• 제목/요약/키워드: Severity of illness

검색결과 178건 처리시간 0.024초

편두통 환자의 임상 양상 및 생체전기 자율반응과의 상관성 고찰 (The clinical manifestation of migraine and correlation study with autonomic bioelectric response)

  • 이현종;정인태;김수영;이두익;김건식;이재동;이윤호;최도영
    • Journal of Acupuncture Research
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    • 제21권3호
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    • pp.215-229
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    • 2004
  • Objective : We had a clinical report in headache but didn't in migraine. We have planned this study in order to get the basic data of migraine in oriental medicine. Methods : The patient of 36 in migraine checked sex, age, onset, family history, severity of pain, influences of life, induced cause, clinical pain characteristics, associated symptom, treatment style, and prescription, frequency, using period of analgesics by a questionnaire and differentiated syndromes in migraine and evaluated autonomic bioelectric response recorder(ABR-2000). Results : There are 23.4% in prevalence rate of migraine. The ratio of sex is M:F=1:17. The age of an attack is the highest in thirties. The patient are the most in forties. The mean duration of illness is $12.0{\pm}9.9$ years. 83.4% had a family history. 61.1% had a moderate grade in severity of pain. 77.8% selected fatigue in induced cause of migraine. 69.4% had tingling sense, nausea and vomiting in the associated symptoms. 91.7% used analgesics for treatment and 51.5% of them used analgesics voluntarily. 61.9% of them take analgesics less than once in a week. 33.6% had the phlegm syncope headache in differentiation of syndrome. In ABR-2000 results, item of graph showed low tendency mostly. Conclusions : We expected that this report of clinical progress, differentiation of syndromes and ABR-2000 results in migraine would be used basic data by oriental medicine to treat migraine.

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Cisplatin, Carboplatin, Oxaliplatin 투여로 인한 말초신경병증에 대한 평가 (Evaluation of Chemotherapy Induced Peripheral Neuropathy by Cisplatin, Carboplatin and Oxaliplatin)

  • 윤완기;허미정;이옥상;임성실
    • 한국임상약학회지
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    • 제22권4호
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    • pp.356-366
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    • 2012
  • Background: Chemotherapy-induced peripheral neuropathy (CIPN) involving sensory and motor nerve damage or dysfunction is a common and serious clinical problem that affects many patients receiving cancer treatment. This condition may pose challenges for the clinician to diagnose and manage, particularly in patients with coexisting conditions or disorders that involve the peripheral nervous system. Many chemotherapeutic agents used today are associated with the development of serious and dose-limiting CIPN that can adversely affect the administration of planned therapy and can impair quality of life by interference with the patients' activities of daily living. The most important clinical objective in the evaluation of patients with CIPN is to determine their level of functional impairment involving activities of daily living. These findings are used to make medical decisions to continue, modify, delay, or stop treatment. The most commonly reported drugs to cause CIPN include taxanes, platinum agents, vinca alkaloids, thalidomide, and bortezomib. We aimed to determine PN incidence during cisplatin, carboplatin and oxaliplatin administration. Methods: We collected data from 125 patients who received at least one cycle of cisplatin, carboplatin or oxaliplatin. They completed a self-reported questionnaire and items related to their disease and peripheral neuropathy. The investigators filled in part of items about disease and treatment. Patient Neurotoxicity Qeustionnaire developed by Bionumerik company were applied for PN assessment. Results: The incidences of sensory neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 23%, 56% and 50%. The incidences of motor neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 18%, 42% and 19%. The incidences of severe neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 13%, 28% and 14%. The incidences of PN were associated with cumulative dose but not age, gender and concurrent illness. 19.2% of the patients (24/125) were prescribed with gabapentin, nortriptyline or gabapentin plus nortriptyline to reduce these peripheral symptoms and 75% of the patients answered the drug were effective. Conclusion: Incidence of PN after cisplatin or oxaliplatin administration is cumulative dose-related. Physician-based assessments under-reported the incidence and severity of CIPN. To overcome this limitation, diagnostic tools specifically designed to assess peripheral neuropathy severity associated with chemotherapy must be developed.

