• Title/Summary/Keyword: patients discharged

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The Therapeutic Factors Affecting Post-discharge Course of Schizophrenia Patients in a University Hospital (일 대학병원 정신분열병 환자의 퇴원 후 경과에 미치는 치료적 요인)

  • Nam, Jung Hyun;Roh, Sungwon;Choi, Joonho;Lee, Kyung Woo
    • Korean Journal of Biological Psychiatry
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    • v.13 no.1
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    • pp.26-31
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    • 2006
  • Object : To evaluate how the therapeutic factors affect post-discharge course of patients with schizophrenia, we analyzed relationship between each therapeutic factor and outcome of inpatients with schizophrenia in Hanyang University Hospital. Methods : This study is a retrospective report. Subjects were schizophrenic inpatients who were discharged from Hanyang University Hospital from January 1, 2003 through December 31, 2004. We obtained demographic and clinical data from review of inpatient and outpatient charts. Results : We analyzed the records of 104 patients with schizophrenia(44 males and 60 females). Patients who had longer first admission days have fewer number of readmission. There were no significant correlation between psychiatric rehabilitation and course of schizophrenia. Courses, such as duration of outpatient department follow-up and number and duration of rehospitalization, did not differ according to the existence of extrapyramidal symptoms or types of antipsychotics prescribed. Conclusion : Among the therapeutic factors, longer duration of the first admission only affected better post-discharge course of patients with schizophrenia.

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Herbal Medicine for Coronavirus Disease 2019 (COVID-19) in Children: a Literature Review

  • Jihong Lee;In-Jun Yang
    • The Journal of Pediatrics of Korean Medicine
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    • v.37 no.3
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    • pp.17-34
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    • 2023
  • Objectives Few studies to date reviewed herbal medicines prescribed to pediatric patients with coronavirus disease 2019 (COVID-19). We aimed to summarize and analyze these herbal medicines. Methods Nine databases were searched for studies published up until November 24, 2020. Nine case reports and one case series involving 17 pediatric patients were included in the study. The clinical symptoms, interventions, outcomes, pattern identification, composition, and frequency of herbal medicine administration were analyzed. Results The symptoms of pediatric patients with COVID-19 treated with herbal medicines were mild or moderate. Herbal medicines have been used to alleviate symptoms, such as fever and cough. No adverse events were reported. All of the patients who received herbal medicines were discharged from the hospital after symptomatic relief. Pattern identification revealed that the lungs were the most affected organs. Epidemic toxins, wind, dampness, and heat were the primary etiological factors. More pediatric patients with COVID-19 were prescribed a combination of herbal and Western medicines than herbal medicines alone. The frequently used herbs include Glycyrrhizae Radix et Rhizoma, Lonicerae Flos, Scutellariae Radix, Armeniacae Semen, Citri Reticulatae Pericarpium, and Astragali Radix. Conclusions Our review can serve as a reference for the treatment of COVID-19 in children.

A Survey on Patients도 Nursing Needs Following Discharge from Hospital (퇴원시 환자의 간호요구도 조사)

  • 이은옥;이선자;박성애
    • Journal of Korean Academy of Nursing
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    • v.11 no.2
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    • pp.33-54
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    • 1981
  • The purposes of this study were to determine the relevant nursing needs of patients following discharge; to identify the degree of their nursing needs; to identify types and status of discharge order and information given to patients; and to determine their specific nursing needs according to their diagnosis. In addition, opinions toward home care services provided by hospitals or by public health nurses and appointment plans with their physicians were also asked in order to determine the necessity of follow-up care for the patient after discharge. Nine hundred and eighty eight subjects were collected among patients being discharged from one national university hospital and four city hospitals. Data were collected from June,1979 to December,1979 using questionnaires and interviews. On the bases of these data the following findings were observed; 1) Almost 40 percents of total subjects discharged from the hospital with some or great degree of nursing needs in general. The most problematic nursing needs were needs for comfort which include needs for releaving pain, for sound sleep and rest, because these needs can only be met by professional help. More than 50% of total subjects have this problem. 2) Needs for mental health, general metabolism, general hygiene and activities and safety were observed in more than 20 percent of subjects. 3) Discharge orders on diet and oral medication were recorded in patients' charts in 70% of all cases. However, more than fifty percents of patients have not been told these information from doctors or nurses. Even though some of them might have had appointment plans with their physicians, they would not keep the appointments unless they completely understood the necessity of the follow-up care. If they have not had any appointment or would not visit the out-patient clinic, there is no method of caring them and prerenting funther discomfort or complications. Even in injection, ski care, dressing and bath, only one thirds of the subjects having recorded discharge orders understood what they need after discharge. The rest of cases have not known what to do for their further care. 4) More than 80 percents and 70 percents of total subjects agreed to a system of home care services provided by hospitals or public health nurses respectively. That is, regardless of sources of medical expenses, most of patients wanted to be taken care of at home following discharge. 5) While more than half of the patients having benefit of medical insurance or paying fully by themselves had appointment plans with their physicians, only one thirds of the patients fully or partially paid by government had appointment plans with their physicians. These results ex-plain that the appointment plan is directly associated with their economic power. This indicates that the home care services are more needed to the people with lower economical status. 6) Those who have been in the hospital more than 24 days wanted !o have home care services more than those who had less hospital days. They also had more appointment plans than other groups. 7) More than 70 percents of the subjects who had been in a university hospital and approximately 30 percents of the subjects in the city hospitals had appointment plans with their physicians. 8) Those who had the cerebrovascular disease, cancer or hypertension demanded more nursing needs such as needs for comfort, for general metabolism and for mental health. 9) Factors which were associated with the degree of patients' nursing needs were age, duration of hospitalization, opinion toward home care services given by public health nurses, hospital appointments and types of hospital. That is, the older they were and the longer the periods of hospitalization were, the higher were their nursing needs. The more they had nursing needs, the more they wanted to have nursing services and had appointment plans. It can be concluded that there is a great demand for a positive and systematic home care services to the people who have been discharged from hospitals following critical care. This program is definitely demanded for the low income groups of people with less education with the financial assistance of the government or other funding agencies.

