Park, Su-Jin;Choi, Ji-Seon;Ahn, Jin-Seok;Shin, Ka-Young;Min, Kyoung-A;Chung, Seon-Young;In, Yong-Won;Sohn, Kie-Ho
Korean Journal of Clinical Pharmacy
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v.20
no.1
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pp.17-23
/
2010
Aprepitant is a substance P/neurokinin-1 (NK1)-receptor antagonist that was approved in 2003 for prevention of CINV. In addition, updated anti-emetic guidelines that include the aprepitant regimen have been published by NCCN and ASCO. However there is scarce clinical data in Korea. The prospective study was performed to evaluate the prevention of high dose cisplatin induced nausea and vomiting in all patients who started high-dose cisplatin-based chemotherapy at our hospital. We checked the nausea severity and vomiting episodes by calling patients within 4 to 5 days after chemotherapy. The retrospective study was performed to compare the prevention of CINV in solid tumor patients who switched their anti-emesis regimen from the standard regimen to the aprepitant regimen. In aprepitant regimen, aprepitant was added to the same anti-emetic regimen used during previous cycles. We checked the nausea, vomiting grades and adverse events in electronic medical records (EMR). In prospective study, 195 patients were included in the analysis. 88.2% of patients achieved a complete response (no emesis and no rescue therapy). In retrospective study, 54 patients were reviewed. With aprepitant regimen, nausea and vomiting grades were improved in 22 patients (40.7%) and in 9 patients (16.7%), respectively. Compared with standard regimen, addition of aprepitant provided superior prevention against CINV in Korean patients receiving highly emetogenic cisplatin-based chemotherapy. Moreover, aprepitant significantly prevented CINV in patients who received the standard regimen to prevent CINV in previous chemotherapy cycles.
Purpose: The purpose of this study was to analyze the characteristics of patients who canceled their ED visits and to determine the factors that influence ED cancellation. Methods: Retrospective study that analyzed data from the electronic medical records(EMR) and Prehospital Care Reports(PCRs) of 305 patients who cancelled their appointments at a single emergency medical center over a six-month period from October 12, 2022, to April 12, 2023. Results: ED cancellations were 2.287 times higher if the patient presented to the ambulance after outpatient hours(09:00~17:00) (p=.007), and ED cancellations were 3.712 times higher if the patient presented to the ambulance under the influence of alcohol(p=.011). For patients' symptoms, medical diseases were associated with a 1.965 times increase in cancelled ED visits compared to other modes of transport (p=.005), while mental and chronic diseases were associated with a 67.3% decrease in cancelled ED visits compared to other modes of transport (OR=0.327, CI=[0.130-0.822], p=.018). symptomatic improvement was associated with a 2.482 times increase in presentations to a 119 ambulance compared to delayed waiting time(p=.022). Conclusion: Emergency medical centers should consider improving the legal system, such as increasing emergency medical care fees, to reduce the number of patients who cancel their appointments.
Purpose: Blunt pancreatic injury has a high mortality rate, especially if adequate management is delayed. Although many guidelines exist for diagnosis and treatment, there is no consensus to date. Therefore, we analyzed the role of endoscopic retrograde cholangiopancreatography (ERCP) as a diagnostic and therapeutic tool for the treatment of traumatic pancreatic injury. Methods: We retrospectively reviewed the electronic medical records (EMR) database at Asan Medical Center (Seoul, South Korea) to identify all patients diagnosed with trauma to the pancreas between June 2003 and December 2010. Clinical and operative findings, CT (computed tomography) images, and ERCP findings were assessed. Results: A total of 40 patients were evaluated in this study. Of these, 14 patients underwent diagnostic ERCP, and 26 did not. Of the 14 patients who underwent diagnostic ERCP, 5 were found to have normal pancreatic ducts, thereby preventing a needless laparotomy in these patients. Of the patients diagnosed with ductal injury, four were treated with endoscopic intervention, and four underwent an exploratory laparotomy. The remaining patient was treated with radiologic intervention (percutaneous drainage) to manage pancreatic pseudocyst formation. Conclusion: Our findings suggest that ERCP is a beneficial diagnostic and therapeutic modality for the treatment of traumatic pancreatic injury.
