• 제목/요약/키워드: clinical nutrition support

검색결과 108건 처리시간 0.02초

전이암 환자에서 단일기관 영양검색 도구의 예후 가치 (Prognostic Value of a Single Center Nutrition Screening Tool in Patients with Metastatic Cancer)

  • 윤성수;김민진;김은혜;이지영;윤성우
    • 대한암한의학회지
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    • 제24권2호
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    • pp.1-11
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    • 2019
  • Objectives : We investigated whether a single center nutrition screening tool (Kyunghee Neo Nutrition Risk Screening, KNNRS) can predict survival in patients with metastatic cancer. Methods : We retrospectively reviewed data of inpatients with metastatic cancer from April 2016 to August 2019. Data on demographic and clinical parameters were collected from electronic medical records, and overall survival was estimated using the Kaplan-Meier method. Stepwise Cox regression analysis was used to determine factors associated with survival. Patients with a KNNRS score of 0 to 3 were classified as "no-risk", 4 to 10 as "low-risk", and 11 to 20 as "high-risk". Results : Total 105 patients were included in the study. According to nutritional screening at baseline, 25 patients (23.8%, median age 57.0) were classified as ""no risk"" group; 80 patients (76.2%, median age 68.5) as "low risk" group; No patients as "high risk" group. Predictors of survival were Eastern Cooperative Oncology Group Performance Status score of 3 or 4 (hazard ratio [HR] = 1.93; 95% confidence interval [CI] = 1.21-3.10), hemoglobin less than 10 g/dL (HR = 1.97; 95% CI = 1.25-3.10) and C-reactive protein more than 1.0 mg/dL (HR = 1.95; 95% CI = 1.21-3.13). Kaplan-Meier survival analysis showed significant differences in the survival between KNNRS groups: ""no risk"" group: 6.1 ± 1.4 months (95% CI = 3.37-8.83); ""low risk"" group: 3.4 ± 0.9 months (95% CI = 1.5-5.37). Conclusions : Nutritional status according to KNNRS wasn't significant predictor of survival for patients with metastatic cancer. Improvement of KNNRS score thresholds is needed.

우리나라 성인의 허혈성 심장질환, 뇌졸중으로 인한 총 진료비 중 과체중 및 비만의 기여분 (Medical Expenditure Attributable to Overweight and Obesity in Adults with Ischemic Heart Disease and Stroke in Korea)

  • 강재헌;정백근;조영규;송혜령;김경아
    • 보건교육건강증진학회지
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    • 제27권4호
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    • pp.83-90
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    • 2010
  • objectives: This study was conducted to estimate medical expenditure attributable to overweight and obesity in adults with ischemic heart disease and stroke using Korea National Health and Nutrition Examination survey data and Korea National Health Corporation data. methods : The medical expenditure of ischemic heart disease and stroke related to overweight and obesity were composed of inpatient care costs, outpatient care costs and medication costs. The population attributable risk (PAR) of overweight and obesity was calculated from national representative data of Korea such as the National Health Insurance Corporation cohort data and 2005 Korea National Health and Nutrition Examination survey data. results: The medical expenditure attributable to overweight and obesity of ischemic heart disease were 97.4 billion won(74.1-122 billion won). and stroke were 64.6 billion won(33.1-98.1 billion won). Consequently, these costs corresponded to 11.4% of total medical expenditure due to ischemic heart disease and stroke. conclusion: We conclude that overweight and obesity have increased medical expenditure from ischemic heart disease and stroke in Korea. These findings provide important support for implementing overweight and obesity management strategies in Korea.

