• Title/Summary/Keyword: Patient's Severity

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Factors Associated with Utilization Patterns of Provincial Patients Discharged from General Hospitals Located in Seoul Area (지방거주환자의 서울지역 의료기관 이용에 영향을 미치는 요인)

  • Hong, Sung-Ok;Suh, Won-S.
    • Korean Journal of Health Education and Promotion
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    • v.26 no.4
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    • pp.117-127
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    • 2009
  • Objectives: The primary objective of the study is to analyze the utilization patterns of provincial patients discharged from hospitals located in Seoul area. Methods: For the analysis, the study employed the nationwide data on 'Survey of Injured Patients Discharged from Hospitals' conducted by KCDC (Korea Centers for Disease Control and Prevention). The statistical methodology used in the measurement model is a logistic regression model. Results: The study has three major findings. First, compared to other disease groups, the discharged on both 'neoplasm(cancer)' and 'congenital malformation, deformity and chromosomal abnormalities' disease groups are more likely to utilize hospitals in Seoul area. Second, as for 'neoplasm(cancer)' disease group, patients with 'bones and articular cartilage' areas are more likely to utilize hospitals in Seoul area. Finally, Hospitals with more than 1,000 beds was primary factor in selecting Seoul-based hospitals by the discharged in provincial areas. Conclusion: In sum, the study showed that patients in provincial areas are more likely to utilize hospitals located in Seoul area regardless of the severity of their cases. Local authority, therefore, is required to monitor local hospitals on regular basis, as well as support them to establish specialized medical centers by providing human and physical resources.

Factors Associated with Injuries after Inpatient Falls in a Tertiary Hospital (상급종합병원 입원환자의 낙상 후 상해 실태 및 상해에 영향을 미치는 요인)

  • Cho, Moon Suk;Lee, Hyang Yuol
    • Journal of Korean Clinical Nursing Research
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    • v.23 no.2
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    • pp.202-210
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    • 2017
  • Purpose: In this study an investigation was done of injuries from inpatient falls and diagnostic tests and treatment after falls to identify what factors affect the occurrence of injury from inpatient falls in a tertiary hospital. Methods: Data for this cross-sectional study were retrieved for 428 fall events from data reported between January 1 and December 31, 2015 and were retrieved from the patient-safety reporting system in the hospital's electronic health records. A multivariate logistic regression model was developed with STATA 13.0. Results: Of the patients, 197 (46.0%) had physical injuries due to falls, 119 (27.8%) were given further diagnostic tests, and 358 (83.6%) received treatment including close observation after inpatient falls. Logistic-regression results identified that age, department, and risk factors had significant impact on injuries from falls. Conclusion: Findings indicate that to reduce the severity of injury after inpatient falls, each hospital should regularly evaluate identified factors, design fall-prevention practices specialized for elders and vulnerable patients, and initiate environmental and equipment innovations.

Usefulness of Balloon-type Hemostatic Device After Transarterial Chemoembolization (간동맥 화학색전술 후 풍선형 지혈기구의 유용성)

  • Kim, Seung-Gi
    • Journal of radiological science and technology
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    • v.42 no.3
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    • pp.181-186
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    • 2019
  • Transarterial chemoembolization is one of the most representative procedures for puncture of the femoral artery. In addition, the same procedure is often repeatedly performed many times, and Hepatocellular carcinoma patients due to cancer is significantly lowered blood tests, regardless of platelet counts are not good enough to stop bleeding. More importantly, hepatocellular carcinoma has a high degree of complication and disease severity, which makes it less likely that the condition of the body will be relatively inferior to other patients. In order to prevent delayed hemorrhage of the femoral artery puncture site after the procedure, it is advised to absolutely stabilize the limb so that it does not bend the limb for 3 hours after climbing in the ward. Therefore, I have been complaining about inconvenience. In addition, in order to prevent delayed hemorrhage after hemostasis, balloon type hemostatic device was used instead of sand bag which was placed on hemostatic site. The results of this study were compared with the results of actual application. The use of a balloon-type hemostatic device to increase the effectiveness of continuous hemostasis and to minimize the inconvenience during the time of patient's absolute bed rest, rather than raising the sandbag to prevent primary delayed hemorrhage by various methods in transarterial chemoembolization. It can be used as a substitute for existing sand bags because it can alleviate pain, increase satisfaction, and can be used as a disposable one.