The Relationship between Hair Zinc and Lead Levels and Clinical Features of Attention-Deficit Hyperactivity Disorder

  • Shin, Dong-Won;Kim, Eun-Ji;Oh, Kang-Seob;Shin, Young-Chul;Lim, Se-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제25권1호
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    • pp.28-36
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    • 2014
  • Objectives : The goal of this study was to examine the association between zinc and lead level and symptoms of attention-deficit hyperactivity disorder (ADHD) among Korean children. Methods : A total of 89 clinic-referred children participated in the study (ADHD group=45, control group=44). The participants were 5-15 years old, and were mainly from urban areas of Seoul, Korea. ADHD was diagnosed using the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. We excluded children with a comorbid psychiatric disorder, medical illness requiring medication, or a prior history of taking ADHD medication. In order to evaluate the severity of ADHD symptoms, parents' Korean ADHD Rating Scale (K-ARS) was used. The ADHD diagnostic system (ADS) was used for evaluation of the severity of inattention and impulsivity. All participants completed the intelligence test and hair mineral analysis. Multiple regression analysis was used to examine the effect of hair zinc and lead levels on the K-ARS and ADS. We measured the predictive ability of the zinc and lead levels using logistic regression analysis. Results : The lead level explained the score for omission errors, commission errors, and response time SD in visual ADS in the ADHD group (adjusted $R^2$=.243, p<.01, adjusted $R^2$=.362, p<.01, and adjusted $R^2$=.275, p<.01), the score for omission errors of auditory ADS in ADHD group (adjusted $R^2$=.407, p<.01) and the entire group (adjusted $R^2$=.292, p<.01). Zinc was significantly explanatory for the K-ARS scores for the entire group (adjusted $R^2$=.248, p<.001) and the ADHD group (adjusted $R^2$=.247, p<.05). Conclusion : These findings suggest a possible role of zinc and lead in ADHD. Lead concentration in hair samples affected the ADS scores, and this was more prominent in children with ADHD. Children with ADHD had a lower zinc concentration in their hair, and the zinc concentration in hair showed negative correlation with the K-ARS score.

신종플루 뉴스 이용 정도가 개인 및 공중에 대한 건강보호 행위의도에 미치는 영향에 관한 연구: 보호동기이론을 중심으로 (Exploring the Relationship between the Level of News Usage on Influenza A(H1N1) and Media Users' Behavioral Intention toward Personal and Public Health Protection: Focusing on Protection Motivation Theory)

  • 김여라
    • 한국언론정보학보
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    • 제51권
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    • pp.5-25
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    • 2010
  • 본 연구는 신종플루 관련 뉴스 이용 정도가 개인 및 공중에 대한 건강보호 행위의도에 미치는 영향을 보호동기이론(protection motivation theory)을 통해 살펴보았다. 구체적으로 신종플루 뉴스 이용 정도를 독립변인으로, 심리적 보호동기요인(신종플루에 대한 인지된 심각성, 취약성, 대처효능감, 자기효능감)을 매개변인으로 그리고 개인과 공중에 대한 건강보호 행위의도를 종속변인으로 설정하였다. 대학생 460명을 대상으로 설문조사를 실시하여 각 구성요인 간의 인과관계를 연구모형으로 설정하고 구조방정식모델(SEM)로 분석하였다. 연구결과에 의하면, 첫째 '개인 건강보호 행위의도' 연구모형에서 신종플루 뉴스 이용 정도는 신종플루 관련 보호동기 요인들에 유의미한 인과관계를 나타냈으나 '대처효능감'은 제외되었다. 또한 세 가지 보호동기 요인(지각된 심각성, 지각된 취약성, 자기효능감)들은 개인 건강보호 행위의도에 유의미한 정적 인과관계를 나타냈다. 둘째 '공중 건강보호 행위의도' 연구모형에서 신종플루 뉴스 이용 정도는 '대처효능감'을 제외한 모든 보호동기 요인에 유의미한 관계를 나타냈으며 보호동기 요인들 중에 '인지된 취약성'과 '대처효능감'만이 공중 건강보호 행위의도에 유의미한 정적 인과관계를 나타냈다. 두 연구모형의 공통점으로는 신종플루 뉴스이용 정도가 개인 또는 공중 건강보호 행위의도에 직접적인 영향을 미치지 않은 것으로 나타났다. 특정 질병에 대한 건강보호 행위의도에 있어서 건강보호 대상(자신 혹은 타인)이 누구인가에 따라 심리적 보호동기들은 다르게 작동하는 것으로 추정된다.

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Clinical Relevance of Bronchial Anthracofibrosis in Patients with Chronic Obstructive Pulmonary Disease Exacerbation

  • Kim, Hyera;Cha, Seung-Ick;Shin, Kyung-Min;Lim, Jae-Kwang;Oh, Serim;Kim, Min Jung;Lee, Yong Dae;Kim, Miyoung;Lee, Jaehee;Kim, Chang-Ho
    • Tuberculosis and Respiratory Diseases
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    • 제77권3호
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    • pp.124-131
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    • 2014
  • Background: Bronchial anthracofibrosis (BAF), which is associated with exposure to biomass smoke in inefficiently ventilated indoor areas, can take the form of obstructive lung disease. Patients with BAF can mimic or present with an exacerbation of chronic obstructive pulmonary disease (COPD). The purpose of the current study was to investigate the prevalence of BAF in Korean patients with COPD exacerbation as well as to examine the clinical features of these patients in order to determine its clinical relevance. Methods: A total of 206 patients with COPD exacerbation were divided into BAF and non-BAF groups, according to computed tomography findings. We compared both clinical and radiologic variables between the two groups. Results: Patients with BAF (51 [25%]) were older, with a preponderance of nonsmoking women; moreover, they showed a more frequent association with exposure to wood smoke compared to those without BAF. However, no differences in the severity of illness and clinical course between the two groups were observed. Patients in the BAF group had less severe airflow obstruction, but more common and severe pulmonary hypertension signs than those in the non-BAF group. Conclusion: Compared with non-BAF COPD, BAF may be associated with milder airflow limitation and more frequent signs of pulmonary hypertension with a more severe grade in patients presenting with COPD exacerbation.

