• Title/Summary/Keyword: Chronic medical condition

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Factors Affecting Emotional Status and Suicidal Risk in Hospitalized Medical Patients (일 종합병원 입원 환자의 자살 위험도 및 정서 상태에 영향을 미치는 요인 연구)

  • Lee, Jeon-Ho;Lee, Jong-Ha;Mok, Young-Eun;Lee, Ho-Jun;Jung, Hyun-Gang;Kim, Seung-Hyun;Lee, Moon-Soo
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.127-134
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    • 2018
  • Objectives : This study aimed to identify the group with high risk of suicide in general hospital inpatient by comparing the depression, anxiety, and distress and their clinical characteristics. Methods : The study included all patients admitted to a general hospital between January 2016 and December 2017, and the final 41,249 patients were analyzed. Distress thermometer (DT) and hospital anxiety-depression scale (HADS) were used for emotional state evaluation. Group with high risk of suicide was defined as showing more than 4 in the DT and more than 8 in one of the two subscales (anxiety and depression) of the HADS. Results : Among the subjects, 3,603 patients (8.7%) met the high-risk criteria for suicide. The group with high risk of suicide experienced more severe pain than the control patient group, and it was found that there was more underlying disease. Patients who reported pain showed higher scores than those who reported no pain on the DT and HADS subscales. Conclusions : Group with high risk of suicide showed more severe pain and more underlying disease. Therefore, suicide prevention program specifically targeted for the group with high risk of suicide should be developed according to the risk of the patient evaluated at the time of the admission.

The Usefulness of Noninvasive Positive Pressure Ventilation in Patients With Acute Respiratory Failure after Extubation (기관내 관 제거 후 발생한 급성 호흡부전에서 비침습적 양압 환기법의 유용성)

  • Na, Joo-Ock;Lim, Chae-Man;Shim, Tae-Sun;Park, Joo-Hun;Lee, Ki-Man;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.3
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    • pp.350-362
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    • 1999
  • Background: Acute Respiratory failure which is developed after extubation in the weaning process from mechanical ventilation is an important cause of weaning failure. Once it was developed, endotracheal reintubation has been done for respiratory support. Noninvasive Positive Pressure Ventilation (NIPPV) has been used in the management of acute or chronic respiratory failure, as an alternative to endotracheal intubation, using via nasal or facial mask. In this study, we evaluated the usefulness of NIPPV as an alternative method of reintubation in patients who developed acute respiratory failure after extubation. Method: We retrospectively analyzed thirty one patients(eighteen males and thirteen females, mean ages $63\pm13.2$ years) who were developed acute respiratory failure within forty eight hours after extubation, or were extubated unintentionally at medical intensive care unit(MICU) of Asan Medical Center. NIPPV was applied to the patients. Ventilatory mode of NIPPV, level of ventilatory support and inspiratory oxygen concentration were adjusted according to the patient condition and results of blood gas analysis by the attending doctors at MICU. NIPPV was completely weaned when the patients maintained stable clinical condition under 8 $cmH_2O$ of pressure support level. Weaning success was defined as maintenance of stable spontaneous breathing more than forty eight hours after discontinuation of NIPPV. Respiratory rate, heart rate, arterial blood gas analysis, level of pressure support, and level of PEEP were monitored just before extubation, at thirty minutes, six hours, twenty four hours after initiation of NIPPV. They were also measured at just before weaning from NIPPV in success group, and just before reintubation in failure group. Results: NIPPV was successfully applied to thirty-one patients of thirty-two trials and one patient could not tolerated NIPPV longer than thirty minutes. Endotracheal reintubation was successfully obviated in fourteen patients (45%) among them. There was no difference in age, sex, APACHE III score on admission at MICU, duration of intubation, interval from extubation to initiation of NIPPV, baseline heart rate, respiratory rate, arterial blood gas, and $PaO_2/FiO_2$ between the success and the failure group. Heart rate and respiration rate were significantly decreased with increase $SaO_2$ after thirty minutes of NIPPV in both groups(p<0.05). However, in the patients of failure group, heart rate and respiratory rate were increased again with decrease in $SaO_2$ leading to endotracheal reintubation. The success rate of NIPPV treatment was significantly higher in the patients with COPD compared to other diseases(62% vs 39%) (p=0.007). The causes of failure were deterioration of arterial blood gas without aggravation of underlying disease(n=9), aggravation of undelying disease(n=5), mask intolerance(n=2), and retained airway secretion(n=l). Conclusion: NIPPV would be a useful therapeutic alternative which can avoid reintubation in patient who developed acute respiratory failure after extubation.

