Jang, Minhee;Kim, Hak-Jae;Lee, Sanghyun;Lee, Sang Won;Kim, Young Ock;Cho, Ik-Hyun
    • Journal of Ginseng Research
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    • 제42권1호
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    • pp.107-115
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    • 2018
  • Background: Depression is one of the most commonly diagnosed neuropsychiatric diseases, but the underlying mechanism and medicine are not well-known. Although Panax ginseng has been reported to exert protective effects in various neurological studies, little information is available regarding its antidepressant effects. Methods: Here, we examined the antidepressant effect and underlying mechanism of P. ginseng extract (PGE) in a chronic restraint stress (CRS)-induced depression model in mice. Results: Oral administration of PGE for 14 d decreased immobility (depression-like behaviors) time in forced swim and tail suspended tests after CRS induction, which corresponded with attenuation of the levels of serum adrenocorticotropic hormone and corticosterone, as well as attenuated c-Fos expression in the amygdala. PGE enhanced messenger RNA expression level of brain-derived neurotrophic factor but ameliorated microglial activation and neuroinflammation (the level of messenger RNA and protein expression of cyclooxygenase-2 and inducible nitric oxide synthase) in the amygdala of mice after CRS induction. Interestingly, 14-d treatment with celecoxib, a selective cyclooxygenase-2 inhibitor, and $N_{\omega}$-nitro-L-arginine methyl ester hydrochloride, a selective inducible nitric oxide synthase inhibitor, attenuated depression-like behaviors after CRS induction. Additionally, PGE inhibited the upregulation of the nuclear factor erythroid 2 related factor 2 and heme oxygenase-1 pathways. Conclusion: Taken together, our findings suggest that PGE exerts antidepressant-like effect of CRS-induced depression by antineuroinflammatory and antioxidant (nuclear factor erythroid 2 related factor 2/heme oxygenase-1 activation) activities by inhibiting the hypothalamo-pituitary-adrenal axis mechanism. Further studies are needed to evaluate the potential of components of P. ginseng as an alternative treatment of depression, including clinical trial evaluation.

치위생과 학생의 임상실습에 따른 만족도와 스트레스요인에 관한 연구 (A Study on the Satisfaction and Stress Factor of Clinical Practice for Students in the Department of Dental Hygiene)

  • 박미영
    • 치위생과학회지
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    • 제6권4호
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    • pp.243-249
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    • 2006
  • 본 연구는 치위생과 학생이 현장임상실습에 따른 만족도와 스트레스요인에 관한 것을 알아보고자 경기도와 인천지역에 위치한 3개 대학의 치위생과 3학년 183명을 대상으로 2006년 9월 12일부터 10월 19일까지 설문조사를 실시하였으며,SPSSWIN 12.0 통계프로그램을 이용하여 분석한 결과 다음과 같은 결론을 얻었다. 1. 치위생과 학생의 전공만족도는 보통이상이 86.3%, 실습만족도는 보통이상이 75.9%, 향 후 직업만족도는 보통이상이 91.8%로 나타났다. 2. 스트레스요인으로는 이상가치영역이 $3.54{\pm}1.23$으로 가장 높게 나타났고, 대인관계영역이 $1.74{\pm}1.20$으로 가장 낮게 나타났다. 3. 일반적 특성에 따른 만족도를 살펴보면, 전공만족도는 학과선택 동기(p = 0.003), 향후 직업만족도는 학과선택 동기(p = 0.036)에서 통계적으로 유의한 차이가 나타났다. 4. 만족도들 간의 상관관계는 전공만족도가 높을수록 실습만족도가 높아지고 향후 직업만족도까지 높아지는 것으로 나타났다. 5. 실습만족도에 영향을 미치는 스트레스요인으로는 역할영역,이상과 가치영역이 영향을 미치는 변수로 나타났다.

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확인적 요인분석을 통한 한국어판 전문직 삶의 질(K-ProQOL) 도구의 타당화 : 간호사를 중심으로 (Validation of Korean version of Professional quality of life(K-ProQOL) for nurses through confirmatory factor analysis)

  • 김주이;최형심
    • 한국산학기술학회논문지
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    • 제20권3호
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    • pp.243-251
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    • 2019
  • 본 연구는 한국어판 전문직 삶의 질 측정도구(Korean version of professional quality of life scale : K-ProQOL)가 한국 간호사의 공감만족, 공감피로와 소진을 측정하기에 타당한 도구인지를 검증하는 방법론적 연구이다. 조사 자료는 서울에 위치한 3개의 상급종합병원에서 근무한 210 명의 간호사로부터 수집되었으며, SPSS WIN (24.0)과 AMOS (18.0)를 이용하여 확인적 요인 분석과 Cronbach 's alpha 검정을 통해 도구의 타당도와 신뢰도를 측정하였다. K-ProQOL의 RMSEA는 .09로 .05~.1 사이의 값을 보였으며 GFI와 CFI는 각각 .72와 .71로 모형 적합도 최소 기준인 .7 이상의 값을 보였다. 각 문항별 요인 적재량을 분석한 결과 .25에서 .82의 수준을 보였다. K-ProQOL의 Cronbach 's alpha는 .72로 각 하위영역인 공감만족, 공감피로, 소진의 Cronbach's alpha값은 각각 .90, .78, .75 수준을 보였다. 본 연구결과를 종합해 볼 때, K-ProQOL 도구는 한국 간호사를 대상으로 공감만족, 공감피로, 소진을 측정함에 있어 일부 문항들에 제한이 존재하지만 최소 기준의 타당도와 신뢰도가 확보되었다. 본 연구는 국내 최초로 간호사를 대상으로 K-ProQOL 도구의 타당도와 신뢰도를 검정한데 의의가 있다.

