• 제목/요약/키워드: Medical illnesses

검색결과 209건 처리시간 0.027초

Medical Care Utilization During 1 Year Prior to Death in Suicides Motivated by Physical Illnesses

  • Cho, Jaelim;Lee, Won Joon;Moon, Ki Tae;Suh, Mina;Sohn, Jungwoo;Ha, Kyoung Hwa;Kim, Changsoo;Shin, Dong Chun;Jung, Sang Hyuk
    • Journal of Preventive Medicine and Public Health
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    • 제46권3호
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    • pp.147-154
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    • 2013
  • Objectives: Many epidemiological studies have suggested that a variety of medical illnesses are associated with suicide. Investigating the time-varying pattern of medical care utilization prior to death in suicides motivated by physical illnesses would be helpful for developing suicide prevention programs for patients with physical illnesses. Methods: Suicides motivated by physical illnesses were identified by the investigator's note from the National Police Agency, which was linked to the data from the Health Insurance Review and Assessment. We investigated the time-varying patterns of medical care utilization during 1 year prior to suicide using repeated-measures data analysis after adjustment for age, gender, area of residence, and socioeconomic status. Results: Among 1994 suicides for physical illness, 1893 (94.9%) suicides contacted any medical care services and 445 (22.3%) suicides contacted mental health care during 1 year prior to suicide. The number of medical care visits and individual medical expenditures increased as the date of suicide approached (p<0.001). The number of medical care visits for psychiatric disorders prior to suicide significantly increased only in 40- to 64-year-old men (p=0.002), women <40 years old (p=0.011) and women 40 to 64 years old (p= 0.021) after adjustment for residence, socioeconomic status, and morbidity. Conclusions: Most of the suicides motivated by physical illnesses contacted medical care during 1 year prior to suicide, but many of them did not undergo psychiatric evaluation. This underscores the need for programs to provide psychosocial support to patients with physical illnesses.

내과적 질환에 동반된 불면증:이차성 불면증 (Insomnia in Medical Illnesses:The Secondary Insomnia)

  • 임세원;김린
    • 수면정신생리
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    • 제12권1호
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    • pp.11-16
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    • 2005
  • Sleep can be easily disrupted by variety of conditions. Most of medical illnesses could be a primary condition causing secondary insomnia. The common underlying mechanism of secondary insomnia is presumed to be stress effects on sleep. The assessment and treatment of secondary insomnia are often complicated. Establishing an causal inference between primary condition and insomnia is the key to assessment. However, it can be difficult even for experienced clinicians due to diagnostic ambiguity of secondary insomnia. Therefore, through medical evaluation and integrative understanding of primary condition is essential to manage secondary insomnia properly. Although treatment have been usually focused on the primary medical illnesses per se, nonpharmacologic interventions, such as sleep hygiene, might be effective in many cases.

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『침구경험방(鍼灸經驗方)』 '제절개속담(諸節皆屬膽)'에 대한 고찰 (Study on 'All Articulations are Controlled by the Gallbladder' in Chimgugyeongheombang)

  • 장희원;정상선;송지청;엄동명
    • 대한한의학원전학회지
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    • 제29권4호
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    • pp.95-103
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    • 2016
  • Objectives : This paper aims to study how 'All articulations are controlled by the gallbladder' as urged by Heoim in Chimgugyeongheombang was reflected in the clinical field, and look into the reason for his assertion. Methods : The paper looked into Chimgugyeongheombang and 1) found examples of how acupoints related to gallbladder were used to treat articulation-related diseases, and 2) investigated the relation between gallbladder and articulations through analyzing the acupoints used for treating articulation-related diseases. These are then compared with Zhenjiuzishengjing to see if the assertions made in 'All articulations are controlled by the gallbladder' were actually applied in clinical fields. Results & Conclusions : Heoim dealt with 20 points out of the 44 acupoints for gallbladder, and used 14 of them for treatments of articulation-related diseases. Gallbladder acupoints were used for ten illnesses, and four of them were related to articulation. Chimgujasaenggyeong showed a difference in that it did not utilize gallbladder acupoints to treat these illnesses. Out of 33 articulation-related illnesses, gallbladder meridians and acupoints were suggested as a means to treat them in 15 cases, and this is an increase in the usage of these points compared to Chimgugyeongheombang. In other words, Heoim actively utilized gallbladder meridian points in treating articulation-related illnesses. The reason Heoim drew a line between gallbladder and articulations is because gallbladder is categorized as a lesser yang pivot and articulations itself functions as a pivot by acting as a pivot for human body movement.

