• Title/Summary/Keyword: hospital patients

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Effect of blended protein nutritional support on reducing burn-induced inflammation and organ injury

  • Yu, Yonghui;Zhang, Jingjie;Wang, Jing;Wang, Jing;Chai, Jiake
    • Nutrition Research and Practice
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    • v.16 no.5
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    • pp.589-603
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    • 2022
  • BACKGROUND/OBJECTIVES: Previous studies have reported that protein supplementation contributes to the attenuation of inflammation. Serious trauma such as burn injury usually results in the excessive release of inflammatory factors and organs dysfunction. However, a few reports continued to focus on the function of protein ingestion in regulating burn-induced inflammation and organ dysfunction. MATERIALS/METHODS: This study established the rat model of 30% total body surface area burn injury, and evaluated the function of blended protein (mixture of whey and soybean proteins). Blood routine examination, inflammatory factors, blood biochemistry, and immunohistochemical assays were employed to analyze the samples from different treatment groups. RESULTS: Our results indicated a decrease in the numbers of white blood cells, monocytes, and neutrophils in the burn injury group administered with the blended protein nutritional support (Burn+BP), as compared to the burn injury group administered normal saline supplementation (Burn+S). Expressions of the pro-inflammatory factors (tumor necrosis factor-α and interleukin-6 [IL-6]) and chemokines (macrophage chemoattractant protein-1, regulated upon activation normal T cell expressed and secreted factor, and C-C motif chemokine 11) were dramatically decreased, whereas anti-inflammatory factors (IL-4, IL-10, and IL-13) were significantly increased in the Burn+BP group. Kidney function related markers blood urea nitrogen and serum creatinine, and the liver function related markers alanine transaminase, aspartate aminotransferase, alkaline phosphatase, and lactate dehydrogenase were remarkably reduced, whereas albumin levels were elevated in the Burn+BP group as compared to levels obtained in the Burn+S group. Furthermore, inflammatory cells infiltration of the kidney and liver was also attenuated after burn injury administered with blended protein supplementation. CONCLUSIONS: In summary, nutritional support with blended proteins dramatically attenuates the burn-induced inflammatory reaction and protects organ functions. We believe this is a new insight into a potential therapeutic strategy for nutritional support of burn patients.

The Relationship between 5-year Overall Survival Rate, Socioeconomic Status and SEER Stage for Four Target Cancers of the National Cancer Screening Program in Korea: Results from the Gwangju-Jeonnam Cancer Registry (국가 암검진 사업의 주요 암종별 5년 생존율과 사회경제적 수준 및 요약병기의 관련성: 광주·전남 지역암등록본부 자료를 중심으로)

  • Kang, Jeong-Hee;Kim, Chul-Woung;Kweon, Sun-Seog
    • Research in Community and Public Health Nursing
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    • v.33 no.2
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    • pp.237-246
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    • 2022
  • Purpose: The aim of this study was to investigate the relationship between the 5-year survival rate, socioeconomic status, and SEER (Surveillance Epidemiology and End Results) stage of stomach, colorectal, breast and cervical cancer patients. Methods: A total of 11,770 cases of four target cancers, which were diagnosed during 2005-2007, were extracted from the database of Gwangju-Jeonnam Regional Cancer Registry. The subjects of the study were 11,770 including stomach (n=5,479), colorectal (n=3,565), breast (n=1,516) and cervical cancers (n=710). Cox's proportional hazards model was used to obtain the hazards ratio (HR) according to the SEER stage and socioeconomic status. Results: Stomach cancer had a significantly higher HR in the medical aid recipients (HR=1.39), and the group below 20% (HR=1.20) compared to the group with the highest income level. Colorectal cancer had a significantly higher HR in the medical aid recipients (HR=1.26) than in the group with the highest income level. In addition, stomach, colorectal, breast and cervical cancers had a significantly higher HR according to the SEER stage in regional direct (stomach=4.10, colorectal=1.76, breast=12.90, cervical=3.10), regional lymph only(stomach=2.58, colorectal=2.33, breast=4.32, cervical=4.43), regional both (stomach=6.74 colorectal=3.04, breast=15.57 cervical=6.50), and regional NOS (Not Otherwise Specified)/distant (stomach=17.53, colorectal=11.53, breast=25.34, cervical=26.51) than in situ and localized only. Conclusion: In order to increase the cancer survival rate, a support system for early detection and early treatment of cancer should be established for groups with low individual income levels, and regular health checkups and management measures should be actively implemented through the National Cancer Screening Program.

