• Title/Summary/Keyword: Elderly age

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Polypharmacy in Patients Discharged from Oncology Department (종양내과 퇴원 환자의 다제병용 분석)

  • Bae, Hyunjin;Hahn, Jimin;Lee, Yong Hwa;Kim, Hyangsook;Lee, Hye Suk;Lee, Se-Hoon;Heo, Dae Seog;Lee, Juyeun
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.1
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    • pp.42-48
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    • 2013
  • Background: Patients diagnosed with cancer tend to have multiple risk factors for drug related problems such as old age, comorbid conditions, self-medication, additional medications for supportive therapy, and the cancer treatment itself. Objective: The aim of this study was to investigate notable polypharmacy and related problems in oncology patients during hospitalization or following clinic visit. Method: The electronic medical records of patients who were discharged from oncology division at Seoul National University Hospital (SNUH) from June $1^{st}$ to June $30^{th}$, 2011 were retrospectively reviewed. Results: A total of 334 discharged patients were included in this study. Among them, 221 patients had pre-admission medications. Forty percent of the patients, including 60.3% of elderly patients (over 65 years of age) were prescribed more than 5 kinds of medications. Twenty percent of the patients were prescribed to take medications more than 7 times a day. Medication duplications were observed in 2.4% of patients. In 10.5% of the reviewed patients, 47 cases of potential drug-drug interaction including 3 cases of contraindication and 17 cases of major clinical implication according to Micromedex were detected. Medication changes were made in 88% of patients during hospitalization and in 94.7% of patients at their first visit after discharge. Antidiarrheal agent (loperamide) was prescribed along with laxatives in 18.5% of the prescriptions and inadequate instructions on how to take it were observed in 63% of the prescriptions. Conclusion: This study identified the prevalence of polypharmacy and related problems in cancer patients, which presents the need for an active role of pharmacists in pharmaceutical care in oncology wards.

Arthroscopic Evaluation on Intra-Articular Pathology in Recurrent Shoulder Dislocation Aged Over 40 Years (40세 이상 재발성 견관절 탈구 환자에서 관절내 병변에 대한 관절경적 연구)

  • Min, Woo-Kie;Kim, Ju-Eun;Cho, Hwan-Seong;Kim, Poong-Taek;Jeon, In-Ho
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.215-220
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    • 2009
  • Purpose: This study is to analyze the prevalence of various intra-articular lesions in patients with traumatic recurrent anterior dislocation of shoulder over 40 years and suggest clinical implications for treatment. Materials and Methods: We retrospectively studied 16 cases that underwent surgical treatment for recurrent anterior dislocation of shoulder from January 2001 to May 2009. There were 9 males and 7 females, and the mean age was 52.7years. We carried out arthroscopic exam for all patients based on standard protocol, which included labrum, capular lesion, cuff, bony lesions. Results: All 16 cases showed Hill-Sachs lesion, 3 patients (19%) had bony Bankart lesion, 6 patients (38%) had labral tear. Capsular tear were found 15 patients (94%). Twelve (75%) had ruptured supraspinatus and 5 (31%) had subscapularis tear. Only one (6%) had SLAP lesion. Conclusion: There was relatively higher incidence of capsular and rotator cuff tears in patients over age 40 years. Preoperative planning to address these lesions is highly recommended.

The Association of Perceived Neighborhood Walkability and Environmental Pollution With Frailty Among Community-dwelling Older Adults in Korean Rural Areas: A Cross-sectional Study

  • Kim, Mi-Ji;Seo, Sung-Hyo;Seo, Ae-Rim;Kim, Bo-Kyoung;Lee, Gyeong-Ye;Choi, Yeun-Soon;Kim, Jin-Hwan;Kim, Jang-Rak;Kang, Yune-Sik;Jeong, Baek-Geun;Park, Ki-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.52 no.6
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    • pp.405-415
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    • 2019
  • Objectives: The aim of this study was to evaluate the associations of frailty with perceived neighborhood walkability and environmental pollution among community-dwelling older adults in rural areas. Methods: The participants were 808 community-dwelling men and women aged 65 years and older in 2 rural towns. Comprehensive information, including demographics, socioeconomic status, grip strength, polypharmacy, perceived neighborhood environment (specifically, walkability and environmental pollution), and frailty, was collected from participants using face-to-face interviews conducted between June and August 2018. Perceived neighborhood walkability was measured using 20 items that were selected and revised from the Neighborhood Environment Walkability Scale, the Neighborhood Walkability Checklist from the National Heart Foundation of Australia, and the Physical Activity Neighborhood Environment Survey. The Kaigo-Yobo Checklist was used to assess participants' frailty. Results: The overall prevalence of frailty in this community-dwelling population was 35.5%. Sex, age, cohabitation status, educational attainment, employment status, grip strength, and polypharmacy were significantly associated with frailty. In the logistic regression analysis, frailty was associated with low perceived neighborhood walkability (adjusted odds ratio [aOR], 0.881; 95% confidence interval [CI], 0.833 to 0.932; p<0.001) and severe perceived neighborhood environmental pollution (aOR, 1.052; 95% CI, 1.017 to 1.087; p=0.003) after adjusting for sex, age, cohabitation status, educational attainment, employment status, monthly income, grip strength, and polypharmacy. Conclusions: More studies are warranted to establish causal relationships between walkability and environmental pollution and frailty.

