• Title/Summary/Keyword: clinical severity

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Effects of the APACHEIII Score, Hypermetabolic Score on the Nutrition Status and Clinical Outcome of the Patients Administered with Total Parenteral Nutrition and Enteral Nutrition (경정영양과 중심정맥영양을 공급받는 환자에서 질병의 상태(APACHEIII Score), 과대사 정도가 영양상태 및 임상적 결과에 미치는 영향)

  • Rha Mi yong;Kim Eun mi;Cho Young Y.;Seo Jeong Meen;Choi Hay mie
    • Korean Journal of Community Nutrition
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    • v.11 no.1
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    • pp.124-132
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    • 2006
  • The aim of this study is to evaluate the clinical outcome. Between January 1,2002 to September 30, 2002, we prospectively and retrospectively recruited III hospitalized patients who received Enteral Nutrition (EN group n = 52) and Total Parenteral Nutrition (TPNgroup n = 59) for more than seven days. The factors of clinical outcomes are costs, incidences of infection, lengths of hospital stay, and changes in weight. The characteristics of patients were investigated, which included nutritional status, disease severity CAP ACHE III score) and hypermetabolic severity Chypermetabolic score). Hypermeta-bolic scores were determined by high fever (> $38^{\circ}C$), rapid breathing (> 30 breaths/min) , rapid pulse rate (> 100 beats/min), leukocytosis (WBC > 12000 $mm^{3}$), leukocytopenia (WBC > 3000 $mm^{3}$), status of infection, inflammatory bowel disease, surgery and trauma. There was a positive correlation between hypermetabolic score and length of hospital stay (ICU), medical cost, weight loss, antibiotics adjusted by age while APACHEIII score did not show correlation to clinical outcome. Medical cost was higher by $18.2\%$ in the TPN group than the EN group. In conclusion, there was a strong negative correlation between the clinical outcome (cost, incidence of infection, hospital stay) and hypermetabolic score. Higher metabolic stress caused more malnutrition and complications. For nutritional management of patients with malnutrition, multiple factors, including nutritional assessment, and evaluation of hypermetabolic severity are needed to provide nutritional support for critically ill patients.

Sleep Disturbances in Patients with Parkinson's Disease according to Disease Severity (파킨슨병의 중증도에 따른 수면 장애)

  • Lee, Su-Yun;Cheon, Sang-Myung;Kim, Jae Woo
    • Annals of Clinical Neurophysiology
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    • v.17 no.1
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    • pp.17-23
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    • 2015
  • Background: Sleep-related disturbances and sleep disorders are common in Parkinson's disease (PD) and have a great impact on daily life of PD patients. This study was done to find the sleep characteristics and sleep disturbing factors in PD patients according to disease severity through clinical interview and polysomnographic (PSG) study. Methods: Fifty patients with PD (22 males, age $60.6{\pm}6.4$, Hoehn and Yahr (HY) stage $2.7{\pm}1.0$) were recruited and thoroughly interviewed about their sleep. PSG was performed on the patients taking routine antiparkinsonian medications. Patients were grouped into mild and moderate/severe group according to HY stage, and the results were compared between each group. Results: Ninety-four percent of total patients had one or more sleep-related disturbances based on the interview or PSG. On interview, the moderate/severe group complained more insomnia and REM sleep behavior disorder (RBD) than mild group. In PSG findings, the moderate/severe group showed lower sleep efficiency, longer sleep latency, REM sleep latency, waking time after sleep onset, and higher prevalence of RBD. Conclusions: In this study, most patients with PD had sleep disturbances. Clinical interview and PSG findings revealed deterioration of sleep quality along the disease severity. Our results suggest that sleep disturbances in PD patients are prevalent and warrant clinical attention, especially to the patients with advanced disease.

Clinical Features of Acute Acetanilide Herbicide Poisoning (급성 아세트아닐라이드계 제초제 중독의 임상 분석)

