• Title/Summary/Keyword: Pediatric physician

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Outpatient Prescription Pattern of Anti-inflammatory Drugs by Pediatricians and ENT Physicians in Ulsan City (울산 지역 소아청소년과 및 이비인후과에서의 항염증제 처방 형태 분석)

  • Kim, Sung-Chull;Kim, Young-Rok;Hwang, Jae-Yoon;Chang, Hyeun-Wook;Nam, Doo-Hyun
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.3
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    • pp.205-212
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    • 2010
  • The prescription sheets for outpatients from July 2008 to June 2009 from 7 community pharmacies in Ulsan City were surveyed for the anti-inflammatory drug (AID) prescription pattern. The AID prescription rate of pediatricians and ENT physicians were 30.0% and 34.8%, respectively. The oral steroidal anti-inflammatory drugs (SAIDs) were prescribed as much as 3.9% by pediatricians and 10.3% by ENT physicians. The chiefly prescribed oral SAID was prednisolone in pediatric clinics and methylprednisolone in ENT clinics. Meanwhile the prescription rate of oral non-steroidal anti-inflammatory drug (NSAID) was 22.5% by pediatricians and 21.4% in ENT physicians. The most favorable NSAIDs were propionate derivatives in both clinics. In case of externally-applied SAIDs, the prescription rate of pediatricians was 3.6% and that of ENT physicians was 2.8%. Among them, nasal spray, inhalant and gargle formulations for upper respiratory infection (URI) treatment occupied 35.8% of externally-applied SAIDs in pediatric clinics and 59.7% in ENT clinics. Further, it was observed that ENT physicians favored much stronger SAIDs in Group III of ATC classification (75.4% of externally-applied SAIDs) than pediatricians (49.2%). In the survey of AID combination rate, pediatric clinics showed much lower rate (1.4% of total AID prescriptions) than ENT clinics (7.5%). Among them, the combination rate of oral SAID and oral NSAID by ENT physicians (52.2% of total AID combinations) was much higher than pediatricians (36.6%), which might be over-prescription of AID agents. In conclusion, the AID prescription rate as well as AID combination rate, especially in SAID prescriptions, was much higher in ENT than pediatric clinics, which implies the higher confidency on AID drugs of ENT physicians even though the severity of patient's symptom could be considered.

A CASE OF INTRAORAL SURGICAL TREATMENT FOR CHILDREN WITH HEMOPHILIA (Hemophilia 환아의 관혈적 치과치료에 관한 증례보고)

  • Lee, Joon-Kyun;Lee, Keung-Ho;Choi, Yeong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.4
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    • pp.589-594
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    • 2005
  • With the progress of medical treatment techniques of bleeding control, dental care of the patient with hemophilia has become more convenient. So many surgical treatments can be performed with out-patient. 2 cases of intraoral surgical treatment of children, one with hemophilia 3, sever, the other with hemophilia A, severe. While the former was treated under general anesthesia, the latter was treated under local anaesthesia. There are principles : 1. When a patient with hemophilia need dental treatment, the dentist must consult to his physician, pediatrician, or hematologist before dental treatment. 2. When the dentist make a treatment plan, there should be consideration of the general condition, cooperation of the patient and risk of the treatment needed. 3. Minimize the number of times of coming for dental treatment so that reduce the times that need replacement therapy of coagulation factor. And during the treatment, dentist should care for infection and bleeding.

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Survey for the Current Status of MCH Service in Rural Area (우리나라 일부 농촌지역의 모자보건 실태조사)

