• 제목/요약/키워드: Geriatric medicine

검색결과 298건 처리시간 0.023초

항암 치료가 불가한 고령의 4기 담낭암 환자 한방치험 1례 (Single Case Report of a Stage IV Geriatric Gallbladder Cancer Patient treated with Korean Medicine Who Could Not Receive Conventional Therapies)

  • 류한성;오혜경;이지영;윤성우
    • 대한암한의학회지
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    • 제21권1호
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    • pp.27-33
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    • 2016
  • Background : This case is to report a gallbladder cancer patient treated with Korean Medicine who could not receive conventional cancer therapies such as operation and chemotherapy due to her underlying diseases, old age and poor performance. Method and Results : An eighty-year-old female patient was diagnosed with stage IV gallbladder cancer on Feb. 2014 and she already had hypertension, diabetes and Parkinsonism. Comprehensive Korean Medicine (KM) treatments instead of operation and chemotherapy were administrated due to her poor condition and old age. KM treatments were done focused on improving symptoms and quality of life combined with best supportive care. During KM treatments her abdominal pain was generally managed and she survived for 22 months. Conclusion : Further studies should be performed in the future to clarify the survival benefit and symptom management of comprehensive KM treatments.

Surgical Treatment of Lumbar Spinal Stenosis in Geriatric Population : Is It Risky?

  • Kim, Dong-Won;Kim, Sung-Bum;Kim, Young-Soo;Ko, Yong;Oh, Seong-Hoon;Oh, Suck-Jun
    • Journal of Korean Neurosurgical Society
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    • 제38권2호
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    • pp.107-110
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    • 2005
  • Objective : Lumbar spinal stenosis is increasingly recognized as a common cause of low back pain in elderly patients. Conservative treatment has been initially applied to elderly patients, however, surgical treatment is sometimes indispensable to relieve severe pain. We retrospectively examine the age-related effects on the surgical risk, and results following general anesthesia and operative procedure in geriatric patients for two different age groups of at least 65years old. Methods : Consecutive 51 patients [${\ge}$ 65years], who underwent open surgical procedure for degenerative lumbar spinal stenosis, were selected in the study. Patients were divided into two groups. Group A included all patients who were between 65 and 69years of age at the time of surgery. Group B included all patients who were at least 70years of age at the time of surgery. We reviewed medical history including preoperative American Society of Anesthesiologists[ASA] classification of physical status, anesthetic risk factor, operative time, estimated blood loss, transfusion requirements, hospital stay, operated level, and clinical outcome to look for comparisons between two age groups [$65{\sim}69$ and over 70years]. Results : In preoperative evaluation, mean anesthetic risk factor of patients was numerically similar between the groups. The American Society of Anesthesiologists classification of physical status was similar between two groups. There was no difference in operated level, operative time, estimated blood loss, hospital stay, and anesthetic risk factor between the two groups. The clinical successful outcome showed 82.7% for Group A and 81.8% for group B. The overall postoperative complication rates were similar for both group A and B. Conclusion : We conclude that advanced age per se, did not increase the associated morbidity and mortality in surgical decompression for spinal stenosis.

장기요양시설 요양보호사의 구강건강관리에 대한 지식, 태도, 행동 (Knowledge, Attitude, and Behavior Status on Oral Health Care of Geriatric Care Workers in Long-Term Care Facilities)

  • 전현선;한선영;정원균;최종훈
    • 치위생과학회지
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    • 제15권5호
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    • pp.569-576
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    • 2015
  • 본 연구는 요양보호사의 구강관리교육 프로그램에 필요한 근거를 마련하기 위해 전국 장기요양시설에 근무하는 요양보호사를 대상으로 구강관리교육 실태와 관련 지식, 태도 및 행동을 설문조사하여 다음과 같은 결과를 얻었다. 연구대상자의 27.9%가 구강관리에 관한 교육을 수혜한 경험이 있다고 하였고, 배운 내용으로는 틀니관리와 이 닦기 방법이 90%로 가장 많았다. 그리고 연구대상자들의 구강관리에 대한 지식수준을 확인한 결과, 노인이 복용하는 약물의 부작용, 오연성 폐렴과 치태의 연관성, 잇몸질환, 틀니세척 방법, 와상노인의 구강위생관리에 대한 지식이 부족함을 알 수 있었다. 입소노인의 구강관리의 책임자로서 연구대상자들의 태도수준은 총 10개의 조사 문항 중 8개 문항에서 3점 이상(5점 만점)의 높은 동의수준을 보였으며, 노인의 구강관리를 제공하기 어려운 이유로 구강관리 방법에 대한 어려움(46.4%), 지식의 부족(27.1%) 순으로 응답하였고, 치과의사와 치과위생사가 업무수행에 도움자로서 매우 필요하다(57.3%, 52.9%)고 생각하였다. 이러한 결과를 통해 연구대상자들은 요양시설 입소노인에게 구강관리를 제공하기 위한 태도는 높았지만, 이와 관련한 교육이 부족하며 구강관리업무를 수행하는 데 있어 전문가의 도움이 필요하다는 것을 확인하였다.

