• 제목/요약/키워드: Risk Severity

검색결과 786건 처리시간 0.026초

The Timing of Femur Fracture Fixation is an Important Factor for Prolonged Mechanical Ventilation

  • Choi, Hyung Chul;Jung, Kwang Hwan;Kyoung, Kyu Hyouck;Choi, Seong Ho
    • Journal of Trauma and Injury
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    • 제32권4호
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    • pp.220-225
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    • 2019
  • Purpose: Mechanical ventilation (MV) is an essential life-saving modality for severely injured patients. However, the long-term use of MV is a major risk factor for late mortality. The surgical correction of long bone fractures plays a critical role not only in improving functional outcomes, but also in reducing physiological derangements, including MV duration. This study investigated the factors affecting prolonged MV (PMV) in severely injured patients with femur fractures. Methods: We retrospectively evaluated all severely injured patients (injury severity score >15) with femur fractures who were taken to the emergency department within 12 hours of the causative accidents between January 2016 and December 2018. PMV was defined as MV lasting for ≥7 days. We analyzed the factors affecting PMV. Results: In total, 35 patients were enrolled and 21 (33.3%) were included in the PMV group. The PMV group required more red blood cell (RBC) transfusions within 7 days RBC (7dRBC) (12.8 vs. 6.8 units; p=0.03) and the time to femur fracture fixation (TFFF) was longer (7.9 vs. 2.7 days; p=0.018). The area under the curve (AUC) for TFFF was 0.740 (95% confidence interval [CI]: 0.572-0.908; p=0.018) and the AUC for 7dRBC was 0.718 (95% CI: 0.546-0.889; p=0.031). Conclusions: This study indicates that TFFF is an independent risk factor for PMV. Early fixation of femur fractures might prevent PMV and its associated complications.

Risk of Gastric Cancer in Children with Helicobacter pylori Infection

  • Cam, Sebahat
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권22호
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    • pp.9905-9908
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    • 2014
  • Background: Helicobacter pylori (H. pylori) is the most common chronic infectious agent in the stomach. Most importantly, it may lead to atrophy, metaplasia and cancer. The aim of this study was to investigate the incidence of H. pylori infection and to detect early mucosal changes that may lead to malignant degeneration in children. Materials and Methods: Children who underwent upper gastrointestinal endoscopy were included. Familial history of gastric cancer was noted. Endoscopic examinations were performed by a single pediatric gastroenterologist. A minimum of three biopsy samples were collected during endoscopy. The patients were accepted as H. pylori infected if results of biopsies and rapid urease test were both positive. Biopsies were evaluated for the presence and degree of chronic inflammation, the activity and severity of gastritis, glandular atrophy and intestinal metaplasia. Results: A total of 750 children (388 boys, 362 girls) were evaluated in our study, with a mean age of 10.1 years. A total of 390 patients (52%) were found to be infected with H. pylori. Among the H. pylori infected patients, 289 (74%) were diagnosed to have chronic superficial gastritis, 24 (6.2%) had gastric atrophy. Most strikingly, intestinal metaplasia was observed in 11 children, all were in the H. pylori positive group. There was no difference in the mean of age, gender and socioeconomic class between H. pylori infected and non-infected groups. The frequency of gastric cancer in family members (4 in number) was higher in patients with H. pylori infection. No gastric cancer case was reported from the parents of non-infected children. The worst biopsy parameters (atropy and metaplasia) were improved after H. pylori eradication on control endoscopy. Conclusions: The current study shows a higher prevalence of familial history of gastric cancer in H. pylori infected children. Intestinal metaplasia was also higher in the infected children. Eradication of H. pylori infection for this risk group may prevent subsequent development of gastric cancer.

