• 제목/요약/키워드: Patient selection

검색결과 539건 처리시간 0.028초

외상성 신경병증 환자의 치험례 (A CASE REPORT OF TRAUMATIC NEUROPATHIC PAIN PATIENT)

  • 최문기
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권2호
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    • pp.200-206
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    • 2008
  • A variety of mechanisms may generate pain resulting from injury to the peripheral nervous system. None of these mechanisms is disease-specific, and several different pain mechanisms may be present simultaneously in any one patient. Diagnosis of neuropathic pain is often easily made from the information gathered on neurologic examination and from patient history. Evidence of sensory disturbances elicited by examination combined with laboratory tests confirming injury to peripheral nerve establishes the diagnosis of neuropathic pain. Although treatment of neuropathic pain may be difficult, optimum treatment can be achieved if dentist has a complete understanding of the therapeutic options. Pharmacologic therapy has been the mainstay of treatment. Selection of an appropriate pharmacologic agent is by trial and error since individual response to different agents, doses, and serum level are highly variable. An adequate trial for each agent tried is key to pharmacologic treatment of neuripathic pain. If pharmacologic treatment is not effective, nerve block using lidocaine, steroid and alcohol and neurectomy must be considered for treatment option.

고정성 보철 수복이 부적절한 환자에서 자가치아이식을 응용한 치험례 (Autotransplantation in patient who is not indicated fixed prosthesis: case report)

  • 백상현;정혜심;성상진;문윤식;장현호;라윤식
    • 대한치과의사협회지
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    • 제42권8호통권423호
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    • pp.514-522
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    • 2004
  • Clinicians often meet the growing patient who is not treated with fixed prosthesis until alveolar bone growth is completed. When both esthetic and function needs are important, and if proper donor tooth is present, the application of autotransplantation may be better treatment option than space maintainer. Although prognosis of autotransplantation is not always favorable, it depends on the treatment design which is based on the ability of case selection and consideration. This report will present the clinical cases of autotransplantation in growing patient, and discuss about several clinical aspects of autotransplantation.

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의사의 커뮤니케이션 스타일이 환자만족에 미치는 영향에 관한 연구 (The Impact of Doctors' Communication Styles on Patient Satisfaction: Empirical Examination)

  • 서판수
    • 한국병원경영학회지
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    • 제7권4호
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    • pp.57-101
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    • 2002
  • These days, the environment of hospital marketing is changing rapidly. The level of expectation and demand of patients have become greater and more diversified, and patients have more alternatives in selecting hospitals. The standard of hospital selection and the type of using hospital have been changed, and competition among hospitals has been accelerated due to the opening of the medical market through globalization. Accordingly, differentiation strategies are critical in hospital marketing. The quality of medical service oriented toward patient satisfaction becomes a strong strategic weapon to secure a hospital's competitive advantage. Therefore, marketing and communication strategies should be focused on patient-oriented, rather than hospital-oriented. Considering the changes in the hospital environment and the increase in the patients' expectation level, this study categorizes doctors' communication styles into four different ones: trust-type, professional-type, cooperation-type, and control-type. The effects of these communication styles on patient satisfaction were empirically examined. The moderating roles of the patient's characteristics and clinical characteristics between the doctors' communication styles and patient satisfaction were also investigated to find out managerial implications for hospital management. To achieve such goals, data were collected from patients of 12 general hospitals in Busan. The data were analyzed to test research hypotheses that examine 1) the relationships between doctors' communication styles and patient satisfaction, 2) the moderating roles of the patient characteristics and clinical characteristics in the research model, and 3) the impact of patient satisfaction on positive word-of-mouth and repurchase. The following summarizes the major results of this research. First, the data showed that patient satisfaction varied across doctors' communication styles. Trust-type style had the strongest impact on patient satisfaction while control-type style had the weakest influence on patient satisfaction. Professional-type style and cooperation-type style also had positive effects on patient satisfaction but the impact of the two are not statistically different. Second, significant differences in terms of patient satisfaction were found depending upon demographic variables such as gender, marital status, age, occupation, and education. Patient satisfaction, however, was consistent across varying income groups. Third, patients' medical insurance types were also related to patient satisfaction. It implies that a doctor may need to use different communication styles depending on a patient's medical insurance type. Fourth, out-patient and in-patient showed a different level of satisfaction with varying communication styles. Fifth, highly professional knowledge and strong control can influence patient satisfaction depending on the characteristics of the patient treatment field. Sixth, patient satisfaction were proved to have significantly positive effects on word-of-mouth and repurchase. The implications drawn from this study must be tempered by its limitations. First of all, the subjects used in this study were patients in Busan and small- and medium-size hospitals were excluded from the research. Therefore, future research should examine the research model by using a variety of hospitals and clinics throughout Korea. Another research agenda has to do with finding more determinant and moderating variables which will increase an explanatory power of the model. In short, this study may be the first empirical research that investigates the effects of doctors' communication styles on patient satisfaction. Interestingly enough, the results showed that each communication style had a unique impact on patient satisfaction. The findings from this research can be very useful in developing hospital marketing strategies.