만성 폐쇄성 폐질환자에서 척추 마취후 발생한 경련발작 1례 (A Case of Convulsive Seizure Following Spinal Anesthesia in a Geriatric Patient with COPO)

  • 서일숙
    • Journal of Yeungnam Medical Science
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    • 제5권2호
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    • pp.213-219
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    • 1988
  • 만성폐쇄성 폐질환을 동반한 노인환자에서 척추마취하에서 치골상부 전립선 절제술을 시행하는 도중 척추마취와는 무관한 것으로 사료되는 원인 불명의 경련 발작 및 혈압강하가 초래된 환자가 발생하였기에 그 원인을 규명하고 문헌적 고찰과 함께 보고하는 바이다.

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Mechanisms and Control Strategies of Antibiotic Resistance in Pathological Biofilms

  • Luo, Ying;Yang, Qianqian;Zhang, Dan;Yan, Wei
    • Journal of Microbiology and Biotechnology
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    • 제31권1호
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    • pp.1-7
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    • 2021
  • Bacterial biofilm is a community of bacteria that are embedded and structured in a self-secreted extracellular matrix. An important clinical-related characteristic of bacterial biofilms is that they are much more resistant to antimicrobial agents than the planktonic cells (up to 1,000 times), which is one of the main causes of antibiotic resistance in clinics. Therefore, infections caused by biofilms are notoriously difficult to eradicate, such as lung infection caused by Pseudomonas aeruginosa in cystic fibrosis patients. Understanding the resistance mechanisms of biofilms will provide direct insights into how we overcome such resistance. In this review, we summarize the characteristics of biofilms and chronic infections associated with bacterial biofilms. We examine the current understanding and research progress on the major mechanisms of antibiotic resistance in biofilms, including quorum sensing. We also discuss the potential strategies that may overcome biofilm-related antibiotic resistance, focusing on targeting biofilm EPSs, blocking quorum sensing signaling, and using recombinant phages.

노인환자 스크리닝 결과와 낙상위험도 간의 관계 (Associations Between Classification of the Geriatric Screening for Care-10 and the Morse Fall Scale)

  • 김윤숙;이종민;최재경;신진영;한설희
    • 한국의료질향상학회지
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    • 제23권2호
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    • pp.69-78
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    • 2017
  • Background: The purpose of this study was to examine associations between classification of the Geriatric Screening for Care-10 (GSC-10) and the Morse Fall Scale (MFS) among elderly inpatients. Methods: Among elderly inpatients aged over 65 admitted to hospital (from November 1, 2016 to July 31, 2017), the data for 5,780 patients (who were evaluated using the Morse Fall Scale and the Geriatric Screening for Care-10) were analyzed using x2-tests and t-tests to examine differences between the GSC-10 and MFS, according to general characteristics of elderly inpatients (i.e., gender) using IBM SPSS Statistics 24. Results: : Scores for the GSC-10 were significantly higher in women than men for depression (p<.001), delirium (p=.048), functional decline (p<.001), incontinence (p<.001), and pain (p<.001). Statistically significant differences in all domains of the GSC-10 for elderly hospitalized patients were found for the classification of fall risk. Conclusion: The findings of this study, as supported by the GSC-10, indicate that the most common problems experienced by the elderly are related to the risk of falling. In order to reduce the incidence of falls in elderly inpatients, customized fall prevention based on the GSC-10 results is necessary.

CT Evaluation of Age-Related Changes in Epaxial Muscle Attenuation and Cross-Sectional Area for Sarcopenia and Myosteatosis in Small Breed Dogs

