• 제목/요약/키워드: First-visit Patients

검색결과 364건 처리시간 0.025초

Optimal First-Line Therapy for Acute Low-Tone Sensorineural Hearing Loss

  • Shin, Seung-Ho;Byun, Sung Wan;Park, Sohl;Kim, Eun Hye;Kim, Min Woo;Lee, Ho Yun
    • 대한청각학회지
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    • 제25권4호
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    • pp.209-216
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    • 2021
  • Background and Objectives: We aimed to analyze treatment outcomes following different initial management approaches and confirm treatment regimens for acute low-tone sensorineural hearing loss (ALHL) that would yield the best results. Subjects and Methods: We retrospectively analyzed the medical records of 106 patients with ALHL who visited a university hospital's otology clinic from March 2013 to June 2019. Pure-tone averages at the initial visit and at 2 and 4 weeks after the initial visit were evaluated. Results: Forty-nine patients were enrolled in this study; of them, 41 (83.7%) exhibited complete recovery (CR) at 2 weeks and 43 (87.8%) exhibited CR at 1 month after the initial visit. Regression analysis revealed that CR at 2 weeks after the initial visit was associated with diuretic use [Exp(B): 10.309, 95% confidence interval (CI): 1.007-100]. An initial daily low-dose steroid use was marginally significant [Exp(B): 1.042, 95% CI: 0.997-1.092; p=0.066]. Isolated diuretic use [Exp(B): 25.641, 95% CI: 1.121-90.909; p=0.039] was an independent, good prognostic factor at 1 month after the initial visit. However, other treatment regimens did not affect the final results. Conclusions: A combination of initial daily administration of ≤30 mg prednisolone plus diuretics was sufficient as the first-line treatment for ALHL. High-dose steroids and salvage intratympanic steroid injections can be applied as a second choice; however, the predicted outcome would not be good in that case.

C소아치과의원의 개량형 Dentocult-SM검사를 이용한 계속관리에 관한 조사 연구 (A study on the incremental oral health care of C pediatric clinic using a Dentocult-SM test)

  • 우희선
    • 한국치위생학회지
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    • 제8권2호
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    • pp.39-51
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    • 2008
  • The research was conducted to 100 child patients selected by random sampling, which got a Dentocult-SM test in the first visit and then was being continuously managed, out of child patients of a pediatric clinic located in Gyeonggi-do. The period of there search is one year from June 2007 to May 2008, Using Dentocult-SM test, we analyzed the correlation between the distribution of dental plaque, a streptococcus mutans in saliva and condition of dental caries cavity in the teeth of child patients, then we measured the distribution of a streptococcusmutans. According to SM score, we applied incremental oral heath care for child patients to clinical and obtained the following results, 1. In terms of the age of child patients in research, the number of 3 years old patients was 29(lst ranked), the number of 2 years old patients was 28(2nd ranked). 2. The result of SM score showed that female child patients(52.0%) was higher than male ones in negative, male child patients(52.0%) was higher than female ones in mild, female child patients(68.2%) was higher than male ones in moderate, male child patients(57.1%) was higher than female ones in severe. 3. At the first visit, the SM score showed statistically remarkable difference between dt and dmft. We can also confirm the average of severe is the highest. 4. At the second visit, the SM score showed statistically remarkable difference among dt, ft, and dmft index We can also confirm the average of severe is the highest. 5. At the third visit, The SM score showed statistically remarkable difference among dt, ft, and dmft index We can also confirm the average of severe is the highest. 6. The comparison of dmft index differences to SM score showed statistically no remarkable difference in incremental oral heath care for negative and mild, In addition to that, we can confirm that the incremental oral heath care makes statistically remarkable differences in moderate and severe. 7. The comparison of dt index differences to SM score showed statistically no remarkable difference in incremental oral heath care for negative, mild, and moderate, In addition to that, we can con firm that the incremental oral heath care makes statistically remarkable differences in severe. 8. The comparison of mt index differences to SM score showed statistically no remarkable difference in incremental oral heath care for mild and moderate, In addition to that, we can confirm that the incremental oral heath care makes statistically remarkable differences m severe. 9. The comparison of ft index differences to SM score showed statistically no remarkable difference in incremental oral heath care for mild, In addition to that, we can confirm that the incremental oral heath care makes statistically remarkable differences in negative, moderate, and severe. 10. According to the comparison of dmft index to the age, the 4 years old patients showed the highest number(5.50 in the first visit and 6,08 in the second one). In the third visit, the 6 years old patients showed the highest number(7.00). By the above results, we can find that the incremental oral heath care by SM score makes the results of oral care better. Therefore, the improvement or maintenance in oral health of child patients needs continuing personal oral health management and regular systematic management focused on prevention by the specialist.

