• Title/Summary/Keyword: severity-adjusted

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Reflection of Pain in Cancer Patients Using a New Screening Tool for Psychological Distress

  • Oh, Seung-Taek;Lee, San;Lee, Hyeok;Chang, Myung Hee;Hong, Soojung;Choi, Won-Jung
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.1
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    • pp.56-62
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    • 2017
  • Objectives : The objective of this study was to investigate the relationship between psychological distress and pain in cancer patients. Methods : 249 patients with cancer who visited National Health Insurance Service Ilsan Hospital between April 2013 and March 2014 were evaluated with National Cancer Center Psychological Symptom Inventory(NCC-PSI) which consisted of Modified Distress Thermometer(MDT) and Modified Impact Thermometer(MIT). Each scale was divided into 3 subscales targeting separate symptoms: insomnia, anxiety, and depression. Psychological distress was defined as positive for those who scored above the cutoff values in at least one of all six subscales. The Numeric Rating Scale for Pain(NRS-Pain) was used to assess the subjective severity of pain. Logistic regression was performed to investigate the association between psychological distress and pain. Results : Univariate logistic regression analysis showed that pain, gender, compliance, and two subscale scores of Hospital Anxiety and Depression Scale(HADS) were significantly associated with psychological distress. Multivariate logistic regression analysis showed that pain and HADS anxiety subscale score maintained a statistically significant association with psychological distress adjusted for variables including age, gender, years of education, Eastern Cooperative Oncology Group performance status, cancer stage, Charlson Comorbidity Index, compliance, and HADS depression subscale score. One point increase in pain was 1.31 times more likely to cause psychological distress. In secondary analysis, pain was significantly associated with all subscales of NCC-PSI, except MIT-anxiety subscale. Conclusions : This study suggests that NCC-PSI, a screening tool for psychological distress, reflects pain. We recommend that physicians who treat cancer patients consider the examination of psychological distress which provides comprehensive evaluation of various factors regarding quality of life.

Effects of the Mixture of Morphine, Bupivacaine and Antidepressants by Continuous Epidural Infusion in Cancer and Non-cancer Pain (모르핀, 국마제 및 항우울제의 경막외강내 지속혼주의 효과)

  • Shin, Hyung-Chul;Kim, Jung-Soon;Kim, Ill-Ho;Song, Hoo-Bin;Ok, See-Young;Hwang, Kyung-Ho;Park, Wook;Kim, Sung-Yell
    • The Korean Journal of Pain
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    • v.5 no.1
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    • pp.29-36
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    • 1992
  • This study was objected to evaluate clinical progressions about both the degree of pain relief and the occurrence of morphine tolerance while the epidural analgesia with low dose of morphine, bupivacaine and antidepressant continued repeatedly at every 5 day intervals of the constant-rate infusion(0.5 ml/hr, 60 ml capacity). The subjects were divided to 56 cancer and 36 non-cancer patients who failed to respond to palliative treatments. Before the relief of pain, the pain severity was moderate(10%) and severe(90%). The dose escalation of morphine noted to 11(20%)patients in cancer pain and to one(5%) case only in non-cancer. During the epidural analgesia, the effect of pain relief was moderate(11%) and good(89%). It suggest that the morphine tolerance may be reduced to some degree such as an initial minimum dose of epidural morphine with local anesthetic and antidepressant should be adjusted on an individual basis using the constant-rate infusor, even though rapid dose escalation occurrs in some patients who the diseases progress over a short period of time.

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Positive association of breastfeeding on respiratory syncytial virus infection in hospitalized infants: a multicenter retrospective study

