• Title/Summary/Keyword: First-visit patient

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One Case of Myelodysplastic Syndrome Treated with Herbal Medicine (골수이형성증후군 환자의 한약을 사용한 치험 1례)

  • Hwang, Cho-Hyun;Kim, Eujin;Lee, Juyoung;Jang, Eungyeong;Lee, Jang-Hoon;Kim, Youngchul
    • The Journal of Internal Korean Medicine
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    • v.43 no.3
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    • pp.444-450
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    • 2022
  • Objectives: The aim of this study was to identify the effects of herbal medicine on the clinical symptoms and abnormal blood tests of a patient with myelodysplastic syndrome. Methods: A 64-year-old woman diagnosed with myelodysplastic syndrome in 2020 was prescribed Bojungikgi-tang-gagambang from January 6, 2022 to June 22, 2022 to reduce bleeding tendency and frequent defecation and to improve laboratory findings, such as platelet count. We observed changes in the symptoms and improvement of laboratory findings after six months of treatment. Results: In this study, approximately six months of treatment with Bojungikgi-tang-gagambang showed considerable improvement in laboratory findings and clinical symptoms, especially frequent defecation, petechiae, and gum bleeding, compared to the baseline parameters of the first visit. Also, no adverse effects, such as liver injury or decreased kidney function, were observed during herbal medicine treatment. Conclusion: This study suggests the availability of herbal medicine as a therapeutic option for managing patients with myelodysplastic syndrome.

Clinical Study for Objectification of Abdominal Examination with Functional Dyspepsia - Epigastric Diagnosis using Algometer (기능성 소화불량 환자의 복진진단 객관화를 위한 임상연구 - 알고미터를 이용한 심하비경 진단 -)

  • Choi, Gyu-Ho;Rho, Gi-Hwan;Choi, Seo-Hyung
    • The Journal of Korean Medicine
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    • v.43 no.1
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    • pp.1-5
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    • 2022
  • Objectives: Using algometer, measure the pressure pain threshold (PPT) of the epigastric pain(心下痞硬) and calculate the cut-off value, and this can serve as the basis for prognostic diagnosis of functional dyspepsia so we would like to evaluate its diagnostic value. Methods: We investigated 353 patients with functional dyspepsia symptoms who admitted Gangnam Weedahm Oriental Hospital from February 1, 2021 to February 27, 2021. At the time of the patient's visit, an oriental medical doctor measured the pressure at the first pain point on the Algometer of (CV14), twice each, at 1minute intervals. The ROC (receiver operating characteristic) curve and the optimal cut-off value derived through the diagnosis of the (CV14) PPT value for epigastric pain(心下痞硬) and the gold standard of oriental medical doctor, it was evaluated through. Results: In 353 patients, the area under the ROC curve (AUC) was 0.909 (p=0). In addition, the optimal cutting value was 10.05 (kg/cm2), which was statistically significant. Additionally, the sensitivity of the Algometer's PPT measurement was 0.704 and the specificity was 0.884. As a result, if the PPT value of the Algometer exceeds 10.05 (kg/cm2) in terms of the optimal cutting value, it can be seen that epigastric pain(心下痞硬) is lost. Conclusion: Algometer's PPT value measurement can be a reliable test method for quantification of epigastric pain(心下痞硬) diagnosis and can be useful as an objective indicator.

Development of antibiotic prescription guidelines for antibiotic prescription quality management (항생제 처방 질 관리를 위한 항생제 처방 지침의 개발)

  • Kim, Hyesung;Oh, Jeongkyu
    • Journal of Korean Academy of Dental Administration
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    • v.5 no.1
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    • pp.45-54
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    • 2017
  • The purpose of this article is to cope with the abuse of antibiotics in the clinic, to determine the necessity of antibiotic administration, to share information on the selection and proper use of appropriate antibiotics, and to increase the appropriateness of antibiotic prescription through continuous monitoring. In line with the latest research and guidelines trends of various agencies, we will supplement the antibiotic prescription guidelines and use them for the treatment in Apple Tree Dental Hospital. Specially, by history taking and the penicillin allergy test, amoxicillin is prescribed as a primary selective antibiotic for 1 day. The complaints and treatment effects of the first antibiotic should be evaluated at the next visit. If the primary antibiotic was ineffective, we replaced it with a broad-spectrum antibiotic. If there was no improvement in symptoms, the patient would be referred to upper grade hospital. The staff of the Apple Tree Dental Hospital regularly monitored and educated antibiotic prescriptions. The current guidelines should be supplemented continually and positively affect the abuse of antibiotics and the habit of dental practice.