횡문근융해증에 의한 급성 신 손상이 동반된 렙토스피라증 1예 (Rhabdomyolysis Induced Acute Kidney Injury in a Patient with Leptospirosis)

  • 최윤정;박정민;정요한;남종호;정현희;김태우;조규향;도준영;윤경우;박종원
    • Journal of Yeungnam Medical Science
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    • 제28권1호
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    • pp.54-59
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    • 2011
  • Leptospirosis is a spirochetal infectious disease caused by $Leptospira$ $interrogans$, and may vary in degree from an asymptomatic infection to a severe and fatal illness. The kidney is one of the principal target organs of $Leptospira$. Renal disorders caused by $Leptospira$ infection vary from an abnonnality in urinalysis to acute kidney injury (AKI). Incidence of AKI in severe leptospirosis varies from 40% to 60%. AKI reflects the severity of leptospirosis and is generally accompanied by cholestatic jaundice. The pathophysiology of AKI in leptospirosis consists of hypovolemia, direct tubular toxicity, and rhabdomyolysis. Most patients with acute leptospirosis experience severe myalgias, and show laboratory evidence of mild rhabdomyolysis. However, occurrence of severe rhabdomyolysis is rare. We report here on a patient with leoptospirosis, who had severe rhabdomyolysis and acute kidney injury without jaundice.

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Evaluation of the role of ischemia modified albumin in neonatal hypoxic-ischemic encephalopathy

  • Talat, Mohamed A.;Saleh, Rabab M.;Shehab, Mohammed M.;Khalifa, Naglaa A.;Sakr, Maha Mahmoud Hamed;Elmesalamy, Walaa M.
    • Clinical and Experimental Pediatrics
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    • 제63권8호
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    • pp.329-334
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    • 2020
  • Background: Birth asphyxia is a leading cause of neonatal mortality. Ischemia-modified albumin (IMA) levels may have a predictive role in the identification and prevention of hypoxic disorders, as they increase in cases of ischemia of the liver, heart, brain, bowel, and kidney. Purpose: This study aimed to assess the value of IMA levels as a diagnostic marker for neonatal hypoxic-ischemic encephalopathy (HIE). Methods: Sixty newborns who fulfilled 3 or more of the clinical and biochemical criteria and developed HIE as defined by Levene staging were included in our study as the asphyxia group. Neonates with congenital malformation, systemic infection, intrauterine growth retardation, low-birth weight, cardiac or hemolytic disease, family history of neurological diseases, congenital or perinatal infections, preeclampsia, diabetes, and renal diseases were excluded from the study. Sixty healthy neonates matched for gestational age and with no maternal history of illness, established respiration at birth, and an Apgar score ≥7 at 1 and 5 minutes were included as the control group. IMA was determined by double-antibody enzyme-linked immunosorbent assay of a cord blood sample collected within 30 minutes after birth. Results: Cord blood IMA levels were higher in asphyxiated newborns than in controls (250.83±36.07 pmol/mL vs. 120.24±38.9 pmol/mL). Comparison of IMA levels by HIE stage revealed a highly significant difference among them (207.3±26.65, 259.28±11.68, 294.99±4.41 pmol/mL for mild, moderate, and severe, respectively). At a cutoff of 197.6 pmol/mL, the sensitivity was 84.5%, specificity was 86%, positive predictive value was 82.8%, negative predictive value was 88.3%, and area under the curve was 0.963 (P<0.001). Conclusion: IMA levels can be a reliable marker for the early diagnosis of neonatal HIE and can be a predictor of injury severity.

