• 제목/요약/키워드: clinical severity

검색결과 1,635건 처리시간 0.027초

퇴행성 대동맥판 협착증의 중증도 평가: 증례보고 3례 (Assessment of the Severity of Degenerative Aortic Stenosis: Three Case Reports)

  • 김성희
    • 대한임상검사과학회지
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    • 제51권2호
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    • pp.270-275
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    • 2019
  • 노령 인구의 기대 수명이 증가함에 따라 퇴행성 판막 질환이 많아지고 있다. 류마티스성 판막 질환인 승모판 협착증과 대동맥판 역류가 점차적으로 감소하고 석회화된 퇴행성 대동맥판 협착증, 승모판 탈출증 및 허혈성 심장 질환으로 인한 승모판막 폐쇄 부전의 빈도가 증가하고 있다. 심장초음파는 심장판막질환의 진단은 물론, 치료방법 및 수술 시기와 더불어 예후 평가에서도 매우 중요한 도구이며, 판막질환을 평가할 때 모든 판막을 자세하게 관찰하는 이면성 심장초음파가 우선해야 한다. 흔히 접하는 퇴행성 판막질환에 대한 이해와 함께 임상적 특성을 파악하여 심장초음파를 정확하게 시행하는 것이 가장 중요하다. 아울러 대동맥판 협착증의 중증도 평가가 수술적 적응증을 판단하는 데 꼭 필요한 검사인만큼 정확한 판단 기준에 따라 평가하여 환자의 정확한 진단 및 치료가 이루어지도록 해야 한다. 퇴행성 대동맥판 협착증 환자 3례를 통해 심장초음파 검사의 중증도 평가를 쉽게 이해할 수 있기를 바라며 퇴행성 판막 질환의 심초음파 소견을 숙지하는 것이 심장초음파검사를 정확하게 수행하는 것에 수반되어야할 것으로 사료된다.

Glyphosate와 Glufosinate 제초제 중독 환자의 임상양상과 중증도 비교 (Comparison of Clinical Characteristics and Severity of Glyphosate and Glufosinate Herbicide Poisoning Patients)

  • 주형선;유태호;조수형
    • 대한임상독성학회지
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    • 제16권2호
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    • pp.124-130
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    • 2018
  • Purpose: The number of glyphosate and glufosinate intoxication cases are increasing in Korea. This study was undertaken is to compare the clinical manifestations of poisoning by these two herbicides and to document severities and clinical outcomes. Methods: We retrospectively evaluated cases of glyphosate or glufosinate intoxication among patients that visited our emergency department between January 1, 2013, and December 31, 2017. Incidences of intoxications were analyzed over this five year period, and underlying diseases, transportation, mental state, shock occurrence, inotropics, gastric lavage, charcoal administration, intubation and ventilator therapy, and hemodialysis were investigated. In addition, we included transfer to the intensive care unit, incidences of pneumonia and of other complications, death, and hopeless discharge. Results: There were 119 cases of glyphosate intoxication and 42 of glufosinate intoxication. Levels of consciousness were lower for glufosinate and vasopressor usage was higher due to a high shock rate (p=0.019). In addition, many patients were referred to the ICU for intubation and ventilation. The incidences of pneumonia and of other complications were significantly higher for glufosinate. Conclusion: Overall glufosinate intoxication was found to be more severe than glyphosate intoxication as determined by complication and ICU admission rates.

Comparing the Therapeutic Effects of Aloe vera and Olive Oil Combination Cream versus Topical Betamethasone for Atopic Dermatitis: A Randomized Double-blind Clinical Trial

  • Panahi, Yunes;Rastgar, Nassim;Zamani, Ali;Sahebkar, Amirhossein
    • 대한약침학회지
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    • 제23권3호
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    • pp.173-178
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    • 2020
  • Objectives: Atopic dermatitis (AD) is a prevalent and chronic, pruritic inflammatory skin condition that can influence all age groups. AD is associated with a poor health-related quality of life. This randomized clinical trial was performed to compare the effectiveness of Olivederma (combination of aloe vera and virgin olive oil) or betamethasone regarding disease severity, quality of life, serum IgE and eosinophil count. Methods: Thirty-six AD patients were randomly allocated to topical Olivederma or betamethasone, and were followed for 6 weeks. Results: Total SCORAD severity scores showed significant decrease in both groups, while it was more prominent in Olivederma group (64.5% improvement in Olivederma vs. 13.5% improvement in Betamethasone, p-value < 0.001). Quality of life (DLQI questionnaire) of AD patients was significantly improved after 6 weeks treatment with Betamethasone (22.3%, p < 0.001) and Olivederma (60.7%, p-value < 0.001). Olivederma group showed a significantly lower DLQI score in comparison with Betamethasone treated patients after 6 weeks of therapy (p < 0.001). Improvements in eosinophil count and serum IgE was observed. Conclusion: In summary, this study shows that Olivederma is superior to topical Betamethasone after 6 weeks of therapy with regard to disease severity, quality of life and eosinophil count.