  • Park, Cheol-Sang;Lee, Mi-Jin;Park, Seong-Soo;Jeong, Won-Joon;Kim, Hyun-Jin
    • Journal of The Korean Society of Clinical Toxicology
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    • v.9 no.2
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    • pp.49-55
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    • 2011
  • Purpose: Acetanilide has been in widespread use as an amide herbicide compound. However, available data regarding acute human poisoning is scarce. The aim of this study was to analyze the clinical characteristics of acetanilide poisoning in order to identify the risk factors associated with severity. Methods: We conducted a retrospective observational study encompassing the period January 2005 to December 2010, including adult ED patients suffering from acetanilide intoxication. Toxicological history, symptoms observed, clinical signs of toxicity, and laboratory test results were collected for each patient. The patients were classified into two groups for analysis, according their poisoning severity score (PSS). Resulting clinical data and prognostic variables were compared between mild-to-moderate poisoning (PSS 1/2 grades), and severe poisonings and fatalities (PSS 3/4 grades). Results: There were a total of 37 patients, including 26 alachlor, 6 s-metolachlor, 4 mefenacet, and 1 butachlor cases. The majority of patients (81.1%) were assigned PSS 1/2 grades. Changes in mental status and observation of adverse neurologic symptoms were more common in the PSS 3/4 group. The median ingested volume of amide herbicide compound was 250 ml (IQR 200-300 ml) in the PSS 3/4 group, and 80 ml (IQR 50-138 ml) in the PSS 1/2 group. Also, the median GCS observed in the PSS 3/4 group was 13 (IQR 10-14), which was markedly low as compared to a median GCS of 15 in the PSS 1/2 group. Overall mortality rate was 5.4%, and profound cardiogenic shock was observed prior to death in all fatalities. Conclusion: When compared to previous reports, acute acetanilide poisoning resulted in relatively moderate severity. The presence of neurologic manifestations, hypotension, lower GCS score, and larger ingested volumes was associated with more serious effects and mortalities.

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Associations of periodontal status in periodontitis and rheumatoid arthritis patients

  • Rovas, Adomas;Puriene, Alina;Punceviciene, Egle;Butrimiene, Irena;Stuopelyte, Kristina;Jarmalaite, Sonata
    • Journal of Periodontal and Implant Science
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    • v.51 no.2
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    • pp.124-134
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    • 2021
  • Purpose: The aim of this study was to assess the association between the clinical status of rheumatoid arthritis (RA) and periodontitis (PD) in patients diagnosed with PD and to evaluate the impact of RA treatment on the severity of PD. Methods: The study included 148 participants with PD, of whom 64 were also diagnosed with RA (PD+RA group), while 84 age-matched participants were rheumatologically healthy (PD-only group). PD severity was assessed by the following periodontal parameters: clinical attachment loss, probing pocket depth (PPD), bleeding on probing (BOP), alveolar bone loss, and number of missing teeth. RA disease characteristics and impact of disease were evaluated by the Disease Activity Score 28 using C-reactive protein, disease duration, RA treatment, the RA Impact of Disease tool, and the Health Assessment Questionnaire. Outcome variables were compared using parametric and non-parametric tests and associations were evaluated using regression analysis with the calculation of odds ratios (ORs). Results: Participants in the PD+RA group had higher mean PPD values (2.81 ± 0.59 mm vs. 2.58 ± 0.49 mm, P=0.009) and number of missing teeth (6.27±4.79 vs. 3.93±4.08, P=0.001) than those in the PD-only group. A significant association was found between mean PPD and RA (OR, 2.22; 95% CI, 1.16-4.31; P=0.016). Within the PD+RA group, moderate to severe periodontal disease was significantly more prevalent among participants with higher RA disease activity (P=0.042). The use of biologic disease-modifying antirheumatic drugs (bDMARDs) was associated with a lower BOP percentage (P=0.016). Conclusions: In patients with PD, RA was associated with a higher mean PPD and number of missing teeth. The severity of PD was affected by the RA disease clinical activity and by treatment with bDMARDs, which were associated with a significantly lower mean BOP percentage.

Hypertensive Retinopathy and the Risk of Hemorrhagic Stroke

  • Thiagarajah, Ramani;Kandasamy, Regunath;Sellamuthu, Pulivendhan
    • Journal of Korean Neurosurgical Society
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    • v.64 no.4
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    • pp.543-551
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    • 2021
  • Objective : Hemorrhagic stroke (HS) and hypertensive retinopathy are known end organ damage of the brain and eye respectively, with HS having deleterious consequence to the patients. This study is to correlate between hypertensive retinopathy and HS in hypertensive disease. Methods : A control group of hypertensive patients only, and an investigated group of hypertensive HS patients. Fundoscopic examination to determine the grade of retinopathy was performed and then divided into low or high severity hypertensive retinopathy. Clinical and radiological parameter included are demography, vital signs, Glasgow coma scale (GCS) on admission, clot volume, site of clot, Intracerebral hemorrhage (ICH) score and Glasgow outcome scale (GOS). Data were correlated with the severity of hypertensive retinopathy. Results : Fifty patient in the control group and 51 patients in the investigated group were recruited. In the hypertensive HS group, 21 had low severity retinopathy (no or mild retinopathy) accounting for 41.2% and 30 patients had high severity (moderate or severe retinopathy). In the hypertensive patients 49 had low severity and one had high severity (p-value of 0.001). In HS group low severity showed better GCS score of 9-15 on admission (p-value of 0.003), clot volume less than 30 mL (p-value 0.001), and also a better 30 days mortality rate by using the ICH score (p-value 0.006), GOS score of 4 and 5 the low severity retinopathy fair better than the high severity retinopathy (p-value of 0.001), and the relative risk to develop HS in low severity and high severity retinopathy was 0.42 and 29.4, respectively. Conclusion : Hypertensive retinopathy screening could be used as an indicator in hypertensive patient, to evaluate the risk of developing hypertensive HS in the future.