Kim, Chihun;Choi, Eunhye;Park, Kyeong-Mee;Kwak, Eun-Jung;Huh, Jisun;Park, Wonse
Journal of Dental Anesthesia and Pain Medicine
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v.19
no.1
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pp.21-27
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2019
Background: Emergencies in dentistry can be classified as medical and dental. Medical emergencies occur mainly during dental treatment in patients with a systemic disease. Dental emergency departments are largely divided into dental emergency rooms located in dental college hospitals and medical emergency rooms located in medical institutions. This study aimed to analyze the characteristics of and provide help to dental emergency patients in a dental hospital. Methods: Overall, 1806 patients admitted to a dental emergency room at Yonsei University Dental Hospital for 1 year were included. The data collection period was from October 1, 2014 to September 30, 2015. An investigator reviewed medical records from the electronic medical record (EMR) system and radiographs. Results: The patients were 1,070 men and 736 women. The sex ratio was 1.45:1. The commonest age group was of 0-9 years, including 451 (25.0%) patients, followed by 20-29 years, including 353 (19.5%) patients, and 30-39 years, including 277 (15.3%) patients. Of the 108 patients transferred to the Severance emergency department, 81 had trauma, 19 were in pain, 4 were bleeding, and 4 had other complaints. Among chief complaints, 1,079 patients (60.3%) had trauma, 564 (31.5%) had pain, and 75 (4.2%) had bleeding. Twenty-three cases (1.3%) were caused by temporomandibular disorder (TMD). Conclusion: Dentists should be able to adequately assess patients in a dental emergency room and treat trauma, pain, and bleeding.
Lee, Koeun;Song, Je Seon;Kim, Seong-Oh;Lee, Jaeho;Choi, Byungjai;Choi, Hyung-Jun
Journal of the korean academy of Pediatric Dentistry
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v.45
no.2
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pp.154-161
/
2018
Sedation is a useful behavior management technique for dental patients who may be uncontrollable or have medical problems. The aim of this study is to investigate the changes in patterns of sedative treatments in pediatric dentistry by analyzing the distribution of patients and used sedative agents. Patients and sedative agents were reviewed based on the electronic medical records (EMR) of the department of pediatric dentistry in Yonsei University Dental Hospital from 2011 to 2016. The number of patients who were treated under sedation generally increased. Male received more sedation treatment than female by 2014, and they became similar from 2015. The treatment percentage of patients with systemic disease decreased in 2013, remained constantly afterwards. The ratio of sedative treatment for the age 4 - 5 and age 6 - 10 generally increased, while that of the age 0 - 2 and older than age 11 decreased. The ratio of the age 3 remained steady. Nitrous oxide was the most frequently used sedative agent. The use of benzodiazepine increased while the use of chloral hydrate decreased. Although the use of sedation has expanded, multidimensional approaches for ensuring safety have been less focused. Therefore, it is necessary to explore further studies for the safety and efficacy of the use of sedation.
Kim, Euimyung;Chun, Jin Woo;Kim, Young Min;Yoon, Jae Chul;Lim, Hae Jun;Cho, Yong Suk;Kim, Dohern;Hur, Jun;Chun, Wook
Journal of the Korean Burn Society
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v.22
no.2
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pp.66-70
/
2019
Purpose: The necrotizing fasciitis is a terrifying infectious disease that can rapidly spreads to surrounding tissues when fascia is infected and it can cause sepsis to death if not properly diagnosed and treated. The purpose of this study is to investigate the characteristics, causes, and treatment methods of necrotizing fasciitis in Korea through reviewing patients admitted to our burn center. Methods: 21 patients with necrotizing fasciitis were selected for this study among those inpatients with electronic medical records (EMR) admitted to Hallym University Hangang Sacred Heart Medical Center from Jan 1, 2008 to June 30, 2019. The medical records and wound photos of those 21 selected subjects were reviewed. Results: There were 13 male and 8 female patients and mean age was 58.76 years old. 13 of 21 subjects were survived and 8 died (38% mortality rate). The surgical treatments performed were I&D, fasciotomy, debridement, allograft, burring, STSG, flap, and amputation. The most common causes were burns in 9 subjects (6 contact burns) and cellulitis occurred on skins in 5 subjects. And other various causes were observed as fournier's gangrene, stab wound, intramuscular injection, tumor and bleu toe syndrome (toe necrosis). The infected areas were 11 feet and legs, 7 hips, 3 abdomen and trunk in 21 subjects. Of the 8 deaths, 3 were infected in feet and legs, 2 were infected in hips, and 2 were infected in abdomen and trunk. As for underlying diseases, 12 patients with hypertension or diabetes were the highest and others such as cancer and stroke were found. Conclusion: The only method to increase the survival rate is to 'suspect' the disease as much as possible and perform early extensive excision. It is advisable to treat the disease by the burn center to properly provide adequate and optimal wound management, infection control, medical care and nutritional supports.