머신러닝을 이용한 급성심근경색증 환자의 퇴원 시 사망 중증도 보정 방법 개발에 대한 융복합 연구 (Convergence Study in Development of Severity Adjustment Method for Death with Acute Myocardial Infarction Patients using Machine Learning)

  • 백설경;박혜진;강성홍;최준영;박종호
    • 디지털융복합연구
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    • 제17권2호
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    • pp.217-230
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    • 2019
  • 본 연구는 기존 동반질환을 이용한 중증도 보정 방법의 제한점을 보완하기 위해 급성심근경색증 환자의 맞춤형 중증도 보정방법을 개발하고, 이의 타당성을 평가하기 위해 수행되었다. 이를 위하여 질병관리본부에서 2006년부터 2015년까지 10년간 수집한 퇴원손상심층조사 자료 중 주진단이 급성심근경색증인 한국표준질병사인분류(KCD-7) 코드 I20.0~I20.9의 대상자를 추출하였고, 동반질환 중증도 보정 도구로는 기존 활용되고 있는 CCI(Charlson comorbidity index), ECI(Elixhauser comorbidity index)와 새로이 제안하는 CCS(Clinical Classification Software)를 사용하였다. 이에 대한 중증도 보정 사망예측모형 개발을 위하여 머신러닝 기법인 로지스틱 회귀분석, 의사결정나무, 신경망, 서포트 벡터 머신기법을 활용하여 비교하였고 각각의 AUC(Area Under Curve)를 이용하여 개발된 모형을 평가하였다. 이를 평가한 결과 중증도 보정도구로는 CCS 가 가장 우수한 것으로 나타났으며, 머신러닝 기법 중에서는 서포트 벡터 머신을 이용한 모형의 예측력이 가장 우수한 것으로 확인되었다. 이에 향후 의료서비스 결과평가 등 중증도 보정을 위한 연구에서는 본 연구에서 제시한 맞춤형 중증도 보정방법과 머신러닝 기법을 활용하도록 하는 것을 제안한다.

간호사의 손 피부염에 대한 심각도와 삶의 질 (Severity of Hand Dermatitis and Quality of Life in Nurses)

  • 정재은;김동희
    • 기본간호학회지
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    • 제24권4호
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    • pp.243-254
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    • 2017
  • Purpose: The purpose of this study was to determine the prevalence, severity and quality of life for nurses with hand dermatitis who want to take advantage of measures to manage their hand dermatitis. Methods: Participants in this research were 422 nurses with clinical experience of more than 12 months. Data were collected using a diagnostic tool for hand dermatitis, subjective severity and objective severity. The skin related quality of life was measured using the Korean version of Skindex-29. Data were analyzed using $x^2$ tests, t-test, and ANOVAs with SPSS 20.0. Results: The prevalence of hand dermatitis among the respondents was 56.9% (240/422). Nurses with hand dermatitis had significantly lower quality of life than nurses with no hand dermatitis. The more severe the hand dermatitis, the lower the quality of life was. Conclusion: The finding in this study indicate that there is a need to improve the health of nurses by lowering the prevalence of hand dermatitis, alleviating the severity of hand dermatitis and improving the quality of life.

만성불면증 환자에게 적용한 단기 인지행동중재의 효과 (Effects of the Abbreviated Cognitive Behavioral Therapy for Chronic Insomniacs)

  • 최수정;이영희
    • 중환자간호학회지
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    • 제1권1호
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    • pp.19-31
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    • 2008
  • Purpose: This study was conducted to exam the effects of the Abbreviated Cognitive Behavioral Therapy(ACBT) on chronic insomnia. Methods: Study was one-group interrupted time series study that involved 13 adults(mean age=51.7, aged 25-77 years) with chronic primary insomnia who visited sleep disorder clinic of S Hospital from November 2004 to October 2005. The subjects received 2-session individual ACBT with 2 week-interval($1^{st}$: 1.5- 2hrs, $2^{nd}$: 20-30min). To measure the subjective insomnia severity and sleep patterns, 3 times of insomnia severity index and sleep logs were completed(before ACBT, after ACBT, and 3-month after ACBT). The main outcomes were subjective insomnia severity and sleep patterns(sleep onset latency, waking after sleep onset, and total sleep time, sleep efficiency). The data were analyzed with SPSS 10.0 version program by Friedman test, Wilcoxon signed rank test with Bonferroni correction. Results: There were statistically significant decrease in insomnia severity index, sleep onset latency, and waking after sleep onset, and increase total sleep time and sleep efficiency. Conclusion: ACBT was effective in reducing subjective insomnia severity and improving sleep patterns. Sleep improvement was better sustained over time with ACBT.

