• Title/Summary/Keyword: Pain: acute

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Secondary Analysis on Pressure Injury in Intensive Care Units

  • Hyun, Sookyung
    • International journal of advanced smart convergence
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    • 제10권2호
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    • pp.145-150
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    • 2021
  • Patients with Pressure injuries (PIs) may have pain and discomfort, which results in poorer patient outcomes and additional cost for treatment. This study was a part of larger research project that aimed at prediction modeling using a big data. The purpose of this study were to describe the characteristics of patients with PI in critical care; and to explore comorbidity and diagnostic and interventive procedures that have been done for patients in critical care. This is a secondary data analysis. Data were retrieved from a large clinical database, MIMIC-III Clinical database. The number of unique patients with PI was 2,286 in total. Approximately 60% were male and 68.4% were White. Among the patients, 9.9% were dead. In term of discharge disposition, 56.2% (33.9% Home, 22.3% Home Health Care) where as 32.3% were transferred to another institutions. The rest of them were hospice (0.8%), left against medical advice (0.7%), and others (0.2%). The top three most frequently co-existing kinds of diseases were Hypertension, not otherwise specified (NOS), congestive heart failure NOS, and Acute kidney failure NOS. The number of patients with PI who have one or more procedures was 2,169 (94.9%). The number of unique procedures was 981. The top three most frequent procedures were 'Venous catheterization, not elsewhere classified,' and 'Enteral infusion of concentrated nutritional substances.' Patient with a greater number of comorbid conditions were likely to have longer length of ICU stay (r=.452, p<.001). In addition, patient with a greater number of procedures that were performed during the admission were strongly tend to stay longer in hospital (r=.729, p<.001). Therefore, prospective studies focusing on comorbidity; and diagnostic and preventive procedures are needed in the prediction modeling of pressure injury development in ICU patients.

Measuring Trends in the Socioeconomic Burden of Disease in Korea, 2007-2015

  • Kim, Tae Eung;Lee, Ru-Gyeom;Park, So-Youn;Oh, In-Hwan
    • Journal of Preventive Medicine and Public Health
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    • 제55권1호
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    • pp.19-27
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    • 2022
  • This study estimated the direct and indirect socioeconomic costs of 238 diseases and 22 injuries from a social perspective in Korea from 2007 to 2015. The socioeconomic cost of each disease group was calculated based on the Korean Standard Disease Classification System. Direct costs were estimated using health insurance claims data provided by the National Health Insurance Service. The numbers of outpatients and inpatients with the main diagnostic codes for each disease were selected as a proxy indicator for estimating patients' medical use behavior by disease. The economic burden of disease from 2007 to 2015 showed an approximately 20% increase in total costs. From 2007 to 2015, communicable diseases (including infectious, maternal, pediatric, and nutritional diseases) accounted for 8.9-12.2% of the socioeconomic burden, while non-infectious diseases accounted for 65.7-70.7% and injuries accounted for 19.1-22.8%. The top 5 diseases in terms of the socioeconomic burden were self-harm (which took the top spot for 8 years), followed by cirrhosis of the liver, liver cancer, ischemic heart disease, and upper respiratory infections in 2007. Since 2010, the economic burden of conditions such as low back pain, falls, and acute bronchitis has been included in this ranking. This study expanded the scope of calculating the burden of disease at the national level by calculating the burden of disease in Koreans by gender and disease. These findings can be used as indicators of health equality and as useful data for establishing community-centered (or customized) health promotion policies, projects, and national health policy goals.