  • Kim, Byung-Sung;Chon, Hae-Jung;Cha, In-Jun
    • Journal of agricultural medicine and community health
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    • v.17 no.1
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    • pp.5-16
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    • 1992
  • The maternal and child health is a basis of national health, and indicates the level of social welfare and health of the country, because it is related with community welfare status, general cultural conditions, and medical and health sciences. This is a study carried out to identify the present practices of maternal and child health care programs implemented by the private clinics located in Guns(counties ; rural area) in Kyungsangnam Province and to propose alternatives to improve their current programs through a self-administrative questionnaire. The subjects were 90 private physicians who operated their own clinics since 1990 and were general practitioners, Obstertrician/Gynecologists or pediatricians: This survey was conducted by mail from 15 January to 25 February 1992. The response rate was 94.4 percent. 1) The major manpower for MCH programs of the studied clinics was physicians and nurseaids. 70.3% of physicians were general practitioners, 81.1% of nursing manpower were nurseaids. 31.1% of the studied clinics employed lab-technicians. 89.2% of them had MCH room whatever the size and the setting, and 84.4% of Ob/Gyn clinics installed laboratory equipments. 2) 55.4% and 63.5% of the studied clinics provided 151 or above consulting services and curative services of MCH per physician a month respectively and 33.8% and 25.7% of them provided 10 or less consulting services and curative services per physician a month. 91.9% of lab-technicians had 10 or less laboratory tests per technician a month. 3) There was a difference between Ob/Gyn and pediatric clinics in terms of services delivered : for example, 80% of Ob/Gyn clinics provided pre- and post- natal care services, while 84.6% of pediatric clinics provided vaccinations for children. It was also found that only a few of general practitioners involved pre-and post- natal care services. 4) There were no clinics which had opened regular health education session but 24.3% of them had opened the sessions irregularly. Ob/Gyn clinics put emphasis on maternity and pediatric clinics did on child health, but general practitioners touched with both maternal and child health. 21.6% of the studied clinics had some kind of educational materials for MCH programs. Most of the materials were pamphlets or small booklets. 5) Proteinuria/glucosuria, blood pressure and blood type were tested in 48.6~69% of the studied clinics ; tests for blood sugar and hepatitis B were provided in 39.2~41.9% of them, most of them were done in Ob/Gyn clinics. 6) 41.9% of physicians, 29.7% of nurses and 45.9% of nurses-aids wanted to receive on-job-training for MCH programs.

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Pediatric Terms and Acupuncture in Medline (소아(小兒) 침구(鍼灸)의 연구(硏究) 동향에 대한 문헌적 고찰(考察)(Pubmed 검색(檢索)을 중심(中心)으로))

  • Lyoo, Eun-kyouog;Park, Dong-seok;Lee, Jae-dong
    • Journal of Acupuncture Research
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    • v.19 no.4
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    • pp.101-111
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    • 2002
  • Objective : In order to review the studies related to the treatment of children by aupuncture or mo ibustion Methods : We referred to a Pubmed site by using searching word of "the terms of pediatrics(for e ample child children infant baby pediatrics etc and acupuncture" Results : 40 journals with 63 papers were searched 50 papers were reported Conclusion : 1 We found 63 articles in 40 journals which were Pediatrics J Tradit chin Med Am Fam Physician Anaesthesia linical research was the most of these studies and the pattern of the rest were review or clinical conferences 3 We analy ed articles and found many articles of nocturnal enuresis asthma bronchitis postoperative vomitting constipation etc 4 The result of clinical studies represented the significant cure rate owever the cases of sensorineural hearing loss vomitting after tonsillectomy e ercise induced asthma were not 5 It was ta en to research for laser acupressure bloodletting ear acupuncture etc as well as body acupuncture in the area of pediatric acupuncture treatment as alternative therapy which was composed of the lower stimulation than adult.

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Impact of perinatal environmental tobacco smoke on the development of childhood allergic diseases

  • Yang, Hyeon-Jong
    • Clinical and Experimental Pediatrics
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    • v.59 no.8
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    • pp.319-327
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    • 2016
  • Allergic diseases such as asthma, allergic rhinitis, atopic dermatitis, and food allergy, are most common chronic, noncommunicable diseases in childhood. In the past few decades, the prevalence has increased abruptly worldwide. There are 2 possible explanations for the rising prevalence of allergic diseases worldwide, that an increased disease-awareness of physician, patient, or caregivers, and an abrupt exposure to unknown hazards. Unfortunately, the underlying mechanisms remain largely unknown. Despite the continuing efforts worldwide, the etiologies and rising prevalence remain unclear. Thus, it is important to identify and control risk factors in the susceptible individual for the best prevention and management. Genetic susceptibility or environments may be a potential background for the development of allergic disease, however they alone cannot explain the rising prevalence worldwide. There is growing evidence that epigenetic change depends on the gene, environment, and their interactions, may induce a long-lasting altered gene expression and the consequent development of allergic diseases. In epigenetic mechanisms, environmental tobacco smoke (ETS) exposure during critical period (i.e., during pregnancy and early life) are considered as a potential cause of the development of childhood allergic diseases. However, the causal relationship is still unclear. This review aimed to highlight the impact of ETS exposure during the perinatal period on the development of childhood allergic diseases and to propose a future research direction.

