• 제목/요약/키워드: Patients' safety

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Efficacy and safety of oxcarbazepine in epileptic children (소아 간질 환자에서 oxcarbazepine의 효용성과 안전성)

  • Shin, Hye Kyung;Lee, Yoon;Lee, Jee-Yeon;Choi, Wooksun;Eun, So-Hee;Eun, Baik-Lin;Hong, Young Sook;Lee, Joo Won
    • Clinical and Experimental Pediatrics
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    • v.51 no.2
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    • pp.162-169
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    • 2008
  • Purpose : Oxcabarzepine (OXC), newly recommended antiepileptic drug, has been prescribed for patients with partial seizures and generalized tonic clonic seizures in Korea from 1999. There are limited reports about an efficacy of OXC therapy in epileptic children in Korea. This study evaluated the efficacy and safety of OXC in the light of our experience. Methods : The patients, who had visited the pediatric neurology clinic of Korea University Guro Hospital from January 2001 to December 2006, were included. The data of 144 patients who were administrated OXC as monotherapy or polytherapy, was summarized retrospectively and we evaluated the efficacy and safety of OXC. Results : After 6 months of OXC therapy, 77 patients (53.5%, n=144) achieved seizure freedom, 48 patients (33.3%) experienced >50% improvement. After 12 months of OXC therapy, cessation of seizure was observed in 88 patients (61.1%, n=133), and 27 patients (18.8%) manifested an improvement. Monotherapy group showed superior efficacy to polytherapy one. The frequent side effects of OXC were drowsiness (20.1%), headache (12.5%), dizziness (9.7%) and rash (8.3%). They did not related to patient's age or sex, and dosage of OXC. Twenty four patients (16.7%) experienced hyponatremia, but which were neither symptomatic nor significant one. Conclusion : The efficacy and safety of OXC in our patients were excellent and had less significant side effects than established international one. We expect this report contributes toward OXC therapy in epileptic children.

Clinical Feasibility of Video-assisted Thoracic Surgery for Thoracic Trauma (흉부외상 치료에서의 비디오 흉강경 수술의 유용성)

  • Kang, Do-Kyun;Kim, Hyeong-Ryul;Kim, Yong-Hee;Kim, Dong-Kwan;Park, Seung-Il
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.170-174
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    • 2010
  • Purpose: As techniques and instruments for video-assisted thoracic surgery (VATS) have been evolving, attempts to perform VATS for chest trauma have been increasing. Several studies have demonstrated the feasibility and safety of VATS for thoracic trauma. We reviewed our experience to evaluate the clinical feasibility and safety of VATS for thoracic trauma. Methods: Fifty-two patients underwent thoracic surgery for chest trauma in Asan Medical Center from January 1990 to December 2009. VATS was performed in 21 patients who showed stable vital signs. We reviewed retrospectively the medical records of those patients to investigate the results of VATS for thoracic trauma. Results: Thoracic exploration for chest trauma was performed in 52 patients. There were 46 males (88.5%) and 6 females (11.5%). The median age was 46.0 years (range: 11~81 years). There were 39 blunt and 13 penetrating traumas. A standard posterolateral thoracotomy was performed in 31 patients, and VATS was tried in 21 patients. We performed successful VATS in 13 patients; 11 males (84.5%) and 2 females (15.5%) with a median age of 46.0 years (range: 24~75 years). The indication of VATS was persistent intrathoracic hemorrhage in 10 patients and clotted hemothorax in 3 patients. There were no complications, but there were two mortalities due to multiple organ failure after massive transfusion. In 8 patients, VATS was converted to a standard posterolateral thoracotomy for several reasons. The reason was inadequate visualization for bleeding control or evacuation of the hematoma in 5 patients. In 3 patients, VATS was performed to evaluate diaphragmatic injury. After the diaphragmatic injury had been confirmed, a standard posterolateral thoracotomy was performed to repair the diaphragm. Conclusion: VATS should be safe and efficient method for diagnostic evaluation and surgical management of stable patients with thoracic trauma.

