• Title/Summary/Keyword: Hospital Management BMI(Body Mass Index)

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Effectiveness and Safety of Tolvaptan for the Management of Hyponatremia: Risk of Inadvertent Overcorrection

  • Park, Mi Seon;Park, Seung Yong;Park, Seoung Ju;Beom, Jin Seon;Ahn, Hyo Cho;Kim, Ju Sin;Lee, Heung Bum
    • Journal of Korean Society of Health-System Pharmacists
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    • v.35 no.4
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    • pp.430-440
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    • 2018
  • Background : Hyponatremia is the most common electrolyte disturbance in hospitalized patients and has been associated with increased morbidity and mortality. Tolvaptan, a vasopressin receptor antagonist, is increasingly used for the treatment of euvolemic and hypervolemic hyponatremia. The aim of this study was to evaluate the effectiveness and safety of tolvaptan for the management of hyponatremia. Methods : This study was a retrospective evaluation of 106 patients who received at least one dose of tolvaptan for hyponatremia at a single tertiary academic hospital between January 2014 and June 2015. The primary endpoint was the change in serum sodium concentration after tolvaptan administration within 24 hours, with secondary endpoints of overcorrection and adverse effects. Results : The mean initial dose of tolvaptan was $20.2{\pm}7.2mg$ and the median duration of treatment was 15 days (range, 1-261 days). The maximal changes in sodium levels at 24 and 48 hours were $8.2{\pm}4.7mmol/L$ and $10.5{\pm}15.3mmol/L$, respectively. Of 99 patients in whom sodium concentrations were followed up, sodium overcorrection was observed in 26 (26.3%) patients, which was associated with concomitant use of an enzyme inhibitor (odds ratio [OR] = 4.80, 95% Cl: 1.27-18.15). However, sex, body mass index (BMI), serum albumin, a daily dose of tolvaptan, and concomitant use of hypertonic saline did not show any significant difference in overcorrection. The most commonly reported adverse effects were mild and related to aquaresis, such as polyuria, thirst, and constipation. However, severe adverse effects such as hyperkalemia, hypotension, and one death related to osmotic demyelination were also reported. Conclusions : Tolvaptan is effective for treating hyponatremia. Nevertheless, the drug should be used cautiously due to serious adverse effects related to sodium overcorrection.

A Study on the Characteristics and Treatment Effects of Underweight Children and Adolescents Treated by Korean Medicine (한의 치료를 받은 저체중 소아청소년의 특성 및 치료 효과에 대한 고찰)

  • Kim, Hye Yeon;Kim, Ye Ji;Kim, Sang Min;Lee, Sun Haeng;Lee, Jin Yong
    • The Journal of Pediatrics of Korean Medicine
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    • v.36 no.3
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    • pp.49-62
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    • 2022
  • Objectives This study aimed to provide evidence for the use of Korean medicine in underweight patients by analyzing the medical records of underweight children and adolescents. Methods Children and adolescents who visited Korean pediatrics at Kyung Hee University Hospital from June 1, 2019 to May 31, 2022, who had an age-specific weight percentile which was less than 5 and diagnosed with E639.005 or R628.001 were selected for the study. A retrospective chart review was conducted by examining the medical records of subjects who received Korean medical treatment. The treatment effect was analyzed in all subjects and subgroups by comparing changes in height, weight, and body mass index (BMI) percentiles before and after Korean medicine treatment. Results A total of 55 underweight subjects were included in the study. General characteristics such as distribution by sex, age, number of visits, and weight percentile, and clinical characteristics such as diagnosis, past history, family history, drug history, current or past symptoms, and symptom differentiation were collected. The composition of herbal medicines and the contents of other Korean medical treatments were analyzed. In the case of treatment effect, the weight and BMI percentile of all subjects increased significantly. Conclusions This study was conducted to suggest Korean medicine as a method of proper weight management in children and adolescents. In the future, follow-up studies with a large number of subjects and controlled variables, such as the period of taking herbal medicine, are needed.