Differential diagnosis of abdominal masses in children (소아 복부 종괴의 감별진단)

  • Sung, Ki Woong
    • Clinical and Experimental Pediatrics
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    • v.51 no.8
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    • pp.787-791
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    • 2008
  • Enlargement of organs or other solid tissues usually presents as an abdominal mass. Often, abdominal masses in children are found by an unsuspected parent or by a physician during a routine examination. Most masses have no specific signs or symptoms. Abdominal masses in children require immediate attention. History and physical examination may provide clues to the diagnosis. Ultrasound examination is the most useful screening test in most cases and may identify the organ involved and clarify whether the mass is solid or cystic. CT may be necessary to make a more precise diagnosis, especially solid masses. MRI is occasionally is helpful for specific abnormalities.

Performance of the xTAG$^{(R)}$ Gastrointestinal Pathogen Panel, a Multiplex Molecular Assay for Simultaneous Detection of Bacterial, Viral, and Parasitic Causes of Infectious Gastroenteritis

  • Claas, Eric C.;Burnham, Carey-Ann D.;Mazzulli, Tony;Templeton, Kate;Topin, Francois
    • Journal of Microbiology and Biotechnology
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    • v.23 no.7
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    • pp.1041-1045
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    • 2013
  • The xTAG$^{(R)}$ Gastrointestinal Pathogen Panel (GPP) is a multiplexed molecular test for 15 gastrointestinal pathogens. The sensitivity and specificity of this test were assessed in 901 stool specimens collected from pediatric and adult patients at four clinical sites. A combination of conventional and molecular methods was used as comparator. Sensitivity could be determined for 12 of 15 pathogens and was 94.3% overall. The specificity across all 15 targets was 98.5%. Testing for the pathogen identified was not requested by the physician in 65% of specimens. The simultaneous detection of these 15 pathogens can provide physicians with a more comprehensive assessment of the etiology of diarrheal disease.

Estimation of Disease Code Accuracy of National Medical Insurance Data and the Related Factors (의료보험자료 상병기호의 정확도 추정 및 관련 특성 분석 -법정전염병을 중심으로-)

  • Shin, Eui-Chul;Park, Yong-Mun;Park, Yong-Gyu;Kim, Byung-Sung;Park, Ki-Dong;Meng, Kwang-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.3 s.62
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    • pp.471-480
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    • 1998
  • This study was undertaken in order to estimate the accuracy of disease code of the Korean National Medical Insurance Data and disease the characteristics related to the accuracy. To accomplish these objectives, 2,431 cases coded as notifiable acute communicable diseases (NACD) were randomly selected from 1994 National Medical Insurance data file and family medicine specialists reviewed the medical records to confirm the diagnostic accuracy and investigate the related factors. Major findings obtained from this study are as follows : 1. The accuracy rate of disease code of NACD in National Medical Insurance data was very low, 10.1% (95% C.I. : 8.8-11.4). 2. The reasons of inaccuracy in disease code were 1) claiming process related administrative error by physician and non-physician personnel in medical institutions (41.0%), 2) input error of claims data by key punchers of National Medical Insurer (31.3%) and 3) diagnostic error by physicians (21.7%). 3. Characteristics significantly related with lowering the accuracy of disease code were location and level of the medical institutions in multiple logistic regression analysis. Medical institutions in Seoul showed lower accuracy than those in Kyonngi, and so did general hospitals, hospitals and clinics than tertiary hospitals. Physician related characteristics significantly lowering disease code accuracy of insurance data were sex, age group and specialty. Male physicians showed significantly lower accuracy than female physicians; thirties and fortieg age group also showed significantly lower accuracy than twenties, and so did general physicians and other specialists than internal medicine/pediatric specialists. This study strongly suggests that a series of policies like 1) establishment of peer review organization of National Medical Insurance data, 2) prompt nation-wide expansion of computerized claiming network of National Medical Insurance and 3) establishment and distribution of objective diagnostic criteria to physicians are necessary to set up a national disease surveillance system utilizing National Medical Insurance claims data.

