• Title/Summary/Keyword: patient care management

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Prevalence and Related Factors of Clonorchis Sinensis for High Risk Population in the Han Riverside Area (한강 유역 간흡충 고위험군의 감염과 관련요인)

  • Kim, Hee-Gerl;Kang, Hee-Kyoung;So, Ae-Young;Kim, Young-Si;Park, Jeong-In;Han, Eun-Hyae;Tak, Kyung-Sook;Lee, Sun-Hee;Kim, Jin-Soon;Han, Myung-Ja;Cha, Sun-Sook;Sung, Myung-Soon;Choi, Sun-Ja
    • Journal of Korean Academy of Rural Health Nursing
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    • v.4 no.1
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    • pp.13-21
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    • 2009
  • Purpose: This study was done to investigate the prevalence and related factors of Clonorchis Sinensis for inhabitants of the Han riverside area and to identify knowledge related to Clonorchis Sinensis and intended behavioral changes to decrease risk of infection. Method: The data were collected from December 16, 2008 to January 10, 2009. Participants were 555 people who responded to a questionnaire. Frequency, percentage, $X^2$-test, and t-test were used to analyze the data. Results: The prevalence of Clonorchis Sinensis was 7.9% in this population. Related factors for Clonorchis Sinensis were gender (male=10.8%, female=3.6%, p=0.002) and smoking (p=0.007). but habits related to ingestion of alcohol and raw fish were not significant. As for knowledge of Clonorchis Sinensis, the Clonorchiasis group had a mean score of 10.09 $({\pm}3.95)$ of a possible 17 compared to a score of only 8.27$({\pm}4.60)$ for the negative group (p=0.011). The intended behavioral change related to risk of infection, according to presence of infection or not, was significant (p=0.004). Conclusion: These results suggest that Clonorchiasis is still highly endemic in all risk areas such as the Han riverside, indicating that it is necessary to set up effective management programs for patient care and prevention of Clonorchis Sinensis.

Oxaliplatin-induced Peripheral Neuropathy in Patients with Advanced or Metastatic Gastric Cancer (진행성 또는 전이성 위암 환자에 있어서 Oxaliplatin 투여로 인한 말초신경통증 분석)

  • Park, Ae-Ryoung;Kim, Soon-Joo;Bang, Joon-Seok;La, Hyen-Oh
    • Korean Journal of Clinical Pharmacy
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    • v.19 no.1
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    • pp.18-22
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    • 2009
  • Oxaliplatin is a tolerable and effective drug of choice in the treatment of advanced or metastatic gastric cancer. However, it has many dose-limiting neurotoxicities. This study was performed to assess the incidence and types of oxaliplatin-related neurotoxicities. Sixty-four patients receiving oxaliplatin-involved regimen as salvage therapy on metastatic gastric cancer or as the first-line therapy on advanced gastric cancer were evaluated during the period between September 1, 2006 and February 29, 2008. The patients were treated with oxaliplatin 100 $mg/m^2$ and leucovorin 100 $mg/m^2$ simultaneously as 2-hour-lasting infusion on Day-1 followed by 5-FU 1200 $mg/m^2$ as a 22-hour-lasting continuous infusion both on Day-1 and Day-2 by every other week. We developed questionnaires to evaluate patient-recognized neurotoxic symptoms rather than the observer-described events. Surveys were completed at bedside or via telephone interview. Acute and chronic neurotoxicities were graded according to the National Cancer Institute Common Toxicity Criteria (NCI-CTC, version 3) as well as the Oxaliplatin-specific Neurotoxicity Scale. The Grade-3 neuropathy was reported in 19% of the patients (n=12) and grade-1/2 neuropathy occurred in 70% (n=45). The most common symptom was cold-related dysesthesia (83%) regarded as nociperception by the patients. Some patients (19%) experienced functional impairment affecting activities of daily living such as writing, buttoning, and walking. Even though 74% of the patients (42/57) were prescribed with gabapentin to reduce these peripheral symptoms, it did not appear to derive any benefit from this medication. It is suggested that notify the patients about their oxaliplatin-associated, debilitating symptoms, and educate them any self-care strategy at the initiating phase of the chemotherapy. Moreover, it needs to design the intervention studies regarding the prevention and management of the peripheral neuropathy.

