• Title/Summary/Keyword: medication review

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A Review on the Report about Drug-induced Hepatitis published by the National Institute of Toxicological Research (국립독성연구원 보고서 '식이유래 독성간염의 진단 및 보고체계 구축을 위한 다기관 예비연구'에 대한 분석 및 고찰)

  • Jang Insoo
    • The Journal of Korean Medicine
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    • v.25 no.3
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    • pp.78-89
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    • 2004
  • Background : A report published by the National Institute of Toxicological Research (NITR) in January 2004 about toxic hepatitis in Korea contained the result of analysis on 55 cases of severe toxic hepatitis from 7 university hospitals for 8 months. NITR claimed that the extrapolated annual frequency of severe toxic hepatitis in Korea was 1904 cases per year. They also claimed that the most frequent etiology of severe toxic hepatitis were herbal medications and similar plant preparations (61.7%), contrasted with traditional therapeutic preparations and healthy foods (29.1%). I have investigated that report to be certain of the result because it is a very important subject for public health and society in Korea. Results : The NITR report has too many problems to have faith in its results. They include the following: 1. The report uses only 55 cases to estimate annual prevalence rate of severe toxic hepatitis in Korea. 2. There was a large regional preponderancy in the NITR report (2 cases in Seoul from a population of 10.17 million, 19 cases in Gwangju from a population of 1.4 million) 3. There was another preponderancy that selected much fewer cases caused by western medication (9.1%) than other reasons. 4. The NITR report used a modified scale than that officially recognized to diagnose toxic hepatitis. 5. There was a mistake using the scale to adapt the right indications. 6. They collected cases before beginning the study, although it was a prospective study. There was also not any questionnaire or other materials concerned with alcohol, drugs, or history of past liver disease. Conclusions : NITR is one of the important official arms of the government of Korea. Nevertheless, there is a severe problem in validity because of selection bias, uncertain accuracy, and insufficiency of raw materials in the report. Therefore it seems incorrect to generalize the results of the report and there is a lack of confidence in it as a national study publishing by the NITR.

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Development and Validation of the Diabetes Management Self-efficacy Scale for Older Adults (DMSES-O) (노인의 당뇨병 관리 자기효능감 측정도구 개발 및 평가)

  • Song, Misoon;Choi, Suyoung;Kim, Se-An;Seo, Kyoungsan;Lee, Soo Jin;Kim, Eun Ho
    • Journal of muscle and joint health
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    • v.21 no.3
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    • pp.184-194
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    • 2014
  • Purpose: The purpose of this study was to develop and validate a diabetes management self-efficacy scale for older adults (DMSES-O). Methods: A preliminary DMSES-O of 22 items was derived from a literature review and seven domains of self-management behaviors. Content validity was confirmed by experts in diabetes self-management education. To test the reliability and validity of the DMSES-O, data were collected from 150 older adults with type 2 diabetes. The data were analyzed using exploratory factor analysis, and Cronbach's ${\alpha}$ and Pearson's correlation coefficients were calculated. Results: From the exploratory factor analysis, 17 significant items in six subscales were derived. Factors derived were named "problem solving for hypoglycemia and self-monitoring blood glucose," "problem solving for hyperglycemia," "coping with psychological distress and taking medication," "reducing risks of diabetes complications," "appropriate exercise," and "healthy eating." The criterion-related validity of the DMSES-O was established by its correlation with the Summary of Diabetes Self-care Activities Questionnaire. Cronbach's ${\alpha}$, a measure of internal consistency, was .84 for the overall scale and ranged from .54 to .80 for the subscales. Conclusion: The DMSES-O is a reliable and valid instrument to measure selfefficacy for diabetes self-management among older adults.

Factors Influencing Antibiotics Prescribing of Primary Health Physicians in Acute Upper Respiratory Infections (급성상기도질환에서 일차의료의사의 항생제 처방에 영향을 주는 요인)

