• 제목/요약/키워드: Clinical Practices

검색결과 499건 처리시간 0.03초

Smoking Cessation Treatment and Outcomes in Medium to Heavy Cigarette Smokers being Treated for Cancer in Jordan

  • Hawari, Feras Ibrahim;Obeidat, Nour Ali;Ayub, Hiba Salem;Dawahrah, Sahar Sattam;Hawari, Saif Feras
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권11호
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    • pp.6875-6881
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    • 2013
  • Background: Studies evaluating smoking cessation treatment outcomes in cancer patients are scarce, despite smoking cessation importance in cancer care. We sought to add to the literature by evaluating smoking cessation in a challenging group of cancer patients (medium-to-heavy smokers) visiting an out-patient smoking cessation clinic (SCC) in a cancer center in Amman, Jordan. Materials and Methods: Patients smoking >9 cigarettes per day (CPD) and referred to the SCC between June 2009 and May 2012 were studied. Clinic records were reviewed to measure demographic and baseline clinical characteristics, and longitudinal (3-, 6- and 12- month) follow-up by phone/clinic visit was conducted. At each follow-up, patients were asked if they experienced medication side-effects, if they had returned to smoking, and reasons for failing to abstain. Descriptive and multivariable logistic regression analyses were performed. Results: A total of 201 smokers were included in the analysis. The 3-month abstinence was 23.4% and significantly associated with older age, being married, and presenting with lower (${\leq}10ppm$) baseline carbon monoxide (CO) levels. On a multivariable level, lower CO levels, a higher income (relative to the lowest income group), being older, and reporting severe dependence (relative to dependence reported as 'somewhat' or 'not') were significant predictors of higher odds of abstinence at three months. Reasons for failing to quit included not being able to handle withdrawal and seeing no value in quitting. Long-term ARs did not reach 7%. Conclusions: In a sample of Jordanian smokers (>9CPD) with cancer and receiving smoking cessation treatment, ARs were low and further declined with time. Results underscore the need for more aggressive patient management and rigorous follow-up during and after smoking cessation treatment, particularly when this takes place in challenging settings. Observed reasons for failure to abstain should be used to tailor counseling practices.

알로스테시스 과부하와 칠정상에 관한 비교 고찰 (Comparative Study between the Allostasis Load and Chiljeongsang)

  • 정진용;김준영;조정효;손창규
    • 동의생리병리학회지
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    • 제30권6호
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    • pp.452-457
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    • 2016
  • If human body is exposed to the continuous stress, it becomes allostasis load which is the condition of homeostasis broken. Its evolutional ecologic point of view and the relation with chiljeongsnag which is a theory in Oriental Medicine were investigated. Upon evolutional ecologic point of view by Maynard Smith, people can be divided by Hawks and Doves resulting in different types of allostasis in response of the stress. Hawks people who are active and aggressive get easily anger in the stressful situation to be vulnerable to the inflammatory hepatic diseases by enhancing Th1 immune system. On the other hand, Doves people who are passive and calm get easily depressed with sadness in the stressful situation to be vulnerable to the allergic pulmonary diseases by enhancing Th2 immune system. According to constitution theory of Oriental Medicine, Yangin and Eumin show the different features of responses to the stress generating Chiljeongsang. With excessive stress continuously, Yangin consider the feeling of anger mainly resulting in Qi reversal and liver damage, while Eumin consider the feeling of sadness mainly in consumption of Qi and lung damage. Hawks and Yangin, and Doves and Eumin show the common behaviors in response to the stress demonstrating the similar features including allostasis load and Chiljeongsang. In the clinical practices with the stressful patients, the viewpoint to consider the behaviors and feelings of the subjects to receive the stress simultaneously can be the new approaching method in Psychosomatic Medicine.

안정된 만성폐쇄성폐질환 환자의 기류제한 정도와 주관적 건강상태 (The Airflow Obstruction and Subjective Health Status Among Stable Chronic Obstructive Pulmonary Disease Patients Residing in the Community)

