• Title/Summary/Keyword: 지속진료기록

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Efforts to Improve Antibiotic Prescribing Trends for Acute Upper Respiratory Infections in a South Korean University Hospital (급성 상기도 감염에서 항생제 처방개선에 관한 연구)

  • Kang, Hye-Kyung
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.1
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    • pp.47-54
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    • 2012
  • 목적: 급성 상기도 감염에 사용되는 항생제 처방유형을 조사하여 항생제 사용을 개선하는데 있다. 방법: 2011년 1월부터 6월까지 경상대학교 병원을 포함한 10개 국립대학병원을 대상으로 급성 상기도 감염에 사용한 항생제 처방율을 조사하고, 경상대학교병원에서 급성 상기도 감염에 사용한 2011년 1월부터 6월까지의 외래환자를 대상으로 항생제 처방 내역을 전자의무기록을 통하여 후향적으로 분석한 후 처방의를 대상으로 항생제 사용 적정성 검토를 위한 그룹미팅 및 교육, 급성 상기도 감염에 항생제 처방 시 경고 안내문을 보여주는 등 중재활동 후 2011년 12월에 처방유형을 조사 하였다. 결과: 경상대학교병원에서 2011년 1월부터 6월까지 급성 상기도 감염에 항생제 사용은 1739명의 상기도 감염 외래환자 중에서 874명 (42.3%)으로 나타났다. 진료과별 급성 상기도 감염에 대한 항생제 처방은 소아과, 이비인후과, 내과, 응급의학과, 호흡기내과, 흉부외과 등에서 처방하였으며 소아과에서 1044명의 상기도 감염환자 중 556건(53.3%)로 가장 빈번하게 사용하였으며 처방율은 이비인후과에서 58.9% (225/382)로 가장 높았다. 사용한 항생제로는 amoxicillin-clavulanic acid가 371례 (36.3%)로 가장 빈번하게 처방된 약제이며, azithromycin이 85례 (9.7%) 처방되었다. 급성 상기도 감염 중 급성 편도염에 항생제 처방율이 가장 높았으며 (70.8%, 80/113), 급성 인두염에 가장 빈번하게 사용되었다 (61.1%, 319/522). 균동정을 위한 혈액배양 의뢰 건수는 1739 상기도 감염 환자 중 15명 (항생제 미사용 4명, 사용 11명)이 의뢰되었으며 모두 음성이었다. 중재활동 후 2011년 12월 상기도 감염에 항생제 처방건수는 소아과에서 1건, 이비인후과에서 2건으로 나타났다. 결론: 처방의를 대상으로 적절한 항생제를 사용을 권장하는 지속적인 교육 및 항생제 처방시 경고 안내문을 띄우는 등의 중재활동과 지속적인 모니터링 및 피드백은 급성 상기도 감염에 있어서 항생제 처방유형에 변화를 보였다.

Infection Control practices in accordance characteristic of Dental institutions -Daegu and North Gyeongsang Province around- (치과의료기관의 특성에 따른 감염관리실태 -대구, 경북지역을 중심으로-)

  • Sung, Mi-Ae;Yoon, Sung-Uk
    • Journal of Digital Convergence
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    • v.16 no.5
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    • pp.299-307
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    • 2018
  • This study survey research of infection control, wastewater management, and instrument disinfection according to characteristic at Daegu, Gyeongbuk Province In 2012 and 2017, the same 114 dental clinics to identify the infection management behavior and prevent infection of dental medical institutions. Scored mean 3.37 points on 8 items of infection control, 95.5% in "records of the patient's medical history", 1.8% in "presence of a wastewater facility." Scored 94.7% in "disinfection of metal trays", 17.5% in "storage from a spitting receptacle in the waste bin and commissioned management.", Scored higher in of infection control, wastewater management and instrument disinfection according to general characteristics and dental characteristics in 2017 than in 2012. Points were higher dental hygienist, University graduation, Type of duty was counseling and management, hospital or higher, Number of dentist(dental hygienist, chair, patient) was high. Therefore raise a need for infection control into consideration the dental characteristics and education and promotion regardless of the hospital size.

