• 제목/요약/키워드: medical advice

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Changing Trends of Colorectal Carcinoma in Nepalese Young Adults

  • Kansakar, Prasan;Singh, Yogendra
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권7호
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    • pp.3209-3212
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    • 2012
  • Introduction: Colorectal carcinoma (CRC) is the most common gastrointestinal malignancy in the older population, but it is also quite frequent among young adults in developing countries. The aim of this study was to update the trends of clinicopathological features of CRC in young Nepalese. Methods: A retrospective comparative study on the data retrieved from the surgical records of all patients between 20 to 39 years of age with CRC was carried out for periods of 5 years each from 1999 to 2003 (early) and 2004 to 2008 (recent), treated at Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Results: The number of young adults with CRC increased from 28 to 34. However, the proportion of young patients in both groups was 28% of all CRC patients. The mean ages were $34{\pm}4.7$ and $31.8{\pm}5.1$ years in early and recent 5 years, respectively, and the male female ratio changed from 2:3 to 4:3. Abdominal pain as the most common presenting symptom was replaced by bleeding per rectum in recent years. The mean duration from onset of symptoms to seeking medical advice decreased from 7.8 months to 5.6 months in recent years. More patients (85.3%) were subjected to endoscopic examination in recent years than early years (60.7%) and right colonic cancer increased from 10.7% to 26.5%. However, the rectum was the commonest site in both early (71.4%) and recent (50%) groups. CRC was detected significantly at an earlier stage (7.1% vs 32.4%) in recent years with large proportion of modified Dukes B stage. Poorly differentiated adenocarcinoma was the predominant histology in both groups (50% vs 60.7%). Curative resection had risen in recent years (39.3% vs 73.6%). Conclusion: CRC among Nepalese young adults accounts for a high incidence (28%) of all CRC cases. Although right sided colonic cancer has been increasing, rectum is the commonest site. There is also an increasing trend for diagnosis at earlier stages of the disease which can be treated with curative intent.

유방자가검진을 위한 효능기대 증진 프로그램의 개발 및 효과 (The Study on the Development of Self Efficacy Expectation Promoting Program and It's Effect for Breast Self Examination)

  • 정명옥;태영숙
    • 종양간호연구
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    • 제2권1호
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    • pp.50-60
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    • 2002
  • Breast self-exam is easiest, safe and cost effective to be recommended as an important method for early detection of breast cancer. This experimental research with non-equal control design was to develop the efficacy expectation program for breast self-exam based on Bandura's self-efficacy information source. The study objects selected from two local churches in Busan. Twenty from S church were selected as a study group, twenty from D church as a control group. Efficacy expectation promoting program was based on Bandura's efficacy promoting source and was two hour lecture including slide, video tape, demonstration, pamphlet. After this, there were individual interviews with them and consultations through telephone f or verbal persuasion on the weekly basis between the first week and the fifth week. The effect from the experiment were measured on the first week after education and on the fifth week. Data from control group was collected during the period from Jan 11, 2 001 to Feb 15, 2001 and data from study group was collected during the period from Jan 12, 2001 to Feb 16, 2001. Measurement instrument for this study was developed by the author with the advice of specialist in order to measure self-efficacy and breast self-exam practice. Data analysis was done by using SPSS/10.0 PC program $with^2-$ test. t-test and ANCOVA. Proved results for hypothesis were as follows. 1) It was supported that "Study group educated by efficacy expectation promoting program has higher score in change rat e of self-efficacy than control group." (1 week after education F=18.395, p=.000 5 weeks after education F=28.972, p=.000) 2) It was supported that "Study group educated by efficacy expectation promoting program has higher score in change rate of exam practice than control group." (1 week after education F=37.984, p=.000 5 weeks after education F=28.972, p=.000) In conclusion, efficacy expectation promoting program for breast self-exam developed by this study may increase s elf-efficacy and breast self-exam practice.