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The Utilization of Aromatherapy in Clinical Physical Therapy (임상물리치료에 있어서 아로마테라피의 활용)

  • Chang Chung-Hoon;Jeong Dong-Hyuk;Park Rae-Joon
    • The Journal of Korean Physical Therapy
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    • v.15 no.1
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    • pp.82-95
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    • 2003
  • Our health is intimately connected to the health of our environment. The contemporary world view which sees a radical distinction between humans as subjects and world as object can obscure our recognition of how much we rely on nature for health and survival. Indigenous traditions and contemporary scholars remind us that we live in a universe in which all things are connected, and in which nature continues to offer its gifts in co-creative partnership for the health and wellbeing of all. Living in awareness of our relationship with nature enables us to open more to the experience of nature's nurturing. Many complementary therapies derive from ancient practices that involve nature in healing partnership. Essential oils have been used for thousands of years. Hippocrates claimed that the way to health was through aromatic baths and massages. Much anecdotal evidence exists regarding aromatherapeutic positive effects on recipients. Aromatherapy is a branch of complementary or alternative therapy which is increasing in popularity, yet has scant scientific credibility. Aromatherapy should be defined as treatment using odors and practised as such. However, essential oils are usually used in conjunction with therapeutic massage and often combined with counselling of some kind. Aromatherapy complements and enhances the therapeutic powers of massage. Massage is one of the most wonderful ways to relax and is throughly beneficial to health. Massage can help unknot tense and aching muscles and other minor symptoms of stress, leaving patients fresh and energized. As the use of aromatherapy within a health care setting has grown so rapidly in recent years, and will continue to do so, the need for suitable training has become apparent. No health service can afford the risk of having staff who are inadequately trained in the practice of aromatherapy using essential oils incorrectly on those in a state of ill-health, especially if the essential oils used are not to a standard suitable for therapeutic use. Training to an acceptable level in aromatic therapy is essential for safety and effectiveness. Knowledge of the nature and make-up of essential oils, their effect on the body and the emotions, and how, when, and where to apply them is imperative in order for them to be beneficial to a patient's health. In order to achieve best practice, further research is necessary to explore the use of aromatherapy in the management of multiple disorder.

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Descending Necrotizing Mediastinitis : The Retrospective Review of Surgical Management (하행 괴사성 종격동염 : 외과적 치료의 후향적 조사)

  • 이재진;신호승;신윤철;지현근;이원진;홍기우
    • Journal of Chest Surgery
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    • v.34 no.10
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    • pp.769-774
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    • 2001
  • Background: Descending necrotizing mediastinitis(DNM) is a serious complication originating in odontogenic or oropharyngeal infection with previously reported mortality rates of 25% to 40%. We retrospectively reviewed the 4 years of our surgical drainage and debridement in DNM. Material and Method: We studied 7 cases diagnosed as DNM from 1997 through 2000. Primary oropharyngeal infection lead to DNM in four cases(57%) and odontogenic abscess in three cases(43%). All patients were received emergent cervicotomy and thoracotomy or sternotomy for debridement of necrotic tissue and mediastinal or pleural drainage. Result: Five cases were evolved well and were discharged after a mean of 42 days. Two patients(28.6%) died. Three patients required reoperation due to local surgical complication; empyema(two) and impending cardiac tamponade. One of these patients died on 12 post-reoperative day due to great vessel erosion, renal and respiratory insufficiency. The other patient died of broncho- esophageal fistula and asphyxia on 10 postoperative day without reoperation. Conclusion: On the basis of experience accrued in treating these patients, early diagnosis by cervicothoracic computed tomographic scan of neck and thorax aids in rapid indication of a surgical approach of DNM. We emphasize that performing early surgical drainage and debridement of necrotic tissues with intensive postoperative care can significantly reduce the mortality rate.

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Pectus Excavatum and Pectus Carinatum: Associated Conditions, Family History, and Postoperative Patient Satisfaction

  • Kuru, Pinar;Cakiroglu, Aylin;Er, Aynur;Ozbakir, Hincal;Cinel, Ali Emin;Cangut, Busra;Iris, Merve;Canbaz, Berkay;Picak, Ebru;Yuksel, Mustafa
    • Journal of Chest Surgery
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    • v.49 no.1
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    • pp.29-34
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    • 2016
  • Background: Pectus excavatum (PE) and pectus carinatum (PC) are the most common chest wall deformities. In this study, we aimed to characterize how patients obtained information about these deformities, as well as patients' family history, associated medical problems, and postoperative satisfaction after the Nuss and Abramson procedures. Methods: This cross-sectional retrospective study included patients who were operated by a single surgeon between 2006 and 2013. Follow-up calls were made after approval of our institution's ethics committee. We reached 207 of the 336 PE patients (61.6%) and 73 of the 96 PC patients (76%). Results: The majority of the patients were male (85% of the PE patients and 91.8% of the PC patients). The age of diagnosis of PE was $14.52{\pm}0.51years$ and the age at the time of operation was $17.89{\pm}0.42years$; for PC patients, the corresponding ages were $15.23{\pm}0.55years$ and $16.77{\pm}0.55years$, respectively. A total of 70% of the PE patients and 63.8% of the PC patients obtained information about pectus deformities through the Internet. In 27.1% of the PE patients with an associated anomaly, 57.1% (n=13) had scoliosis, while 41.1% of the PC patients with an associated anomaly had kyphosis (n=5). Postoperative satisfaction, as evaluated on a scale from 0 to 10, was $8.17{\pm}0.15$ for PE patients and $8.37{\pm}0.26$ for PC patients. The postoperative pain duration was $51.93{\pm}5.18days$ for PE patients and $38.5{\pm}6.88days$ for PC patients. Conclusion: In this study, we found that most patients with pectus deformities were male. The Internet was an important resource for patients to learn about their deformities. Family history and associated anomalies were identified as important aspects for consideration in the clinical setting. The patients reported high levels of postoperative satisfaction, and pain management was found to be one of the most important elements of postoperative care.