Systemic Amyloidosis in a Cocker Spaniel (Cocker spaniel 견에서 발생한 전신성 아밀로이드증)

  • Pak Son-Il;Kim Doo;Han Jeong-Hee
    • Journal of Veterinary Clinics
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    • v.23 no.2
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    • pp.186-189
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    • 2006
  • A 7-month-old female Cocker spaniel dog was examined for chronic anemia. Based on information provided by local clinician the patient had had a 'flu-like' illness three weeks before submission of the sample, had a fever of $40.9^{\circ}C$, and had mild hepatomegaly. This dog had also history of weight loss, vomiting, anorexia, dehydration, lethargy, ascites, polyuria and polydipsia. A blood smear showed non-regenerative anemia. Thoracic radiograph showed irregular shadowing in the left mid-zone. Serum biochemical results showed a hypercalcemia, azotemia, hypercholesterolemia, hyperphosphatemia, hypoalbuminemia, and metabolic acidosis. Results of urinalysis showed proteinuria, slightly acidic with isosthenuria. Histopathologic examination of tissue sections revealed amyloid deposits in multiple sites including kidneys, liver and spleen.

Development of Multichannel On-line Thermometry System (다 채널 직결 온도측정 시스템의 설계 및 제작)

  • Shin, Sei-One;Shin, Hyun-Jin;Kim, Myung-Se;Kim, Sung-Kyu
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.193-199
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    • 1999
  • Background: Measurement of body temperature is an important parameter in patient management in many clinical conditions. Failure to reach minimal acceptable body temperature standards has been associated with physiological derangements and has necessitated the application of additional therapy. The authors developed a new, simple, accurate thermometry system, which could be used to undertake precise temperature measurement for various clinical conditions. Materials and Methods: A new thermometry system using a specially designed temperature detecting and display system was developed. This system contains a temperature detecting sensor(LM 35CZ), which enables multiple serial checking of heat, data collection and processing computer, and 3-dimensional display system. It provides real time volumetric visualization of temperature distribution of a defined volume and stores and prints the data. Results: With this system, temperature can be measured at multiple interesting sites simultaneously, demonstrated as a 3-dimensional temperature distribution and stored. In well-controlled, systematic experiments a significant correlation has been observed between standard temperature and temperature using this system at various measuring points. Conclusion: This thermometry system is a real-time measurement system, which can demonstrate 3-dimensional heat distribution in experimental phantom and human body and can be used for diagnosing abnormal clinical conditions. In addition, this system reduces the nursing staff work load, providing them more time for long term care to patients.

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Treatment Outcome and Prognosis of the Outpatients with Orofacial Pain (구강안면통증 환자의 치료결과와 예후에 관한 연구)

  • Choi, Sea-Hun;Kim, Ki-Suk;Kim, Mee-Eun;Lee, Dong-Ju;Jin, Sang-Bae
    • Journal of Oral Medicine and Pain
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    • v.31 no.2
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    • pp.155-165
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    • 2006
  • The purpose of this study was to evaluate treatment outcome and prognosis of the patients with orofacial pain disorders who visited for treatment in the Department of Oral Medicine, Dankook University Dental Hospital from January 2002 to December 2004. Orofacial pain disorders were categorized into TMD(myogenous, arthrogenous and muscle-joint combined TMDs), neuropathic pain disorder, oral soft tissue disease and complex condition simultaneously having more and two aforementioned categories and treatment period, method and treatment outcome were evaluated. The results of this study were as follows; 1. Average longevity of treatment period was the longest in the neuropathic pain, followed by soft tissue disease, complex conditions, arthrogenous TMD, muscle-joint combined TMD and myogenous TMD in order. 2. When treatment methods were largely categorized into pharmacologic, physical and oral appliance therapy, pharmacologic therapy was used the most frequently for the patients with neuropathic pain or oral soft tissue diseases, oral appliance therapy for those with arthrogenous TMD and physical therapy for those with myogenous TMD. 3. Of physical therapeutic methods used in our clinic, EAST and microwave was employed the most frequently in the patients with myogenous TMD, ultrasound for those with arthogenous TMD and LLLT for those with neuropathic pain or oral soft tissue disease. 4. In comparison with change of pain after treatment, there existed a tendency that pain from neuropathic pain disorders persisted while pain from TMD was getting better or totally disappeared. 5. Concerning the change of mouth opening range in the TMD subgroups, there was no significant difference among the subgroups but significant difference existed among opening ranges, indicating comfortable maximum mouth opening increased the most following treatment. Improvement of active range of mouth opening was the most considerable in those with disc displacement without reduction. It can be said on the basis of the findings from this study that various treatments currently used for the orofacial pain showed good results with TMD in regards with pain control and improvement of function, suggestive of favorable prognosis, while neuropathic pain or soft tissue disease was the clinical conditions difficult to resolve, requiring a long and persistent treatment.

