• Title/Summary/Keyword: Hospitalized medical patient

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Experience of Campylobacter gastroenteritis in Korean children: Single-center study

  • Seo, Seung Hyeon;Lee, Yeoun Joo;Mun, Sang Wook;Park, Jae Hong
    • Kosin Medical Journal
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    • v.33 no.2
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    • pp.150-158
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    • 2018
  • Objectives: Although Campylobacter is the main cause for bacterial acute gastroenteritis (AGE), there has been no notable clinical research into it, especially for Korean children. In this study, we share our experience of clinical, laboratory and image findings with Campylobacter AGE. Methods: Between May 2013 and June 2016, children diagnosed as having Campylobacter AGE were retrospectively enrolled in our study. Campylobacter AGE was considered diagnosed when a patient had symptoms of bacterial AGE and a positive Campylobacter result in stool using multiplex PCR. Results: Among 539 patients with suspected bacterial AGE, 31 (5.8%) patients had a positive result for Campylobacter. The average age of the 31 patients was $10.2{\pm}5.0$ years with a range between 1.1 and 16.9 years. Eighteen (58%) of the total patients were hospitalized between June and August. Diarrhea (93.5%), abdominal pain (83%) and fever (83%) were common symptoms. For 20 patients (65%), diarrhea lasted for less than three days, and fever lasted for 2.1 days on average. Among the 20 patients subjected to imaging studies, 12 patients (60%) showed bowel wall thickening on the right side of colon. In blood tests of 30 patients, 22 (73%) and 29 (97%) patients exhibited leukocytosis and elevated C-reactive protein, respectively. During treatment for Campylobacter AGE, prediagnostic empirical antibiotics were used for 6 (19%) patients. All patients recovered without complications. Conclusions: Among the children with suspected bacterial AGE, 5.8% had a positive result on Campylobacter in stool using multiplex PCR. Therefore, we observe that Campylobacter AGE should be considered in school-age children who have diarrhea, fever, and abdominal pain.

Evaluation of Environmental Contamination and Disinfection Effects in Patient Rooms with Carbapenem-Resistant Enterobacteriaceae Using ATP Measurements and Microbial Cultures (ATP 측정과 미생물 배양검사를 이용한 카바페넴내성장내세균 보유환자 병실 환경 오염 및 환경 소독 효과 평가)

  • Kim, Ji Eun;Jeong, Jae Sim;Kim, Mi Na;Park, Eun Suk
    • Journal of Korean Biological Nursing Science
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    • v.23 no.4
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    • pp.339-346
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    • 2021
  • Purpose: To determine the extent of environmental contamination and the effect of disinfection around patients with carbapenem-resistant Enterobacteriaceae (CRE) using adenosine triphosphate (ATP) measurements and microbial culture tests. Methods: The subjects of this study were 10 patients hospitalized in a single room due to CRE from April 13 to 21, 2021. One hundred and sixty samples were collected using cotton swabs from the patients' environment including the surface and drain of sinks and toilet seats before and after disinfection of the room after discharge. Twenty-one samples were collected from the nurses' personal digital assistants (PDAs), keyboards, and computer mice before disinfection. The relative light units (RLUs) and CRE colony-forming units (CFU) of 181 samples were measured using ATP test equipment and chrome agar plates, respectively. Results: The highest RLUs were measured at the sink drains before and after disinfection. Four CRE samples from the sink drains (2), sink surface (1), and toilet bowl (1) before disinfection were cultured. Based on the failure criteria (≥ 250 RLU/cm2 and ≥ 1 CFU/100 cm2), 90 % and 50 % of the samples from the drain exceeded the failure criteria before and after disinfection, respectively. In the culture tests, CRE was not detected after disinfection. Conclusion: According to the RLU and CFU measurements of drain samples, disinfection was not effective. Thus, improvements in the disinfection methods of drains, as well as more efficient and systematic environmental decontamination and disinfection evaluation tools, are needed to accurately evaluate the effectiveness of disinfection in various places.