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An Objective Evaluation on Menopausal Syndrome and the Effect of Red Ginseng

  • Katsutaro Nagata;Katsuya Morishita;Kotaro Fujioka;Misako Yamazaki;Akihiro Okamoto;Kenji Kubota
    • Proceedings of the Ginseng society Conference
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    • 1998.06a
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    • pp.322-326
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    • 1998
  • In order to evaluate menopausal syndrome objectively, examinations were performed as follows: 1) Simplified Menopausal Index (SMI Koyama) and QOL questionnaire (Nagata) were examined subjectively. 2) Urine 17-KS-5 (S Nishikaze), 17-OHCS (OH) were examined objectively. 3) A mobile telemedical device with EKG and KSG was lent to Patients. The subjects were 48 menopausal patients who visited our university hospital as outpatients. According to the results of 5, OH, the subjects were divided into 4 Groups; Group I is high S & high OH, Group ll low S & low OH, Group 111 is low S & high OH, Group tl is high S & low OH. Group IH was the largest (64.6%), Group of was none. The subjects showed significantly lower QOL condition and higher score of SMI. In the QOL, questionnaire items of fixation to physical status (psychogenic reaction), sleep (insomnia), pain(chronic pain) were in common. In SMI, functional vascular symptoms were the largest number. On treatment, Group I was considered to have no need for supplementary agents, but anti-Oketsu agents was prescribed. For Group ll and in some supplementary agents such as red ginseng were prescribed, because they showed low 5. In conclusion, all the groups showed a sign- nificant improvement of QOL and SMI. Group I showed a decrease of OH, Group ll showed an increase of 5, Group In showed an increase of S and SIOH and a decrease of OH. These phenomena were considered prohomeostatic. In QOL, the items of chronic pain, insomnia and appetite were improved. In SMI, chillness, dyspnea, palpitation, pain and fatigability were improved. In mobile tole-medical device, abnormal findings were found in 88.2% of patients. General sdaptation syndrome (Selye, H.) is considered to adjust human life. Menopause is the transit period to exhausted stage in it. So its symptoms vary from person to person. In conclusion, 5 and OH are useful both for classification of menopausal syndrome and for determining treatments according to the classification

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Effect of Preexisting Musculoskeletal Diseases on the 1-Year Incidence of Fall-related Injuries

  • Lee, Won-Kyung;Kong, Kyoung-Ae;Park, Hye-Sook
    • Journal of Preventive Medicine and Public Health
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    • v.45 no.5
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    • pp.283-290
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    • 2012
  • Objectives: People who have chronic diseases, as well as gait imbalance or psychiatric drug use, may be susceptible to injuries from falls and slips. The purpose of this study was to evaluate the effect of musculoskeletal diseases on incidental fall-related injuries among adults in Korea. Methods: We analyzed data from the 4th Korea National Health and Nutrition Examination Survey (2007-2009), which are national data obtained by a rolling survey sampling method. The 1-year incidence of fall-related injuries was defined by health service utilization within the last year due to injury occurring after a slip and fall, and musculoskeletal diseases included osteoarthritis, rheumatoid arthritis, osteoporosis, and back pain. To evaluate the effects of preexisting musculoskeletal diseases, adults diagnosed before the last year were considered the exposed group, and adults who had never been diagnosed were the unexposed group. Results: The weighted lifetime prevalence of musculoskeletal disease was 32 540 per 100 000 persons. Musculoskeletal diseases were associated with a higher risk of fall-related injury after adjustment for sex, age, residence, household income, education, occupation, visual disturbance, paralysis due to stroke, and medication for depression (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.03 to 1.93). As the number of comorbid musculoskeletal diseases increased, the risk of fall-induced injuries increased (p-value for trend <0.001). In particular, patients who had any musculoskeletal condition were at much higher risk of recurrent fall-related injuries (OR, 6.20; 95% CI, 1.06 to 36.08). Conclusions: One must take into account the risk of fall-related injuries and provide prevention strategies among adults who have musculoskeletal diseases.

