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The Therapeutic Factors Affecting Post-discharge Course of Schizophrenia Patients in a University Hospital (일 대학병원 정신분열병 환자의 퇴원 후 경과에 미치는 치료적 요인)

  • Nam, Jung Hyun;Roh, Sungwon;Choi, Joonho;Lee, Kyung Woo
    • Korean Journal of Biological Psychiatry
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    • v.13 no.1
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    • pp.26-31
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    • 2006
  • Object : To evaluate how the therapeutic factors affect post-discharge course of patients with schizophrenia, we analyzed relationship between each therapeutic factor and outcome of inpatients with schizophrenia in Hanyang University Hospital. Methods : This study is a retrospective report. Subjects were schizophrenic inpatients who were discharged from Hanyang University Hospital from January 1, 2003 through December 31, 2004. We obtained demographic and clinical data from review of inpatient and outpatient charts. Results : We analyzed the records of 104 patients with schizophrenia(44 males and 60 females). Patients who had longer first admission days have fewer number of readmission. There were no significant correlation between psychiatric rehabilitation and course of schizophrenia. Courses, such as duration of outpatient department follow-up and number and duration of rehospitalization, did not differ according to the existence of extrapyramidal symptoms or types of antipsychotics prescribed. Conclusion : Among the therapeutic factors, longer duration of the first admission only affected better post-discharge course of patients with schizophrenia.

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Mini-plate removal in maxillofacial trauma patients during a five-year retrospective study

  • Park, Hyun-Chun;Kim, Su-Gwan;Oh, Ji-Su;You, Jae-Seek;Kim, Won-Gi
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.4
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    • pp.182-186
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    • 2016
  • Objectives: The purpose of this study was to analyze the incidence of indications for the removal of mini-plates over a five-year period in maxillofacial trauma patients. Materials and Methods: The medical records of 530 patients who underwent treatment with mini-plate fixation after maxillofacial trauma were reviewed for a five-year period (May 2007 to May 2012). Patients were evaluated concerning the number of mini-plates removed, age and gender distributions, time between insertion and removal, indication for removal, and site of removal. Results: The plates of 120 patients were removed (26 females and 94 males). The removal rate was 22.6%. The most frequent indication for removal was patient demand (81.7%), followed by tooth extraction (7.5%), and pain (3.3%). The most frequent removal site was the mandible (95.0%). Conclusion: The number of mini-plates removed was small, and the most common indication for removal was patient demand. There is no evidence to support a recommendation for the routine removal of titanium mini-plates.

Predictors of live birth and pregnancy success after in vitro fertilization in infertile women aged 40 and over

  • Kim, Hye Ok;Sung, Nayoung;Song, In Ok
    • Clinical and Experimental Reproductive Medicine
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    • v.44 no.2
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    • pp.111-117
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    • 2017
  • Objective: The aim of this study was to evaluate pregnancy outcomes and the live birth rate at 1-year age increments in women aged ${\geq}40years$ undergoing fresh non-donor in vitro fertilization (IVF) and embryo transfer (ET), and to identify predictors of success in these patients. Methods: This retrospective study was performed among women ${\geq}40years$ of age between 2004 and 2011. Of the 2,362 cycles that were conducted, ET was performed in 1,532 (73.1%). Results: The clinical pregnancy rate and live birth rate in women ${\geq}40years$ significantly decreased with each year of increased age (p<0.001). Maternal age (odds ratio [OR], 0.644; 95% confidence interval [CI], 0.540-0.769; p<0.001), basal follicle-stimulating hormone (FSH) levels (OR, 0.950; 95% CI, 0.903-0.999; p=0.047), the number of high-quality embryos (OR, 1.258; 95% CI, 1.005-1.575; p=0.045), and the number of transferred embryos (OR, 1.291; 95% CI, 1.064-1.566; p=0.009) were significant predictors of live birth. A statistically significant increase in live birth rates was seen when ${\geq}3$ embryos were transferred in patients 40 to 41 years of age, whereas poor pregnancy outcomes were seen in patients ${\geq}43years$ of age, regardless of the number of transferred embryos. Moreover, the cumulative live birth rate increased in patients 40 to 42 years of age with repeated IVF cycles, but the follicle-stimulating hormone in those ${\geq}43years$ of age rarely showed an increase. Conclusion: IVF-ET has acceptable outcomes in those < 43 years of age when a patient's own oocytes are used. Maternal age, basal FSH levels, and the number of high-quality embryos and transferred embryos are useful predictors of live birth.

