• 제목/요약/키워드: History taking

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A medical history taking system using Symptom2Vec (Symptom2Vec 을 활용한 병력 청취 시스템)

  • Kim, Min-Ji;Jee, In-whee
    • Annual Conference of KIPS
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    • 2022.11a
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    • pp.411-413
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    • 2022
  • 임상 환경에서 진료시간의 대부분은 환자의 증상을 듣고, 추가 증상을 이끌어내는데 사용된다. 이를 병력 청취라고 하며, 진료에 있어서 가장 기본적이고 필수적인 활동이다. 하지만 병력 청취에 대한 연구가 1940 년대부터 계속되고 있음에도 아직까지 표준이 정립되지 않았으며, 다양한 분야에 접목되는 딥러닝 기술 또한 병력 청취와 관련해서는 연구가 부족한 현실이다. 본 논문에서는 Symptom2Vec 을 새롭게 제안하였으며, 이를 활용하여 질병에 따른 증상의 평균 cosine 유사도 점수(0.962)로 병력 청취의 기준을 확립하였다. 또한 most similar word Top5 를 확인하는 것을 통해 환자의 증상에 따른 유사 증상을 묻는 병력 청취가 가능한 것을 확인하였다. 이를 통해 실제 임상 환경에서의 자동화된 병력 청취 시스템을 제안한다.

Surgical Repair of Diaphragmatic Hernia-Related Small Intestinal Strangulation in a Neonatal Foal

  • Jungho Yoon;Jeechan Choi;Soomin Ko;Ahram Kim
    • Journal of Veterinary Clinics
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    • v.40 no.5
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    • pp.354-359
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    • 2023
  • This case report describes the clinical presentation and successful surgical repair of a diaphragmatic hernia-related small intestinal strangulation in a neonatal foal. A nine-day-old foal presented with colic signs and respiratory distress. History taking showed that the dam of the foal experienced difficulty during delivery, and the owner assisted in delivery by pulling on the foal. Radiography and ultrasonography confirmed the diaphragmatic rent and the presence of a small intestine within the thoracic cavity. Surgical intervention was required to repair the diaphragmatic defect and address the intestinal strangulation. The diaphragm was reconstructed, and the nonviable incarcerated portion of the small intestine was resected and anastomosed using an end-to-end technique. This unusual case report provides insights into the surgical repair and outcomes of an acquired diaphragmatic hernia in a neonatal foal.

Health-related Quality of Life in Elderly Asian American and Non-Hispanic White Cancer Survivors

  • Suzanne Vang
    • Journal of Preventive Medicine and Public Health
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    • v.56 no.5
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    • pp.440-448
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    • 2023
  • Objectives: The purpose of this study was to assess predictors of health-related quality of life (HRQoL) in elderly Asian American and non-Hispanic White cancer survivors. Methods: We conducted cross-sectional secondary data analyses using the combined datasets from the Surveillance, Epidemiology, and End Results program and the Medicare Health Outcomes Survey. Results: Elderly Asian American cancer survivors reported a lower mental HRQoL but a comparable physical HRQoL relative to elderly non-Hispanic White cancer survivors. Stress factors, such as comorbidities, difficulties with activities of daily living, and a history of depressive symptoms, along with coping resources like self-rated health and the ability to take the survey in English, were significantly associated with mental and physical HRQoL. Among elderly Asian American cancer survivors, a significantly lower mental HRQoL was observed among those taking the survey in the Chinese language. Conclusions: The findings suggest that race exerts a differential impact on HRQoL. Interventions should be designed to address the distinct cultural, linguistic, and systemic needs of elderly Asian American cancer survivors. Such an approach could assist in reducing cancer-related health disparities.

A suspicious clinical case of goiter in aquarium-reared blood parrot cichlid (Amphilophus citrinellus × Vieja melanurus) with subsequent regression by Iodide administration

  • Sang-Ho Choi;Jeong-Ho Kim
    • Journal of fish pathology
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    • v.37 no.1
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    • pp.155-158
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    • 2024
  • A blood parrot (Amphilophus citrinellus × Vieja melanurus) cichlid showing a flared left operculum was sent to the Fish Disease Clinic. The fish showed intermittently irregular ventilation and reddish soft swellings located at the ventral part of the left branchial cavity for one month. Other abnormal symptoms were not observed, and the appetite was normal. Only a putative diagnosis was conducted based on the history taking and external symptoms because the owner did not want an invasive biopsy or other potentially stressful examination of the fish. Therefore, considering the information available and the treatability, goiter (thyroid hyperplasia) was suspected as the top differential diagnosis, and the empirical treatment of administering iodide (0.03~0.015ppm) in environmental water was conducted. The treatment was discontinued for six months because the swelling was noticeably reduced. Body color became pale, but other abnormal signs were not observed.