A Review of Clinical Trials for Development of Assessment Criteria for Chronic Low Back Pain (만성 요통에 대한 한의학적 평가척도 개발을 위한 임상연구 실태조사)

  • Kim, Ji-Hye;Nam, Dong-Woo;Kang, Jung-Won;Kim, Eun-Jung;Kim, Kap-Sung;Kang, Sung-Keel;Lee, Jae-Dong
    • Journal of Acupuncture Research
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    • v.26 no.6
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    • pp.215-224
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    • 2009
  • Objectives : Low back pain is the most prevalent condition for receiving Korean traditional medical treatment. The aim of this review is to provide fundamental data for development of low back pain classification and assessment criteria which can be used in clinical trials and clinical practice. Methods : Domestic and international clinical studies on oriental medicine treatment for low back pain were searched through on-line databases. The searched articles were reviewed and the evaluation tools used in the studies were investigated. Results : A total of 38 possibly relevant articles in Pubmed were identified, of which 34 articles included assessment criteria for low back pain. And 38 articles were reviewed in the Journal of Korean Oriental Medicine and the Journal of Korean Acupuncture & Moxibustion Society. 29 articles used pain scales, 24 used functional scales, and 20 among 34 articles in PubMed used both pain and functional scales. The majority of articles which published in Korea used worthless assessment scales of simple grades. There was no articles which used assessment scales related to the concepts of Korean traditional medicine. Conclusions : Our review of articles suggests that we would use both pain and functional scales. Future assessment scales should include the concepts of Korean traditional medicine.

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Axillary Reconstruction for Hidradenitis Suppurativa with an Inner-Arm Transposition Flap Creating a Brachioplasty Effect

  • Ching, Daniel L.;Mughal, Maleeha;Papas, Athanasios;Soldin, Mark
    • Archives of Plastic Surgery
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    • v.44 no.3
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    • pp.228-233
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    • 2017
  • Background Hidradenitis suppurativa (HS) is a chronic skin condition that can affect any area with apocrine sweat glands and has the potential to involve multiple sites concurrently. Commonly affected sites include the axilla, groin, perineum and perianal areas. In this study we performed a literature review on the surgical methods for HS and describe an innovative technique for reconstructing axilla HS using an inner-arm transposition flap. Methods We reviewed all cases (5 cases from 4 patients) of transposition flap reconstruction performed by the senior author at a single London tertiary hospital from 2008-2013. Patient related outcome measures were collected using the Derriford appearance scale (DAS 24) and a study specific questionnaire. Results All patients were satisfied with their final result. One out of five cases had a complication but did not result in flap failure. There is no disease recurrence to date. DAS 24 scores collected demonstrated acceptable postoperative distress that did not deviate far from the norm tables while study specific questionnaire reveal desirable outcomes. Conclusions We have managed to achieve our aim through the use of the innovative inner-arm transposition flap. Our study hopes to provide an additional technique for axillary reconstruction. This technique offers the effective concealment of scars with the benefit of tightening of the arm tissue producing 'brachioplasty like' effects. All things considered it would be reasonable to conclude the innovative flap technique is a reliable, effective, and simple method that results in multiple benefits.

