• 제목/요약/키워드: Patient risk index

검색결과 184건 처리시간 0.025초

고도비만이 동반된 폐쇄성수면무호흡증 환자에서 시행된 비만대사수술 1례 (A Case of Bariatric Surgery for an OSAS Patient with Severe Obesity)

  • 이상국;홍승노;정재현;최지호
    • 수면정신생리
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    • 제23권2호
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    • pp.93-96
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    • 2016
  • Obstructive sleep apnea syndrome (OSAS) has negative effects on health, including increased mortality, risk of cardiovascular disease, and neurocognitive difficulties. OSAS is common in obese patients and obesity is an important risk factor of OSAS. A 41-year-old female OSAS patient with severe obesity (body mass index [BMI] ${\geq}35$) who failed dietary weight loss underwent bariatric surgery. After surgery, there were improvements in BMI (from 36.9 to $31.7kg/m^2$) and polysomnographic data, including the apnea-hypopnea index (from 25.1 to 11.2 events/hr) and minimum SaO2 (from 69 to 82%). This case demonstrates that bariatric surgery may be an effective therapeutic option to reduce sleep-disordered breathing in severely obese patients with moderate OSAS. Bariatric surgery as a treatment option for OSAS should be considered in OSAS patients with severe obesity who failed dietary weight loss.

한국 여성 유방암의 위험요인 분석 (A Study on the Risk Factors for Breast Cancer in Korean Women)

  • 윤귀옥;박형숙
    • 기본간호학회지
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    • 제8권1호
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    • pp.7-23
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    • 2001
  • This study was done to provide basic data on prevention of breast cancer by identifying and analyzing risk factors for breast cancer in Korean women. The data were collected from three hospitals. The data from Jan. 1995 to Dec. 1997 was based on the patient recordings and personal contacts if possible. Data from 1998 to 1999 was collected from 280 inpatients and outpatients diagnosed as breast cancer. From this data, information about the risk factors of breast cancer could be acquired. The factors are scaled according to the degree of risk. Menstrual history, obstetrical history, family history. lactation period, life style were given 5 point, and body mass index was given 4 point. Using one-way ANOVA. the most important risk factors were identified and analyzed by multiple regression. The conclusion of this study are as follows : General factors which would show an effect on the results of the multiple regression included risk factors such as menstrual history, obstetrical history, lactation period, family history, and life style factors including mortal state, monthly income, educational level, job and age. Family history(R=0.481) was found to be the highest risk factor(23.1%) affecting breast cancer risk. The next factors were dying hair(R=0.603), drinking(R=0.846), body mass index(R=0.885), smoking(R=0.916), age of menopause(R=0.937), pregnancy age of first full-term(R=0.957), eating vegetable(R=0.980) and the number of full term pregnancies in that order. The sum total(R=0.986) of all the above factors accounted for 97.3% of the risk of breast cancer for Korean women. In conclusion, it was found that family history and dyeing hair were the highest risk factors for breast cancer. It is recommended that those with a family history of breast cancer should have regular breast examinations, and those who often dye their hair should reconsider this practice.

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Role of a Risk of Malignancy Index in Clinical Approaches to Adnexal Masses