Concept Analysis of Clinical Nurse's Self-Efficacy (병원 간호사의 자기효능감에 대한 개념분석)

  • Kim-Su Jin;Yoon So Yeon;Lee Bo Ram;Hong Jin Ha;Hwang Do Hyeon;Yoo Seul Gee;Shin-Na Yeon
    • Journal of Digital Policy
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    • v.2 no.3
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    • pp.25-32
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    • 2023
  • This study was done clarify the concept of clinical nurse's self-efficacy. This study was conducted using Walker & Avant's concept analysis framework, There were five aspects of the concept of Clinical Nurse's Self-Efficacy: To have faith and expectation that nurses can overcome stress and adversity in the clinical environment, To have a clear direction by believing that nurses themselves have the ability to perform nursing tasks, Allowing nurses to continue their work by believing that they have appropriate judgment to control various situations in clinical practice, Having a challenging sense of goal and motivating for the future through active participation in nursing work, and influencing various aspects from individual nurses to patients and hospital organizations. This conceptual analysis of clinical nurses' self-efficacy can recognize the need to prepare an educational system to improve nurses' self-efficacy and conduct related research.

A study on the measurement and processing of medical service experience data - From the perspective of realizing patient-centeredness - (의료서비스 경험데이터의 측정 및 가공에 관한 연구 -환자중심성 실현 관점에서-)

  • Jinho, Ahn;Jungmin, Choi
    • Journal of Service Research and Studies
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    • v.13 no.3
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    • pp.147-159
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    • 2023
  • This study is a study to develop a model for measurement and processing of experience data, which is emerging as a core value in quality management of medical services. In the theoretical background, a literature study was conducted on the importance of experience in medical service, measurement and processing of experience data, and realization of patient-centeredness. Based on these literature and theoretical background research results, operational definitions were performed for the following four research variables, and statistical tests were conducted. Hypothesis 1 is the effect of measuring experience data from the perspective of three factors on persona modeling, Hypothesis 2 is the effect of persona modeling on service blueprint visualization, Hypothesis 3 is the effect of service blueprint visualization on realization of patient-centeredness, and Hypothesis 4 is persona modeling This is the effect that modeling has on the realization of patient-centeredness. After data-based testing of factor analysis, reliability analysis, and correlation analysis, all four hypotheses were adopted as a result of verification using regression analysis. In conclusion, in an era where it is difficult to recognize the value of having only good medical staff and medical equipment in hospitals, it was possible to grasp the meaning that what kind of medical service experience is continuously obtained is more important to patients than the effectiveness of medical staff and medical equipment. In the era of the service economy, the core of hospital service competitiveness is providing attractive experiences, which is the real strength of hospitals, so the measurement and processing of experience data, which is the subject of this study, will have an important meaning in realizing patient-centeredness and realizing smart hospitals.

A Retrospective Study on the Effect of Pulp Treatment on the Exfoliation of Primary Teeth (유치 치수치료가 치아 탈락에 미치는 영향에 관한 후향적 연구)

  • Sejung Bang;Miran Han;Jongbin Kim;Junhaeng Lee;Jongsoo Kim;Jisun Shin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.1
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    • pp.24-34
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    • 2023
  • The aim of this study was to retrospectively analyze the effects of pulp treatment on exfoliation of primary teeth and its related factors. In this study, 167 teeth of 97 patients aged 6 months to 12 years who were treated with pulp treatment at Dankook Dental Hospital were selected, and information related to pulp treatment and tooth loss was collected. The included subjects were 72 primary anterior teeth (43.1%) and 95 primary posterior teeth (56.9%), of which 56 were males (57.7%) and 41 females (42.3%). The mean follow-up period was 106.1 ± 38.7 months, and the mean age at pulp treatment was 34.8 ± 15.4 months for primary anterior teeth and 69.1 ± 25.1 months for primary posterior teeth. Unilaterally pulpectomized teeth were significantly exfoliated earlier than the same tooth on the opposite side (p < 0.05). Also, in the case of teeth with periapical lesions, despite pulp treatment, the probability of extraction due to infection has been increased on primary anterior teeth (p < 0.05), but not on posterior teeth (p > 0.05). Pulpectomized teeth were lost earlier, an average of 7.8 months for primary anterior teeth and 8.5 months for primary posterior teeth. Early loss of the primary tooth can lead to space loss and premature eruption of the successor, so this can be considered when planning or performing treatment of the primary tooth.