Outcomes of the arterial switch operation in complete transposition of the great arteries (완전 대혈관 전위에서 대혈관 치환술 후의 예후)

  • Cho, Min-Jung;Park, Ji-Ae;Lee, Hyoung-Doo;Sung, Si-Chan;Choo, Ki-Seok
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.910-916
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    • 2009
  • Purpose : The arterial switch operation (ASO) has become the preferred procedure for the surgical management of transposition of the great arteries (TGA). We conducted a retrospective evaluation of our experience in 30 patients seen from January 2003 to July 2008, in order to determine outcomes and related risk factors after the arterial switch operation. Methods : Patients charts, surgical reports, and echocardiograms were retrospectively reviewed. And they were analyzed in 2 different groups: complex (n=16) versus simple TGAs (n=14). Complex TGAs are TGAs with VSD or the Taussig-Bing anomaly with or without aortic arch anomalies. Simple TGAs are defined as TGAs with intact ventricular septum having no such anomalies. Median follow-up time was 44 months (3-63 months). Results : Hospital mortality was 0%. However, follow-up echocardiographies revealed potential complications, including stenosis of the branch pulmonary arteries, neo-aortic and/or neo-pulmonary valvar regurgitation, and right or left ventricular outflow tract obstructions. Great arterial relationship (side-by-side), association of aortic arch anomalies, and the existence of the Taussig- Bing anomaly were assessed as significant risk factors of neo-aortic and/or neo-pulmonary valvar regurgitation in this series. On the other hand, right or left ventricular outflow tract obstructions were more frequently found in patients demonstrating VSD, side-by-side positioned great arteries, or associated coronary anomalies. Conclusion : The ASO is the procedure of choice in the treatment of TGA. However, special attention and follow-ups are needed to detect residual problems like the stenosis of the branch pulmonary arteries, neo-aortic and/or neo-pulmonary valvar regurgitation, as well as ventricular outflow tract obstructions.

The Effect of Second-Generation Antipsychotics Administration for 1-Year on the Platelet Activities in Patients With Schizophrenia: Retrospective Study (조현병 환자에서 1년간의 2세대 항정신병약물 지속적 투여가 혈소판 활성도에 미치는 영향: 후향적 연구)

  • Yoon-Seok, Oh;Jong Wook, Lee;Hong-Seok, Oh;Seung-Jun, Kim;Na-Hyun, Lee;Woo Young, Im;Ji-Woong, Kim
    • Korean Journal of Psychosomatic Medicine
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    • v.30 no.2
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    • pp.165-171
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    • 2022
  • Objectives : This study was conducted to investigate the effect of 1-year administration of second-generation antipsychotics (SGAs) on the platelet activity in patients with schizophrenia through a retrospective review of the medical records. Methods : The mean platelet component (MPC) value was used as an index of the platelet activity. The included subjects (N=24) were the patients who were confirmed to have taken SGAs continuously for one year after the first MPC measurement had been performed. The change of MPC was verified through a paired sample t-test. Results : The result revealed that the mean MPC value was significantly decreased from 26.5±1.4 g/dL to 25.6±1.8 g/dL after 1-year administration of SGAs from the time of the first MPC measurement. Conclusions : This study suggests that 1-year administration of SGAs may be related with increased platelet activity, and that close monitoring for risks such as cerebrovascular/cardiovascular or thromboembolic diseases may be necessary during SGAs treatment in clinical practice.

Analysis of Actual State for Hospice Programs in Korea (호스피스 프로그램 운영 현황 조사)

  • Chang, Hyun-Sook;Park, Sylvia;You, Sun-Ju
    • Journal of Hospice and Palliative Care
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    • v.3 no.1
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    • pp.4-17
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    • 2000
  • Purpose : This study aimed to investigate and to evaluate the present conditions of hospice programs in Korea for supplying data useful in making policy in hospice, which is not institutionalized yet. Method : For this purpose we surveyed 59 hospice programs regarding the general characteristics, manpower, patients, services, financial conditions, and facilities. Thirty-seven hospice programs answered the questionnaires. Result : They were 11 tertiary hospitals, 11 other hospitals, 3 clinics, 12 home care hospice, and 1 freestanding hospice. Only 9 hospice programs have all of the essential professionals: physicians, nurses, social workers, clergies, and volunteers. In some hospice programs, volunteers who had not been trained for hospice provided services to terminal patients. More than half of the hospice said they provided services to the patients who lost their consciousness and were not suitable for hospice care. 16% of the hospice said they did not keep the patients' record. Some hospitals including tertiary hospitals provided such intensive care as radiotherapy, TPN, injections to hospice patients. Many hospice programs other than hospitals didn't charge patients for hospice care. 60% of the hospice said they suffered from financial problems. Most of the hospice wards were not built for hospice use at first. So they did not have such supplementary facilities as dayroom, waiting room, special bathing facilities etc. Conclusion : For improving the quality of terminal patients and promoting the cost effective use of health care resources, it is necessary to consider the institutionalization of hospice. The institutionalization of hospice programs can improve the quality of hospice care and the standardization of the hospice program can hasten its institutionalization.