  • Jang, Min Jeong;Kim, Yong Joo;Hong, Shinhye;Na, Jaeyoon;Hwang, Jong Hee;Shin, Son Moon;Ahn, Yong Min
    • Clinical and Experimental Pediatrics
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    • v.63 no.4
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    • pp.135-140
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    • 2020
  • Background: Breastfeeding reportedly reduces the overall frequency of infections. Respiratory syncytial virus (RSV), the most common respiratory pathogen in infants, involves recurrent wheezing and has a pathogenic mechanism related to airway structural damage. Purpose: This study aimed to investigate whether breastfeeding has a beneficial effect against RSV-induced respiratory infection compared to formula feeding among infants in Korea. Methods: We retrospectively reviewed the medical records of infants under 1 year of age who were admitted with RSV infection between January 2016 and February 2018 at the department of pediatrics of 4 hospitals. We investigated the differences in clinical parameters such as cyanosis, chest retraction, combined infection, fever duration, oxygen use, oxygen therapy duration, intensive care unit (ICU) admission, and corticosteroid treatment of exclusive breast milk feeding (BMF), artificial milk formula fed (AMF), and mixed feeding (MF) groups. Results: Among the 411 infants included in our study, 94, 161, and 156 were included in the BMF, MF, and AMF groups, respectively. The rates of oxygen therapy were significantly different among the BMF (4.3%), MF (8.1%), and AMF (13.5 %) groups (P=0.042). The odds ratios (ORs) for oxygen therapy was significantly higher in the AMF group than in the BMF group (adjusted OR, 3.807; 95% confidence interval, 1.22-11.90; P=0.021). The ICU admission rate of the BMF group (1.1%) was lower than that of the MF (3.5%) and AMF (4.5%) groups; however, the dissimilarity was not statistically significant (P=0.338). Conclusion: The severity of RSV infection requiring oxygen therapy was lower in the BMF than the AMF group. This protective role of human milk on RSV infection might decrease the need for oxygen therapy suggesting less airway damage.

Effects of a Rehabilitation Program on Quality of Life, Cardiopulmonary Function and Fatigue During Radiotherapy for Breast Cancer Patients (유방암 환자의 방사선 치료 기간 동안 재활치료 프로그램이 삶의 질, 심폐기능, 피로에 미치는 영향)

  • Do, Jung-Hwa;Seong, Jun-Hyuk;Ahn, Jun-Su;Cho, Young-Ki
    • Physical Therapy Korea
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    • v.19 no.1
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    • pp.56-65
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    • 2012
  • This study examines the effects of a rehabilitation program on quality of life (QOL), cardiopulmonary function and fatigue during radiotherapy for breast cancer patients. The program includes aerobic exercise, stretching and strengthening exercises. Sixty-five women participated in this study and they were asked to perform supervised exercises that last for 60 minutes five times a week for six weeks. The European organization for research and treatment of cancer-cancer (EORTC QLQ-C30) and the breast (EORTC QLQ-BR23), predicted maximal volume of oxygen consumption ($VO_{2max}$) and fatigue severity scale (FSS) were assessed before and after the rehabilitation program. The 60-minute program consisted of a 10-minute warm-up, 30-minute of aerobic exercises, and 15-minute of strengthening exercises, followed by a five-minute cool-down. Heart rates were monitored throughout the exercise class to ensure that patients were exercising at the target heart rate of 40~75% of the age-adjusted heart rate maximum. There were statistically significant differences in the changes of physical function and cancer related symptoms in the EORTC QLQ-C30 and EORTC QLQ-BR23 (p<.05). There was a statistically significant improvement in the predicted $VO_{2max}$ (p<.05), although there were no significant differences in the FSS (p>.05). The results of our study suggest that a supervised rehabilitation program may benefit the physical aspects and QOL of patients receiving radiotherapy for breast cancer.

Prealbumin and Retinol Binding Proteins Are Not Usable for Nutrition Follow-Up in Pediatric Intensive Care Units

  • Tekguc, Hakan;ozel, Deniz;Sanaldi, Huriye;Akbas, Halide;Dursun, Oguz
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.4
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    • pp.321-328
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    • 2018
  • Purpose: Feeding children is a problem in pediatric intensive care units (PICU) and it is difficult to know the correct amount. The purpose of this study is to evaluate if prealbumin or retinol binding proteins (RBP) are effective relative to daily enteral nutrition, without being affected by severity of diseases or infections and can be used to follow up nutritional amount. Methods: This is a prospective observational study that includes 81 patients admitted to PICU in Akdeniz University with estimated duration >72 hours, age between 1 month and 8 years. Daily calorie and protein intake were calculated and prealbumin, RBP and C-reactive protein (CRP) levels were measured on the first, third, fifth and seventh mornings. Results: We find moderate correlation between daily calorie intake and prealbumin levels (r=0.432, p<0.001), RBP levels and daily protein intake (r=0.330, p<0.001). When we investigated the relationship between changes of prealbumin, RBP, CRP, calorie and protein intake during intensive care stay, we found that increase of Prealbumin and RBP levels are explained by decrease of CRP levels (r=-0.546 and -0.645, p<0.001) and not with increase of nourishment. Conclusion: Even adjusted for PRISM3, age and CRP, prealbumin and RBP are correlated with last 24 hours' diet. However, it is not convenient to use as a follow up biomarker because increase of their levels is related with decrease of CRP levels.