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The Physical Restraint Use in Hospital Nursing Situation (병원 간호현장에서의 억제대 사용실태에 관한 연구)

  • 김기숙;김진희;이선희;차혜경;신수정;지성애
    • Journal of Korean Academy of Nursing
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    • v.30 no.1
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    • pp.60-71
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    • 2000
  • This research is a field investigation to collect basic information about the safe and efficient use of physical restraint in hospitals and for the ultimate minimization of restraint use. The objects of this study were sixty-four patients. They were restrained physically. Add their 32 family members, 24 nurses of two university hospitals in Seoul were also involved in the study. From April 16, to May 27, 1999. Research data were collected throughout the observation and interview process. Also, the data was analyzed using frequencies and field study notes that were invented by researchers. Results of this study were as follows: 1. According to the sex and age distinction; male's restraint use was 75%, female's was 25% and pre-schoolage children 39.1%, middle age 26.5%, and senior citizens 20.3%. According to the disease distinction; neuro-system was 35.9%, respiratory system was 21.9%. In the Ward, 40.6% of ICU patients were restrained and 39.0% of pediatric ward children were also to restraint. 70.3% of patients were restrained under 5days, while 10.9% were restrained 10days. 2. Types of physical restraints were wrist restraint (45.21%), arm board (35.62%), leg restraint (8.22%), chest restraint (6.85%), elbow restraint (2.74%) and mitten restraint (1.37%). 3. The percentage was 3.5%, which was in 64 restrained out of 1828 hospitalized people. At 1st investigation, the ratio was 3.5%, the 2nd was 3.0% and the 3rd was 3.9%. 4. The reasons of using the physical restraint were 'to protect implements' (72.84%), 'to protect patients' (18.52%), 'to protect an operative site' (8.64%). 5. The result of the patients; family and nurses' response analysis was: 'It seems to be safe', 'It uses properly', 'It is convenient for relatives and nurses', 'It is helpful to treatment', 'Objective think it is not restraint' were 79.9%. 'It is discomfort and stuffy', 'The implement is ineffective' were 21.1%. However in interview of the patients who can do verbally communication, 6 of 7 was responded that 'It is stuffy and uncomfortable'. 6. When restraint is used, the main decision is usually made by the nurses 42.2% of the time. The statistics read as thus: nurses and the physician in charge 31.3%, nurses and family 12.5%, physician's order 7.8%, only family 6.2%. Although the record of restraint was only 15.6% so that only 10 cases out of all the 26 ICU patients restrained. This study shows that physical restraints which of infringe independent-right of patients, are used without using criterion, explaining the agreement. Also, subjective decision of physician, nurses, and family make the decision of using restraint. So development of practice manuals and rules for restraint implementation is urgent.

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Basic Principles of CT Dose Index and Understanding of CT Parameter for Dose Reduction Technique (CT선량지표의 원리와 선량감소 방안에 관한 연구)

  • Kim, Jung-Su;Kwon, Soon-Mu;Kim, Jung-Min
    • Journal of radiological science and technology
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    • v.38 no.1
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    • pp.51-61
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    • 2015
  • Computed tomography(CT) using radiation have potential risks. All medical radiographic examinations should require the justification of medical imaging examinations and optimization of the image quality and radiation exposure. The CT examination was higher radiation dose then general radiography. Especially pediatric CT examinations need to great caution of radiation risk. Because of pediatric patient was more sensitive of radiation exposure. Therefore, physician should consider the knowledge of CT radiation exposure indicator information for reduce a needless radiation exposure. This article was aim to understanding of CT exposure indicator, size-specific dose estimates by American Association of Physicists in Medicine (AAPM) report 204, XR 25 and understanding of CT dose reduction technique.