Evaluation of NSAID Usage and Appropriateness for Prevention of NSAID-Related Ulcer Complications (비스테로이드소염제로 인한 궤양 합병증 예방을 위한 비스테로이드소염제 사용 현황 및 적절성 평가)

  • Cho, Jungwon;Lee, Eunsook;Shin, Wan Gyoon
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.3
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    • pp.211-219
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    • 2012
  • Nonsteroidal antiinflammatory drugs (NSAIDs) are used in the treatment of extensive diseases related to various symptoms; inflammation, pain and fever. NSAIDs work by blocking prostaglandin synthesis, but adverse drug events (ADEs) have been increasing dramatically such as gastrointestinal bleeding, perforation and stenosis, a kind of serious ADEs. Therefore, NSAID-related ulcer complication guidelines have been announced containing various risk factors and symptoms. Thus, this study aims to evaluate of NSAID usage and appropriateness for prevention of NSAID-related ulcer complication based on American journal of gastroenterology (AJG) guideline 2009. Further, the study suggests Korean guideline for prevention of NSAID-related ulcer compared to AJG guideline. For this study, data was collected through electronic medical record (EMR) at Seoul national university of Bundang hospital. The primary end point was a composite of NSAID-related ulcer risk factor, types of NSAIDs, co-prescribed NSAID ulcer prevention drugs and NSAID-related ulcer after taking NSAID. The risk factors include over 65 years, high dose NSAID, previous ulcer history and taking drugs (e.g. aspirin, anticoagulant and steroid) causing ulcer. If a patient has 3 or 4 factors, that patient was classified high risk group. And if 1 or 2 factors that patient was classified moderate risk group. The patient who has no risk factor was in low risk group. I studied 8,120 patients who received NSAID from 1 January 2009 to 31 December 2009. High risk group was 16(0.2%), moderate risk group was 4,364(53.7%), and low risk group was 3,740(46.1%). The results show that high risk group should be prescribed COX-2 inhibitors with ulcer prevention drugs, and moderate or low risk group need traditional NSAIDs with ulcer prevention drugs. This may be different with 2009 AJG guideline because AJG guideline suggested taking COX-2 inhibitor alone in moderate group or taking traditional NSAID alone in low risk group could get higher ulcer complication. The results indicated that choosing preventive drug is important in case that how many risk factors the patients have. The proper drugs would be helpful for safe and effective NSAID usage in each patient group.

Effects of Liver Function in Blood of Drug Users(Herbal and Western) in Koreans (한.양약 복용이 간기능에 미치는 영향-피부과치료 한약복용 환자를 중심으로-)

  • Lee Jung-Seok;Lee Sun-Dong
    • Journal of Society of Preventive Korean Medicine
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    • v.8 no.1
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    • pp.59-74
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    • 2004
  • We have conducted questionnaire and measured serum liver function tests on 153 patients whom have received a treatment at a local Oriental medicine clinic in Seoul from Sept. 1, 2002 to Dec. 31, 2002. Patients were categorized into the groups of control(10), decoction group(41), herbal group(5), western medicine group(45), and the group taking both herbal and western medicines(55) concurrently or separately. This study was conducted to investigate how these treatment methods can affect the liver functions. Following results were obtained : 1) Most of the research subjects were male(l03 individuals) living in large urban area, with drinking habit, highly educated, and with normal marriage. For the treatment history, 45 individuals received western medicine treatment(28.85%), 46 with Oriental medicine (29.49%), and 55 patients(35.26%) experienced both forms of treatment. 2) Measuring SD of serum liver functions for all the research subjects, T-protein was 6.95(0.73)g/dl, 4.07(0.51)g/dl for albumin, 0.44(0.19)mg/dl for T-bilirubin, 23.18(18.68)U/L for ALT, 27.42(27.43)U/L for AST, and 22l.27(64.58)mg/dl for LDH. 3) Among the research subjects with the liver functions outside of normal range were 0.64% for T-protein, 3.21% for T-bilirubin and ALT, 36.62% for AST, 0.64% for LDH, and none for Albumin. 4) Confusion variables which may affect the liver functions such as age, smoking, drinking, occupation, and residence were eliminated in calculation and no significant differences were witnessed between the control and experiment groups. 5) In measuring affects of treatment duration on the liver functions, no statistical significances were shown in multiple regression's ,${\beta}$(SE) values. 6) The values of odd ratio in the experiment groups compared to the control were in the range of $0.26(0.22){\sim}0.62(1.23)$. but T-bilirubin of the group receiving both Oriental and western medicine was 1.47(1.90) which showed statistical increase(p<0.001). 7) Factors affecting the liver functions are drinking volume per round duration of alcohol intake, western medicine treatment, gender, and age difference caused significant influences. 8) 57 individuals with serum liver functions out of normal range were mostly male, living in large urban area, median age of 38.89, with normal marriage, highly educated drinking less than once a week with less than 2 bottles per round, and with prior treatment in either western or Oriental medicine. Summarizing above results, we can carefully deduce that taking herbal medicine (both decoction and pills) or western medicine doesn't cause much affect in the liver functions. But taking two forms of medication simultaneously or altering dosage affect significant increase in the T-bilirubin level, thus one needs to take precaution when taking both. Further research is needed in this field to verify this evidence.

