• Title/Summary/Keyword: Patient Visit

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Treatment of Benign Paroxysmal Positional Vertigo (양성돌발성 체위현훈의 치료)

  • Kim, Chul-Seung
    • Korean Journal of Clinical Laboratory Science
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    • v.40 no.2
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    • pp.135-141
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    • 2008
  • Benign paroxysmal positional vertigo (BPPV) is one of the most common clinical entities encountered in a dizziness clinic. Treatment of this disease, canalith repositioning procedures, have been reported to be successful in 44-90%. Treatment requires only one treatment visit in most patients. However, there are significant numbers of patients who require multiple treatment visits for relief. The goal of this study is to identify variables that may be associated with these difficult to treat cases. Retrospective review was performed for the patients diagnosed as BPPV at St. Carollo dizziness center. Variables for statistical analysis included age, sex, involved canal, presence of bilateral disease, presence of recent head trauma, presence of chronic otitis media, history of middle ear surgery, history of otologic surgery, unilateral vestibular loss, underlying disease such as hypertension or diabetes, change of involved canal during treatment course and number of treatment visits. Two hundred patients with BPPV who received treatment were identified from JAN. 2006 to JUN. 2007. 87% required one treatment visit, 5% required second treatment visit, and 95% were successfully treated after three treatment visits. Variables such as bilateral disease, post-traumatic BPPV, duration of symptom before treatment and change of involved canal during treatment were significantly related with number of treatments. Patient's with bilateral BPPV or with recent head trauma or longer duration of symptom are more likely to require multiple visits for canalith repositioning.

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The Effect of Family Visits on Stress Responses of Patients and Their Families in the Cardiac Intensive Care Unit (가족면회가 심장 중환자실 환자와 가족의 스트레스 반응에 미치는 효과)

  • Park, Chan-Gum;Kim, Hye-Soon;Lee, Myung-Hee
    • Journal of Korean Critical Care Nursing
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    • v.3 no.1
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    • pp.41-51
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    • 2010
  • Purpose: The purpose of this study was to identify the effects of family visits upon the stress response of patients and their families, Methods: This study was the interrupted time series design, The subjects consisted of 197 patients and 197 family members in the cardiac intensive care unit of S Hospital in Bucheon. Physiological stress responses such as blood pressure, heart rates, respiration rates, and oxygen saturation were measured using HP monitors. VAS was used to measure the emotional stress. Collected data was analyzed using repeated measure ANOVA, t-test by SPSS 17.0 statistical program. Results: The family visits did not change patients' blood pressure, pulse rate, respiration rate and oxygen saturation, However the anxiety level of patients and their family members were decreased significantly during family visits. Furthermore, 30-minute family visit reduced more effectively patient's anxiety than 15-minute family visit. Conclusion: Family visits need to be used as a means of nursing intervention to ease the emotional stress of patients and their families. In addition, increasing of visiting time should be considered.

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Efficacy of 694-nm Fractional Toning Ruby Laser in the Treatment of Malar Melasma

  • Kim, Jun Hyun;Park, Eun Soo;Nam, Seung Min;Cha, Han Gyu
    • Medical Lasers
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    • v.10 no.1
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    • pp.45-48
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    • 2021
  • Background and Objectives Among the numerous available therapies, the usefulness of laser treatment has been proven in melasma, especially for refractory to topical agents or chemical peels. This study evaluated the effectiveness of 694-nm wavelength fractional toning ruby laser in melasma presenting on the malar area. Materials and Methods This was a retrospective study of 40 melasma patients treated with 694-nm wavelength ruby fractional toning laser for a total of 8 cycles at intervals of 2 to 3 weeks. Two independent investigators assessed the photographic findings and evaluated the severity of melasma by applying the Melasma Severity Scale (MSS). Subject satisfaction score was also surveyed at every visit. Results After the 4th treatment, subjects were continuously satisfied with their results. At the 8th visit and 1-month after the last treatment, MSS was determined to be significantly improved as compared to the first visit. One case of minor hypopigmentation was reported, but was resolved after one month. Conclusion Application of 694-nm wavelength fractional toning ruby laser for treating melasma on the malar area showed significant improvement in the MSS. Moreover, the treatment could be repeatedly applied, with low complication rate and significant patient satisfaction.