Characteristics of Korean Poisoning Patients: Retrospective Analysis by National Emergency Department Information System (한국 중독환자의 경향: 국가응급진료 정보망을 이용한 후향적 연구)

  • Kim, Woongki;Kim, Kyung Hwan;Shin, Dong Wun;Park, Junseok;Kim, Hoon;Jeon, Woochan;Park, Joon Min;Kim, Jung Eon;Kim, Hyunjong
    • Journal of The Korean Society of Clinical Toxicology
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    • v.17 no.2
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    • pp.108-117
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    • 2019
  • Purpose: The study examined the poisoned patients' characteristics nationwide in Korea by using data from the National Emergency Department Information System (NEDIS). Methods: Among the patients' information sent to NEDIS from January 1, 2013 to December 31, 2015, the included subjects' main diagnosis in ED showed poisoning according to the 7th edition of the Korean Standard Disease Classification (KCD-7). We analyzed the patients' gender, age, initial vital signs, visit time, stay time of staying in ED, results of ED care, main diagnosis in ED, length of hospitalization, and results of hospitalization. Results: A total of 106,779 ED visits were included in the analysis. There were 55,878 males (52.3%), which was more than the number of females. The number of intentional poisoning was 49,805 (59.6%). 75,499 cases (70.8%) were discharged, and 25,858 cases (24.2%) were hospitalized. The numbers of poisoning patients per 1,000 ED visits were 14 in Chungnam and 11.9 in Jeonbuk. The most common cause of poisoning, according to the main diagnosis, was venomous animals. It was the same for hospitalized patients, and pesticide was next. Pesticide was the most common cause of mortality in ED (228 cases, 46.1%) and after hospitalization (584 cases, 54.9%). The incidence of poisoning by age group was frequent for patients in their 30s to 50s, and mortality in ED and post-hospitalization were frequent for patients in their 60s to 80s. Conclusion: This study investigated the characteristics of poisoning patients reported in the past 3 years. Pesticide poisoning had a high mortality rate for patients in ED and in-hospital. For mortality, there was a high proportion of elderly people over 60. Thus, policy and medical measures are needed to reduce this problem. Since it is difficult to identify the poison substance in detail due to nature of this study, it is necessary to build a database and monitoring system for monitoring the causative substance and enacting countermeasures.

A Study on Human Rights Sensitivity in Korean Occupational Therapist (국내 작업치료사의 인권감수성에 관한 연구)

  • Hong, Ki-Hoon
    • The Journal of Korean society of community based occupational therapy
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    • v.8 no.3
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    • pp.49-57
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    • 2018
  • Objective : The purpose of this study was to investigate the level of human rights sensitivity of occupational therapist and to compare the difference of the human rights sensitivity according to their characteristics and to provide basic data for the development of human rights education programs for occupational therapists in the future and to emphasize their role as human rights advocates. Methods : The subjects for this study were occupational therapists who chosen by snowball sampling method. The questionnaire consisted of 5 episodes and 30 questions to measure the level of occupational therapist's human rights sensitivity and 7 questions for identifying general characteristics of subjects. We distributed the questionnaire by on-line. 165 copies were collected and used to final data analysis. Results : The average of occupational therapists' human rights sensitivity was $33.52{\pm}14.96$. According to the subcategories, the average of perception of situation was $20.44{\pm}2.32$, perception of result was $19.85{\pm}2.32$, and the perception of responsibility was $19.14{\pm}2.21$. Among 5 episodes, The highest score was the right to pursue one's happiness of the elderly($12.72{\pm}1.56$), and the lowest score was the right to personal freedom in disabled ($11.04{\pm}2.23$). There were significantly differences of the subjects' age, educational level, organization type, and the level of clinical experiences. Conclusion : Occupational therapists' human rights sensitivity increased with age and the level of clinical experiences. And the human rights sensitivity increased as they were exposed to various human rights related circumstances. The reason of the highest score for situational awareness was that empathy for the client-centered intervention is important. This study confirmed that it is necessary to have human rights education and various educational programs.

