• Title/Summary/Keyword: Clinical guideline

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Fractional exhaled nitric oxide and forced expiratory flow between 25% and 75% of vital capacity in children with controlled asthma

  • Yoon, Ji-Yong;Woo, Sung-Il;Kim, Heon;Sun, Yong-Han;Hahn, Youn-Soo
    • Clinical and Experimental Pediatrics
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    • v.55 no.9
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    • pp.330-336
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    • 2012
  • Purpose: Fractional exhaled nitric oxide (FeNO) and forced expiratory flow between 25% and 75% of vital capacity ($FEF_{25-75}$) are not included in routine monitoring of asthma control. We observed changes in FeNO level and $FEF_{25-75}$ after FeNO-based treatment with inhaled corticosteroid (ICS) in children with controlled asthma (CA). Methods: We recruited 148 children with asthma (age, 8 to 16 years) who had maintained asthma control and normal forced expiratory volume in the first second ($FEV_1$) without control medication for ${\geq}3$ months. Patients with FeNO levels >25 ppb were allocated to the ICS-treated (FeNO-based management) or untreated group (guideline-based management). Changes in spirometric values and FeNO levels from baseline were evaluated after 6 weeks. Results: Ninety-three patients had FeNO levels >25 ppb. These patients had lower $FEF_{25-75}$ % predicted values than those with FeNO levels ${\leq}25$ ppb (P<0.01). After 6 weeks, the geometric mean (GM) FeNO level in the ICS-treated group was 45% lower than the baseline value, and the mean percent increase in $FEF_{25-75}$ was 18.7% which was greater than that in other spirometric values. There was a negative correlation between percent changes in $FEF_{25-75}$ and FeNO (r=-0.368, P=0.001). In contrast, the GM FeNO and spirometric values were not significantly different from the baseline values in the untreated group. Conclusion: The anti-inflammatory treatment simultaneously improved the FeNO levels and $FEF_{25-75}$ in CA patients when their FeNO levels were >25 ppb.

Recommended immunization schedule for children and adolescents: Immunization Guideline (8th edition) released by the Korean Pediatric Society in 2015

  • Kim, Jong-Hyun;Choi, Eun Hwa;Park, Su Eun;Kim, Yae-Jean;Jo, Dae Sun;Kim, Yun-Kyung;Eun, ByungWook;Lee, Jina;Lee, Soo-Young;Lee, Hyunju;Kim, Ki Hwan;Kim, Kyung-Hyo
    • Clinical and Experimental Pediatrics
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    • v.59 no.12
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    • pp.461-465
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    • 2016
  • This report includes the recommended immunization schedule table for children and adolescents based on the 8th (2015) and revised 7th (2012) Immunization Guidelines released by the Committee on Infectious Diseases of the Korean Pediatric Society (KPS). Notable revised recommendations include: reorganization of the immunization table with a list of vaccines on the vertical axis and the corresponding age on the horizontal axis; reflecting the inclusion of Haemophilus influenzae type b vaccine, pneumococcal conjugate vaccine, and hepatitis A vaccine into the National Immunization Program since 2012; addition of general recommendations for 2 new Japanese encephalitis (JE) vaccines and their interchangeability with existing JE vaccines; addition of general recommendations for quadrivalent meningococcal conjugate vaccines and scope of the recommended targets for vaccination; and emphasizing catch-up immunization of Tdap vaccine. Detailed recommendations for each vaccine may be obtained from the full KPS 8th Immunization Guidelines.

Production and Application of the Dose Calculation Program which used MS EXCEL and Bit System (MS EXCEL 및 Bit system을 이용한 피부선량 계산 프로그램의 제작 및 응용)

  • Kim, Sung-Chul;Kim, Chong-Yeal
    • Journal of radiological science and technology
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    • v.32 no.1
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    • pp.39-43
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    • 2009
  • The medical diagnostic examination using ionizing radiation has improved the patients' life and brought revolution in medical examination along with the mechanical development. However, the development of medical imaging systems has also been the reason to increase the patients' exposure for ionizing radiation. ICRP recommends that each country adopts diagnostic reference levels depending on regional and national situations. The Korea Food & Drug Administration suggested the dosimetry measurement guideline for patients in 2007. Nonetheless, in reality, it is hard to know the skin dose of the patients when applying a x-ray since there is no radiation dosimeter in most of clinical situation. Therefore, this study sets a program based on the bit system to figure out easily the skin dose of a patients using MS Excel program in the PC setting. The results showed 10% better outcome.

