• Title/Summary/Keyword: Geriatric screening

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Factors Associated with Vancomycin-Resistant Enterococcus Colonization in Patients Transferred to Emergency Departments in Korea

  • Kim, Hyun Soon;Kim, Dae Hee;Yoon, Hai-jeon;Lee, Woon Jeong;Woo, Seon Hee;Choi, Seung Pill
    • Journal of Korean Medical Science
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    • v.33 no.48
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    • pp.295.1-295.7
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    • 2018
  • Background: Vancomycin-resistant enterococci (VRE) infections have become a major healthcare-associated pathogen problem worldwide. Nosocomial VRE infections could be effectively controlled by screening patients at high risk of harboring VRE and thereby lowering the influx of VRE into healthcare centers. In this study, we evaluated factors associated with VRE colonization in patients transferred to emergency departments, to detect patients at risk for VRE carriage. Methods: This study was conducted in the emergency department of a medical college-affiliated hospital in Korea. Every patient transferred to the emergency department and admitted to the hospital from January to December 2016 was screened for VRE using rectal cultures. In this cross-sectional study, the dependent variable was VRE colonization and the independent variables were demographic and clinical factors of the patients and factors related to the transferring hospital. Patients were divided into two groups, VRE and non-VRE, and previously collected patient data were analyzed. Then we performed logistic regression analyses of characteristics that differed significantly between groups. Results: Out of 650 patients, 106 (16.3%) had positive VRE culture results. Significant variables in the logistic analysis were transfer from geriatric long-term care hospital (adjusted odds ration [aOR]: 8.017; 95% confidence interval [CI]: 1.378-46.651), hospital days (4-7 days; aOR: 7.246; 95% CI: 3.229-16.261), duration of antimicrobial exposure (1-3 days; aOR: 1.976; 95% CI: 1.137-3.436), and age (aOR: 1.025; 95% CI: 1.007-1.043). Conclusion: VRE colonization in patients transferred to the emergency department is associated primarily with factors related to the transferred hospitals rather than demographic and clinical characteristics.

Results of the Korean Medicine Visiting Care Service for Solitary Elderly in a Public Health Center (일개 보건소에서 시행한 독거노인 한방 가정방문 결과보고: 이침치료를 활용한 인지기능 개선을 중심으로)

  • Kwon, Chan-Young;Lee, Boram;Chung, Sun Yong;Kim, Jong-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.30 no.2
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    • pp.47-58
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    • 2019
  • Objectives: To conduct and report the results of a public health promotion program in Korean medicine (KM), namely the KM Visiting Care Service for Solitary Elderly, from November 2018 to April 2019. Methods: Six elderly people living in a rural area received the KM visiting care service, twice a week, for four months. This service consisted of acupuncture, auriculotherapy, and supportive counseling to manage their musculoskeletal pain, cognitive impairment, and/or depression. The changes of symptoms were assessed using Numeric Rating Scale (NRS), Korean version of Mini-Mental State Examination for Dementia Screening (MMSE-DS), Korean version of Montreal Cognitive Assessment (MoCA-K), and Geriatric Depression Scale-Short form Korean (GDS-SF-K). Results: Through the 4-months KM visiting care service, the overall subjects' NRS-rated pain decreased slightly. Most showed improvement in MMSE-DS and/or MoCA-K, except one subject who was diagnosed with Alzheimer's disease. Depression assessed by GDS-SF-K showed improvement in a few subjects who were unable to walk independently. Satisfaction assessed through survey was generally high in all subjects. Conclusions: This KM Visiting Care Service for Solitary Elderly may help improve the pain and cognitive function of frail solitary elderly in rural areas. However, the protocol need to be improved to optimize the effect.