  • Simsek, Hakki Sencer;Tokmak, Aytekin;Ozgu, Emre;Doganay, Melike;Danisman, Nuri;Erkaya, Salim;Gungor, Tayfun
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권18호
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    • pp.7793-7797
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    • 2014
  • Objective: The aim of this study was to evaluate predictive role of risk of malignancy index in discriminating between benign and malignant adnexal masses preoperatively. Methods: This retrospective study was conducted with a total of 569 patients with adnexal masses/ovarian cysts managed surgically at our clinic between January 2006 and January 2012. Obtained data from patient files were age, gravidity, parity, menopause status, ultrasound findings and CA125 levels. For all patients ultrasound scans were performed. For the assessment of risk of malignancy index (RMI) Jacobs' model was used. Histopathologic results of all patients were recorded postoperatively. Malignancy status of the surgically removed adnexal mass was the gold standard. Results: Of the total masses, 245 (43.1%) were malignant, 316 (55.5%) were benign and 8 (1.4%) were borderline. The mean age of benign cases was lower than malign cases ($35.2{\pm}10.9$ versus $50.8{\pm}13.4$, p<0.001). Four hundred and five of them (71.2%) were in premenopausal period. Malignant tumors were more frequent in postmenopausal women (81% versus 29%, p<0.001). All ultrasound parameters of RMI were statistically significantly favorable for malignant masses. In our study ROC curve analysis for RMI provided maximum Youden index at level of 163.85. When we based on cutoff level for RMI as 163.85 sensitivity, specificity, PPV, NPV was calculated 74.7%, 96.2%, 94% and 82.6%, respectively. Conclusions: RMI was found to be a significant marker in preoperative evaluation and management of patients with an adnexal mass, and was useful for referring patients to tertiary care centers. Although utilization of RMI provides increased diagnostic accuracy in preoperative evaluation of patient with an adnexal mass, new diagnostic tools with higher sensitivity and specificity are needed to discriminate ovarian cancer from benign masses.

소방대원의 중량물작업에 대한 인간공학적 분석 (An Ergonomic Analysis for Heavy Manual Material Handling Jobs by Fire Fighters)

  • 임수정;박종태;최서연;박동현
    • 한국화재소방학회논문지
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    • 제27권3호
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    • pp.85-93
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    • 2013
  • 본 연구에서는 소방대원이 수행하는 업무 중 중량물을 다루어야 하는 작업에 대한 분류 및 정량적 분석(NLE, 3DSSPP)을 수행하여 향후 소방대원의 중량물 관련 작업에 대한 위험도를 예측하고, 관련 위험도를 감소시키기 위한 기초 자료를 도출하고자 하였다. 도출된 위험도 등급은 위험도 점수가 3점부터 9점까지 총 7단계로 구성되었다. 가장 위험도가 높은 1등급은 나타나지 않았으며 인명구조 작업이 두 번째로 높은 2등급에 속하는 것으로 나타났다. 3등급은 파괴기구 활용, 환자 들어올리기작업 등으로 나타났다. 본 연구 결과들은 소방대원의 허리 부상을 포함하는 근골격계 질환 예방을 위한 작업방법 및 장비의 개선, 교육 프로그램의 개발에 기본 토대가 될 수 있다고 판단되며, 소방대원들의 근골격계 질환에 대한 지속적인 예방을 위해서는 본 연구의 골격을 토대로 한 추후 심층적인 조사와 연구가 시급하다고 사료된다.

A Study on Health Risk Behavior Factors and Chronic Disease Risk Factors

  • SHIM, Su Jeong;LEE, Ji Hee;PAIK, Jean Kyung
    • 식품보건융합연구
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    • 제8권1호
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    • pp.1-7
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    • 2022
  • This study classified subjects aged 30 to 64 into normal group, impaired fasting glucose group, and diabetes mellitus patient group based on data from the 6th period of the National Health and Nutrition Examination Survey (2013-2015). Skipping breakfast, lack of physical activity, inadequate sleep time, inadequate weight, excessive drinking, and current smoking are classified as a low health risk group when three or less items are present, and a high health risk group when three or more items are included. By classification, each item included in the physical measurement and biochemical analysis factors and health risk behavior factors was comparatively analyzed. As a result, in the normal group, impaired fasting glucose group, and diabetes group, the average age was higher in the group with high health risk factors than the group with low risk factors, and the male ratio was higher. Body mass index, waist circumference, blood pressure, triglyceride showed a significantly higher result. In the normal group, the fasting blood glucose level and total cholesterol level were also higher in group 2. Therefore, it is thought that it is necessary to control health risk behaviors through lifestyle changes in the normal group, fasting glucose disorder group, and diabetes group.

