• Title/Summary/Keyword: Patient's Severity

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Study on Setting the Amount of Thickening Agent in Soup and Beverages as a Guide for Modifying the Viscosity of Dysphagia Diets (연하보조식 점도 조절 가이드를 위한 국과 음료류의 점도증진제 첨가 조건 설정)

  • Ji-Hyun Lee;Dong-Hyun Yook;Mi-Hyun Kim
    • Journal of the Korean Dietetic Association
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    • v.30 no.1
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    • pp.11-28
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    • 2024
  • This study aimed to establish the optimal amount of thickening agent for the appropriate viscosity in soups and beverages, which are part of the dysphagia diet. The soups were bean sprout soup and soybean paste soup; the beverages were orange juice, regular milk, and low-fat milk; the thickening agent was one type of xanthan gum product. After adding the thickening agents (from 1 g to 5 g per 200 mL of the test food), syringe tests were conducted over time (5, 10 and 15 minutes) to verify the effects of the amount of thickening agent added per sample and the time between addition and achieving the resulting viscosity, and to establish the optimal addition conditions to reach IDDSI levels 1, 2, and 3 of the dysphagia diet. Water (based on 200 mL) was used as the standard control. These results provide a useful basis for customized diets based on the patient's dysphagia severity. On the other hand, this study is limited by including only liquid foods in the dysphagia diet and one type of xanthan gum-based thickening agent. Therefore, it is necessary to conduct continuous research, based on the study results, to modify the viscosity of the dysphagia diet using various thickening agents and foods and prevent nutritional deficiencies by managing the diet according to the patient's swallowing ability.

Prosthodontic Treatment of Persons with Disabilities Under Dental Sedation and General Anesthesia (치과진정법과 전신마취를 이용한 장애환자의 보철치료)

  • Kim, Yun-Hee;Lee, Jin-Han
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.12 no.3
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    • pp.183-191
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    • 2012
  • In most persons with disabilities had poor oral hygiene because of less attention and ability to perform a dental care. So the increased prevalence and severity of dental disease were common oral state. Although most persons with disabilities need a adequate dental treatment, it is often very difficult to treat because of noncooperativity and involuntary muscle movements. Dental treatments under sedation and general anesthesia were make to provide a high-quality dental service because of decreased anxiety and fear associated dental treatment in persons with disabilities. The dental professionals must be able to select and apply the proper sedation methods in agreement with the characteristics of the disabilities, general conditions, sedation experience and capacity of dentist, type and time of dental treatment, equipments of dental clinic, consent of patient's protector. The proshodontic treatment procedures, such as abutment preparation, dental impression taking process, try-in process of prosthesis and adjustment of occlusion, are difficult even for patients without disabilities. Those procedures are more difficult to patients with disability because it's too hard to control breathing and muscle. In this report, we performed prosthetic dentistry procedures to three patients with disabilities under dental sedation and general anesthesia.

Comparison of Clinical Laboratory Data and Prevalence according to Arterial Stiffness in Stroke Patients

  • Jin, Bok Hee;Han, Min Ho
    • Korean Journal of Clinical Laboratory Science
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    • v.46 no.4
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    • pp.143-149
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    • 2014
  • Pulse wave velocity (PWV) is used to non-invasively estimate the severity of arteriosclerosis by measuring the patient's arterial stiffness comparing with each normal reference range according to their ages. Increased arterial stiffness is closely related to both atherosclerosis and arteriosclerosis, which have been known for causes of cardiovascular disease and stroke, also negatively affects the prognosis and the re-occurrence in patients with stroke. The study is focused on how brachial-ankle pulse wave velocity (baPWV) is related to cardiovascular disease risk factors in patients with acute stroke. There were 114 subjects, 69 males and 45 females, all in their 60's and had PWV test for acute stroke. The results are as follows: the group with increased arterial stiffness showed significant increase in HbAlc, total cholesterol, RSBP (resting systolic blood pressure), CSBP (central systolic blood pressure) and CDBP (central diastolic blood pressure). Cross tabulation test showed that there was a significant relationship only between the group with increased arterial stiffness and diabetes mellitus (DM). Therefore, it might be useful for preventing re-occurrence and making a favorable prognosis to promptly adjust DM and hypertension-related risk factors in patients with acute stroke.

