• Title/Summary/Keyword: duration of illness

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The effect of high fat dietary modification and nutritional status on the outcome of critically ill ventilated children: single-center study

  • El Koofy, Nehal Mohamed;Rady, Hanaa Ibrahim;Abdallah, Shrouk Moataz;Bazaraa, Hafez Mahmoud;Rabie, Walaa Ahmed;El-Ayadi, Ahmed Ali
    • Clinical and Experimental Pediatrics
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    • v.62 no.9
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    • pp.344-352
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    • 2019
  • Background: Ventilator dependency constitutes a major problem in the intensive care setting. Malnutrition is considered a major determinant of extubation failure, however, attention has been attracted to modulating carbon dioxide production through decreasing carbohydrate loading and increasing the percent of fat in enteral feeds. The detected interrelation between substrate oxidation and ventilation outcome became the base of several research to determine the appropriate composition of the nonprotein calories of diet in ventilated patients. Purpose: We aimed to assess the effect of high-fat dietary modification and nutritional status on ventilatory and final outcomes of pediatric intensive care. Methods: Fifty-one ventilated children (1 month to 12 years of age) with pulmonary disease who could be enterally fed, in the Cairo University Pediatric intensive care unit, were divided into 2 groups: group A included 25 patients who received isocaloric high-fat, low-carbohydrate diet; group B included 26 patients who received standard isocaloric diet. Comprehensive nutritional assessment was done for all patients. Results: Group A had a significant reduction in carbon dioxide tension, but no similar reduction in the duration or level of ventilatory support. Assisted minute ventilation was predicted by weight-for-age and caloric intake rather than the type of diet. Poor nutritional status was associated with higher mortality and lower extubation rates. Mild hypertriglyceridemia and some gastrointestinal intolerance were significant in group A, with no impact on the adequacy of energy or protein delivery. Conclusion: The high-fat enteral feeding protocol may contribute to reducing carbon dioxide tension, with mild hypertriglyceridemia and negligible gastrointestinal intolerance as potential adverse effects. Optimization of nutritional status rather than dietary modification may improve ventilatory and survival outcomes in critically ill-ventilated children.

A Study on Sleep in Rheumatoid Arthritis Patients (류마티스 관절염 환자의 수면 및 관련 요인에 관한 연구)

  • Kim Keum-Soon;Yoo Kyung-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.6 no.2
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    • pp.198-210
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    • 1999
  • This study is to investigate sleep patterns of rheumatoid arthritis patients through a survey research. The subjects for this study were 97 patients registered in Hanyang University Hospital Rheumatoid Arthritis Center, and the period of data collection was from July 15, 1998 to August 30, 1998. The research instruments used in this study were the measures of sleep, pain, and fatigue, and SPSSWIN 8.0 Program was used for data analysis. The research results are as follows ; The patients went to bed between 11 and 12 p.m., but many of them found difficulty in falling asleep within 5 minutes. They woke up quite early at around 4 to 6 o'clock in the morning and remained in bed about 1 hour. Only 39 percent of the subjects reported satisfaction with their sleep. Fifty six percent of the subjects took a nap, generally did in the afternoon and 22.7 percent of them napped for half an hour. They suffered sleep disturbance, but their sleep environments were calm and comfortable, and they turn off the light when they went to sleep. As for the quality of sleep, over 50 percent of the subjects reported not being able to sleep deeply, 30 percent of the subjects woke up frequently during sleep, 60 percent experienced frequent arousal after sleep onset. Over 90 subjects slept for 6 to 8 hours. This shows that even though they had rheumatoid arthritis, the patients remained in bed for a sufficient period of time. They also reported waking up or turning frequently during sleep. The sense of fatigue from sleep disturbance scored a relatively high 35.84 points on average against the possible score of 64 points. Behavior for sleep promotion was very active. Sleep disturbance occurred in proportion to the sense of fatigue and pain, and was negatively correlated with quality of sleep. The pain had positive correlations with the illness duration, sleep disturbance and had a negative correlation with the quality of sleep.