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Review of Randomized Controlled Trials of Oriental Medicine for Recurrent Vulvovaginal Candidiasis (재발성 칸디다성 외음질염의 한약치료 효과에 관한 무작위 대조 연구 문헌고찰)

  • Chae, Min-Soo;Park, Seung-Hyeok;Hwang, Deok-Sang;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bock
    • The Journal of Korean Obstetrics and Gynecology
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    • v.33 no.2
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    • pp.29-43
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    • 2020
  • Objectives: The purpose of this study is to review and evaluate the effectiveness of oriental medicine per oral for recurrent vulvovaginal candidiasis (RVVC). Methods: We searched articles from Korean journal databases including Journal of Korean Obstetrics and Gynecology, Korean studies Information Service Studies, and Chinese National Knowledge Infrastructure, Cochrane Library, PubMed. Searched keywords were "재발성 칸디다성 외음질염", "recurrent vulvovaginal candidiasis", "㚆发性外阴阴道假丝酵母菌病", "中藥". Results: 10 randomized controlled trials with 700 patients were identified and reviewed. 8 studies compared combination of oriental medicine and anti-fungal agent with anti-fungal agent, and 6 of them reported that treatment group (TG) showed statistically higher total effective rate or cure rate and lower recurrence rate. One study compared oriental medicine and anti-fungal agent and TG showed statistically higher total effective rate and lower recurrence rate after 1 month. One study compared combination of oriental medicine and lacto bacillus capsule with lacto bacillus capsule, and TG showed statistically higher total effective rate and lower positive fungul test rate after 6 months. No severe adverse response was reported. Conclusions: Our review found that oriental medicine per oral is effective for alleviating symptoms, lowering recurrence rate and positive fungal test in RVVC patients. We recommend standardized randomized controlled trial guideline should be made to obtain stronger evidence and well designed trials with larger sample sizes are needed.

The Effect of Backrest Elevation Education on ICU Nurse's Knowledge, Perception and Performance (침상각도 상승 교육에 대한 중환자실 간호사의 지식, 인식 및 수행 정도)

  • Lee, Hyun Sim;Park, Young Woo;Kim, Jung Yeon;Lee, Eun Sook;Park, Ai Soon;Han, A Reum;Kim, Eun A;Lee, Ho Sun;Koh, Shin Ok
    • Journal of Korean Clinical Nursing Research
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    • v.14 no.3
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    • pp.117-128
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    • 2008
  • Purpose: This study was conducted to examine the differences of knowledge, perception, and performance between the points of time before and after ICU nurses had the backrest elevation education. Method: The study subjects were 58 nurses at a medical and surgical ICU of one general Y hospital located in Seoul. They received the education, including backrest elevation guideline and related education materials. Data were collected from May 11 throughout August 12, 2007 with a structured questionnaire. Results: 1) There were significant differences in the mean scores of knowledge(2.21 at pre-education, 5.24 at post-education), perception(36.96 at pre-education, 53.36 at post-education), and performance(32.08 at pre-education, 43.51 at post-education), 2) There was a significant correlation between nurse's perception and performance (p=.000). 3) The nurse's perception regarding the importance of the back rest elevation education was significantly effective on their performance (p=.000). Conclusion: The backrest elevation education would contribute to improve ICU nurse's knowledge, perception and performance. The more the nurses would consider the importance of this education, the better they would perform the nursing intervention of backrest elevation.

