• 제목/요약/키워드: Risk function

검색결과 1,719건 처리시간 0.026초

한국인의 항결핵제에 의한 간독성 위험인자 예측 (Prediction of the Hepatotoxicity Risk Factor Induced by Antituberculosis Agents in Koreans)

  • 이지선;김현아;조은;이옥상;임성실
    • 약학회지
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    • 제55권4호
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    • pp.352-360
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    • 2011
  • Standard combination chemotherapy including isoniazid, rifampin, pyrazinamide, and ethambutol is very effective against tuberculosis. But, these medicines can cause hepatotoxicity which is the main reason for treatment interruption or change in drug regimen. In order to identify risk factors associated with hepatotoxcity in Koreans and assess elevated baseline LFTs' contributions to hepatotoxicity, a retrospective case control study was performed. The medical records of 277 patients who diagnosed with tuberculosis at a community hospital from January 1st, 2007 to June 30th, 2010 were reviewed. Patients were categorized into 3 groups (non toxic group, patients without increase in LFT levels; mild to moderate hepatotoxic group and severe hepatotoxic group). And the correlation between risk factors and hepatotoxicity was analyzed by using SPSS program. The overall incidence of hepatotoxicity was 18% and 8.7% of patients developed severe toxicity. Patients in the severe toxic group had the longest treatment period among the three groups. In 75% of severe toxic group, hepatotoxicity occurred within 18.3 days after starting medication. Hypoalbuminemia (serum albumin <3 g/dl) was a significant risk factor for development of severe toxicity. Elevated baseline transaminase (except ALT), total bilirubin, and preexisting hepatitis were also risk factors which were more than twice as likely to increase risk of severe hepatotoxicity (p>0.05). In conclusion, hypoalbuminemia (serum albumin level <3 g/dl) was a significant risk factor for anti-tuberculosis druginduced severe toxicity. Therefore, before starting antituberculosis chemotherapy, serum albumin level should be assessed at baseline. In high-risk patients (hypoalbuminemia, elevated LFTs) for hepatotoxicty, liver function should be closely monitored up to at least 21 days after taking medication.

Comparison of the Pediatric Balance Scale and Fullerton Advanced Balance Scale for Predicting Falls in Children With Cerebral Palsy

  • Kim, Gyoung-mo
    • 한국전문물리치료학회지
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    • 제23권4호
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    • pp.63-70
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    • 2016
  • Background: The Pediatric Balance Scale (PBS) and the Fullerton Advanced Balance (FAB) scale were used to assess balance function in patients with balance problem. These multidimensional clinical balance scales provide information about potential risk factors for falls. Objects: The purpose of this study was to investigate and compare the predictive properties of the PBS and FAB scales relative to fall risk in children with cerebral palsy (CP) using a receiver operating characteristic analysis. Methods: In total, 49 children with CP (boy=21, girl=28) who were diagnosed with level 1 or 2 according to the Gross Motor Function Classification System participated in this study. The PBS and FAB were performed, and verified cut-off score, sensitivity, specificity, and the area of under the curve (AUC). Results: In this study, the PBS scale was as a predictive measure of fall risk, but the FAB was not significant in children with CP. A cut-off score of 45.5 points provided optimal sensitivity of .90 and specificity of .69 on the PBS, and a cut-off score of 21.5 points provided optimal sensitivity of .90 and specificity of .62 on the FAB. Both scales showed moderately accurate of AUC with .79 and .76, respectively. Conclusion: The PBS is a useful screening tool for predicting fall risk in children with cerebral palsy, and those who score 45.5 or lower indicate a high risk for falls and are in need of balance intervention.

중환자실 퇴원환자의 인지장애 위험요인 (Risk Factors for Cognitive Impairment in Intensive Care Unit Survivors)

  • 강지연;이보경
    • 중환자간호학회지
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    • 제13권3호
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    • pp.75-85
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    • 2020
  • Purpose : This study aimed to identify the prevalence and risk factors of cognitive impairment in survivors discharged from the intensive care unit (ICU). Methods : This secondary analysis study utilized data from a multicenter prospective cohort of post-ICU patients. We analyzed the data of 175 patients enrolled in the primary cohort who completed the cognitive function evaluation three months after ICU discharge. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) scale. The cut-off points for cognitive impairment were < 23 for face-to-face evaluation and < 18 for telephone evaluation. Results : The prevalence of cognitive impairment three months after ICU discharge was 32.6%. Significant risk factors for cognitive impairment were age ≥ 60 years (OR=10.52, 95% CI=3.65~30.33, p<.001), education < high school graduation (OR=2.53, 95% CI=1.07~6.01, p=.035), unplanned ICU admission (OR=4.01, 95% CI=1.45-11.14, p=.008), and delirium in the ICU (OR=4.33, 95% CI=1.08-17.23, p=.038). Conclusion : ICU nurses should use preemptive strategies to reduce post-ICU cognitive impairment of patients with risk factors. It is necessary to frequently assess and detect early delirium in critically ill patients, while attempting various non-pharmacological interventions.