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당뇨병 환자의 동반상병 점수에 따른 상급종합병원 이용 차이 (Differences between Diabetic Patients' Tertiary Hospital and Non-tertiary Hospital Utilization According to Comorbidity Score)

  • 조수진;정설희;오주연
    • 보건행정학회지
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    • 제21권4호
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    • pp.527-540
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    • 2011
  • Some patients tend to visit tertiary hospitals instead of non-tertiary hospitals for minor illnesses, which is a chronic problem within the Korean health care delivery system. In order to reduce the number of patients with minor severity diseases unnecessarily utilizing the tertiary medical services in Korea, the Ministry of Health and Welfare raised the outpatient co-insurance rate for the tertiary hospitals in July, 2009. Another increase in the prescription drug co-insurance rate by the general and tertiary hospitals is scheduled to take place in the second half of 2011. An increase in copayments may discourage the utilization rate of medical services among the underprivileged or patients who require complicated procedures. This study aims to analyze the diabetic patients' utilization rates of tertiary hospitals according to the Comorbidity score. Diabetic patients' data was gathered from the Health Insurance Claims Records in the Health Insurance Review & Assessment Service between 2007-2009. Comorbidity scores are measured by the Charlson Comorbidity Index and the Elixhauser Index. Chi-square and logistic regressions were performed to compare the utilization rates of both insulin-dependents (n=94,026) and non-insulin-dependents (n=1,424,736) in tertiary hospitals. The higher Comorbidity outcomes in the insulin-dependent diabetic patients who didn't visit tertiary hospitals compared to those who did, was expected. However, after adjusting the gender, age, location, first visits and complications, the groups that scored >=1 on the comorbidity scale utilized the tertiary hospitals more than the O score group. Non-insulin-diabetic patients with higher Comorbidity scores visited tertiary hospitals more than patients who received lower grades. This study found that patients suffering from severe diabetes tend to frequently visit the tertiary hospitals in Korea. This result implied that it is important for Korea to improve the quality of its primary health care as well as to consider a co-insurance rate increase.

지난 10년간 일 대학병원 정신건강의학과 소아청소년 초진환자 분포의 변화 (The Distributional Changes in the First-Visit Psychiatric Child and Adolescent Outpatients at a University Hospital over a Ten-Year Period)

  • 김효진;정성원;정철호
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제26권3호
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    • pp.165-175
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    • 2015
  • Objectives : The purpose of this study was to investigate changes in child and adolescent outpatients at a university hospital in Daegu from 2004 to 2013. Methods : The subjects were first-visit patients under 18 years old, who visited Dongsan Medical Center, Keimyung University, from January 1, 2004 to December 31, 2013. Computerized medical records of 2,738 patients (male 1,906, female 832) were reviewed. Results : The ratio of male to female was 2.3 : 1 in the period of study. The most prevalent age category was 7-9 years. The mean age was $10.12{\pm}4.68$ years ($9.84{\pm}4.59$ years in males, $10.76{\pm}4.81$ years in females). The ratio of child and adolescent patients to total outpatients was 27.0%. The most common diagnostic category was the attention-deficit hyperactivity disorder (ADHD) group, followed by the mental retardation (MR) group. In males, the ADHD, MR, communication disorder groups were more prevalent, but in females, the MR, ADHD, depressive disorder groups were more prevalent. Conclusion : The female to male ratio and total mean age were on the rise. The ADHD group was the most prevalent and the depressive disorder group was also on the rise in this period.

Visual Analog Scale을 사용하여 분석한 특발성 동결견 환자의 견부 통증 감소에 대한 전침의 효과 연구 (The Effect of Electroacupuncture Therapy with the Shoulder Pain of Frozen Shoulder Patients Analyzed by Visual Analogue Scale)