Comparative Evaluation of the Survival Rates of Zirconia Crown and Stainless Steel Crown for Proximal Caries in Primary Molars: a Retrospective Study (유구치 인접면 우식증 수복 시 지르코니아 전장관과 기성금속관의 생존율 비교 평가: 후향적 연구)

  • Gahui Jeong;Nanyoung Lee;Hyewon Shin;Suhyun Park;Myeongkwan Jih
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.3
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    • pp.307-317
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    • 2023
  • Due to increasing demand for aesthetics, zirconia crowns have become a popular choice for treating primary molars. However, there is limited literature available comparing the survival rates of zirconia crowns with those of other restorative materials. The objective of this study was to compare the 36-month survival rates of zirconia crowns and stainless steel crowns for proximal caries, as well as to analyze failure types associated with each crown type. Electronic medical records and radiographs of 1,061 primary molars from 498 patients treated with 2 types of prefabricated crowns at Chosun University Dental Hospital and 2 private dental clinics between 2017 and 2019 were collected and analyzed. The survival rate of zirconia crowns was found to be lower compared to that of stainless steel crowns. Regarding the groups without pulp treatment, the survival rate of stainless steel crowns was significantly higher than that of zirconia crowns. However, in the groups that received pulp therapy, no significant difference in the survival rates was observed between the two preformed crowns. Notably, abnormal root resorption or periapical lesions were identified as the primary cause of restorative failure in stainless steel crowns, whereas loss of restoration was the predominant cause in zirconia crowns. This study holds valuable implications for clinicians when selecting preformed crowns for primary molars.

An Ethical Consideration on the Standard Operating Procedure Operation Status and the Ethical Review of the Vulnerable Research Subjects of Institutional Review Board, a Medical Institution in Korea (우리나라 의료기관 Institutional Review Board의 취약한 연구 대상자 관련 표준운영지침서 운영 현황과 윤리적 고찰)

  • Eun Hwa Byun;Byung In Choe
    • The Journal of KAIRB
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    • v.5 no.1
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    • pp.21-32
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    • 2023
  • Purspose: The purpose of this study is to examine the meaning and definition of vulnerable subjects in clinical trials in light of domestic and international regulations and guidelines, to analyze the contents of standard operation procedures (SOPs) among advanced general hospitals in Korea that conduct clinical trials, and to examine deliberation procedures for operation plans. Methods: The study examined how vulnerable research subjects were defined and described in related regulations and the classification of vulnerable research subjects presented in the IRB/HRPP SOPs of 18 clinical trial institutions, including 11 AAHRPP-accreditated general hospitals in Korea, as well as the operation of the IRB deliberation. Results: Among all domestic and international regulations and guidelines, only the The Council for International Organization of Medical Sciences (CIOMS) guidelines explain why vulnerability is related to judgments on the severity of physical, psychological, and social harm, why individuals are vulnerable, and for what reasons. However, the classification of vulnerable subjects by institutions differed from the classification by the International Conference on Harmonization-Good Clinical Practice (ICH-GCP). A total of the 16 institutions classified children and minors as vulnerable research subjects. 14 institutions classified subjects who cannot consent freely were classified as vulnerable subjects. 15 institutions classified sujects who can be affected by the organizational hierarchy were classified as vulnerable subjects. Subjects in emergency situations were regarded as vulnerable research subjects in 8 of institutions, while people in wards, patients with incurable diseases, and the economically poor including the unemployed were categorized as vulnerable research subjects in 7, 4, and 4 of institutions, respectively. Additionally, some research subjects were not classified as vulnerable by ICH-GCP but were classified as vulnerable by domestic institutions 15 of the institutions classified pregnant women and fetuses as vulnerable, 11 classified the elderly as vulnerable, and 6 classified foreigners as vulnerable. Conclution: The regulations and institutional SOPs classify subjects differently, which may affect subject protection. There is a need to improve IRBs' classifications of vulnerable research subjects. It is also necessary to establish the standards according to the differences in deliberation processes. Further, it is recommended to maintain a consistent review of validity, assessment of risk/benefit, and a review using checklists and spokeperson. The review of IRB is to be carried out in a manner that respects human dignity by taking into account the physical, psychological, and social conditions of the subjects.

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Case Report: Lower Extremity Paresthesia and Pain with Diabetic Polyneuropathy Combated with Complex Korean Medical Treatment (하지 감각이상 및 통증을 호소하는 당뇨병성 다발신경병증 환자에 대한 복합 한의치험 1례)

