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대구지역 소아청소년과 의사들의 요로감염 관리 실태분석 (Management of Urinary Tract Infections in Children: A Survey of Pediatricians in Daegu City)

  • 이상수;강석정;이재민;조민현;박용훈
    • Childhood Kidney Diseases
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    • 제16권2호
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    • pp.95-101
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    • 2012
  • 목적: 소아의 요로감염은 적절히 관리 되지 않는 경우에 여러 문제를 일으킬 수 있어 다양한 관리 지침이 계속 개발되고 있고, 근래에는 근거 중심의 지침들이 만들어져서 진료에 적용되고 있다. 하지만 소아과 의사들의 요로감염 관리 실태에 대한 조사는 매우 드문 실정이다. 이 연구에서는 소아과 의사들의 요로감염에 대한 인식을 알아보고, 적절하게 관리가 이루어지는지를 평가하고 개선점을 찾고자 하였다. 방법: 대구시 지역의 78명의 소아청소년과 전문의들을 대상으로 요로감염의 진단, 영상검사 및 치료와 예방을 위한 환자교육을 어떻게 하는지를 설문조사로 알아보았다. 결과: 대부분의 응답자들은 발열의 원인을 찾을 수 없는 경우에 요로감염을 감별하기 위하여 소변검사를 하였다. 환자가 소변을 가릴 수 없는 경우 상당수의 응답자가 무균채뇨백을 사용하여 채뇨를 하였으며, 소변배양 검사를 하지 않는 경우도 많았다. 가장 많이 시행하는 영상검사는 초음파였다. 항생제는 입원한 경우에만 주사로 투여하고 외래 통원 시는 경구투여를 하였다. 요로감염의 중요성, 재발과 예방 등에 대한 환자 교육을 선택적으로 하고 있었다. 방광 요관역류의 관리 지침을 가지고 있는 경우는 28.6%로서 많지 않았다. 결론: 요로감염을 진단하기 위한 시도는 적절하게 이루어지고 있었으나, 무균채뇨백을 사용하여 소변배양을 하는 경우가 많아 위양성진단율이 높아져서 과잉치료가 우려되었다. 또한 영상검사를 하지 않는 경우가 많아 동반된 요로 기형의 진단이 조기에 되지 않을 수 있다는 것도 우려되었다. 근거-중심의 요로감염 관리 지침에 따른 보다 적절한 관리를 하기 위한 노력이 필요하다.

농촌 재가 장애인의 가정방문 재활서비스 욕구도 분석 (Needs Analysis for Home Rehabilitation Services by Disabled Person in the Rural Areas)

  • 이충휘;이현주;박경희;안덕현
    • 한국전문물리치료학회지
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    • 제9권2호
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    • pp.61-81
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    • 2002
  • The purposes of this research were to investigate home care rehabilitation services in rural areas and to collect basic data about disabled persons necessary when for carrying out rehabilitation services. Respondents were selected from six of a total of eight townships (Myon) and one town (Eup) in the Wonju city area. Wonju is in Kangwon Province (Do). Of a total of 338 names provided by the Myon offices, 298 persons were located and included registered and non-registered persons. Conditions included stroke, spinal cord injury, and cerebral palsy in addition to disabilities classified as first, second or third degree, in the case of registered cases. Respondent demographic characteristics, medical characteristics, rehabilitation service needs, willingness to receive rehabilitation service and individual opinions regarding rehabilitation services were analysed by frequency and percentage. The results were as follows: 1) Rehabilitation services received by disabled persons living at home in the rural areas surrounding Wonju city were medical rehabilitation (41.7%), diagnosis (36.5%), rehabilitation assistive devices (7.6%), social assistance (7.1%), rehabilitation counseling (3.0%), vocational rehabilitation (1.8%), educational rehabilitation (1.6%) and housekeeping services (0.5%). The majority of rehabilitation services were medical rehabilitation provided at hospitals and oriental medicine hospitals. 2) Sixty point eight percent of respondents expressed their willingness to receive home care rehabilitation services. Needs expressed were highest for medical rehabilitation (27.0%), followed by social assistance (19.4%), medical examination (12.4%), physician-generated diagnosis in the home setting (11.6%), sociopsychological rehabilitation (9.3%), vocational rehabilitation (7.6%), rehabilitation engineering (6.0%), educational rehabilitation (3.3%), and housekeeping services (3.3%). 3) Rehabilitation service needs were analyzed by severity classification: 65.8% of first degree, 62.7% of second degree and 55.6% of third degree disability classification, and 62.7% of non-registered disabled individuals responded that rehabilitation service was necessary. 4) Rehabilitation service needs were also analyzed by diagnosis: 62.6% of stroke, 85.5% of amputation, 60.0% of spinal cord injury and 52.4% of traumatic brain injury respondents answered positively that they were willing to receive rehabilitation service if it were to be provided. Rehabilitation service utilization data of disabled individuals living at home in rural areas were investigated and their rehabilitation needs analyzed. This critical information can be used when community-based rehabilitation programs for disabled persons living at home are planned for provision out of a public health center or when community-based rehabilitation welfare policy is formulated.

