• Title/Summary/Keyword: disease outcome

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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.

The Quality of Life after Lymphaticovenous Anastomosis in 118 Lower Limb Lymphedema Patients

  • Jin Geun Kwon;Yeongsong Kim;Min Young Jang;Hyunsuk Peter Suh;Changsik John Pak;Vaughan Keeley;Jae Yong Jeon;Joon Pio Hong
    • Archives of Plastic Surgery
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    • v.50 no.5
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    • pp.514-522
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    • 2023
  • Background This is a prospective study on 118 patients who underwent lymphaticovenous anastomosis (LVA) due to secondary lower limb lymphedema between January 2018 and October 2020 to evaluate patients' quality of life (QOL) using the Quality of Life Measure for Limb Lymphedema (LYMQoL) questionnaire. Methods The outcome measurement included the LYMQoL leg scoring system tool evaluating the function, appearance, symptom, mood, and overall outcome. In addition, correlation analysis was performed for three factors: based on International Society of Lymphology (ISL) stages, disease duration, and amount of volume reduction. Results The LYMQoL tool overall satisfaction score significantly increased at all intervals from 4.4 ± 0.2 preoperative to 6.5 ± 0.3 postoperative at 12 months (p < 0.001). Significant findings were seen for each domain scores compared preoperatively and at 12 months: function score (18.6 ± 0.5 to 15.4 ± 0.6), appearance score (17.8 ± 0.5 to 16.0 ± 0.6), symptom score (11.8 ± 0.3 to 8.9 ± 0.4), and mood score (14.5 ± 0.4 to 11.4 ± 0.5; p < 0.05). The correlation analysis between improvement of the overall score and the ISL stage (p = 0.610, correlation coefficient [r] = -0.047), disease duration (p = 0.659, r = -0.041), and amount of limb volume reduction (p = 0.454, r = -0.070) showed no statistical significance. Conclusion The QOL of secondary lower limb lymphedema patients was significantly improved after LVA regardless of the severity of disease, duration of disease, and amount of volume reduction after LVA. Understanding the patient-reported outcome measurement will help the surgeons to manage and guide the expectations of the patients.

A Case Report of Postpartum Disease Treated with Gyeji-tang Based on No.12 Shanghanlun Provision (『상한론(傷寒論)』 태양병(太陽病) 12조(條)에 근거하여 계지탕(桂枝湯) 투여 후 호전된 산후풍(産後風) 1례)

  • Jeong, Yeon-Il;Yun, Hyo-Joong
    • 대한상한금궤의학회지
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    • v.10 no.1
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    • pp.37-45
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    • 2018
  • Objective : The purpose of this paper is to report the improvement of a patient who had a postpartum disease treated with herb medication based on Shanghanlun provisions. Methods : According to 'Disease Pattern Identification Diagnostic System based on Shanghanlun Provisions', the patient was diagnosed with TaeYang-byung, number 12 provision, and was administered herb medication for 4 months. Visual Analogue Scale(VAS) was used to estimate the patient's status. Results : The VAS changed 10 to 0. These results suggest that cold pain and weakness in the legs have improved. Conclusions : The patient had an experience of miscarriage 3 times and finally got a baby but with postpartum disease. She treated with the herb medication for 4 months and the outcome was found effective and economical due to the diagnostic system based on Shanghanlun provisions.

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An Analysis of the Existing Guidelines and Clinical Trials for the Development of the Guidelines of Clinical Trials with Herbal Medicinal Products for Gastroesophageal Reflux Disease (GERD) (위식도역류질환 한약제제 임상시험 가이드라인 개발을 위한 관련 국내 가이드라인 분석 및 기존 한약임상시험과의 비교)

  • Han, Ga-jin;Leem, Jung-tae;Kim, Jin-sung;Lee, Jun-hee
    • The Journal of Internal Korean Medicine
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    • v.37 no.1
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    • pp.90-108
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    • 2016
  • Objectives: This study aimed to learn what should be considered in the Guidelines of Clinical Trials with Herbal Medicinal Products for Gastroesophageal Reflux Disease (GERD) by analyzing the existing guidelines and clinical trials.Methods: The development committee searched the existing guidelines for herbal medicinal products or GERD. Then, clinical trials related to GERD using herbal medicine were selected. The chosen trials were analyzed in terms of their inclusion and exclusion of participants, intervention, comparators, outcome, and trial design. Then, we compared the results of the analysis according to the regulations and guidelines of the Ministry of Food and Drug Safety to suggest the issues that we will have to consider when developing the Guidelines of Clinical Trials with Herbal Medicinal Products for Gastroesophageal Reflux Disease (GERD).Results: As a result, few guidelines for GERD and clinical trials with herbal medicinal products were located in the national institution homepage. In addition, 8 articles were found using the following combination of search terms: “Gastroesophageal reflux disease”, “GERD”, “herbal medicine”, “herbal therapy”, “Korean Medicine”, “Traditional Chinese Medicine”, and “TCM”. Even though all trials had their own unique research questions, all studies were performed using a randomization method. Most trials included participants with reflux esophagitis, but two trials targeted proton pump inhibitor-refractory GERD. The type of intervention varied, such as decoction, granules, and capsules. Additionally, individualized herbal medicines were used in two studies. Comparators were diverse, such as placebo, Western medicine, and electro-acupuncture. The most frequently used outcome for efficacy was the effectiveness rate. In addition, the outcome for evaluating quality of life, esophageal mucosa and pressure, esophageal acid reflux, and recurrence rates were used. Safety was investigated by recording adverse events and carrying out laboratory tests.Conclusions: We identified some issues by reviewing the existing guidelines and comparing them with clinical trials for GERD and herbal medicinal products. These results will be utilized for developing the Guidelines of Clinical Trials with Herbal Medicinal Products for Gastroesophageal Reflux Disease (GERD).

