Background: The objective of this study was to evaluate the efficiency of an emergency ambulance system and to investigate socio-economic and clinical characteristics associated with emergency ambulance service. Methods: Based on 2011 Korea health panel, unmet need and inappropriate use of emergency ambulance service were measured by Gibson in 1977. Furthermore, the factors associated with unmet need and inappropriate use of emergency ambulance service were identified by Fisher's exact tests and multiple logistic regression models. Results: Unmet need, defined as the proportion of emergency patients who clinically need ambulance transportation but do not receive it, was found to be 59.8%. Inappropriate use, defined as the proportion of emergency patient receiving ambulance care who did not clinically need it, was found to be 37.2%. There were statistically significant differences between appropriate and inappropriate groups in overall variables of socio-economic and clinical characteristics. Specifically, gender, age, relationship to household, and reasons of visiting emergency department (accident/disease) were statistically significant factors associated with appropriate use of emergency ambulance service. Conclusion: Unmet ambulance need is a useful measure for patients needs assessment, and inappropriate ambulance use is a valid criteria in judging the efficiency of emergency ambulance system. To improve and understand emergency ambulance system, unmet need and inappropriate use of emergency ambulance service should be more concerned.
Kim, Hoon-Hee;Lee, Ok-Sang;Jung, Sun-Hoi;Lim, Sung-Cil
Korean Journal of Clinical Pharmacy
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v.22
no.1
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pp.55-64
/
2012
The quinolones are broad-spectrum antibiotics and enhanced antimicrobial activity has extended the use of the quinolones beyond the traditional indications for quinolone antibiotics in the treatment of urinary tract infections. The quinolones are effective in a wider variety of infectious diseases, including skin and respiratory infections. Because of their excellent safety and tolerability, they have become popular alternatives to penicillin and cephalosporin derivatives in the treatment of various infections. A retrospective study was performed to evaluate efficacy and safety of IV quinolones for inpatient use. Total 117 patients who administerd quinolones for longer than 3 continuous days at community hospital from October 1st, 2008 to December 31st, 2008 were reviewed. The criterias for drug evaluation were included the validation of indication, outcome, dosage and side effects. In the results, ciprofloxacin 13 (total 93), levofloxacin 3 (total 59) and moxifloxacin 2 (total 19) cases were not met the criterias based on the culture results. Major indications were pneumonia (ciprofloxacin 16.3%, levofloxacin 67.8%, moxifloxacin 84.2%), urinary tract infection (ciprofloxacin 44.1%), skin infection (ciprofloxacin 7.5%, levofloxacin 20.3%, moxifloxacin 10.5%), intra-abdominal infection (ciprofloxacin 10.8%, moxifloxacin 5.3%), etc.. In the results of quinolone monotherapy, the frequencies were each ciprofloxacin 74.2%, levofloxacin 50.8% and moxifloxacin 47.4%. In the results of dosage validation, the validities were each ciprofloxacin 54.8%, levofloxacin 94.9% and moxifloxacin 100.0%. In the results of duration validation, the validities were each ciprofloxacin 59.1%, levofloxacin 78.0% and moxifloxacin 89.5%. Adverse drug reactions were reported for total 49 cases and those were gastrointestinal tract effects including nausea, vomiting, diarrhea and central nervous system effects including headache, dizziness. In summary, the quinolones appropriately used for hospitalized patients based on this study. A focused approach emphasizing "correct use of quinolones" may reduce development of antimicrobial resistance and maximize class efficacy. Consequently, correct use of antibiotics will contribute to decrease medical expenses for person and community.
This article describes the orthodontic treatment of a 25-year-old Korean female patient with anterior crowding, including palatally displaced lateral incisors. Her facial profile was satisfactory, but 3.5 mm of maxillary anterior crowding was observed. To correct this crowding, we decided to minimize the use of the conventional fixed orthodontic appliances and employed a less bulky and more aesthetic appliance for applying light continuous force. We determined the final positions of the maxillary teeth via a working model for diagnostic set up and achieved space gaining and alignment with simple Ni-Ti spring and stainless steel round tubes. Tooth alignment was achieved efficiently and aesthetically without the conventional brackets.