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An Algorithm to Guide Recipient Vessel Selection in Cases of Free Functional Muscle Transfer for Facial Reanimation

  • Henry, Francis P.;Leckenby, Jonathan I.;Butler, Daniel P.;Grobbelaar, Adriaan O.
    • Archives of Plastic Surgery
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    • 제41권6호
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    • pp.716-721
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    • 2014
  • Background The aim of this study was to review the recipient vessels used in our cases of facial reanimation with free functional muscle transfer and to identify patient variables that may predict when the facial vessels are absent. From this we present a protocol for vessel selection in cases when the facial artery and/or vein are absent. Methods Patients were identified from November 2006 to October 2013. Data was collected on patient demographics, facial palsy aetiology, history of previous facial surgery/trauma and flap/recipient vessels used. A standard operative approach was adopted and performed by a single surgeon. Results Eighty-seven eligible patients were identified for inclusion amongst which 98 hemifaces were operated upon. The facial artery and vein were the most commonly used recipient vessels (90% and 83% of patients, respectively). Commonly used alternative vessels were the transverse facial vein and superficial temporal artery. Those with congenital facial palsy were significantly more likely to lack a suitable facial vein (P=0.03) and those with a history of previous facial surgery or trauma were significantly more likely to have an absent facial artery and vein (P<0.05). Conclusions Our algorithm can help to guide vessel selection cases of facial reanimation with free functional muscle transfer. Amongst patients with congenital facial palsy or in those with a previous history of facial surgery or trauma, the facial vessels are more likely to be absent and so the surgeon should then look towards the transverse facial vein and superficial temporal artery as alternative recipient structures.

응급실 내원자의 의료서비스 만족에 관한 연구 (A study on Medical servicer satisfaction of Emergency Department patient)

  • 권선숙;유인술;정하숙
    • 한국응급구조학회지
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    • 제1권1호
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    • pp.42-53
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    • 1997
  • To offer basic data about the influential factors on patient's Satisfaction level for emergency medical services the authors were performed this study in 60 patients visited to emergency room of third stage general hospital in Taejeon city. Data were collected through interview with patients by using a 15 items' questionaire according to care subscale, teaching subscale of Likert's five stage quantitative scale and the tools developed by Barbara Davis. The data were analyzed by using the SPSS/PC computerized program for mean, standard deviation, percentage, ANOVA, t-test, and pearson correlation. The results are as followings ; 1. Satisfaction of emergency medical service were showed in care area, but not showed in teaching and total area 2. Satisfaction of sociodemographic characteristics were a statistically significant difference only marriage, that were the higher in marriaged than single(P<.0.05). 3. In the emergency situation characteristics the satisfaction accordings to the visit cause were lower in accident than disease group, the reason of hospital selection were in order trust, introduction group, distance, traffic, kinds, and score of satisfaction were showed each of 43.47, 51.27(P<.001), the transportation vehicle was the 119, hospital ambulance group. but were not a satistically significant difference. 4. The negative correlation was observed between satisfaction and the length of stay at ER and the longer length of stay at ER was showed the lower satisfaction. But the positive correlation was observed between satisfacton and the arrival time, patients who arrived ER from 6:00P.M. to midnight were more satisfied than patients who arrived other time. 5. The length of stay at ER was significantly different according to the reason of hospital selection, the reason of ER selection, the visitant cause and hopital decisioner. Especially the length of stay was much longer in accident group and unconscious group.