Status of Oral Care according to the Type of Surgery for Inpatients at Dental Hospitals

  • Kim, Jae-Eun;Yoon, Young-Jae;Kwon, Yong-Dae;Oh, Sang-Hwan
    • Journal of dental hygiene science
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    • v.21 no.4
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    • pp.275-281
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    • 2021
  • Background: The aim of this study was to understand the importance of professional oral care for inpatients by examining the type and frequency of surgery and hospital discharge period at dental hospitals, and identify the types of professional oral care actually in progress. Methods: In this study, the type of surgery and length of hospitalization were investigated among patients admitted to the dental hospital for oral and maxillofacial surgery, and the professional oral care status of inpatients who had difficulty self-managing their oral care was retrospectively identified by collecting data on oral care before and after surgery, including the type and frequency. Results: The majority of inpatients at dental hospitals were male (57.6%), elderly patients over 60 years accounted for 20% of patients, and the average length of hospitalization was 4 days. In the 20s (aged 20~29 y), the number of orthognathic surgery patients (73.1%) was high, and the incidence of cysts was high in middle-aged patients. Regarding the oral care of hospitalized patients, scaling was performed once by a dentist before surgery. After surgery, surgical dressings using H2O2 balls were applied and oral care education was introduced before discharge. Conclusion: Based on the results of this study, professional oral care is essential to prevent infection and complications caused by oral bacteria among inpatients at dental hospitals. It is necessary to use various oral hygiene aids for inpatients and to conduct effective oral care instruction according to each patient's situation. In addition, it is necessary to raise awareness and the role of dental hygienists in professional oral care.

A Case Report on Opioid-Induced Constipation in a Patient with Cancer Treated by Jowiseunggi-tang (조위승기탕으로 호전된 암 환자의 마약성 진통제로 인한 변비 치험 1례)

  • Yoon, Jee-Hyun;Park, Su Bin;Kim, Eun Hye;Lee, Jee Young;Yoon, Seong Woo
    • The Journal of Internal Korean Medicine
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    • v.43 no.2
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    • pp.229-236
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    • 2022
  • Objective: Jowiseunggi-tang (JWSGT) is a traditional herbal medicine commonly used for purgative activity in constipation. This study evaluates JWSGT for the treatment of opioid-induced constipation (OIC), the most common and debilitating gastrointestinal effect of opioid use. Methods: A 64-year-old man with floor of mouth cancer was hospitalized for OIC, and JWSGT was administered orally twice a day for 10 days, along with acupuncture, moxibustion, and cupping. The primary outcome measures were defecation type according to the Bristol Stool Form Scale (BSFS) and the frequency of bowel movements. The Brief Fatigue Inventory (BFI) and the Functional Assessment of Cancer Therapy-General (FACT-G) were used as secondary measures. Results: After three days of JWSGT administration, spontaneous bowel movements were observed two to three times per week with improved BSFS from type 2 to 4. A reduction in BFI score (8.7 to 2.0) and an increase in FACT-G score (44.3 to 59.0) suggested an improvement in fatigue level and quality of life. Conclusion: This is the first report to assess the efficacy of JWSGT for the management of OIC in patients with cancer, and JWSGT may be an effective option to improve symptoms and quality of life in this group.

Risks for Readmission Among Older Patients With Chronic Obstructive Pulmonary Disease: An Analysis Using Korean National Health Insurance Service - Senior Cohort Data