The Coordinative Locomotor Training Intervention Strategy Using the ICF Tool to Improve the Standing Posture in Scoliosis: A Case Report

  • Lee, Jeong-a;Kim, Jin-cheol
    • The Journal of Korean Physical Therapy
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    • 제33권1호
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    • pp.7-15
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    • 2021
  • Purpose: This study was examined to improve the standing posture of a scoliosis client using the ICF Tool. Methods: For examination, the study subject was a 16-year-old female student diagnosed with 3curve-pelvic (3CP) type scoliosis. Information about her were collected through a client interview and based on international Classification of Functioning, Disability and Health (ICF). The ICF core set was for post-acute musculoskeletal conditions, and the ICF level 2 items suggested by National Rehabilitation Information Center (NARIC) were added to the recommendations for scoliosis. For evaluation, the ICF assessment sheet was used to identify the interaction among the problems. For the diagnosis, the client's functional problems were described in ICF terms. For the prognosis, the global goals for reaching the client's functional activity and participation level were presented as the long-and short-term goals. For the intervention, a coordinative locomotor training program composed of warm-up, main exercise, and cool-down was applied 3 times a week, 50 minutes a day, for 5 weeks. For the outcome, the differences between before and after the intervention were compared with the ICF qualifier and are shown with the ICF evaluation display. Results: Clinical advantages were observed in body function and structure (7° decrease of thoracic angle, 7 score increase of trunk muscle power, 6.47s improve of one leg standing, 4 score decrease of neck pain). The activity for maintaining the standing posture, in which the client had a primary limitation, was improved. Conclusion: Applying the coordinative locomotor training program is expected to improve scoliosis client's standing posture.

Clinical outcomes of bending versus non-bending of the plate hook in acromioclavicular joint dislocation

  • Joo, Min Su;Kwon, Hoi Young;Kim, Jeong Woo
    • Clinics in Shoulder and Elbow
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    • 제24권4호
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    • pp.202-208
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    • 2021
  • Background: We aimed to assess the effect of plate hook bending in treatment of acromioclavicular (AC) dislocation by analyzing clinical and radiological results according to the angle of the plate hook (APH). Methods: This was a retrospective, observational, case-control study including 76 patients with acute AC joint dislocation that were divided into two groups according to treatment with bent or unbent plate hook. The visual analog scale (VAS), the American Shoulder and Elbow Surgeons (ASES) shoulder score, and range of motion (ROM) were evaluated as clinical outcomes. Comparative coracoclavicular distance (CCD) was measured to evaluate radiological outcomes. Results: While the VAS and ASES of the bending group at 4 months after surgery were significantly higher (p=0.021 and p=0.019), the VAS and ASES of the bending group at other periods and ROM of the bending group showed no significant difference. The initial CCD decreased from 183.2%±25.4% to 114.3%±18.9% at the final follow-up in the bending group and decreased from 188.2%±34.4% to 119.1%±16.7% in the non-bending group, with no statistical difference (p=0.613). The changes between the initial and post-metal removal CCD were 60.2%±11.2% and 57.3%±10.4%, respectively, with no statistical difference (p=0.241). The non-bending group showed greater subacromial osteolysis (odds ratio, 3.87). Pearson's coefficients for the correlation between APH and VAS at 4 months after surgery and for that between APH and ASES at 4 months after surgery were 0.74 and -0.63 (p=0.027 and p=0.032), respectively. Conclusions: The APH was associated with improved postoperative pain and clinical outcomes before implant removal and with reduced complications; therefore, plate hook bending is more useful clinically during plate implantation.

항정신병 약물 과량 복용 후 발생한 횡문근융해증으로 인한 급성 구획증후군 (Acute Compartment Syndrome Induced by Rhabdomyolysis Due to Antipsychotic Drug Overuse)

  • 황석하;홍성하;서승표;김주영
    • 대한정형외과학회지
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    • 제55권3호
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    • pp.276-280
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    • 2020
  • 49세 남자 환자가 숙박업소에서 의식을 잃은 채 발견되어 응급실로 내원하였다. 환자는 조현증 및 주요우울증으로 항정신병 약물 및 항우울증 약물(vortioxetine hydrobromide, mirtazapine, sertraline hydrochloride, quetiapine, alprazolam)을 복용 중이었으며 환자 주변에 상기 약물들을 과량 복용한 흔적이 남아있었다. 신체검사에서 좌측 둔부 및 가측 대퇴부로 동통, 창백 및 부종 관찰되었으며 좌측 족관절 이하의 능동 관절운동이 불가하였다. 그리고 경골 및 비골신경 영역의 감각이 소실되어 있었다. 가장 종창이 심했던 가측 대퇴부에서 측정한 둔부 구획 내 압력은 42 mmHg 이었으며 자기공명영상에서 좌측 둔부 근육 및 주변 연부 조직의 부종 및 고강도 신호를 보이고 있었다. 응급 근막절개술을 시행하였고 24시간 이후 하지 감각 및 근력이 일부 회복되었다.

