Critically ill trauma patients generally show good nutritional status upon initial hospitalization. However, they have a high risk of malnutrition due to hyper-metabolism during the acute phase. Hence, suitable nutritional support is essential for the optimal recovery of these patients; therefore, outcomes such as preservation of fat-free mass, maintenance of immune functions, reduction in infectious complications, and prevention of malnutrition can be expected. In this report, we present the experience of a patient subjected to 40 days of nutritional interventions during postoperative intensive care unit (ICU) care. Although the patient was no malnutrition at ICU admission, enteral nutrition (EN) was delayed for > 2 weeks because of several postoperative complications. Subsequently, while receiving parenteral nutrition (PN), the patient displayed persistent hypertriglyceridemia. As a result, his prescription of PN were converted to lipid-free PN. On postoperative day (POD) #19, the patient underwent jejunostomy and started standard EN. A week later, the patient was switched to a high-protein, immune-modulating formula for postoperative wound recovery. Thereafter, PN was stopped, while EN was increased. In addition, because of defecation issues, a fiber-containing formula was administered with previous formula alternately. Despite continuous nutritional intervention, the patient experienced a significant weight loss and muscle mass depletion and was diagnosed with severe malnutrition upon discharge from the ICU. To conclude, this case report highlights the importance of nutrition interventions in critically ill trauma patients with an increased risk of malnutrition, indicating the need to promptly secure an appropriate route of feeding access for active nutritional support of patients in the ICU.
In an effort to obtain preventive, diagnostic and therpeutic medical and exercise training information of rheumatoid arthritis as well as to provide pertinent data to be used in development of exercise program for the management of rheumatoid arthritis, this study was conducted by using literature review. Because RA is a disease that involves both joints and muscles, its activity in the different functional classes influences the patient's ability to exercise. A patient in Functional Class 1 may perform any type of exercise because the disease involvement has not yet reached major importance. Exceptions may include hard physical exercise, running, and individual racket sports. In almost all cases, bicycle exercise is possible. Patients in Functional Class 2 and a few in Class 3 can perform most types of exercise (especially cycling, walking, heated pool exercise and even jogging) in low activity phases of RA. Although a few patients in Functional Class 3 can walk, jog, and perform similar types of exercise, most persons in this class can swim or exercise on a bicycle if the type of exercise, its intensity, and its range of motion are modified according to the patient's anatomic and pathologic conditions. Most patients in Functional Class 4 are not able to carry out complicated movements. We conclude that physical training for persons with RA has physical, psychological, and social consequences that are clearly beneficial. We recommend training be one part of the many involved in the complicated treatment of RA.
Serotonin syndrome (SS) is a potentially life-threatening condition that is caused by the administration of drugs that increase serotonergic activity in the central nervous system. We report a case of serotonin syndrome in a patient with chronic pain who was taking analgesic drugs. A 36-year-old female with chronic pain in the lower back and right buttock area had been taking tramadol hydrochloride 187.5 mg, acetaminophen 325 mg, pregabalin 150 mg, duloxetine 60 mg, and triazolam 0.25 mg daily for several months. After amitriptyline 10 mg was added to achieve better pain control, the patient developed SS, which was mistaken for psychogenic nonepileptic seizure. However, her symptoms completely disappeared after discontinuation of the drugs that were thought to trigger SS and subsequent hydration with normal saline. Various drugs that can increase serotonergic activity are being widely prescribed for patients with chronic pain. Clinicians should be aware of the potential for the occurrence of SS when prescribing pain medications to patients with chronic pain.
Journal of the Korean Society of Food Science and Nutrition
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v.26
no.4
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pp.733-742
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1997
A computerized dietary prescription and nutritional counseling system for patients having hyperlipidemia has been developed using a personal computer. This system is composed of three programs. The first program is designed to investigate dietary history of patient, such as a dietary habit and a preference of food, to find out his incorrect dietary behavior and to give him some suggestions to correct dietary behavior. The second one is developed to analyze the energy and nutrients intake using 24-hour dietary recall method and also evaluate the status of dietary intake, especially the status of dietary fat. With these data, patient can replan pattern of his food intake including in-between-meal snack as well as regular meals. The third one is the diet and menu Planning program made using food exchange table. It provides the patient with a meal pattern suitable in his weight, activity and the other status of the body. Practicing these programs, patient with hyperlipidemia can help himself very conveniently in organizing his meal plan and in improving his dietary behavior.
Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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2009.05a
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pp.899-902
/
2009
As computer network and wireless technology continue to grow rapidly, a wide range of remote application has been applied to medical field such as remote medical consulting and remote patient monitoring. This research aims to design RF telecommunication-based healthcare application to collect and manage patient's physiological data, and describe the overall procedure of experiment. MySQL database is designed to record patient's physiological data including temperature, blood pressure and heart rate and save information about medical behaviors such as doctor's prescription for patients. Therefore, users approved by healthcare application can query patient's data and collected data can be used to reorganize data for clinical test. As a result, temperature and humidity of patient's room which must be checked frequently can be processed automatically through ubiquitous sensor network. The information entered from mobile phones or web is saved in database, ensuring systematical management through computer. Moreover, patient's family members can easily access hospital data, improving their experience with medical service.
The purpose of the study was to compare patient's satisfaction on the pharmacy services after introducing the new system of separation of dispensing from prescribing medicines, between those filling their prescriptions from the pharmacy nearby hospitals and those from the pharmacy in their resident areas. To measure patient's satisfaction, a questionnaire survey was conducted with 354 outpatients who received prescriptions from any of the three university hospitals located in In-Cheon city. Study results showed that geographic accessibility to pharmacy was a main attribute to select pharmacy. Size of the pharmacy and availability of prescription drugs are the second major reasons for pharmacy selection for the patients from the pharmacy nearby hospital, whereas patronage is the second major reason for those from the pharmacy in resident areas. Overall satisfaction was higher among the patients from the pharmacy in resident areas than those from the pharmacy nearby hospitals, mainly due to better facilities(waiting area, public telephone, etc), kindness, cleanliness, shorter waiting time, and pharmacist's concern about patient's health. On the other hand, the patients of the pharmacy nearby hospitals showed low satisfaction because of long waiting time and the lack of pharmacist's knowledge and information about patients' health status and medication history. Patients visiting the hospital that has pharmacy-hospital cooperation system showed higher satisfaction as compared to those visiting the hospital without such system. This study provided an empirical evidence that it would be more advantageous for patients to receive pharmacy services from pharmacies located in their living areas than from pharmacies nearby hospitals. This implies that there is a strong need for adequate strategies to enhance the role of pharmacies in resident areas under the new system of separation of dispensing from prescribing medications.
Medication compliance is essential to improve person's health status through pharmacotherapy. Since separation of dispensing and prescription has been implemented, the importance of pharmacist's role on medication counseling have been emphasized, especially among outpatients. The objective of this study is to investigate the effect of patient's satisfaction with pharmacist's medication counseling on medication compliance among outpatients. We used the 2005 Korea National Health and Nutrition Survey data to examine medication compliance of persons who visited pharmacy. Ordered logistic regression analysis was conducted to assess whether patient's satisfaction with pharmacist's medication counseling was associated with medication compliance. Overall, 86.17% of study subjects(5,494) reported to take the prescribed medicines correctly and 80.54% of respondents were satisfied with pharmacist's medication counseling. Logistic regression analysis presents patient's satisfaction with pharmacist's counseling is significantly associated with medication compliance after controlling patient's characteristics(proxy-measured by age, family income, educational attainments, comorbid conditions). Interestingly, even patients who are dissatisfied with pharmacist's counseling have slightly higher odds of better compliance to medication therapy than those without pharmacist's counseling. In addition, higher educational attainments and older age groups are associated with better medication compliance. In conclusion, pharmacist's medication counseling appears to be effective in improving medication compliance. Further research that assess medication counseling in detail needs to develop strategies to improve medication adherence.
