• 제목/요약/키워드: multiple medications

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스마트 약물 복용 관리 앱 개발 (Development of Smart Medicine Management Application)

  • 이동현;박예진;황석순;이상용
    • 디지털융복합연구
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    • 제19권3호
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    • pp.313-318
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    • 2021
  • 질병의 치료를 위해서는 약을 정시에 정량 복용해야 할 필요가 있으나 다수의 사람들이 약의 복용 시간을 어기거나 잊어버리는 경우가 빈번하게 발생한다. 이러한 문제점을 정보기술을 이용하여 해결하기 위한 앱이 등장하고 있다. 그러나 기존의 앱의 경우, 복용 알림 기능만 제공하거나 사용자 인터페이스가 불평하고, 복용 약의 사진 등록 등이 불가능하여 사용하기 어렵다. 이러한 문제점을 해결하기 위하여 본 연구에서는 복용 알림뿐만 아니라 복용 루틴 설정, 복용여부 확인, 병원 및 약국 검색, 사용자가 복용하고 있는 약의 이미지 첨부가 가능한 스마트 약물 복용 관리 앱을 개발하였다. 본 앱을 통하여 복용 시간을 잊어버리는 빈도를 낮추고, 실제 이미지를 통한 복용 약의 확인을 통한 정확한 투약이 가능하다. 또한 복용 주기가 다른 여러 개의 약을 복용할 경우, 이를 지원하기 위한 복용 루틴 설정도 지원하고 있다. 그리고 현재 위치에서 가까운 병원 및 약국에 대한 정보를 제공하여 병원, 약국에 대한 접근성을 높일 수 있다.

A Dilute-and-Shoot LC-MS/MS Method for Screening of 43 Cardiovascular Drugs in Human Urine

  • Pham, Thuy-Vy;Lee, Gunhee;Mai, Xuan-Lan;Le, Thi-Anh-Tuyet;Nguyen, Thi Ngoc Van;Hong, Jongki;Kim, Kyeong Ho
    • Mass Spectrometry Letters
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    • 제12권1호
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    • pp.1-10
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    • 2021
  • A simple, specific, and economical LC-MS/MS method was investigated for the screening of 43 prescribed antihypertensive and related drugs in human urine. The urine samples were simply prepared by diluting and mixing with internal standard before directly introduced to the LC-MS/MS system, which is fast, straightforward, and cost-effective. Fractional factorial, Box-Behnken, and I-optimal design were applied to screen and optimize the mass spectrometric and chromatographic factors. The analysis was carried out on a triple quadrupole mass spectrometer system utilizing multiple reaction monitoring with positive and negative electrospray ionization method. Chromatographic separation was performed on a Thermo Scientific Accucore RP-MS column (50 × 3.0 mm ID., 2.6 ㎛) using two separate gradient elution programs established with the same mobile phases. Chromatographic separation was performed within 12 min. The optimal method was validated based on FDA guideline. The results indicated that the assay was specific, reproducible, and sensitive with the limit of detection from 0.1 to 50.0 ㎍/L. The method was linear for all analytes with coefficient of determination ranging from 0.9870 to 0.9981. The intra-assay precision was from 1.44 to 19.87% and the inter-assay precision was between 2.69 and 18.54% with the recovery rate ranges from 84.54 to 119.78% for all drugs measured. All analytes in urine samples were stable for 24 h at 25℃, and for 2 weeks at -60℃. The developed method improves on currently existing methods by including larger number of cardiovascular medications and better sensitivity of 12 analytes.

Implication of microRNA as a potential biomarker of myocarditis

  • Oh, Jin-Hee;Kim, Gi Beom;Seok, Heeyoung
    • Clinical and Experimental Pediatrics
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    • 제65권5호
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    • pp.230-238
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    • 2022
  • Myocarditis was previously attributed to an epidemic viral infection. Additional harmful reagents, in addition to viruses, play a role in its etiology. Coronavirus disease 2019 (COVID-19) vaccine-induced myocarditis has recently been described, drawing attention to vaccine-induced myocarditis in children and adolescents. Its pathology is based on a series of complex immune responses, including initial innate immune responses in response to viral entry, adaptive immune responses leading to the development of antigen-specific antibodies, and autoimmune responses to cellular injury caused by cardiomyocyte rupture that releases antigens. Chronic inflammation and fibrosis in the myocardium eventually result in cardiac failure. Recent advancements in molecular biology have remarkably increased our understanding of myocarditis. In particular, microRNAs (miRNAs) are a hot topic in terms of the role of new biomarkers and the pathophysiology of myocarditis. Myocarditis has been linked with microRNA-221/222 (miR-221/222), miR-155, miR-10a*, and miR-590. Despite the lack of clinical trials of miRNA intervention in myocarditis yet, multiple clinical trials of miRNAs in other cardiac diseases have been aggressively conducted to help pave the way for future research, which is bolstered by the success of recently U.S. Food and Drug Administration-approved small-RNA medications. This review presents basic information and recent research that focuses on myocarditis and related miRNAs as a potential novel biomarker and the therapeutics.

