• 중환자간호학회지
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• 제14권3호
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• pp.26-36
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• 2021

Purpose : This study aimed to present the incidence of pressure ulcers and identify different associated factors according to the time of occurrence of pressure ulcers in intensive care unit (ICU) patients. Methods : The participants were 313 patients who reported pressure ulcers among 2,908 patients in ICUs at a large tertiary hospital in Gyeonggi-do. Among them, 220 patients (70.3%) had a pressure ulcer before admission, and 93 patients (29.7%) reported newly developed pressure ulcers after admission to the ICU. Data were collected between August 2018 and April 2019. Along with the time of occurrence and characteristics of pressure ulcers, diverse associated factors were gathered through electronic medical records. Data were analyzed using descriptive statistics, independent t-tests, and 𝑥²-tests. Results : Different risk factors associated with pressure ulcers in ICU patients according to the time of occurrence were main diagnosis, score of acute physiology and chronic health evaluation, score of Richmond agitation sedation scale, level of consciousness, administered sedatives, use of a ventilator, insertion of a feeding tube, and the duration of fasting period. Conclusion : Based on the results of this study, healthcare providers, especially ICU nurses, should try to detect early signs and symptoms of pressure ulcers, taking into account the derived factors associated with pressure ulcers in ICU patients. Practical intervention programs and strategies considering the factors associated with pressure ulcers must be developed to prevent and alleviate such ulcers in ICU patients in the future.

• Journal of information and communication convergence engineering
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• 제9권5호
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• pp.577-582
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• 2011

EMR(Electronic Medical Record) is an emerging technology that is highly-blended between non-IT and IT area. One of methodology to link non-IT and IT area is to construct databases. Nowadays, it supports before and after-treatment for patients and should satisfy all stakeholders such as practitioners, nurses, researchers, administrators and financial department and so on. In accordance with the database maintenance, DAS (Data as Service) model is one solution for outsourcing. However, there are some scalability and strategy issues when we need to plan to use DAS model properly. We constructed three kinds of databases such as plain-text, MS built-in encryption which is in-house model and custom AES (Advanced Encryption Standard) - DAS model scaling from 5K to 2560K records. To perform custom AES-DAS better, we also devised Bucket Index using Bloom Filter. The simulation showed the response times arithmetically increased in the beginning but after a certain threshold, exponentially increased in the end. In conclusion, if the database model is close to in-house model, then vendor technology is a good way to perform and get query response times in a consistent manner. If the model is DAS model, it is easy to outsource the database, however, some technique like Bucket Index enhances its utilization. To get faster query response times, designing database such as consideration of the field type is also important. This study suggests cloud computing would be a next DAS model to satisfy the scalability and the security issues.

• International Journal of Advanced Culture Technology
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• 제7권2호
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• pp.28-33
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• 2019

Electronic health records (EHRs) enable us to use and re-use electronic data for various multiple purposes, such as public reporting, quality improvement, and patient outcomes research. Current hospital-acquired pressure injury (HAPI) risk assessment instruments have not been specifically developed for intensive care unit (ICU) patients and showed false positive rates in this specific populations. Previous research studies report a number of risk factors; however, it is still not clear what factors influence ICU HAPI in this population. As part of a larger research study, we performed an exploratory analysis by using a large electronic health record data. The aims of this study were to compare characteristics of patients who developed HAPIs during their ICU stay with those who did not, and to determine whether the two groups were different in the aspects of length of ICU stay, discharge disposition, and discharge destinations. We conducted chi-square test and t-test for group comparison. Association was examined by using bivariate analyses. Pearson correlation coefficients were used to examine correlation between LOS and number of medications. Our findings suggest a number of consistent and potentially modifiable risk factors, such as sedation, feeding tubes, and the number of medications administered. The mortality of the HAPI group was significantly higher than the non-HAPI group in our data. Discharge disposition was significantly different between the groups. 67% of the HAPI group transferred to intermediate or long-term care hospitals whereas 57.7% of the non-HAPI group went home after discharge. Awareness of these risk factors can lead to clinical interventions that can be preventative in the ICU setting.