상급종합병원 병동담당약사 업무 현황 및 의료인의 인식과 기대 분석 (Clinical pharmacist services in general wards and perception and expectation of healthcare providers towards the services at a tertiary healthcare center)

  • 김정은;백시진;최나예;전수정;남궁형욱;이정화;김은경;이주연
    • 한국임상약학회지
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    • 제32권1호
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    • pp.20-26
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    • 2022
  • Background and objective: The Seoul National University Bundang Hospital (SNUBH) implemented ward-based clinical pharmacy system with designated pharmacists in 10 general wards. Designated pharmacists conduct inpatient medication review, medication intervention, and medication consultation, and provide drug information for health care providers. This study aimed to evaluate the clinical pharmacy services and to examine the perception and expectations of health care providers on the services provided by the designated pharmacists in general wards. Methods: A survey was constructed to include questions on the health care providers' recognition, satisfaction, and perceived needs of designated pharmacists. We determined the frequency and type of interventions of ward pharmacist and their acceptance rate through a retrospective observational study using electronic medical records. Results: A total of 59 health care providers responded the questionnaire and 79.7% of the respondents reported moderate to high levels of satisfaction. Satisfaction with the services was positively associated with clinical interventions and nutrition support team (81.4%). Of 59 respondents, 88.1% agreed that preventing drug-related problems by designated pharmacists' activities were effective. The most common interventions included inadequate dosage (27.4%), omission and additional prescription (14.6%) and inadequate drug form (9.6%). The acceptance rate of intervention was 91.5%, and 151 potentially serious risks and 523 significant risks were prevented by the intervention. Conclusion: Positive results were confirmed in the awareness, satisfaction, and perceived needs of the health care providers for designated pharmacists. Expansion of the ward-based clinical pharmacy system with designated pharmacists to other wards may be considered.

머신러닝을 활용한 뇌졸중 환자의 기능적 결과 예측: 체계적 고찰 (Predicting Functional Outcomes of Patients With Stroke Using Machine Learning: A Systematic Review)

  • 배수영;;남상훈;홍익표
    • 재활치료과학
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    • 제11권4호
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    • pp.23-39
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    • 2022
  • 목적 : 본 연구는 뇌졸중 환자의 기능적 결과를 예측하기 위한 인구통계학적 및 임상학적 특징과 머신러닝의 사용을 체계적으로 분석하고 요약하기 위해 수행되었다. 연구방법 : PubMed, CINAHL과 Web of Science를 사용하여 2010년부터 2021년 사이에 게재된 연구를 검색하였다. 주요 검색어는 "machine learning OR data mining AND stroke AND function OR prediction OR/AND rehabilitation"을 사용하였다. 뇌 이미지 처리 기법만을 분석한 연구, 딥러닝만 적용한 연구와 전체 본문을 열람할 수 없는 연구는 제외되었다. 결과 : 검색한 결과, 총 9편의 국내외 논문을 선정했다. 선정된 논문에서 가장 많이 사용된 머신러닝 알고리즘은 서포트 벡터 머신(support vector machine, 19.05%)과 랜덤포레스트(random forest, 19.05%)였다. 9개 중 7개의 연구에서 뇌졸중 환자의 기능을 예측하기 위해 중요하다고 추출된 변수를 결과로 제시했다. 그 결과, 5개(55.56%)의 연구에서 뇌졸중 환자의 기능을 예측하기 위해 환자의 임상적 특성이 아닌 modified ranking scale (mRS) 및 functional independence measure (FIM)과 같은 초기 또는 퇴원 평가 점수가 중요하다고 도출되었다. 결론 : 이 연구는 mRS 및 FIM과 같은 뇌졸중 환자의 초기 또는 퇴원 평가 점수가 임상적 특성보다 기능적 결과에 더 많은 영향을 미칠 수 있음을 나타냈다. 따라서, 뇌졸중 환자의 기능적 결과를 향상시키기 위한 최적의 중재를 개발하고 적용하기 위해서는 뇌졸중 환자의 초기 및 퇴원 시 기능적 결과를 평가하고 검토하는 것이 필요하다.

