• 제목/요약/키워드: Older patients

검색결과 1,627건 처리시간 0.044초

만성 B형간염 진단 환자의 항바이러스제 처방양상 (Prescribing Patterns of Antivirals for Chronic Hepatitis B)

  • 공혜경;손현순;최경업;권진원;신현택
    • 한국임상약학회지
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    • 제22권1호
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    • pp.81-86
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    • 2012
  • This study was aimed to examine the prescribing patterns of antivirals in outpatients with chronic hepatitis B (CHB), using National Health Insurance adjudicated claims data (total 1,426,065 claims) dated March 19, 2008 submitted from nationwide healthcare providers to Health Insurance Review and Assessment Service. From the data, there were 2,965 claims with CHB diagnosis (ICD-10 code B18.0 and B18.1), and 44.2% (1,311 claims) of the CHB related claims included antivirals such as lamivudine, clevudine, adefovir and entecavir. Lamivudine, adefovir, clevudine and entecavir shared 54.9%, 19.9%, 13.2% and 11.9%, respectively, among antiviral prescriptions. Adefovir and entecavir 1mg presumed as the 2nd line therapy for HBV resistant cases were shared 23.3% of overall antiviral prescriptions. There were statistically significant difference in prescription patterns according to age and institution type: Lamivudine usage was higher in younger (< 20 years old) and older age group (> 70 years old) than the others (p = 0.016), and adefovir and entecavir, which were relatively newer antivirals, had higher prescription rates in higher level of institutions such as tertiary hospitals than the others (p < 0.001). This study would be of help to make an appropriate drug therapy plan for patients with CHB.

사지에 발생한 거대 지방육종 (A Case of Huge Liposarcoma in Thigh)

  • 강신택;황태혁;박범석;김대중;신향미
    • 대한골관절종양학회지
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    • 제14권2호
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    • pp.192-197
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    • 2008
  • 지방육종은 연부 조직 종양 중 가장 흔한 종양 중 하나로 알려져 있다. 주로 50세 이상의 노년층에서 주로 발생하는 것으로 알려져 있고, 사지에서 발생할 경우 근위부에서 발생한다. 저자들은 67세 남자의 좌측 대퇴부의 거대 지방육종을 변연절제술을 이용한 종양 적출술로 치료하였다. 다른 부위로의 전이는 없었으며, 종양은 변연절제에 의해 성공적으로 적출 하였으며, 종양적출 후 6개월간 재발하지 않았다. 환자의 신장은 153 cm이며, 체중은 43 kg인데 반하여 종양은 $34{\times}20{\times}9\;cm$, 2.82 kg이였다. 환자의 신장과 체중에 비하여 종양은 매우 거대하였으며, 조직학적 검사상 잘 분화된 지방육종(well-differentiated liposarcoma)으로 판명되었다. 저자들은 조직학적 분화도와 크기에 관련된 증례가 많지 않고 이에 따른 치료 방법이 명확하지 않다고 생각되어 변연절제를 이용한 종양 적출술로 치료한 잘 분화된 거대지방육종 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

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노인의 직업특성과 삶의 질과의 관련성 (Relationship between Job Characteristic and Quality of Life among some Elderly)

  • 박부연;고대식;박형수
    • 한국전자통신학회논문지
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    • 제8권6호
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    • pp.941-947
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    • 2013
  • 본 연구는 노인들의 직업 활동과 삶의 질과의 관련성을 규명하여 노인일자리 프로그램에 기초자료를 제공하고자 국민건강영양조사 자료를 사용하여 수행하였다. 조사대상은 65세 이상 인구 1,472명을 대상으로 하였다. 조사방법은 t-test, ANOVA 그리고 다단계회귀분석을 사용하였다. 연구결과 직업을 가진 노인들의 삶의 질이 직업이 없는 노인들에 비해 삶의 질이 높게 나타났다(${\beta}=0.041$, p=0.000). 특히, 근로형태에서는 상용직이 평균0.93점(p=0.005), 근로시간은 전일제가 평균 0.91점(p=0.079), 직업분류에서는 전문직이 평균0.96(p=0.044)점으로 삶의 질이 높았다. 노인일자리 사업에서 연구결과를 고려하여 일자리사업을 수행하여 노인들의 삶의 질을 높일 필요가 있다고 생각한다.