New Oral Anticoagulants를 복용하는 환자들에서 위장관 출혈의 위험인자 (Risk Factors of Gastrointestinal Bleeding in Patients Receiving New Oral Anticoagulants)

  • 이주엽
    • 대한상부위장관⦁헬리코박터학회지
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    • 제18권4호
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    • pp.219-224
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    • 2018
  • New oral anticoagulants (NOACs) are now widely used for the prevention and treatment of venous thrombosis, and for the prevention of stroke and systemic embolism in patients with atrial fibrillation. As compared with warfarin, NOACs have the advantage of rapid onset of action and less drug interaction. However, they carry a higher risk of gastrointestinal (GI) bleeding than warfarin. The risk of GI bleeding in patients using NOACs varies according to the type and dose of the drug. By contrast, apixaban and edoxaban are reported to carry similar risks as warfarin, and the risks with dabigatran and rivaroxaban are higher than that with warfarin. In patients using NOACs, old age, impaired renal function, impaired liver function, concurrent use of antiplatelet agents, and nonsteroidal anti-inflammatory drugs are considered major risk factors of GI bleeding, and gastroprotective agents such as histamine-2 receptor antagonist and proton pump inhibitor have preventive effects. To prevent GI bleeding associated with NOACs, the characteristics of each NOAC and the risk factors of bleeding should be recognized.

만성 심신기능저하가 건강관련 일상생활수행능력에 영향을 미치는 요인 (Effect of Chronic Mind-Body Function Decline on Health-Related Activities of Daily Living)

  • 이성란
    • 디지털융복합연구
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    • 제11권1호
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    • pp.309-314
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    • 2013
  • 본 연구는 만성 심신기능저하가 건강관련 일상생활수행능력에 영향을 미치는 요인을 규명하기 위해 시도하였다. 자료수집은 2011년 6월 8일부터 2011년 7월 13일까지 서울에 소재한 종합병원에 내원한 148명을 대상으로 설문 및 면접조사를 하였다. 연구결과는 첫째, 운동습관 여부는 정기적으로 운동하는 경우가 환자군은 남성이 26.7%, 여성은 22.7%였으며, 위험비는 0.25 배로 나타났다. 반면 대조군의 경우 남성은 42.2%, 여성은 31.8%를 보였으며 위험비는 0.61 배이었다. 둘째, 남성의 경우 사회적 요인의 위험비는 45.18 배이었고(p=.04), 여성의 신체적인 요인은 237.1 배의 위험비를 보였다(p=.001). 이러한 결과를 토대로 만성 심신기능 저하를 예방하기 위해서는 건전한 생활리듬을 유지하고 면역력 증진하는 음식을 섭취하며 지속적인 운동 등을 통해 심신의 스트레스를 해소하는 것이 필요하다고 본다.

Average performance of risk-sensitive controlled orbiting satellite and three-degree-of-freedom structure

  • Won, Chang-Hee
    • 제어로봇시스템학회:학술대회논문집
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    • 제어로봇시스템학회 1995년도 Proceedings of the Korea Automation Control Conference, 10th (KACC); Seoul, Korea; 23-25 Oct. 1995
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    • pp.444-447
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    • 1995
  • The satellite in a circular orbit about a planet with disturbances and a three-degree-of-freedom (3DOF) structure under seismic excitations are modeled by the linear stochastic differential equations. Then the risk-sensitive optimal control method is applied to those equations. The mean and the variance of the cost function varies with respect to the risk-sensitivity parameter, .gamma.$_{RS}$ . For a particular risk-sensitivity parameter value, risk-sensitive control reduces to LQG control. Furthermore, the derivation of the mean square value of the state and control action are given for a finite-horizon full-state-feedback risk-sensitive control system. The risk-sensitive controller outperforms a classical LQG controller in the mean square sense of the state and the control action.

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User Requirement Analysis on Risk Management of Architectural Heritage in Virtual Reality

  • Lee, Jongwook
    • 한국컴퓨터정보학회논문지
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    • 제24권9호
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    • pp.69-75
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    • 2019
  • We propose a method to analyze user requirements to design a virtual reality-based risk management system. This paper presents surveys, interviews, prototype evaluation methods, and implementation process. Architectural heritage is easily exposed to natural and artificial dangers caused by various material combinations and structural features. So, risk management of cultural heritage plays a key role in preserving and managing cultural heritage. However, risk management has been carried out through empirical methods using distributed data. This study analyzes user requirements for designing functions and interfaces of VR-based risk management system and evaluates prototypes to overcome the above problems. As a result, most heritage managers wanted a system function to support risk analysis and response. They also found that they prefer 2D information such as existing drawings and photos rather than 3D information. The results of the user requirements analysis derived from this study will be used to create risk management applications.