Evaluation Model of Business process Contextual Situations using goal-scenario (목표 시나리오를 이용한 비즈니스 프로세스 외부상황 평가 모델)

  • Baek, Su-Jin;Ko, Jong-Won;Song, Young-Jae
    • The Journal of the Korea Contents Association
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    • v.11 no.8
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    • pp.43-50
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    • 2011
  • The scope of the problems that could be solved by monitoring and the improvement of the recognition time is directly correlated to the performance of the management function of the business process. However, the current event-managing monitoring system and the real-time advanced alarming business monitoring system decided whether to apply warnings or not by assuming a fixed environment and showing expressions based on the design rules. Therefore, there is a limit for distinguishing the range of occurrence and the level of severity in regard to the new external problems occurring in a complicated environment. Such problems cannot be abstracted. In this paper, evaluation model of business process contextual situations using goal scenario is suggested to provide constant services through the current monitoring process in regard to the service demands of the new scenario which occurs outside. The new demands based on the outside situation are analyzed according to the target scenario for the process activities. Also, a similar process model is found and identified by combining similarity and interrelationship. The process can be stopped in advance or adjusted to the wanted direction.

The Relationship between Metabolic Syndrome and Korean Cardiocerebrovascular Risk Assessment: for Male Researchers in a Workplace (대사증후군과 뇌심혈관질환 발병위험도 평가와의 연관성: 일개 사업장 남성 근로자를 대상으로)

  • Yoon, Jong-Wan;Yi, Kyung-Jin;Lee, Sang-Yun;Oh, Jang-Gyun
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.5
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    • pp.397-403
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    • 2007
  • Objectives: The prevalence of metabolic syndrome has recently increased, Payments from the Korea Labor Welfare Corporation for compensation for mortality in workers caused by cardiovascular and cerebrovascular diseases have also increased in Korea in recent years. The association of metabolic syndrome and cardiocerebrovascular disease has been investigated by several researchers in recent studies, This study was conducted in an attempt to characterize the relationship between metabolic syndrome and Korean cardiocerebrovascular disease risk assessment, and to provide basic data to group health practices for the prevention of cardiocerebrovascular disease. Methods: Health examinations were previously conducted for 1526 male researchers at a private laboratory. The prevalence by age and the odds ratio of metabolic syndrome scores into the "cardiocerebrovascular risk group" (sum of low, intermediate, and high risk groups) of the Korean cardiocerebrovascular disease risk assessment were assessed, in an effort to elucidate the associations between metabolic syndrome and cardiocere brovascular disease risk assessment. Results: The prevalence of metabolic syndrome and inclusion in the cardiocerebrovascular risk group was 11,7% and 22.1% respectively. The severity of metabolic syndrome and cardiocerebrovascular risk assessment showed that individuals in their 40's and 50's were at higher risk than those in their 30's (p<0,001). The age-adjusted odds ratio of metabolic syndrome to cardiocere brovascular risk group inclusion was 5.6. Conclusions: An active prevention program for cardiocerebrovascular disease needs to begin in the 40's, as the prevalence of metabolic syndrome and the risk group of cardiocerebrovascular risk assessment peak in the 40's age group. The odds ratio between metabolic syndrome and the cardiocerebrovascular risk group was high, which indicates that metabolic syndrome scores should be utilized as guidelines during the consultation and behavioral modification program for the workplace prevention of cardiocerebrovascular diseases in group health practices.