• 대한의용생체공학회:의공학회지
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• 제28권1호
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• pp.36-45
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• 2007

Today Human Personal Trainers are becoming very famous in this health conscious world. They teach user to achieve fitness goals in managed way. Due to their high fee and tight schedule they are unavailable to mass number of people. Another solution to this problem is to develop digital personal trainer portable instrument that may replace human personal trainers. We developed a portable digital exercise trainer device - BIOFIT that manages, monitors and records the user's physical status and workout during exercise session. It guides the user to exercise efficiently for specific fitness goal. It keeps the full exercise program i.e. exercises start date and time, duration, mode, control parameter, intensity in its memory which helps the user in managing his exercise. Exercise program can be downloaded from the internet. During exercise it continuously monitors the user's physiological parameters: heart rate, number of steps walked, and energy consumed. If these parameters do not range within prescribed target zone, the BIOFIT will alarm the user as a feedback to control exercise. The BIOFIT displays these parameters on graphic LCD. During exercise it continuously records the heart rate and number of steps walked every 10 seconds along with exercise date and time. This stored information can be used as treatment for the user by an exercise expert. Real-time ECG monitoring can be viewed wirelessly (RF Communication) on a remote PC.

• 한국임상약학회지
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• 제28권4호
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• pp.279-284
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• 2018

Objective: To compare the analgesic effects and adverse drug reactions (ADRs) of fentanyl intravenous patient-controlled analgesia (ivPCA) with nefopam, a centrally acting analgesic agent with demonstrated opioid sparing activity, as compared to ketorolac in a tertiary teaching hospital. Methods: A retrospective evaluation of electronic medical records was conducted on patient records including either nefopam or ketorolac with opioid ivPCA for post-operative pain management in general surgery department from January to December 2014. The status of pain control and ADRs were collected. Results: Out of 6,330 general surgery cases, nefopam was given in 153 prescriptions (6.9%) and ketorolac in 81 prescriptions (3.6%). The level of pain control was not different between two groups (70.9% vs. 75.3%; p = 0.51), but ADRs were more frequently reported in nefopam group (9.8% vs. 2.5%; p < 0.05). New ADRs of hot flushes (n = 1) and paresthesia in hands (n = 1) were reported in nefopam group and they were unlisted in the approved package insert. No serious ADRs were reported in both groups. Conclusion: Our findings presented that nefopam showed a similar analgesic effect and higher ADR rates compared to ketorolac as an adjuvant to fentanyl iv PCA for post-operative pain management in general surgery patients in South Korea.

• PNF and Movement
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• 제18권3호
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• pp.453-463
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• 2020

Purpose: This study aimed to investigate the effect of an intensively rehabilitation program on the gait, balance, functional performance, and wearing satisfaction of patients with traumatic lower extremity amputations caused by industrial accidents. Methods: In this study, the anonymized electronic medical records of individuals who participated in the intensive rehabilitation program (among those who were admitted to the hospital belonging to the Labor Welfare Corporation) due to an industrial accident from August 2018 to September 2019 were collected. As a result, the records of 12 subjects meeting the screening criteria were analyzed. Results: According to the time of application to the intensive rehabilitation program, the 10 Meter Walk Test (10MWT) (p < 0.01), Berg Balance Scale (BBS) (p < 0.01), Timed Up and Go Test (TUG) (p = 0.01), the L Test of Functional Mobility (L-test) (p < 0.01), Prosthetic Limb Users Survey of Mobility (Plus-M) (p < 0.01), and Houghton Score Question (HSQ) (p < 0.01) values significantly improved with time. Conclusion: This study confirmed the positive effect of an intensive rehabilitation program on the gait, balance, functional performance, and wearing satisfaction of patients with traumatic lower extremity amputations caused by industrial accidents. However, this study was limited by the absence of a control group, and, thus, it highlights the need for more extensive research with a large sample.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.9865-9869
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• 2014

Background: Transthoracic fine needle aspiration (FNA) is one of several methods for establishing tissue diagnosis of lung lesions. Other tissue or cell sources for diagnosis include sputum, endobronchial biopsy, washing and brushing, endobronchial FNA, transthoracic core needle biopsy, biopsy from thoracoscopy or thoracotomy. The purpose of this study was to compare the sensitivity and specificity of FNA and other diagnostic tests in diagnosing lung lesions. Materials and Methods: The population included all patients undergoing FNA for lung lesions at Meir Medical Center from 2006 through 2010. Information regarding additional tissue tests was derived from the electronic archives of the Department of Pathology, patient records and files from the Department of Oncology. Sensitivity, specificity, diagnostic accuracy, and positive and negative predictive values were calculated for each test. Results: FNA was carried out in 245 patients. Malignant tumors were diagnosed in 190 cases (78%). They included adenocarcinoma (43%), squamous cell carcinoma (15%), non-small cell carcinoma, not otherwise specified (19%), neurondocrine tumors (7%), metastases (9%) and lymphoma (3%). The specificity of FNA for lung neoplasms was 100%; sensitivity and diagnostic accuracy were 87%. Conclusions: FNA is the most sensitive procedure for establishing tissue diagnoses of lung cancer. Combination with core needle biopsy increases the sensitivity. Factors related to the lesion (nature, degenerative changes, location) and to performance of all stages of test affect the ability to establish a diagnosis.