The Efficacy of Stellate Ganglion Block in Sensorineural Anosmia Patients Unresponsive to Steroid Therapy (스테로이드에 반응 않는 감각신경성 후각소실 환자에서 성상신경절블록의 효과)

  • Moon, Ho Sik;Lee, Hae Jin;Sung, Choon Ho;Lim, Su Jin;Choi, Jin Hwan
    • The Korean Journal of Pain
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    • v.20 no.2
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    • pp.154-157
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    • 2007
  • Background: Anosmia can be frustrating for both the patient and physician, with no clear treatment. We prospectively investigated the effects of stellate ganglion block (SGB) in anosmic patients who were unresponsive to conventional steroid therapy. Methods: Thirteen patients with anosmia were treated with SGB. To evaluate the improvement in olfactory function, we evaluated both changes in subjective symptoms and the butanol threshold test. The number of SGB required for improvement in olfactory function was counted. Results: Seven patients (54%) showed improvement of olfactory function with SGB. The average number of SGB for the first response was $7.4{\pm}5.9times$. Conclusions: These results suggest that SGB may be a good treatment modality for patients with anosmia unresponsive to steroid therapy.

Incidence and Factors Influencing Oral Mucositis in Patients with Hematopoietic Stem Cell Transplantation (조혈모세포이식 환자의 구강 점막염 발생실태와 영향요인)

  • Jo, Kwan Suk;Kim, Nam Cho
    • Journal of Korean Academy of Nursing
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    • v.44 no.5
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    • pp.542-551
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    • 2014
  • Purpose: This study was done to examine the incidence of oral mucositis in hematopoietic stem cell transplantation patients and to identify factors influencing oral mucositis and patient outcomes according to severity. Methods: In this retrospective study, data were collected from electronic medical records of 222 patients who had received hematopoietic stem cell transplantation. Oral mucositis was evaluated using WHO's assessment scale. Data were analyzed using Chi-square test, Fisher exact test, Spearman's correlation, Ordinal logistic regression, ANOVA and Kruskal-Wallis test. Results: A total of 69.8% of the patients evaluated developed oral mucositis (grade II and over). As a results of ordinal regression, factors influencing oral mucositis severity were found to be diagnosis, type of transplantation, oxygen inhalation and the number of antiemetics administration before transplantation. The severity of oral mucositis was found to increase the days of hospitalization, days of TPN administration, days of using antibiotics and the number and dosage of analgesics. Conclusion: The results would help predict severity of oral mucositis in hematopoietic stem cell transplantation patients and suggest that provision of appropriate nursing assessment and oral care would improve patient outcomes.

A Survey on Health Status of Group Controlled Pulmonary Tuberculosis Patients -Application of Cornell Medical Index- (집단관리 결핵환자들의 건강실태조사 -코오넬 의학지수의 응용-)

  • Jung, K.J.
    • Journal of Preventive Medicine and Public Health
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    • v.11 no.1
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    • pp.14-23
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    • 1978
  • This survey was conducted on a total 672 pulmonary tuberculosis patients who were registered at certain health center in Busan, during the period from July 15th to August 31st, 1977, based on Modified Cornell Medical Index(CMI) consisting of 70 questions. Number of 'Yes' response of an individual patients was collected by each large section of Modified CMI. The each number of 'Yes' response was standardized by mean of Z scoring. Z score was obtained by following formula. Z=50+10(Xi-m)/s M : means of 'Yes' response by each section for all subjects s : standard deviation of the mean Xi : number of 'Yes' response by each section in an individual patients The results of obtained were as follows: 1. The number of investigated cases were 672 (459 males and 213 females). The most prevalent group was 20-24 years old group as 18.4% by age, moderate advanced group as 50.8% by radiological diagnosis, INH+PAS+SM group as 34.7% by antituberculotics and unemployed group as 59.9% by occupation. By bacteriological examination of sputum, the rate of negative group was 60.5% and positive group was 39.5%. 2. Z score of complaints by sex was higher in female as 52.4 than in male as 48.9 in general. By radiological diagnosis, there was decreasing tendency with age in male but increasing tendency with age in female. 3. By age group, Z score of complaints was increasing tendency with age in male but there was non-significant differences in female. 4. By bacteriological examination of sputum, the Z score of complaints was increasing tendency with the more discharged bacteria in both sex generally. 5. By antituberculotics, INH group was revealed the highest Z score of complaints as 50.4 in male and INH+PAS group was the highest as 51.21 in female. 6. By occupation, agricultural and fisherman group was the highest as 53.5 and the next group was professional, technical and related workers, unemployed and sales workers in that order.