Pelvic Symphyseal Distraction Osteotomy for Constipation Management Secondary to Pelvic Stenosis (골반강 협착증으로 인해 발생한 변비를 가진 고양이에서의 골반강 확장술을 이용한 치료 증례)

  • Oh, Kwang-Seon;Choi, Sung-Jin;Kim, Nam-Soo;Kim, Min-Su;Lee, Ki-Chang;Lee, Hae-Beom
    • Journal of Veterinary Clinics
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    • v.31 no.6
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    • pp.527-530
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    • 2014
  • A 7-year-old neutered male Korean domestic short-haired cat was referred to our clinic to treat constipation which had persisted for 6 months. The rectal examination revealed narrowing of the right lateral portion of the pelvic canal. A reduced pelvic canal diameter by pelvic fracture malunion was revealed on radiography. The pelvic canal diameter ratio measured from preoperative was 0.68. Based on rectal and radiographic examinations, constipation caused by pelvic canal narrowing was confirmed. Pelvic symphyseal distraction-osteotomy and iliac wedge osteotomy were performed. An iliac osteotomy of the ilium was performed to ease the pelvic symphyseal distraction. After the symphysis was split longitudinally, pelvic symphyseal distraction was maintained by using a spacer made of poly-methyl-methacrylate. The osteotomy of the ilium was fixed using a bone plate and screws. Increased pelvic canal diameter was confirmed on post-operative radiography and the postoperative pelvic canal diameter ratio was 0.91. The patient received antibiotics, NSAIDs, crystalloids and Lactulose for post-operative care. The cat recovered normal defecation abilities and did not have constipation at one week postoperatively. No episodes of constipation persisting longer than 6 months have been reported by owners in previous studies. Pelvic symphyseal distraction osteotomy and iliac wedge osteotomy may prove to be a useful surgical procedure to treat pelvic canal stenosis that is caused by pelvic fracture malunion.

Study on the Epidemiological Features of Lyme Disease in Korea between 2011 and 2018 (2011~2018년 라임병의 역학적 특성 연구)

  • Seo, Choong Won
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.4
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    • pp.436-443
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    • 2019
  • Lyme disease is a national notifiable infectious disease as of September 2018. The number of cases of Lyme disease has recently been increasing. This study analyzed the epidemiological features and clinical symptoms of domestic and imported. From 2011 to December 31, 2018, of the 119 cases, 48 confirmed cases, 63 probable cases, and 8 suspected cases. 70 cases (58.8%) were reported in Korea and 49 cases (41.2%) of imported. In addition, 91 cases (76.5%) were reported during the summer~autumn season (June~November). In 2017, the highest number of 31 cases. The time needed to make a diagnosis was 2.8±14.7 days for domestic occurrences versus 1.4±4.5 days for those cases that infection occurred imported. Among the clinical symptoms, fever and rash were statistically significant (P<0.001). Clinical trials included early localized 31 cases (52.1%), early disseminated 43 cases (35.3%), and late disseminated 15 cases (12.6%). The estimated regions of infection in Korea were Chungnam 12 cases (17.1%), Gyeonggi 12 cases (17.1%), and Gangwon 8 cases (11.4%), Patient care is also considered to be very important as this disease occurs of all ages. Therefore, the promotion of preventive education and identification of epidemiological features are of paramount importance and should be implemented. The study's findings can be used as basic data for the prevention and management of patients with lyme disease.