Excessive Sweating and Widespread Pain in Fibromyalgia Syndrome after Long-term Stress Improved by Complex Korean Medical Treatment (장기간의 스트레스 이후 전신 다한증 및 광범위한 통증을 호소하는 섬유근통증후군 환자에 대한 복합 한의치험 1례)

  • Eunkyung Lee;Juyoung Lee;Minjeong Park;Jang-Hoon Lee;Youngchul Kim
    • The Journal of Internal Korean Medicine
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    • v.45 no.2
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    • pp.323-333
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    • 2024
  • Objectives: This case report describes the effect of complex Korean medical treatment on the clinical symptoms of a patient with fibromyalgia syndrome (FMS). Methods: A 60-year-old female woman diagnosed with FMS in 2015 was prescribed Youngsunjaetong-em-hap-Sopunghwalhyeol-tang from 2 May 2023 to 20 June 2023 to reduce excessive sweating and widespread pain. With the same objective, acupuncture, moxibustion, and cupping treatment were administered from 23 May 2023 to 11 June 2023. Changes in excessive sweating and widespread pain were recorded 2 months post-treatment. Results: Treatment with Youngsunjaetong-em-hap-Sopunghwalhyeol-tang led to a considerable improvement in clinical symptoms after 2 months, especially excessive sweating and widespread pain compared to the baseline parameters of the first visit. In addition, no adverse effects, such as liver injury or decreased kidney function, were recorded during the herbal medicine treatment. Conclusion: This case report points to the use of complex Korean medical treatment as a therapeutic option for the management of FMS.

A Study on Correlation between Anti-Obesity Effect and Safety According to Medication Period of Korean Medicine in Overweight and Obese Patients: A Retrospective Analysis (과체중 및 비만 환자의 복약기간에 따른 치료효과 및 안전성의 상관관계: 후향적 분석)

  • Hyeon Choi;Jung-Hun Nam;Hyuk-Jae Lee;Ki-Seong Seo
    • Journal of Korean Medicine for Obesity Research
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    • v.24 no.1
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    • pp.76-86
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    • 2024
  • Objectives: This retrospective study attempted to determine whether the treatment effect improves as the longer the medication for obese patients, also, analyzed whether the long medication increases the burden on liver function. Methods: The subjects were 278 overweight and obese female patients who took the herbal medicine Jibangsayak (JBSY) for more than 15 days. The correlation between the duration of medication and the treatment effect was confirmed, and the correlation with the safety was also analyzed. Results: JBSY significantly reduced all obesity-related measures after treatment. All these valuables before treatment were not factors in determining the duration of medication. As the duration increased, the body mass index (BMI) improvement decreased and lean body and muscle mass increased. As the duration was closer to 60 days, BMI improvement increased, and in more than 90 days group, the BMI and body fat percentage improvement stagnated as the duration longer. Aspartate aminotransferase (AST), alanine aminotransferase, and gamma-glutamyl transferase decreased after treatment. Additionally, AST decreased as the duration increased. Conclusions: This result suggests that not only the high obesity-related measures at first visit not lengthen the duration of JBSY medication. And liver function levels did not worsen as the duration increased. This result is different from the general perception that the longer the duration of medication, the greater the burden on patient's drug metabolism. However, the fact that other factors that could affect liver function could not be excluded and that kidney function evaluation should have been performed simultaneously are limitations of this study and require more detailed research in the future.

A Study on the Perceived Stress Level of Mothers in the Neonatal Intensive Care Unit Patients (신생아 중환자실에 입원한 환아 어머니의 스트레스)