  • Kim, Nam-Soon;Jang, Sun-Mee;Jang, Soong-Nang
    • Journal of Preventive Medicine and Public Health
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    • v.38 no.1
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    • pp.1-8
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    • 2005
  • Objectives : To explore the factors influencing antibiotics prescription by primary health physicians for acute upper respiratory infections(URI). Methods : We performed a survey of 370 primary health physicians randomly sampled in April, 2003. The questionnaire consisted of a prescription on the scenario of acute bronchitis case, along with opinions and reasons for prescribing antibiotics on URI. Results : We found that 54.7% of the physicians prescribed antibiotics on the example case of acute bronchitis which is known as not needing antibiotics. Female physicians and ENT physicians had a greater tendency to prescribe antibiotics. The factors influencing antibiotics prescription on URI were the belief about the effectiveness of antibiotics, preference for their own experiences rather than clinical guidelines, perception of patients' expectations, and perception of competitive environment. The prescription of antibiotics in the example case was affected by how much they usually prescribe antibiotics (OR=2.400, 95% CI=1.470-3.917) and the physicians who thought that antibiotics were helpful for their income prescribed antibiotics more than others (OR=6.773, 95% CI=1.816-25.254). Conclusion : These findings demonstrated that the false belief on the effectiveness of antibiotics, patient's expectation of medication and fast relief of symptoms, and perception of competitive environment all affected the physicians prescription of antibiotics on URI. It may help to find barriers to accommodate scientific evidence and clinical guidelines among physicians and to specify subgroups for education about appropriate prescription behaviors.

A Case of Xanthoma Disseminatum with Laryngeal Involvement (후두에 발생한 파종성 황색종 1예)

  • Park, Jin Su;Lee, Young Woo;Lee, Sang Hyuk;Jin, Sung Min
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.26 no.1
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    • pp.58-62
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    • 2015
  • Xanthoma disseminatum (XD) is a benign, non-Langerhans cell histiocytosis characterized by disseminated xanthomatous lesions with face, flexures, and mucosa. Most of XD develops in mucocutaneous lesions including skin, oral cavity and pharynx, however laryngeal involvement is uncommon. While the natural course of XD is usually benign and often self-limiting, but XD develop in critical anatomical locations may result in morbidity and mortality. Localized mucous lesions in oropharynx and larynx lead to dysphagia, dyspnea and air way obstruction. The diagnosis of XD was based on clinical, histological and immunohistochemical findings. The treatment is complex and non-consensual. Local treatment with cryotherapy, radiotherapy, surgery, and carbon dioxide lasers have been attempted with various results. Systemic medication with peroxisome proliferator-activated gamma receptors, statins, fenofibrate, chlorodeoxyadenosine, cyclophosphamide, doxycycline, and cyclosporine have also been reported, but none have proven particularly successful. A 59-year-old man presented with respiratory symptoms because of laryngeal involvement of XD. We had to remove the obstructive lesion for relieving the symptoms. We experienced XD in Larynx that was rare in otorhinolaryngology. So we report this case with review of literatures.

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A Study on the Factors Influencing Injury Prevention Practices of the Elderly (노인의 사고예방 실천정도와 그 영향요인에 관한 연구)

  • Kim, Mi-Hee
    • The Journal of Korean Academic Society of Nursing Education
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    • v.8 no.1
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    • pp.38-50
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    • 2002
  • The purpose of this study is to identify the relationship among injury prevention practices, health locus of control, and response patterns to HLOC of the elderly. Subjects were 121 healthy elderly. The data had been collected from November 5 to 18 in 2001 and analyzed with descriptive statistics, t-test, ANOVA, Pearson's correlation and stepwise multiple regression. Health locus of control and injury prevention practices were measured by using MHLC scale and an instrument created by the researcher on the basis of the results of literature review respectively. The results of this study were as follows: The mean score of injury prevention practices was 2.80 and the mean scores for the health locus of control were internal health locus of control : 17.25, external health locus of control : 16.09, and chance health locus of control : 14.26. The response patterns of the HLOC identified were six types; pure internal, pure powerful others, pure chance, double external, believers in control, and complex control. The 'pure internal' was the largest group(35.5%), and the 'believers in control' was the next(31.4%). The relationship between internal health locus of control and the injury prevention practices of the elderly revealed a significant correlation(r=.215, p=.018). The relationship between external health locus of control and the injury prevention practices of the elderly revealed a significant correlation (r= .208, p=.022). There was significant difference between response patterns of the health locus of control and injury prevention practices(F=2.393, p=.042). There were significant differences between injury prevention practices and general characteristic factors, which were education, family type, administration of medication, injury experience, ADL, and self-directed search for health information. Self-directed search for health information, injury experience, and education explained 16.7% of the variance for injury prevention practices. The above results may be used as the basic data for seeking more efficient way of improving safety of the elderly.