Ipsilesional Movement Deficit of Proximal & Distal Upper Extremity in Patients With Unilateral Brain Damage (편측 뇌손상 환자에서 동측 상지의 근위부 및 원위부의 운동 결함에 관한 분석)

  • Kwon, Yong-Hyun;Choi, Jin-Ho;Shin, Hwa-Kyung;Bai, Dai-Seg
    • Physical Therapy Korea
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    • v.12 no.1
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    • pp.71-79
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    • 2005
  • The purpose of this study was to analyze the presence of ipsilesional movement deficit, with segmental performance in each proximal or distal upper extremity. The visuoperceptual complex task of the ipsilesional upper extremity was investigated in patients with unilateral brain damage and a control group of healthy sex-age-matched controls. Tracking movements were tested in the proximal and distal upper extremities. Movements were measured by the accuracy index, which was normalized to each subject's own range of motion and took into account any differences between subjects in the excursion of the tracking target. The findings revealed that stroke patients experienced difficulties with tracking movement of both proximal and distal segments in the upper extremities on the so-called "non-affected side", irrespectively of the extent of patient's age, time since onset, or severity of contralateral upper extremity. Therefore, the unilateral brain damage affected ipsilateral motor function of the proximal and distal upper limbs in the performance of complex motor tasks, requiring central processing and the higher order cognitive function in the integrity of both hemispheres.

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Endovascular embolization of persistent liver injuries not responding to conservative management: a narrative review

  • Simon Roh
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.165-171
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    • 2023
  • Trauma remains a significant healthcare burden, causing over five million yearly fatalities. Notably, the liver is a frequently injured solid organ in abdominal trauma, especially in patients under 40 years. It becomes even more critical given that uncontrolled hemorrhage linked to liver trauma can have mortality rates ranging from 10% to 50%. Liver injuries, mainly resulting from blunt trauma such as motor vehicle accidents, are traditionally classified using the American Association for the Surgery of Trauma grading scale. However, recent developments have introduced the World Society of Emergency Surgery classification, which considers the patient's physiological status. The diagnostic approach often involves multiphase computed tomography (CT). Still, newer methods like split-bolus single-pass CT and contrast-enhanced ultrasound (CEUS) aim to reduce radiation exposure. Concerning management, nonoperative strategies have emerged as the gold standard, especially for hemodynamically stable patients. Incorporating angiography with embolization has also been beneficial, with success rates reported between 80% and 97%. However, it is essential to identify the specific source of bleeding for effective embolization. Given the severity of liver trauma and its potential complications, innovations in diagnostic and therapeutic approaches have been pivotal. While CT remains a primary diagnostic tool, methods like CEUS offer safer alternatives. Moreover, nonoperative management, especially when combined with angiography and embolization, has demonstrated notable success. Still, the healthcare community must remain vigilant to complications and continuously seek improvements in trauma care.

Massive traumatic abdominal wall hernia in pediatric multitrauma in Australia: a case report

  • Sarah Douglas-Seidl;Camille Wu
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.447-450
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    • 2023
  • Traumatic abdominal wall hernia is a rare presentation, most commonly reported in the context of motor vehicle accidents and associated with blunt abdominal injuries and handlebar injuries in the pediatric population. A 13-year-old boy presented with multiple traumatic injuries and hemodynamic instability after a high-speed motor vehicle accident. His injuries consisted of massive traumatic abdominal wall hernia (grade 4) with bowel injury and perforation, blunt aortic injury, a Chance fracture, hemopneumothorax, and a humeral shaft fracture. Initial surgical management included partial resection of the terminal ileum, sigmoid colon, and descending colon. Laparostomy was managed with negative pressure wound therapy. The patient underwent skin-only primary closure of the abdominal wall and required multiple returns to theatre for debridement, dressing changes, and repair of other injuries. Various surgical management options for abdominal wall closure were considered. In total, he underwent 36 procedures. The multiple injuries had competing management aims, which required close collaboration between specialist clinicians to form an individualized management plan. The severity and complexity of this injury was of a scale not previously experienced by many clinicians and benefited from intrahospital and interhospital specialist collaboration. The ideal aim of primary surgical repair was not possible in this case of a giant abdominal wall defect.