고속도로 Weigh-in-Motion(WIM) 이벤트 자료를 활용한 후미추돌 위험도 분석 기법 (Analysis of Rear-end Collision Risks Using Weigh-in-Motion Data)

  • 오민수;박현진;오철;권순민
    • 한국ITS학회 논문지
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    • 제17권2호
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    • pp.152-167
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    • 2018
  • 고속축중기 시스템은 개별 차량의 통행속도 및 하중 정보를 수집할 수 있어 기존의 차량검지장비와 비교하여 다양한 활용이 가능하다. 그러나 고속축중기 원시 자료는 지점 검지 자료로 구간별 안전성 분석에 직접 적용하는 것은 한계가 있다. 이를 극복하기 위하여 본 연구에서는 고속축중기 자료 중 검지 시간, 검지 속도, 차량길이, 차량 종류, 차량 무게정보를 수집하여 대리안전척도로 이용한 상충률과 충격량을 산출하는 방법론을 제시하였다. 이를 통하여 고속도로 교통류 내의 추종관계 별 후미추돌 위험도를 분석하고 안전성을 평가하는 것이 가능할 것으로 판단되며 해당 구간 내 교통안전 위해차종 선별 및 계도 방안 모색에 기초연구로 활용될 수 있을 것으로 기대된다.

우울증 자살시도자들에서 표준우울평가척도들의 요인분석 : CRESCEND 연구 (Factor Analysis of Standardized Depression Scales in Suicidal Attempters among Patients with Depressive Disorders : CRESCEND Study)

  • 홍민아;김민경;김정범;전태연;임현우;이민수;김재민
    • 대한불안의학회지
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    • 제11권1호
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    • pp.3-11
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    • 2015
  • Objective : The aim of this study was to find associations between specific symptoms and suicidal behavior by using global severity on depression scales. Methods : Data were obtained from 1,183 patients of CRESCEND study. Factor analysis of the 17-item Hamilton Rating Scale for Depression (HAM-D) and the Beck Depression Inventory-II (BDI-II) was used to compare symptom clusters between the past suicide attempters and the non-suicide attempters, among the patients with depressive disorders. Results : Factor analyses of HAM-D and BDI-II extracted three factors. Suicide attempters had significantly higher scores on core factor of HAM-D, including depressed mood, feeling of guilt, suicide, work, and activities. The higher scores on all factors of BDI-II or scores correlated with a total of 7 suicide attempts and with known risk factors for suicidal behavior. Conclusion : These findings suggest that the suicide attempters complained of more cognitive, affective, somatic symptoms on BDI-II, but the core factor on HAM-D was the only differentiated factor between the two groups. Clinician-rated scales as well as self-reported questionnaires were valid in measuring suicidal attempts, and the clinical profile may help in guiding the studies of biological correlates and the treatments to reduce suicide risk.

Effects of a Cancer Prevention Advertisement on Beliefs and Knowledge about Cancer Prevention

  • Kye, Su Yeon;Yoo, Jisu;Lee, Min Hee;Jun, Jae Kwan
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권14호
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    • pp.5793-5800
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    • 2015
  • Background: Outcome-expectation beliefs and knowledge may ultimately influence behavior for cancer prevention. The aims of this study were to measure changes in knowledge and beliefs about cancer prevention before and after viewing a television advertisement and identify the factors affecting receptivity to its messages. Materials and Methods: A one-group pretest-posttest design was used in this study of 1,000 individuals aged 20 to 65 years who were recruited online in November 2014. The outcome variables included cancer prevention beliefs based on the Health Belief Model (five items) and knowledge about risk factors for cancer (seven items). Results: Perceived susceptibility, perceived benefits, and self-efficacy increased significantly and their perceived severity and perceived barriers decreased significantly, after participants viewed the television advertisement. Correct responses to questions about risk factors also increased significantly, except for smoking. The main factors affecting changes in the outcome variables were age, interest in cancer prevention, social network, satisfaction with the ad, and pretest scores. Conclusions: Television advertisements with positive frameworks can be an efficient channel of improving beliefs and knowledge about cancer prevention in a short period. The continuous development of intervention materials that consider the demographics, needs, and satisfaction of the target group will be necessary for future studies.