Subcapsular Splenic Hemorrhage in Vivax Malaria

  • Im, Jae Hyoung;Chung, Moon-Hyun;Durey, Areum;Lee, Jin-Soo;Kim, Tong-Soo;Kwon, Hea Yoon;Baek, Ji Hyeon
    • Parasites, Hosts and Diseases
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    • v.57 no.4
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    • pp.405-409
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    • 2019
  • In malaria, splenic rupture is a serious complication potentially leading to death. Subcapsular hemorrhage of spleen is thought to be an impending sign of splenic rupture; however, the characteristics of subcapsular hemorrhage are not well known. We report 3 cases of subcapsular hemorrhage of the spleen in vivax malaria, with varying degrees of severity. Case 1 showed subcapsular hemorrhage without splenic rupture, was treated by antimalarial drug without any procedure. The healing process of the patient's spleen was monitored through 6 computed tomography follow-up examinations, over 118 days. Case 2 presented subcapsular hemorrhage with splenic rupture, treated only with an antimalarial drug. Case 3 showed subcapsular hemorrhage with splenic rupture and hypotension, treated using splenic artery embolization. They all recovered from subcapsular hemorrhage without any other complications. These 3 cases reveal the process of subcapsular hemorrhage leading to rupture and a potentially fatal outcome. The treatment plan of subcapsular hemorrhage should be determined carefully considering the vital signs, changes in hemoglobin, and bleeding tendency.

Treatment for ophthalmic paralysis: functional and aesthetic optimization

  • Kim, Min Ji;Oh, Tae Suk
    • Archives of Craniofacial Surgery
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    • v.20 no.1
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    • pp.3-9
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    • 2019
  • Facial nerve palsy has an effect on a person's well-being functionally and psychologically. Therefore, comprehensive patient management is essential. One of the most common uncomfortable and potentially debilitating features is associated with the incapacity for eye closure. Restoration of eye closure is a key consideration during the surgical management of facial palsy. In this article, we introduce simple surgical methods-which are relatively easy to learn and involve the upper and lower eyelids-for achieving eye closure. Correcting upper eyelid function involves facilitating the component of eye closure that is in the same direction as gravity and is, therefore, less complicated and favorable outcomes than correction of lower lid. Aesthetic aspects should be considered to correct the asymmetry caused by facial palsy. Lower eyelid function involves a force that opposes gravity for eye closure, which makes correction of lower eyelid ectropion more challenging than surgery for the upper eyelid, particularly in terms of effecting a sustained correction. Initially, proper ophthalmic evaluation is required, including identifying the chronicity and severity of ectropion. Also, it is important to determine whether or not lateral canthoplasty is necessary. The lateral tarsal strip procedure is commonly used for lower lid correction. However, effective lower lid correction can be achieved with better cosmesis when extensive supporting techniques are applied, including those involving cheek tissue.

Benefits and risks of therapeutic alternatives for macrolide resistant Mycoplasma pneumoniae pneumonia in children

  • Yang, Hyeon-Jong
    • Clinical and Experimental Pediatrics
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    • v.62 no.6
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    • pp.199-205
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    • 2019
  • Although Mycoplasma pneumoniae pneumonia (MPP) has been generally susceptible to macrolides, the emergence of macrolide-resistant MPP (MRMP) has made its treatment challenging. MRMP rapidly spread after the 2000s, especially in East Asia. MRMP is more common in children and adolescents than in adults, which is likely related to the frequent use of macrolides for treating M. pneumoniae infections in children. MRMP is unlikely to be related to clinical, laboratory, or radiological severity, although it likely prolongs the persistence of symptoms and the length of hospital stay. Thereby, it causes an increased burden of the disease and poor quality of life for the patient as well as a societal socioeconomic burden. To date, the only alternative treatments for MRMP are secondary antimicrobials such as tetracyclines (TCs) or fluoroquinolones (FQs) or systemic corticosteroids; however, the former are contraindicated in children because of concerns about potential adverse events (i.e., tooth discoloration or tendinopathy). A few guidelines recommended TCs or FQs as the second-line drug of choice for treating MRMP. However, there have been no evidence-based guidelines. Furthermore, safety issues have not yet been resolved. Therefore, this article aimed to review the benefits and risks of therapeutic alternatives for treating MRMP in children and review the recommendations of international or regional guidelines and specific considerations for their practical application.

3 Cases of Burning Mouth Syndrome Treated with Sosiho-tang-Based Korean Medicine (소시호탕(小柴胡湯) 위주의 한방 치료로 호전된 구강 작열감 증후군 환자 3명에 대한 증례 보고)

  • Kim, Su-Jin;Kim, Yeon-Soo;Jee, Seon-Young;Hwangbo, Min
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.34 no.4
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    • pp.146-153
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    • 2021
  • Objectives : This study was carried out to investigate the effect of Sosiho-tang on Burning mouth syndrome of female after menopause. Methods : We treated 3 Burning mouth syndrome patients with Sosiho-tang-Based Korean Medicine. We evaluated the severity of pain and heat by using the Visual Analogue Scale(VAS). Results : After the treatments, all patient's objective score of Burning mouth syndrome was remarkably decreased. Conclusions : This study suggests that Sosiho-tang is effective against Burning mouth syndrome of female after menopause.