방사선학적 출혈양상에 근거한 뇌간출혈의 분류에 따른 임상결과 (Clinical Outcomes according to Radiological Classification of Brainstem Hemorrhages)

  • 조원중;문성호;이승민;양재영;최천식;주문배
    • Journal of Korean Neurosurgical Society
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    • 제29권2호
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    • pp.217-221
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    • 2000
  • Objective : Brainstem hemorrhages usually result in much higher mortality and morbidty than any other intracranial vascular lesions. The purpose of the study is to evaluate the relationship of the radiological classification of the lesions and the clinical outcomes, and to evaluate the value of such classification on the choice of management modality. Method : Thirty seven patients with primary brainstem hemorrhage were managed medically or surgically between Oct. 1995 and Mar. 1998. The lesions were classified as two groups based on radiological findings as follows : Focal subependymal hematoma(group I, n=7) and diffuse tegmentobasilar hemorrhage(group II, n=30). The outcomes at discharge were retrospectively reviewed according to such classification. Result : The most common clinical pictures and radiological findings in each group were as followings : 1) Group I : focal compressive lesion which displaces rather than destroys brain tissue. It occurs in a younger age group and causes neurological deficits which are often partially reversible. Operative hematoma evacuation was performed in 43.3%. Their mean improved Glasgow Coma Scale(GCS) score was 4.7. 2) Group II : hypertensive brain stem hemorrhage. It usually causes a diffuse lesion occurring in an older age group and most often associated with profound irreversible neurological deficits which are often fatal. Operative hematoma evacuation was performed in 16.7%. Their mean improved GCS score was 1.4. In both conservatively treated group I and II has no siginificant clinical improvement. Conclusion : Although there is an overlap among them and the size of the group is small, the pathophysiologic classification of this lesion based on clinical features and radiological findings may be useful for decision of treatment method.

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1985-2000년에 15세 미만 한국인에서 발생한 1형 당뇨병의 역학적 특징 (Epidemiologic characteristics of type 1 diabetes in children aged 14 years or under in Korea, 1985-2000)

  • 신충호
    • Clinical and Experimental Pediatrics
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    • 제51권6호
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    • pp.569-575
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    • 2008
  • Type 1 diabetes mellitus (T1 DM) develops in genetically susceptible individuals as a result of progressive autoimmune destruction of beta cells. There is larger global variation in incidence among children aged 0-14 years. The incidence of T1 DM in Korea is very low. The latest survey in Korea was conducted in 2001 by Korean Society of Pediatrics to analyse the childhood (0-14 years) national-wide incidence during 1 995-2000. The average childhood incidence (/100,000 and year) was 1.36 (95% CI: 1.23-1.48), higher than 1.06 of Korea in 1 994. This survey reported that higher mean annual incidence was observed in female (girls, 1.67 vs boy 1.07), older age group (10-14 years, 1.98; 5-9 years, 1.43; 0-4 years, 0.73), Kangwondo (2.09) and Seoul (1.99), and more new patients developed in spring (spring, 27.1%; winter, 26.6%; summer, 24.8%; autumn, 21.5%). The increase of childhood T1 DM incidence has occurred in every region (4.0% in Asia, 3.2% in Europe during 1990-1999). Also, steady increase in incidence was observed during 1985-2000 in Korea. This trends may be maintained or accelerated by environmental factors, known as triggers, modifiers and promoters of the T1 DM occurrence. The rising incidence of T1 DM suggests the need for continuous monitoring of incidence by using standardized methods in order to plan or assess prevention strategies.