  • 송희영
    • Journal of Korean Biological Nursing Science
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    • 제19권1호
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    • pp.38-47
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    • 2017
  • Purpose: This study was undertaken to examine the relationship between airflow obstruction and subjective health status reported by stable patients with chronic obstructive pulmonary disease (COPD) residing in the community. Methods: A cross-sectional descriptive study was conducted with 78 stable COPD patients aged 69.7 years old on average and selected by a convenient sampling from an outpatient department of pulmonology in tertiary hospitals. They completed a constructed questionnaire including general characteristics, smoking history, dyspnea by modified medical research council (mMRC) scale, and health status by COPD assessment test (CAT). Anthropometric measurements were performed for body mass index (BMI) and pulse oxymetry for $O_2$ saturation (Sat $O_2$). Medical records were reviewed to obtain disease-related characteristics including duration of the disease, cardiovascular comorbidity, and forced expiratory volume in 1 second ($FEV_1$). Data were analyzed using PASW statistics 20.0. Results: Mean $FEV_1%$ and CAT scores were 55.11% and 17.73, respectively. Those in the lower stage of mMRC showed significantly higher $FEV_1$ and lower CAT. $FEV_1$ and CAT showed significant negative correlations; age and BMI with $FEV_1$, and Sat $O_2$ with CAT. Conclusion: The findings suggest that the less airway obstruction was, the better health status was, and provide the support for using subjective measures in clinical practices for COPD patients.

Gastric Cancer in Asian American Populations: a Neglected Health Disparity

  • Taylor, Victoria M.;Ko, Linda K.;Hwang, Joo Ha;Sin, Mo-Kyung;Inadomi, John M.
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권24호
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    • pp.10565-10571
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    • 2015
  • Gastric cancer incidence rates vary dramatically by world region with East Asia having the highest rate. The Asian population of the United States (US) is growing rapidly and over 17 million Americans are of Asian descent. A majority of Chinese, Korean and Vietnamese Americans are immigrants. Americans of East and Southeast Asian descent experience marked gastric cancer disparities and the incidence rate among Korean men in the US is over five times higher than the incidence rate among non-Hispanic white men. Randomized controlled trials have provided evidence for the effectiveness of helicobacter pylori identification and eradication in preventing gastric cancer. Additionally, Japan and South Korea have both experienced improvements in gastric cancer mortality following the implementation of programs to detect early stage gastric cancers. There are currently no clear US guidelines regarding the primary and secondary prevention of gastric cancer in high-risk immigrant populations. However, it is likely that a proportion of US physicians are already recommending gastric cancer screening for Asian patients and some Asian immigrants to the US may be completing screening for gastric cancer in their native countries. Surveys of US primary care physicians and Asian American communities should be conducted to assess current provider practices and patient uptake with respect to gastric cancer prevention and control. In the absence of clinical guidelines, US health care providers who serve high-risk Asian groups could consider a shared decision-making approach to helicobacter pylori identification and eradication, as well as gastric endoscopy.

『황제내경(黃帝內經)』의 침구법(鍼灸法) 연구 - 시간(時間) 개념을 중심으로 - (A Study on the Acupuncture & Moxibustion of Huangdineijing - focused on Concept of Time -)

  • 류정아
    • 대한한의학원전학회지
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    • 제29권3호
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    • pp.57-74
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    • 2016
  • Subject : Treatment of acupuncture & moxibustion in Huangdineijing Objectives : Discover the principles and substances of acupuncture & moxibustion treatment of Huangdineijing Methods : The author reviewed the Huangdineijing: Suwen, Lingshu to gain a realistic sense of the facts and the medical book's contents that deal with the practices of acupuncture & moxibustion treatment for clinical praxis. Conclusions : 1. The acupuncture & moxibustion of Huangdineijing can be defined as follows. A treatment for correcting of meridian's drift by proper selection of surgical site, using suitable implementation and appropriate manipulation skill from a correct judgement of meridian's flowing through sensing the pulse for diagnosis when the meridian's flowing which come and go constantly driven by the tidal order of defensive Qi tactually appeared hard or soft caused by diseases, thus bring out the soft & gradual 50 laps circulation of nutrient Qi moderately driven by defensive Qi. 2. Today's acupuncture & moxibustion treatments greatly differ from those of Huangdineijing in that we do not know the substance of that treatment which is correcting of meridian's drift and do not obligatorily carry out feeling of the pulse for diagnosis which is a measure & judgement of meridian's flowing against a preliminary treatment in parallel with treatment so reduce use and power of that treatment. 3. I could form a list of general principle from the substances of acupuncture & moxibustion of Huangdineijing like as the flowing or fate of meridian Qi(tidally going in order of defensive Qi and nutrient Qi), deficiency or excess of Meridian flowing, comparing diagnosis before and after treatment, bring out the soft & gradual Qi. That was imposing "the concept of time" on recognition and treatment to human body.