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The Prevalence and Associated Factors of the Metabolic Syndrome in Pre-menopausal Housewives: An Analysis of the 2010~2015 Korean National Health and Nutrition Examination Survey (폐경 전 전업주부의 대사증후군 관련 요인: 2010~2015년 국민건강영양조사자료분석)

  • Kim, Chul-Gyu;Kim, Youngji
    • Research in Community and Public Health Nursing
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    • v.29 no.1
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    • pp.108-119
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    • 2018
  • Purpose: The purpose of this study is to estimate the prevalence of the metabolic syndrome in pre-menopausal housewives and to explore controllable and uncontrollable factors regarding metabolic syndrome. Methods: The study population of this cross-sectional survey was from the Korean Health and Nutrition Examination Survey (KHANES) 2010 through 2015, including the fifth and sixth population-based studies. The criteria for metabolic syndrome include waist circumference, blood pressure, fasting plasma glucose, triglyceride, high-density lipoprotein (HDL) based on Korean Clinical Practice Guideline for Metabolic Syndrome by the Korean Academy of Family Medicine 2015. Results: Among the 2,498 subjects, 247 subjects had metabolic syndrome and the prevalence was estimated to be 9.9%. The number of subjects who met the criterion of HDL was 936 (36.2%), which was the most prevalent among the criteria for metabolic syndrome. Statistically significant (p<.05) factors include age, livinghood benefit group, perceived health status, obesity, family history of DM, sleeping time, awareness of stress,leukocyte, and erythrocyte count. The odds ratio of obesity in the BMI ${\geq}25$ group was 12.59 times as high as that of the BMI <25 group (p<.001) for metabolic syndrome. Conclusion: The prevalence of metabolic syndrome in pre-menopausal housewives in the survey was not low, and it is necessary to develop and apply comprehensive health habit management programs to improve controllable factors including exercise and food intake.

An analysis of nursing focuses for standardization of ICU nursing records (중환자실 간호기록 표준화를 위한 간호초점 분석)

  • Kang, Young-Mi;Yu, Ji-Ho;Cho, Yong-Ae;Ryoo, Sung-Suk;Cho, Jeong-Koo;Sung, Young-Hee
    • Journal of Korean Critical Care Nursing
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    • v.1 no.1
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    • pp.73-83
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    • 2008
  • Purpose: Purpose of this study was to analyze the nursing focuses for standardization of ICU nursing records. Methods: The data were collected from 1,000days'nursing records of 197 ICU patients at a tertiary hospital in Seoul. Nursing focuses were unified at the consulting group meeting and they were cross-mapped with the NANDA nursing diagnoses. Results: The 62 nursing focuses in 7 NANDA categories were extracted from nursing record. Among total nursing focuses 41 correspond to the NANDA nursing diagnoses and 21 were added to ICU nursing focuses. The 10 most frequently used nursing focuses are 'Ineffective airway clearance', 'Impaired gas exchange', 'Ineffective tissue perfusion: cardiopulmonary', 'Ineffective breathing pattern', 'Ineffective tissue perfusion: renal', 'Ineffective infant feeding pattern', 'Risk for impaired skin integrity', 'Hyperthermia', 'Impaired skin integrity', 'Decreased cardiac output', Conclusion: Nursing focuses list of ICU was extracted from the result of this study. These nursing focuses might form a framework for development of research-based assessment guideline and care plans for ICU patients through standardization of nursing records.

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Effects of Oral Care Protocol on Oral Mucositis in Hematologic Malignancy Patients Receiving Chemotherapy (구강관리 프로토콜 적용이 항암화학요법을 받는 혈액암 환자의 구내염에 미치는 영향)

  • Park, Soo Jin;Cha, Gyeong Suk;Kim, Hyeung Sun;Park, Eun Young
    • Journal of Korean Clinical Nursing Research
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    • v.22 no.1
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    • pp.1-9
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    • 2016
  • Purpose: This study was done to identify effects of oral care protocol on oral mucositis and oral care performance in hematologic malignancy patients receiving chemotherapy. Methods: The design of this study was a nonequivalent control group pretest-posttest design. Both groups were patients diagnosed with hematologic malignancies who were receiving chemotherapy-each group had 20 patients. In the experimental group, patients were given intensive education on oral care based on the oral care protocol, whereas in the controlled group, each patient was given an educational brochure. Before chemotherapy, and 3 days, 7 days, and 14 days after chemotherapy, oral mucositis status of two groups were assessed using the guide to physical assessment of the oral cavity. Oral care performance was examined before chemotherapy and 14 days later. Results: The experimental group with the oral care protocol showed a significant difference (F=18.15, p<.001) in the oral mucositis status, and also in oral care performance (t=-10.33, p<.001). Conclusion: Findings indicate that the application of the oral care protocol is an effective tool for lowering the occurrence of oral mucositis and enhancing oral care performance in hematologic malignancy patients receiving chemotherapy.

