• 제목/요약/키워드: Medical organization

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Standardized Breast Cancer Mortality Rate Compared to the General Female Population of Iran

  • Haghighat, S.;Akbari, M.E.;Ghaffari, S.;Yavari, P.
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권11호
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    • pp.5525-5528
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    • 2012
  • Introduction: Breast cancer is the most common cancer in women. Improvements of early diagnosis modalities have led to longer survival rates. This study aimed to determine the 5, 10 and 15 year mortality rates of breast cancer patients compared to the normal female population. Materials and Methods: The follow up data of a cohort of 615 breast cancer patients referred to Iranian Breast Cancer Research Center (BCRC) from 1986 to 1996 was considered as reference breast cancer dataset. The dataset was divided into 5 year age groups and the 5, 10 and 15 year probability of death for each group was estimated. The annual mortality rate of Iranian women was obtained from the Death Registry system. Standardized mortality ratios (SMRs) of breast cancer patients were calculated using the ratio of the mortality rate in breast cancer patients over the general female population. Results: The mean age of breast cancer patients at diagnosis time was 45.9 (${\pm}10.5$) years ranging from 24-74. A total of 73, 32 and 2 deaths were recorded at 5, 10 and 15 years, respectively, after diagnosis. The SMRs for breast cancer patients at 5, 10 and 15 year intervals after diagnosis were 6.74 (95% CI, 5.5-8.2), 6.55 (95%CI, 5-8.1) and 1.26 (95%CI, 0.65-2.9), respectively. Conclusion: Results showed that the observed mortality rate of breast cancer patients after 15 years from diagnosis was very similar to expected rates in general female population. This finding would be useful for clinicians and health policy makers to adopt a beneficial strategy to improve breast cancer survival. Further follow-up time with larger sample size and a pooled analysis of survival rates of different centres may shed more light on mortality patterns of breast cancer.

The Burden of Cancer in Member Countries of the Association of Southeast Asian Nations (ASEAN)

  • Kimman, Merel;Norman, Rosana;Jan, Stephen;Kingston, David;Woodward, Mark
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권2호
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    • pp.411-420
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    • 2012
  • This paper presents the most recent data on cancer rates and the burden of cancer in the ASEAN region. Epidemiological data were sourced from GLOBOCAN 2008 and disability adjusted life years (DALYs) lost were estimated using the standard methodology developed within the World Health Organization's Global Burden of Disease study. Overall, it was estimated there were over 700,000 new cases of cancer and 500,000 cancer deaths in ASEAN in the year 2008, leading to approximately 7.5 million DALYs lost in one year. The most commonly diagnosed cancers were lung (98,143), breast (86,842) and liver cancers (74,777). The most common causes of cancer death were lung cancer (85,772), liver cancer (69,115) and colorectal cancer (44,280). The burden of cancer in terms of DALYs lost was highest in Laos, Viet Nam and Myanmar and lowest in Brunei, Singapore and the Philippines. Significant differences in the patterns of cancer from country to country were observed. Another key finding was the major impact played by population age distribution on cancer incidence and mortality. Cancer rates in ASEAN are expected to increase with ageing of populations and changes in lifestyles associated with economic development. Therefore, ASEAN member countries are strongly encouraged to put in place cancer-control health care policies, focussed on strengthening the health systems to cope with projected increases in cancer prevention, treatment and management needs.

Investigation of Association between oipA and iceA1/iceA2 Genotypes of Helicobacter pylori and Gastric Cancer in Iran