The Study on the relationship between the brain function of obese population and their level of obesity based on brainwave (뇌파기반 성인 비만인의 뇌기능과 비만도와의 상관성 연구)

  • Kim, Sun-Hyung;Bak, Ki-Ja;Yi, Seon-Gyu
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.7
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    • pp.2949-2954
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    • 2012
  • This study was to examine the correlation between the brain function of adult suffering from obesity and the level of their obesity based on brainwave measurements. Based on the result of Body Composition Analysis (BCA) examination, population of 651 overweight pupils was chosen from June 2011 to December of 2012 in S city, I hospital. These patients were measured by timeseries linear analysis for their brain function and observed via brainwave activities. The results have been thus far; first, as their BMI (Body Mass Index) and level of obesity (body fat percentage) were higher, degree of mental stress and resistant to stress marked lower. These results prove that by managing the stress resistant ability and attention ability, self-controlling ability, one can expect a positive effect on finding a methods to ease the obese-related problems.

HIV/AIDS Management: Dolutegravir Based Antiretroviral Drug Therapy

  • John, Ikpeama Osita;Emmanuel, Okoh Emeka;Anthonia, Ikpeama Chizoba;Joy, Ikpeama Chinwe;Adimabua, Okafor Patrick;Osazuwa, Igbineweka Osa;Andrew, Ikpeama Emeka;Mariam, Onuzulike Nonye;Gami, Hilary Tumba
    • The Korean Journal of Food & Health Convergence
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    • v.6 no.4
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    • pp.17-19
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    • 2020
  • HIV/AIDS disease still remain a global pandemic and it's management has undergone series of treatment changes and improvement although there is still no permanent cure.Dolutegravir belongs to a group of HIV drugs called integrase inhibitors. Integrase inhibitors block an HIV enzyme called integrase. By blocking integrase, integrase inhibitors prevent HIV from multiplying and can reduce the amount of HIV in the body.Dolutegravir combination based regimen has turned out to be very effective (antiviral) with negligible rare side effects on clients. This drug (Dolutegravir based regimen) combination has successfully increased the appetite for food of all the clients, unlike others and has shown to reduce viral load in the most shortest period ever. It can be deduced that development of resistant mutant virus will be reduced if not eliminated with dolutogravir based regimen.The role of Continuous adherence counseling has shown to improve clients treatment management. It is important to note that the availability of food has direct effect on the economic status or financial weight on the client. Hence the progress that is increase in body mass index (BMI) is a direct impact of the availability of food for the clients.

Single Incision Laparoscopic Appendectomy for Management of Complicated Appendicitis: Comparison between Single-Incision and Conventional

  • Oh, Yoon Jung;Sung, Nak Song;Choi, Won Jun;Yoon, Dae Sung;Choi, In Seok;Lee, Sang Eok;Moon, Ju Ik;Kwon, Seong Uk;Park, Si Min;Bae, In Eui
    • Journal of Minimally Invasive Surgery
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    • v.21 no.4
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    • pp.148-153
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    • 2018
  • Purpose: Single incision laparoscopic appendectomy (SILA) is a widely used surgical procedure for treatment of appendicitis with better cosmesis. However, many surgeons generally tend to choose conventional multiport laparoscopic appendectomy regarding with complicated appendicitis. The aim of this study is to demonstrate the safety and feasibility of SILA for treatment of complicated appendicitis by comparison with 3-ports conventional laparoscopic appendectomy (CLA). Methods: Retrospective chart review of patients diagnosed appendicitis at single hospital during January 2015 to May 2017 collected 500 patients. Among 134 patients with complicated appendicitis, we compared outcomes for 29 patients who got SILA and 105 patients who got CLA. Results: 179 and 321 patients were treated by SILA and CLA, respectively. 134 (26.8%) patients were treated for complicated appendicitis, 29 patients by SILA and 105 patients by CLA, respectively. There was no case converted to open or added additional trocar in both groups. There were no differences in demographics with regard to age, sex, body mass index (BMI), and American society of anesthesiologists (ASA) scores. There was no difference in mean operating time ($58.97{\pm}18.53$ (SILA) vs. $57.57{\pm}21.48$ (CLA), p=0.751). The drain insertion rate (6.9% vs 37.1%, p=0.001) and the length of hospital stay ($2.76{\pm}1.41$ vs. $3.97{\pm}2.97$, p=0.035) were lower in SILA group with significance. There was no significant difference in the rate of surgical site infection (6.9% vs. 6.7%, p=1.000). Conclusion: This study demonstrates that SILA is a feasible and safe procedure for treatment of complicated appendicitis.