  • 손지형;임호제;이원희;정병주;한승혜;성수민;문성일
    • Journal of Acupuncture Research
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    • 제22권4호
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    • pp.27-34
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    • 2005
  • Objectives : To evaluate the pain improvement of the frozen shoulder patients taken the electro-acupuncture therapy using Visual Analogue Scale. Methods : The 38 frozen shoulder patients visited department of Acupuncture & Moxibustion in National Medical Center from 1st September 2004 to 28th February 2005 had taken the electroacupuncture therapy or body-acupuncture therapy more than 3 times.(Electroacupuncture group was 24 persons and body-acupuncture group was 14 persons.) We evaluated their improvement of shoulder pain using Visual Analog Scale(VAS) at each visit. Then we analyzed the pain improvement comparing with two groups. Results : Both VAS scores of electroacupuncture group and body-acupuncture group have significantly improved. VAS score at third visit of electroacupuncture group and body-acupuncture group have significantly improved. VAS score at third visit of electroacupuncture group was significantly lower than that of body-acupuncture group (p=0.0057). The decreased VAS score after first visit of electroacupuncture group was also significantly higher than that of body-acupuncture group(p=0.0225). Conclusion : The pain of electroacupuncture group decreased more than body-acupuncture group at early visit. But the total decreased VAS scores of two groups was not significantly different.

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A Pilot Clinical Study of the Efficacy and Safety of Phellinus Linteus (Sanghuang) Extract Treatment for Knee Osteoarthritis

  • Ryu, Hwa yeon;Lee, Hyun;Kang, Jae Hui
    • Journal of Acupuncture Research
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    • 제39권2호
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    • pp.115-121
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    • 2022
  • Background: To evaluate the efficacy and safety of Phellinus linteus (PL) extract for the treatment of knee osteoarthritis (KOA) a pilot clinical study was performed. Methods: There were 24 patients with KOA who enrolled in this double-blind, randomized, controlled, clinical trial. There were 3 groups: PL 1,000 mg/day (PL 1,000), PL 1,500 mg/day (PL 1,500), and dextrin 3,000 mg/day (placebo). Patients took capsules twice a day, 3 capsules at a time, over 8 weeks. Patients were monitored prior to treatment (Visit 1: Week 0), and followed up every 4 weeks (Visit 2: Week 4 and Visit 3: Week 8) where outcome measurements were taken. The primary outcome measure was the score from the Korean version of the Western Ontario and McMasters Universities from baseline to Week 8. The secondary outcomes were measurements from the visual analog scale, quality of life scale, erythrocyte sedimentation, and c-reactive protein. Adverse events were recorded at every visit. Results: The Korean version of the Western Ontario and McMasters Universities score showed the greatest improvement in symptoms of KOA in the PL 1,500 group compared with the placebo group. The erythrocyte sedimentation tended to decrease in the PL 1,500 group compared with the placebo group (which was within the normal range). The visual analog scale score decreased in all groups, with no significant differences between groups. No adverse events related to PL were reported. There were no abnormal hematological or physical findings. Conclusion: This pilot clinical trial was the first step to assess the efficacy and safety of PL used in the treatment of patients with KOA.

Incidence of interappointment emergencies in multiple-visit root canal treatments performed with or without intracanal medicament by undergraduate students

  • Annemarie Baaij;Corine Mirjam Visscher ;Manon Jansen ;Ahmet Rifat Ozok
    • Restorative Dentistry and Endodontics
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    • 제48권3호
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    • pp.31.1-31.11
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    • 2023
  • Objectives: This retrospective cohort study examined the incidence of interappointment emergencies during multiple-visit molar root canal treatments conducted by undergraduate students. Treatments performed without the use of intracanal medicament were compared to treatments that incorporated calcium hydroxide as an intracanal medicament. Materials and Methods: Interappointment emergencies, defined as instances of pain or swelling that required the patient to make an unscheduled follow-up visit, were recorded for up to 2 months after the intervention. To avoid the influence of obturation on the observed incidence of emergency visits, only unscheduled visits occurring between the start and end of the root canal treatment were included. Results: Of the 719 patients included in this study, 77 (10.7%) were recorded as experiencing interappointment emergencies. Of these emergencies, 62% occurred within 2 weeks following the most recent intervention. In the group of patients who did not receive intracanal medicament, the incidence of interappointment emergencies was 11.9% (46 of 385 patients). In comparison, this rate was 9.3% (31 of 334 patients) among those who received calcium hydroxide as an intracanal medicament (odds ratio, 1.33; 95% confidence interval, 0.82-2.15; p = 0.249). Conclusions: Interappointment emergencies may arise at any point during root canal treatment, but they most commonly occur within the first 2 weeks following intervention. The omission of intracanal medicament in multiple-visit molar root canal treatments, performed by undergraduate students, did not significantly increase the incidence of these emergencies.