외래 급성 방광염 환자에서 잠재적으로 불필요한 위장약 사용 (Potentially Unnecessary Gastrointestinal Drug Use in Patients with Acute Cystitis)

  • 김태연;전송현;제남경
    • 한국임상약학회지
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    • 제33권1호
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    • pp.8-21
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    • 2023
  • Background: Gastrointestinal (GI) drugs are often co-prescribed with other medications to prevent GI complications. This study aimed to evaluate the prescribing pattern of potentially unnecessary GI drugs in patients with acute cystitis who were prescribed oral antibiotics and investigate the influencing factors affecting this. Methods: We identified female patients ≥20 years with acute cystitis who visited the outpatient clinic and were prescribed oral antibiotics between July and December by analyzing Health Insurance Review and Assessment Service (HIRA)-National Patients Sample (NPS)-2019 data. Patients with no prior history of GI disorders within 180 days prior to acute cystitis, excluding or including the date of diagnosis of acute cystitis, were selected (Group A and B). Multiple logistic regression analysis was performed to estimate the factors affecting the prescription of potentially unnecessary GI drugs. Results: A total of 1,544 in Group A and 552 patients in Group B were included for the final analysis. Potentially unnecessary GI drugs were prescribed in 1,176 patients in Group A (76.2%) and 231 patients in Group B (41.8%). Third generation cephalosporines and sulfonamides showed the lower odds ratio for prescribing GI drugs than penicillins. Prescribers from Urology clinics showed more than twice odds ratio for the prescription of GI drugs compared to prescribers from internal medicine clinics. Conclusion: The results of this study showed that potentially unnecessary GI drug prescriptions for patients with acute cystitis were high in South Korea. The positive risk factors affecting the prescription of unnecessary GIs were not patient-related factor but healthcare facility and prescriber-related factors.

The Outcome of Long QT Syndrome, a Korean Single Center Study

  • Kyung Jin Ahn;Mi Kyoung Song;Sang Yun Lee;Ja Kyoung Yoon;Gi Beom Kim;Seil Oh;Eun Jung Bae
    • Korean Circulation Journal
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    • 제52권10호
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    • pp.771-781
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    • 2022
  • Background and Objectives: Although long QT syndrome (LQTS) is a potentially life-threatening inherited cardiac channelopathy, studies documenting the long-term clinical data of Korean patients with LQTS are scarce. Methods: This retrospective cohort study included 105 patients with LQTS (48 women; 45.7%) from a single tertiary center. The clinical outcomes were analyzed for the rate of freedom from breakthrough cardiac events (BCEs), additional treatment needed, and death. Results: LQTS was diagnosed at a median age of 11 (range, 0.003-80) years. Genetic testing was performed on 90 patients (yield, 71.1%). The proportions of genetically confirmed patients with LQTS types 1, 2, 3, and others were 34.4%, 12.2%, 12.2%, and 12.2%, respectively. In the symptomatic group (n=70), aborted cardiac arrest was observed in 30% of the patients. Treatments included medications in 60 patients (85.7%), implantable cardioverter-defibrillators in 27 (38.6%; median age, 17 years; range, 2-79 years), and left cardiac sympathetic denervation surgery in 7 (10%; median age, 13 years; range, 2-34). The 10-year BCE-free survival rate was 73.2%. By genotype, significant differences were observed in BCEs despite medication (p<0.001). The 10-year BCE-free survival rate was the highest in patients with LQTS type 1 (81.8%) and the lowest in those with multiple LQTS-associated mutations (LQTM). All patients with LQTS survived, except for one patient who had LQTM. Conclusions: Good long-term outcomes can be achieved by using recently developed genetically tailored management strategies for patients with LQTS.