Properties of Synchronous Versus Metachronous Bilateral Breast Carcinoma with Long Time Follow Up

  • Eliyatkin, Nuket;Zengel, Baha;Yagci, Ayse;Comut, Erdem;Postaci, Hakan;Uslu, Adam;Aktas, Safiye
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.12
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    • pp.4921-4926
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    • 2015
  • Background: Breast cancer is the most common cancer type among women with increasing incidence rates, improved prognosis and survival. According to the localization of the tumor, breast cancer is designated as unilateral (UBC) or bilateral (BBC). BBC can be classified as synchronous (SBBC) or metachronous (MBBC) based on the time interval between the diagnosis of the first and the secondary tumors. According to the guideline of WHO 2012, BBC is generally defined as SBBC when contralateral breast carcinoma is diagnosed within 3 months. The aim of this study was to compare the characteristics and patterns of metastasis of BBC patients with UBC. Materials and Methods: A cohort of 768 patients with breast cancer treated at the Turkish Ministry of Health-Izmir Bozyaka Research and Training Hospital between 1976 and 2012 were studied. Survival analysis was performed comparing UBC and BBC patients. In addition, evaluations were performed in patients with SBBC and MBBC sub-groups. We used a 3-months interval to distinguish metachronous from synchronous. Results: When clinical and histopathological parameters were statistically evaluated, ER status, event-free and overall survival were found to be significant between UBC and BBC patients. In comparison of SBBC and MBBC patients, age, histological type of tumor, event-free and overall survival were found to be significant. Conclusions: BBC cases were found to show worse prognosis than UBC cases. Among BBC, SBBC had the worst prognosis based on overall survival rates.

Secular Trends of Species and Antimicrobial Resistance of Blood Isolates in a Tertiary Medical Center for Ten Years: 2003~2012

  • Shin, Kyeong Seob;Son, Young Il;Kim, Yong Dae;Hong, Seung Bok;Park, Je-Seop;Kim, Sunghyun;Yu, Young-Bin;Kim, Young Kwon
    • Biomedical Science Letters
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    • v.20 no.2
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    • pp.77-84
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    • 2014
  • Periodic analysis of local epidemiologic data of prevalent pathogens of blood culture can provide clinicians with relevant information to guide empirical antibiotic therapy. In this study, we analyzed a pattern of change of causative microorganisms and antimicrobial resistance at a tertiary medical center in Chungcheong province from 2003 to 2012, retrospectively. Of 70,258 blood specimens cultured, 6,063 (8.6%) were positive. Among the positive isolates, 95.9% were aerobic or facultative anaerobic bacteria, 0.1% were anaerobes, and 3.9% were fungi. Coagulase-negative Staphylococci (CoNS) (32.9%), Escherichia coli (16.7%), Staphylococcus aureus (9.1%), Klebsiella pneumoniae (6.4%), and ${\alpha}$-hemolytic Streptococcus (5.9%) were commonly isolated bacteria, and Candida albicans (1.4%) was the most commonly isolated fungi. Enterococcus faecium progressively increased but Streptococcus pneumoniae, Acinetobacter baumannii and Proteus species gradually decreased over a period of 10 years. The multidrug-resistant microorganisms such as methicillin-resistant S. aureus (MRSA), vancomycin-resistant enterococci (VRE), cefotaxime-resistant E. coli, imipenem-resistant Pseudomonas aeruginosa (IRPA) and imipenem-resistant A. baumannii (IRAB), were significantly increased. Therefore, there is a need for a more strict control of antibiotics and a more updated guideline for the treatment of bloodstream infection.