• Title/Summary/Keyword: Patient's Severity

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Risk Factors of Severity of Pressure Injuries in Acute University Hospital Inpatients (급성기 대학병원 입원환자의 욕창중증도의 영향요인)

  • Cho, Bo Kyung;Ko, Young;Kwak, Chanyeong
    • Journal of Convergence for Information Technology
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    • v.10 no.11
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    • pp.98-106
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    • 2020
  • This study was conducted to identify the factors influencing the severity of pressure injuries of patients with pressure injuries admitted to acute university hospital. This study was a secondary analysis on the data of the study conducted to identify the factors influencing the deterioration of pressure injuries during hospitalization. The data were collected by retrospectively examining the medical records of patients with pressure injuries who were 18 years of age or older and who were admitted to acute university hospital from May 2017 to November 2018. We used data from 472 patients with pressure injuries at admission for this secondary analysis. In order to identify the factor influencing of severe pressure injuries compare to superficial pressure injuries, we analyzed the data using logistic regression analysis. As a result of the study, gender, body temperature, and patient's movement were identified as factors affecting severe pressure injuries. Therefore, special care is necessary to increased the number of position change for inpatients with pressure injuries, especially for patients with decreased mobility.

Concurrent Use of Sulfonylureas and Antimicrobials of the Elderly in Korea: A Potential Risk of Hypoglycemia (고령자에서 Sulfonylureas와 항균제의 병용투여 현황)

  • Lee, Sera;Ock, Miyoung;Kim, Hyunah
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.3
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    • pp.188-193
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    • 2018
  • Background: Previous studies have noted that the simultaneous use of sulfonylureas and antimicrobials, which is common, could increase the risk of hypoglycemia. In particular, an age of 65 years or older is a known risk factor for sulfonylurea-related hypoglycemia in hospitalized patients. Therefore, we performed this study to determine the potential risk of hypoglycemia from the concurrent use of antimicrobials and sulfonylureas. Methods: We performed a cross-sectional study on the National Health Insurance Service-National Sample Cohort from 2013. The eligibility criteria included patients of 65 years of age or older taking a sulfonylurea with 25 different antimicrobials. Different risk ratings of severity in drug-drug interactions (potential DDIs), level X, D, or C in Lexi-$Interact^{TM}$ online, and contraindicated, major, or moderate severity level in $Micromedex^{(R)}$ were included. SAS version 9.4 was used for data analysis. Results: A total of 6,006 elderly patients with 25,613 prescriptions were included. The largest age group was 70 to 74 (32.7%), and 39.7% of patients were men. The mean number of prescriptions was 4.3 per patient. The most frequently used antimicrobials were levofloxacin (6,583, 25.7%), ofloxacin (6,549, 25.6%), fluconazole (4,678, 18.0%), and ciprofloxacin (2,551, 9.8%). Among sulfonylureas, glimepiride was prescribed most frequently, followed by gliclazide, glibenclamide, and glipizide. Conclusion: Of the antimicrobials with a high potential of hypoglycemia, levofloxacin, ofloxacin, fluconazole, and ciprofloxacin were used frequently. Thus, the monitoring of clinically relevant interactions is required for patients concurrently administered sulfonylureas and antimicrobials.

A CLINICAL STUDY ABOUT NATURE AND SEVERITY OF THE ZYGOMATIC BONE FRACTURES (관골 골절의 양상 및 정도에 관한 임상적 연구)

  • Ryu, Soo-Jang;Kim, Mi-Sook;Ro, Ki-Mun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.2
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    • pp.211-218
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    • 2000
  • This is a retrospective study on the nature and severity of zygomatic bone fractures. This study was based on a series of 358 patients with zygomatic bone fractures who treated as in-patient at Soonchunhyang Chonan Hospital during the period of Jan. 1993 through Dec. 1996. The results obtained are as follows : 1. The ratio of men to women was 4.41:1. The age frequency was highest in the second, third decade. The yearly distribution was the highest in 1993. The monthly distribution was highest in Feb. and Jun. 2. The most frequent cause was the traffic accident.(66.2%) 3. The most frequent type of fractures was the class I(undisplaced fx.).(25%) 4. The most frequent associated oral and maxillofacial injuries was soft tissue.(46.9%) 5. The most frequent associated systemic injuries was upper, lower extremity.(38%) 6. In A.I.S of oral and maxillofacial area, the mean score of A.I.S was $2.5{\sim}3$. In I.S.S, the highest mean score was in the ped TA.(19) 7. In respect of treatment, the most common method was open reduction with rigid fixation on fronto-zygomatic suture area.(47.8%) 8. The incidence of complication was 12% and the most common complication was malunion.(6.1%)

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Experience with Conventional Radiofrequency Thermorhizotomy in Patients with Failed Medical Management for Trigeminal Neuralgia