The Effects of PM10 on the Hospital Admission of Patients with Respiratory Disease in Seoul, Korea (서울지역 미세먼지가 호흡기계 질환으로 입원한 환자에 미치는 영향)

  • Pak, Hae-Yong;Pak, Yun-Suk
    • Journal of Convergence for Information Technology
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    • v.9 no.6
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    • pp.194-201
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    • 2019
  • This cohort study aimed to identify the effects of daily PM10 exposure on the hospital admission of patients with respiratory diseases, during the nine-year period (2002-2010), in Seoul, Korea. The research subjects were 13,974 patients who had been hospitalized with respiratory diseases, including chronic obstructive pulmonary disease (COPD), asthma, and pneumonia. During the follow-up period, an increase of 10 ug/m3 in PM10 under the threshold of 50 ug/m3 of PM10 led to hospital admission in 1.38% of the age group younger than 15 years, 1.62% in those 65 years or older, 2.87% in patients 75 years or older and in 1.50% of pneumonia patients, 1.51% of COPD patients, and 1.55% of pneumonia and asthma patients. Under the threshold of 80 ug/m3 of PM10, there was a 3.71% increase in new patients admitted in the age group 65 years or older and 4.25% in those at least 75 years old. Our study found that high PM10 was associated with increased risk of admission of respiratory patients, especially in the elderly. People who already have a respiratory disease should refrain from exposure to particulate matter when there is a high concentration of PM10, especially older patients.

Clinical Characteristics and Prognostic Factors of Lung Cancer in Korea: A Pilot Study of Data from the Korean Nationwide Lung Cancer Registry

  • Kim, Ho Cheol;Jung, Chi Young;Cho, Deog Gon;Jeon, Jae Hyun;Lee, Jeong Eun;Ahn, Jin Seok;Kim, Seung Joon;Kim, Yeongdae;Kim, Young-Chul;Kim, Jung-Eun;Lee, Boram;Won, Young-Joo;Choi, Chang-Min
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.2
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    • pp.118-125
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    • 2019
  • Background: Lung cancer is a leading cause of morbidity and mortality worldwide, and the incidence continues to rise. Although many prognostic factors have been identified, the clinical characteristics and outcomes in Korean lung cancer patients are not well defined. Methods: Of the 23,254 new lung cancer cases registered at the Korea Central Cancer Registry in 2013, total 489 patients from 19 hospitals were abstracted by the Korean Central Cancer Registry. The clinical data retrospectively analyzed, patients were followed up until December 2015. Results: The median age was 69 years (interquartile range, 60-74 years); 65.4% were male and 62.1% were ever-smokers. Cough was the most common initial symptom (33.5%); 13.1% of patients were asymptomatic. While squamous cell carcinoma was the most common subtype in male patients (37.2%), adenocarcinoma was the most frequent histological type in all patients (48.7%) and females (76.3%). The majority of patients received treatment (76.5%), which included surgery, radiation therapy, and chemotherapy. Older age (hazard ratio [HR], 1.037), lower body mass index (HR, 0.904), ever-smoker (HR, 2.003), small cell lung cancer (HR, 1.627), and distant metastasis (HR, 3.990) were independent predictors of mortality. Patients without symptoms (HR, 0.387) and without treatment (HR, 0.364) were associated with a favorable outcome in multivariate Cox analysis. Conclusion: Lung cancer in Korea occurs predominantly in elderly patients, with adenocarcinoma being the most frequent subtype. The prognosis was poorer in ever-smokers and older, malnourished, and untreated patients with advanced lung cancer.

A Study on the Chinese Dai Tattoo Culture (두룽족 여성의 얼굴 문신 문화에 관한 연구)

  • Huo-Tao;Hee-Kyung Lim
    • Journal of the Korean Applied Science and Technology
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    • v.40 no.2
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    • pp.348-354
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    • 2023
  • A tattoo is a cultural form that has been handed down to mankind for a long time. Traditional tattoo customs that have been handed down and developed in the various cultures of mankind have the important value of academic research in various fields such as history, art, society, etc. The Derung people, one of the minorities living in Yunnan Province and nearby areas in the southwest of China, have 'facial tattoo' customs. The traditional culture of the Derung people, which had maintained the form of primitive society until 1949 when the People's Republic of China was established, was passed down through oral tradition, so there are no preserved materials about their tattoo culture, showing the need for research on the culture. Therefore, it was conducted in two ways: a research on modern and contemporary literature and a field trip to Yunnan Province. The exact reason and time of facial tattoo customs are unknown, but the customs disappeared after being banned in 1966 due to the Chinese Cultural Revolution. The symbols and functions of facial tattoos can be largely divided into four categories, including religious worship, coming-of-age ceremonies, aesthetic decorations, and ethnic and social history, through an on-site survey and research by modern and contemporary scholars. And, it is known that women of the Derung People get tattoos from the age of 7 to 8. The design of facial tattoos became more complicated for upper-class women and simpler for lower-class women depending on the area they live. Tattoos are mainly performed by relatives, and mainly bamboo skewers and lixivium extracted from the bottom of the pot are used as the materials. Currently, there are fewer than 25 women of the Derung people with facial tattoos, and most of them are elderly. Therefore, they seem to disappear altogether within a few decades. Therefore, it is urgent to have documentation on the unique facial tattoo culture of the Derung people.