전문치과위생사제도 확립을 위한 기초 조사 연구 (A basic study for establishment of specialized dental hygienist system around the duties of dental hygienist)

  • 배성숙
    • 한국치위생학회지
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    • 제7권3호
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    • pp.301-316
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    • 2007
  • With these changes in the environment of dental service, dental hygienists are suggested to change their roles to cope with the changes. Hygienists are putting forth many efforts to promote smooth and efficient dental treatments, and as a practical measure. As a part to cope with such changes. Korea Dental Hygienists Association(KDHA) has prepared the system of Specialized Dental Hygienist and put the system into enforcement through an affiliated organization, Korean Academy of Dental Hygiene. The purpose of this study is to investigate the specialized nurse system in our country's medical environment and the specialized dental hygienist systems in other countries as similar cases comparable to the specialized dental hygienist system in our country and present basic data for the establishment of specialized dental hygienist system. For this study, a survey of dental specialists, such as dentists, dental hygienists and nurses, and patients, has been conducted qualitatively through person-to-person depth interview. The interview questions were related to the need for a specialized dental hygienist system, educational programs, functions and roles, and issues that must be solved for establishment of the system. Based on the interview results, the following conclusions were derived. The specialized dental hygienist system must encourage dental hygienists to possess advanced abilities in clinical practices, present systematic and developmental directions in educational programs, and stimulate specialized dental hygienists to actively work as manager and supervisor, medical health service providers, educators, and researchers. Lastly, for issues that must be solved for the establishment of the system, the duties and jobs of specialized dental hygienists must be defined more concretely, which must be acknowledged by people working in related occupations, citizens and the government. Furthermore, we need to examine the scope of duties of dental hygienists and enact laws and systems to protect the scope. These roles will lead dental hygienists to lay the foundation that allow them to make enthusiastic activities as an oral hygienist and clinician as well as show the way how to act as an educator, a researcher, a manager and an administrator.

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Adherence to Varenicline and Abstinence Rates for Quitting Smoking in a Private Health Promotion Center-Based Smoking Cessation Clinic

  • Lee, Jin-Young;Kim, Min-Ji;Jun, Hee-Jung;Kang, Mi-Ra;Park, Ah-Rham;Oh, Dae-Eun;Choi, Yoon-Ho;Hwang, Jung-Hye
    • Tuberculosis and Respiratory Diseases
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    • 제72권5호
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    • pp.426-432
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    • 2012
  • Background: Varenicline is an effective smoking cessation aid. However, smokers prescribed with varenicline do not always receive varenicline for 12 weeks, as recommended. This study analyzed the subjects who received varenicline and investigated the effect of varenicline treatment duration on the success rate of 6-month smoking cessation. Methods: This study retrospectively analyzed 78 subjects, who received varenicline, out of the 105 smokers that had visited the smoking cessation clinic after medical examination from September 2007 to December 2009. Results: The subjects were all males. Twenty-two subjects (28.2%) had varenicline treatment for 12 weeks or longer; 18 subjects (23.1%) for 8~12 weeks; 22 subjects (28.2%) for 4~8 weeks; and 16 subjects (20.5%) for less than 4 weeks. The total success rate of the 6-month smoking cessation was 47.4%. The success rate of the 6-month smoking cessation was 63.6% in the group that received varenicline for 12 weeks or longer, which was higher than 41.1% of the group that early terminated the varenicline treatment (p=0.074). The period of varenicline treatment was extended for one more week, the odds ratio of the 6-month smoking cessation success increased to 1.172-folds (p=0.004; 95% confidence interval, 1.052~1.305). Adverse events occurred in 30.8% of the subjects who received varenicline, but no serious adverse events were found. Conclusion: If varenicline treatment period is extended, the odds ratio of the success rate for the 6-month smoking cessation increases. Therefore, an effort to improve drug compliance for varenicline in clinical practices could be helpful for the long-term success of smoking cessation.

실시간 심전도 모니터링을 위한 HL7 메시지 간소화 전략 (A Lightweight HL7 Message Strategy for Real-Time ECG Monitoring)

  • 이구연;강경태;이재면;박주영
    • 정보과학회 컴퓨팅의 실제 논문지
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    • 제21권3호
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    • pp.183-191
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    • 2015
  • 최근 IT 기술이 발전함에 따라 실시간 심전도 모니터링이 가능해 졌으며, 이는 의료정보교환을 위한 HL7 표준의 전도 유망한 응용 중 하나로 인식되고 있다. 하지만 HL7 메시지 내 데이터 중복으로 인한 메시지의 크기 및 생성시간의 증가로 인해 HL7 표준을 실시간 심전도 모니터링에 바로 적용하기에는 무리가 있다. 이에 본 논문에서는 실시간 심전도 모니터링에 적합한 HL7 메시지의 간소화 전략을 제안한다. 다양한 형식의 심전도 데이터를 Feature Scaling을 거쳐 정형화된 포맷으로 조정하고 HL7 규약에 순응하는 메시지를 생성한다. 또한 HL7 ORU 메시지 내의 중복되는 OBX 필드를 제거하기 위해 De-Duplication 알고리즘을 수행한다. 이를 통해 기존의 HL7 표준 적용 대비 메시지의 생성시간은 최대 51%, 크기는 최대 1/8로 줄일 수 있음을 실험적으로 확인하였다.