수면장애가 있는 중장년 환자에게 적용한 비약물적 중재의 효과: 메타분석 (Effects of Non-pharmacological Interventions on Primary Insomnia in Adults Aged 55 and Above: A Meta-analysis)

  • 김지현;오복자
    • 성인간호학회지
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    • 제28권1호
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    • pp.13-29
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    • 2016
  • Purpose: This study was performed to evaluate the effects of non-pharmacological interventions on sleep disturbance amongst adults aged 55 and above. Methods: PubMed, Cochrane Library, EMBASE, CINAHL and several Korean databases were searched. The main search strategy combined terms including non-pharmacological interventions and presence of insomnia. Non-pharmacological interventions included cognitive behavioral therapy, auricular acupuncture, aromatherapy, and emotional freedom techniques. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. Data were analyzed by the RevMan 5.3 program of Cochrane Library. Results: Sixteen clinical trials met the inclusion criteria with a total of 962 participants. Non-pharmacological interventions was conducted for a mean of 5.5 weeks, 7.7 sessions, and an average of 70 minutes per session. The effects of non-pharmacological interventions on sleep quality (ES=-1.18), sleep efficiency (ES=-1.14), sleep onset latency (ES=-0.88), awakening time after sleep onset (ES=-0.87), and sleep belief (ES=-0.71) were significant, and their effect sizes were ranged from moderate to large. However, the effects on total sleep time and insomnia severity were not significant. Conclusion: The findings of the current study suggest that non-pharmacological interventions have a positive impact on attitudes and beliefs about sleep, sleep quality, sleep duration, and sleep efficiency. Therefore, the findings of the study provide an evidence to incorporate various non-pharmacological interventions into nursing practice to improve both sleep quality and quantity in patients with insomnia.

A Nomogram for Predicting Non-Alcoholic Fatty Liver Disease in Obese Children

  • Kim, Ahlee;Yang, Hye Ran;Cho, Jin Min;Chang, Ju Young;Moon, Jin Soo;Ko, Jae Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제23권3호
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    • pp.276-285
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    • 2020
  • Purpose: Non-alcoholic fatty liver disease (NAFLD) ranges in severity from simple steatosis to steatohepatitis. Early detection of NAFLD is important for preventing the disease from progressing to become an irreversible end-stage liver disease. We developed a nomogram that allows for non-invasive screening for NAFLD in obese children. Methods: Anthropometric and laboratory data of 180 patients from our pediatric obesity clinic were collected. Diagnoses of NAFLD were based on abdominal ultrasonographic findings. The nomogram was constructed using predictors from a multivariate analysis of NAFLD risk factors. Results: The subjects were divided into non-NAFLD (n=67) and NAFLD groups (n=113). Factors, including sex, body mass index, abdominal circumference, blood pressure, insulin resistance, and levels of aspartate aminotransferase, alanine aminotransferase (ALT), γ-glutamyl transpeptidase (γGT), uric acid, triglycerides, and insulin, were significantly different between the two groups (all p<0.05) as determined using homeostatis model assessment of insulin resistance (HOMA-IR). In our multivariate logistic regression analysis, elevated serum ALT, γGT, and triglyceride levels were significantly related to NAFLD development. The nomogram was established using γGT, uric acid, triglycerides, HOMA-IR, and ALT as predictors of NAFLD probability. Conclusion: The newly developed nomogram may help predict NAFLD risk in obese children. The nomogram may also allow for early NAFLD diagnosis without the need for invasive liver biopsy or expensive liver imaging, and may also allow clinicians to intervene early to prevent the progression of NAFLD to become a more advanced liver disease.

알레르기 비염의 비강 내 광 치료 : 체계적 문헌고찰 (Intranasal Phototherapy for Allergic Rhinitis : a systematic review)

