• 제목/요약/키워드: medical information standard

검색결과 606건 처리시간 0.03초

Relationship between sonorheometry parameters and laboratory values in a critical care setting in Italy: a retrospective cohort study

  • Antonio Romanelli;Renato Gammaldi;Alessandro Calicchio;Salvatore Palmese;Antonio Siglioccolo
    • Journal of Trauma and Injury
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    • 제36권3호
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    • pp.210-216
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    • 2023
  • Purpose: This preliminary retrospective cohort study analyzed the relationship between the parameters provided by sonorheometry device Quantra and the coagulation values obtained from standard venous blood samples in patients admitted in intensive care unit (ICU). Methods: We reviewed medical charts of 13 ICU adult patients in whom at least one coagulation study with Quantra was performed. The relationship between Quantra and laboratory data was analyzed with the Spearman rank correlation coefficient (rho). The 95% confidence interval (CI) was computed. A P-value <0.05 was considered statistically significant. Results: We collected 28 data pairs. Statistically significant moderate correlations were found for the following parameters: clot time (CT) and activated partial thromboplastin time (rho=0.516; 95% CI, 0.123-0.904; P=0.009; clot stiffness (CS) and the international normalized ratio (INR; rho=0.418; 95% CI, 0.042-0.787; P=0.039); INR and platelet contribution to CS (rho=0.459; 95% CI, 0.077-0.836; P=0.022); platelet count and platelet contribution to CS (PCS; rho=0.498; 95% CI, 0.166-0.825; P=0.008); and fibrinogen and fibrinogen contribution to CS (FCS; rho=0.620; 95% CI, 0.081-0.881; P=0.001). Conclusions: Quantra can provide useful information regarding coagulation status, showing modest correlations with the parameters obtained from laboratory tests. During diffuse bleeding, CT and FCS values can guide the proper administration of clotting factors and fibrinogens. However, the correlation of INR with CS and PCS can cause misinterpretation. Further studies are needed to clarify the relationship between Quantra parameters and laboratory tests in the critical care setting and the role of sonorheometry in guiding targeted therapies and improving outcomes.

Rome IV Clinical Criteria and Management of Functional Constipation: Indonesian Health Care Professionals' Perspective

  • Andy Darma;Khadijah Rizky Sumitro;Leilani Muhardi;Yvan Vandenplas;Badriul Hegar
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제27권2호
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    • pp.125-135
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    • 2024
  • Purpose: The updated ROME IV criteria for functional constipation (FC) in children were published in 2016. However, information on the use of these criteria is scarce. This study aimed to report the frequency of the use of the ROME IV criteria by Indonesian pediatricians and general practitioners (GPs) in FC management in infants and toddlers. Methods: An anonymous cross-sectional online survey was conducted between November 2021 and March 2022. Results: A total of 248 respondents (183 pediatricians and 65 GPs) from 24 Indonesian provinces completed the survey. Most respondents reported an estimated prevalence of FC to be less than 5% both in infants and toddlers. On average, only 64.6% of respondents frequently used the ROME IV criteria. Pediatricians used the ROME IV criteria more often than GPs did (p<0.001). The most frequently used criteria were painful or hard bowel movements (75.0%) and ≤2 defecations/week (71.4%). Lactulose as a laxative was the preferred treatment choice, followed by changing the standard formula to a specific nutritional formula. Most of the respondents carried out parenteral reassurance and education. Normal growth, as a marker of good digestion and absorption function, and normal stool consistency and frequency were the most reported indicators of gut health. Conclusion: The ROME IV criteria for functional constipation are not extensively used by pediatricians and GPs in Indonesia. Laxatives and specific nutritional formulas were the most used management approaches in infants and toddlers. Medical education, especially for general practitioners, should be updated.