Effects of Nutrition Education and Exercise Program on Obesity Index and Behavioral Modification in Moderate Obese Women (영양교육과 운동을 병행한 프로그램이 중등도비만여성의 비만도와 행동변화에 미치는 효과)

  • Chang, Myung-Hee;Jung, Su-Jin
    • Korean Journal of Community Nutrition
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    • v.23 no.4
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    • pp.318-332
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    • 2018
  • Objectives: The purpose of this study was to investigate the behavioral modification of obese adults who underwent nutritional and physical activity education. Twenty obese females, aged 20-60 years old, with BMIs (Body Mass Index) >30 or body fat (%) >40 were subjected to this study. Methods: The physical activity education program consisted of doing exercise in a gymnasium together or home exercise. Dietary attitudes and dietary intakes were assessed using weight control, physical activity, and eating habits. The nutrition-exercise educational period was 12 weeks. Results: After the study period, there was significant improvement in physical activity and eating habits score. Furthermore, there was a significant increase in the dietary intakes of fiber, iron, potassium, vitamin A, vitamin $B_6$, and niacin. Blood pressure, blood glucose, and total cholesterol levels showed a tendency to decrease, but there was no significant difference. BMI, fat mass, abdominal circumference, and visceral fat levels were significantly reduced while muscle mass significantly increased. Conclusions: This study suggests that behavioral modification by nutrition and physical activity education with feedback has positive effects on dietary intake and anthropometric biomarkers in obese adults. Therefore, lifestyle interventions of this kind could be recommended as a method for obesity management.

A Study on the Nutritional Status in Hospitalized Patients with Pulmonary Tuberculosis (폐결핵 환자의 입원기간동안 영양상태 변화 연구)

  • You, Hyun-Jai;Kim, Yang-Ha
    • Journal of Nutrition and Health
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    • v.42 no.7
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    • pp.615-621
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    • 2009
  • This study was conducted to evaluate the change of nutritional status and to analyze related factors in hospitalized tuberculosis (TB) patients during their hospitalization. The subjects were 398 men patients (mean age: 47.3 ${\pm}$ 14.4 y) who had hospitalized more than 3 months at TB hospital located in Seoul. The anthropometric and blood biochemical indices were measured, and dietary intakes were assessed. At the time of admission the body weight of subjects was about 76% of the average body weight of Korean men with same age, Body mass index (BMI) of subjects was 18.5 kg/$m^2$, and 53.8% of subjects were under weight status. Average level of blood hemoglobin and hematocrit of subjects was lower than the normal value. After 3 months of hospitalization period, the body weight and body mass index were significantly increased compared to admission by 3.9 kg (7.41%) and 1.4 kg/$m^2$ (7.61%)(p < 0.001), respectively. Blood levels of hemoglobin, hematocrit, albumin, and total protein were also significantly increased after 3 months of hospitalization period compared to admission (p < 0.001). The increment in the body weight and blood indices was significantly higher in below 29 years group than over 60 years group (p < 0.05). The increment in the body weight and body mass index was significantly higher in the under-body weight group compared to the normal-body weight group (p < 0.05). In conclusion the body weight and body mass index of subjects were significantly increased after 3 months of hospitalization period, and the age and body weight of subjects at admission were supposed to influence the degree of change in the nutritional status.