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A Retrospective Analysis of Use in Hospitalized Children with Upper Respiratory Tract Infection (상기도 감염으로 입원한 소아환자에서 항생제 사용에 대한 후향적 분석)

  • Jung, Minyoung;Park, Ji Hyun;Oh, Chi Eun
    • Pediatric Infection and Vaccine
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    • v.24 no.2
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    • pp.87-94
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    • 2017
  • Purpose: The inappropriate prescription of antibiotics in children with upper respiratory tract infection (URTI) is common. This study evaluated the factors that influence antibiotics use in hospitalized children with viral URTI confirmed by reverse transcriptase-polymerase chain reaction (RTPCR) assay. Methods: The medical records of admitted patients who performed RT-PCR assay for respiratory virus pathogens from January 2013 to November 2014 were examined. The demographic and clinical features were compared between patients who were administered antibiotics at admission and those who were not. We also investigated differences between children who continued antibiotics and those who stopped antibiotics after a viral pathogen was identified. Results: In the total 393 inpatients, the median age was 23 months (interquartile range, 13 to 41.3 months). Antimicrobial agents were prescribed in 79 patients (20.1%) at admission. Patients with acute otitis media (AOM) had higher rates of antibiotics prescription than those without AOM (48.1% vs. 2.2%, P<0.001), with an adjusted odds ratio of 91.1 (95% confidence interval, 30.5 to 271.7). Level of high-sensitivity C-reactive protein and the proportion of acute rhinosinusitis were also significantly associated with antibiotics use (P<0.001). Among the 44 patients with viruses identified using the RT-PCR method during hospitalization, antibiotic use was continued in 28 patients (63.6%). AOM was statistically associated with continued antibiotic use in the patients (P=0.002). Conclusions: Although the respiratory virus responsible for URTI etiology is identified, clinicians might not discontinue antibiotics if AOM is accompanying. Therefore, careful diagnosis and management of AOM could be a strategy to reduce unjustified antibiotic prescriptions for children with URTI.

A SURVEY OF DENTAL TREATMENT UNDER OUTPATIENT GENERAL ANESTHESIA IN DEPARTMENT OF PEDIATRIC DENTISTRY AND CLINIC FOR DISABLED AT YONSEI UNIVERSITY DENTAL HOSPITAL (연세대학교 치과대학병원 소아치과 및 장애인 클리닉에서 시행된 외래 전신마취하의 치료에 대한 연구)

  • Lee, Dong-Woo;Song, Je-Seon;Choi, Hyung-Jun;Kang, Jeong-Wan;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.1
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    • pp.65-72
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    • 2010
  • General anesthesia has been researched and developed in dentistry as on type of management technique to sedate patients who may be uncontrollable or require medical consideration. There has been continuous research into this area, but analysis of large set of patients over a sustained period of time is lacking. Thus, this study analyzes the records of patients who received general anesthesia at the Yonsei University Dental Hospital Department of Pediatric and Clinic for the Disabled. 1. Patient's age ranged from 1 to 66, with under 5 being the largest group with 410 members(38.5%). The study included more men than women, with 695 male members(65.3%). 2. Type of dental procedure performed were as follows(per person) : 5.6 Dental restoration; 2.3 Endodontic treatment of deciduous and primary teeth; 2.5 preformed crowning; and 1.6 extractions. Procedures took an average of 100 minutes. 3. 1022 patients(95.9%) received dental care under general anesthesia once and 43 patients(4.1%) received dental care under general anesthesia two or more times. Dentistry under general anesthesia has the many benefit. However, without appropriate post-treatment care, it is difficult to maintain good oral health. Therefore, it is important to improve the efficiency and safety of general anesthesia through future research.