A LightGBM and XGBoost Learning Method for Postoperative Critical Illness Key Indicators Analysis

  • Lei Han;Yiziting Zhu;Yuwen Chen;Guoqiong Huang;Bin Yi
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • 제17권8호
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    • pp.2016-2029
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    • 2023
  • Accurate prediction of critical illness is significant for ensuring the lives and health of patients. The selection of indicators affects the real-time capability and accuracy of the prediction for critical illness. However, the diversity and complexity of these indicators make it difficult to find potential connections between them and critical illnesses. For the first time, this study proposes an indicator analysis model to extract key indicators from the preoperative and intraoperative clinical indicators and laboratory results of critical illnesses. In this study, preoperative and intraoperative data of heart failure and respiratory failure are used to verify the model. The proposed model processes the datum and extracts key indicators through four parts. To test the effectiveness of the proposed model, the key indicators are used to predict the two critical illnesses. The classifiers used in the prediction are light gradient boosting machine (LightGBM) and eXtreme Gradient Boosting (XGBoost). The predictive performance using key indicators is better than that using all indicators. In the prediction of heart failure, LightGBM and XGBoost have sensitivities of 0.889 and 0.892, and specificities of 0.939 and 0.937, respectively. For respiratory failure, LightGBM and XGBoost have sensitivities of 0.709 and 0.689, and specificity of 0.936 and 0.940, respectively. The proposed model can effectively analyze the correlation between indicators and postoperative critical illness. The analytical results make it possible to find the key indicators for postoperative critical illnesses. This model is meaningful to assist doctors in extracting key indicators in time and improving the reliability and efficiency of prediction.

신체질환에서 나타나는 불안의 평가와 치료 (Recognition and Treatment of Anxiety in Medically Ill Patients)

  • 나철
    • 정신신체의학
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    • 제3권2호
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    • pp.214-221
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    • 1995
  • There appears to be an increased incidence of anxiety symptoms in association with certain medical illness. It is usually assumed that certain medical disorders are directly associated with anxiety symptoms in that the pathophysilolgy of the medical illness somehow causes the anxiety symptoms. However, the pathophysilolgies of many such medical illnesses as well as anxiety are not known and no discrete group of medical illnesses is clearly more likely to produce anxiety symptoms than any other Moreover, anxiety symptoms may be the representation of other psychiatric symptoms, like depression and delirium. Though it is important to differentiate primary and other causes(secondary) of anxiety clinically, the clear differentiation is somewhat arbitrary, as the confusion of mind-body dichotomy. for the purpose of accurate treatment of anxiety symptoms relating medical illness, this review article focuses on those clinical features and mechanisms of anxiety that are potentially useful in differential diagnosis.

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Clinical predictors of chest radiographic abnormalities in young children hospitalized with bronchiolitis: a single center study

  • Kim, Ga Ram;Na, Min Sun;Baek, Kyung Suk;Lee, Seung Jin;Lee, Kyung Suk;Jung, Young Ho;Jee, Hye Mi;Kwon, Tae Hee;Han, Man Yong;Sheen, Youn Ho
    • Clinical and Experimental Pediatrics
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    • 제59권12호
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    • pp.471-476
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    • 2016
  • Purpose: Chest radiography is often performed on patients hospitalized with typical clinical manifestations of bronchiolitis. We aimed to determine the proportion of subjects with pathologic chest radiographic findings and the clinical predictors associated with pathologic chest radiographic findings in young children admitted with the typical presentation of bronchiolitis. Methods: We obtained the following data at admission: sex, age, neonatal history, past history of hospitalization for respiratory illnesses, heart rate, respiratory rate, the presence of fever, total duration of fever, oxygen saturation, laboratory parameters (i.e., complete blood cell count, high-sensitivity C-reactive protein [hs-CRP], etc.), and chest radiography. Results: The study comprised 279 young children. Of these, 26 had a chest radiograph revealing opacity (n=24) or atelectasis (n=2). Multivariate logistic regression analysis showed that after adjustment for confounding factors, the clinical predictors associated with pathologic chest radiographic findings in young children admitted with bronchiolitis were elevated hs-CRP level (>0.3 mg/dL) and past history of hospitalization for respiratory illnesses (all P<0.05). Conclusion: The current study suggests that chest radiographs in young children with typical clinical manifestations of bronchiolitis have limited value. Nonetheless, young children with clinical factors such as high hs-CRP levels at admission or past history of hospitalization for respiratory illnesses may be more likely to have pathologic chest radiographic findings.

신체·정신복합질환자의 민간의료보험 가입 여부가 의료이용에 미치는 영향: 한국의료패널 데이터 2018년 자료 활용 (The Effects of Private Health Insurance on Healthcare Utilization of People with Physical and Mental Illness: According to 2018 Korea Health Panel Survey Data)