  • Kim Tae Im
    • Child Health Nursing Research
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    • v.6 no.2
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    • pp.224-239
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    • 2000
  • This descriptive study was conducted to understand the contents and degree of parental stress level in the NICU patients, and to give a baseline data in developing nursing intervention program. Subjects were the 62 mother of hospitalized newborn in NICU of 1 University Hospital in Taejon City from May 1st, 1999 to November 30th, 1999, who agreed to take part in this study. The instrument used in this study were Parental Stressor Scales : NICU(PSS:NICU) developed by Miles et al. and validated by 3 NICU practitioners and 3 child health nursing faculties. The questionnaire has 4 dimensions and 45 items; sight and sounds of NICU(5 items), babies' appearance and behavior(19 items), parental role alteration and relationship with their baby(10 items), communication with health team(11 items). The questionnaire asks parents to rate each item on a five-point Likert type scale that ranges from (1) to (5). Total scores representing overall stress from the NICU environment are calculated by summing response to each item. A high score indicates high stress. A subscale score is calculated by summing the responses to each item in the subscale. Cronbach's α coefficients were .93. The data was analyzed as average, Frequency, Standard deviation, t-test, ANOVA, Pearson correlation coefficient by use of SPSS/PC+. The results of this study is summarized as follows ; 1. The total perceived stress level score of mothers was slightly high(3.6±.7). The highest scored dimension was 'appearance and behavior of the baby'(3.9±1.5), and next were 'relationship with their baby and parental role change'(3.5±1.4), 'communication with health team'(3.4±.9), 'sight and sounds of NICU'(3.2±.8). 2. Two variables were statistically significant with PSS:NICU total scale ; mother's perceived severity of the baby's condition (r=.482, P=.002) and mother's religious attendance(t=2.83, P=.01). The more the mother perceive their baby's condition severe, the higher the total stress score. There were high stress score noted in the mother of no religious attendance. 3. Four variables were statistically significant with NICU environment subscale ; mother's educational background(F=3.45, P=.04), religious attendance(t=2.28, P=.04), sex of the baby(t=2.83, P=.01) and NICU patients' hospital day(r=.359, P=.004). That is mother with high educational background and girl baby were high NICU environment subscale score. 4. Four variables were statistically significant with appearance and behavior of the baby subscale ; when first saw baby(F=3.52, P=.04), incubator care(t=2.83, P=.01), mother's perceived severity of the baby's condition(r=.303, P=.017), number of NICU visit(r=.441, P=.002). That is, seeing the baby first in the NICU and recieved incubator care was very stressful. Also, the more the mother perceive their baby's condition severe and more NICU visit, the higher the appearance and behavior of the baby subscale stress score. 5. Four variables were statistically significant with relationship with their baby and parental role change subscale ; when first saw baby(F=3.37, P=.04), sex of the baby(t=2.36, P=.03), incubator care(t=5.60, P=.00), mother's perceived severity of the baby's condition(r=.401, P=.001). That is, seeing the baby first in the NICU and girl baby was very stressful. Also, the more the mother perceive their baby's condition severe, the higher the relationship with their baby and parental role change subscale stress score. 6. Three variables were statistically significant with communication with health team subscale ; mother's educational background (F=3.63, P=.04), incubator care(t=4.24, P=.00), gestational age(r=-.394, P=.047), and birth weight(r=-.460, P=.004). That is, mother with high educational background and receiving incubator care were high communication with health team subscale score. Also, the shorter the gestational age and smaller the baby's birth weight, the higher the communication with health team subscale score. In conclusion, information about physical environment of NICU, the mother's perceived severity of baby's illness state, maternal role change related variables and the knowledge of characteristics of NICU patients must be included in nursing intervention program of mother's of NICU patients in reducing the maternal stress and anxiety level.

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Estimating the Economic Burden of Osteoporotic Vertebral Fracture among Elderly Korean Women (우리나라 노인여성의 골다공증성 척추골절로 인한 경제적 부담 추계)

  • Kang, Hye-Young;Kang, Dae-Ryong;Jang, Young-Hwa;Park, Sung-Eun;Choi, Won-Jung;Moon, Seong-Hwan;Yang, Kyu-Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.5
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    • pp.287-294
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    • 2008
  • Objectives : To estimate the economic burden of osteoporotic vertebral fracture (VF) from a societal perspective. Methods : From 2002 to 2004, we identified all National Health Insurance claims records for women ${\geq}50$ years old with a diagnosis of VF. The first 6-months was defined as a "clearance period," such that patients were considered as incident cases if their first claim of fracture was recorded after June 30, 2002. We only included patients with ${\geq}$ one claim of a diagnosis of, or prescription for, osteoporosis over 3 years. For each patient, we cumulated the claims amount for the first visit and for the follow-up treatments for 1 year. The hospital charge data from 4 hospitals were investigated to measure the proportion of the non-covered services. Face-to-face interviews were conducted with 106 patients from the 4 study sites to measure the out-of-pocket spending outside of hospitals. Results : During 2.5 years, 131,453 VF patients were identified. The patients had an average of 3.38 visits, 0.40 admissions and 6.36 inpatient days. The per capita cost was 1,909,690 Won: 71.5% for direct medical costs, 20.6% for direct non-medical costs and 7.9% for indirect costs. The per capita cost increased with increasing age: 1,848,078 Won for those aged 50-64, 2,084,846 Won for 65-74, 2,129,530 Won for 75-84and 2,121,492 Won for those above 84. Conclusions : Exploring the economic burden of osteoporotic VF is expected to motivate to adopt effective treatment options for osteoporosis in order to prevent the incidence of fracture and the consequent costs.

