• 제목/요약/키워드: Acute Care

검색결과 972건 처리시간 0.028초

압박골절 후유증 관리 중 발생 한 섬망 환자 1례 증례보고 (A Case with Unspecified Delirium during Care for Sequela of Compression Fracture)

  • 김경옥;김현일;김근우;구병수;김주호
    • 동의신경정신과학회지
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    • 제16권1호
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    • pp.227-235
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    • 2005
  • Delirium is a acute syndrome of disorientation caused by dysfunction of brain tissue and has a many varied symtome. It is characteristic of consciousness disturbance with disorientation and dys-mnesia and emotional disturbance. We experienced a 91 year-old woman who had a sequela of compression fracture as well as unspecified delirium, and whose condition was improved through oriental medical treatment. We had given herb medication, acupuncture treatment and decreased medication to this patient, and observed. The patient's delirium symptom had improved through oriental medical treatment and decreasing medication. It is able to improve a delirium caused by not specified origin and side effect on drug abuse through oriental medical treatment and decreasing medication.

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산후 역절풍 1례 임상경과 보고 (Clinical study for the one case who contracts of Arthritis after parturition)

  • 박영애;박영선;김동철
    • 대한한방부인과학회지
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    • 제20권3호
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    • pp.246-258
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    • 2007
  • Purpose: The purpose of this study is to report the effect of TKM to Rhumatitis Arthritis after parturition and show the importance of recuperation after parturition. Methods: The patient was a 33-year-old woman who complains arthralgia, edema and sense of coldness after her third parturition. The patient was treated by Herb medicine, Acupuncture treatment, Moxa treatment and Physical Treatment. And the progress of symptoms was evaluated by cheking the change of VAS, and inspecting the DITI. Results: The Pain and edema have declined. After discharge, she got definite diagnosis as Rhumatitis Arthritis. But We already estimated it from the results of serum test. So we had treated the patience with TKM and we could explain the prognosis. We regulated the pain and edema successfully at the acute phase. And the patient could take care of herself, she didn't play her disease down as a simple symptoms of parturition. Conclusion: TKM is expected to have positive effects on Rheumatic arthritis with quick onset after parturition.

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A Study for Health Hazard Evaluation of Methylene Chloride Evaporated from the Tear Gas Mixture

  • Park, Seung-Hyun;Chung, Eun-Kyo;Yi, Gwang-Yong;Chung, Kwang-Jae;Shin, Jung-Ah;Lee, In-Seop
    • Safety and Health at Work
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    • 제1권1호
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    • pp.98-101
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    • 2010
  • This study explored the health hazard of those exposed to methylene chloride by assessing its atmospheric concentration when a tear gas mixture was aerially dispersed. The concentration of methylene chloride ranged from 311.1-980.3 ppm (geometric mean, 555.8 ppm), 30 seconds after the dispersion started. However, the concentration fell rapidly to below 10 ppm after dispersion was completed. The concentration during the dispersion did not surpass the National Institute for Occupational Safety and Health 'immediately dangerous to life or health' value of 2,300 ppm, but did exceed the American Conference of Governmental Industrial Hygienists excursion limit of 250 ppm. Since methylene chloride is highly volatile (vapor pressure, 349 mmHg at $20^{\circ}C$), the post-dispersion atmospheric concentration can rise instantaneously. Moreover, the o-chlorobenzylidenemalononitrile formulation of tear gas (CS gas) is an acute upper respiratory tract irritant. Therefore, tear gas mixtures should be handled with delicate care.

담뱃잎농부병으로 진단된 고령 환자 1례 (A Case of Green Tobacco Sickness (GTS) in Elderly Patient)

  • 정동길;김도의
    • 대한임상독성학회지
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    • 제17권2호
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    • pp.132-134
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    • 2019
  • Green tobacco sickness is an illness caused by dermal exposure to nicotine. The common symptoms of the disease include dizziness, headache, nausea, vomiting, severe general weakness, fluctuations of blood pressure or heartbeat, abdominal cramping, chills, increased sweating, salivation, and difficulty breathing. A 79-year-old female arrived at the emergency room for an evaluation of sudden onset dizziness. Magnetic resonance imaging and angiography of the brain did not show any relevant abnormal findings. Four days later, with supportive care, she said that she had harvested green tobacco for six hours on the day of admission and the tobacco harvest was the first time in her life. She sweated excessively during the hot and humid weather and the tobacco leaves were wet from rain the night before. The serum cotinine tested at five days of admission was 16ng/ml. She was diagnosed with acute nicotine poisoning by her clinical symptoms and the half-life of cotinine in the blood.