  • Aghdam, Saeed Mahboubi;Sardari, Zeinab;Safaralizadeh, Reza;Bonyadi, Mortaza;Abdolmohammadi, Reza;Moghadam, Mostafa Soltani;Khalilnezhad, Ahad
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권19호
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    • pp.8295-8299
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    • 2014
  • Background: H pylori is the main causative agent of Gastric cancer and chronic gastritis. Genetic diversity of H. pylori has major contribution in its pathogenesis. We investigated the prevalence of oipA and iceA1/iceA2 positive strains of H. pylori among patients with gastric cancer and gastritis. Materials and Methods: Sampling performed by means of endoscopy from 86 patients. DNA was extracted from tissue samples using DNA extraction kit. PCR assay was performed and products were monitored by Agarose Gel Electrophoresis. Results: Urease Test and 16S rRNA PCR did not show significant differences in detection of H. pylori. The frequency of iceA1 allele in patients with gastric cancer was significantly higher than those with gastritis (p<0.05). However, there was no significant difference in prevalence of oipA and iceA2 genes among the two groups of patients (p>0.05). Conclusions: The iceA1 gene, but the oipA and iceA2 genes, is associated with H. pylori-induced gastric cancer. However, confirmatory studies must be performed in future.

A Study on the Nurse Scheduling Optimization Model for Nurse Needs-Type Scheduling Automation System

  • Song, Mi-Young
    • 한국컴퓨터정보학회논문지
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    • 제25권3호
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    • pp.57-64
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    • 2020
  • 오늘날 정보 기술의 발전으로 병원은 의료분야에서 모바일 컴퓨팅 기술을 접목하여 의료 정보의 방대한 데이터를 관리를 위해서 시간과 공간의 제약을 받지 않는 병원정보시스템을 활발하게 연구하고 있다. 그럼에도 불구하고 대부분의 병원에서는 여전히 수작업으로 근무 편성표를 작성하는데 많은 노력과 시간을 소요하고 있다. 이에 본 논문은 간호사의 교대 근무를 편성하는 최적화 모델을 연구하고 이를 적용한 간호사 니즈형 근무 편성 자동화 시스템을 구축하였다. 실제 S병원에 근무하는 간호사를 대상으로 간호사의 정보 데이터와 요구조건 및 제약조건들을 구성하였다. 이를 적용하여 최적화된 스케줄링 처리 방법을 제안하였고 웹 서버를 중심으로 실시간 상호 교환 및 공유가 가능하기 위해서 수간호사가 사용하는 웹 기반 플랫폼과 일반 간호사가 사용하는 모바일 앱 플랫폼을 구축하였다. 따라서 개발된 간호사 니즈형 근무 편성 자동화 시스템을 통해서 수간호사는 매월 간호사의 근무 편성을 위한 업무 편리성을 증가시켜 주며, 간호사는 개인 일정관리를 통해서 좀 더 정확하게 업무를 처리할 수 있도록 도움을 줄 것이다. 또한 간호사간의 근무 일정의 공유하여 업무의 효율성이 증가할 것으로 기대한다.

An Analysis of the Management of a Tertiary General Hospital (2011 to 2013)

  • Park, Hyun-Suk
    • 한국임상보건과학회지
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    • 제3권1호
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    • pp.276-289
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    • 2015
  • Purpose. To efficiently manage hospitals, this study aims to analyze the general characteristics, common-type balance sheet, common-type profit and loss statement and financial ratio of a tertiary general hospital and use the results as basic data for future hospital development by comprehending causes for problems and analyzing hospital management. Methods. By using information about a tertiary general hospital, located in A Metropolitan City, provided through Alio (www.alio.go.kr), a public organization information provider, Health Insurance Review & Assessment Service, and Ministry of Health and Welfare, this study used data during 3 years(2011 to 2013) by analyzing the general characteristics, common-type balance sheet, common-type profit and loss statement, industrial mean ratio and financial ratio of hospitals. Results. This study came to the following conclusions through the general characteristics, common-type balance sheet, common-type profit and loss statement, industrial mean ratio, financial ratio, circular chart and ROI by analyzing the data from 2011 to 2013. Conclusions. Overall, A Tertiary General Hospital showed an increase in fixed cost due to the construction of J Hospital and even in the size of capital and assets. It also showed an increase in medical profit, but the increase of its medical cost was higher, resulting in a financial loss. Especially, this hospital showed a slight decrease in net profit, featuring a reduction in inventory turnover. When the management of A Tertiary General Hospital was predicted based on such features, this hospital is expected to improve its profit structure through the opening of J Hospital, and it is necessary for this hospital to increase and sustain the turnover rate of inventories accumulated by managing them better.