There are several methods currently being used to diagnose tuberculosis in patients, such as smear, PCR, tuberculosis culture and X-ray. For a proper medical treatment, antimicrobial susceptibility test and rapid drug susceptibility testing have been operated. Tuberculosis bacilli usually need 3~8 weeks of culture period because of delay in RNA synthesis and require 15~22 hours for generation. After a germ raises in culture, we initiated antimicrobial susceptibility test for a proper treatment. It has some difficulties to give a proper prescription for a tuberculosis patient because antimicrobial susceptibility test requires 4 weeks. To supplement this, we are practicing drug susceptibility testing which allow us to know the sensibility of RMP and INH after 2 or 3 days. But this is only possible when more than 2 positive germ. Therefore, we should practice rapid drug susceptibility testing with culture test. But if media is contaminated by other germs except Mycobacterium tuberculosis, it's hard to interpret result about culture test and to practice antimicrobial susceptibility test and rapid drug susceptibility testing. Because we have to practice again smear, culture test after extracting specimen from the patient, time is consumed and proper patient treatment is postponed. To address these problems and quick patient treatment, rapid drug susceptibility testing is practiced by using GenoType$^{(R)}$ MTDRplus method. As a result of this method we detected sensibility 10 and 7 cases and resistance 0 and 3 cases using RIM and INH respectively with other 1 case toward medicals out of the total 11 test. In conclusion rapid drug susceptibility testing can be used from the contaminated specimen after elimination of contaminated source from culture and proved that it can be practiced for rapid examination of a tuberculosis patient.
Purpose: This study applies the ICF to identify the patient's body function, structure, and participation, evaluates the patient's environmental factors and individual factors, and is a high level of movement to return to the society of patients with multiple ligament injury of the knee joint. Methods: Progressive strength training and ROM exercise were performed 30 minutes a day, 5 times a week for 6 weeks. The evaluation was performed by examining the ROM, length, MMT, instability, dynamic balance, pain and depression. Results: The ROM of the knee joint was improved from 110° to 135° after intervention, and the knee flexion length decreased from 69 cm to 45 cm. Knee flexor is Good after intervention from Poor-, and knee extensor is Good+ after intervention from Poor, and the plantar flexor of the ankle joint improved from Poor- before intervention to Good after intervention and dorsi-flexor of the ankle joint improve to Good from Poor. Pain index was moderate before and after the intervention, with a score of 3, 2 after the intervention, and when maintaining the sitting cross-legged, the before intervention score was 7 to 4 after the intervention. Conclusion: The patient's posture of sitting cross-legged was maintained from 30 seconds before intervention to 14 minutes after intervention. These results were able to set the hypothesis design, intervention method and goal that the multifaceted approach of environment and individual factors as well as body function and structure area, activity and participation area using ICF checklists, it is helped the patient to return to daily life.
Journal of Physiology & Pathology in Korean Medicine
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v.36
no.4
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pp.143-146
/
2022
This study aims to report a case of facial dermatitis herpetiformis with allergy diseases improved by administration of Mahaengeuigam-tang (Maxingyigan-tang). Multiple blisters appeared on the patient's face, Erythema, papules, and scales were also observed on the neck, back, and knee areas of the patient. The patient has had cough, sputum, and dyspnea symptoms since she was 5-6 months old. After diagnosing the patient's condition as dermatitis herpetiformis, atopic dermatitis, and bronchial asthma through history taking and symptom observation, Mahaengeuigam-tang (Maxingyigan-tang) was prescribed for about 30 days. As a result of evaluation through our own criteria, dermatitis herpetiformis symptoms improved from 18 to 2 points. Atopic dermatitis and asthma symptoms also decreased from 12 to 0 and 20 to 3 points, respectively. Since this study has proven the efficacy of Mahaengeuigam-tang (Maxingyigan-tang) for dermatitis herpetiformis patient, this prescription may be fully utilized as the treatment for other inflammatory skin diseases.
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