제2형 당뇨병 환자의 평소 식사 중 당질섭취량과 glycemic index 관련 연구 (Carbohydrate Consumption and Glycemic Index of the Usual Diet in Type 2 Diabetes Mellitus Patients)

  • 임희숙;김순경
    • 대한영양사협회학술지
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    • 제10권3호
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    • pp.322-332
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    • 2004
  • The possibility that high, long-term intake of carbohydrates that are rapidly absorbed as glucose may increase the risk of type 2 diabetes has been long-standing controversy. A high consumption of carbohydrates with a high glycemic index produces greater insulin resistance than did the intake of low glycemic index carbohydrates. This study was designed to evaluate the cabohydrate intake status include glycemic index and correlation carbohydrtae intake status with anthropometry factors & other nutrients in usual diet of the Korean type 2 diabetes mellitus. In 104 tpye 2 diabetes mellitus patients(mean age : 51.8yr, male=44.femal=60), we determined carbohydrte intake status include glycemic index with 24hr recall method and measured anthropometry. Mean daily carbohydrtae intakes and glycemic index were 307.3g(male 323.1g, female 295.5g) and 90.7(male 93.4, female 88.8), respectively. We found a strong and statistically significant association between carbohydrate ratio and glycemic index in obese factors, other nutrient. But carbohydrate intake/kg of body weight was low a significant differences in obese factors, other nutrient. Also glycemic index was effected by total energy intake and carbohydrate ratio than carbohydrate intake/kg of body weight. In conclusion, emphasis for dietary modification should be total energy intake and carbohydrate ratio in diabetes mellitus patient.

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치매노인의 낙상위험요인에 관한 메타분석 (A Meta-analysis of the Risk Factors related to Falls among Elderly Patients with Dementia)

  • 홍선영;박희옥
    • 성인간호학회지
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    • 제29권1호
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    • pp.51-62
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    • 2017
  • Purpose: The purpose of this study was to provide data about the risk factors related to falls among elderly patients with dementia using meta-analysis. Methods: Key words used for search through electronic database (CINAHL, PubMed, Ovid-MEDLINE, RISS, KISS, DBPIA, National Assembly Library) included 'dementia', 'Alzheimer', 'fall'. Twenty studies met the inclusion criteria for the meta-analysis and 'R' version 3.2.2 was used to analyze the correlated effect size. Results: Study results showed that risk factors related to falls were identified as the demographic (age, gender, education), dementia-related (disease duration, cognition), physical (body mass index, walking, balance, activity of daily living, use of walking aids, number of medications including psychotropic drugs, musculoskeletal problems, parkinsonism, comorbidity), psychological (neuropsychiatric symptom, depression), environmental (Physical environment), and fall-related (fall history, high risk group of fall) factors. The effect size of risk factors such as high risk group of fall (r=.35), use of walking aids (r=.33), depression (r=.31), psychotropic drugs (r=.27), Musculoskeletal problems (r=.25) were higher than the other risk factors. Conclusion: Based on the findings of this study, strategies to improve elderly patient's depression, intensive care for high risk group of fall, and adequate training with walking aids are needed for prevention of falls in elderly patients with dementia.

압박 궤양 수술 후 발생된 페색전증 치험례 (Clinical Experience of Pulmonary Embolism after Coverage of Pressure Sore)

  • 서상우;이원재;탁관철
    • Archives of Plastic Surgery
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    • 제32권4호
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    • pp.543-546
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    • 2005
  • Pulmonary embolism is a one of the major cause of postoperative death. Surgery predisposes patients to pulmonary embolism, even as late as one month after the operation. The accurate detection of pulmonary embolism remains difficult, and the differential diagnosis is extensive. The prevention of pulmonary embolism is thus of paramount importance. We report a case of pulmonary embolism after coverage of pressure sore on the left ischium on the 8th day after operation. The patient was 60 years old, a severe smoker, in the high quantity of body mass index and had hypertension. The risk factors are 60 years of age or older who were in the highest quantity of body mass index. Heavy cigarette smoking and high blood pressure are also identified as risk factors. Plastic surgeons should keep the probability of pulmonary embolism development after operation in mind. When taking history, the risk factors should be checked certainly. The immobilization may explain the probability of pulmonary embolism development. Therefore absolute bed rest or positional maintenance should be avoided. Until recently, low molecular weight heparin has been used for preoperative prophylaxis. Plastic surgeons should be concerned in low molecular weight heparin for prophylaxis of the pulmonary embolism and study the indications and effectiveness in liposuction or abdominoplasty.