Effects of a problem drinking monitoring program for bereaved older men: A pilot study (사별 남성 노인의 문제성 음주 경감 프로그램 효과성에 관한 파일럿 연구)

  • Nam, Ilsung;Yoon, Hyunwoo;Kim, Taewhan
    • 한국노년학
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    • v.40 no.3
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    • pp.477-483
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    • 2020
  • Purpose: The aim of this study is to test a brief modified version of intervention for problem drinking monitoring program for bereaved men who lost their loved one. Methods: Inclusion criteria were experiencing the recent loss of a spouse and providing informed consent for participation. Of the 32 referred individuals who met the inclusion criteria, 26 participants were recruited. Study participants were randomly assigned into Alcohol problem monitoring(APM) group (N=13) or comparison group (N=13). Results: Older men receiving APM substantial decreased in problem drinking during three months of intervention. Improvement over time was observed on the outcomes, particularly in the Short Michigan Alcoholism Screening Test-Geriatric Version(SMAST-G). Conclusion: The findings that a modified version of APM for bereavement helped improve complicated grief symptoms and social impairments and reduce levels of problem drinking, provide important insights into the interventions for psychological and alcohol-related difficulties in bereavement.

Ginsenoside 20(S)-Rg3 reduces KIF20A expression and promotes CDC25A proteasomal degradation in epithelial ovarian cancer

  • Rong Zhang;Lei Li;Huihui Li;Hansong Bai;Yuping Suo;Ju Cui;Yingmei Wang
    • Journal of Ginseng Research
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    • v.48 no.1
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    • pp.40-51
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    • 2024
  • Background: Ginsenoside 20(S)-Rg3 shows promising tumor-suppressive effects in ovarian cancer via inhibiting NF-kB signaling. This study aimed to explore the downstream tumor suppressive mechanisms of ginsenoside Rg3 via this signaling pathway. Materials and methods: A systematical screening was applied to examine the expression profile of 41 kinesin family member genes in ovarian cancer. The regulatory effect of ginsenoside Rg3 on KIF20A expression was studied. In addition, we explored interacting proteins of KIF20A and their molecular regulations in ovarian cancer. RNA-seq data from The Cancer Genome Atlas (TCGA) was used for bioinformatic analysis. Epithelial ovarian cancer cell lines SKOV3 and A2780 were used as in vitro and in vivo cell models. Commercial human ovarian cancer tissue arrays were used for immunohistochemistry staining. Results: KIF20A is a biomarker of poor prognosis among the kinesin genes. It promotes ovarian cancer cell growth in vitro and in vivo. Ginsenoside Rg3 can suppress the transcription of KIF20A. GST pull-down and co-immunoprecipitation (IP) assays confirmed that KIF20A physically interacts with BTRC (β-TrCP1), a substrate recognition subunit for SCFβ-TrCP E3 ubiquitin ligase. In vitro ubiquitination and cycloheximide (CHX) chase assays showed that via interacting with BTRC, KIF20A reduces BTRC-mediated CDC25A poly-ubiquitination and enhances its stability. Ginsenoside Rg3 treatment partly abrogates KIF20A overexpression-induced CDC25A upregulation. Conclusion: This study revealed a novel anti-tumor mechanism of ginsenoside Rg3. It can inhibit KIF20A transcription and promote CDC25A proteasomal degradation in epithelial ovarian cancer.

Effects of Visiting Cognitive Activities Using Brain Training on Cognition, Subjective Memory Complaints, and Depression in Community-Dwelling Elderly People - Focusing on Gwangmyeong City (브레인 트레이닝을 활용한 방문형 인지활동이 지역사회 노인의 인지, 주관적 기억감퇴, 우울감에 미치는 효과 - 광명시를 중심으로)

