• Title/Summary/Keyword: patient outcome

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Clinical Features and Long-Term Outcome in Adult Stroke Patient due to Moyamoya Disease : A Single Subject Study

  • Kwon, Yong Hyun;Kim, Chung Sun
    • The Journal of Korean Physical Therapy
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    • v.25 no.3
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    • pp.126-131
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    • 2013
  • This case report described a single case of adult stoke patient due to Moyamoya disease through long-term follow-up observation, which included his demographics, brain images, and change of motor function and functional activities. The subject was the 54-year-old male diagnosed with left hemiparesis from a stroke due to multifocal encephalomalacia in both hemispheres. At the time of the stroke attack, he took brain surgery intervention including external ventricular drain. Physical and occupational therapy for stroke rehabilitation were admitted including muscle strengthening exercises, functional activity/ADL training, neurofacilitative techniques with bobath or proprioceptive neuromuscular facilitation concepts, and compensatory strategy. Patient's MRI showed that right frontal lobe, right peri-ventricular area, left parietal, and left occipital lobes were damaged, and MRA showed that abnormal collateral vessel was richly developed in both hemispheres by occlusion of proximal internal carotid arteries in both sides. His motor strength was improved from poor to good grade in all of upper and lower limb motions, that MBC was improved from stage 1 to stage 5. In FAC and barthel index, at the initial evaluation, he could not perform any functional movement, but his FAC and barthel index were on 3 and 14 points at present, respectively. During long-term follow-up for approximately 4 years, the subject's functional motor ability was improved, as similar with recovery progression of usual stroke patient. We believe that this single case report will provide clinical information and concern regarding Moyamoya disease with physical therapist, in terms of such as epidemiology, pathogenesis, diagnostic procedures, clinical features, recovery process, and prognosis.

Diagnosis and Treatment Planning in Severely Worn Dentition (심한 교모증 환자에서의 진단 및 치료계획 수립)

  • Jung, Jae-Hyun;Choi, Min-Ho;Park, Young-Rok
    • Journal of Dental Rehabilitation and Applied Science
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    • v.19 no.3
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    • pp.239-245
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    • 2003
  • The occurrence and pattern of tooth wear are related to cultural, dietary, occupational, and geographic factors, Excessive occlusal wear can result in pulpal exposure, occlusal disharmony, functional inability. Surface loss can be differentiated into 3 general causal categories: i) mechanical loss, which includes attrition, ii) abrasion chemical loss including erosion, and finally iii) a proposed biomechanical category described as abfraction. Considering that mechanical wear is frequently asymptomatic, patients may have parafunctional habit. Structured clinical decision analysis in fixed prosthodontics, as other branches of dentistry do, allows the practitioner to consider the patient's problems more thoroughly based on the clinical data and extenuation factors. This discipline of decision making is intended to complement the experience level and educational background of the clinician in assisting the patient through the decision process. Additionally, CDA helps the clinician define not only the pre-existing condition of the patient prior to irreversible therapy, but also better treatment strategies for the patient over an extended period. The systematic nature of decision analysis stimulates the dentists to pay further attention to those factors, which is germane to the overall complexity of the case, and exclude factors, which have little influence on its final outcome. Further implementation of computerized databases, procedural outcome probabilities based on clinical and laboratory studies and the clinical experience of those who use it, may provide quite a promising future in the field of structured and formalized clinical decision analysis.

Digital approach integrating 3D facial scan and a virtual mockup for esthetic restorative treatment: A case report (심미보철 수복을 위한 3차원 안면스캔과 가상 보철물 시각화를 이용한 디지털 치료 증례)

  • Mai, Hai Yen;Choi, Yong-Do;Lee, Du-Hyeong
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.4
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    • pp.425-431
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    • 2019
  • This clinical case report describes the digital workflow that combines a face scan, cone beam computed tomography and an intraoral scan to visualize the outcome of prosthodontic treatment in the anterior region. This approach improves communication between clinic, laboratory and patients. A patient with healthy general condition came for a restorative treatment to treat post-traumatic central incisors of maxilla. A virtual patient replica was made by incorporating a face scan, cone beam computed tomography and an intraoral scan. Design mockup of definitive restorations was shown to the patient and modified according to the patient's desire. This digital workflow facilitates the fabrication of optimal esthetic restorations, and enhances the predictability of outcome of restorations.