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A Survey of Utilization of Complementary Alternative Medicine in Diabetes Mellitus (당뇨병 환자의 대체요법 경험실태에 대한 조사 연구)

  • 이명숙
    • Journal of Korean Academy of Nursing
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    • v.31 no.1
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    • pp.7-19
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    • 2001
  • In our country, patients with diabetes mellitus are searching for complementary treatments to recover from illness, while they received treatments from the doctor. However, have been evaluated or investigated systematically. This study was carried out to explore application of complementary treatments for patients with DM. For this survey, questionnaires were developed by researchers and the data was collected from July to October of 1999. Among the 223 subjects, there is one general hospital, one oriental hospital, 15 area C.H.P, ahd 2 area health centers. The results were as follows: 1. The total number of cases was 223 and the average age was 62.85 years old and average duration of DM was 8.1 years. The number of patients who had experience with alternative therapies was 145 (65%). The number of those who have not undergone treatments was 78 (35%). 2. The 43.5% of experienced CAM were advised family and relatives. Only 30.3% approved the effect of CAM and 52.5% said that If another a new CAM is introduced, they will try it. 4. Ninety three kinds of complementary treatments were used. Among the used items, 63.7% was various types of plants, 21.6% was animal material and 14.7% was the mixed group. As a single item, Bombyx Mori (Silkworm) was the most frequently used (10.5%) followed by the bean, mushroom, Morus bombycis (mulberry), Ginseng, Commelina Communis (Dalgaebi), Chinese medicine, root of Rosa rugosa (Haedangwha). 5. Among the used items, Trichosanthes kirilowii Max. Eucommia ulmoides Oliver, Commelina Communis, Aralia elata, pine needle, mulberry fruit, root of Rosa rugosa. Ginseng, Lycii Fructus, Dioscorea radix, Polygonatum odoratum, Cassia tora L, Bombyx Mori, loach, Crucian carp were based upon the pharmacological function of effect for control of diabetes mellitus symptom. 6. In the analysis of the relationships between the general characters of the patients with new complementary alternative medicine try and hospital treatment; 1) The shorter group suffered from DM (p=.038), poor Self-MBG (p=.037) and wanted to try new complementary alternative medicine. 2) The group of DM education experience were carried out hospital treatment well (p=.045). In conclusion, further study will be required for the patients experience using alternative therapies as the D-M in terms of holistic view of patients.

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A Case Study of 20 Patients with Lateral Epicondylitis of the Elbow by Using Hwachim (Burning Acupuncture Therapy) and Sweet Bee Venom Pharmacopuncture

  • Jung, Seho;Lee, Chamgeol;Yeo, Inho;Sung, Heejin;Roh, Jeongdu;Jo, Nayoung;Lee, Eunyong
    • Journal of Pharmacopuncture
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    • v.17 no.4
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    • pp.22-26
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    • 2014
  • Objectives: This study was performed to estimate the effectiveness of burning acupuncture therapy (Hwachim) and sweet bee venom pharmacopuncture (S-BV pharmacopuncture) in treating lateral epicondylitis of elbow. Methods: We selected 33 patients at first, but 13 patients were excluded due to unclear medical records. Finally, a total of 20 patients who had received treatment from January 2012 to December 2013 were included in this study; all 20 patients had undergone Hwachim for the treatment of lateral epicondylitis of elbow, and 19 of the 20 had been treated with S-BV pharmacopuncture (Korea Pharmacopuncture Institute, KPI) and transcutaneous electrical nerve stimulation (TENS) as an ancillary treatment method. The degrees of pain of the 20 patients were evaluated by using the visual analogue scale (VAS) score at their first and final visits. The Wilcoxon signed rank test and the Kruskal-Wallis test were used to compare the VAS scores statistically. Results: The VAS score had decreased significantly from $10.00{\pm}0.00$ to $4.00{\pm}2.47$ (P = 0.000) by the end of the treatment. No significant changes were observed based on the number of treatments (P = 0.246), the age of the patients (P = 0.810), the duration of the illness (P = 0.705), and the location of the lesion (P = 0.076). Conclusion: This study suggests Hwachim and S-BV pharmacopuncture are very effective for treating lateral epicondylitis of the elbow.

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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    • v.61 no.3
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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.

A Study of Symptom of Health and Fatigue-regulation Behavior in Middle-aged Women (중년여성의 건강증상호소와 피로조절행위)