  • Tae-Hoon Kim;Nam-Hae Jung
    • Journal of The Korean Society of Integrative Medicine
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    • v.12 no.2
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    • pp.111-119
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    • 2024
  • Purpose : This study aimed to demonstrate the effects of visiting cognitive activities using brain training on cognition, subjective memory complaints and depression among elderly participants residing in community living in Gwangmyeong city. Methods : Over a 14-month period (October 2022 to December 2023), four brain training instructors visited the homes of older adults and conducted the intervention using a brain training kit. The participants included 32 elderly individuals aged 65 years and older, who were living in Gwangmyeong city. The assessments were conducted by an occupational therapist, a nurse and a social worker at the Gwangmyeong dementia relief center. These assessments included the following the subjective memory complaints questionnaire (SMCQ), short geriatric depression scale-Korean (SGDS-K), a cognitive impairment screening test (CIST), the consortium to establish a registry for Alzheimer's disease-Korean (CERAD-K). The participants were divided into three groups (A: 20-30 points, B: 10-19 points, C: 1-9 points) based on the CIST score. For data analysis, descriptive statistics and wilcoxon signed-rank test were performed using SPSS 24.0, and the statistical level was at a=.05. Results : The results of the intervention showed that the SMCQ score of group A improved significantly (p<.05), the CIST score of group B also improved significantly (p<.05). However, the SGDS-K score of group C improved, but did not demonstrate statistical significance (p=.080). Conclusion : The visiting cognitive activities using brain training produced significant effects on cognition, depression, and subjective memory disorders, depending on the cognitive level of the elderly participants. In the future, it will be necessary to demonstrate the effects according to cognitive level in various aspects with more elderly people.

The Effects of Group Occupational Therapy Program on Depression and Quality of Life in Patients with Mild Cognitive Impairment (집단작업치료 프로그램이 경도인지장애 환자의 우울과 삶의 질에 미치는 영향)

  • Park, Su-Jong;Kim, Jeong-Ki
    • Journal of Society of Occupational Therapy for the Aged and Dementia
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    • v.12 no.2
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    • pp.107-115
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    • 2018
  • Objective : The purpose of this study is to investigate the effect of a group occupational therapy program on the depression and quality of life of the elderly with Mild Cognitive Impairment(MCI). Method : The elderly with Mild Cognitive Impairment were selected based on the Mini Mental State Examination-Dementia Screening(MMSE-DS). The group occupatinal therapy program consisted of various cognitive domains and was performed 12 times for 6 weeks. The Geriatric Depression Scale(SGDS-K) and Quality of Life(QOL) were used to assess depression and quality of life of the subjects before and after the intervention. Result : The elderly with MCI improved significantly on the SGDS-K and QOL after the intervention program(p<0.05). Particularly, in some items of the QOL, there was a statistically significant difference, but the results of the SGDS-K and QOL did not show any correlation(p>0.05). Conclusion : In the case of the elderly with MCI, the QOL scale and the depressive symptom test were statistically significant when the group occupational therapy program was applied for 6 weeks.

A Preliminary Study for the Application of Michigan Alcoholism Screening Test-Geriatric Version in Korea (한국에서 노인용 미시간주정의존선별검사의 적용을 위한 예비연구)