Summative Usability Assessment of Software for Ventilator Central Monitoring System (인공호흡기 중앙감시시스템 소프트웨어의 사용적합성 총괄평가)

  • Ji-Yong Chung;You Rim Kim;Wonseuk Jang
    • Journal of Biomedical Engineering Research
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    • v.44 no.6
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    • pp.363-376
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    • 2023
  • According to the COVID-19, development of various medical software based on IoT(Internet of Things) was accelerated. Especially, interest in a central software system that can remotely monitor and control ventilators is increasing to solve problems related to the continuous increase in severe COVID-19 patients. Since medical device software is closely related to human life, this study aims to develop central monitoring system that can remotely monitor and control multiple ventilators in compliance with medical device software development standards and to verify performance of system. In addition, to ensure the safety and reliability of this central monitoring system, this study also specifies risk management requirements that can identify hazardous situations and evaluate potential hazards and confirms the implementation of cybersecurity to protect against potential cyber threats, which can have serious consequences for patient safety. As a result, we obtained medical device software manufacturing certificates from MFDS(Ministry of Food and Drug Safety) through technical documents about performance verification, risk management and cybersecurity application.The purpose of this study is to conduct a usability assessment to ensure that ergonomic design has been applied so that the ventilator central monitoring system can improve user satisfaction, efficiency, and safety. The rapid spread of COVID-19, which began in 2019, caused significant damage global medical system. In this situation, the need for a system to monitor multiple patients with ventilators was highlighted as a solution for various problems. Since medical device software is closely related to human life, ensuring their safety and satisfaction is important before their actual deployment in the field. In this study, a total of 21 participants consisting of respiratory staffs conducted usability test according to the use scenarios in the simulated use environment. Nine use scenarios were conducted to derive an average task success rate and opinions on user interface were collected through five-point Likert scale satisfaction evaluation and questionnaire. Participants conducted a total of nine use scenario tasks with an average success rate of 93% and five-point Likert scale satisfaction survey showed a high satisfaction result of 4.7 points on average. Users evaluated that the device would be useful for effectively managing multiple patients with ventilators. However, improvements are required for interfaces associated with task that do not exceed the threshold for task success rate. In addition, even medical devices with sufficient safety and efficiency cannot guarantee absolute safety, so it is suggested to continuously evaluate user feedback even after introducing them to the actual site.

Subjectivity on Patient Safety Recognized by Inpatients

  • Lee, HoYeon;Jang, SunYoung;Wang, MeeSuk
    • International Journal of Internet, Broadcasting and Communication
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    • v.12 no.3
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    • pp.196-205
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    • 2020
  • The purpose of this study is to identify the subjectivity of patient and describe the characteristics of each type to understand the categorization of types on patient safety. Q methodology was applied to the study. A total of 40 patients admitted to the S hospital in Seoul were asked to categorize 33 statements on patient safety. The collected data was analyzed using QUANL PC Program. After analysis, patient safety as perceived by the admitted patient was categorized into 6 types. The types were as follows: Type 1 'Those who note adequate patient safety', Type 2 'Those who consider preventive safety to be lacking' Type 3 'Those who see the evaluation criteria to be met', Type 4 'Those who see the facility safety to be lacking', Type 5 'Those who find the patient and facility safety to be adequate', Type 6 'Those who see patient support to be lacking'. The study provides a basic set of data for developing mediation measures needed to identify the direction in which patient safety should be promoted.