Clinical Study on Effect of Carthmi- Flos Herbal acupuncture therapy to Low back pain patient (요통환자(腰痛患者)의 홍화약침치료(紅花藥針治療)에 대한 임상적(臨床的) 연구(硏究))

  • Yoon, Min-Young;Cho, Eun-Hee;Lee, Ok-Ja;Moon, Sung-Jae;Hur, Tae-Young;Cho, Nam-Geun;Kim, Kyung-Sik
    • Journal of Acupuncture Research
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    • v.19 no.3
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    • pp.216-229
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    • 2002
  • Objective : To compare the effect of Carthmi- Flos herbal acupuncture theraphy and acupucture treatment to Low back pain patient. Methods : 70 patients with Low back pain are evaluated by being divided Carthmi- Flos herbal acupuncture theraphy Group(HAG, 30 peples) and non- Carthmi- Flos herbal acupuncture theraphy Group(NHAG, 40 peoples) at Ik-San Oriental medical hospital in wonkwang university from the first November 2000yr to 31th December 2001yr. Results : 1. In the cause of Low back pain, the most of HAG is acute sprain(9cases, 30%) and NHAG is non-inducement(13 cases, 22.5%). 2. In the analysis of the radiation result, HIVD and Degenerative change respectively were 22 cases(50%) in HAG and 29 cases(52.8 %) in NHAG. 3. The effect of treatment by Duration as follows :Two groups were the most improved highly in acute stage and they were improved lowly in chronic stage(6 month). 4. The effect of treatment by condition of patients was follows: After treatment, Grade IV & III were decreased 69.5% in HAG and 60% in NHAG. 5. In the distribution of treatment progression : 28 cases(93.3%) were recoverd in HAG but 30 cases(90%) in NHAG. Conclusion : These results shows that the effect of treatment by Carthmi- Flos herbal acupuncture treatmen is exellent by relaxing contracted muscles, strengthening weakened ligaments and improving inflammatory parts.

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Effect of Diamond Taping Applied to the Elbow Joint on Wrist Extensor Muscle Activity in Healthy Subjects (팔꿉관절 부위에 적용한 다이아몬드 테이핑이 정상인의 파악력 수준별 손목 폄근의 근활성도에 미치는 영향)

  • Huang, Tian-zong;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.27 no.2
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    • pp.118-125
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    • 2020
  • Background: Lateral epicondylitis (LE) is the most common chronic musculoskeletal pain condition of the upper extremities. LE is often related to forceful grip activities that require isometric contraction of the wrist extensors. A previous study evaluated the effect of the diamond taping technique on grip strength and pain; however, there has been no report on the change in the electromyography (EMG) findings of wrist extensors. Objects: The aim of this study was to investigate the effect of diamond taping technique, using a rigid tape, on the EMG activities of the extensor carpi radialis (ECR) during grip activities. Methods: Twenty-four healthy subjects (mean age = 21.50 ± 2.76 years) volunteered to participate in this study. The subjects were instructed to perform forceful grip activities with and without diamond-type taping on the origin area of the ECR. Grip strength tests were performed at 100%, 75%, 50%, and 25% for maximal isometric contraction force. EMG data were collected from the ECR. Repeated measure analysis of variance was used to analyze the effect of grip force and taping (with and without). Statistical significance levels were set at α = 0.05. Comparison of the results with and without taping at different grip force were analyzed using independent t-test. Statistical significance levels were set at α = 0.01. Results: Statistically significant association was observed between the taping application and forceful grip activity as revealed by the EMG data of the ECR (p < 0.05). EMG of the ECR significantly reduced for all muscle strength levels (p < 0.01) after taping. Conclusion: This study shows an impressive effect of the diamond taping technique, using rigid tape, on wrist extensors during grip activities. Decreasing muscle activity via this taping approach could be utilized to enhance pain-free grip force and reduce pain in patients with LE. Our study suggested that this taping technique could be considered as an effective management strategy of LE.