Risk Factors of the Masticatory Function in Patients with Temporomandibular Disorders: A Cross-Sectional Cohort Study

  • Kim, Keon-Hyung;Park, Jo-Eun;Kim, Mee-Eun;Kim, Hye-Kyoung
    • Journal of Oral Medicine and Pain
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    • 제44권3호
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    • pp.92-102
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    • 2019
  • Purpose: To investigate the masticatory function of patients with different temporomandibular disorders (TMD) phenotypes, and to explore the risk factors for the masticatory function of TMD patients among multiple biopsychosocial variables using patient-reported outcomes (PROs). Methods: Clinical features and TMD diagnoses of 250 cases were investigated by reviewing medical records. Psychosocial factors were evaluated using four questionnaires representing pain severity and pain interference (Brief Pain Inventory), pain catastrophizing (Pain Catastrophizing Scale, PCS), psychological distress (Symptom Check List-90-Revised, SCL-90R) and kinesiophobia (Tampa Scale for Kinesiophobia for Temporomandibular Disorders, TSK-TMD). Masticatory function, as a dependent variable, was determined using the Jaw Functional Limitation Scale (JFLS). Kruskal-Wallis test and Spearman's rank correlation were used for analyses. Results: A total of 145 cases were included and classified into four subgroups including group 1: TMD with internal derangement without pain (n=14), group 2: TMD with muscle pain (n=32), group 3: TMD with joint pain (n=60) and group 4: TMD with muscle-joint combined pain (n=39). Pain severity (p=0.001) and interference (p=0.022) were the highest in group 2, but the mean global score of JFLS was the highest in group 3, followed by group 4, group 2, and group 1 (p=0.013). Pain severity, pain interference, the mean global score of PCS and the mean global score of TSK-TMD showed significant and moderate correlation with the mean global score of JFLS. All subdimensions and the global severity index of SCL-90R had significant, but weak correlations with all scores of JFLS. Conclusions: The results suggest that masticatory functional limitation depends on the TMD phenotypes. Among the various PROs, pain perception, pain catastrophizing and kinesiophobia seem to be more influential risk factors on jaw function than psychological distress, such as depression and anxiety.

심혈관계 질환과 구강기능제한의 관련성 (Association between cardiovascular disease and limited oral function)

  • 김선미;김인자
    • 한국치위생학회지
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    • 제21권6호
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    • pp.751-761
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    • 2021
  • Objectives: The purpose of this study was to examine the relationship between limited oral function and cardiovascular disease in adults over 40 years of age. Methods: Data from the Seventh Korean National Health and Nutrition Examination Survey (2016-2018) was used. In this study, 8,766 adults over the age of 40 years were included as study subjects. They completed a health survey which included current prevalence of hypertension, stroke, myocardial infarction, and angina pectoris, as well as information about blood tests, physical measurements, and oral examinations. Statistical analyses were carried out using complex sample cross-tabulation analysis, general linear model, and logistic regression analysis. Results: The study showed that limited oral function was experienced by patients with stroke (61.3%), myocardial infarction (49.1%), cardiovascular disease (38.5%), hypertension (38.1%), and angina (36.4%) (p<0.05). In patients with stroke, the risk of limited oral function was 2.393 times higher than in patients without stroke. Patients with hypertension were 1.233 times more at risk of speaking difficulty than those without hypertension. Conclusions: Limited oral function is associated with cardiovascular disease. To improve oral health, it is necessary to provide integrated, health-based oral care.

2기간 모형에서의 손실통제 노력 (The Efforts of Self-Insurance-cum-Protection Activity in a Two-Period Model)

  • 홍지민
    • 한국산학기술학회논문지
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    • 제20권10호
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    • pp.47-53
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    • 2019
  • 본 연구는 기존 연구에서 초점을 맞춘 1기간 모형과는 달리 2기간 모형에서 위험회피성향의 증가에 따라 노력의 투입에 따라 손실의 크기와 발생확률이 동시에 감소하는 손실통제 노력의 변화를 살펴보고 있다. 노력의 투입과 손실의 발생시점간의 시점 분리를 고려한 본 연구의 가정은 장기에서 위험회피성향의 영향을 관찰할 수 있게 해준다. 그 결과 첫째, 손실함수 및 비용함수에 추가적인 제약이 존재했던 단기 모형인 기존 연구와는 달리 장기에서는 위험회피성향의 증가가 손실통제 노력의 증가를 가져왔다. 둘째, 손실통제 노력을 자가보험 노력 및 자가보호 노력으로 세분화해 볼 때, 위험회피성향의 증가가 자가보험 노력은 증가시키나 자가보호에 미치는 영향이 불분명하던 기존 단기모형의 결과와는 달리, 장기에서는 위험회피성향의 증가로 인해 자가보험 노력 및 자가보호 노력이 모두 증가한다는 것을 알 수 있다. 셋째, 평균이 0인 배경위험이 존재하는 경우 2기간 모형에서 위험회피성향의 증가에 따라 손실통제 노력이 증가할 충분조건은 효용함수가 신중성 조건을 나타내는 것이다.