The Necessity of Redefining the Radiological Technologist Independent Law (방사선사법 제정의 필요성)

  • Lim, Woo-Taek;Lim, Cheong-Hwan;Joo, Young-Cheol;Hong, Dong-Hee;Jung, Hong-Ryang;Jung, Young-Jin;Choi, Ji-Won;Yoon, Yong-Su;Kim, Eun-Hye;Yoo, Se-Jong;Park, Myeong-Hwan;Yang, Oh-Nam;Jeong, Bong-Jae
    • Journal of radiological science and technology
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    • v.44 no.5
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    • pp.545-554
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    • 2021
  • According to the changes of the medical environment of the times, it is necessary to discuss the issues of the doctor's medical guidance and to conduct continuous research so that alternatives can be prepared systematically. Furthermore, in order to enhance the professionalism of radiological technologists and to develop the medical technician system, the new Radiological Technologist Independent Act has been established, which contains the overall contents of the scope of work, professional qualifications, and specialized education of radiological technologists, and provides quality medical services to patients through professional procedures and treatment. In order to increase the level of medical care, the purpose, definition, mission, role, and scope of work specified in the Medical Act, Medical Service Technologists, etc. Act, the Enforcement Decree, and the Enforcement Rules were variously analyzed and new directions were presented. First, the definition of a medical technician should use a generic term so that the factors of conflict and prejudice could be resolved. Second, change the doctor's guide to doctor's prescription; and then legislate the authority to sign and write medical records after examination by radiological technologists, thereby prohibiting unlicensed technicians that seriously endanger patient safety. Third, an accurate definition of radiological technologists' roles should be established; not only selection and management of radiological technologists' work but also procedures and treatment for each radiology field should be specified to suit the current medical system. Fourth, a professional radiological technologists' qualification system and a specialized education system should be established in order to secure human resources that could provide patients trust in procedures and treatment based on professional knowledge and experience in the field of radiology. Fifth, the Education and Evaluation Institute should be operated in Korea education system to educate the professional knowledge and competency for students. In addition, it is necessary to in-depth analysis of foreign cases could be applied to the medical system and education system in Korea; it could strive to nurture systematic human resources.

Korean physicians' attitudes toward the prenatal screening for fetal aneuploidy and implementation of non-invasive prenatal testing with cell-free fetal DNA

  • Kim, Soo Hyun;Kim, Kun Woo;Han, You Jung;Lee, Seung Mi;Lee, Mi-Young;Shim, Jae-Yoon;Cho, Geum Joon;Lee, Joon Ho;Oh, Soo-young;Kwon, Han-Sung;Cha, Dong Hyun;Ryu, Hyun Mee
    • Journal of Genetic Medicine
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    • v.15 no.2
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    • pp.72-78
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    • 2018
  • Purpose: Physicians' attitudes may have a strong influence on women's decision regarding prenatal screening options. The aim of this study is to assess the physicians' attitudes toward prenatal screening for fetal aneuploidy including non-invasive prenatal testing (NIPT) in South Korea. Materials and Methods: Questionnaires were distributed and collected at several obstetrics-gynecological conferences and meetings. The questionnaire included 31 multiple choice and 5 fill-in-the-blank questions. Seven questions requested physicians' demographic information, 17 questions requested information about the NIPT with cell-free fetal DNA, and 12 questions requested information about general prenatal screening practices. Results: Of the 203 obstetricians that completed the survey. In contrast with professional guidelines recommending the universal offering of aneuploidy screening, only 53.7% answered that prenatal aneuploidy testing (screening and/or invasive diagnostic testing) should be offered to all pregnant women. Physicians tended to have positive attitudes toward the clinical application of NIPT as both primary and secondary screening methods for patients at high-risk for fetal trisomy. However, for patients at average-risk for fetal trisomy, physicians tended to have positive attitudes only as a secondary screening method. Physicians with more knowledge about NIPT were found to tend to inform their patients that the detection rate of NIPT is higher. Conclusion: This is the first study to investigate expert opinion on prenatal screening in South Korea. Education of physicians is essential to ensure responsible patient counseling, informed consent, and appropriate management after NIPT.

Traumatic Experiences and Posttraumatic Growth of Nursing Students who were in the Clinical Training (간호학생의 임상실습에서의 외상 경험과 외상후 성장)

  • Sung, Kyung Mi;Park, Sun Ah;Oh, Eun Jin;Lee, Seung Min;Lee, Se-Young
    • Journal of Digital Convergence
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    • v.16 no.12
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    • pp.489-503
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    • 2018
  • The purpose of this study was to explore traumatic experiences and posttraumatic growth of nursing students who were in clinical training. The data were collected from 490 nursing students at four nursing colleges with clinical training experience more than 1 year, from November 20th 2017 to December 20th. Collected data were analyzed through t-test, ANOVA, and $Scheff{\acute{e}}$ test with the SPSS/WIN 25.0 program, and qualitative data were analyzed by content analysis. 26.5% of the subjects had traumatic experiences in their daily life, 61.2% in the clinical practice. Their posttraumatic growth was scored 2.63 out of 5 on average. The contents of traumatic experiences were 'Violence experienced by medical staff','Negative perception of nursing care','Non-Educational Practical Environment' Clinical practice in a harsh environment, Witness of a serious patient, et al. The findings can be used as important basic data for the development of nursing practice education program for encouraging the posttraumatic growth of nursing students.