• 제목/요약/키워드: First-visit Patients

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심혈관계 질환 합병증을 동반하지 않은 본태성 고혈압 환자의 안정시 심박수에 따른 대사증후군 세부 요인 변화에 대한 12개월 추적조사: 고혈압 초진과 재진 (The Components of Metabolic Syndrome according to the Resting Heart Rate in Hypertensive Patients without Cardiovascular Disease Complication after 12month Follow-up: First Visit and Revisit Hypertensive Patients)

  • 옥종선
    • 한국콘텐츠학회논문지
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    • 제20권10호
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    • pp.401-410
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    • 2020
  • 본 연구에서는 심혈관계 질환 합병증을 동반하지 않은 국내 본태성 고혈압 환자의 안정시 심박수에 따른 대사증후군 세부요인 변화에 대한 12개월 추적 조사 결과를 확인해 보고자 한다. 2013년부터 국내 25개 대학병원에서 진행되어 온 대규모 전향적 관찰 연구인 KorHR(Korean Hypertension Registry) 자료를 이용하였고 총 951명의 데이터를 R 통계 프로그램을 이용하여 분석하였다. 본 연구결과 초진과 재진 고혈압 환자의 안정시 심박수 그룹에 따라 대사증후군 세부요인의 변화 및 대사증후군 세부요인 증가 위험이 다른 것으로 나타났다. 따라서 초진과 재진 고혈압 환자에 따른 맞춤형 안정시 심박수 조절을 위한 지침 마련과 안정시 심박수 조절을 위한 다양한 중재방안 마련이 필요하다고 생각된다. 이를 통해 대표적인 만성질환인 고혈압에 따른 심혈관계 질환 발생을 예방하여 환자 및 가족의 삶의 질을 향상시킬 뿐만 아니라 보건 의료 분야에서의 효율성을 증대시키는데 기여하고자 한다.

Clinical Characteristics of Febrile UTI First Developed Over 5 Years of Age

  • Roh, Da Eun;Suh, Hyo Rim;Min, So Yoon;Jo, Tae Kyoung;Baek, Hee Sun;Cho, Min Hyun
    • Childhood Kidney Diseases
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    • 제21권1호
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    • pp.15-20
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    • 2017
  • Purpose: Febrile urinary tract infection (UTI) is one of the commonest bacterial infections in children. The purpose of this study is to investigate the clinical characteristics of the first episode of febrile UTI occurring in children over 5 years compared to those in infants younger than a year. Methods: We retrospectively reviewed the medical records of 10 patients over 5 years, having febrile UTI, and 25 controls under 1 year. Clinical characteristics including symptoms at admission, the time interval between symptom onset and hospital visit and/or diagnosis, duration of fever, urinalysis, and other laboratory and imaging test results were compared between the two groups. Results: Most patients in the control group showed only high fever at the time of presentation to the hospital. However, 60% of the case group had fever along with gastrointestinal (GI) symptoms such as abdominal and flank pain, vomiting, as well as relatively mild pyuria. The case group showed a longer duration between symptom onset and hospital visit and/or diagnosis. Conclusions: Delay in diagnosis and initiation of treatment of UTI increases the risk of permanent renal scarring and associated complications. Therefore, early diagnosis and treatment of febrile UTI is vital for very young infants, as well as children considering that febrile UTI could be an important cause of febrile illness in children over 5 years.

농어촌지역 응급환자 실태조사 - 서남해안 지역을 중심으로 - (Research on Actual Condition of Emergency Patients in Farming and Fishing Villages - In southwest coast district center -)