Functional Characteristics of Soybean Oligosaccharide (콩 함유 올리고당의 기능적 특성)

  • 정명근;이재철
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.48
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    • pp.58-64
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    • 2003
  • To enjoy a healthy life, it is important to have a well-balanced diet. However, in today's society, there is an increase in the consumption of preprocessed foods and frequency of eating out. Also the western diet, which is becoming move popular worldwide, contains relatively high levels of protein and fat, and a low amount of fiber, Furthermore, the increased availability of favorite foods has created a condition were the individual diet is less variable. With these conditions, it is difficult to maintain a diet that is nutritionally balanced. With these unbalanced diets, which are difficult to change, there has been an increase in adult disease and health problems, such as colon and breast cancer, It is speculated that metabolites for carcinogens are produced from diet components and that intestinal bacteria contribute to the production of these metabolites. Therefore, it is necessary to evaluate the relationships between health, diet, and intestinal microflora. Soybean oligosaccharide is composed of water-soluble saccharides that have been extracted from soybean whey, a by-product from the production of soy protein. This is mainly a mixture of mono-, di-, tri-, and tetrasac-charides, with the principle components being the oligosaccharide raffinose and stachyose. When consumed by humans, the oligosaccharides cannot be digested in the human duodenal and small intestinal mucosa, and these are selectively utilized by beneficial bifidobacteria in intestines. The results of acute and subacute toxicity tests, soy-bean oligosaccharides were nonpoisonous. Soybean oligosaccharides promote the growth of indigenous bifido-bacteria in the colon which by their antagonistic effects, suppress the activity of putrefactive bacteria. Also, they reduce toxic metabolites, detrimental enzymes and plasma lipid, and increase in the frequency of bowel evacuation and fecal quantities. Consequently, soybean oligosaccharides as functional foods components have potential roles in the prevention and medical treatment of chronic adult diseases. The study of processing property and physiological function of soybean oligosacchavides and development of high oligosaccharide variety allow the creation of new and exciting foodstuffs that aye functional healthy.

Therapeutic alternatives in painful diabetic neuropathy: a meta-analysis of randomized controlled trials

  • Vilar, Samuel;Castillo, Jose Manuel;Martinez, Pedro V. Munuera;Reina, Maria;Pabon, Manuel
    • The Korean Journal of Pain
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    • v.31 no.4
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    • pp.253-260
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    • 2018
  • Background: One of the most frequent problems caused by diabetes is the so called painful diabetic neuropathy. This condition can be treated through numerous types of therapy. The purpose of this study was to analyze, as a meta-analysis, different treatments used to alleviate painful diabetic neuropathy, with the aim of generating results that help making decisions when applying such treatments to tackle this pathology. Methods: A search was conducted in the main databases for Health Sciences, such as PUBMED, Web of Science (WOS), and IME biomedicina (Spanish Medical Reports in Biomedicine), to gather randomized controlled trials about treatments used for painful diabetic neuropathy. The analyzed studies were required to meet the inclusion criteria selected, especially those results related to pain intensity. Results: Nine randomized controlled trials were chosen. The meta-analysis shows significant positive effects for those treatments based on tapentadol [g: -1.333, 95% CI (-1.594; -1.072), P < 0.05], duloxetine [g: -1.622, 95 % CI (-1.650; -1.594), P < 0.05], pregabalin [g: -0.607, 95% CI (-0.980; -0.325), P < 0.05], and clonidine [g: -0.242, 95 % CI (-0.543; -0.058), P < 0.05]. Conclusions: This meta-analysis indicates the effectiveness of the treatments based on duloxetine, gabapentin and pregabalin, as well as other drugs, such as tapentadol and topic clonidine, whose use is better prescribed in more specific situations. The results provided can help increase the knowledge about the treatment of painful diabetic neuropathy and also in the making of clinical practice guidelines for healthcare professionals.