Variant angina diagnosed on pre-hospital 12-lead electrocardiogram: A case report (병원 전 12-Lead ECG 측정을 통해 진단된 이형성 협심증 1례)

  • Kim, Ji-Won;Ki, Eunyoung
    • The Korean Journal of Emergency Medical Services
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    • v.25 no.1
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    • pp.243-249
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    • 2021
  • A decrease in coronary blood flow leads to an imbalance between the supply of oxygen to the myocardium and its demand, and reversible or irreversible damage to the myocardium could occur depending on the severity of the resultant ischemia and the duration of the imbalance. This imbalance results in a cascade of ischemic reactions in the following order: metabolic abnormalities, diastolic dysfunction, systolic dysfunction, and electrocardiogram changes. Variant angina is caused by the closure of the coronary artery due to reversible coronary artery spasm, resulting in myocardial ischemia and subsequent chest pain as a clinical symptom. Variant angina may be observed as ST segment elevation in electrocardiogram measured when present in chest pain. However, 12-lead electrocardiogram performed after the patient's chest pain resolves does not help in the diagnosis. Since the duration of chest pain appears to be <15 minutes, it is important to perform the 12-lead electrocardiogram when clinical symptoms are present. If nitroglycerin is administered without performing 12-lead electrocardiogram by 119 pre-hospital paramedics, the chest pain would be resolved, making it impossible to identify changes in the ST segment. Before administration of nitroglycerin, changes in the ST segment must be recorded by performing 12-lead electrocardiogram.

The role of cone-beam computed tomography in the radiographic evaluation of obstructive sleep apnea: A review article

  • Marco Isaac;Dina Mohamed ElBeshlawy;Ahmed ElSobki;Dina Fahim Ahmed;Sarah Mohammed Kenawy
    • Imaging Science in Dentistry
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    • v.53 no.4
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    • pp.283-289
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    • 2023
  • The apnea-hypopnea index is widely regarded as a measure of the severity of obstructive sleep apnea (OSA), a condition characterized by recurrent episodes of apnea or hypopnea during sleep that induce airway collapse. OSA is a catastrophic problem due to the wide range of health issues it can cause, including cardiovascular disease and memory loss. This review was conducted to clarify the roles of various imaging modalities, particularly cone-beam computed tomography (CBCT), in the diagnosis of and preoperative planning for OSA. Unfortunately, 2-dimensional imaging techniques yield insufficient data for a comprehensive diagnosis, given the complex anatomy of the airway. Three-dimensional (3D) imaging is favored as it more accurately represents the patient's airway structure. Although computed tomography and magnetic resonance imaging can depict the actual 3D airway architecture, their use is limited by factors such as high radiation dose and noise associated with the scans. This review indicates that CBCT is a low-radiation imaging technique that can be used to incidentally identify patients with OSA, thereby facilitating early referral and ultimately enhancing the accuracy of surgical outcome predictions.

Application of Quantitative Assessment of Coronary Atherosclerosis by Coronary Computed Tomographic Angiography

  • Su Nam Lee;Andrew Lin;Damini Dey;Daniel S. Berman;Donghee Han
    • Korean Journal of Radiology
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    • v.25 no.6
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    • pp.518-539
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    • 2024
  • Coronary computed tomography angiography (CCTA) has emerged as a pivotal tool for diagnosing and risk-stratifying patients with suspected coronary artery disease (CAD). Recent advancements in image analysis and artificial intelligence (AI) techniques have enabled the comprehensive quantitative analysis of coronary atherosclerosis. Fully quantitative assessments of coronary stenosis and lumen attenuation have improved the accuracy of assessing stenosis severity and predicting hemodynamically significant lesions. In addition to stenosis evaluation, quantitative plaque analysis plays a crucial role in predicting and monitoring CAD progression. Studies have demonstrated that the quantitative assessment of plaque subtypes based on CT attenuation provides a nuanced understanding of plaque characteristics and their association with cardiovascular events. Quantitative analysis of serial CCTA scans offers a unique perspective on the impact of medical therapies on plaque modification. However, challenges such as time-intensive analyses and variability in software platforms still need to be addressed for broader clinical implementation. The paradigm of CCTA has shifted towards comprehensive quantitative plaque analysis facilitated by technological advancements. As these methods continue to evolve, their integration into routine clinical practice has the potential to enhance risk assessment and guide individualized patient management. This article reviews the evolving landscape of quantitative plaque analysis in CCTA and explores its applications and limitations.