  • Park, Chai-Soon;Oh, Jeong-Ah;Yeoum, Soon-Gyo
    • Women's Health Nursing
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    • v.7 no.4
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    • pp.447-460
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    • 2001
  • The purpose of this study were to identify a relationship between symptom of health and fatigue-regulation behavior in middle-aged women. The subjects were 241 women living in Seoul and near the city, ranging in ages of 30-59(mean= 42.1 years) being interviewed during the month of Oct. to Dec., 2000. The following questionnaires were utilized in this study: a self reported symptom of health and a fatigue-regulation behavior scale originated from Kwon(1997). The analysis for the data was done by SAS program, t-test, ANOVA, and Pearson correlation. The results of this study were as follows 1. Total mean scores of health status were shown 29.1, physical symptom 17.9 and psychological symptom 11.2. According to symptom of body system were higher in muscular-skeletal sympom 5.5, neurologic symptom 3.5, and digestive symptom 2.7. 2. The mean scores of symptom of health were significantly different in duraion of marriage, status of menstruation, perceived fatigue, perceived cause of fatigue, perceived help of family, hours of sleep. Physical symptom was significantly different in years of educational, status of menstruation, perceived fatigue, perceived cause of fatigue, perceived help of family, hours of sleep. Psychological symptom was significantly different in parity, whether or not having past illness, perceived fatigue. 3. The neurologic symptom was significantly different in years of education, status of menstruation, perceived fatigue, time to rest The respiratory symptom was significantly different in years of education, status of menstruation and hours of physical exercise. The muscular-skeletal symptom was significantly different duration of marriage, status of menstruation, BMI. perceived fatigue, perceived cause of fatigue, perceived help of family. The cardiovascular symptom was significantly different in whether or not having religion, number of children, duration of marriage, number of pregnancy & abortion, parity, status of menstruation, BMI. The digestive symptom was significantly different in whether or not having religion and the number of children. The urologic symptom was significantly different in whether or not having job, type of family, status of menstruation, BMI, perceived fatigue, perceived cause of fatigue, perceived help of family. The score of fatigue was significantly different in number of pregnancy. 4. There were significantly positive relationships in the area of symptom on health, especially fatigue was significantly positive relationships in score of symptom of health, physical symptom and psychological symptom. 5. They choose fatigue-regulation behavior physical rest, method of diversion, management of stress, enough sleep, and psychological rest in order. In the near future, it is required that further studies investigate socio-environmental factors related to symptoms of health and develop programs motivating fatigue-regulation behaviors actively.

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Alterations of Cortical Folding Patterns in Patients with Bipolar I Disorder : Analysis of Local Gyrification Index (제1형 양극성장애 환자에서 대뇌피질 주름 패턴의 변형 : Local Gyrification Index 분석)

  • Lee, Junyong;Han, Kyu-Man;Won, Eunsoo;Lee, Min-Soo;Ham, Byung-Joo
    • Korean Journal of Biological Psychiatry
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    • v.24 no.4
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    • pp.225-234
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    • 2017
  • Objectives Local gyrification reflects the early neural development of cortical connectivity, and is regarded as a potential neural endophenotype in psychiatric disorders. Several studies have suggested altered local gyrification in patients with bipolar I disorder (BD-I). The purpose of the present study was to investigate the alterations in the cortical gyrification of whole brain cortices in patients with BD-I. Methods Twenty-two patients with BD-I and age and sex-matched 22 healthy controls (HC) were included in this study. All participants underwent T1-weighted structural magnetic resonance imaging (MRI). The local gyrification index (LGI) of 66 cortical regions were analyzed using the FreeSurfer (Athinoula A. Martinos Center for Biomedical Imaging). One-way analysis of covariance (ANCOVA) was used to analyze the difference of LGI values between two groups adjusting for age and sex as covariates. Results The patients with BD-I showed significant hypogyria in the left pars opercularis (uncorrected-p = 0.049), the left rostral anterior cingulate gyrus (uncorrected-p = 0.012), the left caudal anterior cingulate gyrus (uncorrected-p = 0.033). However, these findings were not significant after applying the multiple comparison correction. Severity or duration of illness were not significantly correlated with LGI in the patients with BD-I. Conclusions Our results of lower LGI in the anterior cingulate cortex and the ventrolateral prefrontal cortex in the BD-I group implicate that altered cortical gyrification in neural circuits involved in emotion-processing may contribute to pathophysiology of BD-I.

Studies on Characteristics and Related Factors in Halitosis Patients (구취 환자의 특성 및 관련 인자에 대한 연구)