전을(錢乙) 사백산(瀉白散)의 방의(方義)에 대한 소고(小考) - 오국통(吳鞠通)의 비판을 중심으로 - (A Study on the Meaning of Xiebaisan Made by Qianyi - Focused on Wujutong's Critiques -)

  • 백유상
    • 대한한의학원전학회지
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    • 제32권1호
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    • pp.191-204
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    • 2019
  • Objectives : Focusing on Wujutong's critiques for Xiebaisan misuse, this study investigates how Xiebaisan and its constituent drugs have historically been used by medical doctors and analyzes the disputes in the controversial context with a summary. Methods : The contents of Xiebaisan prescription were collected and examined from the past literature and medical database, and the issues related to the debate were examined by analyzing the contents. Results : In the results of exploring the opinions of medical doctors, in general, Xiebaisan and Sangbaipi, a major medicinal drug, were seen to play a role in the work of reinforcing and reducing. In particular, Ye Tianshi was used with cold and pungent medicine to Xiebaisan as a method of releasing heat with pungent medicine for acute fever in spring, and at the same time, care was taken to avoid depletion of secretion in the stomach. Conclusions : Wujutong's critique is that in early symptoms of viral infection, the misuse of Xiebaisan seems to emphasize the adverse effects of the illness. It is hoped that further research on Xiebaisan incremental medication will be conducted in the future to help clinical applications of Xiebaisan system medication.

병원간호사의 type D 성격, 소진, 간호근무환경이 재직의도에 미치는 영향 (The Influences of Type D Personality, Burnout and Work Environment on Nurses' Intention to Stay in the Hospitals)

  • 김숙영;서연옥
    • 동서간호학연구지
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    • 제24권2호
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    • pp.163-170
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    • 2018
  • Purpose: The purpose of this study was to identify the influences of type D personality, burnout and work environment on nurses' intention to stay at the hospitals among nurses. Methods: A cross-sectional descriptive design was used. Participants were 135 nurses working at general hospitals. Data were collected using self-report questionnaires. Data were analyzed using the SPSS/WIN 23.0 program for descriptive statistics, independent t-test, ANOVA, $Scheff{\acute{e}}$ test, Pearson's correlation, and hierarchical multiple regression. Results: The score of nurses' intention to stay was 4.78. 39.3% of participants were classified as type D personality group. The scores of burnout and work environment were 2.92 and 2.39, respectively. Intention to stay was negatively correlated with burnout and positively correlated with nurse participation in hospital affairs, nursing foundations for quality of care, nurse manager ability, leadership, and support of nurses, staffing and resource adequacy. Burnout and manager ability, leadership, and support for nurses explained 46.0% of variance of nurses' intention to stay in the hospitals. Conclusion: The results of the study indicate that nursing intervention programs for increasing intention to stay for nurses should include strategies for decreasing the burnout and increasing manager ability, leadership, and support for nurses.

Factors that Affect Depression and Anxiety in Service and Sales Workers Who Interact With Angry Clients

  • Park, Jungsun;Kim, Yangho
    • Safety and Health at Work
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    • 제12권2호
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    • pp.217-224
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    • 2021
  • Introduction: We evaluated depression and anxiety in service and sales workers from Korea who interacted with angry clients to identify factors that mediated and moderated depression and anxiety in these workers. Methods: This was a secondary analysis of data from the fifth Korean Working Conditions Survey conducted in 2017. A structural equation model was used for mediation and moderation analysis. Results: Service and sales workers who had more interactions with angry clients had increased risk for depression and anxiety. Experiencing clients' adverse behaviors (acute episodes) mediated the relationship between interacting with angry clients (a chronic situation) on depression and anxiety. Job satisfaction and managers' support moderated the relationship between interacting with angry clients and mental health problems. Conclusion: We suggest that employers of service and sales workers should recruit staff based on their aptitude for such work, thus ensuring job satisfaction, and train them to deal with angry clients in such a way that they experience less emotional burden. Employers should also make bylaws requiring managers to directly take care of adverse social behavior by clients. Furthermore, a sociocultural campaign to prevent adverse social behavior by clients is also needed.