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Cardiovascular Manifestations and Clinical Course after Acute Carbon Monoxide Poisoning (급성 일산화탄소 중독에 의한 심혈관계 독성의 임상 양상 및 경과)

  • Lee, In Soo;Jung, Yoon Seok;Min, Young Gi;Kim, Gi Woon;Choi, Sang Cheon
    • Journal of The Korean Society of Clinical Toxicology
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    • v.10 no.2
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    • pp.103-110
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    • 2012
  • Purpose: The aim of this study was to evaluate the cardiovascular manifestations and clinical course in patients with acute carbon monoxide poisoning. Methods: A retrospective study was conducted over a 36 month period on consecutive patients who visited an emergency medical center and were diagnosed with acute carbon monoxide poisoning. A standardized data extraction protocol was performed on the selected patients. Results: A total of 293 patients were selected during the study period. Cardiac manifestations were observed in 35.2% (n=103) of the patients: hypotension in 11 patients (3.8%), ECG abnormalities in 44 patients (15.0%) and cardiac enzyme abnormalities in 103 patients (35.2%). Echo cardiography was performed on 56 patients with cardiac toxicity: 12 patients had abnormal results (5 patients with global hypokinesia and 7 patients with regional wall akinesia). Five patients died within 3 hours after ED admission, and the remaining patients were discharged alive. At 3 months after discharge, none of these patients had died.The SOFA scores in the severe cardiac toxicity group and non-severe cardiac toxicity group at the time of arrival were $2.53{\pm}2.29$ and $2.19{\pm}2.12$, respectively (p=0.860). Conclusion: Cardiovascular manifestations occur after acute CO poisoning at arateof 35.2%. Even those with severe cardiovascular toxicity recovered well within 10 days after admission. Therefore, the importance of cardiac toxicity after acute CO poisoning is not significant in itself in the clinical course, and the short-term prognosis of cardiac toxicity is unlikely to be unfavorable in acute CO poisoning.

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Effects of The Home Physical Therapy on Recovery of Muscle Strength and Gait for Discharged Patients Who Underwent Total Knee Replacement

  • Jang, Yong Su;Kim, Moo Ki;Kim, Ji Sung;Koo, Ja Pung;Park, Si Eun;Choi, Wan Suk;Kim, Bo Kyoung;Kim, Yong Youn;Kim, Soon Hee
    • Journal of International Academy of Physical Therapy Research
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    • v.5 no.2
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    • pp.743-751
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    • 2014
  • This study aims to identify the effect of home physical therapy on patients who left the hospital after total knee arthroplasty, compared to the Daily living group, when it was applied to them, under the guidance of physical therapists. As research subjects, 20 patients that were scheduled to leave the hospital after unilateral total knee arthroplasty, were chosen, and they were randomly divided into a home physical therapy group(10 patients) and an Daily living group(10 patients) in order to conduct an experiment. During the 4-week research, home physical therapy was offered for 40 mins once for 5 days a week, and muscular strength, gait components were measured. For muscular strength, quadriceps muscle strength, hamstring muscle strength were measured, and as gait components, endurance, speed, step time, single-limb support were analysed. For this experiment, pre- and post-measurement were performed, and collected data were analyzed using SPSS ver. 18.0 statistical program. From the analysis of data, the following study results were obtained. Home physical therapy group and Daily living group both showed significant improvements in quadriceps muscle strength, hamstring muscle strength, and quadriceps muscle strength, hamstring muscle strength of home physical therapy group more significantly improved than Daily living group's. In relation to gait components, gait endurance, gait speed, step time significantly improved in both of home physical therapy group and Daily living group, whereas home physical therapy group only showed significant improvements in single-limp support. According to the comparison between two groups, gait speed, single-limp support and step time improved more significantly in the home physical therapy group than in the Daily living group. In conclusion, positive results were revealed in both home physical therapy group and Daily living group, with regard to muscular recovery of lower limbs of patients discharged from the hospital after total knee arthroplasty and walking, but considering the comparison results between two groups, it seems that applying home physical therapy is more effective than maintaining a daily life.

