• Title/Summary/Keyword: Medication therapy management

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A Clinical study of Recurrent Acne in the Oriental Medicine (여드름에 관한 임상적 연구)

  • Choi In-Hwa
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.13 no.2
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    • pp.140-151
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    • 2000
  • Acne is a common chronic disease which most frequently affects the face, appearing in both males and females near puberty, and in most cases becomes less active as adolescence ends. The intensity and duration of activity vary for each individual. The disease may be minor, with only a few comedones or papules, or it may occur as the highly inflammatory and diffusely scarring acne conglobation. Permanent scarring of the skin and psyche can result from such inaction. The disease, however, has implications far beyond the few marks that may appear on the face. The lesions cannot be hidden under clothing; each is prominently displayed and detracts significantly from one's personal appearance and self-esteem. Recently many of acne patients are visiting to Oriental Medicine Hospitals. They want to receive the treatment of acne related another disease and causes, or worry about side effects of antibiotics and hormone therapy. This study was performed at Pundang Cha Oriental Medicine Hospital Department of Dermatology from March 1, 1997 to February 29, 2000 in 31 patients with recurrent acne. We investigated the clinical findings, included distribution of age & sex, severity of acne, sites on face, related causes, duration of disease and causes of visiting Oriental Medicine Hospital and so on. The results were as follows : The peak age at onset was 20-29 years old in females with 16 cases reported. The 22 total cases patients had severe signs with most frequently sites being forehead & chin. They visited Oriental Medicine Hospital because they want to take the treatment of acne related with another body problems(12 cases) and worry about side effects of antibiotics. Twenty cases were diagnosed 肺熱血熱(20 cases). And given acupuncture treatment, herb-medication and sometimes we used external applications. Relatively, their satisfaction grade was high. Dermatologists are trying to treat new methods in order to remove scar and decrease sebaceous gland secretion,. And we, Oriental Medicine doctors, have to develop and offer to patients the most effective management and successful treatment of this disease.

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A Prioritizing for the Evidence-Based Nursing Practice Guidelines Development (국내 근거기반 임상간호실무지침 주제의 우선순위 결정)

  • Gu, Mee Ock;Cho, Myoung Sook;Cho, Yong Ae;Jeong, Jae Sim;Eun, Young;Jeong, Ihn Sook;Park, Jeong Sook;Kim, Hea Jeong
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.1
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    • pp.39-51
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    • 2012
  • Purpose: Thisstudy was conducted with an aim to get a kind of prioritiesin developing the evidence-based nursing practice guidelines in fields. Methods: This study utilized a two-round Delphi surveys from November to December, 2010 with self-administered questionnaires which had a scale ranged from 0 to 9. A total of 95 head nurses working at the forty different general hospitals was asked to evaluate the priorities in four criteria; patient coverage, certainty, improvement in patient outcome and in nursing practice (first round) and 65 head nurses were asked to decide the importance of the criteria afterwards (second round). Results: The relative importance of 4 criteria was 22.3% in patient coverage, 26.5% in certainty, 23.5% in improvement of patient outcome, and 27.7% in improvement of nursing practice as the results of the 1st round and 20.6%, 26.6%, 24.8%, and 28.0% for the 2nd round, respectively. Top five nursing practices showed high scores after considering the relative importances of the 4 criteria were medication, intravenous therapy, checking vital sign, pain management, and diagnostic test or procedures care. Conclusion: It is recommended to take into account of the priorities that were found in this study when someone intends to develop a evidence-based nursing practice guideline.