복부수술환자의 간호과정 (Nursing Process of Abdominal Surgery Patients)

  • 유형숙
    • 간호행정학회지
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    • 제8권3호
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    • pp.411-430
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    • 2002
  • Purpose : This study was to develop Nursing Process Model of abdominal surgery patient using nursing diagnoses of NANDA, Nursing Interventions Classification(NIC), and Nursing Outcomes Classification(NOC). Method : The data in database were collected from nursing records in sixty patients with abdominal surgery admitted in a university hospital and open questionnaires of thirteen nurses. Systematic nursing process resulting from each nursing diagnoses, most common, was developed by the statistical analysis through database query from clinical database of abdominal surgery patients. Result : 51 nursing diagnoses were identified in abdominal surgery patients. The most commonly occurred nursing diagnoses were Pain, Risk for Infection, Sleep Pattern Disturbance, Hyperthermia, Altered Nutrition: Less Than Body Requirements in order. The linkage lists of NANDA to NIC and NANDA to NOC, and the nursing activities according to nursing diagnoses of abdominal surgery patients were identified in unit. Conclusion : Nursing Process of abdominal surgery patients was comprised of core nursing diagnoses, core nursing interventions, core nursing outcomes which provides the most reliable data in unit and could make nurses facilitate nursing process easily without full consideration of knowledge about nursing language classification system. Therefore, it could support nurses' decision making and recording of nursing process especially in the computerized patient record system if unit nursing process model using standardized nursing language system which contains of their own core nursing process data was developed.

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The Most Important Social Determinants of Slum Dwellers' Health: A Scoping Review

  • Nejad, Farhad Nosrati;Ghamari, Mohammad Reza;Kamal, Seyed Hossein Mohaqeqi;Tabatabaee, Seyed Saeed;Ganjali, Raheleh
    • Journal of Preventive Medicine and Public Health
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    • 제54권4호
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    • pp.265-274
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    • 2021
  • Objectives: Given the importance of social determinants of health in promoting the health of slum residents, this study was conducted with the aim of identifying the main dimensions and components of these determinants. Methods: This scoping review study was conducted according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). A comprehensive search was performed of PubMed, ProQuest, Scopus, and Web of Science for articles conducted from 2010 to the end of 2019. Studies were selected based on inclusion criteria, with a special focus on studies dealing with the social determinants of physical and mental health or illness. Results: Thirty-three articles were selected to extract information on the social determinants of health. After reviewing the articles, 7 main dimensions (housing, socioeconomic status of the family, nutrition, neighborhood characteristics, social support and social capital, occupational factors, and health behaviors) and 87 components were extracted as social determinants of health among slum dwellers. Conclusions: This framework could be used by planners, managers, and policy-makers when making decisions affecting the health of these settlements' residents due to the common characteristics of slums around the world, especially in developing countries.

Suppressing breast cancer by exercise: consideration to animal models and exercise protocols

  • Lee, Jea Jun;Beak, Suji;Ahn, Sang Hyun;Moon, Byung Seok;Kim, Jisu;Lee, Kang Pa
    • 운동영양학회지
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    • 제24권2호
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    • pp.22-29
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    • 2020
  • [Purpose] Exercise is thought to have a significant effect on chemotherapy, and previous studies have reported that exercise can increase patient survival. Thus, in this review, we aimed to summarize various animal models to analyze the effects of exercise on breast cancer. [Methods] We summarized types of breast cancer animal models from various reports and analyzed the effects of exercise on anti-cancer factors in breast cancer animal models. [Results] This review aimed to systematically investigate if exercise could aid in suppressing breast cancer. Our study includes (a) increase in survival rate through exercise; (b) the intensity of exercise should be consistent and increased; (c) a mechanism for inhibiting carcinogenesis through exercise; (d) effects of exercise on anti-cancer function. [Conclusion] This review suggested the necessity of a variety of animal models for preclinical studies prior to breast cancer clinical trials. It also provides evidence to support the view that exercise plays an important role in the prevention or treatment of breast cancer by influencing anticancer factors.