Objectives: The aim of this study is to introduce the Clinical presentation and announce the importance of developing Clinical presentation of Korean medicine and suggest about development direction of Clinical presentation of Korean medicine. Methods: To Investigate the Clinical presentation used in western medicine. I think that Clinical presentation of Korean medicine is a systematic list of Korean medicine symptoms and a standard syndrome differentiation and treatment(辨證論治). So I would like to offer "PangYakHapPyon(方藥合編)" as a basis for developing Clinical presentation of Korean medicine. Results: The clinical presentation term has become widespread in use at Calgary Medical college. Calgary Medical college created a list of 120 clinical presentations In 1991. In Korea, 101 clinical presentations were made in 2016. "PangYakHapPyon(方藥合編)" has been used effectively for over 130 years and widely used in the public. In addition, "PangYakHapPyon(方藥合編)" is summarized in the symptoms and prescriptions that occur frequently in Korea. Conclusions: For the globalization and standardization of Korean medicine, Clinical presentation of Korean medicine should be developed. The overall form of Clinical presentation of Korean medicine uses the form of Clinical presentation of Canada and a standard syndrome differentiation and treatment(辨證論治) for diagnosis and treatment is based "PangYakHapPyon(方藥合編)".
Objectives : This study proposes developing Sasang Medical Diagnosis Program using Facial form for increase in Sasang Constitution Diagnosis objectivity and putting the Diagnosis Program into practical use. The author presents a review of extant research on Sasang constitution diagnosis utilizing facial feature analysis and suggests an agenda for further research. Methods : For this thesis, a collection of dissertations on the subject of 'Usage of facial form for constitution diagnosis' published until September of 2012 such as RISS4U, OASIS, KISTI, Korean TK were reviewed. The final 33 dissertations were classified into two categories, basic or clinical research and then analyzed. Results : 9 out of 33 dissertations were of basic research and 24 were of clinical research. 1) As result of review of references, a uniform tendency was found in facial form according to Sasang Constitution. 2) In the grade of practical use, facial element is repeatedly used and the facial element of important use has constitutional differences. 3) Standard faces per Sasang Constitution were derived as result of 2-dimensional research. 4) 3-dimensional research focused on improvement of accuracy and reliability of 3D-AFRA, and there has been an attempt to develop a prototype for identification. Conclusions : For practical use of facial feature in Sasang Constitution Diagnosis, 1) Standardization of diagnosis through establishing Sasang Medical Diagnosis clinical protocol must be preceded. After the standardization, practical purpose and direction of facial form in general may be decided. 2) Information on high quality facial form of constitutional and conditional patients must be collected to form extensive database. 3) Subdivided symptomatology, as well as Sasang Constitution must be considered for diagnosis in order for diagnosis technique to acquire clinical practicality.
Shin, Eun Jeong;Ha, Hun Joo;Shin, Wan Gyoon;Park, Kwang Jun
Korean Journal of Clinical Pharmacy
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v.15
no.1
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pp.27-33
/
2005
This study was intended to contribute towards the development of proper drug use system for pediatric patients by investigationg problems related to their medication and identifying drugs that need to be developed into low dosage tab-lets or syrups for pediatric use based on our analysis on the prescriptions for pediatric inpatients from 22 hospitals in South Korea on a day of Feb. 2003. The usage rates in the proportion of less than 0.5 and 1 per unit of oral solid formulation were $29.9{\%}$ and $54.3{\%}$ in hospitals with 1000 beds or more, 36.5 and $60.6{\%}$ in hospitals with 500 to less than 1000 beds, $60.8{\%}$ and $81.6{\%}$ in hospitals with less than 500 beds. Of the 63 oral solid formulation products that were used two or more times in the proportion oi less than 0.5 units, 34 products ($54.0{\%}$) were used as such despite the fact that syrups and lower dosage tablets or capsules were available in the market, and 24 products ($38.1{\%}$) so even when syrup formulations were available. Therefore, it would be desirable that pharmacist communities in charge of dispensing identify the most frequently crushed drugs or those that require special attention in choosing dispensing powders or solutions and develop dispensing guidelines that can be adopted by pharmacists in practice. Moreover government-led policies are needed to encourage development and manufacture of the formulations for pediatrics and to correct unsound prescription and dispensing practices such as using crushed forms of certain oral solid formulations although alternative formulations are available in the market.
Park, Ji-Min;Yoon, Young-Hoon;Horeczko, Timothy;Kaji, Amy Hideko;Lewis, Roger J
Journal of Trauma and Injury
/
v.30
no.2
/
pp.25-32
/
2017
Purpose: The use of computed tomography (CT) to evaluate acute abdominal complaints has increased over the past two decades. We investigated how the clinical practice of patients with intestinal perforation has changed with the increasing use of abdominal CT in the emergency department (ED). Methods: We compared ED arrival to CT time, ED arrival to surgical consultation time, and ED arrival to operation time according to the method of diagnosis from 2003-2004 and 2013-2014. Results: In patients with gastrointestinal perforation, time from ED arrival to CT was shorter ($111.4{\pm}66.2min$ vs. $199.0{\pm}97.5min$, p=0.001) but time to surgical consultation was longer ($135.1{\pm}78.8$ vs. $77.9{\pm}123.7$, p=0.006) in 2013-2014 than in 2003-2004. There was no statistically significant difference in time to operation for perforation confirmed either by plain film or CT between the two time periods. There was no statistically significant difference in length of hospital or ICU stay or mortality between the two groups. Conclusion: With the increasing use of abdominal CT in ED, ED arrival to CT time has decreased and ED arrival to surgical consultation time has increased in gastrointestinal perforation. These changes of clinical performance do not delay ED arrival to operation time or adversely influence patient outcome.