일부 치위생과 학생들의 임상실습 시 경험하는 스트레스 요인에 관한 조사 (A Study on Causes of Stress Experienced by Part Students of Dental Hygiene Department During Clinical Training)

  • 이정화;전은숙
    • 치위생과학회지
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    • 제9권1호
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    • pp.137-143
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    • 2009
  • 본 조사의 대상자 선정은 총 6주의 임상실습을 마친 경남, 울산지역의 일부 치위생과 학생을 대상으로 하였으며 보건(지)소 2주, 치과 병의원 4주로 자료수집 방법은 연구자가 직접연구의 목적과 취지를 설명하고 구조화된 총 200부의 설문지를 배부하여 회수된 198부를 분석에 이용하였다. 임상실습 시 경험할 수 있는 스트레스 요인 및 정도를 각 실습지 별로 파악하여 임상실습지도와 개선에 도움을 주며, 임상실습의 문제점을 파악하여 효율적인 임상실습 교육이 이루어 질 수 있도록 기초자료를 제공하고자 하였다. 1. 학년별 치위생과 지원동기는 졸업 후 "취업률이 높아서"가 2학년 64.8%, 3학년 62.2%로 나타났으며, 학년별 전공에 대한 만족도에서 "만족한다"가 2학년 29.6%, 3학년 73.3%로 나타났다. 2. 학년별 보건소, 병의원 실습에 대한 만족도에서 보건소 실습의 경우 "만족한다" 2학년 46.3% 3학년 46.7%로 나타났고, 병의원 실습의 경우 "만족한다" 2학년 50.9%, 3학년 66.7%로 나타났다. 3. 보건소 실습 시 느끼는 스트레스 요인 중 가치와 이상의 학교실습과 보건소실습과의 관계에서는 현장상황과 실습내용과의 차이에서 "느낀다"가 50.0%로 가장 높게 나타났다(p < 0.05). 4. 병, 의원 실습 시 느끼는 스트레스 요인 중 가치와 이상의 학교실습과 병원실습과의 관계에서 "느낀다"가 54.5%로 가장 높게 나타났고(p < 0.05), 이론과 지식의 실제적용 어려움에서는 "느낀다"가 62.1%로 가장 높게 나타났으며 (p < 0.05), 현장상황과 실습내용과의 차이에서는 "느낀다"가 58.1%로 가장 높게 나타났고(p < 0.05), 활동분야의 관련분야 지식부족에서는 "느낀다"가 50.5%로 가장 높게 나타났다(p < 0.05). 이상과 같은 결과에서 임상실습시 경험하는 스트레스요인을 최소화하기 위해서는 실습지에서 학교에서 배운 지식을 환자에게 직접 적용시킴으로써 학습에 대한 흥미유발과 실습에 대한 만족도를 높일 수 있도록 실습생에 대한 프로그램개발이 필요할 것으로 사료된다.

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졸업학년 간호학생이 지각하는 간호전문직관 영향 요인 (Affecting Factors of Nursing Professionalism Perceived by Senior Nursing Students)

  • 함연숙;김화순;조인숙;임지영
    • 한국간호교육학회지
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    • 제17권3호
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    • pp.536-544
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    • 2011
  • Purpose: The purpose of this descriptive study was to investigate the level of nursing professionalism and influencing factors of professionalism in nursing students. Method: A convenience sample of 207 subjects were recruited from two universities in I city and one university in S city. The subject for this survey were senior students who finished all clinical practicum to be done before graduation. Results: The mean scores of the nursing professionalism and the satisfaction with clinical practice were 3.43 and 3.28 individually. The mean of self-efficacy and image of nurses were 3.60 and 3.71 individually. Mean of major satisfaction score was 3.88. There were significant correlations among nursing professionalism, satisfaction with clinical practice, self-efficacy, image of nurses and major satisfaction. The most strong factor affecting nursing professionalism was the image of nurses and accounted 52.0 percentage of the variance. Sixty point one percentage of the variance was explained by image of nurses, major satisfaction, religion and satisfaction with clinical practice. Conclusion: To make students have more positive nursing professionalism, strategies enhancing the positive nurse image, clinical satisfaction, and major satisfaction need to be developed during school years.

중환자실 간호사의 기관내 흡인 임상지침 수행 현황 (Adherence to Clinical Guideline for Endotracheal Suction in ICU Nurses)

  • 양은정;신현숙
    • 동서간호학연구지
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    • 제23권1호
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    • pp.53-62
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    • 2017
  • Purpose: This study aimed to evaluate the adherence to the clinical guideline for endotracheal suction in nurses working at intensive care units (ICU) and to identify the characteristics of nurses with good adherence. Methods: This study was a descriptive study to evaluate the pattern of adherence and its related factors to endotracheal suction. One hundred fifty five nurses working at ICU participated in this study. We used a questionnaire developed based on American Association for Respiratory Care (AARC) guidelines and other associated factors from previous studies. Results: Around half of the participants reported that their adherence to the clinical guideline was poor. Items deviated from the recommended guideline were reasons for initiating a suctioning, applied suction pressure ranged from 20 to 200mmHg, and applied catheter size from 6 to 17 french. Other factors deviated were the depth of inserted catheter, and inappropriate use of normal saline instillation. The most significant factor was related to hospital; the misused or misled clinical protocol. Conclusions: The adherence to the clinical guidelines of the endotracheal suction in ICU nurses was not appropriate, which might contribute to the patient health outcomes. More enhanced continuing education as well as hospital regulation is warranted.