Clinical Observation for Endotracheal intubation Patients in ICU (중환자실(重患者室)에서 기관내(氣管內) 삽관후(揷管後) 퇴원(退院)한 환자(患者)의 임상통계(臨床統計) 고찰(考察))

  • Nam, Chang-Gyu;Moon, Byung-Soon
    • The Journal of Korean Medicine
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    • v.17 no.1 s.31
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    • pp.407-432
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    • 1996
  • Clinical Observation was made on 37 cases of Endotracheal intubation patients in the ICU of Oriental Medical Hosptal of Tae- Jon University from January in 1992 to June in 1995. 1. There were many cases of Endotracheal intubation in ischemic attack hemorragic in order. 2. Cerebral embolism mostly occured in the MCA territory and cerebral thrombosis, ICH, in the pons, generally. 3. On admission the consciousness of the most patients was 3 to 7 point by GCS. 4. The ordinary preceeding disease was hypertension. 5. Most patients were discharged from ICU after 2 days. 5. Most patients were discharged from ICU after 2 days. 6. Endotracheal intubation was done most frequently from 1 p.m. to 3 p.m. and intubated time was less than 2 hours. 7. Endotracheal intubation was done in case of heart arrest than dyspnea cases. 8. The main complication of patients of C.V.A. in ICU were urinary tract infection, pneumonia in order. 9. There were no side effects after and by Endotracheal intubation.

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A retrospective analysis of outpatient anesthesia management for dental treatment of patients with severe Alzheimer's disease

  • So, Eunsun;Kim, Hyun Jeong;Karm, Myong-Hwan;Seo, Kwang-Suk;Chang, Juhea;Lee, Joo Hyung
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.4
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    • pp.271-280
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    • 2017
  • Background: The number of patients with Alzheimer's disease is growing worldwide, and the proportion of patients requiring dental treatment under general anesthesia increases with increasing severity of the disease. However, outpatient anesthesia management for these patients involves great risks, as most patients with Alzheimer's disease are old and may show reduced cardiopulmonary functions and have cognitive disorders. Methods: This study retrospectively investigated 43 patients with Alzheimer's disease who received outpatient anesthesia for dental treatment between 2012-2017. Pre-anesthesia patient evaluation, dental treatment details, anesthetics dose, blood pressure, duration and procedure of anesthesia, and post-recovery management were analyzed and compared between patients who underwent general anesthesia or intravenous sedation. Results: Mean age of patients was about 70 years; mean duration of Alzheimer's disease since diagnosis was 6.3 years. Severity was assessed using the global deterioration scale; 62.8% of patients were in level ${\geq}6$. Mean duration of anesthesia was 178 minutes for general anesthesia and 85 minutes for intravenous sedation. Mean recovery time was 65 minutes. Eleven patients underwent intravenous sedation using propofol, and 22/32 cases involved total intravenous anesthesia using propofol and remifentanil. Anesthesia was maintained with desflurane for other patients. While maintaining anesthesia, inotropic and atropine were used for eight and four patients, respectively. No patient developed postoperative delirium. All patients were discharged without complications. Conclusion: With appropriate anesthetic management, outpatient anesthesia was successfully performed without complications for dental treatment for patients with severe Alzheimer's disease.

Clinical Value of Procalcitonin in Patients with Spinal Infection

  • Jeong, Deok-Ki;Lee, Hyun-Woo;Kwon, Young-Min
    • Journal of Korean Neurosurgical Society
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    • v.58 no.3
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    • pp.271-275
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    • 2015
  • Objective : This study was designed to evaluation the diagnostic value of procalcitonin (PCT) in patients with spinal infection, compare to the classical biomarkers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell (WBC) count. Methods : All patients who were diagnosed as a spinal infection between January, 2013 and July, 2014 were included in this study. Serum PCT, CRP, ESR, and WBC count were checked at initial hospital visit and once a week serially until they were discharged. Patient's medical history, causes and pathogens of spinal infection were reviewed. Results : Total 34 (16 men, 18 women) patients were included in this study. Mean age of the patients was 65.6 year-old. Causes of spinal infection were pain block procedure (14, 41.2%) and post-operation (5, 14.7%). Out of 25 patients who showed elevated initial serum PCT level, 20 patients (80%) had a combined systemic infection. 14 patients (6.7%) had a sepsis, 3 patients (14.2%) had a urinary tract infection and 2 (9.6%) had a pneumonia. 14 patients (41.2%) showed elevation of serum PCT level during treatment. Among them, 9 patients (64.3%) had a combined infection such as sepsis and urinary tract infection. Conclusion : Serum CRP showed more sensitivity compared to serum PCT in patients with spinal infection. Patients with spinal infection who showed elevated serum PCT level should be investigated for combined infection and proper antibiotics should be applied.

