• Title/Summary/Keyword: Patient outcome

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Experience on Telemedicine Use of Community Health Practitioners (보건진료원의 원격관리 경험)

  • Kwon, Myung Soon;Park, Dong-Jin;Choi, Jounghwa
    • Korean Journal of Health Education and Promotion
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    • v.30 no.2
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    • pp.23-39
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    • 2013
  • Objectives: This study was conducted to investigate practical experiences of telemedicine of community health practitioners(CHPs). Methods: Qualitative data were collected by in-depth interviews from 10 CHPs who have experiences in managing telemedicine system. All interviews were recorded and transcribed according to qualitative conventional content analysis processes. Results: As a result, 32 themes were deduced and 11 theme clusters and 3 categories were formed and each coding categories were derived directly from the text data. 11 theme clusters derived from the 32 meaningful themes were as follows: Human resources, equipments and systems, computer program (Input resources), human resource management, patient registration and management, medication, laboratory test (Progress), benefits in telemedicine system managing, difficulties in telemedicine system managing, complains in telemedicine system managing, client responses to telemedicine system (Outcome evaluation). 3 categories derived 11 theme clusters were 'input', 'progress', and 'outcome evaluation'. Conclusions: This study has contributed to the understanding of operation of telemedicine by CHPs in community health posts. For more systematic and comprehensive management, further study should be conducted to reflect experience and positions of public health center physicians, collaborative hospital physician and patients.

Results of radial head resection after Mason type 3 or 4 fracture of the elbow

  • Mebouinz, Ferdinand Nyankoue;Kasse, Amadou;Sy, Mouhamadou Habib
    • Clinics in Shoulder and Elbow
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    • v.23 no.3
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    • pp.131-135
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    • 2020
  • Background: Resection of the radial head is a surgical indication for comminuted radial head fracture in which internal fixation is inaccessible. Some complications from the surgery can alter the function of the patient's elbow. The objective of this study was to assess functional outcome of the elbow after resection of the radial head. Methods: A retrospective longitudinal study was performed with patients who underwent radial head resection between 2008 and 2018. Elbow function was assessed by the Mayo Elbow Performance Index (MEPI) for 11 patients comprising three women and eight men. The mean follow-up was 47.6 months. The mean age was 41±10.3 years. Results: Nine patients had a stable and painless elbow. The mean extension-flexion arc was 97.73°±16.03°. The mean values of pronation and supination were 76.8° and 74.5°, respectively. The mean MEPI score was 83.2 points, and restoration of overall function was achieved in 81% of the cases. Poor function was noted in one in 10 that presented with a terrible triad. Conclusions: Resection of the radial head restored elbow functionality at a rate of 81%, which was a good outcome for patients.

Statistical Evaluation of the Cleft Lip Nose Deformity Image (구순열 환자 코변형(Cleft Lip Nose Deformity) 영상의 통계적 평가)

  • Kim, Jin-Tae;Nam, Ki-Chang;Hong, Hyun-Ki;Rah, Dong-Kyun;Kim, Deok-Won
    • The Transactions of the Korean Institute of Electrical Engineers D
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    • v.54 no.8
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    • pp.517-520
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    • 2005
  • Cleft lip is a congenital deformity condition with separation of the two sides of the lip and results in nose deformity Evaluation of surgical corrections and outcome assessments in nose deformity resulting from the cleft lip depend mainly on doctor's objective judgment. Development of an objective assessment tool in evaluation of the condition and surgical outcome of cleft lip nose deformity patients will help in advancement and evaluation of surgical techniques of cleft lip. Hence, our study aimed at quantitative assessment of a cleft lip nose deformity condition by comparing following parameters gathered from a photographic image of a cleft lip patient: (1) angle difference between two nostril axis, (2) center of the nostril and distance between two centers, (3) overlapped area of two nostrils and (4) the overlapped area ratio of two nostrils. Assessment results of the nose deformity were determined by statistical analysis of evaluation results from three experienced plastic surgeons. In addition, regression model was developed using correlation relationship and factor analysis of parameters from results of the image analysis

The effectiveness of corticotomy and piezocision on canine retraction: A systematic review

  • Viwattanatipa, Nita;Charnchairerk, Satadarun
    • The korean journal of orthodontics
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    • v.48 no.3
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    • pp.200-211
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    • 2018
  • The aim of this systematic review was to evaluate the effectiveness and complications of corticotomy and piezocision in canine retraction. Five electronic databases (PubMed, SCOPUS, Web of Science, Embase, and CENTRAL) were searched for articles published up to July 2017. The databases were searched for randomized control trials (RCTs), with a split-mouth design, using either corticotomy or piezocision. The primary outcome reported for canine retraction was either the amount of tooth movement, rate of tooth movement, or treatment time. The secondary outcome was complications. The selection process was based on the PRISMA guidelines. A risk of bias assessment was also performed. Our search retrieved 530 abstracts. However, only five RCTs were finally included. Corticotomy showed a more significant (i.e., 2 to 4 times faster) increase in the rate of tooth movement than did the conventional method. For piezocision, both accumulative tooth movement and rate of tooth movement were twice faster than those of the conventional method. Corticotomy (with a flap design avoiding marginal bone incision) or flapless piezocision procedures were not detrimental to periodontal health. Nevertheless, piezocision resulted in higher levels of patient satisfaction. The main limitation of this study was the limited number of primary research publications on both techniques. For canine retraction into the immediate premolar extraction site, the rate of canine movement after piezocision was almost comparable to that of corticotomy with only buccal flap elevation.