Effects of Aerobic Exercise on Disease Severity and Walking Ability in Patients with Parkinson's Disease

  • Bang, Dae-Hyouk;Noh, Hyeon-Jeong
    • The Journal of Korean Physical Therapy
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    • v.28 no.4
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    • pp.227-231
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    • 2016
  • Purpose: This study was conducted to explore the effects of aerobic exercise on the severity of disease and walking ability in patients with Parkinson's disease. Methods: Twelve patients with Parkinson's disease participated in the study. Participants were randomly assigned to either an aerobic exercise group (n=6) or a self-exercise group (n=6). All participants underwent treadmill training for 30 minutes. In addition, the experimental group (aerobic exercise group) and control group (self-exercise group) participated in a 30 minutes exercise program. In both groups, exercise was performed five times a week for four weeks. Outcome including disease severity (Unified Parkinson's Disease Rating Scale) and walking ability (10 m walking speed test, 6 minutes walking test, timed up-and-go test) were measured at baseline and after 4-weeks. Results: Significant differences in disease severity and walking ability were observed between the pre- and post-exercise groups (p<0.05). The improvement of disease severity and walking endurance was significantly higher in the experimental group than in the control group (p<0.05). Conclusion: These findings demonstrate that aerobic exercise is effective at improving disease severity and walking endurance in patients with Parkinson's disease.

Predictors of Mortality after Surgery for Empyema Thoracis in Chronic Kidney Disease Patients

  • Pulle, Mohan Venkatesh;Puri, Harsh Vardhan;Asaf, Belal Bin;Bishnoi, Sukhram;Malik, Manish;Kumar, Arvind
    • Journal of Chest Surgery
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    • v.53 no.6
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    • pp.392-399
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    • 2020
  • Background: Surgical treatment of empyema thoracis in patients with chronic kidney disease is challenging, and few studies in the literature have evaluated this issue. In this study, we aim to report the surgical outcomes of empyema and to analyze factors predicting perioperative mortality in patients with chronic kidney disease. Methods: This retrospective study included data from 34 patients with chronic kidney disease (estimated glomerular filtration rate <60 mL/min/1.73 ㎡ for 3 or more months) who underwent surgery for empyema between 2012 and 2020. An analysis of demographic characteristics and perioperative variables, including complications, was carried out. Postoperative mortality was the primary outcome measure. Results: Patients' age ranged from 20 to 74 years with a 29-to-5 male-female ratio. The majority (n=19, 55.9%) of patients were in end-stage renal disease (ESRD) requiring maintenance hemodialysis. The mean operative time was 304 minutes and the mean intraoperative blood loss was 562 mL. Postoperative morbidity was observed in 70.5% of patients (n=24). In the subgroup analysis, higher values for operative time, blood loss, intensive care unit stay, and complications were found in ESRD patients. The mortality rate was 38.2% (n=13). In the univariate and multivariate analyses, poor performance status (Eastern Cooperative Oncology Group >2) (p=0.03), ESRD (p=0.02), and late referral (>8 weeks) (p<0.001) significantly affected mortality. Conclusion: ESRD, late referral, and poor functional status were poor prognostic factors predicting postoperative mortality. The decision of surgery should be cautiously assessed given the very high risk of perioperative morbidity and mortality in these patients.