Safety Education Programs for Patients and Families in Overseas Institutions (국외 환자대상의 환자안전 교육 사례)

  • Kim, Yoon-Sook;Kwak, Mi-Jeong;Kim, Moon-Sook;Kim, Hyun-Ah;Kim, Hyuo-Sun;Chun, Ja-Hae;Hwang, Jee-In
    • Quality Improvement in Health Care
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    • v.25 no.1
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    • pp.2-10
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    • 2019
  • Purpose: The purpose of this study was to share program and/or resource on patient safety education for patients and families conducted overseas agency. This study will help the patient safety officer establish and implement an educational plan for patients and families. Methods: We searched the Internet for patient safety related organizations. We chose an institution that provided education for patients and families. Results: Most of the program and/or resource was about patient and family involvement; Taking Care of Myself, My Questions for This Visit, Patient Prep Card, 20 Tips to Help Prevent Medical Errors, Ask Me 3(R), Health and Safety Passport, My Medication log etc. Conclusions: It is necessary to distribute educational materials for patients and families in the country through the results of this study. For patient safety, education and publicity are needed so that developed educational materials can be actively used.

Rhabdomyolysis after Lamotrigine Poisoning: A Case report (Lamotrigine 단독 과량복용으로 발생한 횡문근융해증)

  • Kim, Gun-Bea;Gu, Hong-Du
    • Journal of The Korean Society of Clinical Toxicology
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    • v.6 no.2
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    • pp.142-145
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    • 2008
  • Lamotrigine is a newer anti-epileptic drug for adjunctive treatment of refractory epilepsy, partial seizures, generalized tonic-clonic seizures, and bipolar disorder. Lamotrigine overdose causes serious central nervous and cardiovascular problems, but reports are uncommon. Few lamotrigine overdoses have been described because anti-epileptic drug use is limited and usually used with combination of other anti-epileptic drugs. In addition, most patients visit emergency departments with multi-drug overdoses, so few cases of lamotrigine poisoning alone exist. We had a female patient visit our emergency department a couple of hours after a lamotrigine overdose treated with intravenous hydration and urine alkalization by NaHCO3. She recovered successfully without any evidence of renal injury. However, she developed profound rhabdomyolysis, a previously unreported complication of this medication. We suggest that serial creatine kinase levels should be measured after lamotrigine poisoning.

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Single Dose Topical Application of Clotrimazole for the Treatment of Otomycosis: Is This Enough?

  • Dundar, Riza;Iynen, Ismail
    • Korean Journal of Audiology
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    • v.23 no.1
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    • pp.15-19
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    • 2019
  • Background and Objectives: To determine the efficacy of filling the external auditory meatus with 1% clotrimazole at a single visit for the treatment of otomycosis. Subjects and Methods: This prospective study included 40 patients who were referred to our clinic with complaints of ear itching, pain, and fullness, and were diagnosed with unilateral otomycosis. After cleaning the mycotic hyphae from the external auditory meatus, the ear canal was filled with 1% clotrimazole, using an intravenous catheter and syringe. The patients received follow-up examinations on post-treatment days 7, 15, and 45. Results: The follow-up otomicroscopic examinations revealed that 95% of the ear canals were entirely clean and that all symptoms had resolved. The post-treatment scores of pain, aural fullness and itching were significantly lower than the pre-treatment scores (p<0.01). Conclusions: Filling the external auditory meatus with 1% clotrimazole at a single visit is an easy, efficient, and cost-effective treatment for otomycosis. Additionally, high patient compliance makes this treatment superior to long-term topical therapy.

Single Dose Topical Application of Clotrimazole for the Treatment of Otomycosis: Is This Enough?

  • Dundar, Riza;Iynen, Ismail
    • Journal of Audiology & Otology
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    • v.23 no.1
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    • pp.15-19
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    • 2019
  • Background and Objectives: To determine the efficacy of filling the external auditory meatus with 1% clotrimazole at a single visit for the treatment of otomycosis. Subjects and Methods: This prospective study included 40 patients who were referred to our clinic with complaints of ear itching, pain, and fullness, and were diagnosed with unilateral otomycosis. After cleaning the mycotic hyphae from the external auditory meatus, the ear canal was filled with 1% clotrimazole, using an intravenous catheter and syringe. The patients received follow-up examinations on post-treatment days 7, 15, and 45. Results: The follow-up otomicroscopic examinations revealed that 95% of the ear canals were entirely clean and that all symptoms had resolved. The post-treatment scores of pain, aural fullness and itching were significantly lower than the pre-treatment scores (p<0.01). Conclusions: Filling the external auditory meatus with 1% clotrimazole at a single visit is an easy, efficient, and cost-effective treatment for otomycosis. Additionally, high patient compliance makes this treatment superior to long-term topical therapy.