Traumatic Displacement of the Globe into the Maxillary Sinus: Case Report (외상성 상악동 안구탈출의 치험례: 증례보고)

  • Lim, Chan Soo;Kang, Dong Hee
    • Archives of Plastic Surgery
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    • v.34 no.4
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    • pp.524-527
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    • 2007
  • Purpose: Globe displacement due to a blowout fracture is a rare clinical phenomenon. The authors present reduction of a globe displacement to the maxillary sinus due to trauma suffered in a fall and the reconstruction of a large defect left in the medial and inferior orbit. Methods: A 39-year-old male patient was unable to open his left eye after being struck on the periorbital area by a metal edge. Laceration was not noted in that area but we were unable to observe the intraorbital globe. A facial computed tomography (CT) scan showed that the globe was displaced through the maxillary sinus. A transconjunctival approach was used to access the infraorbital margin and the globe entrapped in the inferior margin of the orbit was successfully reduced. A large defect in the medial and inferior orbit was reconstructed using a graft from the iliac bone. Results: In 5 months after the operation, no atrophy of the globe was seen. Both sides retained a similar shape. A satisfactory functionality outcome in terms of improved extraocular muscle movement, and a satisfactory aesthetical outcome were achieved. Conclusion: The authors report the reduction of a globe displaced to the maxillary sinus following a fall and the reconstruction of the large defect left in the medial and inferior orbit.

A Study on the Improvement of Visual Acuity and Refractive Power According to General Characteristics of Cataract Surgery Patients

  • Cho, Seon Ahr;Lee, Seong Jae
    • International Journal of Advanced Culture Technology
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    • v.6 no.4
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    • pp.71-79
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    • 2018
  • For 299 patients who had undergone cataract surgeries we investigated the difference in visual acuity and refractive power before and after cataract surgery and the clinical change of the visual acuity and the refractive power according to age, gender, hospital visit time and specific medical history. We found the factors affecting preoperative and postoperative outcomes of the cataract patients in metropolitan hospitals by input, process, and outcome and analyzed medical characteristics and patient characteristics as the input variables. T-test and ANOVA have been performed for statistical analysis of functional status, and general status and the technical characteristic as the process variable and the outcome variable of diagnosis. Visual acuity improved significantly in patients who had undergone cataract surgery. However, the change in refractive power did not show a statistically significant difference but only a slight difference. The improvement of male patients was greater than that of female patients. The difference in age was more effective in patients under 50 years old and the effect of cataract surgery was relatively high in patients without the presence of specific medical history. Cataract surgery did not seem to help all of the patients, but it is more effective in improving visual acuity and refractive power. We conclude that simultaneous cataract surgery in both eyes is reasonable in order to have at least the better effect.

Risk Stratification for Patients with Upper Gastrointestinal Bleeding (상부위장관 출혈 환자에서 위험의 계층화와 이에 따른 치료 전략)

  • Lee, Bong Eun
    • The Korean journal of helicobacter and upper gastrointestinal research
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    • v.18 no.4
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    • pp.225-230
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    • 2018
  • Upper gastrointestinal (GI) bleeding (UGIB) is the most common GI emergency, and it is associated with significant morbidity and mortality. Early identification of low-risk patients suitable for outpatient management has the potential to reduce unnecessary costs, and prompt triage of high-risk patients could allow appropriate intervention and minimize morbidity and mortality. Several risk-scoring systems have been developed to predict the outcomes of UGIB. As each scoring system measures different primary outcome variables, appropriate risk scores must be implemented in clinical practice. The Glasgow-Blatchford score (GBS) should be used to predict the need for interventions such as blood transfusion or endoscopic or surgical treatment. Patients with GBS ${\leq}1$ have a low likelihood of adverse outcomes and can be considered for early discharge. The Rockall score was externally validated and is widely used for prediction of mortality. The recently developed AIMS65 score is easy to calculate and was proposed to predict in-hospital mortality. The Forrest classification is based on endoscopic findings and can be used to stratify patients into high- and low-risk categories in terms of rebleeding and thus is useful in predicting the need for endoscopic hemostasis. Early risk stratification is critical in the management of UGIB and may improve patient outcome and reduce unnecessary health care costs through standardization of care.