  • Cheon, Jin-Sook;Oh, Byoung-Hoon;Choi, Young-Tai
    • Korean Journal of Biological Psychiatry
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    • v.6 no.1
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    • pp.102-110
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    • 1999
  • Objectives : The alcohol dependence in elderly people has been prevalent because of increase in geriatric population. However, it is difficult to find out alcohol dependence in the aged, because they have less specific clinical features as compared with adult alcoholics. The aims of this study were to screen alcohol dependence among elderly Koreans and to know the clinical characteristics of Korean delerly alcoholics. Methods : The questionnaires translated into Korean such as Michigan Alcoholism Screening Test(MAST-K), the Brief MAST and the MAST-Geriatirc Version (MAST-KG) were used to screen alcohol dependence in the elderly alcoholic inpatients aged over 60(N=43), adult alcoholic inpatients within 20-59 Yrs of age(N=60), which were compared with age matched normal healthy aged(N=18) or adult controls(N=45). The demographic data such as sex, age, education, occupation, socioeconomic status, marital status, numbers of children, dwelling and religion as well as alcohol history such as duration of alcohol drinking, onset age, family history, impulsivity, somatic illness and motivation were also obtained to identify characteristic features of Korean aged alcoholics by structured interviews. Results : 1) The aged alcoholics had the charateristic features of more in males, lower age, low education levels, more in blue-collar workers, lower socioeconomic class, more in single, few babies, more living alone, having no religion without statistical significance. 2) The onset age of alcohol dependence was significantly higher in the aged alcoholics($45.3{\pm}13.6Yrs$) than in the adult alcoholics($27.7{\pm}8.7Yrs$)(p<0.0001). The duration of problematic alcohol drinking was significantly longer in the aged alcoholics($22.0{\pm}15.1Yrs$) than in adult alcoholics($14.2{\pm}8.4Yrs$)(p<0.01). Otherwise, there were no significant difference between aged and adult alcoholics in the family history, imulsivity, somatic illness and motivation. 3) The mean score of the MAST-K was significantly higher in the aged alcoholics($20.6{\pm}5.4$) than in the normal aged($6.7{\pm}4.4$)(p<0.0001), which was significantly lower than in the adult alcoholics($26.2{\pm}8.0$) and in normal adult controls($9.5{\pm}3.2$)(p<0.05). The mean score of the Brief MAST was significantly lower in the aged alcoholics($9.3{\pm}3.5$) than in the adult alcoholics($14.5{\pm}6.6$)(p<0.0001). The mean score of the MAST-KG was significantly higher in the aged alcoholics($10.6{\pm}3.5$) than in the normal aged($4.8{\pm}4.3$)(p<0.0001). The former was significantly lower than in the adult alcoholics($12.9{\pm}4.3$)(p<0.005), and the mean score was $4.5{\pm}2.8$ in normal adult controls. 4) The items which showed statistically significant differences between aged alcoholics and normal aged controls could be found in 10 items of the MAST-K(items 2, 3, 4, 5, 11, 14, 17, 21, 22 and 23), 2 items of the Brief MAST(items 2 and 9), and 7 items of the MAST-KG(items 6, 13, 18, 19, 22, 23 and 24)(p<0.01). Conclusions : The scores of the MAST-K, the Brief MAST and the MAST-KG were significantly lower in the aged alcoholics than those in the adult alcoholics (p<0.05). The statistically significant differences between aged alcoholics and normal aged controls could be found in 10 items of the MAST-K, 2 items of the Brief MAST and 7 items of the MAST-KG. Therefore, a briefer rating scales around 10 items are needed to screen alcohol dependence among Korean elderly people.

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Effects of a Short-term Multimodal Group Intervention Program on Cognitive Function and Depression of the Elderly (단기 집단 복합중재가 정상 노인의 인지기능 및 우울에 미치는 영향)

  • Jung, Beom-Jin;Choi, Yu-Jin
    • Therapeutic Science for Rehabilitation
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    • v.8 no.3
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    • pp.57-68
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    • 2019
  • Purpose: This study aimed to investigate the effects of a short-term group multimodal intervention program that mixes physical activity, cognitive motion, and social interaction, on the cognitive function and depression level of healthy over 75-year-old individuals. Method: This study used a one group pre-test-post-test design, and intervention was made for 70 minutes per session, once a week, for four sessions in total. To compare changes in cognitive function, depression level and physical function before and after intervention, this study used the Mini-Mental State Examination-Dementia Screening (MMSE-DS), Geriatric Depression Scale-Short Form (GDS-SF), and Berg Balance Scale (BBS). Result: After applying group multimodal interventions to healthy over 75-year-old individuals, there was a statistically significant improvement in their cognitive function (p < 0.01), and there was a statistically significant decrease in their depression level (p < 0.05). Also, there was an increase in the rating score of the degree of balance from $46.83{\pm}9.11$ points before the intervention, to $48.08{\pm}7.00$ points after the intervention; however, it was not statistically significant (p > 0.05). Conclusion: Short-term group multimodal intervention that mixes physical activity, cognitive motion, and social interaction had a significant effect on slowing down the deterioration of cognitive function in healthy over 75 year-old individuals, and decreased their depression level. This study is significant in that it presents a foundation for providing more systematic intervention for the prevention of dementia and depression in the healthy older individuals. Follow-up studies should verify the result through research on the effects of an occupational therapist's professional treatment, and experimental group-control research.