Changing Trends in Daegu and Gyeongbuk-based Patients' Use of Health Facilities in Seoul (대구.경북 거주환자의 서울지역 의료이용 변화추이)

  • Lee, Sang-Ju;Park, Jae-Yong
    • Health Policy and Management
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    • v.20 no.4
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    • pp.19-44
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    • 2010
  • This study was conducted to investigate the changes in patterns of Daegu- and Gyeongbuk-based patients' use of medical care facilities located in Seoul. The 'Patient Survey' data issued by the Ministry of Health and Welfare for 2002, 2005, and 2008 were used. Among all discharged patients residing in Daegu and Gyeongbuk, 133,456 who used medical facilities in Daegu, Gyeongbuk, and Seoul were selected. Among patients residing in Daegu, 2.2% used medical facilities in Seoul in 2002, 3.7% in 2005, and 3.5% in 2008. The corresponding rates among patients living in Gyeongbuk were 5.6%(2002), 7.1%(2005), and 7.3%(2008). Regarding the ICD-10 disease groups, the use of medical facilities in Seoul by patients residing in either Daegu or Gyeongbuk increased in 2005 right after the introduction of the KTX high-speed train service, covering various disease groups, but decreased again in 2008. 'Neoplasm' cases, however, showed a progressive rising trend during the years studied. Multivariate data analysis for the three years showed that sex, age, payment type, hospital type, residence, year, and disease groups were all significantly associated with the utilization of medical facilities in Seoul. The major results are : First, use of medical facilities in Seoul by Gyeongbuk patients was 2.4-fold higher than that by Daegu patients, but with respect to 2005 and 2008 vs. 2002, use of medical facilities in Seoul by Daegu resident patients' showed a larger increase than that by Gyeongbuk's patients. Second, for patients residing in the two regions, use of medical facilities in Seoul was highest for 'congenital malformations, deformations and chromosomal abnormalities', followed by 'neoplasms'. Third, for patients residing in the two regions, general hospitals comprise the primary factor in the use of medical facilities in Seoul. The study shows that local medical facilities should individually exert more efforts to improve the quality of their medical services. Relevant authorities should likewise help these facilities develop their own unique services and respective specialization.

Analysis of Patients with Acute Industrial Toxic Exposure at an Emergency Department in an Industrial Complex (공단밀집지역에 위치한 일개 응급의료센터에 내원한 급성산업중독환자에 대한 분석)

  • Shin, Jun-Hyun;Moon, Sung-Woo;Baek, Seung-Won;Lim, Sung-Ik;Yoon, Young-Hun;Lee, Sung-Woo;Hong, Yun-Sik
    • Journal of The Korean Society of Clinical Toxicology
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    • v.6 no.2
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    • pp.117-122
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    • 2008
  • Purpose: Surveys on poisoning usually involves intoxication rather than inhalation, skin contact, etc. Therefore, we examined the characteristics of patients who visited the emergency department in an industrial complex after acute industrial exposure to toxic materials. Methods: Medical records of patients exposed to toxic materials in the work places from April, 2006, to March, 2008, were analyzed retrospectively. Inhalation patients due to fire were excluded. Results: Subjects included 66 patients, with a mean age of $35.4{\pm}10.9$ years, mostly men (91%). Toxicity occurred in 51 patients (77%) by contact, 15 patients (23%) by inhalation, and none by oral ingestion. For toxic materials, 10 patients were exposed to hydrofluoric acid, 8 to hydrochloric acid, 7 to sodium hydroxide, 7 to metals, and others. The face and hands were the most frequent exposure site by contact. Most exposures were caused by accidents, with 29 cases (42%) exposed because of carelessness or not wearing protective equipment. Most complaints were pain on exposure site, but 7 of the inhalation patients complained of dyspnea. The majority of patients with contact exposure were discharged after wound care or observation. After inhalation exposure, 1 patient died and 5 patients were admitted to the intensive care unit. Conclusion: Major causes of workplace exposure were not wearing protective equipment or carelessness. Although contact exposures are usually benign, cautious observation and management are required in patients with inhalation exposure.

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