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건강진단 후 추구 관리의 현황 및 의의 (Significance of Follow-up Blood Test after Health Examination)

  • 이명신;김민규;이동하;이주용;류재기;명미혜
    • 대한임상검사과학회지
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    • 제41권3호
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    • pp.123-127
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    • 2009
  • After a health examination, abnormal patients were classified into two groups. One needs clinical treatment immediately, while the other one needs check-up in 2~3 month after for blood tests and preventive medical study. To discover the status and importance of the follow-up study in a health program, blood test upon health examination was compared to the test from the follow-up. We examined patients of ages from 20's to 70's. Among these patients, most of them were between 40's and 50's, and in male patients the follow-up test were more freguent than female. We examined blood obtained from January 2007 to December 2008. We analyzed and compared initial and the follow up blood test. Lipid profile, liver test, thyroid function tests (TFTs), glucose fasting, and HbA1c were examined from the blood tests. We also surveyed their distribution and status. The value of the follow up blood tests was significantly decreased with the most striking differences in lipid profiles and liver test. Follow up study is able to improve life style of patients through doctor's advice in a health program. Therefore, we can conclude that the follow up blood test is also quite critical.

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의사용, 환자용 설문지의 중요도 분석 (Importance Analysis of Questionnaire for Doctors and Questionnaire for Patients)

  • 설유경;전수형;권석동;김훈;이의주;김규곤;김종원
    • 사상체질의학회지
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    • 제18권3호
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    • pp.94-123
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    • 2006
  • 1. Objectives This study integrates and studied variable of Questionnaire for doctors and Questionnaire for patients. After, found extremely useful variable. 2. Methods Through the medium of statistical method and advice of the Department of Sasang Constitution Medicine specialist, found extremely useful variable. 3. Results and Conclusions 1) Through the medium of statistical method (STEPDISC, DISCRIM), The variable which is selected lastly above once from 36 taxon, In the Questionaire for doctors Taeyang items is 18, Soyang items is 16, Taeumin items is 21, Soeumin items is 20. In the Question patients Taeyang items is 50, Soyang items is 53, Taeumin items is 63, Soeumin items is 64. 2) The variable which got above 25 from the Department of Sasang Constitution Medicine specialist, In the Questionaire for doctors Taeyang items is 5, Soyang items is 8, Taeumin items is 7, Soeumin items is 12. items is 32. 3) The variable which got above 25 from the Department of Sasang Constitution Medicine specialist and got above 3 the selection frequency, the Questionaire for doctors Taeyang items is 4, Soyang items is 4, Taeumin items is 5, Soeumin items is 8. In the Questionaire for patients Taeyang items is 10, Soyang items is 17, Taeumin items is 24, Soeumin items is 23.

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한국성인의 비타민무기질제 사용 실태조사를 통한 영양정보교육의 필요성연구 (General Pattern of the Nutrition Information on the Vitamin Supplement use Among Koreran Adults)

  • 김태정;조정현;정경철;장현수;정주호;손의동
    • 약학회지
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    • 제52권5호
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    • pp.323-330
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    • 2008
  • This study was conducted to investigate the actual conditions of vitamin supplement usage, the importance of their agents for health management, and the distribution of basic data for their correct consumption. For a period of one month 2003, the study was conducted based on questionnaires to the parents of students in both a middle school and a high school, and the personnel of K Company at random. The material used the survey sheets by setting up the previous investigation. The collected data analyzed the frequency and percentage of the following items: General demographic characteristics of consumers; the supplements taking; the reasons for taking them; the kinds of supplements taken; the media used for distributing data on their use; the potential use in the future, etc. According to the survey, the number of people who were taking supplements was higher than the number of people who weren’t taking them. Multi-vitamins were mostly consumed. The rate of supplements consume was high in people of a higher income bracket, had the time to exercise and to enjoy physical recreation. Most of the consumers who were taking the supplements said they did it to maintain their health and to recover from the fatigue. Those who weren’t taking them said they had enough vitamins from eating the appropriate food, and they were also concerned about the effectiveness of taking the supplements. The majority of useful information or advice for purchasing vitamins came from doctors, medical experts, relatives, and various media sources such as TV, newspapers, and magazines.