A Case Report of Korean Medicine Treatment Focused on Acupotomy Therapy for Acute Cervical Radiculopathy Presenting with Shoulder Pain (어깨 통증 양상으로 나타난 급성 경추부 신경뿌리병증 환자의 침도치료를 중심으로 한 한의치료 1례)

  • Taehyeong, Kim;Dasol Park;Jungtae Leem;Gawon Choe
    • Korean Journal of Acupuncture
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    • v.41 no.2
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    • pp.51-57
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    • 2024
  • This case report aims to illustrate the diagnostic challenge and effective management of acute cervical radiculopathy presenting as shoulder pain, differentially diagnosed through physical examinations, and subsequently treated with acupotomy. A male patient in his late 20s with no significant medical history or comorbidities reported acute left shoulder pain upon awakening, rated at a severity of 7 on the numeric rating scale (NRS). Initial physical evaluations of the shoulder assembly revealed no abnormalities, but a positive Spurling test, relief with cervical distraction, and diminished sensation across the left C5~C8 dermatomes pointed towards a cervical spine origin. Immediate acupotomy at identified tender points significantly reduced pain, with additional therapies enhancing recovery. Pain was eliminated after the second treatment, and this resolution was sustained at the 4-week follow-up, confirming the treatment's effectiveness and verifying the absence of adverse effects. This case presents the critical need for precise diagnosis in cases of neck and shoulder pain. Additionally, the employment of acupotomy provided a swift and effective resolution of symptoms in acute cervical radiculopathy, showing its value in clinical practice.

Biomechanics of stabbing knife attack for trauma surgeons in Korea: a narrative review

  • Kun Hwang;Chan Yong Park
    • Journal of Trauma and Injury
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    • v.37 no.1
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    • pp.1-5
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    • 2024
  • The aim of this paper was to review the biomechanics of knife injuries, including those that occur during stabbing rampages. In knife stab attacks, axial force and energy were found to be 1,885 N and 69 J, respectively. The mean velocity of a stabbing motion has been reported to range from 5 to 10 m/sec, with knife motions occurring between 0.62 and 1.07 seconds. This speed appears to surpass the defensive capabilities of unarmed, ordinarily trained law enforcement officers. Therefore, it is advisable to maintain a minimum distance of more than an arm's length from an individual visibly armed with a knife. In training for knife defense, particularly in preparation for close-quarter knife attacks, this timing should be kept in mind. Self-inflicted stab wounds exhibited a higher proportion of wounds to the neck and abdomen than assault wounds. Injuries from assault wounds presented a higher Injury Severity Score, but more procedures were performed on self-inflicted stab wounds. Wound characteristics are not different between nonsuicidal self-injury and suicidal self-wrist cutting injuries. Consequently, trauma surgeons cannot determine a patient's suicidal intent based solely on the characteristics of the wound. In Korea, percent of usage of lethal weapon is increasing. In violence as well as murders, the most frequently used weapon is knife. In the crimes using knife, 4.8% of victims are killed. Therefore, the provision of prehospital care by an emergency medical technician is crucial.

Validation Study of Behavior Problems Inventory-01 among Korean Children and Adolescents (한국판 문제행동 평가도구(Behavior Problems Inventory-01) 표준화 연구)