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Clinico-Pathological Patterns and Survival Outcome of Colorectal Cancer in Young Patients: Western Saudi Arabia Experience

  • Elsamany, Shereef Ahmed;Alzahrani, Abdullah Saeed;Mohamed, Mervat Mahrous;Elmorsy, Soha Ali;Zekri, Jamal Eddin;Al-Shehri, Ahmed Saleh;Haggag, Rasha Mostafa;Alnagar, Ahmed Abdel-Reheem;El Taani, Hani Abdalla
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권13호
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    • pp.5239-5243
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    • 2014
  • Background: The prognosis of young colorectal cancer (CRC) patients has been addressed by several studies but with contradictory results. The aim of the present study was to evaluate the clinico-pathological features of young Saudi patients with CRC in addition to displaying their survival outcome. Materials and Methods: In this retrospective study, young CRC patients (${\leq}40$ years) diagnosed between 2007 and 2011 from 4 centres in western Saudi Arabia, were included. Clinico-pathological features, tumor markers, dates of disease relapse and death were collected. Survival parameters were compared with those of older Saudi patients, reported in previous studies. Results: One hundred and sixteen young patients with CRC were identified (32.2% rectal, 67.8% colon). Some 44% were metastatic while 32.7% had stage III at diagnosis. Patients with grade 3 tumors made up 29.4% of the total while 49.5% had positive lymphovascular invasion (LVI), 56% had a lymph node (LN) ratio ${\geq}0.2$ and 40.2% were K-ras mutant. Median disease-free survival (DFS) and overall survival (OS) in non-metastatic cases were 22.8 and 49.6 months respectively with better median DFS in K-ras wild compared to mutant patients (28.5 vs 20.9 months, p=0.005). In metastatic cases, median OS was 19.5 months. These survival outcomes are inferior compared to those of older Saudi patients reported in prior studies. Conclusions: Young CRC patients present more commonly with advanced stage and a high incidence of adverse prognostic factors such as LVI and high LN ratio. Young CRC patients seem to have worse survival compared to older Saudi patients.

Lateral pterygoid muscle volume and migraine in patients with temporomandibular disorders

  • Lopes, Sergio Lucio Pereira De Castro;Costa, Andre Luiz Ferreira;Gamba, Thiago De Oliveira;Flores, Isadora Luana;Cruz, Adriana Dibo;Min, Li Li
    • Imaging Science in Dentistry
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    • 제45권1호
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    • pp.1-5
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    • 2015
  • Purpose: Lateral pterygoid muscle (LPM) plays an important role in jaw movement and has been implicated in Temporomandibular disorders (TMDs). Migraine has been described as a common symptom in patients with TMDs and may be related to muscle hyperactivity. This study aimed to compare LPM volume in individuals with and without migraine, using segmentation of the LPM in magnetic resonance (MR) imaging of the TMJ. Materials and Methods: Twenty patients with migraine and 20 volunteers without migraine underwent a clinical examination of the TMJ, according to the Research Diagnostic Criteria for TMDs. MR imaging was performed and the LPM was segmented using the ITK-SNAP 1.4.1 software, which calculates the volume of each segmented structure in voxels per cubic millimeter. The chi-squared test and the Fisher's exact test were used to relate the TMD variables obtained from the MR images and clinical examinations to the presence of migraine. Logistic binary regression was used to determine the importance of each factor for predicting the presence of a migraine headache. Results: Patients with TMDs and migraine tended to have hypertrophy of the LPM (58.7%). In addition, abnormal mandibular movements (61.2%) and disc displacement (70.0%) were found to be the most common signs in patients with TMDs and migraine. Conclusion: In patients with TMDs and simultaneous migraine, the LPM tends to be hypertrophic. LPM segmentation on MR imaging may be an alternative method to study this muscle in such patients because the hypertrophic LPM is not always palpable.