Secondary Analysis on Pressure Injury in Intensive Care Units

  • Hyun, Sookyung
    • International journal of advanced smart convergence
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    • 제10권2호
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    • pp.145-150
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    • 2021
  • Patients with Pressure injuries (PIs) may have pain and discomfort, which results in poorer patient outcomes and additional cost for treatment. This study was a part of larger research project that aimed at prediction modeling using a big data. The purpose of this study were to describe the characteristics of patients with PI in critical care; and to explore comorbidity and diagnostic and interventive procedures that have been done for patients in critical care. This is a secondary data analysis. Data were retrieved from a large clinical database, MIMIC-III Clinical database. The number of unique patients with PI was 2,286 in total. Approximately 60% were male and 68.4% were White. Among the patients, 9.9% were dead. In term of discharge disposition, 56.2% (33.9% Home, 22.3% Home Health Care) where as 32.3% were transferred to another institutions. The rest of them were hospice (0.8%), left against medical advice (0.7%), and others (0.2%). The top three most frequently co-existing kinds of diseases were Hypertension, not otherwise specified (NOS), congestive heart failure NOS, and Acute kidney failure NOS. The number of patients with PI who have one or more procedures was 2,169 (94.9%). The number of unique procedures was 981. The top three most frequent procedures were 'Venous catheterization, not elsewhere classified,' and 'Enteral infusion of concentrated nutritional substances.' Patient with a greater number of comorbid conditions were likely to have longer length of ICU stay (r=.452, p<.001). In addition, patient with a greater number of procedures that were performed during the admission were strongly tend to stay longer in hospital (r=.729, p<.001). Therefore, prospective studies focusing on comorbidity; and diagnostic and preventive procedures are needed in the prediction modeling of pressure injury development in ICU patients.

Complementary health education and clinical guidance for treating women experiencing infertility along with unexplained resistant hyperprolactinemia

  • Atef M.M. Darwish;Dina A.M. Darwish
    • Journal of Medicine and Life Science
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    • 제20권4호
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    • pp.158-165
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    • 2023
  • This study prospective randomized controlled trial aims to test the impact of adding health education, awareness of some contributing factors and clinical guidance to therapeutic cabergoline given to infertile women with unexplained resistant hyperprolactinemia. It comprised 120 infertile women with unexplained persistent hyperprolactinemia not responding to therapeutic doses of cabergoline 1.5-2 mg/week who were subjected to proper history taking to exclude concomitant drug intake or possible brain problems in all cases. They were classified into group A (60 cases) who received health education and clinical guidance to search for possible contributing factors and were instructed to avoid them in addition to proper therapeutic doses of cabergoline, while group B (60 cases) received proper therapeutic doses of cabergoline only without clinical guidance. After 1 month, serum prolactin (PRL) was measured for all cases. All cases had high PRL level at the start of the study (79.9±28.4 [39-195] and 78.2±19.9 [42-189] in group A and B, respectively) without any significant difference. Pretreatment counselling revealed that lifestyle factors, sexual behaviors or feeding habits may contribute to resistant hyperprolactinemia in all cases without a significant difference between both groups. Serum PRL dropped significantly more in group A (20.14±10.31 [11-45] vs. 49.32±37.03 [12-100]) after combined health education, clinical guidance of the couple and proper treatment. It is concluded that lifestyle factors, sexual behaviors, and feeding habits would affect the response of hyperprolactinemia to treatment. Health education and clinical guidance with some advice to avoid them, would concomitantly improve the response of resistant hyperprolactinemia to therapeutic doses of dopamine agonists.

Fetal safety of medicinal herbs and food ingredients during pregnancy: Recommendations from traditional Korean medicine based on expert opinions

  • Hyeong Joon Jun;Dong Il Kim;Jeong-Eun Yoo;Seung-Jeong Yang;Deok-Sang Hwang;Hyeong Jun Kim;Yoon Jae Lee;Dong Chul Kim;Sanghun Lee
    • 대한한의학회지
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    • 제44권4호
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    • pp.121-135
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    • 2023
  • Objectives: This study aimed to establish and provide reliable information for general public, based on expert consensus, on the risks of misuse of medicinal herbs for food and pure food ingredients for the fetus during pregnancy. Methods: A panelist of seven traditional Korean medicine (TKM) gynecologists responded to a questionnaire summarizing the fetal safety literature for twenty-five medicinal herbs for food and pure food ingredients derived from medicated diet (藥膳, Yaksun) recipes during three online Delphi rounds anonymously. Results: Ginkgonis Semen (Ginkgo nut), Illici Veri Fructus (Star anise), lavender, bitter gourd, and parsley were agreed at the level 1 of "Do not consume". These five ingredients were recognized as having significant risks both in the literature evidence and in expert opinion. Rosemary, Citri Unshius Pericarpium, Discoreae Rhizoma, lemongrass, Schisandrae Fructus, Cassiae Semen, Foeniculi Fructus, Mori Fructus, Cinnamomi Cortex, and Astragali Radix were agreed at the level 2 of "consultation with TKM practitioner is required". Conclusion: Based on the consensus of a seven-member expert panel of TKM gynecologists, consumption of Ginkgonis Semen (Ginkgo nut), Illici Veri Fructus (Star anise), lavender, bitter gourd, and parsley should be avoided by pregnant women. For Rosemary, Citri Unshius Pericarpium, Discoreae Rhizoma, lemongrass, Schisandrae Fructus, Cassiae Semen, Foeniculi Fructus, Mori Fructus, Cinnamomi Cortex, and Astragali Radix, the level 2 advisory may be recommended to use with caution and to consult a TKM practitioner for advice on consumption, dose, and duration.