노인의 낙상에 영향을 미치는 요인 : 2014년 노인실태조사를 중심으로 (Factors Associated with Falls in the Elderly : Based on 2014 the Korean Elderly Survey)

  • 김민주
    • 한국콘텐츠학회논문지
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    • 제17권6호
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    • pp.479-489
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    • 2017
  • 본 연구는 2014년 노인실태조사를 이용하여 노인의 낙상에 영향을 미치는 요인을 파악하기 위해 실시된 서술적 조사연구이다. 연구대상자는 2014년 노인실태조사에 참여한 노인 중 주요 변수에 결측치가 없는 10,272명의 노인이다. 인구사회학적 특성, 건강관련 특성(주관적 건강상태, 만성질환 수, 복용 중인 약물의 수, 운동 일수, 시력 이상, 근력 상태, ADL, IADL, 인지기능, 낙상에 대한 두려움)을 조사하였다. 수집된 자료는 SPSS ver. 23.0의 복합표본분석을 이용하여 분석하였다. 노인의 낙상은 인구사회학적 특성, 건강 관련 특성에 따라 차이가 있었다(p<.001). 다중로지스틱회귀분석 결과, 연령(OR=1.262, 95%CI 1.111-1.433), 교육수준(OR=0.846, 95%CI 0.764-0.937), 주관적 건강상태(OR=1.172, 95% CI 1.041-1.320; OR=1.422, 95%CI 1.289-1.570), 만성질환 수(OR=1.438, 95%CI 1.050-1.968), 복용 중인 약물의 수(OR=0.798, 95%CI 0.659-0.967), 하지근력상태(OR=1.260, 95%CI 1.101-1.441) 및 낙상에 대한 두려움(OR=3.576, 95%CI 3.166-4.039; OR=14.236, 95%CI 12.637-16.038)이 노인의 낙상에 영향을 미치는 주요 요인으로 확인되었다(p<.05). 따라서 다양한 대상자의 특성을 고려한 낙상 예방 프로그램을 개발하여 집중적인 관리가 필요하다.

전방 슬관절 동통 증후군 및 경부목 (Anterior Knee Pain Syndrome & Shin Splint)

  • 김영진;전철홍;이지완;추지웅
    • 대한정형외과스포츠의학회지
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    • 제9권1호
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    • pp.7-15
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    • 2010
  • 전방 슬관절 동통 증후군은 여러 가지 형태의 다양한 원인으로 서서히 양측 슬개-대퇴 관절 내 또는 주위에 동통을 야기하는 증상이다. 원인으로는 하지의 부적절한 생역학, 전체적인 신전 기전의 병변, 슬개-대퇴 관절 병변, 슬개골 자체의 병변 또는 부정정렬, 단단한 연부조직, 약화된 근육 등이며, 전방 슬관절 동통 증후군을 평가하기 위해서는 슬개골 정열의 측정이 필요하고 현재 이학적 검사 및 방사선 검사 등 다양한 방법이 사용되어 진단 및 치료 정도를 평가하는데 사용되고 있다. 치료는 슬관절 전방 통증의 원인에 따라 결정되며, 주로 수술적 치료보다는 약물 치료나 대퇴사두근 근력 강화 운동, 함스트링 스트레칭운동 등이 보편적으로 사용되고 있다. 경부목 또는 내측 경골 스트레스 증후군은 전내측 경골 원위 2/3 부위에서 발생되는 통증을 의미하며, 반복적이고 조화되지 않는 충격이 하퇴부에 가해지는 스포츠를 하는 체육인에게 흔히 발생된다. 문제의 원인을 정확히 파악하여 진단하는 것이 치료에 매우 중요하며, 따라서 원인, 치료, 재활 및 예방까지 여러 이론이 보고되었다. 치료는 통증이 심할 경우 휴식과 함께 얼음찜질을 실시하며, 진통제를 복용하여 통증을 완화시켜 주는 것이 좋으며, 또한 다리 근육을 강화시켜 줄 수 있는 운동을 하며, 적절한 재활과 예방적 처치가 추후 재발을 방지하는 데 도움이 된다.

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Effects of Atomoxetine on Hyper-Locomotive Activity of the Prenatally Valproate-Exposed Rat Offspring