A Clinical Reports on Psoriasis (乾癬患者 臨床報告)

  • Oh, Eun-Young;Park, Hye-seon;Gu, Duk-mo;Jee, Seon-young
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.14 no.2
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    • pp.278-285
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    • 2001
  • A Reports were done on proriasis which were treated bv medications of Sasang Constitution and Constitution-Acupunture in Dept. surgery, opthalmology & otolaryngology, college of Oriental Medicine, Kyungsan University, Pohang, Korea, from May 30. 2000 to JUN 30 2001. we gave score and checked involvement, plaque, erythematous popules, invasiveness according to psoriasis area and severity index. The results were as follows: 1. Sasang Constitution classification was Soyanggin 11($93.33\%$), Taeumgin 1($6.67\%$) in the 15 cases, Hyungbangsabaeksan is used in 9 cases($60\%$), Yanggeuksanhoatang is used in 3cases($13.11\%$), Geopungchunggisan is used in 3 cases($20\%$), Hyungbangdojucksan is used in 1 case($6.57\%$) 2. In the 9 cases, we checked for over 4 weeks, clinical severity of involvement, plaque, total score(psoriasis area and severity index) was siginificantly decreased(p <0.05), clinical severity of erythematous popules, itching was decreased but It is not siginificant(p>0.05). 3. The mean duration of treatmemt was 73.3 days, result of Excellent or Good improvement was showed on over 120 days. These results indicate that Sasang Constitution and Constitution-Acupuncture treatment is effective on psoriasis and the more study is needed.

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A Study on comparison of menstrual pattern according to Mibyeong Index of Korean women in their thirties and forties (30-40대 여성의 미병상태에 따른 월경양상 비교연구)

  • Park, Minyoung;Oh, Hyunjoo;Hwang, Minwoo
    • Journal of Society of Preventive Korean Medicine
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    • v.23 no.1
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    • pp.61-72
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    • 2019
  • Introduction : The aim of this study was to investigate menstrual pattern according to Mibyeong Index(MBI) and compare Mibyeong symptom score according to severity of menstrual pain. Mibyeong Index was designed to measure inconvenience and resilience of subject's complains including four physical symptoms(fatigue, pain, low sleep quality, indigestion) and mental distress including anxiety, anger, depression. Method : We used the clinical data of Korean medicine Date Center(KDC) for subjects who participated in the study of 'Clinical research for collecting of clinical cases based on the personal type of Mibyeng' conducted in Seoul, from June 26, 2015 to June 26, 2017. A total of 566 fertile women aged 30 to 50 who completed the questionnaires were included in this study. In this study, we used items of Mibyeong Index and the menstrual pattern by self-report questionnaires. The date were analyzed through Kruskal Wallis test, Pearson's chi-square test, and one-way ANOVA using SPSS statistics 19.0. Results : Mibyeong status was significantly associated with severity of menstrual pain(p<0.001), worst day of menstrual pain(p<0.05), and type of menstrual pain(low back pain, nausea, depression, and none (respectively, p<0.05)). In addition, The 7-subtype score (fatigue (p<0.001), pain(p<0.001), low sleep quality(p<0.001), indigestion(p<0.001), anxiety(p<0.05), anger(p<0.05) and depression(p<0.05)) of Mibyeong index and total score of Mibyeong Index (p<0.001) showed significant difference for severity of menstrual pain. Conclusion : This result indicates that a close relationship between Mibyeong status and severity of menstrual pain. Further studies are needed but, we hope that this results will be used as the basic data to improve mibyeong status through health care to alleviate dysmenorrhea.