Comparison of Propacetamol plus Fentanyl and Fentanyl alone with Patient Controlled Analgesia after Total Knee Arthroplasty (수술 후 자가통증조절장치 사용 환자에서 propacetamol과 fentanyl 복합제 및 fentanyl 단일제제의 효과 비교)

  • Kim, Minhyung;Jeong, Hyokeun;Park, Sohyun;Rhie, Sandy Jeong
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.1
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    • pp.17-23
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    • 2018
  • Objective: Opioid analgesics, for postoperative pain management, are an indispensable group of medication; however, they also have a variety of adverse drug reactions (ADR). Multimodal methods, combining non-opioid analgesics with opioid analgesics, have been investigated to increase the effects of analgesics and reduce ADR with opioid-sparing effects. The purpose of this study was to compare the effects of patient-controlled analgesia (PCA) with fentanyl alone, and PCA with fentanyl and intravenous (i.v.) propacetamol to determine the effects of pain control, cumulative opioid usage, and opioid ADR. Methods: The subjects were patients who underwent total knee arthroplasty at the Seoul Veterans hospital from January 1, 2015 to December 31, 2016. The study period was from postoperative day 0 (POD0) to day 3 (POD3), and the retrospective study was conducted using electronic medical records. Results: Pain severity was significantly low at POD1 (p = 0.017), POD2 (p = 0.003), and POD3 (p = 0.002) in the multimodal group. The fentanyl only group frequently reported both moderate and severe pain at a statistically significant level. This was consistent with the analysis of the pro re nata (PRN) intramuscular analgesia usage at the time of numerical rating scale (NRS) 4 and above. The opioid-sparing effect confirmed that the average opioid dose equivalent to i.v. morphine dose was 9.4 mg more than that used for the multimodal group in the fentanyl only group. The ADRs and length of stay between the two groups were not statistically different. Conclusion: The results of this study suggest that the combination therapy of fentanyl and i.v. propacetamol is superior to fentanyl monotherapy.

A case of steroid-induced psychosis in a child having nephrotic syndrome with toxic epidermal necrolysis (신증후군 환아에서 발생한 독성표피괴사용해 치료를 위해 사용된 고용량 스테로이드로 인한 정신질환 1례)

  • Kim, Sae Yoon;Lee, Jae Min;Park, Yong Hoon
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.437-441
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    • 2010
  • Toxic epidermal necrolysis (TEN) and Stevens Johnson syndrome (SJS) are rare, life-threatening mucocutaneous -diseases, usually attributable to drugs and infections. Corticosteroids have been used in the management of TEN for the last 30 years. This remains controversial and is still much debated. TEN can occur despite administration of high doses of systemic corticosteroids. The psychiatric side effects of corticosteroids can include headache, insomnia, depression, and mood disorders with or without psychotic episodes. Steroid-induced psychosis is dealt with by tapering or discontinuing the steroid; antipsychotics are also sometimes used. We report a case of an 11-year-old boy who was admitted with TEN. He had also been diagnosed as having nephrotic syndrome in the past. Remission was achieved through induction therapy and by maintaining the use of steroids. After a full-dose intravenous dexamethasone for TEN, he showed psychotic symptoms. We diagnosed him as having steroid-induced psychosis. We tapered the steroid use and initiated an atypical antipsychotic medication, olazapine and intravenous immunoglobulin (IV-IG). His symptoms dramatically improved and he was discharged.

The one case of acute dermatitis patient during the period of pregnancy (임신중 급성기 피부염 환자 1례에 대한 임상보고)

  • Lee, Chang-Hoon;Cho, Jung-Hoon;Jang, Jun-Bock;Lee, Kyung-Sub;Kim, Eun-Sook
    • The Journal of Korean Obstetrics and Gynecology
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    • v.18 no.4
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    • pp.195-202
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    • 2005
  • Purpose : The purpose of this study is to report clinical management of acute dermatitis patient during the period of pregnancy by oriental medicine. Methods : Generally acute dermatitis is treated by corticosteroids, antibiotics, antihistamines ec. But the use of these drugs may affect pregnancy women adversely. So we think that oriental medical therapy is useful to treat a pregnancy women who has acute dermatitis. We experienced a case of acute dermatitis patient during the period of pregnancy. In the beginning of treatment, she has severe itching, burning sensation, bulla, papule. We treated her with herbal medicine and normal saline wet dressing. Results : After treatment during 10days(admission treatment-herb medication, normal saline wet dressing), her symptoms was improved fairly After that she took herb medicine for a month, and all of her symptoms was disappeared. So she was satisfied with the result. Conclusion : Dermatosis gravidarum is a pregnancy-associated disease, which include itching, papule, eczema ec. It is generally due to blood deficiency(血虛) under pregnancy condition. So samooltang is effective on dermatitis under blood deficiency.