  • Singh, Sarita;Verma, Reetu;Kumar, Manoj;Rastogi, Virendra;Bogra, Jaishree
    • The Korean Journal of Pain
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    • v.27 no.3
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    • pp.260-265
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    • 2014
  • Background: To evaluate the results of conventional radiofrequency thermorhizotomy (CRT) for trigeminal neuralgia (TN) in patients with failed medical management. Methods: Patients with Trigeminal neuralgia who were referred to us for 'limited intervention' during the time frame July-2011 to Jan-2013 were enrolled for this study. CRT was administered by the Sweet technique. Pain relief was evaluated by the principle investigator. Results: Eighteen patients were enrolled and completed a mean follow-up of 18.0 months. Pain relief was observed in 14 of 18 (77.8%) patients on the post-operative day, 14 of 18 (77.8%) at 1-month follow-up, 14 of 17 (82.4%) at 3-months follow-up, 12 of 15 (80%) at 6-months follow-up, 7 of 11 (63.6%) at 1-year follow-up and 2 of 6 (33.3%) 1.5 years of follow-up. Four patients required a repeat cycle of CRT; two at six months of follow-up and two at one year of follow-up. One patient was transferred for surgical intervention at six months of follow-up. Side-effects included facial hypoesthesia (n = 6); nausea/vomiting (n = 2), diminished corneal reflex (n = 13) and difficulty in chewing (n = 11). Severity of adverse effects gradually diminished and none of the patients who are beyond 6 months of follow-up have any functional limitation. Conclusions: CRT is an effective method of pain relief for patients with Trigeminal neuralgia. Successful outcome (excellent or good) can be expected in 66.7% of patients after first cycle of CRF. The incidence and severity of adverse effects is less and the procedure is better tolerated by the patients.

A Patient with a Diagnosis of Spinal Neurofibroma and Complaining of Lower Back Pain: A Case Report, Including Two Follow-ups after Discharge (척추 신경섬유종 진단을 받은 요통 환자에 대한 복합적 한방처치 및 영상학적 경과 관찰 증례 보고 1례)

  • Moon, Heeyoung;Ryu, Gwang-hyun;Ju, Ah-ra;Choi, Yo-sup;Choo, Won-jung;Park, Ji-won;Kim, Doori;Jeon, Yong-hyun
    • The Journal of Internal Korean Medicine
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    • v.40 no.5
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    • pp.938-947
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    • 2019
  • Objective: This study was performed to report the changes in symptoms and radiological consequences of a patient diagnosed with spinal neurofibroma and complaining of lower back pain. Methods: The patient was diagnosed with a spinal neurofibroma after MRI examination and was treated with traditional Korean medicine, including traditional Korean medication and acupuncture. We measured the change in symptom severity using a numerical rating scale (NRS) and the Oswestry Disability Index (ODI). We also used the EQ-5D (EuroQoL-5D) scale to assess the patient's quality of life. In addition, we examined the change in the size of the cyst by MRI twice after discharge: at about 3 months after discharge and at about 8 months after discharge. Results: After about 6 weeks of treatment, most pathological symptoms had decreased. The patient showed a decline in NRS and ODI scores and showed an increase in quality of life. The two MRI examinations after the discharge revealed a decrease in the size of the cyst. Conclusions: Traditional Korean medicine can be a solution for patients with spinal neurofibroma causing neurological pain.

A Case of Chronic Cough in a Child Misdiagnosed as a Tic Disorder (틱 장애로 오인된 소아청소년의 만성 기침 1례)

  • Ji-Young Choi;Ji-One Im;Young-Eun Lee;Seon-Young Jee;Min Hwangbo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.37 no.2
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    • pp.104-112
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    • 2024
  • Objectives : This study aimed to report improvement of patient with chronic cough treated with Korean medical treatment. Methods : A 12-year-old male patient who began coughing at the end of October 2023 misdiagnosed by a tic disorder and was prescribed oral medication. However, the cough worsened, persisting throughout the day without respite, accompanied by sleep disturbances (desire to sleep continuously) and gait disturbance (only able to walk with support). The patient visited the clinic on December 15, 2023, and was re-diagnosed with chronic cough. And the patient received Korean medical treatment, including herbal medicine(Ryokankyomishinge-tang, Ryokankyomishingenin-tang, Sogunjung-tang), and acupuncture. The severity of chronic cough was evaluated by VAS before and after administration of each treatment term. Results : The patient's symptoms improved and VAS changed 10 to 0. Conclusions : This case study showed an effectiveness of Korean medical treatment on chronic cough.