  • Seong-Hoon Jeong;Young-Seon Lee;Si-Yun Sung;Han-Gyul Lee;Ki-Ho Cho;Sang-Kwan Moon;Woo-Sang Jung;Seungwon Kwon
    • The Journal of Internal Korean Medicine
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    • v.44 no.2
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    • pp.231-243
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    • 2023
  • Background: Diabetic polyneuropathy is the most common complication in diabetics, occurring in 50% of all cases. About 10-20% of all diabetics are accompanied by neurological pain, showing a tendency to increase with age. Clinical aspects are very diverse, from mild abnormalities on nerve conduction tests to severe abnormalities in all sensory, motor, and autonomic nerves; however, sensory symptoms usually precede motor symptoms. Patients typically express sensory symptoms, such as positive and negative symptoms, which decrease the quality of life and have marked clinical implications, such as increased morbidity and mortality. Although Western medical drugs, such as tricyclic antidepressants, anticonvulsants, and narcotic analgesics, are used for diabetic polyneuropathy, a standard treatment has not been established. Case report: A 65-year-old male with paresthesia and pain due to diabetic polyneuropathy was treated with Uchashinki-hwan, acupuncture, electroacupuncture, moxibustion, and Jungsongouhyul pharmacopuncture for 10 days. We used the Toronto Clinical Neuropathy Scoring System, EuroQol-5 Dimension, and Visual Analog Scale to evaluate symptoms. Subsequently, the Neuropathy Scoring System, EuroQol-5 Dimension, and subjective discomfort improved. Conclusion: The present case report suggests that combined Korean medicine treatment might be an effective treatment for paresthesia and pain with diabetic polyneuropathy. Several follow-up studies should be conducted to clarify the effectiveness of the treatment.

Case Report of Pressure Injury in Intracerebral Hemorrhage Patients Improved by Combining Radix Astragali Pharmacoacupuncture Solution during Antibiotic Treatment (항생제 치료 중 드레싱과 황기 약침액 도포를 병행하여 호전된 뇌출혈 환자 욕창 1례)

  • Geun Young Kim;Dabin Lee;Seon Uk Jeon;Han-Gyul Lee;Ki-Ho Cho;Sang-Kwan Moon;Woo-Sang Jung;Seungwon Kwon
    • The Journal of Internal Korean Medicine
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    • v.44 no.2
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    • pp.167-177
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    • 2023
  • Background: Pressure injuries are localized areas of damage to the skin and/or underlying tissue, usually over a bony prominence due to pressure. Cerebrovascular disease increases the risk of pressure injuries due to the immobility caused by physical paralysis. The general approach to managing a patient with pressure injuries should include pain relief, the treatment of the infection, optimizing nutritional intake, proper positioning, and contamination prevention. Nonetheless, the duration of treatment for pressure injuries varies from person to person. Case report: An 80-year-old female intracerebral hemorrhage patient developed a pressure injury. To improve the injury faster, a Radix Astragali pharmacoacupuncture solution was applied to the pressure sore. The pressure injury's width, length, and depth was assessed using a ruler, and the exudate amount and tissue types were assessed. The treatment was performed for 35 days. The rate at which the size of the pressure sore lessened increased since the Radix Astragali pharmacoacupuncture solution was applied to the pressure sore. In addition, the tissue type of the pressure injury improved, and the exudates decreased. There was no significant difference in the Pressure Ulcer Scale for Healing Tool 3.0, since the Radix Astragali pharmacoacupuncture solution was applied to the pressure injury. Conclusion: This clinical case study suggests that the Radix Astragali pharmacoacupuncture solution might be effective in speeding up the healing of pressure injuries.

Effect of Nurse's Perception of People with Disabilities, Experience of Contact with Persons with Disabilities, and Human Rights Sensitivity on Attitudes toward Persons with Disabilities (간호사의 장애인에 대한 인식, 장애인 접촉경험, 인권감수성이 장애인에 대한 태도에 미치는 영향)

  • Ahn, Eun-young;Lee, Hye-Kyung
    • Journal of the Korean Applied Science and Technology
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    • v.39 no.2
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    • pp.205-219
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    • 2022
  • This study is a descriptive research study to understand the effects of nurses' perception of the disabled, contact experience with the disabled, and human rights sensitivity on attitudes toward the disabled. The subjects of the study were 181 nurses working at two university hospitals in D City and one university hospital in C Special Self-Governing City. Data were collected from September 2, 2021 to October 6, 2021. The collected data wre analyzed using IBM SPSS 26.0 program, and analyzed with t-test, ANOVA, Pearson's Correlation Coefficients, and Multiple Regression Analysis. Factors affecting the subject's attitude toward people with disabilities were perception of people with disabilities(t=-3.96, p<.001), presence or absence of contact with patients with disabilities(t=3.23, p=.001), and the ability to perceive responsibility among human rights sensitivity(t=2.13, p=.035), whether or not they had completed education for improvement the awareness of the disabilities(t=2.90, p=.004), and whether they were recognized of the Act on the Right to Health and Medical Accessibility for the Disabled(t=2.44, p=.016), which showed 30% of explanatory power(F=9.36, p<.001). Accordingly, it is necessary to develop an educational program that can foster nurses' attitudes toward the disabled, including awareness of the disabled, human rights sensitivity, the Health Rights Act for the Disabled, and the experience of contact with the disabled.