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Factors Affecting the Purchase of Indemnity Private Health Insurance and Related Factors of Outpatient Healthcare Utilization among Chronic Disease Patients (만성질환자에서 실손형 민간의료보험의 가입 관련 요인과 외래 의료이용의 관련 요인)

  • Hur, Jung Won;Kwon, Young Dae
    • Korea Journal of Hospital Management
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    • v.24 no.3
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    • pp.1-10
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    • 2019
  • Purpose: The purpose of this study was to investigate determinants of purchasing indemnity private health insurance and its impact on the healthcare utilization among outpatients with chronic disease. Methods: The study analyzed 4,997 chronic ill patients using 2015 Korean Health Panel data. Logistic regression analysis was conducted to analyze the factors affecting the purchase of indemnity private health insurance and multiple regression analysis was conducted to analyze the effect of private health insurance on the number of outpatient visits and outpatient expenditures. Findings: The age, education level, and number of chronic diseases were significant factors affecting the purchasing of indemnity private health insurance among chronic patients. As a result of analyzing the impact of indemnity private health insurance on healthcare utilization, the number of outpatient visits for those who enrolled in the indemnity private health insurance was higher than the number of outpatient visits for those who did not. But there was no statistically significant difference in outpatient medical expenses. Practical Implications: The results of this study shows that indemnity private health insurance may cause inequality in the healthcare utilization of the socially vulnerable. It is necessary to seek ways to strengthen the health security of chronic disease patients and high-risk elderly people who need more healthcare.

Development and Evaluation of a Dysphagia Nursing Intervention Program for Patients with a Stroke (뇌졸중 환자에게 제공한 연하곤란 간호중재 프로그램 효과)

  • Song, Young Ae;Beom, Ji Hyun;Ham, Young Sun;Kim, Sang Hee
    • Journal of Korean Clinical Nursing Research
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    • v.17 no.3
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    • pp.340-348
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    • 2011
  • Purpose: The purpose of this study was to develop and provide a standardized nursing intervention program for stroke patients with dysphagia and evaluate the effectiveness of the program. Methods: Data on the number of tube feedings, incidence of aspiration pneumonia and length of stay were collected from 42 patients in the control group and 51 patients in the experimental group over the 6 months of this study. The data were analyzed using $x^2$-test and t-test. Results: The number of tube feedings in the experimental group was significantly lower than control group (p=.002). The incidence of aspiration pneumonia in the experimental group was not significantly lower than the control group (p=.097). Length of stay in the experimental group was significantly shorter than the control group (p<.001). Conclusion: The results of this study indicate that a standardized nursing intervention program for stroke patients with dysphagia could be useful to decrease tube feedings and length of stay.

Prediction of medication-related osteonecrosis of the jaw (MRONJ) using automated machine learning in patients with osteoporosis associated with dental extraction and implantation: a retrospective study

  • Da Woon Kwack;Sung Min Park
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.3
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    • pp.135-141
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    • 2023
  • Objectives: This study aimed to develop and validate machine learning (ML) models using H2O-AutoML, an automated ML program, for predicting medication-related osteonecrosis of the jaw (MRONJ) in patients with osteoporosis undergoing tooth extraction or implantation. Patients and Methods: We conducted a retrospective chart review of 340 patients who visited Dankook University Dental Hospital between January 2019 and June 2022 who met the following inclusion criteria: female, age ≥55 years, osteoporosis treated with antiresorptive therapy, and recent dental extraction or implantation. We considered medication administration and duration, demographics, and systemic factors (age and medical history). Local factors, such as surgical method, number of operated teeth, and operation area, were also included. Six algorithms were used to generate the MRONJ prediction model. Results: Gradient boosting demonstrated the best diagnostic accuracy, with an area under the receiver operating characteristic curve (AUC) of 0.8283. Validation with the test dataset yielded a stable AUC of 0.7526. Variable importance analysis identified duration of medication as the most important variable, followed by age, number of teeth operated, and operation site. Conclusion: ML models can help predict MRONJ occurrence in patients with osteoporosis undergoing tooth extraction or implantation based on questionnaire data acquired at the first visit.

Factors Associated with the Long-Stay Admissions in Geriatric Hospitals - Focused on Dementia's Inpatients - (요양병원 치매노인의 장기입원 관련 요인)

  • Lee, Yun Jin;Lee, Sang Gyu;You, Chang Hoon;Kim, Bomgyeol;Kim, Tae Hyun
    • Korea Journal of Hospital Management
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    • v.25 no.3
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    • pp.29-37
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    • 2020
  • Purposes: The purpose of this study was to identify the factors related to the long-stay hospitalization of dementia patients aged 65 years or older who had received inpatient care at geriatric hospitals according to the minute facility characteristics and patient features. Methodology: This study was conducted on 317,353 cases of 1,512 geriatric hospitals using the Health Insurance Review and Assessment Service dataset. The data collected were processed using the SAS Enterprise Guide 4.3 for descriptive statistics, the chi-square test, and the binary logistic regression analysis. Findings: As a result of the study, in the facility characteristics of geriatric hospitals, the long-stay hospitalization of the aged with dementia were found to be related to the type of facility establishment, the number of hospital beds, the number of medical specialists, the number of nursing personnel, and the number of geriatric hospitals by region and province. In the personal features of patients, the long-stay hospitalization was found to be associated with the gender, age, insurance, and the patient classification groups. Practical Implication: Considering the results of this study, it seems that securing the sufficient medical personnel in a geriatric facility, providing the good quality medical services, and preparing the appropriate discharge plan can reduce the unnecessary long-stay hospitalization and spend the medical expenses for the older patients.