The severity of clinical symptoms according to cancer diagnosis in fever patients visiting the emergency department: a retrospective analysis (응급실에 내원한 발열 환자에서 암 진단 유무에 따른 임상증상의 중증도에 대한 후향적 조사 연구)

  • Eun Seam Lee;Purum Kang;You Kyoung Shin;Geun Hee Seol
    • Journal of Korean Biological Nursing Science
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    • v.25 no.2
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    • pp.105-112
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    • 2023
  • Purpose: This study aimed to understand the general characteristics and biomarkers of inflammation in adult patients who visited the emergency department with fever and to determine whether the severity of clinical symptoms varies according to cancer diagnosis. Methods: Data were collected retrospectively from 4,002 adult patients with fever who visited the emergency department at a tertiary hospital from January 2018 to December 2018 using medical records. Results: On average, cancer patients were older than non-cancer patients (p < .001), and differences were observed between cancer and non-cancer patients in the origin of fever and biomarkers associated with inflammation. A higher proportion of cancer patients than non-cancer patients had a Korean Triage and Acuity Scale level of 1 to 3 (p < .001), and more cancer patients than non-cancer patients met two or more criteria for systemic inflammatory response syndrome (p = .001). More life-saving interventions in the emergency department were required in cancer patients than in non-cancer patients (p < .001), and cancer patients spent more time in the emergency department than non-cancer patients (p < .001). Conclusion: This study showed that the general characteristics and biomarkers of inflammation differed among adult patients with fever depending on cancer diagnosis. Furthermore, among adult patients with fever, cancer patients had more severe clinical symptoms than non-cancer patients. The results of this study are hoped to be helpful as a basis of nursing knowledge for adult patients with fever in the emergency department and as evidence for the classification of severity in patients with fever according to cancer diagnosis.

A study on the Correlation between Primary dysmenorrhea and Blood stasis (원발성(原發性) 월경곤난증(月經困難症)과 어혈(瘀血)의 상관성 연구)

  • Yoon, Young-Jin;Cho, Jung-Hoon;Jang, Jun-Bock;Lee, Jin-Moo;Lee, Chang-Hoon;Lee, Kyung-Sub
    • The Journal of Korean Obstetrics and Gynecology
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    • v.22 no.1
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    • pp.148-160
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    • 2009
  • Purpose: We intended to observe the correlations between Primary dysmenorrhea severity and Questionnaires for Blood Stasis Pattern. Methods: After initial approval by Kyung-Hee University Oriental Medical Hospital Institutional Review Board of Clinical Trials, volunteers for the clinical trial were recruited. We selected the 52 primary dysmenorrhea patients by the screening tests (clinical examination and inquiry). The severity of dysmenorrhea was evaluated by VAS (Visual Analog Scale), VRS (Verbal Rating Scale) & MVRS (Multidimensional Verbal Rating Scale). The severity of Blood Stasis was evaluated by Questionnaires for Blood Stasis Pattern. For statistics, we used Spearman's rho correlations, SPSS 13.0 for windows. Results: In case of VAS, though two items (眼瞼下靑紫, 便黑) of Questionnaires for Blood Stasis Pattern were correlated, total score & discriminant function score of Questionnaires for Blood Stasis Pattern were not correlated. In case of VRS, though two items (小腹痛, 夜間痛) of Questionnaires for Blood Stasis Pattern were correlated, total score & discriminant function score of Questionnaires for Blood Stasis Pattern were not correlated. In case of MVRS, though one items (久痺症) of Questionnaires for Blood Stasis Pattern were correlated, total score & discriminant function score of Questionnaires for Blood Stasis Pattern were not correlated. Conclusion: Though the results showed partial correlation of Primary dysmenorrhea severity and Questionnaires for Blood Stasis Pattern, we need further study after improvement and complementation of Questionnaires for Blood Stasis Pattern.

Cognitive Behavioral Therapy in Childhood Tic Disorder : A Case of Report (틱 장애 아동의 인지행동치료 증례: 5회기 습관뒤집기 훈련과 호흡훈련을 중심으로)

  • Song, Jung-Rim;Hong, Jong-Woo;Doh, Jin-Ah;Kim, Hyun-Woo;Lim, Myung-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.22 no.1
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    • pp.38-43
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    • 2011
  • Chronic tic disorder or Tourette syndrome is known to be a chronic neuro-behavioral disease for which cognitive behavioral therapy (CBT) strategies have recently been introduced. Here, we report the effectiveness of CBT in a case of childhood chronic tic disorder, which is very common in clinical settings. The DSM-IV clinical diagnosis was applied by a child psychiatrist. The Yale Global Tic Severity Scale, Kovac's children's depression inventory, Spielberger State-Trait Anxiety Inventory, Abbreviated Conners' Rating Scales, and the Dupaul ADHD Rating Scales were used. This case involved a pharmacological treatment-refractory patient over the previous year. Thus, psychiatric consultation was undertaken. Subsequently, we administered five sessions of CBT for four weeks, consisting of symptom evaluation and planning, habit reversal training, and ventilation training. Following four weeks of CBT administration, there were improvements in the scores of the Yale Global Tic Severity Scale and the Clinical Global Improvement scale. Our observations indicate that CBT may be effective in the treatment of childhood tic disorder.