  • Choi, Chang Soon;Hong, Minha;Kim, Ki Chan;Kim, Ji-Woon;Yang, Sung Min;Seung, Hana;Ko, Mee Jung;Choi, Dong-Hee;You, Jueng Soo;Shin, Chan Young;Bahn, Geon Ho
    • Biomolecules & Therapeutics
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    • 제22권5호
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    • pp.406-413
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    • 2014
  • to valproic acid (VPA) during pregnancy produces ASD-like core behavioral phenotypes as well as hyperactivity in offspring both in human and experimental animals, which makes it a plausible model to study ASD-related neurobiological processes. In this study, we examined the effects of two of currently available attention defecit hyperactivity disorder (ADHD) medications, methylphenidate (MPH) and atomoxetine (ATX) targeting dopamine and norepinephrine transporters (DAT and NET), respectively, on hyperactive behavior of prenatally VPA-exposed rat offspring. In the prefrontal cortex of VPA exposed rat offspring, both mRNA and protein expression of DAT was increased as compared with control. VPA function as a histone deacetylase inhibitor (HDACi) and chromatin immunoprecipitation experiments demonstrated that the acetylation of histone bound to DAT gene promoter was increased in VPA-exposed rat offspring suggesting epigenetic mechanism of DAT regulation. Similarly, the expression of NET was increased, possibly via increased histone acetylation in prefrontal cortex of VPA-exposed rat offspring. When we treated the VPA-exposed rat offspring with ATX, a NET selective inhibitor, hyperactivity was reversed to control level. In contrast, MPH that inhibits both DAT and NET, did not produce inhibitory effects against hyperactivity. The results suggest that NET abnormalities may underlie the hyperactive phenotype in VPA animal model of ASD. Profiling the pharmacological responsiveness as well as investigating underlying mechanism in multiple models of ASD and ADHD may provide more insights into the neurobiological correlates regulating the behavioral abnormalities.

한국어판 HIV 감염인의 건강관리 자기효능감 도구의 타당도와 신뢰도 (Psychometric Properties of the Korean Version of Self-Efficacy for HIV Disease Management Skills)

  • 김광숙;김라영;심미소;백서영;김남희;박민경;이영진
    • 대한간호학회지
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    • 제53권3호
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    • pp.295-308
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    • 2023
  • Purpose: This study evaluated the validity and reliability of Shively and colleagues' self-efficacy for HIV disease management skills (HIV-SE) among Korean participants. Methods: The original HIV-SE questionnaire, comprising 34 items, was translated into Korean using a translation and back-translation process. To enhance clarity and eliminate redundancy, the author and expert committee engaged in multiple discussions and integrated two items with similar meanings into a single item. Further, four HIV nurse experts tested content validity. Survey data were collected from 227 individuals diagnosed with HIV from five Korean hospitals. Construct validity was verified through confirmatory factor analysis. Criterion validity was evaluated using Pearson's correlation coefficients with the new general self-efficacy scale. Internal consistency reliability and test-retest were examined for reliability. Results: The Korean version of HIV-SE (K-HIV-SE) comprises 33 items across six domains: "managing depression/mood," "managing medications," "managing symptoms," "communicating with a healthcare provider," "getting support/help," and "managing fatigue." The fitness of the modified model was acceptable (minimum value of the discrepancy function/degree of freedom = 2.49, root mean square error of approximation = .08, goodness-of-fit index = .76, adjusted goodness-of-fit index = .71, Tucker-Lewis index = .84, and comparative fit index = .86). The internal consistency reliability (Cronbach's α = .91) and test-retest reliability (intraclass correlation coefficient = .73) were good. The criterion validity of the K-HIV-SE was .59 (p < .001). Conclusion: This study suggests that the K-HIV-SE is useful for efficiently assessing self-efficacy for HIV disease management.

대학생의 호흡기감염 예방행위에 영향을 미치는 요인 (Factors Influencing the Respiratory Infection Preventive Behavior among College Students)

  • 이선희;유하나
    • 실천공학교육논문지
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    • 제15권2호
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    • pp.449-457
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    • 2023
  • 본 서술적 조사연구의 목적은 대학생의 호흡기감염 예방행위에 영향을 미치는 요인으로 건강신념과 호흡기 감염관리 자기효능감을 알아보고자 시도되었다. 대상자는 경상북도 K 시 일개 대학에 재학 중인 학생 178명으로 2020년 9월 1일부터 10월16일까지 구조화된 설문지로 자료를 수집하였다. 연구결과는 다음과 같다; 건강신념은 참여자의 성별(t=-2.86, p=.005), 전공계열(F=2.95, p=.034), 처방된 약물 복용 유무(t=2.18, p=.030)와 유의한 차이가 있었다. 호흡기 감염관리에 대한 자기효능감은 대학생의 성별(t=-3.56, p=<.001), 전공계열(F=4.59, p=.004)과 유의한 차이가 있었다. 건강신념(r=.276, p<.001)과 호흡기 감염관리에 대한 자기효능감(r=.195, p<.001)은 호흡기감염 예방행위에 정적 상관이 있었다. 다중회귀분석 결과 호흡기 감염관리에 대한 자기효능감(β=.66, p<.001)이 호흡기감염 예방 행동에 유의한 영향을 미치는 것으로 나타났고, 모형의 설명력은 43%로 나타났다. 따라서, 대학생의 호흡기감염을 예방하기 위한 행동을 촉진하기 위해서는 호흡기 감염관리에 대한 자기효능감을 강화할 수 있는 프로그램이 개발되어야 할 것이다.