Estimation of Premature Deaths due to Exposure to Particulate Matter (PM2.5) Reflecting Population Structure Change in South Korea (인구구조 변동 추세를 반영한 미세먼지 노출에 의한 조기 사망자 추정)

  • Junghyun Park;Yong-Chul Jang;Jong-Hyeon Lee
    • Journal of Environmental Health Sciences
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    • v.49 no.6
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    • pp.362-371
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    • 2023
  • Background: PM2.5 pollution has been a persistent problem in South Korea, with concentrations consistently exceeding World Health Organization (WHO) guidelines. The aging of the population in the country further exacerbates the health impacts of PM2.5 since older adults are more susceptible to the adverse effects of air pollution. Objectives: This study aims to evaluate how the health impact (premature death) due to long-term exposure to PM2.5 in South Korea could change in the future according to the trend of change in the country's population structure. Methods: The study employs a relative risk function, which accounts for age-specific relative risks, to assess the changes in premature deaths by age and region at the average annual PM2.5 concentration for 2022 and at PM2.5 concentration improvement levels. Premature deaths were estimated using the Global Exposure Mortality Model (GEMM). Results: The findings indicate that the increase in premature deaths resulting from the projected population structure changes up to 2050 would significantly outweigh the health benefits (reduction in premature deaths) compared to 2012. This is primarily attributed to the rising number of premature deaths among the elderly due to population aging. Furthermore, the study suggests that the effectiveness of the current domestic PM2.5 standard would be halved by 2050 due to the increasing impact of population aging on PM2.5-related mortality. Conclusions: The study highlights the importance of considering trends in population structure when evaluating the health benefits of air pollution reduction measures. By comparing and evaluating the health benefits in reflection of changes in population structure to the predicted PM2.5 concentration improvements at the provincial level, a more comprehensive assessment of regional air quality management strategies can be achieved.

Patterns of self-harm/suicide attempters who visited emergency department over the past 10 years and changes in poisoning as a major method (2011-2020) (지난 10년간 응급실로 내원한 자해/자살 시도자의 양상 및 주요 수단으로서의 중독질환 변화 추이 분석(2011-2020))

  • Kyu Hyun Pai;Sung Woo Lee;Su Jin Kim;Kap Su Han;Juhyun Song;Sijin Lee;Ji Hwan Park;Jeijoon Song
    • Journal of The Korean Society of Clinical Toxicology
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    • v.21 no.2
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    • pp.69-80
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    • 2023
  • Purpose: Suicide ranks among the top causes of death among youth in South Korea. This study aimed to identify the characteristics of suicidal individuals treated at emergency departments between 2011 and 2020. Methods: A retrospective analysis was conducted using data from January 2011 to December 2020 in the Injury Surveillance Cohort, a prospective registry. Patients' sex, age, mortality, methods of self-harm, and previous suicide attempts were analyzed. The methods of self-harm were categorized into falls, asphyxiation, blunt injuries, penetrating injuries, poisoning, and others. Sub-groups with and without poisoning were compared. Results: The proportion of self-harm/suicide attempts increased from 2.3% (2011) to 5.0% (2020). The mortality rate decreased from 10.8% (2011) to 6.3% (2020). Poisoning was the most common method (61.7%). Mortality rates ranged from 42.0% for asphyxiation to 0.2% for blunt injuries. Individuals in their 20s showed a marked increase in suicide/self-harm attempts, especially in the last three years. A large proportion of decedents in their 70s or older (52.6%) used poisoning as a method of suicide. The percentage of individuals with two or more previous attempts rose from 7.1% (2011) to 19.7% (2020). The death rates by poisoning decreased from 7.7% (2011) to 2.5% (2020). Conclusion: Our findings underscore the urgent need for targeted interventions and suicide prevention policies. Managing and reducing suicide and self-harm in emergency settings will require a focus on poisoning, the 10-29 age group, and the elderly. This paper will be valuable for future policies aiming to reduce the societal burden of suicide and self-harm.