Operating Room Nurses' Experiences of Securing for Patient Safety (수술실 간호사의 환자안전 확보 경험)

  • Park, Kwang-Ok;Kim, Jong Kyung;Kim, Myoung-Sook
    • Journal of Korean Academy of Nursing
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    • v.45 no.5
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    • pp.761-772
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    • 2015
  • Purpose: This study was done to evaluate the experience of securing patient safety in hospital operating rooms. Methods: Experiential data were collected from 15 operating room nurses through in-depth interviews. The main question was "Could you describe your experience with patient safety in the operating room?". Qualitative data from the field and transcribed notes were analyzed using Strauss and Corbin's grounded theory methodology. Results: The core category of experience with patient safety in the operating room was 'trying to maintain principles of patient safety during high-risk surgical procedures'. The participants used two interactional strategies: 'attempt continuous improvement', 'immersion in operation with sharing issues of patient safety'. Conclusion: The results indicate that the important factors for ensuring the safety of patients in the operating room are manpower, education, and a system for patient safety. Successful and safe surgery requires communication, teamwork and recognition of the importance of patient safety by the surgical team.

Survey for Alternative Therapy Used by Cancer Patients Receiving Radiation Therapy (방사선치료 암 환자의 대체요법 경험실태 조사연구)

  • Park Cheol Woo;Park Tae-Jin
    • The Journal of Korean Society for Radiation Therapy
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    • v.13 no.1
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    • pp.75-90
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    • 2001
  • Although it is presumed that cancer patients take various alternative therapies, the present status is not well recognized. The purpose of this study is to survey alternative therapies used by cancer patients receiving radiation therapy and then, find associated factors of taking alternative therapies. The study subjects were composed of those who receiving radiation therapy in the department of radiation oncology in 5 hospitals located at Extended Busan city and who were on follow-up after medical cure. They were 394 male and female patients over 20 years old. The mean age of the subjects was 53.2 years old and the age ranged from 23 to 83 years old. 188 patients($47.7\%$) used alternative therapies. Total 68 different kinds of alterative therapies were used, average 7.3 kinds per patient were experienced, and average total cost expenditure was 2,830,000 won. Among the alternative therapies, black bean($38.8\%$) was the most commonly used and brown rice($38.3\%$), ganoderm lucidum($37.8\%$), elm tree($33.5\%$), and phellinus linteus($30.8\%$) were followed in order of frequency. However in considering the time, cost and effort spent, phellinus linteus was the first. In terms of cost, phellinus linteus was the highest with average expenditure of 2,740,000 won. Among the motivation of using alternative therapies, expecting auxiliary help for the hospital therapy was the highest ($31.4\%$). About half of users($56.9\%$) of alternative therapies were recommended by their relatives to use alternative therapies. In comparing the characteristics of experienced and unexperienced groups, alternative therapy was experienced significantly more in patients of younger age(p=0.001), in patient of higher educational level(p=0.001), and in patients of higher income(p=0.030) The proportion of using alternative therapies was significantly higher in the group treated with chemotherapy(p=0.005), and in the patients who did not satisfy with radiation therapy(p=0.001). The frequency of drinking was significantly higher tendency in the inexperienced group(p=0.046), There was no significant difference in marital status, job, religion, other disease, surgical operation of the cancer and smoking staus between the two groups. Among the unexperienced group, $34.0\%$ of the patients did not take the alternative therapies because they did not have know]edge for the alternatives, and $22.3\%$ worried about negative effects on hospital-based therapy $58.7\%$ of them were willing to take the alternative therapies if the effects and safety were proven by the government or research institutes. $21.9\%$ of the patients wanted to take the alternatives if they were affordable. $72.3\%$ of the patients was willing to take them if their families recommend, but $27.2\%$ responded they would not take them in any situation. Conclusively, various kinds of alternative therapies which were not proved medically were exposed to patients, In these circumstances, it is required to investigate, study and evaluate the medical effects and safety of the alternative therapies.