Park, Sun Hee;Yang, Young-Mo;Choe, In;Yoon, Hyonok;Choi, Eun Joo
YAKHAK HOEJI
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v.59
no.3
/
pp.85-91
/
2015
Highly active antiretroviral therapy (HAART) has reduced AIDS-related morbidity and mortality; however, it has been associated with metabolic abnormalities including dyslipidemia and dysglycemia depending on the regimens used. The aims of this study were to analyze the prescription patterns of antiretroviral agents and to examine the prevalence of lipid abnormalities among the prescriptions of HAART. The electronic medical records (EMR) of HIV patients were retrospectively reviewed from January 2007 to September 2012 based on our inclusion criteria. The patients who had taken HAART for at least 3 months were included in this study. The lipid profiles of patients on antiretrovirals (ARTs) were collected from his or her laboratory data, and dyslipidemia was defined as total cholesterol (TC) ${\geq}240mg/dL$ and triglycerides (TG) >200 mg/dL. Eighty-four prescriptions were discovered during the study period. Twenty-three prescriptions were the combination of two nucleoside reverse transcriptase inhibitors (NRTIs) and one non-nucleoside reverse transcriptase inhibitor (NNRTI). Fifty-three prescriptions were the combination of two NRTIs and one protease inhibitor (PI) and thirty-nine prescriptions of them included a PI booster. Eight prescriptions were the combination of two NRTIs and one integrase inhibitor. The Incidence of hypertriglyceridemia among the patients receiving HAART was totally about 41.7% (2NRTIs+PI regimen vs. 2NRTIs+NNRTI regimen vs. 2 NRTIs+integrase inhibitor regimen, 52% vs. 12.5% vs. 25%), but there was no incidence of hypercholesterolemia. This study investigated that the prescription medication patterns and dyslipidemia associated with lipid abnormalities among HIV patients receiving HAART. The types of HAART prescription regimens had an effect on the occurrence of hypertriglycemia. Further studies related to metabolic abnormalities and adverse effects of HIV patients on ARTs are needed in the near future.
The purpose of this study was to identify the characteristics and the attributes related to Internet use in patients with Internet addiction. This study is a descriptive secondary analysis study, at Internet addiction clinics used the data of 63 patients diagnosed with Internet addiction. Data were obtained from Internet addiction clinic Electronic Medical Records(EMR), there was included the Korean Internet addiction scale(K-scale), Beck Anxiety Inventory(BAI), Beck Depression Inventory(BDI), Barratt Impulsivity scale(BIS), Conners ADHD Rating Scale(CAARS), Lubben Social Network Scale(LSNS). K-scale had significantly correlations with Internet use time per day, anxiety, impulsivity, Attention deficit Hyperactivity Disorder(ADHD) symptom. In stepwise multiple regression, factors significantly affecting ADHD symptom (${\beta}=.37$), Internet use time per day(${\beta}=.29$), Impulsivity(${\beta}=.25$), which accounted for 44% of the variance. Results indicate that patients with Internet addiction had psychological difficulties and suggest that children with ADHD needed to intervention for appropriate internet use.
The Journal of Korean Academic Society of Nursing Education
/
v.24
no.4
/
pp.433-442
/
2018
Purpose: This study was performed to investigate the factors affecting postoperative pain and length of hospital stay of liver transplantation donors. Methods: This is a retrospective study using the Electronic Medical Records (EMR) of 91 patients operated on at a tertiary hospital in Seoul, Korea in 2016. The collected data were analyzed using descriptive statistics, t-test, Mann-Whitney U test and Kruskal-Wallis test, Spearman's rank correlation, and multiple regression analysis. Results: The average age of the donors was $35.7{\pm}12.2$ years, and all donors were family members. PCA was applied for control pain in all patients, and 40.7% of PCA-related side effects were observed. The average length of hospital stay was $9.24{\pm}2.52$ days. The factors influencing the length of hospital stay were operative methods, pain control methods, and postoperative complications. The length of hospital stay was 1.29 days shorter if donors had no complication, 1.43 days shorter when only PCA was used, and 1.19 days shorter when laparoscopic resection was performed (Adjusted $R^2=0.17$, F=4.67, p<.05). Conclusion: The results of this study can be used as basic data for practical and effective postoperative nursing education and intervention of living liver donors.
Objectives : The purpose of this study is to investigate interaction and safety in administering herb-medicine with warfarin. Methods : For this study, we selected 19 patients who have been taking warfarin, from the ones that have been transferred from western hospital to oriental hospital. During their stay in the oriental hospital, we gave herb-medicine in addition to warfarin. Then we gathered informations and data on sex, age, main indications, and International Normalized Ratio(INR) values of selected patients through Electronic Medical Records(EMR) of Dong-Guk university hospital. Accordingly, we compiled all of the above data for a period of 10 days prior and 10 days post admission(western hospital period and oriental hospital period, respectively). Results and Conclusions : The statistical analysis of the data have revealed that there was no significant change of INR values after giving herb-medicine with warfarin(p=0.586). The result shows that administration of herb-medicine with warfarin is safe and has little drug interaction. However, this study was carried out on small sample size and the interaction with other drugs and various kinds of herb-medicine was not considered. Although we attained a restrictive result from this study, we are able to suggest the safety about co-administration of herb-medicine and warfarin.
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