Clinical Prognostic Score for Predicting Disease Remission with Differentiated Thyroid Cancers

  • Somboonporn, Charoonsak;Mangklabruks, Ampica;Thakkinstian, Ammarin;Vatanasapt, Patravoot;Nakaphun, Suwannee
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권6호
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    • pp.2805-2810
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    • 2016
  • Background: Differentiated thyroid cancer is the most common endocrine malignancy with a generally good prognosis. Knowing long-term outcomes of each patient helps management planning. The study was conducted to develop and validate a clinical prognostic score for predicting disease remission in patients with differentiated thyroid cancer based on patient, tumor and treatment factors. Materials and Methods: A retrospective cohort study of 1,217 differentiated thyroid cancer patients from two tertiary-care hospitals in the Northeast of Thailand was performed. Associations between potential clinical prognostic factors and remission were tested by Cox proportional-hazards analysis in 852 patients (development cohort). The prediction score was created by summation of score points weighted from regression coefficients of independent prognostic factors. Risks of disease remission were estimated and the derived score was then validated in the remaining 365 patients (validation cohort). Results: During the median follow-up time of 58 months, 648 (76.1%) patients in the development cohort had disease remission. Five independent prognostic factors were identified with corresponding score points: duration from thyroid surgery to $^{131}I$ treatment (0.721), distant metastasis at initial diagnosis (0.801), postoperative serum thyroglobulin level (0.535), anti-thyroglobulin antibodies positivity (0.546), and adequacy of serum TSH suppression (0.293). The total risk score for each patient was calculated and three categories of remission probability were proposed: ${\leq}1.628$ points (low risk, 83% remission), 1.629-1.816 points (intermediate risk, 87% remission), and ${\geq}1.817$ points (high risk, 93% remission). The concordance (C-index) was 0.761 (95% CI 0.754-0.767). Conclusions: The clinical prognostic scoring model developed to quantify the probability of disease remission can serve as a useful tool in personalized decision making regarding treatment in differentiated thyroid cancer patients.

관상동맥질환 위험인자 유무 판단을 위한 심박변이도 매개변수 기반 심층 신경망의 성능 평가 (Performance Evaluation of Deep Neural Network (DNN) Based on HRV Parameters for Judgment of Risk Factors for Coronary Artery Disease)

  • 박성준;최승연;김영모
    • 대한의용생체공학회:의공학회지
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    • 제40권2호
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    • pp.62-67
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    • 2019
  • The purpose of this study was to evaluate the performance of deep neural network model in order to determine whether there is a risk factor for coronary artery disease based on the cardiac variation parameter. The study used unidentifiable 297 data to evaluate the performance of the model. Input data consists of heart rate parameters, which are SDNN (standard deviation of the N-N intervals), PSI (physical stress index), TP (total power), VLF (very low frequency), LF (low frequency), HF (high frequency), RMSSD (root mean square of successive difference) APEN (approximate entropy) and SRD (successive R-R interval difference), the age group and sex. Output data are divided into normal and patient groups, and the patient group consists of those diagnosed with diabetes, high blood pressure, and hyperlipidemia among the various risk factors that can cause coronary artery disease. Based on this, a binary classification model was applied using Deep Neural Network of deep learning techniques to classify normal and patient groups efficiently. To evaluate the effectiveness of the model used in this study, Kernel SVM (support vector machine), one of the classification models in machine learning, was compared and evaluated using same data. The results showed that the accuracy of the proposed deep neural network was train set 91.79% and test set 85.56% and the specificity was 87.04% and the sensitivity was 83.33% from the point of diagnosis. These results suggest that deep learning is more efficient when classifying these medical data because the train set accuracy in the deep neural network was 7.73% higher than the comparative model Kernel SVM.