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Evaluation of Vancomycin Use before and after the Computerized Restricted Antibiotic Control Program (제한항균제 전산 관리 프로그램 도입 전과 후의 반코마이신 사용 평가)

  • Ahn, Hyo-Cho;Lee, Chang-Seop;Lee, Mi-Kyung;Yang, Jae-Heon
    • YAKHAK HOEJI
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    • v.53 no.3
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    • pp.107-113
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    • 2009
  • Since 2006, the Computerized Restricted Antibiotic Control Program (CRACP) has been incorporated to facilitate a more efficient approval process of vancomycin use at the Chonbuk National University Hospital. The purposes of the study were to evaluate proper use of vancomycin and to examine if there is any improvement when administering the CRACP. The use of vancomycin was retrospectively reviewed by a medical record review based on the American Society of Hospital Pharmacists (ASHP) criteria (i.e., indication, use of critical process indicators and use of outcome measurements) and compared before (Group I) and after the CRACP (Group II). Two hundred fifty six patient records were evaluated (138 in Group I and 118 in Group II). There was a statistically significant improvement in the report of justification for vancomycin use after CRACP (42.0% vs. 62.7%, p=0.001). Out of eight critical process indicators, two indicators (appropriate cultures prior to medication [68.8% vs. 85.6%, p=0.002] and serum vancomycin level measurement [0% vs. 7.6%, p=0.001]) were significantly improved after CRACP. The total incidence of adverse effects was decreased from 14.5% to 6.8%. In addition, there was a statistically significant difference in WBC count reduction within normal range (52.8% vs. 73.1%, p=0.024). The CRACP appears to be a promising approach to improve use of vacomycin in a hospital setting. However, further evaluation for the long-term period should be performed to confirm the performance of the program.

Pharmacological Effect of Decursin and Decursinol Angelate from Angelica gigas Nakai (신약 개발을 위한 참당귀(Angelica gigas Nakai) 추출 Decursin과 Decursinol Angelate의 약리 작용)

  • Son, Chu-Young;Baek, In-Hwan;Song, Gyu-Yong;Kang, Jae-Seon;Kwon, Kwang-Il
    • YAKHAK HOEJI
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    • v.53 no.6
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    • pp.303-313
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    • 2009
  • Traditionally, Cham dang-gui (Angelica gigas Nakai) is one of the most popular herbal medicines in Asian countries including Korea. A. gigas has been used as a functional food product for treatment anemia, women's health care, a sedative, an anodyne or a tonic agent. Decursin and decursinol angelate isolated from the roots of A. gigas are pyranocoumarin compounds. Recently, as the global herbal medication market is increasing, investigations about pharmacological effects of decursin and decursinol angelate are rapidly increasing. We summarized previous studies about pharmacological effects of decursin and decursinol angelate, and reviewed relation with pharmacological effects of decursin and decursinol angelate on human disorder, focused on the approach for new drug development. Pharmacological effects of decursin and decursinol angelate were classified as anti-tumor activity, anti-bacterial activity, improvements of the circulating system, inhibition of cytochrome P-450 activity, anti-inflammation activity, anti-oxidant activity and cognitive-enhancing activites. The activity of A. gigas with improvement of the circulating system may have wide therapeutic potential for circulatory diseases, including diabetes, hyperlipidemia and atherosclerosis. Also, anti-inflammation activity A. gigas may be beneficial for the treatment and prevention of asthma, atopic dermatitis and rheumatism arthritis. This relation could potentially lead to the development of herbal new drugs. In order to development a new drug containing decursin and decursinol angelate, it is also necessary to consider the safety profile, and the information in this review would contribute to development a new drug from herbal medicine.

The Literature Review of FibroMyalgia Syndrome (섬유근통 증후군에 대한 문헌고찰)