두통 초진 환자에서 신경영상검사 소견 (Neuroimaging Findings of First-Visit Headache Patients)

  • 김병수;김수경;김재문;문희수;박광렬;박정욱;손종희;송태진;주민경;차명진;김병건;조수진
    • 대한신경과학회지
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    • 제36권4호
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    • pp.294-301
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    • 2018
  • Background: Neuroimaging can play a crucial role in discovering potential abnormalities to cause secondary headache. There has been a progress in the fields of headache diagnosis and neuroimaging in the past two decades. We sought to investigate neuroimaging findings according to headache disorders, age, sex, and imaging modalities in first-visit headache patients. Methods: We used data of consecutive first-visit headache patients from 9 university and 2 general referral hospitals. The International Classification of Headache Disorders, third edition, beta version was used in headache diagnosis. We finally enrolled 1,080 patients undertook neuroimaging in this study. Results: Among 1,080 patients (mean age: $47.7{\pm}14.3$, female: 60.8%), proportions of headache diagnosis were as follows: primary headaches, n=926 (85.7%); secondary headaches, n=110 (10.2%); and cranial neuropathies and other headaches, n=43 (4.1%). Of them, 591 patients (54.7%) received magnetic resonance imaging (MRI). Neuroimaging abnormalities were found in 232 patients (21.5%), and their proportions were higher in older age groups and male sex. Chronic cerebral ischemia was the most common finding (n=88, 8.1%), whereas 76 patients (7.0%) were found to have clinically significant abnormalities such as primary brain tumor, cancer metastasis, and headache-relevant cerebrovascular disease. Patients underwent MRI were four times more likely to have neuroimaging abnormalities than those underwent computed tomography (33.3% vs. 7.2%, p<0.001). Conclusions: In this study, the findings of neuroimaging differed according to headache disorders, age, sex, and imaging modalities. MRI can be a preferable neuroimaging modality to identify potential causes of headache.

탈모증 환자의 한의학적 임상 유형에 대한 연구 (A Study of Clinical features and classifications of alopecia patients in Korean medicinal clinic)

  • 이태후;문정배;정지행;임강현;김희택
    • 한방안이비인후피부과학회지
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    • 제22권3호
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    • pp.153-166
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    • 2009
  • Objectives : This study was planed to evaluate clinical status of the alopecia patients who had visited Korean medicine clinic. And the result from this study would provide a standard in Korean medical diagnostic and classification method of alopecia. Methods : Clinical records of 183 patients with alopecia seen from January 2004 to April 2005 at Korean medical clinic was examined. They were classified into 4 different types according to chief complains besides alopecia by 2 Korean medical doctors. Results and conclusions : We made clinical analysis of patients of alopecia from January 2004 to April 2005. Among the alopecia patients who visit Korean medical clinic, people age between 20 and 30 had high ratio. The duration from the recognition of initial hair loss to the time of the first visit to the Korean medical clinic was less than 12 months in 20.8%(38/138), and less than 60 months in 72.2% (132/183). The condition of alopecia was more worse than other alopecia patients who visit the west medical clinic. Also the ratio with increased temperature of face or scalp is chief complaint except alopecia in alopecia patients was high in men and the ratio with dysfunction of digestive system or chronic weakness was high in women. Among the incidence of alopecia, the androgenic alopecia was most in number; 43.7%(80/183) and the sex distribution showed 83 men and 100 women.

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관절가동술과 TENS가 만성요통환자의 통증역치 및 호르몬 변화에 미치는 영향 (The Effects of Joint Mobilization and TENS on Pain Threshold and Hormonal Changes in Patients with Chronic Low Back Pain)

  • 이승병;정성관;이호준
    • 대한정형도수물리치료학회지
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    • 제26권1호
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    • pp.65-72
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    • 2020
  • Background: The purpose of this research is to investigate the effects of joint mobilization and transcutaneous electrical nerve stimulation (TENS) on pain threshold and hormonal changes in patients with chronic LBP. Methods: 14 patients with chronic LBP were divided into the experimental group and the control group with 7 patients each, and both groups of patients were evaluated on pain duration, blood tests, and pressure pain threshold (PPT) on their first visit. On their second visit, joint mobilization was applied to the experimental group for 10 min and TENS to the control group for 20 min. Results: Pain threshold and duration of analgesia increased from after treatment in the experimental group. Serotonin and Cortisol decreased after treatment in the experimental group. Conclusion: Joint mobilization in patients with chronic LBP caused an increase in pain duration and pain thresholds and a decrease in serotonin, whereas there was little difference in cortisol.