A Study on Illness Behavior of Panic Disorder Patients (공황장애 환자의 질환행동에 관한 연구)

  • Kim, Sang-Soo;Je, Young-Myo;Kim, Sang-Yeop;Lee, Dae-Soo;Lee, Sung-Ho;Choi, Eun-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.6 no.2
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    • pp.104-119
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    • 1998
  • This study was conducted to determine the important factors in the illness behavior of panic disorder patients. And then, find the best ways to lead the patients who have recurrent panic attacks to the adequate therapeutic situations. We studied 53 patients diagnosed as panic disorder according to DSM-IV among the outpatients who had been followed up at Bong Seng Memorial Hospital for 6 Ms, from May 1997 to October 1997. To evaluate the illness behaviors, we designed a checklist including socio-demographic data, degree of subjective distress from medical and psychiatric treatment, panic symptoms, life events, places of help-seeking, Anxiety Sensitivity Index. Using the checklist, we had semistructured interviews with the panic disorder patients to elucidate their help-seeking behaviors from first panic attack to diagnosing as panic disorder. The results were as follows ; 1) After first panic attack, the patients initially sought help at 1) Emergency room 40%, 2) Rest &/or Personal emergency care 35%, 3) Pharmacy 10%, 4) Outpatient care at hospital 10%, 5) Oriental medicine 5%. 2) Considering the panic symptoms, derealization, paresthesia and the severity of panic symptoms were the most important factors affecting the patient's help-seeking behaviors who had experienced the first panic attack. 3) Most of all the patients (80%) were apt to visit the hospitals within 15 days after experiencing about 3 panic attacks. 4) Before diagnosed as panic disorder, the patients had visited 3-5 health care centers during about 1 year. 5) Primary care physicaians(for example, emergency care physicians, family doctors and internists) had the most important roles in treating or guiding the patients to the adequate therapeutic situations. From the above results, the authors propose that non-psychiatric physicians have to know the panic disorder or attacks exactly. When patients complaint sudden onset physical symptoms e.g. palpitation, dyspnea, dizziness or the cognitive symptoms like the fear of death or insanity, physicians should consider the possibility of panic attack and encourage the patients to be evaluated for psychiatric illness.

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Childhood Trauma and Pharmacotherapy Retention among Outpatients with Panic Disorder (공황장애 외래 환자의 아동기 외상과 약물치료 유지)

  • Kim, Dong Joo;Kim, Daeho;Lee, Jinbok;Kim, Yaeseul;Sohn, Sujin
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.1
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    • pp.53-62
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    • 2020
  • Objectives : This study investigated lifetime experiences of trauma, treatment retention, and psychiatric symptoms among outpatients with panic disorder after initiation of pharmacotherapy. Our research hypothesis was that panic patients with childhood trauma would display more severe symptoms and less treatment retention compared to those without such history. Methods : A total of 135 first-visit outpatients with DSM-IV panic disorder were approached during the period from March 2012 to August 2016. Fifty-three patients (39%) either refused or returned incomplete questionnaires, leading to a final sample size of 82. Participants completed the Trauma History Screen, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Abbreviated PTSD checklist. Results : The number of lifetime trauma was significantly correlated with treatment retention (rho=-0.269, p=0.015). Among subtypes of trauma, only childhood physical abuse was significantly correlated with treatment retention (rho=-0.298, p=0.007). Conclusions : Our results indicated that psychological trauma, particularly of an interpersonal nature from childhood, can affect pharmacotherapy treatment retention in panic disorder. This may be mediated by poor patient-doctor relationships originating from trust issues among childhood trauma survivors or lack of perceived improvement due to the more severe symptoms and unfavorable course experienced by those with childhood trauma. Further studies are needed to explore the reasons for poor treatment adherence in this population.

A Case Report about Treatment of Childhood Conversion Disorder with Psychotherapy of Oriental Medicine -The Giungoroen(至言高論), Supportive Psychotherapy and Behavioral Therapy- (한의학 정신요법을 이용한 소아 전환장애 환자 1례 - 지언고론요법(至言高論療法), 지지적 정신치료와 행동치료 -)

  • Suh, Hyun-Uk;Suh, Jin-Woo;Hwang, Eun-Young;Kim, Jong-Woo;Jung, Sun-Young
    • Journal of Oriental Neuropsychiatry
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    • v.20 no.4
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    • pp.185-196
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    • 2009
  • Objectives : This case report presents a 7-year-old female patient diagnosed with conversion disorder improved by application of oriental medical psychotherapy, the Giungoroen. Her chief complaint was dysesthesia of anal. Methods : Through interview and several psychological testing such as HTP test, DAF test, JTCI 7-11, we assessed her psychological state and seek for the psychological reason induced her physical symptom, dysesthesia of anal. After assessment we concluded her main psychological problem was loss of love relationship with her parents. So we decided to use supportive psychological therapy and behavioral therapy-like changing upbringing attitudes of her parents, for example- with Herbal medicine treatment. Results : After 2-month of therapeutic period, chief physical symptom of patient-dysesthesia of anal-was reduced to 20% compared with first visit day. Conclusions : The Giungoroen corresponds to supportive psychotherapy and behavioral therapy. And this oriental medical psychotherapy is fairly effective on the treatment of conversion disorder in childhood.

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