  • Kim Myung-Chul;Kim Jin-Sang
    • The Journal of Korean Physical Therapy
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    • v.16 no.4
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    • pp.23-37
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    • 2004
  • Fibromyalgia syndrome(FMS) is a chronic pain disorder of unknown etiology characterized by widespread musculoskeletal aches and pains, stiffness, and general fatigue, disturbed sleep and sleepiness. Frequently misdiagnosed, FMS is often confused with myofascial pain syndrome, polymyalgia rheumatica, polymyositis, hypothyroidism, metastatic carcinoma, rheumatoid arthritis (RA), juvenile rheumatoid arthritis, chronic fatigue syndrome, or systemic lupus erythematosus, any of which may occur concomitantly with FMS. The management of FMS often begins with a thorough examination and a diagnosis from a physician who is formally trained in tender-point/trigger-point recognition. An initial diagnosis provides reassurance to the patient and often reduces the anxiety and depression patterns associated with FMS. The most common goals in the management of FMS are (1) to break the pain cycle, (2) to restore sleep patterns, and (3) to increase functional activity levels. Because FMS is a multifactorial syndrome, it is likely that the best treatment will encompass multiple strategies. Medication with analgesics and antidepressants and also physiotherapy, are often prescribed and give some relief. The other most effective intervention for long-term management of FS to date is physical exercise. Physical therapists can instruct patients in the use of heat at home (moist hot packs, heating pads, whirlpools, warm showers or baths, and hot pads) to increase local blood flow and to decrease muscle spasm and tension. Also instruct patients in the proper use of cold modalities (ice packs, ice massage, and cool baths) to anesthetize localized areas of pain (tender points) and break the pain cycle. Massage and tender-point massage also may promote muscle relaxation. To date, the two most important interventions for the long-term management of FS are patient education and physical exercise. Lately, is handling FMS and Chronic Fatigue syndrome(CFS) together, becuase FMS and CFS are poorly understood disorders that share similar demographic and clinical characteristics. Because of the clinical similarities between both disorders it was suggested that they share a common pathophysiological mechanism, namely, central nervous system dysfunction.

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A Study on the Anorexia and Diet Patterns in Cancer Chemotherapy Patients (항암 화학요법을 받는 환자의 식욕부진 정도와 식이양상에 관한 연구)

  • Choi Eun-Sook;Kim Keum-Soon
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.2 no.1
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    • pp.19-35
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    • 1995
  • This study was designed to identify the severity of anorexia and the diet patterns in receiving chemotherapy. The identification of anorexia would provide useful and basic information to oncology nursing care. The subjects of this study were 102 hospitalized chemotherapy patients in a September 10, 1994. The subjects were 20 years old or above and who agreed to participate in this study and could understand the questionnaire. Three-days diet history were collected and analysed. The study subjects change, food aversions, the severity of anorexia. Data related to demographic and other mecdical characteristics such as age, diagnosis, and medication were collected by review of patient medical record. The results of this study were summarized as follows : 1) The score of anorexia was 73.7 in Anorexia Visual Analogue Scales and mean amount of fool intake per a day was 823cc. The larger the anorexia VAS score, the more severe of anorexia. 2) The food preferences of subjects were identified. Those were aversions, or dislikes the meat such as beef, pork, and chicken, and greesy or fried foods. The Caffeinated drinks such as coffee and tea were disgusted, also. The patients preferred vegetables and Korean traditional food especially kimchee and soy bean soap. 3) Those who were administered analgesics and cisplatin suffered more severe in anorexia than those who analgesics and cisplatin was not administarted. The patients with gastrointestinal cancer has more severe anorexia than those who have the other site cancer ; head and neck, genirourinary etc. The result of this study in turn provide valuable nursing practice guidelines for nutritional counseling in cancer chemotherapy patient. Nurses working with chemotherapy ward should identify the severity of anorexia and diet patterns. In conclusion, the severity of anorexia in cancer chemotherapy patients is very important problems. Health care personnels recognize the potential problems of anorexia and encourage the nutritional counseling in cancer chemotherapy patients.

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Public Perception and Routes of Acquiring Information on Drug Safety (소비자의 의약품안전성 인식정도 및 관련정보 획득경로)

  • Ji, Eun-Hee;Kim, Su-Kyeong;Oh, Jung-Mi;Lee, Suk-Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.4
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    • pp.311-318
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    • 2011
  • Misinformation and inappropriate use of medication has become one of the most pressing concerns in drug safety. The purpose of this study was to survey public perception on drug safety as well as the channels most relied upon providing such information. The survey was performed for patients or their families visiting pharmacies in a local city in Korea. Analysis was performed from 367 respondents to the survey. The contents of this survey revealed that consumers were aware of the fact that medications should not be taken at any higher dosage or more often than directed by their prescriptions. The survey revealed a general awareness that symptoms might not be relieved immediately by their medications. However, the perception that there could be adverse drug reaction (ADR) at therapeutic dose was low except among the young or highly educated members. Respondents recognized that skin rashes were the most whereas drowsiness was the least common ADR symptom. There was a high awareness of drug-food or drug-drug interactions except in the case of certain nutraceuticals. Doctors and pharmacists were ranked as the most reliable resources to the consumer for providing drug related information. However, public relations or education programs were in need since there were still not negligible numbers of consumers depending on personal experience rather than health professionals.