  • Yu Seong Hwang;Heui Sug Jo
    • Journal of Preventive Medicine and Public Health
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    • v.56 no.6
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    • pp.563-572
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    • 2023
  • Objectives: The high readmission rate of patients with chronic obstructive pulmonary disease (COPD) has led to the worldwide establishment of proactive measures for identifying and mitigating readmissions. This study aimed to identify factors associated with readmission, as well as groups particularly vulnerable to readmission that require transitional care services. Methods: To apply transitional care services that are compatible with Korea's circumstances, targeted groups that are particularly vulnerable to readmission should be identified. Therefore, using the National Health Insurance Service's Senior Cohort database, we analyzed data from 4874 patients who were first hospitalized with COPD from 2009 to 2019 to define and analyze readmissions within 30 days after discharge. Logistic regression analysis was performed to determine factors correlated with readmission within 30 days. Results: The likelihood of readmission was associated with older age (for individuals in their 80s vs. those in their 50s: odds ratio [OR], 1.59; 95% confidence interval [CI], 1.19 to 2.12), medical insurance type (for workplace subscribers vs. local subscribers: OR, 0.84; 95% CI, 0.72 to 0.99), type of hospital (those with 300 beds or more vs. fewer beds: OR, 0.77; 95% CI, 0.66 to 0.90), and healthcare organization location (provincial areas vs. the capital area: OR, 1.66; 95% CI, 1.14 to 2.41). Conclusions: Older patients, patients holding a local subscriber insurance qualification, individuals admitted to hospitals with fewer than 300 beds, and those admitted to provincial hospitals are suggested to be higher-priority for transitional care services.

Consultations to Department of Dentistry for Child and Adolescent Inpatients with Dental Trauma (치과적 외상이 있는 소아청소년 입원환자의 치과 협진 의뢰)

  • Jo, Chanwoo;Kim, Jihun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.4
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    • pp.403-411
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    • 2017
  • The purpose of this research is analyzing present condition, and pursuing developmental direction of consultation to department of dentistry for medical inpatient with dental trauma. This research conducted a retrospective analysis of consultation to department of dentistry for medical inpatient at Wonju Severance Christian Hospital from March 2011 to February 2017. This research analyzed chief complaint and dental diagnosis, referring department, time of consultation after dental trauma, relation between hospitalization period and time of consultation after dental trauma, relation between dental trauma and admission in the medical department due to trauma, cause and age of dental trauma occurrence, treatment of dental trauma, and revisiting rate of inpatient with dental trauma after discharge. Among all the chief complaint and dental diagnosis, dental trauma was the highest. Among all the referring departments, departments of surgery were the highest. In relation to being delayed of consultation term after dental trauma, it turned out that there's pretty high mutual relation between the hospitalization period and the consultation term after dental trauma, and the hospitalization period had the quantitative influence on the consultation term. Statistically, dental trauma and admission in the medical department due to trauma had significant relations. In case of those patients due to car accidents, they had dental trauma without exception. Statistically, patient's group with dental trauma in hospital room was younger than patient's group with dental trauma in non-hospital room. Statistically, dental trauma and treatment in hospitalization had no significant relations, and dental trauma and revisiting department of dentistry after discharge had no significant relations. For the child and adolescent inpatients hospitalized for car accidents, there is high possibility of accompanying dental trauma, and dental consultations can be delayed. For the young child inpatients, the possibility of dental trauma occurrence in hospital room is high. Moreover, treatments during hospitalization and revisiting department of pediatric dentistry after discharge are not performed well for inpatients with dental trauma. Regarding these results, it can be an alternative that improving of consultation system, dedicated workforce placement and having dental facilities and equipment in the hospital ward, education to medical doctor and dentist, communication between medical doctor and dentist. This research can be used as a study material of medical and dental departments, and it's expected to be committed to developing of consultations to department of dentistry for child and adolescent inpatients with dental trauma.

The Association between Family Support, Activities of Daily Living and Depression among Hospitalized Older Patients with Chronic Diseases (만성질환 입원노인의 가족지지 및 일상생활 수행능력과 우울과의 관련성)

