Lee, Suh-Young;Kim, Kyungjoo;Park, Yong Bum;Yoo, Kwang Ha
Tuberculosis and Respiratory Diseases
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v.85
no.1
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pp.11-17
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2022
Background: In asthma, consistent control of chronic airway inflammation is crucial, and the use of asthma-controller medication has been emphasized. Our purpose in this study is to compare the incidence of acute exacerbation and healthcare costs related to the use of asthma-controller medication. Methods: By using data collected by the National Health Insurance Review and Assessment Service, we compared one-year clinical outcomes and medical costs from July 2014 to June 2015 (follow-up period) between two groups of patients with asthma who received different prescriptions for recommended asthma-controller medication (inhaled corticosteroids or leukotriene receptor antagonists) at least once from July 2013 to June 2014 (assessment period). Results: There were 51,757 patients who satisfied our inclusion criteria. Among them, 13,702 patients (26.5%) were prescribed a recommended asthma-controller medication during the assessment period. In patients using a recommended asthma-controller medication, the frequency of acute exacerbations decreased in the follow-up period, from 2.7% to 1.1%. The total medical costs of the controller group decreased during the follow-up period compared to the assessment period, from $3,772,692 to $1,985,475. Only 50.9% of patients in the controller group used healthcare services in the follow-up period, and the use of asthma-controller medication decreased in the follow-up period. Conclusion: Overall, patients using a recommended asthma-controller medication showed decreased acute exacerbation and reduced total healthcare cost by half.
Oral medication is the most frequent treatment measure for follow up treatment, which is leading by childrens' parents for them. In medication for preoperational children, they tend to concentrate the result rather than the motivation or cause. So, they frequently refuse medication which has bitter taste. So this study was attempted to develop token economy program which promote children's medication and help their parents, and to evaluate its' effect to construct the experimental ground. This study was a quasi experimental study under the nonequivalent control group posttest only design. The subjects of this study were 36 children who were aged 3-6 years and admitted pediatric ward because of their respiratory disease. Token economy program was consisted of cartoon record paper with stickers which expresses the better medication is taken the more germs die, and gift was given for back up reinforcer. To evaluate this program, time for oral medication was measured to both experimental group and control group. To determine the effect of the program, the data were analyzed by the SAS 6.12 program with t-test. The results of this study were as follows: 1. Between experimental group and control group, there was no significant difference (t=-1.2411, P=0.2374). Therefore, the hypothesis of this study was rejected. In conclusion, the token economy program for follow up care didn't change the children's behavior of oral medication. But it was found that the cartoon on recording paper gave a pleasure to participated children. Parents who were in experimental group expressed their appreciation for token economy program. So it can be said that the token economy program for follow up care was effective in inducing the children's pleasure and parents' satisfaction even though it wasn't successful in experiment. If the measuring tools for token economy program was made with well planned design and high reliability, it can be improved the effectiveness of that To develope the theoretical bases of nursing care, the well planned programs and measuring tools for them should be developed.
Background: Long-term comparisons of phacoemulsification with topical medication are limited in canine diabetic cataracts. Objectives: To compare outcomes of eyes submitted to phacoemulsification with those of topical medication for canine diabetic cataracts and identify risk factors for complications. Methods: Through medical records review, 150 eyes (76 dogs) with diabetic cataracts were included; 58 eyes (31 dogs) underwent phacoemulsification (phaco-group) and 92 eyes (48 dogs) received ophthalmic solution alone (medication-group). The medication-group was divided into owner-led and vet-led groups depending on who elected not to perform surgery. Comparisons involved time-to-complications, vision, and the number and type of ophthalmic solutions administered. The association between complications and pretreatment clinical findings was investigated. Results: No difference was found in complication risk between the phaco and owner-led medication groups. Conversely, the vet-led medication-group had a higher complication risk than the other groups. At the last follow-up, 94.8% of the phaco-group had vision, whereas 7.6% of the medication-group restored some visual axis. Poor glycemic control in the medication-group and younger age in the phaco-group increased complication risk. At 1-year post-treatment, the average number of ophthalmic solutions administered was 1.7 and 2.6 in the phaco and medication groups, respectively. The medication-group used anti-inflammatories the most throughout the follow-up, whereas the phaco-group used anti-inflammatories the most until 1-year post-treatment and lacrimostimulants at 1.5-year post-treatment. Conclusions: For canine diabetic cataracts, phacoemulsification is recommended because it is superior to topical management alone in terms of maintaining vision and reducing the number of ophthalmic solutions required in the long term.