• 한국임상약학회지
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• 제24권3호
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• pp.206-212
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• 2014

Objectives: This was to evaluate the current usage of three erythropoietin stimulating agents (ESA) and their efficacy for management of anemia in peritoneal dialysis (PD) patients with chronic kidney disease. Methods: It was a retrospective comparative study through review of electronic medical records of chronic kidney disease patients undergoing PD at a tertiary teaching hospital from January 1998 to June 2013. Results: Average administration frequency was 1.66 times/week in EPO group, 0.75 times/week in DA group, and 0.19 times/week in MPG-EPO group. At the first 4 weeks, there were significant differences in mean hemoglobin levels between EPO and DA groups ($9.25{\pm}1.28g/dL$, $10.02{\pm}0.95g/dL$ each, p = 0.018) and also in hemoglobin response rates (10.0%, 45.2% each, p = 0.008), but since after 4 week, there had been no significant differences. There also showed no significant differences in achievement of hemoglobin target between the two groups. When converted to MPG-EPO in EPO/DA groups, there showed a slight increase in hemoglobin levels of both groups. MPG-EPO was the highest compared with two other drugs by the average cost based on the average weekly dose. Conclusion: EPO, DA, and MPG-EPO showed similar effects in treatment of anemia of PD patients based on hemoglobin target range (11.0~12.0 g/dL) which NFK-K/DOQI guidelines suggest. Though the average cost of MPG-EPO was higher than the other two drugs, the number of PD patients using MPG-EPO has increased and it is thought that long half-life and low administration frequency of MPG-EPO have improved the compliance of PD patients who have to self-administrate.

• 중환자간호학회지
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• 제16권3호
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• pp.24-33
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• 2023

Purpose : This study aims to establish an optimal cut-off score on the Braden scale for the assessment of pressure injury to detect pressure injury risks among inpatients in a South Korean tertiary hospital. Methods : This retrospective study used electronic medical records, from January to December 2022. A total of 654 patients were included in the study. Of these, 218 inpatients with pressure injuries and 436 without pressure injuries were classified and analyzed using 1:2 Propensity Score Matching (PSM), and the generalized estimating equation was performed using SPSS Version 26 and the R Machlt package program. Results : The cut-off value on the Braden scale for distinguishing pressure injury was 17 points, and the AUC (area under the ROC curve) was 0.531 (0.484-0.579). The sensitivity was 56.6% (45.5-67.7%) and the specificity was 69.7% (66.0-73.4%). With 17 points, the Braden scale cut-off distinguished those who had pressure injuries from those who did not at the time of admission (p < .03). In the pressure injury group, the Braden score on the day of the pressure injury was 14, with significant results in all subcategories except the moisture category. Conclusion : Our findings revealed that a cut-off value of 17 was optimal for predicting the risk of pressure injuries among tertiary hospital inpatients. Future studies should evaluate the optimal cut-off values in different clinical environments. Additionally, it is necessary to conduct multicenter large sample studies to verify the effectiveness of a 17 value in PI risk assessments.

• Clinics in Shoulder and Elbow
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• 제26권3호
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• pp.296-301
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• 2023

Background: A supervised physiotherapy program (SPP) is a standard regimen after surgical rotator cuff repair (RCR); however, the effect of a home-based exercise program (HEP), as an alternative, on postoperative functional recovery remains unclear. Therefore, the purpose of this meta-analysis was to compare the functional effects of SPP and HEP after RCR. Methods: We searched electronic databases including Central, Medline, and Embase in April 2022. The primary outcomes included the Constant score, American Shoulder and Elbow Surgeons score, University of California Los Angeles shoulder score, and pain score. Secondary outcomes included range of motion, muscle strength, retear rate, and patient satisfaction rate. A meta-analysis using random-effects models was performed on the pooled results to determine the significance. Results: The initial database search yielded 848 records, five of which met our criteria. Variables at 3 months after surgery were successfully analyzed, including the Constant score (mean difference, -8.51 points; 95% confidence interval [CI], -32.72 to 15.69; P=0.49) and pain score (mean difference, 0.02 cm; 95% CI, -2.29 to 2.33; P=0.99). There were no significant differences between the SPP and HEP. Other variables were not analyzed owing to the lack of data. Conclusions: Our data showed no significant differences between SSP and HEP with regard to the Constant and pain scores at 3 months after RCR. These results suggest that HEP may be an alternative regimen after RCR. Level of evidence: I.