  • Kim, Jeong Yi;Ryu, So Yeon;Han, Mi Ah;Choi, Seong Woo
    • Journal of agricultural medicine and community health
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    • v.41 no.1
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    • pp.13-26
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    • 2016
  • Purpose: This study was performed to identify the association between family support, activities of daily living (ADL) and depression among hospitalized older patients with chronic diseases. Methods: This study subjects were 100 elderly patients with chronic diseases including chronic respiratory diseases, diabetes mellitus and et al. in a general hospital. The collected data were patient characteristics, family support, ADL, and depression by structured questionnaire and medical chart review. The used statistical analyses were t-test, analysis of variance, Pearson's correlational analysis and multiple regression analysis. Results: The mean scores of family support, ADL and depression were $49.95{\pm}8.68$, $8.65{\pm}2.65$, $6.66{\pm}3.78$, respectively. The prevalence rate of depression was 64.0%. In simple analysis, the statistically significant associated factors with depression were age, spouse, economic status, social activity, subjective health status, and number of pain. Depression had statistically a significant positive correlation with ADL and a negative correlation with family support. The final result of hierarchial multiple regression analysis (Model 3), the factors related to depression were family support (b=-.135, p<.001), subjective health status (b=2.510, p=.001). Conclusions: It is necessary to develop and apply the program for controlling the depression of elderly patients with health education, reinforcement of supportive systems in hospital. And, further multidisciplinary studies should be done.

The clinical study on 44 cases of patient with Thoracolumbar Compression Fracture (흉(胸)·요추(腰椎) 압박골절(壓迫骨折) 환자(患者)에 대한 임상적(臨床的) 고찰(考察))

  • Lim, Jeoung-Eun;Kim, Kee-Hyun;Hwang, Hyeon-Seo
    • Journal of Acupuncture Research
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    • v.17 no.2
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    • pp.41-51
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    • 2000
  • Clinical observation was made on 44 cases of stable thoracolumbar compression fracture that were confirmed through simple x-ray and neurological examination. They were hospitalized and treated by acupuncture and moxibustion, bed rest, herb medicine and physical therapy. If necessary, patient was given an enema. The results obtained are as follows. 1. The patient distribution ratio, in regard to sex, was shown to be 1: 13.7 for males to females. In regard to age, it was shown that people in their 60's was the most predominant case, followed by people in their 70's, 80's, 50's and 40's, respectively. 2. In regard to contributing factors, it was observed that accidental falls were most frequent, followed by reasons unknown, repetitive lifting of heavy objects, overlaboring and bruise in that order. 3. In regard to duration of illness before treatment, it was found that treatment within 1 week was most predominant, followed by over 4 weeks, and 1-2 weeks, respectively. 4. With regard to the duration of hospitalization, hospitalization within 2 weeks was found to be most predominant, followed by 2-4 weeks. 5. In regard to the level of the affected vertebral body; The affected vertebral bodies distributed between T3 to L5 except for T7; T12 was found to be most predominant, followed in turn by L1 and L5. 6. In regard to the number of affected vertebral bodies, 2 was the most frequent followed by 1 and 3, in that order. The average of the number of affected vertebral bodies was observed to be 2.8 and single vertebral body compression fracture was shown to have no clinical and statistical difference as compared with multiple vertebral body compression fractures. 7. In regard to the grade of the seriousness of symptoms, it was found that Grade IV was most predominant, followed by Grade III. 8. With regard to signs at the first medical examination, low back pain was seen in the highest number, and followed in order by gait disturbance, flank pain, flexion-extension disturbance, disturbance of rotation to right or left, and bowel dysfunction. 9. Concerning the effect of treatment, good results were most predominantly seen, and 95.5% of total patients showed fair results. 10. The duration of admission treatment due to the grade of clinical symptoms was as follows; In the case of the Grade IV, it was observed that within 2 weeks was most predominant and for Grade III was 2-4 weeks. It was also found that the grade of clinical symptoms was not in proportion to the duration of admission treatment. 11. In regard to the result of treatment due to the grade of clinical symptoms; It was found that in the case of Grade IV, within 2 weeks was most predominant, and for Grade III, it was found to be 2-4 weeks. 12. Intestinal obstruction was shown in 50% of total patients; In the case of duration of constipation, more than 1 week was found to be most predominant, followed by 2 and 4 days respectively. 13. With regard to the treatment of intestinal obstruction, using acupuncture and moxibustion, herb - medicine and enema together were found to be most effective. 14. Intestinal obstruction was mostly seen in the case of Grade IV.