A Clinical Case Report of Soyangin Patient Diagnosed as Sjögren's Syndrome with Irritable Bladder (과민성 방광을 동반한 쇼그렌 증후군 소양인 환자 치험 1례)

  • Lee, Min-jung;Park, Minyoung;Hwang, Min-woo
    • Journal of Sasang Constitutional Medicine
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    • v.32 no.3
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    • pp.46-54
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    • 2020
  • Introduction This study aims to report a significant improvement of Sjögren's syndrome patient with irritable bladder, diagnosed as 'Soyangin chest-binding symptomatology' based on Sasang medicine. Methods The patient had treatment with 'Dojeokganggi-tang' and western medications. We evaluated the treatment outcome of Sjögren's syndrome symptoms by using a numerical score of 0 to 10, based on the patient's subjective discomfort of dry eye and dry mouth, and irritable bladder symptoms by recording the number of night urination every month. Results Sjögren's syndrome symptoms were significantly improved, and the number of night urination was decreased. After 41 weeks of treatment, the patient didn't have dry mouth any more and had only a little dry eye. The number of night urination was decreased from 3-4 times to once a night. Discussion The patient diagnosed with Sjögren's syndrome, treated with Dojeokganggi-tang and western medications for 41 weeks, showed a significant improvement in dry eye, dry mouth, and night urination compared to the first visit.

A Systematic Review on Nurse-Led Transitional Care Programs for Discharged Patients from Hospital to Home (퇴원환자를 위한 간호사 주도 전환 프로그램의 내용과 효과에 관한 체계적 문헌고찰)

  • Lee, Hyun Joo;Kim, Yukyung;Oh, Eui Geum
    • Journal of Korean Clinical Nursing Research
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    • v.23 no.3
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    • pp.376-387
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    • 2017
  • Purpose: This study was to systematically review the contents and effects of nurse-led transitional care programs for discharged patients from hospital to home. Methods: Randomized controlled trials published between 2005 and 2015 were searched in Pubmed, Embase, Cochrane(Central Register of Controlled Trials) and CINAHL. Data were analyzed using Cochrane Review Manager(Revman) software 5.3. Results: Nine studies were selected and analyzed. Patient assessment, education and discharge planning were included in pre-discharge phase. Referring, communication and care planning were performed by nurses in transition phase. Home and phone visits, monitoring and multidisciplinary advices were included in post-discharge phase. Various outcome measures such as hospital utilization(30 days readmission and emergency department visit), quality of life, and cost were used to identify effectiveness of nurse-led transitional care programs. 30 days readmission(OR=.73, 95% CI 0.54, 0.98; p=.03) and emergency department visit(OR=.67, 95% CI 0.50, 0.88; p=.005) were statistically significant in meta-analysis. However, participant blinding was not done in seven studies which put at the risk of performance bias. Conclusion: The results indicated that nurse-led transitional care program is effective in reducing unnecessary hospital utilization. Nevertheless, small sample size and risk at performance bias are the limitation of this study. Thus, we suggest that well-designed randomized controlled trials need to be conducted.

The Effect of Doctor's Payment Method on Practice Behavior (지불보상체계가 의사의 진료행태에 미치는 영향 : 미국사례 분석)

  • Lim Jae-Young
    • Health Policy and Management
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    • v.14 no.4
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    • pp.48-74
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    • 2004
  • Considering the existence of asymmetric information between doctor and patient, the doctor's reimbursement method has been considered as a desirable policy device of improving efficiency of patient's use of medical care in terms of its affecting doctor's practice pattern by determining doctor's practice revenue. By using the Community Tracking Study (CTS) physician data set, which includes not only various information on doctors practice arrangements and sources of practice revenue, but also vignettes of various clinical presentations, this paper investigates doctor's reaction to the financial incentive under the control of patient's specific medical situation. Under the econometric model for exploring the effect of doctor's reimbursement method on his/her practice patterns; referring patients, recommend doctor-visit or medical tests, the Hausman's specification test was used for checking out the possibility of the doctor's reimbursement method being endogeneized explanatory variable. In the case where the endogeneity problem of doctor's reimbursement method exists, the 2SLS method was used for correcting that problem, and the multiple regression method was used in the case where the problem is found to be nonexistent. Based on the empirical results, this paper finds that doctors do appear to respond to financial incentive. The empirical results show that the doctor's reimbursement method statistically significantly affects doctor's practice pattern and are coincident with the theoretical result proposed by previous researches, This results suggest, as doctor's practice revenues are mainly determined by prospective method, such as capitation, doctors would more refer their patients to specialists, and hesitate in recommending doctor-visit or medical exam.