미래지향적 역량교육을 위한 전문대학생 핵심역량 진단 도구 고도화 개발: Y대학 사례를 중심으로 (Advanced development of the core competency diagnosis tool for college students for future-oriented competency education: Focusing on the case of Y University)

  • 길효정;박복남;안종일
    • 보건의료생명과학 논문지
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    • 제10권1호
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    • pp.69-80
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    • 2022
  • 본 연구의 목적은 미래사회가 요구하는 인재를 양성하기 위한 역량 중심 교육 실행을 위하여 전문대학생이 갖추어야 할 핵심역량 진단 도구를 고도화 개발하고 타당도와 신뢰도를 검증하는 것이다. 이를 위해 선행연구 분석과 구성원 의견수렴, FGI, 전문가 자문을 통해 기존 진단 도구를 분석하고 예비문항을 도출하였다. 도출된 문항은 총 46문항이었으며 이는 내용 타당도로 검증하였다. 이후 재학생 중 희망자 380명을 대상으로 예비조사를 실시하였다. 구성 타당도 검증을 위해서 AMOS 18.0을 사용하여 탐색적 요인분석을 시행하였다. 그 결과 6개 핵심역량으로 구성된 30개 최종 문항을 도출하였다. 핵심역량 진단 도구는 재학생의 역량을 진단하여 향후 미래지향적 역량교육의 실행과 평가, 질 관리 도구로 적극적으로 활용될 것으로 기대된다.

Erectile Dysfunction in Men With Adult Congenital Heart Disease: A Prevalent but Neglected Issue

  • Alicia Jeanette Fischer;Christin Grundlach;Paul C Helm;Ulrike Mm Bauer;Helmut Baumgartner;Gerhard-Paul Diller;German Competence Network for Congenital Heart Defects Investigators
    • Korean Circulation Journal
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    • 제52권3호
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    • pp.233-242
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    • 2022
  • Background and Objectives: For adult men with congenital heart disease (ACHD), data on erectile dysfunction (ED) is limited. We aimed to assess the frequency of ED, its role in patient-physician communication and to identify parameters predicting ED. Methods: Male ACHD ≥18 years registered at the German National Register for Congenital Heart Defects were invited to participate in an online questionnaire about sexual health. Participants with presumed ED according to International Index of Erectile Function Score were compared to patients without ED. Results: The 371 patients responded to the questionnaire (83% with moderate to highly complex ACHD). The 43% presented with more than mild ED. When ED was present, patients complained about general anxiety to be sexually active more often (p<0.05) and underwent sexual activity less frequently compared to those without ED (p<0.05). Age ≥40 years (odds ratio [OR], 3.04; p=0.002), being single (OR, 6.82; p<0.0001), anxiety to be sexually active (OR, 2.64; p=0.0002) and psychiatric disease (OR, 4.33; p<0.0007) emerged as independent predictors for ED. Overall, patients sought medical advice in 6.7% of cases, whilst 29.6% would appreciate an active approach by the physician to address this sensitive topic. Conclusions: ED is affecting one third to one half of male ACHD according to a questionnaire-based analysis. Older age, being single, fear of sexual activity due to ACHD and psychiatric disorder emerged as independent predictors for ED. These parameters can easily be assessed to identify patients at risk. ED should be addressed proactively by health professionals.