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A Study on the Contamination of Solution with Suction used in Tracheostomy Patients (기관지절개술 환자의 흡인시 사용하는 용액의 오염수준 변화 연구)

  • Lim Yun-Hee;Yu Kwang Soo
    • Journal of Korean Public Health Nursing
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    • v.12 no.2
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    • pp.185-200
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    • 1998
  • It has been contributed to public health that the hospital has multiplied in the aspect of number and has been a large size with development of modern medical science, meanwhile the problem of hospital infection is coming out seriously. Respiratory hospital infection among hospital infections develops, very commonly from patients having taken the operation of intubation or tracheostomy, which results from a big factor that the infection developed from medical appliances used for respiration aids, contamination of solution and infection of medical staff. This study is separated into four steps-the time to use normal saline and distillation water for storaging catheter which are the cause of the infection of solution to store distillation water and catheter, not to say the catheter used when the patient who should get tracheostomy operation takes suction. The purpose of this study is to offer the basic data which are needed to check contamination degree as time goes by and nurse intervention and grope for a new nursing intervention. The target of this study is hospitalized 1D an intensive care unit having 700 sickbeds which is located in IKSAN city and it targeted patients before 7 days passed after an operaion of a tracheostormy. Materials collected were analyzed by SPSS PC+ figures program. The result of this study were as follows ; 1. The gradual contamination levels of the normal saline used In suction are showing that colony increase in proportion to the length of time. 2. while colony increases in normal saline with the lapse of time. distillation water mixed with 5cc of potadine did not show any sign of the formation of colony from its preparation until it was used for 8 hours. 3. Such variables as the period of intubation insertion. the length of hospitalization in I.C.U. the age and the level of contamination of normal saline have no inter-relationship. Therefore. as the length of normal saline used In suction. the contamination level increases with the excelleration of the contamination speed. 4. Regarding the number of suction and the contamination level of the normal saline. We can observe correlation contamination level in the 3 step of suction(mean value:13.4) and the saline which was used for one hours(r=0.702. P=0.00l). four hours(r=0.694. P=0.00l). eight hours(r=0.488. P=0.029). Further we can observe contamination in the 4 step of suction (mean value: 17 .8) well as saline used for eight hours; [for one hours (r=0.64l. P=0.002). four hours (r=0.670. P=0.00l). eight hours (r=0.57 4. P=0.008)]. Thesedays clinics use normal saline by changing it. three times a day. however. the timing of saline change and the current suction methoed should be changed given the one hour used normal saline contamination number 79.850. Regarding the number of suction and the contamination lend of the normal saline.

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A Comparative Study on the Clinical Features and Complications of Snake Bite Patients in Urban and Rural Areas (도시와 농촌에서 발생한 독사 교상 환자의 임상적 양상과 합병증 비교 연구)

  • Hong, Seong-Jun;Lee, Joo-Hwan;Choi, Woo-Ik;Jin, Sang-Chan;Jeon, Jae-Cheon
    • Journal of agricultural medicine and community health
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    • v.45 no.3
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    • pp.154-161
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    • 2020
  • Purpose: The purpose of this study is to compare the clinical features and complications of snake bite patients in urban and rural areas. Methods: A retrospective study was conducted on patients over 18 years of age who were hospitalized for snake bites from January 2013 to December 2019. Patients were categorized into urban and rural groups according to their respective locations at the time of the snake bite and the clinical characteristics and complications of the two patient groups were researched and compared. Results: Of the 77 snake bite patients, 44 patients were categorized into the rural group (57.1%). The rura1 group showed significant differences in old age (p=0.011), delayed hospital visits (p=0.010), far hospital distance (p<0.001), high local effect score (p<0.001), high traditional snake-bite severity grading scale (p=0.008) and use of large amounts of antivenins (p=0.026). There was a significantly higher incidence of acute kidney injury (p=0.030), rhabdomyolysis (p=0.026), and coagulopathy (p=0.033) in the rural group as well as a longer hospitalization period (p<0.011). Conclusion: Snake bites that occurred in rural areas resulted in patients with more complications compared to urban areas due to farther distances from hospitals, causing a delay in antivenom treatment.