암 환자에 대한 한국어판 FACIT-호흡곤란 10개 항목 단축형 설문지의 신뢰도와 타당도 분석 (Reliability and Validity of Korean Version of FACIT-dyspnea 10 Item Short Form in Patients With Cancer)

  • 구본일;오덕원;이민지;김성경
    • 한국전문물리치료학회지
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    • 제27권2호
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    • pp.111-117
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    • 2020
  • Background: The Functional Assessment of Chronic Illness Therapy (FACIT) for Dyspnea was developed to assess multidimensional dyspnea using two subscales (experience of dyspnea and functional limitation) and a total score. Objects: This study aimed to assess the reliability and validity of the Korean version of the FACIT-dyspnea 10-item short form questionnaire (FACIT-dyspnea-K). Methods: Subjects were 163 patients with cancer. Dyspnea-related scales (modified Medical Research Council scale [mMRC], European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 [EORTC QLQ-C30], Hospital Anxiety and Depression [HAD], and WHO Performance Scale) were used to validate the FACIT-dyspnea-K. Results: Internal consistency was confirmed by Cronbach's alpha values of 0.90 and 0.95 in factors 1 and 2, respectively. Convergence validity was determined by comparing the two factors and total score of the FACIT-dyspnea-K with conceptually related assessment tools measuring the physical and emotional effects of dyspnea, with which correlations ranged from 0.364 to 0.567. Criterion validity was established by significant differences in the FACIT-dyspnea-K score between groups when the patients were classified by performance status as assessed by the WHO performance scale. Furthermore, the FACIT-dyspnea-K showed notable correlations with other dyspnea scales (mMRC, EORTC QLQ-C30, and HAD) for cancer patients (r = 0.28 to 0.54). The test-retest reliability of the two factors and total score of the FACIT-dyspnea-K appeared to be excellent (Cronbach's alpha = 0.96 to 0.97). Conclusion: This study supports FACIT-dyspnea-K as a valid and reliable instrument to assess the dyspnea experience of cancer patients in clinical settings.

Changes of Quality of Life after Gastric Cancer Surgery

  • Kong, Horyon;Kwon, Oh Kyung;Yu, Wansik
    • Journal of Gastric Cancer
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    • 제12권3호
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    • pp.194-200
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    • 2012
  • Purpose: The aim of this study was to evaluate chronological change of quality of life after surgery in patients with gastric cancer during one year postoperatively. Materials and Methods: Quality of life data were obtained from 272 gastric cancer patients who underwent curative gastrectomy between September 2008 and February 2011 at the Kyungpook National University Hospital. The Korean versions of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core (QLQ) 30 with gastric cancer-specific module, the EORTC QLQ-STO22 were used to assess quality of life. All patients had no evidence of recurrence or metastasis during the first postoperative year. Patients were asked to complete the questionnaire, by themselves preoperatively, 3-, 6-, 9-, and 12-months postoperatively. Results: Physical functioning score and role functioning score significantly decreased at first 3 months after surgery and the significant differences were noticed until 12 months after surgery. Emotional functioning score started with the lowest score before surgery and significant improvement was shown 6 months after surgery. Most symptom scores and STO-22 scores were highest at 3 months after surgery and gradually decreased, thereafter. Eating restriction, anxiety, taste, body image scores was highest at 3 months after surgery without significant decrease afterwards. Conclusions: Most scales worsened after surgery and gradually recovered afterwards with some differences in rate of recovery. However the scales did not fully recover by 1 year period. Further follow-up after 1 year would be helpful in determining which scales are permanently damaged and which are just taking longer time to recover.