  • 강정인;민경진;이동효
    • 한방안이비인후피부과학회지
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    • 제33권4호
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    • pp.55-73
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    • 2020
  • Objectives : We investigated the effectiveness and safety of intranasal phototherapy for allergic rhinitis (AR). Methods : We searched 8 electronic databases (PubMed, Cochrane Library, CNKI, CiNii Articles, OASIS, NDSL, KISS, KMbase) to identify randomized controlled trials (RCTs) that reported the use of intranasal phototherapy for AR from their inception until May 30, 2020. Two investigators independently searched, collected, and screened the RCTs. We performed data extraction and evaluation for risk of bias using the Cochrane risk-of-bias tool. Results : This study included 12 RCTs; six studies compared intranasal and sham phototherapy, of which four studies reported a significant inter group difference and two studies reported a significant difference partially. No significant changes in symptoms were observed between the phototherapy and conventional therapy groups. The phototherapy and concurrent acupuncture treatment group showed a significantly higher effectiveness rate compared with the group that received only acupuncture. Both the phototherapy and laser acupuncture group showed significant improvement in the symptom severity scale scores. Six studies reported mild adverse effects, such as dryness and nasal pain in the intranasal phototherapy group; however, no severe adverse effects were reported. Conclusions : This study confirmed the safety and effectiveness of intranasal phototherapy for symptom relief and improved quality of life in patients with AR. However, further studies are needed on this topic in order to demonstrate it clearly.

대장암 환자의 옥살리플라틴(oxaliplatin) 유도 말초신경병증에 대한 약물유전학적 접근: 체계적 문헌고찰 (Current Pharmacogenetic Approach for Oxaliplatin-induced Peripheral Neuropathy among Patients with Colorectal Cancer: A Systematic Review)

  • 안수정;최소영;정혜정;추상희
    • Journal of Korean Biological Nursing Science
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    • 제20권2호
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    • pp.55-66
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    • 2018
  • Purpose: Peripheral neuropathy is common among colorectal cancer (CRC) patients who undergo oxaliplatin-based (OXL) chemotherapy. A pharmacogenetic approach can be used to identify patients at high-risk of developing severe neuropathy. This type of approach can also help clinicians determine the best treatment option and prevent severe neurotoxicity. The purpose of this study is to investigate the evidence of pharmacogenetic markers for OXL-induced peripheral neuropathy (OXIPN) in patients with CRC. Methods: A systematic literature search was conducted using the following databases up to December 2017: Pubmed, EMBASE, and CINAHL. We reviewed the genetic risk factors for OXIPN in observational studies and randomized controlled clinical trials (RCTs). All processes were performed independently by two reviewers. Results: Sixteen studies published in English between 2006 and 2017 were included in this review. A genome-wide association approach was used in one study and various candidate genes were tested, based on their functions (e.g., DNA damage or repair, ion channels, anti-oxidants, and nerve growth etc.). The genes associated with incidence or severity of OXIPN were ABCG2, GSTP1, XRCC1, TAC1, and ERCC1. Conclusion: This study highlighted the need and the importance of conducting pharmacogenetic studies to generate evidence of personalized OXIPN symptoms management. Additional studies are warranted to accelerate the tailored interventions used for OXIPN in patients with CRC (NRF-2014R1A1A3054386).

FMEA기법을 이용한 화학제품의 PL 대응체계 연구 (A Study on Product Liability Response System of Chemical Products by Using Failure Mode and Effect Analysis)

  • 고재욱;유진환;김대흠
    • 한국가스학회지
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    • 제7권4호
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    • pp.30-35
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    • 2003
  • 제조물책임(Product Liability : PL)이란 제조물의 결함으로 인하여 소비자 또는 제3자의 생명, 신체, 재산 등에 손해가 발생했을 경우 그 제조물의 제조자 또는 판매자 등에게 손해배상 책임을 부과시키는 법으로 국내에서는 제조물책임법은 2002년 7월 시행되었다. 본 연구에서 FMEA를 이용한 화학제품의 제조물책임 대응체계를 구성하였으며, 깍N-Dimethyethylamine을 사례로 적용하여 연구를 진행하였다. 우선 화학제품의 취급설명서 역할을 하는 MSDS(Material Safety Data Sheet)를 통해 제품의 정보를 파악하고, 제품의 결함으로 인한 영향을 분석하는 FMEA기법을 적용하여 결함의 심각도, 결함의 발생빈도 및 검출도의 곱으로 정의된 RPN(Risk Priority Number)에 의하여 위험성을 정량적으로 제시하였다.

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