입원 노인의 연령별 영양불량 위험요인 (Risk Factors of Malnutrition by Age in Hospitalized Older Adults)

  • 김은정
    • 임상간호연구
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    • 제27권1호
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    • pp.77-84
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    • 2021
  • Purpose: Malnutrition affects all age groups, but older adults are particularly more vulnerable to nutritional deficiencies. This study evaluated the age-specific factors affecting malnutrition in hospitalized older adults. Methods: A retrospective study was conducted on inpatient elderly people who received artificial nutrition from 2010 to 2017. Data of demographics, diagnosis, type of nutrition therapy, number of comorbidity, fall risk assessment, Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) score, and intensive care unit admission were collected. Malnutrition was defined as a body mass index (BMI) of less than 18.5 kg/m2. Patients were classified as the young-old (65~74 years old), the old-old (75~84 years old), or the oldest-old (85 years old or older). Results: A total of 7,130 older adults were included, and 4,028 patients were classified as the young-old, 2,506 into the old-old, and 596 into the oldest-old. Proportion of malnutrition was higher in the oldest-old compared to the other groups. In multivariate analysis, parenteral nutrition, alcohol, and high risk of falls were factors affecting malnutrition in all groups. Parenteral nutrition and alcohol in the young-old, high risk of falls in the old-old, and male sex in the oldest-old were the factors affecting malnutrition by the age group. Conclusion: Older age was the most significant factor affecting malnutrition. Specific strategies by age are needed to improve nutritional status in hospitalized older adults as influencing factors for malnutrition vary among different age groups.

Trauma Surgery and War: A Historical Perspective

  • Hwang, Kun
    • Journal of Trauma and Injury
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    • 제34권4호
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    • pp.219-224
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    • 2021
  • The aim of this review is to introduce the progress in trauma surgery made during war. In the 16th century, Paré reintroduced ligature of arteries, which had been introduced by Celsus and Galen, instead of cauterization during amputation. Larrey, a surgeon in Napoleon's military, adapted the "flying artillery" to serve as "flying ambulances" for rapid transport of the wounded. He established rules for the triage of war casualties, treating wounded soldiers according to the seriousness of their injuries and the urgency of medical care. To treat fractures and tuberculosis, Thomas created the "Thomas splint", which was used to stabilize fractured femurs and prevent infection; in World War I (WWI), use of this splint reduced the mortality of compound femur fractures from 87% to less than 8%. During WWI, Cushing systematized the treatment of head injuries, reducing mortality among head injury patients. Gillies repaired facial injuries, and his experiences became the basis of craniofacial and aesthetic surgery. In WWII, McIndoe discovered that immersion in saline promoted burn healing and improved survival rates, and thus began saline baths and early grafting instead of using tannic acid. A high mortality rate in patients with acute renal failure was noted in WWII and the Korean War. In the Korean War, Teschan used the Kolff-Brigham dialyzer. The first use of medevac with helicopters was the evacuation of three British pilot combat casualties by the US Army in Burma during WWII. As a lotus blooms in the mud, military surgeons have contributed to trauma surgery during wartime.

Pathophysiology, classification, and complications of common asymptomatic thrombocytosis in newborn infants

  • Jeon, Ga Won
    • Clinical and Experimental Pediatrics
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    • 제65권4호
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    • pp.182-187
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    • 2022
  • We frequently encounter newborn infants with thrombocytosis in the neonatal intensive care unit. However, neonatal thrombocytosis is not yet fully understood. Thrombocytosis is more frequently identified in newborns and young infants, notably more often in those younger than 2 years than in older children or adults. The production of megakaryocytes (megakaryopoiesis) and platelets (thrombopoiesis) is mainly regulated by thrombopoietin (TPO). Increased TPO levels during infection or inflammation can stimulate megakaryopoiesis, resulting in thrombopoiesis. TPO concentrations are higher in newborn infants than in adults. Levels increase after birth, peak on the second day after birth, and start decreasing at 1 month of age. Initial platelet counts at birth increase with gestational age. Thus, preterm infants have lower initial platelet counts at birth than late-preterm or term infants. Postnatal thrombocytosis is more frequently observed in preterm infants than in term infants. A high TPO concentration and low TPO receptor expression on platelets leading to elevated plasma-free TPO, increased sensitivity of megakaryocyte precursor cells to TPO, a decreased red blood cell count, and immaturity of platelet regulation are speculated to induce thrombocytosis in preterm infants. Thrombocytosis in newborn infants is considered a reactive process (secondary thrombocytosis) following infection, acute/chronic inflammation, or anemia. Thrombocytosis in newborn infants is benign, resolves spontaneously, and, unlike in adults, is rarely associated with hemorrhagic and thromboembolic complications.