지역 정신보건센터에 등록된 조현병 환자의 삶의 질 및 관련 정신사회적 요인 (The Quality of Life and Related Psychosocial Factors of Schizophrenia Patients Registered in Community Mental Health Center)

  • 장창현;안동현;이정임
    • 생물정신의학
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    • 제21권1호
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    • pp.28-35
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    • 2014
  • Objectives This study aimed to identify the relationship between quality of life (QoL) and psychosocial factors of schizophrenia patients registered in a community mental health center. Methods The ninety patients with schizophrenia, diagnosed by Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition-Text Revision, registered in a community mental health center were studied cross-sectionally. Four trained personnels interviewed each subject individually for the assessment of QoL, psychopathology, severity of depressed mood, insight of illness, attitude toward drugs, social function, degree of social supports and conflicts. Results QoL was significantly related to the psychopathology, depressed mood, social conflict, social support; and other aspects of QoL were slightly differently related to depressed mood, social conflict, social support and attitude toward drug by scales. In multiple regression analysis, depressed mood (20.0%) and social conflict (10.3%) were contributed to QoL assessed by Korean version of 4th revision of Schizophrenia Quality of Life. Social support (21.4%), social conflict (20.9%) and depressed mood (3.1%) were contributed to QoL assessed by Korean modification of the Scale to measure Subjective Well-being under Neuroleptic treatment. Conclusions These findings demonstrated that QoL of schizophrenia patients in a community is affected by depressed mood, social support and conflict rather than psychotic symptoms, insight and attitude toward drugs. And this result suggests the necessity of approaching not only to the psychotic symptoms but also to the psychosocial characteristics in caring schizophrenia patients in the community.

Clinical manifestation of Campylobacter enteritis in children

  • Bae, Joon Yeol;Lee, Dong Hyuk;Ko, Kyung Ok;Lim, Jae Woo;Cheon, Eun Jeong;Song, Young Hwa;Yoon, Jung Min
    • Clinical and Experimental Pediatrics
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    • 제61권3호
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    • pp.84-89
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    • 2018
  • Purpose: Timely antibiotic therapy in selected cases of diarrhea associated with bacterial infections can reduce the duration and severity of illness and prevent complications. The availability of a predictive index before identification of causative bacteria would aid in the choice of a therapeutic agent. Methods: The study included patients admitted to the pediatrics unit at Konyang University Hospital for acute inflammatory diarrhea from August 1, 2015 to July 31, 2016 who underwent multiplex polymerase chain reaction testing. Of 248 patients, 83 had positive results. The clinical symptoms and blood test results were examined in 61 patients with Campylobacter spp. (25 patients), Salmonella spp. (18 patients), and Clostridium perfringens (18 patients) infections. The mean age of the 61 patients (male:femal=31:30) was $84.0{\pm}54.8months$, and the mean hospital stay was $4.6{\pm}1.7days$. Results: There were no statistical differences in sex, age, clinical symptoms, or signs. Patients with Campylobacter infection were significantly older (P=0.00). C-reactive protein (CRP) levels in patients with Campylobacter infection were higher than those in the other 2 groups, at $9.6{\pm}6.1mg/dL$. The results of receiver-operating characteristic curve analysis showed that the cutoff age was ${\geq}103.5months$ (sensitivity, 72%; specificity, 86%) and the CRP cutoff level was ${\geq}4.55mg/dL$ (sensitivity, 80%; specificity, 69%). Conclusion: Age (${\geq}103.5months$) and higher CRP level (${\geq}4.55mg/dL$) were good predictors of Campylobacter enterocolitis. If neither criterion was met, Campylobacter enterocolitis was unlikely (negative predictive value 97.2%). When both criteria were met, Campylobacter enterocolitis was highly likely.

급성 조증환자에서 Risperidone의 치료효과: 임상 개방 연구 (Effects of Risperidone in Acute Manic Patients: An Open Clinical Trial)

  • 백인호;이창욱;이철;이수정;김재현
    • 생물정신의학
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    • 제2권2호
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    • pp.281-286
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    • 1995
  • Objects : Manic phase of bipolar disorder is treated with a combination of mood stabilizer and antipsychotic drug, especially in the acute phase. Such combined treatment is often required for the clinical management of manic symptoms until therapeutic effects of mood stabilizer become evident. The present study was the first open trial to evaluate the efficacy of risperidone, and safety of the combination of mood stabilizer and risperidone in the treatment of acute manic patients. Method : This study was performed as an open clinical study. The subjects of this study were 42 patients who had been admitted with first manifestations or acute exacerbations of illness were selected, using DSM-III-R criteria for bipolar disorder, manic episode. Patients were rated using the the Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression (CGI), Extrapyramidal Symptom Rating Scale(ESRS). Other adverse events were assessed by a symptom checklist and by observation by medical personnel. Vital signs were monitored in a standard way and electrocardiography, routine laboratory analysis were performed. Results : Thirty patients(67%) completed the 12-week trial period. The CGI showed a good therapeutic effect with a minimal incidence or severity of side effects. The majority of patients showed a continuos reduction in their BPRS scores. The extrapyramidal symptoms assessed on ESRS generally showed mild to moderate degree. laboratory porameters showed no significant changes during the course of treatment. Conclusion : The results of the study showed a good efficacy of the risperidone in manic patients and further controlled studies are warranted.

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