Clinical features of Epstein-Barr virus-associated infectious mononucleosis in hospitalized Korean children

  • Son, Keun-Hyung;Shin, Mee-Yong
    • Clinical and Experimental Pediatrics
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    • 제54권10호
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    • pp.409-413
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    • 2011
  • Purpose: Few studies have been conducted on the recent status of infectious mononucleosis (IM) in Korean children. The aim of this study was to evaluate the recent trend in the clinical manifestations of Epstein-Barr virus (EBV)-associated IM as well as the clinical differences according to age. Methods: A retrospective study was performed on 81 children hospitalized with EBV-associated IM who fulfilled the serological criteria for the diagnosis of EBV infection (viral capsid antigen immunoglobulin M positive). The patients were divided into 3 age groups: <5 years, 5 to 9 years, and ${\geq}10$ years. We evaluated the recent trend in clinical manifestations and the differences in clinical and laboratory findings among the 3 age groups. Results: Thirty (37%) children were under 5 years of age, 38 (46.9%) were 5 to 9 years of age, and 13 (16%) were 10 years of age or older. The differences in the symptoms and signs among the 3 age groups were not statistically significant, except for headache. The mean duration of fever was 7.7 days (range, 0 to 18 days). A comparison of liver enzyme elevation among the age groups showed an association with advancing age (26.6%, 63.1%, and 76.9%, respectively, P=0.04) Conclusion: This study showed that EBV-associated IM in Korean children continues to occur mostly in children under 10 years of age. In children with EBV-associated IM, the incidence of headache and liver enzyme elevation, the duration of fever, and the proportion of females to males were all positively associated with advancing age.

Prostate Cancer in Iran: Trends in Incidence and Morphological and Epidemiological Characteristics

  • Pakzad, Reza;Rafiemanesh, Hosein;Ghoncheh, Mahshid;Sarmad, Arezoo;Salehiniya, Hamid;Hosseini, Sayedehafagh;Sepehri, Zahra;Afshari-Moghadam, Amin
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권2호
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    • pp.839-843
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    • 2016
  • Background: Prostate cancer is second most common cancer in men overall in the world, whereas it is the third most common cancer in men and the sixth most common cancer in Iran. Few studies have been conducted on the epidemiology of prostate cancer in Iran. Since ethnicity of Iranian men is different from Asian people and given the epidemiologic and demographic transition taking place in Iran, this study aimed to investigate trends of incidence and morphology of prostate cancer during 2003 - 2008 in the country. Materials and Methods: Data were collected retrospectively reviewing all new prostate cancer patients in the Cancer Registry Center of the Health Deputy for Iran during a 6-year period. Also carcinoma, NOS and adenocarcinoma, NOS morphology were surveyed. Trends analysis of incidence and morphology was by joinpoint regression. Results: During the six years a total of 16,071 cases of prostate cancer were recorded in Iran. Most were adenocarcinomas at 95.2 percent. Trend analysis of incidence (ASR) There was a significant increase incidence, with annual percentage change (APC) of 17.3% and for morphology change percentage trends there was a significant decrease in adenocarcinoma with an APC of -1.24%. Conclusions: Prostate cancer is a disease of older men and the incidence is increasing in Iran. The most common morphology is adenocarcinoma this appears to be decreasing over time. Due to the changing lifestyles and the aging of the population, epidemiological studies and planning assessment of the etiology of prostate cancer and its early detection are essential.

Epidemiologic Survey of Infantile Cancer in Iran based on the Data of the Largest Pediatric Cancer Referral Center (Ali-Asghar Children Hospital), 1996-2005

  • Bahoush-Mehdiabadi, Gholamreza;Habibi, Roshanak;Shariftabrizi, Ahmad;Vossough, Parvaneh
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권3호
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    • pp.1211-1217
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    • 2014
  • Background: Cancer in infants younger than one year of age represents a unique problem with distinct epidemiological, clinical and genetic characteristics compared with older age groups. No report is yet available from Iran regarding epidemiological and survival rate of cancers diagnosed in this age group. Materials and Methods: The population under study comprised of patients which were diagnosed and admitted to Ali-Asghar hospital between years 1996-2005. In total, 287 infants were included in the retrospective descriptive survey. Patient files were evaluated for age of patient at the time of diagnosis, sex, geographical residence, consanguinity of parents, histological diagnosis, site of cancer involvement, type of therapy, date of last follow-up and cause of death (if applicable). Results: The average age at the time of diagnosis was 7.2 months old. The most frequent malignancy was retinoblastoma (44%), followed by leukemia (19%) and neuroblastoma (10%), with five-year overall survival rates of 77.7%, 41% and 90%, respectively Parents of 40 infants (13.9%) had consanguinity relationships. Conclusions: Although we cannot make any conclusions regarding the incidence of infant cancer subtypes based on this study, survival rates for major types were similar to the developed countries, which signifies strict adherence to standards of care in Ali-Asghar hospital, the main infant cancer care centre in Iran. A Childhood Cancer Registry with high-resolution data collection and also advanced genetic testing is advocated for in-depth analysis of variation in incidence and survival.