  • 나리영;윤석준
    • 보건행정학회지
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    • 제33권3호
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    • pp.264-272
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    • 2023
  • Background: Private health insurance supplements the coverage of national health insurance in Korea. In this situation, the subject of the study is to identify the healthcare utilization of people with physical and mental illnesses according to private health insurance. Methods: This study used data from the Korea Health Panel Survey 2018. The study population consisted of 813 individuals with physical and mental illnesses (PMI). Multiple logistic regression analysis and binominal logistic regression analysis were conducted about the utilization of emergency, inpatient, and outpatient medical services of people with PMI depending on enrollment in private health insurance (PHI). Results: The results of this study indicated that individuals with PHI utilized emergency and outpatient medical services less frequently compared to those without PHI. Conversely, having PHI was associated with a higher utilization of inpatient medical services compared to not having PHI. Binomial logistic regression analysis revealed that individuals with PMI who had PHI exhibited a higher frequency of visits to emergency and outpatient medical services compared to those without PHI. However, the significance of this trend was not observed in the case of emergency medical services. On the other hand, individuals with PMI who had PHI showed a lower frequency of visits to inpatient medical services compared to those without PHI. Conclusion: In conclusion, there was a significant relationship between having PHI and the utilization of medical services in people with PMI. There is a need for a follow-up study considering the type of mental illnesses, length of stay, and health outcome of people with PMI depending on having PHI.

『식료찬요(食療纂要)』에 나타난 피부과 질환 식치(食治)에 대한 고찰 (A Study on Food Therapy for Dermatological Diseases in Sikryochanyo)

  • 안진희
    • 대한한의학원전학회지
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    • 제32권2호
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    • pp.93-110
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    • 2019
  • Objectives : To examine food therapy for dermatological illnesses within their relationship with Pattern Identification and Treatment Discussion in "Sikryochanyo". Methods : Texts concerning dermatological conditions in "Sikryochanyo" were selected, followed by identifying each condition's pattern and treatment through examining each food ingredient's nature, flavor and main effect. Results : Each food ingredient such as eel, white sesame, duck meat, mallow, red beans, oyster, chicken meat, mung beans, female pig hooves, Chinese cabbage, venison, roe deer meat, kelp, seaweed, wheat, lappa fruit used to treat certain dermatological conditions could be categorized according to its properties in regulating Coldness, Heat, Deficiency, and Excessiveness of a given condition. Conclusions : When applying food ingredients to dermatological illnesses, Coldness, Heat, Deficiency, Excessiveness of the condition must be differentiated first for appropriate administration of food to the pattern that is being addressed.

Occupational Injuries and Illnesses and Associated Costs in Thailand

  • Thepaksorn, Phayong;Pongpanich, Sathirakorn
    • Safety and Health at Work
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    • 제5권2호
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    • pp.66-72
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    • 2014
  • Background: The purpose of this study was to enumerate the annual morbidity and mortality incidence and estimate the direct and indirect costs associated with occupational injuries and illnesses in Bangkok in 2008. In this study, data on workmen compensation claims and costs from the Thai Workmen Compensation Fund, Social Security Office of Ministry of Labor, were aggregated and analyzed. Methods: To assess costs, this study focuses on direct costs associated with the payment of workmen compensation claims for medical care and health services. Results: A total of 52,074 nonfatal cases of occupational injury were reported, with an overall incidence rate of 16.9 per 1,000. The incidence rate for male workers was four times higher than that for female workers. Out of a total direct cost of $13.87 million, $9.88 million were for medical services and related expenses and $3.98 million for compensable reimbursement. The estimated amount of noncompensated lost earnings was an additional $2.66 million. Conclusion: Occupational injuries and illnesses contributed to the total cost; it has been estimated that workers' compensation covers less than one-half to one-tenth of this cost.

Pathophysiology and protective approaches of gut injury in critical illness

  • Jung, Chang Yeon;Bae, Jung Min
    • Journal of Yeungnam Medical Science
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    • 제38권1호
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    • pp.27-33
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    • 2021
  • The gut is a complex organ that has played an important role in digestion, absorption, endocrine functions, and immunity. The gut mucosal barriers consist of the immunologic barrier and nonimmunologic barrier. During critical illnesses, the gut is susceptible to injury due to the induction of intestinal hyperpermeability. Gut hyperpermeability and barrier dysfunction may lead to systemic inflammatory response syndrome. Additionally, gut microbiota are altered during critical illnesses. The etiology of such microbiome alterations in critical illnesses is multifactorial. The interaction or systemic host defense modulation between distant organs and the gut microbiome is increasingly studied in disease research. No treatment modality exists to significantly enhance the gut epithelial integrity, permeability, or mucus layer in critically ill patients. However, multiple helpful approaches including clinical and preclinical strategies exist. Enteral nutrition is associated with an increased mucosal barrier in animal and human studies. The trophic effects of enteral nutrition might help to maintain the intestinal physiology, prevent atrophy of gut villi, reduce intestinal permeability, and protect against ischemia-reperfusion injury. The microbiome approach such as the use of probiotics, fecal microbial transplantation, and selective decontamination of the digestive tract has been suggested. However, its evidence does not have a high quality. To promote rapid hypertrophy of the small bowel, various factors have been reported, including the epidermal growth factor, membrane permeant inhibitor of myosin light chain kinase, mucus surrogate, pharmacologic vagus nerve agonist, immune-enhancing diet, and glucagon-like peptide-2 as preclinical strategies. However, the evidence remains unclear.