  • 최길순;권혜란
    • 한국응급구조학회지
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    • 제10권1호
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    • pp.13-21
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    • 2006
  • Purpose: This study aims to examine characteristics and actual conditions of patients using emergency room at farming and fishing villages, solve overcrowding of emergency room at the tertiary hospital and activate local emergency clinics. Methods: It examines department of diagnosis and treatment, vehicles used, sex, age, residential area, visit hour, length of stay, presence or absence of trauma, measures after first aid and degree of severity based on medical records of 6,740 patients using emergency room at farming and fishing villages from Jan. 1 to Dec. 31, 2005. Conclusion : 1. Sex distribution of patients of emergency room was male 54.9% and female 45.1% and age distribution between over 40 and below 50 was most as 15.9%. 2. Transport means to emergency room were 91.4 of private car and others (public transport and going on foot), 7.5 of 119, 129 and police car and 1.0% of ambulance. 3. According to distribution of residential areas of emergency patients, 38.9% were Eup area, 42.1% Myeon area, 11.4% distant area and 7.5% adjacent area. 4. According to distribution of emergency patients by department of diagnosis and treatment, internal medicine was most as 35.8% and 55% of patients visited emergency room from 3:31 p.m. to 11:30 p.m.. 5. According to total hours of diagnosis and treatment of subjects, 51.2% were within 30min. and cases of non-trauma disease were 68.2%. 6. According to degree of emergency of emergency patients, non-emergency cases were 65.3%, urgent cases 27.7% and emergency cases 7.0% and 74.2% of patients returned home after first aid and 20.6% of them hospitalized. In conclusion, characteristics and diversification of patients should be examined and efforts by government and local medical institutions which must organize emergency system and facility and personnel levels suitable to regional conditions are needed in order to prevent overcrowding of emergency center of the tertiary hospital and activate local emergency center.

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측두하악골관절염 환자의 보존적 치료에 관한 연구 (A Study of Conservative Treatment for Patients with Osteoarthritis of the TMJ)

  • 손대은;옥승준;고명연;안용우
    • Journal of Oral Medicine and Pain
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    • 제32권2호
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    • pp.227-239
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    • 2007
  • 1994년부터 2006년까지 부산대학교병원 구강내과에 내원하여 측두하악골관절염으로 진단받고 보존적 치료를 받은 환자 101명과 저작근장애로 진단받고 보존적 치료를 받은 환자 74명의 진료기록부를 통해 초진 시와 치료 종결 시의 증상, 시행된 치료방법, 치료기간, 치료횟수에 따른 치료 결과를 조사하였다. 그리고, 측두하악골관절염 환자의 초진 시 방사선 사진, 전산화 단층사진 및 단광자 방출 전산화 단층사진의 양성도, 관절잡음의 치료 전후 변화를 평가하여 다음과 같은 결과를 얻었다. 1. 골관절염군은 보존적 치료에 의해서 치료 결과가 좋았으나, 치료 종결 시 근육장애군에 비해서 증상의 개선이 미흡하였다. 2. 골관절염군의 파노라마 방사선 사진과 경두개 촬영사진의 양성도는 60%정도였으나, 전산화 단층사진과 단광자 방출 전산화 단층사진의 양성도는 90%이상이었다. 3. 치료 종결 시의 골관절염군의 관절잡음은 초진 시에 비해 유의하게 감소하였다. 4. 골관절염군은 대부분 물리치료, 투약, 교합안정장치로, 근육장애군은 대부분 물리치료, 투약으로 증상이 현저히 개선되었다. 5. 골관절염군은 6개월에서 2년의, 근육장애군은 6개월 미만의 치료가 필요하였다. 6. 골관절염군은 10회 이상으로, 근육장애군은 10회 미만의 치료로도 예후가 좋았다.

Comparing Inhaler Use Technique Based on Inhaler Type in Elderly Patients with Respiratory Disease