Sleep problems in children and adolescents at pediatric clinics

  • Kim, Dong Soon;Lee, Cho Long;Ahn, Young Min
    • Clinical and Experimental Pediatrics
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    • 제60권5호
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    • pp.158-165
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    • 2017
  • Purpose: To investigate the frequency of childhood sleep problems at pediatric clinics in Seoul and Gyeonggi provinces. Methods: Children (n=936) and their parents who visited 5 primary and 1 secondary pediatric outpatient clinics were invited to complete a Pediatric Sleep Questionnaire. Results: Among patients, 901 (96.3%) answered questionnaires in sufficient detail for evaluation. The participant's mean age was $4.35{\pm}3.02years$ (range, 0-18 years). The male to female ratio was 1:0.93 (466 boys, 435 girls). Habitual snoring (>3 day/week) was reported in 16.9% of the participants. The prevalence of habitual snoring in children <2 years and those between 2-5 years was 9% and 18%, respectively. Sleep disordered breathing was found in 15.1% (106 of 700) of children >2 years. Insomnia was reported in 13.2% of children. The prevalence of sleepwalking, night terrors, and bruxism, is 1.6%, 19%, and 21.1%, respectively. Snoring was associated with increased incidence of sleepwalking, night terrors, and bruxism. Age was associated with insomnia and habitual snoring (P<0.05). Insomnia was more prevalent in younger (21%) than in older children (6%). Snoring was more frequent in both preschool (34%) and school-aged children (33%). The frequency of sleep disordered breathing and insomnia did not vary significantly with gender. However, snoring was more prevalent in boys. Conclusion: Sleep problems are frequent among children in Korea. Children with snoring have an increased risk of sleepwalking, night terror, and bruxism. Primary clinicians should consider children's sleep habits to improve their health.

Epidemiology of Moyamoya Disease in Korea: Based on National Health Insurance Service Data

  • Kim, Tackeun;Lee, Heeyoung;Bang, Jae Seung;Kwon, O-Ki;Hwang, Gyojun;Oh, Chang Wan
    • Journal of Korean Neurosurgical Society
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    • 제57권6호
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    • pp.390-395
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    • 2015
  • There have been a few studies reporting the epidemiology of moyamoya disease in Korea. Previous studies revealed relatively high prevalence and incidence of moyamoya disease in Korea and Japan. This study was designed to provide the latest epidemiologic information of moyamoya disease in Korea. We analyzed a database comprising of 50 million people covered in Korea by the National Health Insurance Service to calculate the prevalence. The incidence was estimated by eliminating the duplicated records of previous 3 years. We summarized the prevalence and incidence according to age, sex, and local distribution. In addition, the chronological changes were demonstrated with direct standardization using the 2010 population structure information. The standardized prevalence was 6.5 per 100000 persons in 2005, which was increased to 18.1 in 2013. In the same period, standardized incidence was increased from 2.7 to 4.3 per 100000 persons. The prevalence for men was 4.9 and 8.3 for women in 2005. In 2013, the prevalence had increased for men and women to 13.8 and 25.3, respectively. The incidence for men and women was 2.2 and 3.2, respectively, in 2005. It had increased to 3.5 and 5.7, respectively. The mean age of patients was 33.5 in 2005 and increased to 42.5 in 2013. The peak prevalent age group had shifted slightly to the older age groups, with chronologically consistent female predominance. The prevalence was highest in Jeollabuk province and lowest in Ulsan city.