Objective : Gamma knife radiosurgery (GKRS) is the least invasive surgical option for patients with trigeminal neuralgia (TN). However, the indications and long term outcomes of GKRS are still controversial. Additionally, a series with uniform long-term follow-up data for all patients has been lacking. In the present study, the authors analyzed long-term outcomes in a series of patients with TN who underwent a single GKRS treatment followed by a minimum follow-up of 60 months. Methods : From 1994 to 2009, 40 consecutive patients with typical, intractable TN received GKRS. Among these, 22 patients were followed for >60 months. The mean maximum radiation dose was 77.1 Gy (65.2-83.6 Gy), and the 4 mm collimator was used to target the radiation to the root entry zone. Results : The mean age was 61.5 years (25-84 years). The mean follow-up period was 92.2 months (60-144 months). According to the pain intensity scale in the last follow-up, 6 cases were grades I-II (pain-free with or without medication; 27.3%) and 7 cases were grade IV-V (<50% pain relief with medication or no pain relief; 31.8%). There was 1 case (facial dysesthesia) with post-operative complications (4.54%). Conclusion : The long-term results of GKRS for TN are not as satisfactory as those of microvascular decompression and other conventional modalities, but GKRS is a safe, effective and minimally invasive technique which might be considered a first-line therapy for a limited group of patients for whom a more invasive kind of treatment is unsuitable.
Lee, Dong-Han;Choi, Youn-Hee;Lee, Kang-Hee;Kang, Dae-Ryong;Jee, Sun-Ha;Nam, Chung-Mo;Suh, Il
Journal of Preventive Medicine and Public Health
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v.36
no.3
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pp.289-297
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2003
Objectives : The main objectives of this study are to identify the factors associated with hypertension control and to determine the influencing factors associated with antihypertensive therapy. Methods : The study was conducted on 107 subjects who participated in the 1999 and 2002 Gwacheon Study and who had had uncontrolled hypertension (systolic$\geq$140 or diastolic$\geq$ 90mmHg) in 1999, We compared the characteristics of the controlled and uncontrolled hypertensive group and investigated the characteristics of those taking antihypertensive medication. Univariate associations between hypertension control and its characteristics and the association between antihypertension treatment and its characteristics were tested with $x^2$-test. We also peformed logistic regression analysis. Results : The participants who had their blood pressure checked within 6 months before their first measurement and those who had taken the antihypertensive medication showed significantly better hypertension control during the follow-up. The multivariate analysis showed that baseline antihypertensive therapy was the most important determinant factor of hypertension control during the follow-up. Socioeconomic level and life style did not affect hypertension control when controlled by the treatment variable in this study. The factors associated with antihypertensive therapy at follow-up were previous antihypertensive therapy, old age, and high educational level. Conclusions : Those who received antihypertensive therapy and those who had their blood pressure re-checked within 6 months both showed well controlled hypertension. The subjects with high educational level complied well with the antihypertensive regimen, but those in their forties did not.
Purpose: Needlestick injuries (NSI) is the most frequent occupational hazard for healthcare personnel (HCP), and immediate report and adequate post-exposure prophylaxis (PEP) is essential in preventing occupational transmission of blood-borne pathogens. Methods: From June 2010 to October 2010, 544 NSI were reported through websites from 21 general hospitals in Korea. Among those, 499 cases of NSI were analyzed to identify the rate of follow-up treatment completion and for seroconversion. Results: 88.2% of the cases were completed with follow-up treatment, 8.8% of the NSI were not completed with follow-up treatment, and 5 cases were unavailable to trace. 4.2% cases of NSI required a hepatitis B vaccination concurrent with hepatitis B immunoglobulin. 41.1% of the cases and 31.1% of the cases needed to be tested for anti HCV and anti HIV, respectively. Prophylaxis medication for HIV was prescribed in 3 cases, and all cases completed required 1 month of medication. There was 1 case (0.2%) of seroconversion to HCV. Conclusion: The PEP completion rate was not satisfactory, and the importance of completion of PEP treatment should be emphasized through education and counseling. Also, a careful risk assessment is needed for HCP who are exposed to HCV or HIV.