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주간 졸림을 호소하는 소양인(少陽人) 환자에 대한 형방도(荊防導) 적산(赤散) 치험 1례 (A Case Report of Hyungbangdojeock-san on Daytime sleepiness Diagnosed as Soyangin Type)

  • 전규리;임태빈;최정우;김하리;박성욱;박정미;고창남;조승연
    • 대한중풍순환신경학회지
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    • 제21권1호
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    • pp.47-56
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    • 2020
  • This case study is to report the effectiveness of Hyungbangdojeock-san in the treatment of daytime sleepiness. The patient was diagnosed as a Soyangin, one of the 4 constitution types in Korean medicine, and treated with herbal medicine, Hyungbangdojeock-san and acupuncture treatment for 14 days. The severity of symptom was assessed using Epworth Sleepiness Scale (ESS). After treatment, the severity of daytime sleepiness was reduced. ESS score was decreased from 11 to 2. As a result this case showed the effect of Hyungbangdojeock-san on daytime sleepiness.

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뇌졸중 이후 수면관련 행동장애를 보이는 환자에 대한 억간산가미 치험 2례 (Two cases of Ukgansan-gami on Sleep-related Behavior Disorder after Stroke)

  • 김수현;이유진;양정윤;조기호;문상관;정우상;권승원;진철
    • 대한중풍순환신경학회지
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    • 제20권1호
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    • pp.9-16
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    • 2019
  • ■ Objectives This case study is to report the two cases of Ukgansan-gami on sleep-related behavior disorder after stroke. ■ Methods Two patients who had sleep-related behavior disorder after stroke were treated by Ukgansan-gami about a month. We evaluated these patients with the frequency and severity of symptoms. ■ Results During treatment period, decreases in both frequency and severity of symptoms were observed in two cases. ■ Conclusion Two patients who were suffered from sleep-related behavior disorder due to sequelae of stroke showed significant improvement of their symptom after taking Ukgansan-gami.

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불면을 호소하는 뇌실질내출혈 환자 치험 1례 (A case study of post-stroke insomnia patient using conservative Korean medical treatment)

  • 김경묵;김세원;서유나;정우상;문상관;진철;조기호;권승원
    • 대한중풍순환신경학회지
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    • 제20권1호
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    • pp.1-8
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    • 2019
  • A case of a 46-year-old Korean male with post-stroke insomnia that induced by intracranial hemorrhage was presented. He was treated with Transcutaneous electric acupoint stimulation (TEAS) at BL62 and KI6 once per a day for 17 days. We recorded the patient's sleep time and time of asleep, and used PSQI-K to assess severity of patient's insomnia symptom. After using TEAS, there was improvement in patient's insomnia severity and the time of sleep. From the result of this case, electrical stimulation at acupoint can may be effective in treating post-stroke insomnia.

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소음인(少陰人) 과민성 장 증후군 설사형 증례 1례 (A Case Report of Irritable Bowel Syndrome with Diarrhea Diagnosed as Soeunmin Type)

  • 김하리;정혜선;최정우;신희연;조승연;박성욱;고창남;박정미
    • 대한중풍순환신경학회지
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    • 제20권1호
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    • pp.53-64
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    • 2019
  • ■ Objectives The purpose of this case is to report the effectiveness of Korean medicine in the treatment of irritable bowel syndrome with diarrhea. ■ Methods The patient was diagnosed as a Soeumin, one of the 4 constitution types in Korean medicine, and treated with herbal medicine, Osuyubujaijung-tang and acupuncture treatment. The severity of symptom was assessed using daily defecation frequency, Numerical Rating Scale (NRS) of abdominal pain, Gastrointestinal Symptom Rating Scale (GSRS) score and Irritable Bowel Syndrome - Quality of Life (IBS-QOL) score. ■ Results After treatment, the defecation frequency was reduced from 6 to 2 times a day, and the severity of abdominal pain was reduced from NRS 6 to NRS 2. Also, GSRS score was decreased from 18 to 4 and IBS-QOL score was improved from 70.59 to 81.18. ■ Conclusion This study suggested that Korean medical treatment could be an effective option for treating irritable bowel syndrome with diarrhea.

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