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The Effect of Deoxyribonuclease-Bromelain Tablet in Patients with Inflammation of Otorhinolaryngology (이비인후과 염증질환에 대한 데옥시리보뉴클레아제-브로멜라인정의 효과 조사)

  • Park, Sung Yong
    • Korean Journal of Clinical Pharmacy
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    • v.14 no.2
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    • pp.71-77
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    • 2004
  • The author has tested the clinical efficacy and safety of an anti-inflammatory drug in patients with inflammation of the otnrhinolaryngology. Deoxyribonuclease prepared from bovine pancreas destroyed fibers and reduced the viscosity of the exudates. Bromelain is a group of proteolytic enzymes which are known to have an effect on inflammation, swelling, and pain in inflammatory disorders. The mucolytic and anti-inflammatory properties of deoxyribonuclease associated with bromelain in inflammation of otorhinolaryngology were assessed in 67 patients. A standard dose of 3 tablets of deoxyribonuclease bromelain tablet was given for not less than 7 days. In all tile groups of patients considered, the drug showed a considerable therapeutic effectiveness. At the end of 7-28 days treatment, more than $89.6\%$ of treatment was improved. These findings suggest that it could be permitted to use deoxyribonuclease-bromelain tablet in patients with inflammation of the otorhinolaryngology.

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Characteristics of Intraoral Air Pressure, Airflow in Relation to Phonatory Efficiency in Cleft Palate Speakers

  • Baek, Jin-A;Shin, Hyo-Keun
    • Proceedings of the KSLP Conference
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    • 2003.11a
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    • pp.147-147
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    • 2003
  • Recent aerodynamic and acoustic studies of VPI(velopharyngeal insufficiency) are non-invasive and safety, therefore, many researchers have used it to diagnose the hyper/hyponasality and articulation disorders of cleft palate patients. The purpose of this study was to estimate mainly the oropharyngeal air pressure and over all air flow in cleft lip and palate patients. The pressure-collecting catheter was positioned in the oropharyngel cavity around tongue base. Twelve adult control group and three cleft lip & palate patients were participated to this experimentation. Aerophone II was used to measure peak air flow, mean air flow, phonatory airflow, phonatory efficiency and resistance. The results were as follows: 1) Airflow of cleft lip & palate patients group were higher than those of control group. Fricative sounds /s/ and /s'/ showed the statistic significance of mean airflow and volume data. 2) Intraoral air pressure of cleft lip & palate patients was lower than those of control group.

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Breakthrough pain and rapid-onset opioids in patients with cancer pain: a narrative review

  • Jinseok Yeo
    • Journal of Yeungnam Medical Science
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    • v.41 no.1
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    • pp.22-29
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    • 2024
  • Breakthrough pain is transitory pain that occurs despite the use of opioids for background pain control. Breakthrough pain occurs in 40% to 80% of patients with cancer pain. Despite effective analgesic therapy, patients and their caregivers often feel that their pain is not sufficiently controlled. Therefore, an improved understanding of breakthrough pain and its management is essential for all physicians caring for patients with cancer. This article reviews the definition, clinical manifestations, accurate diagnostic strategies, and optimal treatment options for breakthrough pain in patients with cancer. This review focuses on the efficacy and safety of rapid-onset opioids, which are the primary rescue drugs for breakthrough pain.

Aortic Stenosis: New Insights in Diagnosis, Treatment, and Prevention

  • Saki Ito;Jae K. Oh
    • Korean Circulation Journal
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    • v.52 no.10
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    • pp.721-736
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    • 2022
  • Aortic stenosis (AS) is one of the most common valvular heart diseases and the number of patients with AS is expected to increase globally as the older population is growing fast. Since the majority of patients are elderly, AS is no longer a simple valvular heart disease of left ventricular outflow obstruction but is accompanied by other cardiac and comorbid conditions. Because of the significant variations of the disease, identifying patients at high risk and even earlier detection of patients with AS before developing symptomatic severe AS is becoming increasingly important. With the proven of efficacy and safety of transcatheter aortic valve replacement (TAVR) in the severe AS population, there is a growing interest in applying TAVR in those with less than severe AS. A medical therapy to reduce or prevent the progression in AS is actively investigated by several randomized control trials. In this review, we will summarize the most recent findings in AS and discuss potential future management strategies of patients with AS.