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A Study on Identifying Nursing Activities and Standard Nursing Practice Time for Developing a Neonatal Patient Classification System in Neonatal Intensive Care Unit (신생아중환자 분류도구 개발을 위한 간호활동 규명 및 표준간호시간 조사연구)

  • Ko, Bum Ja;Yu, Mi;Kang, Jin Sun;Kim, Dong Yeon;Bog, Jeong Hee;Jang, Eun Kyung;Park, Sun Ja;Oh, Sun Ja;Choi, Yun Jin
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.2
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    • pp.251-263
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    • 2012
  • Purpose: It was necessary for developing a neonatal classification system based on nursing needs and direct care time. This study was, thus, aimed at identifying nursing activities and measuring the standard nursing practice time for developing a neonatal patient classification system in Neonatal Intensive Care Unit (NICU). Methods: The study was taken place in 8 general hospitals located in Seoul and Kyungi province, South Korea from Dec, 2009 to Jan, 2010. By using 'the modified Workload Management System for critical care Nurses' (WMSN), nursing categories, activities, standard time, and task frequencies were measured with direct observation. The data were analyzed by using descriptive statistics. Results: Neonatal nursing activities were categorized into 8 areas: vital signs (manual), monitoring, activity of daily living (ADL), feeding, medication, treatment and procedure, respiratory therapy, and education-emotional support. The most frequent and time-consuming area was an ADL, unlike that of adult patients. Conclusion: The findings of the study provide a foundation for developing a neonatal patient classification system in NICU. Further research is warranted to verify the reliability and validity of the instrument.

Consumer Perspectives on the Informed Consent of Off-label Drug Use in South Korea (의약품의 허가외사용 정보제공과 동의에 대한 일반인 인식)

  • Lee, Iyn-Hyang;Kye, Seunghee;Je, Nam Kyung;Lee, Sukhyang
    • Korean Journal of Clinical Pharmacy
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    • v.24 no.4
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    • pp.265-271
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    • 2014
  • Objective: This study aims to explore the perception of off-label use of medications and the provision of informed consents from the general public's perspective. Methods: The study subjects (n=291) were recruited from 7 cities in Korea through a convenience sampling method. The self-administered questionnaire with 13 items was issued and collected. The study subjects who have had a pharmaceutical job were excluded. Results: The total of 231 respondents was included. Only 23% of respondents were familiar with the concept of off-label use of medications. Eighty five percent of respondents (n=196) stated that the prescribers should explain the off-label use of a medication to their patients. The preferred method for delivering the message was the oral explanation (n=122, 53%), followed by oral explanation plus a pamphlet (n=94, 41%). The safety issue is the most concerned aspect regarding the off-label drug use, also effectiveness and insurance coverage. The majority of respondents (n=217, 94%) agreed that the prescriber should get a consent from patients before prescribing medications for off-label use. They preferred written consent to oral consent (140 vs. 77). Conclusion: This study demonstrated general publics are infrequently aware of off-label use of medications. It is important to raise public awareness of the off-label use of medications and to openly discuss its pros and cons for safe and effective drug therapy.