  • Choi, Miji;Kim, Yeni;Ban, Ji-Jeong;Hwang, Samuel Suk-Hyun;Kim, Bung-Nyun;Yang, Young-Hui
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.28 no.4
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    • pp.220-227
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    • 2017
  • Objectives: The purpose of this study was to examine the reliability and validity of the Korean version of the Behavior Problems Inventory (BPI-01) among children and adolescents aged between 3 and 18. Methods: The control group consisting of one hundred children and adolescents was recruited from schools and the patient group consisting of forty one children and adolescents with autism spectrum disorder were recruited from a hospital. We compared the measurements of both groups. To assess the concurrent validity of the BPI-01, we compared the problem behavior index of the Korean Scale of Independent Behavior-Revised (K-SIB-R) and, to assess the discriminant validity, we compared the Korean version of the Child Behavior Checklist (K-CBCL). The Cronbach's alpha of the BPI-01 was measured to assess its reliability. Correlation analyses between the BPI-01 and the other scale were carried out to examine the former's concurrent and discriminant validity. Results: The patient group showed a significantly higher score for all three subscales of the BPI than the control group. The Cronbach's alpha was 0.92 for the total severity score of the BPI and ranged between 0.67-0.89 for each subscale in the patient group. All subscales of the BPI-01's, i.e., self injurious behavior, stereotyped behavior and aggressive/destructive behavior, were significantly correlated with the corresponding subscales of the K-SIB-R. The BPI-01 generally did not demonstrate any significant correlation with emotional items such as anxiety/depression in the K-CBCL. Especially, the BPI-01's stereotyped behavior subscale showed little correlation with externalizing behaviors such as social problems and aggressive behaviors. Conclusion: This study found that the Korean version of BPI-01 is a reliable and valid behavior rating instrument for problem behavior in developmental disabilities among children and adolescents.

Guidelines for dental clinic infection prevention during COVID-19 pandemic (코로나 바이러스 대유행에 따른 치과 의료 관리 가이드라인)

  • Kim, Jin
    • Journal of Korean Academy of Dental Administration
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    • v.8 no.1
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    • pp.1-7
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    • 2020
  • Dental settings have unique characteristics that warrant specific infection control considerations, including (1) prioritizing the most critical dental services and provide care in a way that minimizes harm to patients due to delayed care, or harm to personnel from potential exposure to persons infected with the COVID-19 disease, and (2) proactively communicate to both personnel and patients the need for them to stay at home if sick. For health care, an interim infection prevention and control recommendation (COVID-19) is recommended for patients suspected of having coronavirus or those whose status has been confirmed. SARS-CoV-2, which is the virus that causes COVID-19, is thought to be spread primarily between people who are in close contact with one another (within 6 feet) through respiratory droplets that are produced when an infected person coughs, sneezes, or talks. Airborne transmission from person-to-person over long distances is unlikely. However, COVID-19 is a new disease, and there remain uncertainties about its mode of spreads and the severity of illness it causes. The virus has been shown to persist in aerosols for several hours, and on some surfaces for days under laboratory conditions. COVID-19 may also be spread by people who are asymptomatic. The practice of dentistry involves the use of rotary dental and surgical instruments, such as handpieces or ultrasonic scalers, and air-water syringes. These instruments create a visible spray that can contain particle droplets of water, saliva, blood, microorganisms, and other debris. While KF 94 masks protect the mucous membranes of the mouth and nose from droplet spatter, they do not provide complete protection against the inhalation of airborne infectious agents. If the patient is afebrile (temperature <100.4°F)* and otherwise without symptoms consistent with COVID-19, then dental care may be provided using appropriate engineering and administrative controls, work practices, and infection control considerations. It is necessary to provide supplies for respiratory hygiene and cough etiquette, including alcohol-based hand rub (ABHR) with 60%~95% alcohol, tissues, and no-touch receptacles for disposal, at healthcare facility entrances, waiting rooms, and patient check-ins. There is also the need to install physical barriers (e.g., glass or plastic windows) in reception areas to limit close contact between triage personnel and potentially infectious patients. Ideally, dental treatment should be provided in individual rooms whenever possible, with a spacing of at least 6 feet between the patient chairs. Further, the use of easy-to-clean floor-to-ceiling barriers will enhance the effectiveness of portable HEPA air filtration systems. Before and after all patient contact, contact with potentially infectious material, and before putting on and after removing personal protective equipment, including gloves, hand hygiene after removal is particularly important to remove any pathogens that may have been transferred to the bare hands during the removal process. ABHR with 60~95% alcohol is to be used, or hands should be washed with soap and water for at least 20 s.