Factors Affecting Disease-Free Status of Differentiated Thyroid Carcinoma Patients

  • Thamnirat, Kanungnij;Utamakul, Chirawat;Chamroonrat, Wichana;Kositwattanarerk, Arpakorn;Anongpornjossakul, Yoch;Sritara, Chanika
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.737-740
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    • 2015
  • Purpose: The study aim was to assess factors that impact on the outcome of radioiodine therapy in patients diagnosed with differentiated thyroid carcinoma (DTC). Materials and Methods: We performed a retrospective cohort study on 256 patients with DTC who underwent thyroidectomy and received radioiodine therapy during December 2003 to January 2012. All patients were followed up for at least 1 year. They were considered diseasefree by the criteria of the revised American Thyroid Association Management Guideline for Patients with Thyroid nodules and DTC (ATA guideline 2009). Results: On Cox univariate analysis, factors associated with disease-free status were age<45, stage I tumor, low risk group by histopathology, unifocal tumor involvement, stimulated serum Tg level at 1st dose of radioiodine therapy and no distant metastasis from 1st post-treatment WBS (post RxWBS). On multivariate analysis, stage I tumor and stimulated serum Tg level at 1st dose of radioiodine therapy < 30 ng/mL were the significant prognostic factors that increased disease-free rate by 1.73 times and 2.60 times, respectively (P-value <0.05). Conclusions: Factors affecting the outcome of radioiodine therapy in our study were age, stage, risk of recurrence by histopathology, unifocal tumor involvement and 1st postRxWBS findings. From these factors, stage I tumor and stimulated serum Tg level at 1st dose of radioiodine therapy were independent prognostic factors that substantial increase the disease-free rate.

Outcome of Operation in Crohn's Disease in Children (소아 크론병의 수술적 치료)

  • Ko, Eun-Young;Park, Kwi-Won;Kim, Hyun-Young;Jung, Sung-Eun;Kim, Woo-Ki;Min, Hae-Sook
    • Advances in pediatric surgery
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    • v.11 no.2
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    • pp.131-140
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    • 2005
  • The purpose of this study is to review the operative management and outcome of operation for Crohn's disease. The medical records of 17 patients who underwent operations for Crohn's disease at Seoul National University Children's Hospital from January of 1988 to June of 2005 were reviewed. The male-to -female ratio was 1.8: 1. The median age at the onset of symptoms and the time of diagnosis was 9 years 6 months and 11 years 6 months respectively. The median time interval from diagnosis to operation was 2 years and 1 month (0 month~8 years). The ileocolic or ileocecal region was the most common site of involvement. The indications for operation were intractable symptoms (8 cases) and obstruction or stricture (7 cases). The median postoperative hospitalized days were 14.4 days (8~35 days). Five patients (29 %) experienced postoperative complications. Symptom free state or symptom relief was observed in 11 cases after surgery and 6 cases had intermittent episodes of remissions and recurrences. In pediatric Crohn's disease patients who present with intractable symptoms despite medical treatment or develop surgical complications, symptom free state or symptom relief can be achieved by minimal resection of the diseased segment.

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Cohort Profile: Korean Tuberculosis and Post-Tuberculosis Cohort Constructed by Linking the Korean National Tuberculosis Surveillance System and National Health Information Database

  • Jeong, Dawoon;Kang, Hee-Yeon;Kim, Jinsun;Lee, Hyewon;Yoo, Bit-Na;Kim, Hee-Sun;Choi, Hongjo
    • Journal of Preventive Medicine and Public Health
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    • v.55 no.3
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    • pp.253-262
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    • 2022
  • We aimed to review the current data composition of the Korean Tuberculosis and Post-Tuberculosis Cohort, which was constructed by linking the Korean Tuberculosis Surveillance System (KNTSS; established and operated by the Korean Disease Control and Prevention Agency since 2000) and the National Health Information Database (NHID; established by the National Health Insurance Service in 2012). The following data were linked: KNTSS data pertaining to patients diagnosed with tuberculosis between 2011 and 2018, NHID data of patients with a history of tuberculosis and related diseases between 2006 and 2018, and data (obtained from the Statistics Korea database) on causes of death. Data from 300 117 tuberculosis patients (177 206 men and 122 911 women) were linked. The rate of treatment success for new cases was highest in 2015 (86.7%), with a gradual decrease thereafter. The treatment success rate for previously treated cases showed an increasing trend until 2014 (79.0%) and decreased thereafter. In total, 53 906 deaths were confirmed among tuberculosis patients included in the cohort. The Korean Tuberculosis and Post-Tuberculosis Cohort can be used to analyze different measurement variables in an integrated manner depending on the data source. Therefore, these cohort data can be used in future epidemiological studies and research on policy-effect analysis, treatment outcome analysis, and health-related behaviors such as treatment discontinuation.

Surgical treatment of pulmonary hydatid cysts: two cases report (폐포충낭종의 수술치험 2)

  • 정경영
    • Journal of Chest Surgery
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    • v.16 no.4
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    • pp.518-525
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    • 1983
  • Hydatid cystic disease of the lung is rare in Korea. Recently, the authors encountered 2 patients with this disease who were treated surgically with a successful outcome in both. The first patient, a 27 year old housewife never traveled outside Korea and the second, 25 year old man had a history of spending a year in Kuwait. These 2 cases are the first documented cases of pulmonary hydatoidosis among Koreans reported in the literature.

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