Colorectal Cancer Incidence and Mortality in China, 2010

  • Zheng, Zhao-Xu;Zheng, Rong-Shou;Zhang, Si-Wei;Chen, Wan-Qing
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권19호
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    • pp.8455-8460
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    • 2014
  • Background: The National Central Cancer Registry of China (NCCR) affiliated to the Bureau of Disease Control, National Health and Family Planning Commission of China is responsible for cancer surveillance in the entire country. Cancer registration data from each local registry located in each province are collected by NCCR annually to be analyzed and published to provide useful information for policy makers and cancer researchers. Materials and Methods: Until 1st June, 2013, 219 population-based cancer registries submitted data of 2010 to the National Central Cancer Registry of China covering about 207,229,403 population, and 145 cancer registries were selected after quality evaluation for this study. Colorectal cancer cases were selected from the database according to ICD-10 coded as "C18-C20". We calculated the crude incidence and mortality rates by sex, age groups and location (urban/rural). The China population in 2000 and Segi's population were used as standardized populations for the calculation of age-standardized rates. The 6th National Population Census data of China was used to combined with the cancer registries' data to estimate the colorectal cancer burden in China in 2010. Results: Colorectal cancer was the sixth most common cancer in China. It was estimated that there were 274,841 new cases diagnosed in 2010 (157,355 in males and 117,486 in females), with the crude incidence rate of 20.1/100,000, highest in males in urban areas. Age-standardized rates by China standard population of 2000 (ASRcn) and World standard population (Segi's population, ASRwld) for incidence were 16.1/100,000 and 15.9/100,000 respectively. There were 132,110 cases estimated to have died from colorectal cancer in China in 2010 (76,646 men and 55,464 women) with the crude mortality rate of 10.1/100,000. The ASRcn and ASRwld for mortality were 7.55/100,000 and 7.44/100,000 respectively, higher in males and urban areas than in females and rural areas. The incidence and mortality rates increased with age, reaching peaksin the 80-84 year old, and oldest age groups, respectively. Conclusions: Colorectal cancer is one of the most common incident cancers and cause of cancer death in China. Primary and secondary prevention, with attention to a health lifestyle, physical activity and screening should be enhanced in the general population.

Bactericidal Efficacy of a Fumigation Disinfectant Containing Paraformaldehyde Against Salmonella Typhimurium

  • Cha, Chun-Nam;Son, Song-Ee;Yoo, Chang-Yeul;Park, Eun-Kee;Jung, Ji-Youn;Kim, Suk;Lee, Hu-Jang
    • 한국식품위생안전성학회지
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    • 제31권3호
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    • pp.216-221
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    • 2016
  • 본 연구는 S. Typhimurium을 대상으로 paraformaldehyde 35%를 함유한 훈증소독제의 살균효과를 평가하기 위해 수행되었다. 예비 시험에서, S. Typhimurium의 현탁액 균수는 모두 $3.9{\times}10^8CFU/mL$이었으며, 훈증소독제에 노출시킨 모든 담체의 균수는 평판배지법과 여과법으로 배양한 시험균주 현탁액의 균수의 50%보다 많았다. 또한, 대조 담체로부터 회복된 S. Typhimurium 균수는 모두 $3.3{\times}10^6CFU/mL$이었다. 훈증소독제의 살균효과 시험에서는, 훈증 소독제를 처리한 담체의 S. Typhimurium의 감소 균수는 5.22 log CFU/mL로 나타났다. 이상의 결과로부터, paraformaldehyde를 주성분으로 하는 훈증소독제는 S. Typhimurium에 대해 효과적인 살균력을 갖는 것으로 확인되었으며, 병원성 세균에 오염된 식품재료 및 주방용품의 소독에 적용할 수 있을 것으로 사료된다.

한방진단설문지 DSOM (r) S.1.1의 Upgrade를 위한 신뢰도 연구 (Reliability Study for Upgrade of Diagnosis System of Oriental Medicine DSOM(r) S.1.1)

  • 이인선;김종원;지규용;이용태;김규곤
    • 동의생리병리학회지
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    • 제26권1호
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    • pp.88-97
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    • 2012
  • DSOM(Diagnosis System of Oriental Medicine), questionnaire for oriental medical(medicine) diagnosis is an online survey system containing 152 questions for female, 149 questions for male that asking the basic symtoms of 16 pathogenic factors(病機). The result of DSOM denotes reliability according to the level of major symptoms of each pathogenic factor. Standard level of reliability is equal to all 16 pathogenic factor basically except phlegm(痰). In case of phlegm(痰) we give different weight depending on whether the factor includes gray color under the orbit(痰飮氣) or not. To examine reliability of DSOM, statistical analysis has been done to the data of felmale 10101, male 1564 except for bad responses and stored between 1st April 2000 to 3rd June 2011. Based on the study, the conclusions were as follows. Reliability of DSOM. For female, all pathogenic factors showed over 85% confidence level except for phlegm 82.6%. For male, all pathogenic factors showed more than 90% confidence level except two factors, phlegm(痰) indicates 87.% and damp(濕) indicates 89.8%. HH rates among pathogenic factors were more than 50 points. For female, HH rates of other 14 pathogenic factors were all over 80% except for heat(熱) 78.2% and insufficiency of Yang(陽虛) 75.3%. For male HH rates of all pathogenic factors were more than 80% except HH rates of heat 78.2% and damp 77.8%. Research based on a degree of satisfaction of reliability derived from pathogenic factors with scores of HH results in for all 16 pathogenic factors showed over 85% of relatively high level of satisfaction for both sexes whose reliability standard come under 5~4 points. Comparing appearance frequency of pathogenic factors for both sexes. Male only displays higer than female in heat(熱). Whereas female were higher than male for other 15 pathogenic factors and the difference was biggest in heart(心) and least in insufficiency of Yin(陰虛). Comparing appearance frequency order of pathogenic factors for both sexes. Female outdistanced male in blood stasis(血瘀) coldness(寒) blood-deficiency(血虛) phlegm(痰), while male outdistance female in heat(熱) insufficiency of Yin(陰虛) deficiency of qi(氣虛). Male had lower average of each pathogenic factors than female except heat(熱) as well as deficiency of qi(氣虛).