Long Term Assessment of Outcome of Essential Competencies in CPPE at Tertiary and Secondary Hospitals Located in Seoul and Gyeonggi-do: College of Pharmacy Students' Evaluation from 2014 to 2018 (서울과 경기도 소재 상급종합병원과 종합병원의 필수실무실습 핵심역량교육 성과에 대한 장기적인 고찰)

  • Chun, Pusoon;Sin, Hye Yeon
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.4
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    • pp.300-307
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    • 2018
  • Objective: As the demands of healthcare environment change, it is necessary to advance human health care by improving students' essential competencies including knowledge, skills, abilities, inter-professional collaboration and patient centered care. This study identified long term accomplishment and improvement of the essential competencies in clinical pharmacy practice education (CPPE) at Korean hospitals over time. Methods: This study was conducted for pharmacy students who completed CPPE evaluation related to tertiary hospitals and secondary hospitals located in Seoul and Gyeonggi-do regional area from 2014 to 2018. Results: Over the past 5 years, overall results of student evaluation on the essential competencies in CPPE at both tertiary and secondary hospitals showed a decreasing trend or did not change. Essential competency in CPPE at tertiary hospitals had been identified as superior on 'Learn clinical knowledge in the treatment of diseases' to secondary hospitals [average number of students (%): 210 (72.9%) vs 68 (68.0%)]. On the other hand, essential competencies in CPPE at secondary hospitals had been identified as better at 'inter-professionals collaborative teamwork and direct patient care' than tertiary hospitals [average number of students (%): 64 (64.0%) and 56 (56.0%) vs 121 (42.0%) and 90 (31.3%)]. A total of 176 (61.1%) students in tertiary hospitals and 66 (66.0%) in secondary hospitals evaluated that 'patient-centered care' education was good. Conclusion: In tertiary hospitals, all six essential competency outcomes have not been improved, whereas four essential competency outcomes showed an increasing trend in secondary hospitals. It will be necessary to develop outcome-based CPPE education program to better reflect the essential competencies.

A Systematic Review of Outcomes Research in the Hospital Pharmacists' Interventions in South Korea (국내 병원약사의 중재활동과 성과에 대한 체계적 문헌고찰)

  • Lee, So Young;Cho, Eun
    • Korean Journal of Clinical Pharmacy
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    • v.29 no.3
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    • pp.193-201
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    • 2019
  • Background and Objective: Since the introduction of hospital pharmacy residency programs in 1983, hospital pharmacists in South Korea have been expected to expand their roles. However, their services and the outcomes have not been fully understood. In this study, we conducted a systematic review of Korean hospital pharmacist-provided interventions with regard to intervention type, intervention consequences, and target patient groups. Methods: A literature search of the following databases was performed: Embase, PubMed, Medline, KoreaMed, RISS, KMbase, KISS, NDSL, and KISTI. The search words were "hospital pharmacist", "clinical pharmacist", and "Korea". Articles reporting clinical or economic outcome measures that resulted from hospital pharmacist interventions were considered. Numeric measures for the acceptance rate of pharmacist recommendations were subjected to meta-analysis. Results: Of the 1,683 articles searched, 44 met the inclusion selection criteria. Most articles were published after 2000 (81.8%) and focused on clinical outcomes. Economic outcomes had been published since 2011. The interventions were classified as patient education, multidisciplinary team work, medication assessment, and guideline development. The outcome measures were physicians' prescription changes, clinical outcomes, patient adherence, economic outcomes, and quality of life. The acceptance rate was 80.5% (p < 0.005). Conclusion: Studies on pharmacist interventions have increased and showed increased patient health benefits and reduced medical costs at Korean hospital sites. Because pharmacists' professional competency would be recognized if the economic outcomes of their work were confirmed and justified, studies on their clinical performance should also include their economic impact.

Effects of Treadmill Gait Training Combined with Muscle Tone Control Technique on Gait Ability in Patient with Chronic Stroke (근긴장도 조절기법을 병행한 트레드밀 보행훈련이 만성 뇌졸중 환자의 보행능력에 미치는 영향)

  • Dong-Hoon Kim;Kyung-Hun Kim
    • Journal of The Korean Society of Integrative Medicine
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    • v.11 no.3
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    • pp.147-157
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    • 2023
  • Purpose : Stroke patients exhibit considerable variations in gait patterns. Stroke patients generally show abnormal muscle tone and gait. This study was performed to evaluate the effects of treadmill gait training combined with muscle tone control technique (TM) on gait ability in patient with chronic stroke. Methods : A single-blind, randomized controlled trial was conducted with 36 patient with chronic stroke. They were randomly allocated 2 groups; treadmill gait training combined with muscle tone control technique group (TM group; n=18) and conservative treatment group (CG group; n=18). The TM group received 15 minutes muscle tone control technique and 15 minute treadmill gait training. In the conservative treatment group received 30 minutes conservative physical therapy. Each group performed 30 minutes a day 3 times a week for 8 weeks. The primary outcome gait ability were measured by gait measurement system (Optogait, Microgate, Italy) and 10 m walking test (10MWT). An independent t-test was used to statistically analyze the pre-test and pos-ttest gait ability results. Results : Both groups demonstrated significant improvement of outcome in gait ability during intervention period. TM group showed significant differences in gait ability as compared to the CG groups (p<.05). TM group showed significant differences in 10MWT as compared to the CG groups (p<.05). Our results showed that TM was more effective on gait ability in patients with chronic stroke. Conclusion : Our findings of this study confirmed that the treadmill gait training combined with muscle tone control technique provided significant improvements on gait ability in patient with chronic stroke. Therefore treadmill gait training combined with muscle tone control technique may positive influenced gait ability. This study will be able to be used as an intervention data for recovering gait ability in patients with chronic stroke.