Urgent Intracranial Carotid Artery Decompression after Penetrating Head Injury

  • Kim, Seong Joon;Park, Ik Seong
    • Journal of Korean Neurosurgical Society
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    • v.53 no.3
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    • pp.180-182
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    • 2013
  • We describe a case of intracranial carotid artery occlusion due to penetrating craniofacial injury by high velocity foreign body that was relieved by decompressive surgery. A 46-year-old man presented with a penetrating wound to his face. A piece of an electric angular grinder disc became lodged in the anterior skull base. Computed tomography revealed that the disc had penetrated the unilateral paraclinoid and suprasellar areas without flow of the intracranial carotid artery on the lesion side. The cavernous sinus was also compromised. Removal of the anterior clinoid process reopened the carotid blood flow, and the injection of glue into the cavernous sinus restored complete hemostasis during extraction of the fragment from the face. Digital subtraction angiography revealed complete recanalization of the carotid artery without any evidence of dissection. Accurate diagnosis regarding the extent of the compromised structures and urgent decompressive surgery with adequate hemostasis minimized the severity of penetrating damage in our patient.

Current concepts of craniofacial fibrous dysplasia: pathophysiology and treatment

  • Dong Yeon Kim
    • Archives of Craniofacial Surgery
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    • v.24 no.2
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    • pp.41-51
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    • 2023
  • Fibrous dysplasia is an uncommon genetic disorder in which bone is replaced by immature bone and fibrous tissue, manifesting as slow-growing lesions. Sporadic post-zygotic activating mutations in GNAS gene result in dysregulated GαS-protein signaling and elevation of cyclic adenosine monophosphate in affected tissues. This condition has a broad clinical spectrum, ranging from insignificant solitary lesions to severe disease. The craniofacial area is the most common site of fibrous dysplasia, and nine out of 10 patients with fibrous dysplasia affecting the craniofacial bones present before the age of 5. Surgery is the mainstay of treatment, but the technique varies according to the location and severity of the lesion and associated symptoms. The timing and indications of surgery should be carefully chosen with multidisciplinary consultations and a patient-specific approach.

Analysis of Patients with Acute Carbon Monoxide Poisoning in one Hospital (일개 병원에서의 일산화탄소 중독증으로 내원한 환자에 대한 분석)

  • Kim Kyung Hwan;Kim Ah Jin;Shin Dong Wun;Rho Jun Young
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.1
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    • pp.27-32
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    • 2005
  • Purpose: The frequency of carbon monoxide poisoning has been decreased in the interior of the Korea. But occasionally it is occurred and the risk of exposure is high in working place so far. Because of the characteristics of gas, the detection of exposure and poisoning could be delayed and fatality is high. We should apprehend of carbon monoxide poisoning. So we would report analysis of patients with carbon monoxide poisoning. Methods: A retrospective review of CO poisoned patients visited emergency department from January 2000 to December 2004 was conducted. Results: 24 patients were enrolled. Their average of age was $37.6\pm20.9$ years old and COHb was $19.4\pm13.32\%$. The blood level of initial COHb and mental status on arrival were not correlated each other. The blood level of initial COHb and loss of consciousness were not correlated, too. Initial electrocardiography (EKG) was not correlated with cardiac enzymes such as CK-MB and troponin I. But base excess was correlated with mental status on arrival and complication such as rhabdomyolysis. Hyperbaric oxygen therapy was correlated with base excess and mental status on arrival. Conclusion: The clinical features of carbon monoxide poisoning are nonspecific. For proper diagnosis, it is important that we should consider patient's environment and take patient's history carefully. The blood level of initial COHb does not reflect severity of poisoning accurately. So We should determine the treatment of choice depending on patient's status.

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Clinical outcome of 1,000 consecutive cases of liver transplantation: a single center experience

  • Kwak, Bong Jun;Kim, Dong Goo;Han, Jae Hyun;Choi, Ho Joong;Bae, Si Hyun;You, Young Kyoung;Choi, Jong Young;Yoon, Seung Kew
    • Annals of Surgical Treatment and Research
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    • v.95 no.5
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    • pp.267-277
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    • 2018
  • Purpose: The aim of this study was to analyze survival outcomes in 1,000 consecutive liver transplantations (LTs) performed at a single institution from 1993 to April 2017. Methods: The study population was divided into 2 groups based on donor type: deceased donor LT (DDLT; n = 181, 18.1%) and living donor LT (LDLT; n = 819; 81.9%), and into 3 periods based on the number of cases (first 300 cases, middle 300 cases, last 400 cases). Results: Infection was the most common cause of death, accounting for 34.8% (95 of 273). Mortality due to hepatocellular carcinoma recurrence occurred most frequently between 1 and 5 years after transplantation. Mortality rate by graft rejection was highest between 5 and 10 years after transplantation. And mortality by de novo malignancy occurred most frequently after 10 years after transplantation. The patient survival rates for the entire population at 5 and 10 years were 74.7%, and 68.6%, respectively. There was no difference in survival rate between the LDLT and DDLT groups (P = 0.188). Cause of disease, disease severity, case period, and retransplantation had a significant association with patient survival (P = 0.002, P = 0.031, P = 0.003, and P = 0.024, respectively). Conclusion: Surgical techniques and perioperative management for transplant patients have improved and undergone standardization. Controlling perioperative infection and managing patients with HCC as LT candidates will result in better outcomes.