환자안전 주제별 보고서의 주제 우선순위 설정: 델파이 조사를 통한 분석 (Prioritizing Themes Using a Delphi Survey on Patient Safety Theme Reports)

  • 박정윤;신은정;김리은;김수경;박춘선;박태준;최윤경;허영희
    • 한국의료질향상학회지
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    • 제28권1호
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    • pp.45-54
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    • 2022
  • Purpose: The study aims to identify the theme list and priority criteria of patient safety theme reports in South Korea. Methods: The survey was conducted twice, and the importance of each criterion and theme was measured on a nine-point scale using the Delphi technique by a panel of 19 patient safety experts. The criteria included severity, universality, preventability, and organizational-social impact. Descriptive statistics such as frequency, percentage, mean, standard deviation, median, and interval quartile range were used to analyze the data. Results: The parameters were assigned a weighted average of 35% for severity, 20% for universality, 30% for preventability, and 15% for organizational-social impact, respectively. The final top three rankings were surgery safety, blood transfusion safety, and medication safety. In addition to expert opinion, for the theme that is selected based on the priority ranking, one to five sub-topics can be derived from the theme based on the priority ranking, societal demands, or the yearly priority list of patient safety incidents. Conclusion: It is recommended that the official patient safety center distribute the report in the form of a summary that can be utilized nationwide at medical institutions, government institutions, and other places. Updates, as well as accumulated theme reports, will serve as the baseline data for the proposal of the system and for the policy designed to implement and improve institutions' safety practices as a standard of domestic patient safety practice guidelines.

보건행정 전공 대학생들의 병원실습 만족도에 영향을 미치는 요인분석 (Factors Analysis Related to Health Administration Students' Satisfaction on Hospital Practice)

  • 박은영;장영진;홍종필
    • 한국임상보건과학회지
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    • 제5권1호
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    • pp.825-833
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    • 2017
  • Purpose .This study aims to assess the influence factors on the level of satisfaction with hospital training and to provide basic data for more efficient hospital practice of students' public health administration . Methods . We have conducted a survey on students satisfaction with their hands on practice against 200 students in Busan, Kyeongnam and Kyungbook area, who have completed their practice in public health administration. We have identified the general characteristics of the target respondents, the current training status of the department for the hospital practice and training venue; also analyzed the characteristics composed of the apprentice student's attitude before the practice, satisfaction with the department training program and hospital for practice, as well as their practice at hospital. The general characteristics of the target respondents and clinic practice status at the hospital were measured in percentage and frequency analysis; the average and standard deviations of hospital size were also measured; and the correlations between satisfaction with the department, attitude towards the practice and satisfaction with the hospital were analyzed. Results . Most public health administration students experienced their practice at the hospital after the first semester on the $2^{nd}$year and they have received the foundation training for the practice. The survey allowed multiple responses and the results are as follows: medical terminology 49.5%, medical coordinator 36.7%, Hospital administration 26.5%, Health insurance 17.3%, and medical recording and practice 13.8% respectively. In terms of each individual student's attitude towards the practice at the hospital, the respondents answered as follows: I have completed the obligatory subjects for the practice before the practice 89.5%; I have been fully informed on the hospital for my practice. 74.5%; I responsibly practiced and worked with professionalism and sense of belonging to the hospital as a member of staff 90%; I have actively learned and adopted 95%; My knowledge and skills from the practice was relevant to the theory and practice from my course 83.5%. The findings of satisfaction by size of hospital were in order of a small clinic($3.24{\pm}0.63$), medium sized clinic($3.27{\pm}0.65$), hospital ($3.20{\pm}0.61$), and large sized comprehensive hospital ($2.93{\pm}0.74$). Consequently the satisfaction rate shows no significant difference by size of hospital. In relations between practice attitude and satisfaction with subject, the matter of acquiring information and fully understanding of the hospital for practice before practice(p=0.04), the matter of a sense of belonging and responsibility at hospital during practice(p=0.33). the matter of active adaptation attitude during practice (p=0.42), and the matter of correlations with school curriculum during practice(p=0.00) showed significant results. In relations between practice attitude and satisfaction with the hospital for practice, the matter of acquiring information and fully understanding of the hospital for practice before practice(p=0.01), the matter of a sense of belonging and responsibility at hospital during practice(p=0.04), and the matter of correlations with school curriculum during practice(p=0.00) showed significant results. Conclusion . The most essential subject for the practice in public health administration is medical terminology and there is no significance in satisfaction with the practice by size of hospital. Students were content with the hospital where they can experience as much as possible. Students content with their major show positive attitude towards the practice and so do those content with the hospital. Those with the positive attitude towards the practice show the high correlation of satisfaction with both the major and hospital. As a result, the satisfaction with the major is the significant attribute to the practice in the hospital.