소양인처방(少陽人處方) 활용(活用)에 대한 임상적(臨床的) 연구(硏究) (A Clinical Study on Soyangin Prescription)

  • 구덕모
    • 사상체질의학회지
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    • 제17권2호
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    • pp.52-63
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    • 2005
  • 1. Objectives Due to a lack of detail guidelines for prescriptions to ordinary and pathological symptoms in ${\ulcorner}$DongyiSuseBowon${\lrcorner}$, doctors depend on their own decision when give a prescription. This study aimed to compare ordinary symptoms and pathological symptoms in regards to six prescriptions being applied to Soyangin to utilize them as guidelines in practices. 2. Methods Date were collected from September, 2003 to August, 2004 at the Sasang Constitutional clinic of Pohang Oriental Medicine Hospital. Patients were first asked to fill Out a questionnaire of symptoms that they had at the time of visiting. Data from 273 Soyangin patients whose chief complains got alleviated after taking the prescribed drug were analyzed to examine if there were differences in prescriptions according to ordinary or pathological symptoms complained. 3. Results and Conclusions 1. Hyungbangpaedog-san(Paedog) was given more to the patients having good digestive function than Hyungbangjihwang-tang(Hyungji) and Hyungbangdojeok-san (Dojeok) ; Dojeok was given for bloating symptom compared to Hyungbangsabaek-san(Sabaek). Yangkyuksanhwa-tang(Yangkyuk) and Dojeok were more like for patients with stomachache compared to Paedog. Doghwaljihwang-tang(Dogji) was prescribed to patients complaining frequent voiding compared to Sabaek while Sabaek was given for patients who prefer cold water and feel their body warm compared to other prescriptions. Yangkyuk and Dojeok were prescribed more likely to patients with feeling of suffocation than Sabaek. 2. In symptom comparisons between one prescription and the group of the rest of 5 prescriptions, Paedog was found to be prescribed when patients had good digestive function while Dojeok was given in symptoms cases of indigestion, bloating, constipation and dizziness. Sabaek was applied more for patients having tendency of preferring cold water and feeling of heat body as well as good digestive function. Hyungji was used for patients complaining a symptom of fatigue, in addition Yangkyuk was given to patients who were nervous, sensitive, or impatient when compared to Other prescriptions. Dogji was applied to frequent voiding, insomnia, tingling of extremities, backache or leg pain, or in case of tendency of catching a common cold.

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구조화된 운동 프로그램이 인공고관절 전치환술 환자의 고관절 통증, 신체기능 및 삶의 질에 미치는 효과 (Effects of Structured Exercise Program on Hip Pain, Physical Function and Quality of Life in Patients with Total Hip Arthroplasty)

  • 권은희;이해정;이성화
    • 근관절건강학회지
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    • 제25권2호
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    • pp.122-134
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    • 2018
  • Purpose: The purpose of this study was to develop a 12-week structured exercise program (12-week-SEP) and evaluate its effects on pain, physical function and quality of life in patients with total hip arthroplasty (THA). Methods: A nonequivalent control group non-synchronized design was utilized to examine the effects of the 12-week-SEP on patients' outcomes after THA. A total of 46 adult patients (experimental group=25, control group=21) who had THA were recruited for the study. The 12-week-SEP consisted of education, exercise (muscle strengthening and progressive walking), and feedback. Data were analyzed by SPSS/WIN 21.0 using the $x^2$ test and repeated measures ANOVA. Results: The mean age of the participants was 60.9 years and 25 men (54.5%) and 21 women (45.7%) were included in the study. There were significant intervention effects on pain reduction and increased physical function but no effects on quality of life. Conclusion: The 12-week-SEP provided pain relief and enhanced physical function in patients underwent THA. Clinical application of the 12-week-SEP can improve postoperative nursing practices for patients with THA. Future research with larger sample is of necessity to obtain greater generalizability of the empirical evidences of the 12-week-SEP.