• Title/Summary/Keyword: Early Dementia

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Behavioral Contextualization for Extracting Occupant's ADL Patterns in Smart-home Environment (스마트 홈 환경에서의 재실자 일상생활 활동 패턴 추출을 위한 행동 컨텍스트화 프로세스에 관한 연구)

  • Lee, Bogyeong;Lee, Hyun-Soo;Park, Moonseo
    • Korean Journal of Construction Engineering and Management
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    • v.19 no.1
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    • pp.21-31
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    • 2018
  • The rapid increase of the elderly living alone is a critical issue in worldwide as it leads to a rapid increase of a social support costs (e.g., medical expenses) for the elderly. In early stages of dementia, the activities of daily living (ADL) including self-care tasks can be affected by abnormal patterns or behaviors and used as an evidence for the early diagnosis. However, extracting activities using non-intrusive approach is still quite challenging and the existing methods are not fully visualized to understand the behavior pattern or routine. To address these issues, this research suggests a model to extract the activities from coarse-grained data (spatio-temporal data log) and visualize the behavioral context information. Our approach shows the process of extracting and visualizing the subject's spaceactivity map presenting the context of each activity (time, room, duration, sequence, frequency). This research contributes to show a possibility of detecting subject's activities and behavioral patterns using coarse-grained data (limited to spatio-temporal information) with little infringement of personal privacy.

Severe Endobronchial Inflammation Induced by Aspiration of a Ferrous Sulfate Tablet

  • Lim, Sang Youn;Sohn, Sung Birm;Lee, Jung Min;Lee, Ji Ae;Chung, Sangmi;Kim, Junga;Choi, Juwhan;Kim, Sehwa;Yoo, Ah Young;Roh, Jong Ah;Park, Haein;Kim, Won Shik;Sim, Jae Kyeom;Shim, Jae Jeong;Min, Kyung Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.1
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    • pp.37-41
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    • 2016
  • Iron supplements such as ferrous sulfate tablets are usually used to treat iron-deficiency anemia in some elderly patients with primary neurologic disorders or decreased gag reflexes due to stroke, senile dementia, or parkinsonism. While the aspiration of ferrous sulfate is rarely reported, it is a potentially life-threatening condition that can lead to airway necrosis and bronchial stenosis. A detailed history and high suspicion of aspiration are required to avoid delays in diagnosis and treatment. The diagnosis can be confirmed by bronchoscopic examination and a tissue biopsy. Early removal of the aspirated tablet prevents acute complications, such as bronchial necrosis, hemoptysis, and lobar consolidation. Tablet removal is also necessary to prevent late bronchial stenosis. We presented the first case in Korea of a ferrous sulfate tablet aspiration that induced severe endobronchial inflammation.

Delirium Management: Diagnosis, Assessment, and Treatment in Palliative Care (섬망의 돌봄: 완화의료 영역에서의 진단, 평가 및 치료)

  • Seo, Min Seok;Lee, Yong Joo
    • Journal of Hospice and Palliative Care
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    • v.19 no.3
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    • pp.201-210
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    • 2016
  • Delirium is a common symptom in patients with terminal cancer. The prevalence increases in the dying phase. Delirium causes negative effects on quality of life for both patients and their families, and is associated with higher mortality. However, some studies reported that it tends to remain unrecognized in palliative care setting. That may be related with difficulties to distinguish the symptom from others with overlapping characteristics such as depression and dementia, and a lack of knowledge regarding assessment and diagnostic tools. We suggest that accurate recognition with validated tools and early diagnosis of the symptom should be highly prioritized in delirium management in palliative care setting. After diagnosing delirium, it is important to identify and address reversible precipitants such as medication, dehydration, and infection. Non-pharmacological interventions including comfortable environment for the patient and family education are also essential in the management strategy. If such interventions prove ineffective or insufficient to control hyperactive symptoms, pharmacologic interventions with antipsychotics and benzodiazepine can be considered. Until now, low levels of haloperidol remains the standard treatment despite a lack of evidence. Atypical antipsychotics such as olanzapine, quetiapine and risperidone reportedly have similar efficacy with a stronger sedating property and less adverse effect compared to haloperidol. Currently, delirium medications that can be used in palliative care setting require more clinical trials, and thus, clinical guidelines are not sufficiently available. We suggest that it is warranted to develop clinical guidelines based on well-designed clinical studies for palliative care patients.

Factors Related to Motor Subtypes of Delirium Patients in a Surgical Intensive Care Unit (일 종합병원 외과 중환자실 환자의 섬망 아형별 관련 요인)

  • Park, Sang Hee;Kim, Hee Jeong;Choi, Hee Young;You, Ji Eun;Park, Ji Eun;Kim, Eun Jung;Lim, Soo Jung
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.2
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    • pp.207-216
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    • 2020
  • Purpose: The purpose of this study was to investigate the motor subtypes of delirium in patients in a Surgical Intensive Care Unit (SICU), and identify the factors related to the characteristics of patients according to the motor subtypes of delirium. Methods: Data were collected in the SICU of a tertiary hospital in city from October 2018 to June 2019. Delirium was detected using the Confusion Assessment Method for the ICU (CAM-ICU) and motor subtypes of delirium were measured with the Delirium Motor Subtype Scale (DMSS)-4. Patients' characteristics were obtained by using the electronic medical records. Descriptive statistics were used to analyze the data. Results: Among 1,112 patients, 172 patients showed delirium (15.5%). After excluding dementia patients and patients refusing to participate in the study, 126 patients included in the final analysis. Delirium patients were classified as hyperactive delirium (32.5%), hypoactive delirium (42.9%), mixed delirium (11.9%), and non-motor subtype delirium (12.7%). Conclusion: The study results suggest that hypoactive delirium is the most prevalent motor subtype of delirium in SICU. More application of ventilators, more administration of sedatives, more use of catheters, and higher nursing severity were reported for hypoactive delirium cases than hyperactive ones. Therefore, it is necessary to assess early the motor subtypes of delirium using structured tools and develop appropriate nursing interventions suitable for each subtype of delirium.

Expert Opinions and Recommendations for the Clinical Use of Quantitative Analysis Software for MRI-Based Brain Volumetry (뇌 자기공명영상 뇌용적 분석 소프트웨어의 임상적 적용에 대한 전문가 의견과 권고안)

  • Ji Young Lee;Ji Eun Park;Mi Sun Chung;Se Won Oh;Won-Jin Moon;Aging and Neurodegeneration Imaging (ANDI) Study Group, Korean Society of Neuroradiology (KSNR)
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1124-1139
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    • 2021
  • The objective assessment of atrophy and the measurement of brain volume is important in the early diagnosis of dementia and neurodegenerative diseases. Recently, several MR-based volumetry software have been developed. For their clinical application, several issues arise, including the standardization of image acquisition and their validation of software. Additionally, it is important to highlight the diagnostic performance of the volumetry software based on expert opinions. We instituted a task force within the Korean Society of Neuroradiology to develop guidelines for the clinical use of MR-based brain volumetry software. In this review, we introduce the commercially available software and compare their diagnostic performances. We suggest the need for a standard protocol for image acquisition, the validation of the software, and evaluations of the limitations of the software related to clinical practice. We present recommendations for the clinical applications of commercially available software for volumetry based on the expert opinions of the Korean Society of Neuroradiology.