The Clinical Effect of Phellinus linteus Grown on Germinated Brown Rice in the Treatment of Atopic Dermatitis (소아 아토피 피부염에서 발아현미 상황버섯의 임상적 치료효과)

  • Hong, Won-Kyu;Shin, Jeong-Hyun;Lee, Yeon-Hee;Park, Dong-Ki;Choi, Gwang-Seong
    • The Korea Journal of Herbology
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    • v.23 no.1
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    • pp.103-108
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    • 2008
  • Objective: Atopic dermatitis is the most common chronic inflammatory skin disease in childhood. Phellinus linteus, an orange color mushroom, has been used as a traditional herb medicine for years. Recent preliminary animal experiments suggest that Phellinus linteus grown on germinated brown rice is effective in chronic inflammatory disease. The aim of this study was to evaluate the efficacy of Phellinus linteus grown on germinated brown rice in the treatment of atopic dermatitis(AD). Methods: 35 patients, 2 to 14 years of age, with mild to moderate AD were treated with Phellinus linteus grown on germinated brown rice powder per oral, $6{\sim}12g$/day adjusted by the body weight, divided three for up to 12 weeks without other treatment. The mean age of patients was 7.3 years. The disease activity has been monitored by objective SCORAD index. The symptom score of the pruritus was measured by using a traditional visual analogue scale (VAS). In addition, the global assessments of clinical response were also monitored by patients or their parents. Results: After 12 weeks of the study, significant reductions in mean severity scores and mean symptom scores were observed. The mean objective SCORAD indices of 35 patients decreased from 25.31${\pm}$8.96 to 18.73${\pm}$13.89(p<0.05). And the mean symptom score of pruritus assessment decreased from 7.37${\pm}$1.33 to 4.6${\pm}$2.3(p<0.05). The patient's global assessment of clinical response were also improved through the period of treatment(p<0.05). Conclusions: Phellinus linteusgrown on germinated brown rice may play a role in the treatment of mild and moderate AD in Children.

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Postoperative Contralateral Blepharoptosis in Patients with Unilateral Blepharoptosis and Negative Hering's Law Dependence Test (헤링씨 법칙 비의존성 단안성 윗눈꺼풀처짐증 환자에서 수술 후 생긴 건측의 눈꺼풀처짐증)

  • Ha, Won Ho;Lee, Yong Jig;Park, David Dae Hwan;Han, Dong Gil;Shim, Jeong Su
    • Archives of Craniofacial Surgery
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    • v.14 no.1
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    • pp.36-40
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    • 2013
  • Background: Correction of unilateral blepharoptosis is unexpectedly difficult because healthy eye is often affected by Hering's law. Methods: We measured changes of marginal reflex distance (MRD1) on the unaffected eyelids between preoperative and 3-month postoperative photographs after ptosis correction. This study analyzed 134 unilateral blepharoptosis patients with ptosis correction from February 2002 to February 2011. Fifty patients among them were negative in Hering's law dependence test. From the preoperative and postoperative photographs the MRD1 of unaffected upper eyelids were measured and adjusted with the average pupil diameter of Koreans. Mean age was 34.4 and male was 30 and female was 20. Average follow-up periods were 14 months. Results: Thirteenth unaffected eyes (26%) showed decreased MRD1, and 3 patients (6%) showed decreased MRD1 value over 1.0 mm. Then 3 patients needed additional operations for correction of preoperatively unaffected but ptotic eyelids. Conclusion: There were no meaningful data statistically in the value of MRD1 in every unaffected eye of the patients and in the difference between preoperative and postoperative MRD1 of groups divided according to severity, causes, and types of operation.

The Effect of Obstacles in a Compartment on Personnel Injury Caused by Blast (격실 내 장애물이 폭압에 의한 인원 피해에 미치는 영향)

  • Park, Sung-Jun
    • Journal of the Korea Society for Simulation
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    • v.26 no.3
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    • pp.1-11
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    • 2017
  • Blast injuries in a compartment are investigated, and the effects of obstacles on blast injury are particularly analyzed by comparing injuries in the compartments with or without protruding obstacles inside. Even if blast pressure profile tends to be complicated in a confined space unlike in open field, it can be obtained in a relatively short time by using some empirical fast running models for simple confined spaces. However, a finite element method should be employed to obtain blast pressure profiles in a case with obstacles in confined spaces, because the obstacles heavily disturb blast waves. On the other hand, Axelsson SDOF(Single degree of freedom) model and ASII(Adjusted severity of injury index) injury level are employed to estimate blast injury in compartments, because the usual pressure-impulse injury criterion based on the ideal Friedlander waves in open the field cannot be applied to personnel in a confined space due to complexity of blast waves inside. In cases with obstacles, chest wall velocity was reduced by 26 to 76 percent(%) and the personnel injury in the compartment caused by blast was also reduced.