Bilateral foot drop caused by T12 infectious spondylitis after vertebroplasty: a case report

  • Kim, Dong Hwan;Shin, Yong Beom;Ha, Mahnjeong;Kim, Byung Chul;Han, In Ho;Nam, Kyoung Hyup
    • Journal of Trauma and Injury
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    • 제35권1호
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    • pp.56-60
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    • 2022
  • The most common cause of foot drop is lumbar degenerative disc herniation, particularly at L4/5. We present a rare case of spinal cord injury accompanied by a thoracolumbar lesion that presented with bilateral foot drop. A 69-year-old male patient presented with sudden-onset severe bilateral leg pain and bilateral foot drop. Radiologic findings revealed T12 spondylitis compressing the conus medullaris. He had undergone vertebroplasty for a T12 compression fracture after a fall 6 months before. A physical examination showed bilateral foot drop, paresthesia of both L5 dermatomes, increased deep tendon reflex, and a positive Babinski sign. An acute bilateral L5 root lesion and a conus medullaris lesion were suspected based on electromyography. A surgical procedure was done for decompression and reconstruction. After the operation, bilateral lower extremity muscle strength recovered to a good grade from the trace grade, and the patient could walk without a cane. The current case is a very rare report of bilateral foot drop associated with T12 infectious spondylitis after vertebroplasty. It is essential to keep in mind that lesions of the thoracolumbar junction can cause atypical neurological symptoms. Furthermore, understanding the conus medullaris and nerve root anatomy at the T12-L1 level will be helpful for treating patients with atypical neurological symptoms.

버섯의 유독물질 (有毒物質) (Poisonous Substances from Mushrooms)

  • 조재현;이태성;김보민;황병호
    • Journal of Forest and Environmental Science
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    • 제26권1호
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    • pp.37-51
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    • 2010
  • A mushroom as a functional food material is being increasingly used in these days. It has been that about 1,500 species of mushrooms grow naturally in Asia. Among them about 700 species are edible, but about 30-50 species are poisonous. Even a poisonous mushroom is a very interesting subject for the dietary life research from biochemical viewpoint due to the fact that any mushroom can be the physiological active material. Not a few identified poisonous materials are being used as research reagents thus far. It is suggested that more useful materials could be obtained by progresses in future researches. The identification of the poisonous ingredient can open up a route for mushroom intoxication cure. It is known that cell destruction and troubles on skin, liver, and kidney troubles can be occurred from mushroom intoxication. Recently the author reported as a collection of treatises regarding anti-tumor substances of mushroom (2005), antibiotic substances of mushroom (2006), living-body functional and control substance (2007), and medicinal mushroom commonly used in Korean herbal medicines (2008). In this sequel, published research data on protoplasm, nerve, stomach and intestines, malodor, and acute pain poison of mushroom are collected and reported.

Peptides derived from high voltage-gated calcium channel β subunit reduce blood pressure in rats