Sample Size and Statistical Power Calculation in Genetic Association Studies

  • Hong, Eun-Pyo;Park, Ji-Wan
    • Genomics & Informatics
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    • 제10권2호
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    • pp.117-122
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    • 2012
  • A sample size with sufficient statistical power is critical to the success of genetic association studies to detect causal genes of human complex diseases. Genome-wide association studies require much larger sample sizes to achieve an adequate statistical power. We estimated the statistical power with increasing numbers of markers analyzed and compared the sample sizes that were required in case-control studies and case-parent studies. We computed the effective sample size and statistical power using Genetic Power Calculator. An analysis using a larger number of markers requires a larger sample size. Testing a single-nucleotide polymorphism (SNP) marker requires 248 cases, while testing 500,000 SNPs and 1 million markers requires 1,206 cases and 1,255 cases, respectively, under the assumption of an odds ratio of 2, 5% disease prevalence, 5% minor allele frequency, complete linkage disequilibrium (LD), 1:1 case/control ratio, and a 5% error rate in an allelic test. Under a dominant model, a smaller sample size is required to achieve 80% power than other genetic models. We found that a much lower sample size was required with a strong effect size, common SNP, and increased LD. In addition, studying a common disease in a case-control study of a 1:4 case-control ratio is one way to achieve higher statistical power. We also found that case-parent studies require more samples than case-control studies. Although we have not covered all plausible cases in study design, the estimates of sample size and statistical power computed under various assumptions in this study may be useful to determine the sample size in designing a population-based genetic association study.

Treatment of Isoniazid-Resistant Pulmonary Tuberculosis

  • Jhun, Byung Woo;Koh, Won-Jung
    • Tuberculosis and Respiratory Diseases
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    • 제83권1호
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    • pp.20-30
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    • 2020
  • Tuberculosis (TB) remains a threat to public health and is the leading cause of death globally. Isoniazid (INH) is an important first-line agent for the treatment of TB considering its early bactericidal activity. Resistance to INH is now the most common type of resistance. Resistance to INH reduces the probability of treatment success and increases the risk of acquiring resistance to other first-line drugs such as rifampicin (RIF), thereby increasing the risk of multidrug-resistant-TB. Studies in the 1970s and 1980s showed high success rates for INH-resistant TB cases receiving regimens comprised of first-line drugs. However, recent data have indicated that INH-resistant TB patients treated with only firs-tline drugs have poor outcomes. Fortunately, based on recent systematic meta-analyses, the World Health Organization published consolidated guidelines on drug-resistant TB in 2019. Their key recommendations are treatment with RIF-ethambutol (EMB)-pyrazinamide (PZA)-levofloxacin (LFX) for 6 months and no addition of injectable agents to the treatment regimen. The guidelines also emphasize the importance of excluding resistance to RIF before starting RIF-EMB-PZA-LFX regimen. Additionally, when the diagnosis of INH-resistant TB is confirmed long after starting the first-line TB treatment, the clinician must decide whether to start a 6-month course of RIF-EMB-PZA-LFX based on the patient's condition. However, these recommendations are based on observational studies, not randomized controlled trials, and are thus conditional and based on low certainty of the effect estimates. Therefore, further work is needed to optimize the treatment of INH-resistant TB.

구침가(九鍼歌) 역석(譯釋) (A Translation and Annotation for Nine Classical Needles in Rhymes)

  • 손인철;안성훈;김유리;양승범;김재효
    • Korean Journal of Acupuncture
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    • 제29권3호
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    • pp.453-466
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    • 2012
  • Objectives : The purpose of this study is to make nine classical needles understood easily through interpreting Nine Classical Needles in Rhymes. Methods : The principle of classification and clinical application of Nine Classical Needle was sorted out referring to "The beginning of Nine Classical Needles in Rhymes" and "The prescription and treatment of Nine Classical Needles in Rhymes" which is the chapter of "Golden Mirror of Medicine". Results & Conclusions : The Nine Classical Needles, which were designed to get harmonious interaction between human beings and the nature, have been representative medical appliance in Korean Medicine. The needles consist of shear needle, round-pointed needle, spoon needle, lance needle, stiletto needle, round-sharp needle, filiform needle, long needle, and big needle. Nine Classical Needles in Rhymes was formed in a poem format to help us easily memorize the essential contents of Nine Classical Needles. "The beginning of Nine Classical Needles in Rhymes" dealt with the reasons of making needles and organization principles about Nine Classical Needles. "The prescription and treatment of Nine Classical Needles in Rhymes" sorted main treatment applications of nine needles, helping understand needles as medical appliance.