SPECT/CT에서 감쇠 보정 및 위치 정보의 유용성 평가 (The Usefulness Assessment of Attenuation Correction and Location Information in SPECT/CT)

  • 최종숙;정우영;신상기;조시만
    • 핵의학기술
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    • 제12권3호
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    • pp.214-221
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    • 2008
  • 목적 : 융합 SPECT/CT가 기존 SPECT에 비해 병소의 해부학적 위치를 정확히 판단할 수 있는지 정성 평가하고, CT 감쇠 보정이 SPECT 영상에 미치는 효과를 알아보아 SPECT/CT의 유용성을 제시하고자 한다. 실험재료 및 방법 : 1. 융합 영상의 평가 : 2008년 1월(月)부터 8월(月)까지 Precedence 16 혹은 Symbia T2에서 $^{131}I$-MIBG, Bone, $^{111}In$-Octreotide, Meckel 게실, Parathyroid MIBI 등을 SPECT/CT 시행한 환자를 대상으로 하였고, SPECT/CT영상을 융합한 것과 하지 않은 것을 비교하여 정성 평가하였다. 2. 감쇠보정의 평가 : Symbia T2로 2008년 6월에서 8월까지 $^{201}Tl$ 심근 검사를 한 환자 38명을 대상으로 Cedars-Sinai의 QPS를 이용하여 산출하였다. Ant, Inf, Lat, Septum, Apex로 5개부분으로 분류하고, 각 부분에 대한 관류의 상태를 백분율로 산출했다. CT AC와 Non AC를 평균${\pm}$표준편차로 각 부분에 대한 관류 상태를 비교하고 차이를 분석하였다. 결과 : 1. 융합 영상의 평가 : 에너지가 높은 $^{131}I$ SPECT의 경우 병소와 주위 조직 간의 섭취율 차이로 인해 (주위 조직이 saturation 됨) 병소의 위치 파악이 어려웠으나 CT로 융합한 결과 해부학적 위치를 정확히 평가할 수 있었다. 또한 멕켈게실이나 $^{111}In$과 같이 장이나 장기쪽에 질환을 찾는 경우에는 그 우수성이 더욱 뛰어 났다. Bone SPECT/CT는 척추간의 구별을 확실히 할 수 있어 임상의가 정확한 결과를 제시하는데 도움을 준다. 2. 감쇠 보정의 평가 : 감쇠 보정 전후의 관류 백분율의 차이가 Ant, Lat에서는 통계적으로 유의한 차이가 없었으나(p>0.05), Inferior, Apex, Septum에서는 유의한 차이가 있었다(p<0.05). 차이를 보이는 값 중 Inferior Wall에서 CT AC perfusion : $76.84{\pm}6.52%$, Non AC perfusion : $68.58{\pm}7.55%$로 CT 보정에 의한 차이가 $8.26{\pm}4.95%$로 가장 크게 측정되었다(t=10.29, p<0.01). 결론 : SPECT에 CT가 부착되면서 병변의 기능적 활성도를 나타내는 분자학적 영상은 물론 병변의 해부학적 위치 정보를 보다 정확하게 확인할 수 있게 되었다. 이것은 비정상적 부위를 찾아내는 것에 그치지 않고 복잡한 인체 부위에서 정상군과 비정상군을 분리하는데 많은 도움을 주게 되었다. 따라서 임상의는 하나의 검사 영상으로 진단과 치료계획을 동시에 시행할 수 있을 것이다. 또한 감쇠가 잘 되는 흉곽 부위 안에 있는 심근 검사에는, CT로 보다 정확한 감쇠 보정을 할 수 있기 때문에 SPECT 검사 시 관심부위의 관류 상태를 더욱 신뢰할 수 있어 치료 예후의 정당성을 입증할 수 있을 것으로 판단된다.