Satisfaction with the Effect of Local Dynamical Micro-massage Therapy on the Pain and Discomfort after Breast Reconstruction Surgery

  • Ahn, Kwang Hyeon;Lee, Sun Jae;Park, Eun Soo;Park, Yu Gil
    • Medical Lasers
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    • v.9 no.1
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    • pp.39-43
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    • 2020
  • Background and Objectives Breast reconstruction has the advantage of reducing the loss of the body image of patients after mastectomy surgery, and also improving the quality of the social and sexual life of breast cancer patients. However, in surprising and unfortunate number of patients, acute postoperative pain persists beyond the normal course of postsurgical recovery. We set out to investigate the effect of local dynamical micro-massage (LDM) treatment for achieving pain relief and reducing other postoperative complications. Materials and Methods We performed a retrospective analysis on 58 patients who underwent LDM treatment for postoperative pain management at Soonchunhyang University Bucheon Hospital between February 2017 and June 2019. Those patients who complained of persistent postoperative pain, which was uncontrollable with medication, were treated with LDM. The degree of pain and discomfort with contracture were recorded using numerical rating scale (NRS) scoring system with numbers from 0 to 10 ('none' to 'worst'). Results The median NRS score of pain was reduced by 62.3% from the start to the end of LDM treatment (p<0.001). Further, the NRS score of discomfort with contracture was reduced 66.0% (p<0.001). There was no complication related to the LDM treatment. Conclusion Dual-frequency ultrasound LDM can be an effective therapeutic option for persisting pain after breast reconstruction surgery. It was also effective in improvement of discomfort with contracture and erythema of the surgical wound.

Analysis of the propensity of medical expenses for auto insurance patients by type of medical institution (의료기관 종류별 자동차보험 환자의 진료비 성향 분석)

  • Ha, Au-Hyun
    • Journal of Convergence for Information Technology
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    • v.12 no.2
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    • pp.184-191
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    • 2022
  • This study aims to provide basic information necessary to find an efficient management plan for patients using auto insurance. The analysis was conducted on the five-year auto insurance medical expenses review data registered in the health care bigdata Hub from 2016 to 2020. As a result of the analysis, the number one composition ratio of auto insurance inpatient treatment expenses was treatment and surgery fees for Certified tertiary hospitals, hospitalization fees for general hospitals, hospitals and clinics, and treatment and surgery fees for oriental medical institutions and dental hospitals. outpatient treatment expenses was doctor's fee for medical institution, treatment and surgery fees for oriental medical institutions and dental hospitals. The ratio of medication, anesthesia, and special equipment significantly affected the cost of inpatient. And the ratio of physical therapy significantly affected the cost of outpatient.

The Effects of Yongin-Emotional Management Training Program on the Improvement of Life Care in Patients with Chronic Schizophrenia (만성 조현병 환자의 라이프케어 증진을 위해 용인 정서관리 훈련 프로그램이 미치는 영향)

  • Lee, Eun-Young;Jin, Myung-Ja;Kim, Young-Woon
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.4
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    • pp.385-400
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    • 2019
  • We reviewed existing studies and proposed future research on the sustainability of short-term effects, and of the Yongin Emotion Management Training program (Y-EMT). In this study, we conducted Y-EMT to verify its effectiveness in relation to affective disorders associated with chronic schizophrenia. Thirty-five patients were assigned to the experimental group, and 35 to the control group. First, results of repeated-measures analysis supported the effectiveness of Y-EMT. Comparisons of the results on the pre-test with those for the 5-month and 1-year post-training tests showed significant differences in mean scores between the experimental and control groups. Furthermore, these differences persisted at the 2-year follow-up. Second, in the experimental group, interactions between emotional behavior and expression, self-efficacy, and changes in interpersonal relationships showed significant effects at 5 months after the program ended, and these effects continued to increase up to 1 year post-training. Taken together, the findings indicate that, to maintain the effects of therapy in patients with chronic schizophrenia, patients should undergo Y-EMT along with cognitive rehabilitation training and social skills training. Human relations training such as Y-EMT is most helpful for rehabilitation when it is paired with high levels of medication.