  • Yoon, Sang-Hyub;Ryu, Bong-Ha;Ryu, Ki-Won;Kim, Jin-Sung
    • The Journal of Internal Korean Medicine
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    • v.25 no.4
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    • pp.252-259
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    • 2004
  • Objectives : Halitosis is a common human condition, exact pathophysiological mechanisms of which are unclear. This study, which investigates halitosis patients' characteristics and their related factors, was done with intent to establish a foundation for the Oriental Medical treatment of halitosis. Methods : 329 patients were surveyed by reviewing medical charts and questionnaires from the East-West Halitosis Clinic of Kyunghee Medical Center from May 1, 2001 to December 31, 2002. Sex, age, illness duration, coating on the tongue, postnasal drip, globus pharyngeus, indigestion, condition of feces, halimeter measurements and results of the salivary scans were analyzed. Results : The thick and yellowish coating on the tongue was not a major cause of halitosis in the patients studied. Among the halitosis patients, 21.6% complained of postnasal drip, 15.6% of globus pharyngeus, 37.4% of indigestion, and 23.8% of diarrhea or constipation, suggesting the possibility of extra-oral origin in oral malodor. Conclusions : This study suggests that, when treating halitosis patients, intra-oral causes of halitosis aside, Oriental Medical treatments such as solving qi-stasis(氣鬱), augmenting deficiency of the spleen qi(碑氣虛) and treating gastric fever(胃熱) constitute effective management for oral malodor patients.

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Recent Trends in Clinical Research of Herbal Medicine Treatment for Anorexia in Children - Focused on Chinese Randomized Controlled Trials - (소아의 식욕부진에 대한 한약치료의 최신 임상연구 동향 - 중국 RCT 연구를 중심으로 -)

  • Shin, Hye Jin;Park, Yong Seok;Lee, Jihong;Chang, Gyu Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.33 no.4
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    • pp.1-25
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    • 2019
  • Objectives The purpose of this study is to analyze the trends of Chinese clinical research in the last 5 years of Chinese herbal medicine treatment for anorexia in children, and to find ways to utilize the diagnostic criteria and herbal medicine treatment for children who have anorexia in Korea. Methods The authors searched literatures using China National Knowledge Infrastructure published from January 1, 2015 to June 18, 2019. Selected literatures were collected in order of recent publication year. And then, demographic data, duration of illness, intervention, treatment period, outcome, and adverse events were analyzed. In addition, the diagnostic criteria for anorexia in children are categorized and presented in chart. Results A total of 50 papers were included in the analysis of this study. In the selected studies, the most commonly used diagnostic criteria for anorexia in children were ${\ll}$Zhu Futang Practice of Pediatrics${\gg}$ in Western medicine and ${\ll}$Diagnostic and therapeutic criteria for TCM syndromes${\gg}$ in traditional Chinese medicine. As a result, in all the studies reporting total efficacy, the total effective rate of the treatment group treated with herbal medicine was significantly higher than that of the control group. Also, appetite recovery rate and weight gain were significantly higher, gastric emptying time and appetite recovery time were significantly shorter in the treatment group. Conclusions Herbal medicine treatment can help improve anorexia in children. In Korea, diagnostic criteria for anorexia in children should be established. In addition, criteria should be established to evaluate the effectiveness of herbal medicine treatment.

Diagnostic Values of Tongue Coating Thickness and Sterno-costal Angle in Functional Dyspepsia (기능성 소화불량 환자에서 설태후박 및 흉늑각 측정의 진단적 가치)

  • Son, Ji-Young;Kim, Jin-Sung
    • The Journal of Internal Korean Medicine
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    • v.35 no.2
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    • pp.157-174
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    • 2014
  • Objectives : The aims of this study were to evaluate the diagnostic values of tongue coating thickness and sterno-costal angle as the quantitative diagnostic indicators in functional dyspepsia. Methods : We surveyed 60 functional dyspepsia patients recruited by the clinical trial, 'Clinical Trial for Evaluation on Availability of tongue diagnosis system (CTS-1000) : a Pilot study'. The patients were classified into three groups according to Rome III criteria for functional dyspepsia, and categorized into five groups according to Instrument of pattern identification for functional dyspepsia. Nepean dyspepsia index-Korean version (NDI-K) score, tongue coating thickness (percentage of tongue coating by tongue diagnosis system (CTS-1000), and weight of tongue coating by microbalance), sterno-costal angle, duration of illness and body mass index (BMI) were investigated. Results : Among the 5 types by instrument of pattern identification for functional dyspepsia, a significant difference of percentage of tongue coating was found. Percentage of tongue coating and weight of tongue coating showed significant correlation with total NDI-K score. Sterno-costal angle showed strong positive correlation with BMI and also showed significant difference between the non-overweight (BMI<23, n=32) and overweight ($BMI{\geq}23$, n=28) groups. Conclusions : Tongue coating thickness showed its potential as a new quantitative diagnostic indicator of functional dyspepsia. Further studies on the sterno-costal angle are anticipated to evaluate its potential as a new quantitative diagnostic indicator.