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맥진 가압 트레이닝 시스템 개발 (Development of Indentation Training System for Pulse Diagnosis)

  • 이전;이유정;전영주;우영재;김종열
    • 전자공학회논문지SC
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    • 제45권6호
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    • pp.117-122
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    • 2008
  • 맥진은 한의 진단에 있어 중요한 요소이나 맥진 교육에 있어서 수련자와 교육자 간에 언어적 표현 외에는 적절한 교육 정보 소통의 도구가 없어 정량적이며 과학적 교육이 어려운 실정이다. 이에 본 논문에서는 맥진 시 한의사가 세 손가락을 통해 맥진 부위에 가하는 가압력 프로파일을 정량적으로 측정할 수 있는 하드웨어와 이를 기반으로 맥진 동작을 트레이닝할 수 있는 프로그램을 개발하였다. 가압력 프로파일 측정 하드웨어는 인조 팔 속 맥진 위치에 놓인 3개의 로드셀과 맥진 가압력 신호를 증폭하는 증폭부 및 상용 A/D 변환 모듈인 NI-USB 6009로 구성하였으며, 3채널 가압력 신호는 200Hz로 샘플링하였다. 하드웨어 출력 신호를 질량 값으로 교정할 수 있도록 $50{\sim}500g$ 범위의 8개 추를 인조 팔에 올려놓았을 때의 질량 대비 출력전압 테이블을 작성하였다 또한, 이 시스템을 통해 한방 전문의 3명의 맥진 가압 프로파일을 각 3회씩 측정해 보았으며, 이를 통해 한의사의 맥진은 크게 3개의 구간으로 나눌 수 있고 최대 가압력이 약 $500g{\cdot}f$인 것 등을 알 수 있게 되었다. 맥진 가압트레이닝 프로그램은 LabView를 통해 구현하였으며, 수련자가 미리 저장된 목표 맥진 가압 프로파일과 유사하도록 인조 팔을 맥진할 때의 가압 프로파일이 목표 가압 프로파일과 유사한 정도를 평가하여 일정 범위를 벗어나면 경고하고, 실습이 끝나면 목표 프로파일과 유사도 점수를 화면에 표시하도록 하였다. 더 나아가 유사도 점수의 추이를 통해 숙련 추이를 관찰 할 수 있도록 하였다. 이 시스템을 맥진 교육에 활용한다면 보다 정량적이며 과학적인 교육이 가능해질 뿐만 아니라 교육의 효율도 크게 향상될 것으로 기대된다.

제3기 지역보건의료계획서에 기술된 핵심사업의 특성에 관한 연구 (A Study on Characteristics of Core Projects Described in 3rd Community Health Plans)

  • 김동문;이원영;문옥륜;김창엽
    • Journal of Preventive Medicine and Public Health
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    • 제37권1호
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    • pp.88-98
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    • 2004
  • Objectives : The 3rd community health plan let health centers select and promote core projects considering budget and manpower. This study analyzed the content and selection processes of core projects, using the nationwide 3rd community health plans, to give relevant information on health center policies. Methods : Classification criteria for content analysis of core projects were established and verified through a literature review and by specialist discussions. Fifty plans were selected by stratified proportional random sampling for regional characteristics. And coding criteria standardized through coding repetition and discussion, by 2 persons (k>0.7). Using stratified proportional random sampling for 16 cities and provinces, regional characteristics, 117 plans were selected, and the contents of the core project selection processes and program contents analyzed. Results : The survey was used by 59.8 % of samples as a core project decision-making method. The partici- pants included 98.6, 81.4, 40 and 38.6% of the health staffs, residents, medical institutions, and administrators, respectively. Discussion was used by 15.4% of samples. The participants were health staffs by 100% as a great. The ranking of the frequencies of the selected core projects were, in order; chronic disease control, health promotion, elderly health, maternal-child health, and oral health at 16.4, 14.8, 14.3, 12.7 and 11.9%, respectively. Analyses on the chronic disease control and elderly health contents showed the diversity of object disease, high rates of visitors on patient detection programs, high rates of unclear target populations, and the provision of medical exams and treatments as the main services, with high variations in business per-formance. The national health budgets for health centers in 2003 were about 910 and 240 million won for chronic disease control and elderly health, respectively, which were less than for the other five priority core projects. Conclusions : The chronic disease control and elderly health at the health centers were not standardized for object disease, patient detection program, target population, service provision, and national support budget was insufficient. Thus it is necessary to develop standard guidelines, and increase financial support, for chronic disease control and elderly health