정주체계를 고려한 농촌마을의 정주여건 진단지표 개발 (Development of Settlement Condition Diagnosis Index in Rural Village)

  • 박미정;전정배;배승종;김대식;최진아;김은자
    • 농촌계획
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    • 제23권1호
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    • pp.65-83
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    • 2017
  • This paper proposes a village level settlement environment diagnostic indices in rural areas which can apply to analyze various conditions at village level. A living space in rural areas has been changed with a diverse aspect according to living infrastructure, industrial structure, accessibility to neighbor city and so on. This indicators considered these mega-regionalization of economy and lifestyle in rural areas. The indicators consists of basic indices for all types villages and convenience service indices for center villages and the other neighbor ones classified by a functionality of their convenience facilities. As the results of delphi expert survey and a field validation, rural village settlement environment diagnostic indicators were selected 3 types, 15 domains, 24 subdomains and 61 items. And these indicators weight were determinted by AHP method. These developed indicators were used to diagnosis settlement conditions of 31 villages, located on county of Yeongdong. to validate a applicability and feasibility.

Epidemiological Study on Breast Cancer Associated Risk Factors and Screening Practices among Women in the Holy City of Varanasi, Uttar Pradesh, India

  • Paul, Shatabdi;Solanki, Prem Prakash;Shahi, Uday Pratap;Srikrishna, Saripella
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권18호
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    • pp.8163-8171
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    • 2016
  • Background: Breast cancer is the second most cause of death (1.38 million, 10.9% of all cancer) worldwide after lung cancer. In present study, we assess the knowledge, level of awareness of risk factors and screening practices especially breast self examination (BSE) among women, considering the non-feasibility of diagnostic tools such as mammography for breast screening techniques of breast cancer in the holy city Varanasi, Uttar Pradesh, India. Materials and Methods: A cross-sectional population based survey was conducted. The investigation tool adopted was self administrated questionnaire format. Data were analysed using SPSS 20 version and Chi square test to determine significant association between various education groups with awareness and knowledge, analysis of variance was applied in order to establish significance. Results: The attitude of participants in this study, among 560 women 500 (89%) responded (age group 18-65 years), 53.8% were married. The knowledge about BSE was very low (16%) and out of them 15.6% were practised BSE only once in life time. study shown that prominent age at which women achieve their parity was 20 yrs, among 500 participants 224 women have achieved their parity from age 18 to 30 yrs. Very well known awareness about risk factors of breast cancer were alcohol (64.6%), smoking (64%) and least known awareness risk factors were early menarche (17.2%) and use of red meat (23%). The recovery factors of breast cancer cases were doctors support (95%) and family support (94.5%) as most familiar responses of the holy city Varanasi. Conclusions: The study revealed that the awareness about risk factors and practised of BSE among women in Varanasi is extremely low in comparison with other cities and countries as well (Delhi, Mumbai, Himachal Pradesh, Turkey and Nigeria). However, doctors and health workers may promote the early diagnosis of breast cancer.

Seroprevalence of Antibodies against Anisakis simplex Larvae among Health-Examined Residents in Three Hospitals of Southern Parts of Korea

  • Kim, Jung;Jo, Jin-Ok;Cho, Seon-Hee;Cho, Min-Kyoung;Yu, Hak-Sun;Cha, Hee-Jae;Ock, Mee-Sun
    • Parasites, Hosts and Diseases
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    • 제49권2호
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    • pp.139-144
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    • 2011
  • The present study was performed to estimate the seroprevalence of larval Anisakis simplex infection among the residents health-examined in 3 hospitals in southern parts of Korea. A total of 498 serum samples (1 serum per person) were collected in 3 hospitals in Susan Metropolitan city, Masan city, and Geoje city in Gyeongsangnam-do (Province) and were examined by IgE-ELISA and IgE-western blotting with larval A. simplex crude extract and excretory-secretory products (ESP). The prevalence of antibody positivity was 5.0% and 6.6% with ELISA against crude extracts and ESP, respectively. It was also revealed that infection occurred throughout all age groups and higher in females than in males. A specific protein band of 130 kDa was detected from 10 patients with western blot analysis against crude extract and ESP among those who showed positive results by ELISA. Our study showed for the first time the seroprevalence of anisakiasis in Korea. The allergen of 130 kDa can be a candidate for serologic diagnosis of anisakiasis.