  • Lee, Ha Youn;Song, Jin Hwa;Won, Ha-Kyeong;Park, Yeonkyung;Chung, Keun Bum;Lim, Hyo-Jeong;Ahn, Young Mee;Lee, Byoung Jun
    • Tuberculosis and Respiratory Diseases
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    • 제84권1호
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    • pp.46-54
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    • 2021
  • Background: The aim of this study was to investigate inhaler device handling in elderly patients. Inhaler devices with respect to misuse and error correction were also compared. Methods: Inhaler use technique was assessed using standardized checklists at the first visit and 3-month follow-up visit after retraining. The primary outcome was difference in the acceptable use ratio among inhaler devices. Secondary outcomes included differences in error correction, the most common step of misuse, and factors affecting the accuracy of inhaler use. Results: A total of 251 patients (mean age, 76.4 years) were included. The handling of 320 devices was assessed in the study. All patients had been trained before. However, only 24.7% of them used inhalers correctly. Proportions of acceptable use for Evohaler, Respimat, Turbuhaler, Ellipta, and Breezhaler/Handihaler were 38.7%, 50.0%, 61.4%, 60.8%, and 43.2%, respectively (p=0.026). At the second visit, the acceptable use ratio had increased. There were no significant differences among inhaler types (Evohaler, 63.9%; Respimat, 86.1%; Turbuhaler, 74.3%; Ellipta, 64.6%; and Breezhaler/Handihaler, 65.3% [p=0.129]). In multivariate analysis, body mass index, Turbuhaler, and Ellipta showed positive correlations with acceptable use of inhalers, whereas Chronic Obstructive Pulmonary Disease Assessment Test score showed a negative correlation. Conclusion: Although new inhalers have been developed, the accuracy of inhaler use remains low. Elderly patients showed more errors when using pressurized metered-dose inhalers than using dry powder inhalers and soft-mist inhalers. However, there were no significant differences in misuse among inhaler devices after individual training. Results of this study suggests that repeat training is more important than inhaler type.

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

  • 배현진;한지민;이용화;김향숙;이혜숙;이세훈;허대석;이주연
    • 한국임상약학회지
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    • 제23권1호
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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.

한약 단독 치료로 호전된 소양인 환자의 도한 : 후향적 증례보고 6례 (Herbal Medicine Treatment for Persistent Night Sweats in Soyangin Patients: A Retrospective Case Series)

  • 이민정;이지연;황민우
    • 사상체질의학회지
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    • 제33권3호
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    • pp.146-160
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    • 2021
  • Introduction This study is the first to report a significant improvement of Soyangin patients with persistent night sweats through herbal medicine treatment. Methods We reviewed the total of 6 Soyangin patients with moderate to severe persistent night sweats who visited the outpatient clinic. The patients received herbal medicine treatment alone for 4 to 9 weeks. We evaluated the treatment outcome using Night Sweats Degree criteria, developed by Lea and Aber(1985), every other 2 to 4 weeks. In addition, we recorded the treatment period from the first visit to symptom alleviation. Results Persistent night sweats improved significantly in all 6 Soyangin patients, and 4 out of 6 patients had better sleep quality after the treatment. It took 1 to 3 weeks until the symptom alleviated from moderate or severe to mild, and 3 to 7 weeks until the patients have no sign of night sweating. The progression of persistent night sweats and treatment period until no sign of symptom varied according to the Soyangin External and Internal disease diagnosis. Discussion The Soyangin patients having persistent night sweats treated with herbal medicines showed a significant improvement in their symptoms. This result proposes the possibility of using herbal medicine in primary care patients experiencing persistent night sweats.

방사선치료를 받는 암환자의 피로와 삶의 질 변화 (Changes in Fatigue and the Quality of Life of Cancer Patients Receiving Radiotherapy)

  • 이은숙;조루시아
    • 대한간호학회지
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    • 제27권3호
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    • pp.489-502
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    • 1997
  • Quality of life(QOL) and fatigue in cancer patients receiving the radiotherapy was assessed. The subjects were 46 cancer patients who daily attended the radiotherapy department. Assessment was done on four occassions : the first assessment was done on the treatment simulation visit, the second one was four weeks after treatment started, the third one at the completion of treatment and the last assessment was done between six and eight week following treatment. The results are as follows : The fatigue scores of the patients at each stage of assessment ranged from 5.49 points to 7.67 points and highest score was recorded at the third assessment that is, at the completion of treatment. The fatigue points showed an increase from the 1st. to 3rd. stage. However, at the 4th. stage, fatigue points decreased to the level at the first stage of assessment. QOL were assessed in three areas namely, physical, emotional and social /functional. The QOL scores in the physical area showed the highest score, followed by social /functional and emotional areas. The QOL scores decreased gradually to the third. stage of assessment thereafter recovered to the level of the first. stage. Correlation between QOL and fatigue scores during the treatment indicated that the level of QOL decreased as the level of fatigue increased. In particular, fatigue persisted after completion of the treatment and showed a significantly negative correlation with QOL. The present study strongly suggests that a strategy to restore the emotional well being level of the patient should be devised in order to improve QOL and reduce fatigue of patients receiving radiotherapy.