A Study on the Clinical Usefulness of MMSE and BCRS for Cognitive Function Test in Patients with Non-Traumatic Subcortical Cerebrovascular Disease (비외상성 피질하 뇌혈관질환 환자에서 인지평가도구로서 정신상태소검사(MMSE)와 간이인지평가척도(BCRS)의 임상적 유용성에 대한 연구)

  • Choi, Hong;Lee, Young-Ho;Choi, Young-Hee;Ko, Dae-Kwan;Chung, Young-Cho;Park, Byoung-Kwan;Kim, Soo-Ji;Chung, Sook-Haui;Ko, Byoung-Hee;Song, Il-Byoung;Park, Kun-Woo;Lee, Dae-Hie
    • Sleep Medicine and Psychophysiology
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    • v.3 no.1
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    • pp.68-78
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    • 1996
  • Objective : The Mini-Mental State Examination(MMSE) and Brief Cognitive Rating Scale(BCRS) are frequently using screening tests fur evaluating the cognitive function in clinical practice and research. The authors tried to evaluate the clinical usefulness of these tests for the patients with non-traumatic subcortical cerebrovascular disease. Method : We administered the MMSE and BCRS to 85 patients and 195 normal control group. In order to compare the test results according to the lesion site, we divided patients into left sided lesion group(21 patients), right sided lesion group(31 patients) and both sided lesion group(13 patients). Their cognitive function was evaluated by the BNA and daily living functional activity was examined by the IADLs(Instrumental Activities of Daily Living Scale)and GERRI(Geriatric Evaluation by Relative's Rating Instrument). Results : The results are as follows : 1) In the BNA, the patients scored significantly lower than control group at all items(except Right-Left Orientation and Motor Impersistence), but there were no difference in the MMSE(total score and all 5 items), and only 2 items(recent memory and self-care) were significantly different between two groups in the BCRS. 2) In the comparison by lateralization, there were significant differences among three groups at 3 items(Left Tactile Form Perception, Left Finger Localization and Right Finger Localization) in the BNA. But, there were no difference in the MMSE and BCRS. 3) In the correlation between daily living functioning and the MMSE/BCRS, control group showed no relation(except item of cognitive functioning), but patient group was significantly correlated with 3 items(social functioning, instrumental activities of daily living and cognitive functioning). Conclusions : These findings suggest that MMSE and BCRS are not useful as the test for cognitive function and discrimination of lateralization in patients with non-traumatic subcortical cerebrovascular disease. However, scores of these tests may be related with the functional level(such as daily living function) of patients.

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Manifestation of Cognitive Function in Geriatric Patient with Subjective Memory Complaint (주관적 기억력 저하를 호소하는 노인 환자의 인지기능 양상)

  • Park, Han-Kyul;Kim, Jin-Sung;Lee, Jong-Bum;Seo, Wan-Seok;Koo, Bon-Hoon;Bai, Dai-Seg
    • Journal of Yeungnam Medical Science
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    • v.27 no.1
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    • pp.27-36
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    • 2010
  • Purpose : The purpose of this study was to find out cognitive function of the patients with subjective memory complaint. Material and Methods : From March 1st 2005 to May 31st 2009, 155 normal individuals without any medical illness who visited Yeungnam University Hospital to undergo medical checkup with neurocognitive test was enrolled, and checked by using Cognitive Assessment & Reference Diagnostic System. Results : 107 of the patients had normal cognitive function, 21 patients (about 15%) were diagnosed with dementia, and 10 patients (about 7%) were diagnosed with considerable psychiatric illness, such as depression, anxiety disorder, adjustment disorder. In amnesia, agnosia, aphasia, attention, calculation, dysexecution, Dementia group and Psychiatric illness group has worse score than Normal individuals group. But, in apraxia, Dementia group has worse score than Psychiatric illness group and Normal individual group. Conclusion : Because the patients with subjective memory complaint can be diagnosed as any psychiatric illness as well as dementia, sensitive screening test and early psychiatric approach is needed.

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