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The effects of behavior of preventive treatment on job satisfaction in dental hygienist (치과위생사의 예방처치업무행태가 직무만족에 미치는 영향)

  • So, Mi-Hyun;Kim, Sun-Sook
    • Journal of Korean society of Dental Hygiene
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    • v.11 no.6
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    • pp.951-959
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    • 2011
  • Objectives : The author has studied the effects of behavior of preventive treatment on job satisfaction in dental hygienist. Methods : The hygienists who had worked from June 27th to August 1st in 2011 were explained about this research objectives and only the hygienists who agreed with this research participation were conducted a self-administered Questionnaire survey and the results were collected immediately. The collected questionnaire was 297, but the final 250 questionnaire were decided as a target except for the trustless ones. This analysis was extracted using SPSS(SPSS 12.0 for windows, SPSS Inc, Chicago, USA). Results : 1. Preventive treatment of dental hygienist was shown as this order - Educational needs 4.25, Importance 4.12, Usefulness 4.09, Perform 3.42. Job satisfaction was reached the moderate level. 2. Analysis of preventive treatment of hygienist was shown as this order - Basic brushing education 4.72 was ranked the highest, Taking patient history and Incremental dental health care 4.58 was held the second place. Dental caries activity tests 3.30 was shown the lowest figures. Response of preventive treatment conducting was like this order - Taking patient history 4.30, Dental prophylaxis 4.28, Basic brushing education 4.11, Incremental dental health care 4.04. Dental caries activity tests 2.05 was shown the lowest figures. 3. General characteristics in behavior of preventive treatment was resulted in this case that the respondents who have worked for less one year in current job than the ones who have worked for more than five years was shown such a low level, this was taken as a meaningful difference.(p=0.008) 4. It was shown that the higher fulfillment of preventive treatment(${\beta}$=0.340, p<0.001) and the greater earnings(${\beta}$=0.194, p=0.001) and usefulness of preventive treatment(${\beta}$=0.130, p=0.042), the higher job satisfaction. Conclusions : Considering these results, environment where the hygienists can concentrate on preventive treatment which is their proper job should be built up as soon as possible. And through this environment, the atmosphere where hygienists, as oral health professionals, can play a role to improve the oral health of the people by boosting job satisfaction should be created. Also It is thought that an institutional, actual improvement-changing the social awareness towards hygienists and dentists, the recognition of scope of the hygienists' work - should be established urgently.

Exercise Prescription and Dietary Modification for Prevention and Treatment of Chronic Degenerative Disease I. On Obesity and Diabetes (성인병의 예방과 치료를 위한 영양과 운동처방 I. 비만과 당뇨병에 미치는 영향)