청소년들의 변증에 대한 단면조사 연구 - 2017 성남시 교의사업을 중심으로 - (A Cross-sectional Study of Pattern Identification in Adolescents - School doctor Program of Seongnam - city in 2017)

  • 이동녕;신선미;박정수;성현경;고재언;고호연
    • 대한예방한의학회지
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    • 제23권2호
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    • pp.101-115
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    • 2019
  • Objective : This study is aimed to application possibility and status of pattern identification in middle and high school students. Method : This study was cross-sectional study. We recruited 277 students through school doctor program of Seongnam city in 2017. Male students are 66 in middle school, 32 in high school. Female students are 117 in middle school, 62 in high school. For pattern identification, we used the tool of Qui Xui Shui pattern identification in students. Students fill questionnaires in inquiry of pattern identification and Korean medicine doctor diagnosis inspection and palpation of students. Results : Among 277 students, no pattern identification were 114(41.2%). It appeared in the order of phlegm, blood deficinecy, qi deficiency, qi stagnation and qi reversal. Qi deficiency, qi stagnation, qi reversal, blood deficiency and phlegm pattern are statistically significant by gender except blood stagnation. of 277 students, 105 (37.9%) had one more pattern identification. Conclusions : This study showed possibility of Qui Xui Shui pattern for student health management. In the future, large scale follow up study will be needed to clarify the relationship of pattern identification and student's health.

만성질환 영향요인 분석을 통한 지역사회 건강융합 -세종특별자치시 30-40대를 중심으로- (Community Health Convergence through Analysis of Chronic Disease Influencing Factors -Focusing on 30-40s Adults in Sejong City-)

  • 이미경;조아라;임순옥
    • 한국융합학회논문지
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    • 제8권5호
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    • pp.127-135
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    • 2017
  • 본 연구는 세종특별자치시 동, 면 거주자의 만성질환 진단율과 영향요인을 확인하기 위해 조사되었다. 2013-2015년 지역사회 건강조사 자료를 활용한 2차 분석 연구로 총 1,067명의 자료가 이용되었고 위계적 로지스틱 회귀분석을 이용하여 분석하였다. 분석결과, 동 지역 거주자는 만성질환 진단을 받을 확률이 여자보다 남자가 7.34배 높았고, 걷기 일수가 3일 미만인 군이 3일 이상인 군에 비해 2.20배 높았다. 면 지역 거주자는 비 흡연 군 보다 흡연 군이 1.19배 높은 것으로 나타났다. 연구결과, 동지역 거주자와 면지역 거주자에게 차별화된 만성질환 예방건강관리 프로그램 개발이 필요한 것으로 확인되었다.

국내 도심지 콘크리트 교각 취약부의 탄산화 조사에 대한 연구 (A Study on Survey of Carbonation for Sound, Cracked, and Joint Concrete in RC Column in Metropolitan City)

  • 권성준;박상순;남상혁;조호진
    • 한국구조물진단유지관리공학회 논문집
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    • 제11권3호
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    • pp.116-122
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    • 2007
  • 대도시의 콘크리트 구조물은 주로 탄산화에 노출되고 이에따라 매립된 철근은 시간이 경과함에 따라 부식이 발생한다. 콘크리트 구조물의 조사 및 진단에서, 건전부의 탄산화 깊이가 주로 평가되며, 이를 근거로 내구수명이 평가된다. 그러나 일반적으로 교각과 같은 매스 콘크리트 구조물에서는 적절한 타설을 위하여 조인트를 설치하게 되며, 초기재령에서 균열이 쉽게 발생한다. 본 연구에서는 20년 경과된 국내 대도시의 교각 구조물을 대상으로 탄산화 깊이를 평가하였으며, 건전부, 균열부, 시공이음부와 같은 국부적인 환경을 고려하여 탄산화 거동을 분석하였다. 균열부 및 시공이음부의 탄산화 깊이는 건전부에 비하여 크게 증가하였으며, 피복두께가 작은 구조물에 대해서는 이러한 영향을 고려하는 것이 바람직하게 평가되었다. 또한 균열폭의 함수로 균열부 탄산화 깊이를 예측할 수 있는 기법을 제시하였으며, 기존의 실태조사 결과와 비교하여 그 적용성을 검증하였다.