  • Ji Yeong Lee;Tae Sung Hwang;Hee Chun Lee
    • 한국임상수의학회지
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    • 제40권3호
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    • pp.182-188
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    • 2023
  • Sarcopenia and myosteatosis can increase the risk of adverse effects in dogs and humans. However, such imaging study results for evaluating sarcopenia and myosteatosis in small dogs have not yet been available. The objective of this study was to assess age-related changes according to the breed in epaxial muscle cross-sectional area (CSA) and fat infiltration using CT to evaluate sarcopenia and age-related myosteatosis in small breed dogs. In 144 dogs (92 Maltese dogs, 27 Poodle dogs, and 25 Shih Tzu dogs), Hounsfield Unit (HU) values and CSA of left epaxial muscle were measured at the thirteenth thoracic vertebral level on non-contrast transverse CT images. Differences in HU values and CSA according to age and breed were analyzed. The geriatric group (≥12 years) had significantly lower HU values of epaxial muscle than mature adult group (2 to 6 years) of all breeds. The geriatric group had significantly lower CSA of epaxial muscle than mature adult and senior groups (7 to 11 years) of Maltese dogs. HU values of epaxial muscle were not significantly different among all age groups of all breeds. Maltese dogs had significantly lower CSA of epaxial muscle than Poodle and Shih Tzu dogs in all age groups. Results of this study showed that as age increased in small breed dogs, muscle mass and density decreased.

복약 정보 관리를 위한 NFC기반 u-Drug Cap 개발 (The Development of u-Drug Cap based on NFC for Medication Information Management)

  • 윤태복;이종희;이광형
    • 한국산학기술학회논문지
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    • 제16권3호
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    • pp.2165-2171
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    • 2015
  • 최근 생활환경의 개선과 의학기술의 발달로 인해 성인병 질환을 앓고 있는 환자의 경우 병원 입원 치료 보다는 통원치료를 통한 주기적인 약물 복용이 증가하고 있다. 이러한 성인병 환자의 경우 주기적인 약물 치료가 유지되기 위해 복약관리에 보다 많은 관심이 요구되고 있다. 본 논문에서는 환자의 주기적이고 안정적인 복약을 위한 NFC 기반의 u-Drug Cap 을 이용한 복약정보 서비스 시스템을 제안하고 개발된 시스템과 테스트 결과를 기술한다. 개발된 시스템은 성인병을 앓고 있는 환자나 고령 환자의 올바른 복약 지도 및 알람을 통해 약품 미복용 및 오복용 방지함으로써 환자의 건강 유지가 가능할 것으로 기대된다.

Success rate of nitrous oxide-oxygen procedural sedation in dental patients: systematic review and meta-analysis

  • Rossit, Marco;Gil-Manich, Victor;Ribera-Uribe, Jose Manuel
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제21권6호
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    • pp.527-545
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    • 2021
  • The aim of this systematic review was to determine the success rate of nitrous oxide-oxygen procedural sedation (NOIS) in dentistry. A systematic digital search was conducted for publications or reports of randomized controlled trials evaluating the clinical performance of NOIS. Abstracts of research papers were screened for suitability, and full-text articles were obtained for those who met the inclusion and exclusion criteria accordingly. The quality of the studies was assessed using the revised Cochrane risk-of-bias tool (RoB 2). A total of 19 articles (eight randomized clinical trials with parallel intervention groups and 11 crossover trials), published between May 1988 and August 2019, were finally selected for this review. The studies followed 1293 patients reporting NOIS success rates, with a cumulative mean value of 94.9% (95% CI: 88.8-98.9%). Thirteen trials were conducted on pediatric populations (1098 patients), and the remaining six were conducted on adults (195 patients), with cumulative efficacy rates of 91.9% (95% CI: 82.5-98.1%) and 99.9% (95% CI: 97.7-100.0%), respectively. The difference was statistically significant (P = 0.002). Completion of treatment and Section IV of the Houpt scale were the most used efficacy criteria. Within the limitations of this systematic review, the present study provides important information on the efficacy rate of NOIS. However, further well-designed and well-documented clinical trials are required and there is a need to develop guidelines for standardization of criteria and definition of success in procedural sedation. Currently, completion of treatment is the most used parameter in clinical practice, though many others also do exist at the same time. To maximize NOIS efficacy, clinicians should strictly consider appropriate indications for the procedure.

CONTINUOUS-TIME MARKOV MODEL FOR GERIATRIC PATIENTS BEHAVIOR. OPTIMIZATION OF T도 BED OCCUPANCY AND COMPUTER SIMULATION

  • Gorunescu, Marina;Gorunescu, Florin;Prodan, Augustin
    • Journal of applied mathematics & informatics
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    • 제9권1호
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    • pp.185-195
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    • 2002
  • Previous research has shown that the flow of patients around departments of geriatric medicine and ex-patients in the community may be-modelled by the application of a mixed-exponential distribution. In this proper we considered a ave-compartment model using a continuous-time Markov process to describe the flow of patients. Using a M/ph/c queuing model, we present a way of optimizing the number of beds in order to maintain an acceptable delay probability a sufficiently low level. Finally, we constructed a Java computer simulation, using data from St George's Hospital, London.