  • 백영호;전병학
    • Journal of Life Science
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    • v.9 no.2
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    • pp.222-230
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    • 1999
  • Obesity is an excessive increased state of total body fat, and diabetes is a disease lack or defect of insulin which controls blood sugar. The reason of obesity and diabetes are history, lack of exercise, overeating, stress and so forth. The principle of dietary modification in the obesity and diabetes are controling total calorie control, and taking orderly meals, and restricting high calorie food. General exercise guidance will recommend to take precedence over the medical diagnosis, case history test before the exercise begins, and the beginning of exercise. It start with light excercise, and gradually enhance intensity The fundamental and effective cure of obesity and diabetes is aerobic exercise (as jogging, swimming, playing tennis, aerobic dancing). It is reasonable for exercise intensity to be 60~80$\%$ HRmax(50~70$\%$ $Vo_2$ max) and for the duration to be 15~60minutes a day and frequency to be 3~6 times a week. Especially the exercise intensity may be changeable according to the, pattern of diabetes. The snack that contains carbohydrate during exercise will discontinue the exercise when insulin activity is reached on high peak, and it is a proper way taking 15~20g's carbohydrate contained food against possibility of the low blood sugar occurance after exercise, At last, it is much effective the exercise therapy is combined with the diet therapy for best diabetes treatment.

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A Study on the Clinical Characteristics of Patients with Dry Mouth (구강건조증 환자의 임상적 특징에 관한 연구)

  • Oh, Jeong-Kyu;Kim, Youn-Joong;Kho, Hong-Seop
    • Journal of Oral Medicine and Pain
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    • v.26 no.4
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    • pp.331-343
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    • 2001
  • Advances in medical procedures and utilization of medication have resulted in expanding aged population, which leads to increased aged patients with salivary hypofunction and its associated symptoms in dental clinic. The purpose of this study was to investigate clinical characteristics of patients with dry mouth and its correlation with their salivary flow rate. Forty dry mouth patients (7 males, 33 females, mean age 42.0 years) whose flow rate of unstimulated whole saliva was less than 0.15 ml/min were included and their gender- and age-matched controls (7 males, 33 females, mean age 42.9 years) who did not report any complaints, suggestive of salivary gland dysfunction and had the flow rate of greater than 0.20 ml/min were included for comparison. The salivary flow rate was measured in both unstimulated and stimulated conditions. Dry mouth-related clinical information including history, dry mouth associated symptoms, exacerbating and relieving factors, drugs, systemic diseases, and family history was investigated using questionnaires. The differences in distribution of patients and control subjects to each question and their relation to the salivary flow rate were analyzed and we came to following conclusions. 1. There were statistically significant differences in the distribution of patients and controls to the following questions: the period and frequency of suffering from dry mouth; severity of dry feeling during a meal; severity of discomfort during swallowing; necessity of sipping liquids during swallowing dry foods, severity of discomfort in usual life due to dry feeling; self-assessment of residual salivary volume; taking medications. 2. The patients had more stress-related medical histories including indigestion, insomnia, and gastritis compared with controls. The patients took many kinds of medications to control their systemic diseases. 3. There were statistically significant differences in the salivary flow rate between different groups of patients to following questions: severity of dry feeling during a meal; severity of discomfort during swallowing; necessity of sipping liquids during swallowing dry foods. The difference was more significant in the case of stimulated salivary flow rate rather than unstimulated one. 4. The salivary flow rate of patients taking medications was significantly less than that of patients who did not take medications. The difference was more significant in the case of stimulated salivary flow rate rather than unstimulated one.

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Factors Influencing Cognitive Impairment of the Seniors using Senior Center (경로당 이용 노인의 인지기능장애 영향요인)

  • Lee, Sun Young;Kim, Yunyoung
    • Journal of Digital Convergence
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    • v.15 no.3
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    • pp.393-403
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    • 2017
  • The purpose of this study was to investigate the degree of cognitive impairment for the elders taking part in activities at senior community center and to identify the multiple factors affecting the cognitive dysfunction of them. Data were collected for the 375 elders taking part in activities at senior community center at 4 different areas of dong, up, and myun of C-city from June 2016 to July 2016, and their general characteristics as well as health-related characteristics, depression, and cognitive dysfunction were investigated and analyzed. The results of this study showed that cognitive dysfunction was affected by the age, education, economic support, history of stroke, and exercise. The risk of cognitive dysfunction was 3.50 times higher in patients over 80 years old than patients below 74 years old(p=.002), and the lower the level of education showed the higher the risk of cognitive dysfunction(p=.036)(p<.001). In addition, the risk of cognitive dysfunction was low in the absence of a history of stroke(p=.033), and the risk of cognitive dysfunction increased by 1.84 times if they do not exercise(p=.044). Based on the present study, It is required to consider the risk factors for cognitive dysfunction efforts to prevent and manage cognitive impairment before the onset of cognitive dysfunction.