  • Hyung Kyu Kim;Jiyeon Jun;Tae Wan Kim;Dong-ho Youn
    • The Korean Journal of Physiology and Pharmacology
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    • 제27권5호
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    • pp.481-491
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    • 2023
  • The β subunits of high voltage-gated calcium channels (HGCCs) are essential for optimal channel functions such as channel gating, activation-inactivation kinetics, and trafficking to the membrane. In this study, we report for the first time the potent blood pressure-reducing effects of peptide fragments derived from the β subunits in anesthetized and non-anesthetized rats. Intravenous administration of 16-mer peptide fragments derived from the interacting regions of the β1 [cacb1(344-359)], β2 [cacb2(392-407)], β3 [cacb3(292-307)], and β4 [cacb4(333-348)] subunits with the main α-subunit of HGCC decreased arterial blood pressure in a dose-dependent manner for 5-8 min in anesthetized rats. In contrast, the peptides had no effect on the peak amplitudes of voltage-activated Ca2+ current upon their intracellular application into the acutely isolated trigeminal ganglion neurons. Further, a single mutated peptide of cacb1(344-359)-cacb1(344-359)K357R-showed consistent and potent effects and was crippled by a two-amino acid-truncation at the N-terminal or C-terminal end. By conjugating palmitic acid with the second amino acid (lysine) of cacb1(344-359)K357R (named K2-palm), we extended the blood pressure reduction to several hours without losing potency. This prolonged effect on the arterial blood pressure was also observed in non-anesthetized rats. On the other hand, the intrathecal administration of acetylated and amidated cacb1(344-359)K357R peptide did not change acute nociceptive responses induced by the intradermal formalin injection in the plantar surface of rat hindpaw. Overall, these findings will be useful for developing antihypertensives.

Magnetic Resonance Imaging Assessment of Paraspinal Muscles in Dogs with Intervertebral Disc Herniation

  • Ye-Jin Kim;Ju-Yeong Kim;Ah-Won Sung;Hyun-Ju Cho;I-Se O;Ho-Jung Choi;Young-Won Lee
    • 한국임상수의학회지
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    • 제39권6호
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    • pp.334-341
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    • 2022
  • A decrease in the paraspinal muscle cross-sectional area (CSA) and functional cross-sectional area (FCSA) are associated with low back pain and disc herniation in humans. This study examined whether chronicity or lateralization of disc herniation affects the CSA and FCSA of the paraspinal muscles. The CSA and FCSA of the paraspinal muscles between the 12th and 13th thoracic vertebrae were measured in 31 dogs with intervertebral disc herniation (IVDH). The muscle CSA and FCSA were evaluated by dividing the values of the body weight, spinal disc CSA, and spinal canal CSA to offset the differences in body type between subjects. In the chronic IVDH group, the ratio of the paraspinal muscle CSA divided by the body weight was significantly lower, and fat infiltration in the paraspinal muscle was significantly higher than in the acute group. The lateralization of the disc herniation was significantly related to the changes in the paraspinal muscle CSA. In the right-sided disc herniation group, right epaxial muscle CSA was significantly reduced compared to the left-sided disc herniation group. The change in the paraspinal muscle might be a helpful indicator to localize less obvious disc pathologies and target the search for the pathology responsible for disc-related symptoms in dogs.

Ergonomic Evaluation of Young Agricultural Operators Using Handle Equipment Through Electromyography and Vibrations Analysis Between the Fingers

  • Federico Roggio;Ermanno Vitale;Veronica Filetti;Venerando Rapisarda;Giuseppe Musumeci;Elio Romano
    • Safety and Health at Work
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    • 제13권4호
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    • pp.440-447
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    • 2022
  • Background: Agricultural handle equipment is present on all production areas' farms. They are handy and portable; however, excessive use can lead to acute traumas or accidental injuries. Repetitive movements, awkward postures, and hand-arm vibrations predispose them to pain and work-related musculoskeletal disorders. The purpose of this study was to observe the interaction of handle equipment in terms of electromyographic activity and analyze the postural work-related alterations. Materials and methods: Twenty male agricultural operators, mean age 24±1.54 years, underwent the electromyographic analysis testing their muscular activities with a brushcutter, electric saw, and hedge trimmer in four different test conditions. Results: The brushcutter proved to be the agricultural handle equipment with the higher mean frequency (3.37±0.38 Hz) and root mean square (5.25±1.24 ms-2). Furthermore, the digital postural analysis showed a general asymmetry of the main arm and the respective side of the trunk. The head resulted right inclined in the anterior frontal plane by 5.7°±1.2°; the right scapula lower than the left in the posterior frontal plane (8.5°±1.8°), and a working trunk inclination of 34.15°±5.7°. Conclusions: Vibrations of handle equipment and awkward working postures represent a risk for agricultural operators. Preventive measures are required to avoid young operators from experiencing musculoskeletal disorders all lifelong.