Investigating LVF directly, quantitatively and non-invasively by MUGA helps to validate and to follow up the effectiveness of new kinds of therapy. This is performed in controlled studies comparing groups of patients as demonstrated in the case of intracoronary thrombolysis. But it is also applicable on an individual basis. Contrary to the protocol in controlled studies medication was not discontinued in our patients before and after bypass surgery. This resembles the situation under routine conditions. Therefore the number of patients with reduced LVF was rather small before and after bypass operation. But, and this in the main result of our study, implementing MUGA for follow-up under this conditions can help: 1. To find out early those patients in whom LVF deteriorates postoperatively despite adequate medication. 2. To better define whether in cases of persistent or recurrent angina there is also deterioration of LVF. By this means MUGA can significantly contribute to find out whether reangiography is necessary or not, a question which often is difficult to answer in those patients.
ㆍPurpose: This study was performed to investigate the initial conservative treatment for TMD patients using careful counselling and medication prospectively.
ㆍMaterials and Methods: Careful counselling and medication were performed in 51 TMD patients and 27 patients had follow-up check 2 months or more. Diagnosis of TMD was based on medical history and, physical and radiographic examination. TMD included masticatory disorder, internal derangement, degenerative joint disease, inflammatory joint disorder. and problems resulting from extrinsic trauma. All patients had chief complaints of TMJ pain, mouth-opening limitation. joint noise, and/or referred pain. We counselled and explained to the patient about the pathogenesis, etiologic factors, diagnosis and treatment plan for abut 10 minutes. We prescribed nonsteroidal anti-inflammatorv analgesic(Somalgen) and amitriptyline 10mg per day for 2 weeks. We informed the patient of the attention sheet and taught self-exercise of jaw. The patient were assessed by answering the questionnaire of subjective evaluation of TMD & maxillofacial pain. Questionnaire of an activity limitation. Questionnaire of a jaw function, and Questionnaire for the evaluation of TMD.
ㆍResults: In questionnaire for the evaluation of TMD, 88.5% of 26 patients answered that the treatment was efficacious. 71.4% of 21 patients answered no problem in everyday life. There were significant differences between pretreatment and final follow-up in the evaluation of the subjective pain in the following sections: opening widely, chewing, resting, morning, masticatory muscle, and temporal portion(SAS program, paired T-test, P = 0.05).
ㆍConclusions: Considerate counselling and proper medication could be significantly effectve in the initial treatment of TMD.
This study describes the clinical steps taken in the treatment of a patient who had an avulsed right upper central incisor that presented with incomplete root development and chronic apical periodontitis. A 7-year-old boy was referred from a private dentist to a dental office specializing in endodontics. The tooth had remained in a dry environment for 20 minutes, and tooth replantation was performed at an emergency appointment. After clinical and radiographic examinations, root canal decontamination was performed, followed by several changes in intracanal calcium hydroxide medication. Blood clot formation was attempted, but bleeding within the root canal was insufficient; therefore, we opted for an intracanal medication change to stimulate mineralized tissue formation in the apical region. Root obturation was performed 45 days after the last change of intracanal medication, and clinical, radiographic, and tomographic follow-up examinations were performed at 3, 6, 18, and 40 months after the endodontic intervention. The increase in thickness and length of the root structure and the absence of root resorption were verified through follow-up examinations. Therefore, it was concluded that the procedures used were successful for tooth replantation.
Purpose: Sublingual immunotherapy is currently promoted by various companies, with administration schedules variable in the different products even though almost all are standardized immunologically. So, this study was planned to examine the efficacy of simple nondaily dosing of sublingual immunotherapy instead of the widely used daily schedule. Materials and Methods: Fifty-two patients with allergic rhinitis and bronchial asthma were enrolled. Sublingual immunotherapy (manufactured at the allergen immunotherapy preparation unit at Mansoura University) was given in suitable bottles with a dropper mechanism that permits comfortable dosing under the tongue. The physician recommended that the patient put the drops under his/her tongue and leave the drops beneath the tongue for 2 minutes before swallowing. This was repeated every 3 days, with the drop number and concentration gradually rising. Results: After 2 months of follow-up, 65.8% responded partially to the symptom score and 26.3% responded completely to the medication score. There was a significant decline in the symptom and medication scores from the baseline scores (p<0.0001). After 4 months of follow-up, 95.8% responded partially to symptom scores and no one has not responded; 54.2% responded completely to medication scores; and 81% of studied patients had no side effects. However, the most frequent side effect was a sore throat. Conclusion: Our nondaily schedule of sublingual immunotherapy is tolerable, safe, and effective in patients with allergic rhinitis and bronchial asthma.
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