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아토피 피부염 환아의 정신 건강 분석 및 아토피 피부염 교육을 통한 인식, 인지도 개선에 대한 고찰 (A Study on Mental Health Analysis of Atopic Children and Awareness Improvement through Atopic Education)

  • 박승구;노현민;조은희;박민철
    • 한방안이비인후피부과학회지
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    • 제30권2호
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    • pp.51-85
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    • 2017
  • Objectives : This study aimed to investigate the awareness improvement of atopic dermatitis(AD) for AD children's parents and to evaluate the mental health condition of AD children and QoL of their parents. Methods : We conducted elementary school visit education(the first education) and recruited children and parents who wanted to participate the hospital visit education(the Second education). In the first education, we lectured about AD, performed survey about QoL and awareness about AD and obtained 48 valid results. In the second education, we performed an education for AD again, skin condition evaluation, mental health analysis survey and obtained 29 valid results. We compared the AD and non-AD groups of each education in the first and second education. We assessed atopic awareness, FDLQI, DFI, CDI, BAI, and KISE scores by gender, age, duration of disease, onset, and severity of AD. Results : Despite children with AD, the survey showed their parents lacked knowledge about AD. However, they acquired the necessary knowledge in AD education. There was a significant difference in the total score of Atopic awareness between the AD group in the first education and the AD group in the second education. (p=0.042) In addition, the CDI and BAI scores of all patients were divided by the duration of disease, and it was estimated that depression and anxiety disorders may be aggravated by longer term illness. Conclusions and Discussions : This study confirmed duration of AD affects AD children's mental health, and verified positive changes in atopic awareness after AD education.

말초성 안면신경마비를 주소로 한방병원에 내원한 소아청소년기 환자 185례에 대한 임상적 특징 분석 (Clinical Characteristics Analysis of 185 Pediatric and Adolescent Patients Who Visited Korean Medicine Hospital with Peripheral Facial Nerve Paralysis)

  • 홍예나;유선애
    • 대한한방소아과학회지
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    • 제37권1호
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    • pp.58-72
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    • 2023
  • Objectives The purpose of this study is to analyze the latest clinical trends in peripheral facial nerve palsy pediatric and adolescent patients who treated in Korean medicine hospital. Methods The study was conducted based on 185 cases of pediatric and adolescent patients with peripheral facial nerve paralysis who visited Korean medicine hospital from January 2017 to June 2022. Results The mean age of onset of facial nerve paralysis in children and adolescents was 11.7 years, and the incidence rate was higher in boys than in girls. The seasonal distribution was the most common in autumn, and 91.4% were diagnosed with Bell's palsy. The recurrence rate was 7.6%. The severity was evaluated on the House-Brackmann Grading System (HBGS) scale, and the most common was Grade III. It took an average of 6.5 days from the date of onset to visit the hospital, and 75.7% visited the hospital within a week from the date of onset. Hospitalized treatment was 69.2%. The higher the HBGS grade, the more hospitalized treatment was, and the total number of treatments and the duration of treatment tended to increase. The average treatment period from the first visit date was 119.6 days. 17.8% received only Korean medicine treatment, and 69.2% took Western medicine with herbal medicine. Conclusions In this study, there was a difference in the average treatment period from previous studies according to the study period setting. Long-term studies on the recovery rate and prognosis of pediatric facial paralysis are needed.