Risk Factors for Surgical Site Infections According to Electronic Medical Records Data (전자의무기록(EMR) 자료를 활용한 수술부위감염 관련요인)

  • Kim, Young Hee;Yom, Young-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.21 no.2
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    • pp.151-161
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    • 2014
  • Purpose: The purpose of this study was to identify the risk factors that influence surgical site infections after surgery. Methods: This study was a retrospective research utilizing Electronic Medical Records. Data collection targeted 4,510 adult patients who had 8 different kinds of surgery (gastric surgery, colon surgery, laparoscopic cholecystectomy, hip & knee replacement, hysterectomy, cesarean section, cardiac surgery) in 4 medical care departments, at one general hospital between January 2006 and December 2011. Multivariate logistic regression analyses were used to identify the risk factors affecting surgical site infections after surgery. Results: Risk factors for increased surgical site infection following surgery were confirmed to be age (OR=1.59, p<.001), BMI (Body Mass Index)(OR=1.25, p=.034), year of operation (OR=2.45, p<.001), length of operation (OR=3.06, p<.001), ASA (American Society of Anesthesiology) score (OR=1.36, p=.025), classification of antibiotic used (OR=2.77, p<.001), duration of the prophylactic antibiotics use (OR=1.85, p<.001), and interaction between classification of antibiotic used and duration of the prophylactic antibiotics use (OR=1.90, p=.016). Conclusions: Results suggest that risk factors affecting surgical site infections should be monitored before surgery. The results of this study should contribute to establishing effective infection management measures and implementing surveillance systems for patients who have actual risk factors.

Relationships among Malnutrition, Depression and Quality of Life in Patients with Gynecologic Cancer receiving Chemotherapy (항암화학요법을 받는 부인암 환자의 영양장애, 우울 정도와 삶의 질과의 관계)

  • Nho, Ju-Hee;Kim, Sung Reul;Kang, Gyeong Seon;Kwon, Yong Soon
    • Women's Health Nursing
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    • v.20 no.2
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    • pp.117-125
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    • 2014
  • Purpose: The purpose of this study was to identify nutritional status, and relationships among malnutrition, depression and quality of life in patients with gynecologic cancer who were receiving chemotherapy. Methods: For this study a descriptive cross-sectional design was used. Participants were 111 women who were enrolled and agreed to undergo a face-to-face interviews including administration of the structured questionnaires: Patient-Generated Subjective Global Assessment (PG-SGA), Beck Depression Inventory (BDI), Simplified Nutritional Appetite Questionnaire (SNAQ), and Functional Assessment of Cancer Therapy-General (FACT-G). Results: Mean body mass index was 23.3 and mean body weight was 56.5 kg. Sixty-three (57%) of the 111 patients were malnourished according to the PG-SGA. The malnourished patients showed higher levels of depression and lower quality of life compared to the non-malnourished patients. In addition, malnutrition was associated with BMI level, depression, appetite and quality of life. Conclusion: The findings indicate that the prevalence of malnutrition is high and malnutrition in patients with gynecologic cancer influences depression and adversely affects the quality of life of these women. To improve the patient's quality of life, nutritional assessment and appropriate management is important to decrease malnutrition in patients with gynecologic cancer.

Wound Complications after Laparotomy for Endometrial Cancer

  • Nhokaew, Wilasinee;Temtanakitpaisan, Amornrat;Kleebkaow, Pilaiwan;Chumworathayi, Bundit;Luanratanakorn, Sanguanchoke;Kietpeerakool, Chumnan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7765-7768
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    • 2015
  • This study was conducted to determine the incidence of wound complications after laparotomy for endometrial cancer and significant predictors of risks. Medical records of patients with endometrial cancer undergoing laparotomy for surgical staging at Srinagarind Hospital, Khon Kaen University between January 2007 and December 2013 were reviewed. Intravenous antibiotic prophylaxis was routinely given 30 minutes before surgery. The primary endpoint was wound complications (including seroma, hematoma, separation, or infection) requiring additional medical and/or surgical management within 4 weeks of laparotomy. During the study period, 357 patients with complete medical records were reviewed. The mean age was 56.9 years. Wound complications were observed in 28 patients (7.84%, 95% CI, 5.27% to 11.14%). Body mass index (BMI) ${\geq}30kg/m^2$, diabetes mellitus (DM), and prior abdominal surgery were observed as significant independent factors predicting an increased risk of wound complications with adjusted odds ratios (95% CIs) of 2.96 (1.23-7.16), 2.43 (1.06-5.54), and 3.05 (1.03-8.98), respectively. In conclusion, the incidence of wound complications after laparotomy for endometrial cancer was 7.8%. Significant independent predictors of risk included BMI, DM and prior abdominal surgery.