A study on the current state of Korean medicine treatment in infertile women: an observational multi-center study protocol (여성 난임환자의 한의치료 현황 및 경과 관찰을 위한 전향적 다기관 관찰연구 프로토콜)

  • Choi, Su-Ji;Kim, Dong-Il
    • The Journal of Korean Medicine
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    • v.43 no.2
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    • pp.42-50
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    • 2022
  • Objectives: The purpose of this study is to investigate the characteristics of female infertility patients who come to Korean medicine clinics and analyze the trends of Korean medicine treatment methods and the effects of female infertility by registry data. Methods: We are recruiting study participants from Korean medicine hospitals and clinics. If female infertility patients come, we will ask them to register for this study. After enrollment, we will collect demographic information, treatment methods, pregnancy results, adverse events, and treatment costs. Result: First, we will analyze the characteristics of patients, the status of the use of Korean medicine treatment interventions, the cost status of Korean medicine infertility treatment, and the delivery characteristics of pregnant women after Korean medicine treatment. Second, we will analyze the effectiveness of Korean medicine treatment. The primary outcome is clinical pregnancy rate, and secondary outcomes are 12-week pregnancy maintenance rate, degree of dysmenorrhea and premenstrual syndrome, stress level, and health-related quality of life score. Discussion: This study is the first observational multi-center study in Korea for female infertility. By establishing the registry, we are creating a resource that contains patient-reported outcome measures for female infertility. The registry is expected to provide valuable data for developing Korean medicine Clinical practice guidelines for female infertility.

Grading of Intracerebral Hemorrhage in Ruptured Middle Cerebral Artery Aneurysms

  • Shim, Yu-Shik;Moon, Chang-Taek;Chun, Young-Il;Koh, Young-Cho
    • Journal of Korean Neurosurgical Society
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    • v.51 no.5
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    • pp.268-271
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    • 2012
  • Objective : To propose grading of intracerebral hemorrhage (ICH) in ruptured middle cerebral artery (MCA) aneurysms, which helps to predict the prognosis more accurately. Methods : From August 2005 to December 2010, 27 cases of emergent hematoma evacuation and aneurysm clipping for MCA aneurysms were done in the author's clinic. Three variables were considered in grading the ICH, which were 1) hematoma volume, 2) diffuse subarachnoid hemorrhage (SAH) that extends to the contralateral sylvian cistern, and 3) the presence of midline shifting from computed tomography findings. For hematoma volume of greater than 25 mL, we assigned 2 points whereas 1 point for less than 25 cc. We also assigned 1 point for the presence of diffuse SAH whereas 0 point for the absence of it. Then, 1 point was assigned for midline shifting of greater than 5 mm whereas 0 point for less than 5 mm. Results : According to the grading system, the numbers of patients from grade 1 to 4 were 4, 6, 8 and 9 respectively and 5, 7, 8, 4 and 3 patients belonged to Glasgow Outcome Scale (GOS) 5 to 1 respectively. It was found that the patients with higher GOS had lower ICH grade which were confirmed to be statistically significant (p<0.01). Preoperative Hunt and Hess grade and absence of midline shifting were the factors to predict favorable outcome. Conclusion : The ICH grading system composed of above three variables was helpful in predicting the patient's outcome more accurately.

Therapeutic Outcomes and Prognostic Factors in Guillain-Barre Syndrome Treated with Intravenous Immunoglobulin (정주 면역글로불린을 투여 받은 길랑-바레 증후군 환자에서 치료효과와 예후에 영향을 주는 인자들에 관한 연구)

  • Lee, Jee-Young;Cho, Joong-Yang;Kim, Sung Hun;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.6 no.2
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    • pp.92-97
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    • 2004
  • Background: There were several studies comparing prognostic factors in Guillain-Barre syndrome treated with intravenous immunoglobulin and plasmapheresis. However, there were controversies in what were significant factors and there were few studies so far comparing the therapeutic outcomes in patients treated with immunoglobulin. This study was aimed to determine the prognostic factors which affected the therapeutic outcome of Guillain-Barre syndrome treated with intravenous immunoglobulin. Method: We retrospectively reviewed the medical records of patients with Guillain-Barre syndrome admitted to our hospital between January 1999 and March 2004. All patients were treated with intravenous immunoglobulin. Outcome and prognosis were followed up after four weeks using the overall disability sum score. Results: Thirty-six patients were enrolled in this study. According to the clinical and electrophysiological findings, 17 patients were AIDP, 10 were axonal forms, two were mixed and seven had electrophysiologically no evidence of abnormalities. At a follow-up of four weeks, disabilities at the nadir (p<0.001) and admission (P<0.012), initial manifestations of bulbar symptom (P<0.024) and electrodiagnostic features (P<0.013) were significantly correlated with outcome in patients treated with intravenous immunoglobulin. But only disabilities at the nadir (P<0.033) and electrodiagnostic features (P<0.018) were significant in the multivariate logistic regression analysis. Conclusion: Among the patient treated with intravenous immunoglobulin, the outcomes were significantly different according to the neurological status at the nadir. Therefore early diagnosis, administration of intravenous immunoglobulin and preventing complications during acute stages are essential to minimize neurological deficit and shorten the periods of recovery.

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