Round Atelectasis - One case report - (Round Atelectasis 수술치험 1예 보고)

  • 유영종
    • Journal of Chest Surgery
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    • v.22 no.5
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    • pp.857-861
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    • 1989
  • Round atelectasis is an uncommon benign pulmonary condition not relevant to neoplastic or inflammatory lung disease, usually presenting as a peripheral parenchymal round mass density on a chest roentgenogram. Recently, authors experienced one patient with this disease entity associated with spontaneous pneumothorax who was treated surgically with a successful outcome. The case is thought to be the first documented report of round atelectasis in Korea.

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The Effects of Medical Staffing Level on Length of Stay (의료 인력의 확보가 환자 입원일수에 미치는 영향)

  • Lee, Han-Ju;Ko, Yu-Kyung;Kim, Mi-Won
    • Journal of Korean Academy of Nursing Administration
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    • v.17 no.3
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    • pp.327-335
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    • 2011
  • Purpose: The objective of this study was to analyze the effects of medical staffing level as bed-to-medical staff ratio on patient outcomes as length of stay (LOS) among hospitals in Korea. Methods: Two hundred and fifty one hospitals participated in the study between January and March 2008. Data for the study was requested by an electronic data interchange from the Health Insurance Review Agency in 2008. In data analysis, SPSS WIN 15.0 program was utilized for descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression. Results: The mean score for length of stay was 13.6 days. The mean of operating bed-to-nurse ratio was 7.93:1. The predicting factors for LOS were bed-to-nurse's aide ratio, bed-to doctor's ratio, severely ill patient rate, and hospital type. These factors explained 28.9% of the variance in patient outcomes. Conclusion: This study results indicate that the relationship between medical staffing level and patient outcomes is important in the improvement of the quality of patient care. Thus, improvements in the quality of the nurse practice environment could improve patient outcomes for hospitalized patients.

Aneurysmal Subarachnoid Hemorrhage in Third and Fourth Decades of Life

  • Kim, Su-Yong;Lee, Chul-Hee;Park, In Sung;Hwang, Jae Ha;Hwang, Soo Hyun;Han, Jong Woo
    • Journal of Korean Neurosurgical Society
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    • v.52 no.3
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    • pp.167-171
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    • 2012
  • Objective : The aim of this study was to compare clinical characteristics of ruptured aneurysms in young adults, of the third and fourth decades of life, and to compare several clinical characteristics affecting the outcome of patients. Methods : We retrospectively investigated 1459 patients who underwent surgery and endovascular treatment for ruptured cerebral aneurysms from June 1992 to December 2010 and compared clinical characteristics. We also reviewed pre-existing medical conditions and perioperative complications. Results : Among 1459 patients, there were 21 patients (1.44%) in the third decade and 104 patients (7.13%) in the fourth decade of life. Within two age groups, 88 (70.4%) were male and 37 (29.6%) were female, a ratio of 2.37 : 1. In both groups, we observed the anterior cerebral artery (ACA) aneurysm with the most frequency (p=0.028). In general, favorable outcome was achieved in both age groups (90.5% and 81.7%, respectively). An initial univariate analysis showed Hunt-Hess grade, Fisher grade, location of aneurysm, and rebleeding significantly associated with outcome after aneurysm rupture. Further, multivariate analysis demonstrated that only Hunt-Hess grade (grade 4-5) was a risk factor for the outcome (odds ratio=9.730, 95% confidence interval 2.069-45.756, p=0.004). Conclusion : The incidence of subarachnoid hemorrhage (SAH) was higher in the male population of the third and fourth decades of life. Aneurysms on the ACA were most frequently occurred in both age groups and the outcome of aneurysmal SAH among the third and fourth decades was favorable. Multivariate analysis revealed that high Hunt-Hess grade was a risk factor for patient's outcome.