근위축 마우스 모델에서 한국산 겨우살이 추출물에 의한 단백질 합성 신호전달 경로의 활성화 (Activation of Signaling Pathways for Protein Synthesis by Korean Mistletoe (Viscum album coloratum) Extract in a Mouse Model of Muscle Atrophy)

  • 정주성;박춘호;김인보;김종배
    • 한국식품영양학회지
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    • 제30권2호
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    • pp.371-377
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    • 2017
  • Muscle atrophy is characterized by a decrease in the mass of the muscle. With an increase in life expectancy and chronic illnesses, the incidence of muscle atrophy is increasing and the quality of life of patients is decreasing. Thus, reducing muscle atrophy is of high clinical and socio-economic importance. Mistletoe is a semi-parasitic plant that has been used as a traditional medicine in many countries to treat various human illnesses. It has been reported that Korean mistletoe extract (KME) has diverse biological functions including anti-tumor, anti-oxidant, anti-diabetic, anti-obesity properties, and extension of lifespan. Especially, we have recently reported that KME improves exercise endurance in mice, indicating its beneficial roles in enhancing the capacity of skeletal muscle. In this study, we investigated whether KME could activate the signaling pathway related to protein synthesis in a mouse model of muscle atrophy. Interestingly, KME efficiently activated the Akt/mTOR pathway, and Akt and mTOR are important signaling hub molecules for the acceleration of protein synthesis in muscle cells. In addition, KME also increased the activity of S6 kinase which is involved in the regulation of muscle cell size. Moreover, the ERK activity, required for transcription of ribosomal RNA for protein synthesis, was also enhanced in KME-treated mouse muscle. These data support the idea that KME increases muscle mass via increased protein synthesis. Our findings also suggest that Korean mistletoe might be a promising candidate for the development of functional foods that are beneficial for preventing muscle atrophy.

Relationship between 25-hydroxyvitamin D and metabolic syndrome among Jordanian adults

  • Khader, Yousef S.;Batieha, Anwar;Jaddou, Hashim;Batieha, Zahi;El-Khateeb, Mohammed;Ajlouni, Kamel
    • Nutrition Research and Practice
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    • 제5권2호
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    • pp.132-139
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    • 2011
  • Evidence of the association between 25-hydroxyvitamin D (25(OH)D) and metabolic syndrome (MeS) remains uncertain and incongruent. This study aimed to determine the association between 25(OH)D and MeS among Jordanian adults. A complex multistage sampling technique was used to select a national population-based household sample. The present report deals exclusively with adults aged > 18 years who had complete information on all components of MeS (n = 3,234). A structured questionnaire was used to collect all relevant information. Anthropometric, clinical, and laboratory measurements were obtained. MeS was defined according to the International Diabetes Federation (IDF) definition. Of the total, 42.0% had MeS and 31.7% had 25(OH)D < 30 ng/ml. In a stratified analysis, the prevalence of MeS did not differ significantly between subjects with low and normal 25(OH)D levels for men and women in all age groups. In the multivariate analysis, the odds of MeS were not significantly different between subjects with low and normal 25(OH)D levels (OR = 0.85, 95% CI: 0.70, 1.05, P-value = 0.133). The association between 25(OH)D and MeS remained non-significant when 25(OH)D was analyzed as a continuous variable (OR = 1.004, 95% CI; 1.000, 1.008, P = 0.057) and when analyzed based on quartiles. None of the individual components of MeS were significantly associated with 25(OH)D level. This study does not provide evidence to support the association between 25(OH)D level and MeS or its individual components. Prospective studies are necessary to better determine the roles of 25(OH)D levels in the etiology of MeS.

7개월간 선식만 먹인 영아에서 발생한 구루병 1례 (A Case of Rickets Developed after Feeding on Sunsik for Seven Months)

  • 양정아;장경아;박혜원;장욱;한만용;조영아;이은
    • Clinical and Experimental Pediatrics
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    • 제46권11호
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    • pp.1143-1146
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    • 2003
  • 저자들은 아토피 피부염 조절을 위해 7개월간 선식만 먹고 발생한 구루병 1례를 경험하여 근래에 대두되고 있는 영양식의 실태와 문제점을 살펴보고자 문헌 고찰과 함께 보고하는 바이다.