Background: The association between calcium channel blockers (CCBs) and survival in cancer patients remains unclear and the results of related studies are conflicting. The objective of the study was to investigate the association between calcium channel blockers (CCBs) use and survival in cancer patients. Materials and Methods: We searched PubMed, EMBASE, Web of Science and Cochrane Library for studies published before January 2016 with the terms related to CCBs and survival in cancer patients. The information was reviewed and extracted by two evaluators independently. Data of publications was extracted and calculated into hazard ratios (HRs) for overall survival (OS). Statistical analysis was performed by using Review Manager 5.3. Results: There were 11 studies included in our meta-analysis. Analysis of all studies showed that CCBs use was not associated with survival in cancer patients (HR=1.07; 95% CI: 0.91-1.25; P=0.42). No association between CCBs use and overall survival in cancer patients was existed whether in Asian (HR=1.18, 95% CI: 0.72-1.93; P=0.52) or Caucasian population (HR=1.03, 95% CI: 0.89-1.20; P=0.66). Conclusions: There is no evidence that CCBs use is associated with a better or worse outcome of survival in cancer patients.
Forte, Antonio Jorge;Boczar, Daniel;Sarabia-Estrada, Rachel;Huayllani, Maria T.;Avila, Francisco R.;Torres, Ricardo A.;Guliyeva, Gunel;Aung, Thiha;Quinones-Hinojosa, Alfredo
Archives of Plastic Surgery
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v.48
no.5
/
pp.559-567
/
2021
The potential to differentiate into different cell lines, added to the easy and cost-effective method of extraction, makes adipose-derived stem cells (ADSCs) an object of interest in lymphedema treatment. Our study's goal was to conduct a comprehensive systematic review of the use of ADSCs in lymphatic tissue engineering and regeneration. On July 23, 2019, using PubMed/MEDLINE, Cochrane Clinical Answers, Cochrane Central Register of Controlled Trials, and Embase databases, we conducted a systematic review of published literature on the use of ADSCs in lymphatic tissue engineering and regeneration. There were no language or time frame limitations, and the following search strategy was applied: ((Adipose stem cell) OR Adipose-derived stem cell)) AND ((Lymphedema) OR Breast Cancer Lymphedema). Only original research manuscripts were included. Fourteen studies fulfilled the inclusion criteria. Eleven studies were experimental (in vitro or in vivo in animals), and only three were clinical. Publications on the topic demonstrated that ADSCs promote lymphangiogenesis, and its effect could be enhanced by modulation of vascular endothelial growth factor-C, interleukin-7, prospero homeobox protein 1, and transforming growth factor-β1. Pilot clinical studies included 11 patients with breast cancer-related lymphedema, and no significant side effects were present at 12-month follow-up. Literature on the use of ADSCs in lymphatic tissue engineering and regeneration demonstrated promising data. Clinical evidence is still in its infancy, but the scientific community agrees that ADSCs can be useful in regenerative lymphangiogenesis. Data collected in this review indicate that unprecedented advances in lymphedema treatment can be anticipated in the upcoming years.
The purpose of this study was to evaluate the accuracy of a mobile wireless digital automatic blood pressure monitor for clinical use and mobile health (mHealth). In this study, a manual sphygmomanometer and a digital blood pressure monitor were tested in 100 participants in a repetitive and sequential manner to measure blood pressure. The guidelines for measurement used the Korea Food & Drug Administration protocol, which reflects international standards, such as the American National Standard Institution/Association for the Advancement of Medical Instrumentation SP 10: 1992 and the British Hypertension Society protocol. Measurements were generally consistent across observers according to the measured mean ${\pm}SD$, which ranged in $0.1{\pm}2.6mmHg$ for systolic blood pressure (SBP) and $0.5{\pm}2.2mmHg$ for diastolic blood pressure (DBP). For the device and the observer, the difference in average blood pressure (mean${\pm}$SD) was $2.3{\pm}4.7mmHg$ for SBP and $2.0{\pm}4.2mmHg$ for DBP. The SBP and DBP measured in this study showed accurate measurements that satisfied all criteria, including an average difference that did not exceed 5 mmHg and a standard deviation that did not exceed 8 mmHg. The mobile wireless digital blood pressure monitor has the potential for clinical use and managing one's own health.
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