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외래 급성 비부비동염 환자의 잠재적으로 부적절한 항생제 사용 (Potentially Inappropriate Prescriptions of Antibiotics in Patients with Acute Rhinosinusitis in Ambulatory Settings in South Korea)

  • 정다이;제남경
    • 한국임상약학회지
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    • 제33권4호
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    • pp.261-269
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    • 2023
  • Background: Acute rhinosinusitis (ARS) is a common condition encountered in ambulatory practice and is one of the most common reasons for antibiotic prescriptions. This study aimed to evaluate the potentially inappropriate antibiotic prescribing for ARS in South Korea and identify influencing factors. Methods: We analyzed Health Insurance Review and Assessment Service-National Patient Samples data. We selected outpatients aged 20 to 64 with ARS, prescribed antibiotics between February and November 2020. Potentially inappropriate antibiotic prescribing was categorized as: 1) inappropriate antibiotic selection and 2) inappropriate antibiotic dosage or duration. Multiple logistic regression was conducted to estimate the impact of various factors on inappropriate antibiotic prescribing. Results: Of 1,210 patients, 80.83% received potentially inappropriate ARS antibiotic prescriptions. Inappropriate antibiotic selection accounted for 43.55%, and inappropriate antibiotic dosage and duration contributed to 37.28%. Otolaryngologists had higher odds ratio (OR) of potentially inappropriate antibiotic prescribing compared to internal medicine practitioners, while dentists had lower OR. Patients aged 20 to 29 years had a higher OR than other age groups, and those who visited primary care clinics had a higher OR than those who visited hospitals. Conclusion: Potentially inappropriate antibiotic prescribing for ARS is prevalent in South Korea. This study identified physician specialty, patient age group, and the level of healthcare facility as factors influencing potentially inappropriate antibiotic prescriptions. Addressing this issue through targeted interventions, such as improved guidelines adherence and patient education, is imperative to mitigate the risks associated with antibiotic misuse and antibiotic resistance.

Category Variable Selection Method for Efficient Clustering

  • Heo, Jun;Kim, Chae Yun;Jung, Yong-Gyu
    • International journal of advanced smart convergence
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    • 제2권2호
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    • pp.40-42
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    • 2013
  • Recent medical industry is an aging society and the application of national health insurance, with state-of-the-art research and development, including the pharmaceutical market is greatly increased. The nation's health care industry through new support expansion and improve the quality of life for the research and development will be needed. In addition, systemic administration of basic medical supplies, or drugs are needed, the drug at the same time managing how systematic analysis of pharmaceutical ingredients, based on data through the purchase of new medicines and pharmaceutical ingredients automatically classified by analyzing the statistics of drug purchases and the future a system that can predict a patient is needed. In this study, the drugs to the patient according to the component analysis and predictions for future research techniques, k-means clustering and k-NN (Nearest Neighbor) Comparative studies through experiments using the techniques employ a more efficient method to study how to proceed. In this study, the effects of the drugs according to the respective components in time according to the number of pieces in accordance with the patient by analyzing the statistics by predicting future patient better medical industry can be built.

Restoration of Mandibular Edentulous Patient By Dental Implant: Case Report

  • Kwon, Ji-Yung;Kim, Yung-Soo
    • 대한치과보철학회지
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    • 제38권3호
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    • pp.360-365
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    • 2000
  • The completely edentulous patient has few treatment options in conventional dentistry. When implants are considered, treatment plans range from a 2-implant overdenture to a completely implant-supported prosthesis. Fixed prosthesis is often the preferred selection of the edentulous patient. fixed full-arch cert amo-metal restorations can be a predictable implant treatment modality for the edentulous patient. Implant-supported fixed prosthesis has several advantages: predictability, fixedness, retrievability, improved function, lower maintenance of prosthesis, long-term published success. Edentulous patients with a severely resorbed mandible often experience problems with their dentures. Treatment concepts involving two to four implants for the support of an overdenture have been proposed. There seems to be no need to insert more than two endosteal implants to support an overdenture, however, long-term prospective studies are needed to support this notion. Using short endosseous implants and an overdenture in the extremely resorbed mandible is a justified treatment option because of the relative simplicity and low morbidity of this treatment strategy. Implant-supported overdenture has several advantages: Cost, retrievability, hygiene access, profile and contour control, increased retention and stability, implant installed in a predicted region(ant. mandible).

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Intervention Mapping을 적용한 지역사회기반의 골관절염 자기관리지지 프로그램 개발 (Using Intervention Mapping to Develop a Community-based Disease Self-management Support Program for Patients with Osteoarthritis)

  • 안양희
    • 근관절건강학회지
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    • 제22권3호
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    • pp.245-257
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    • 2015
  • Purpose: The purpose of this study was to apply intervention mapping (IM) to develop a community-based disease self-management support program for patients with osteoarthritis. Methods: IM was applied as follows: i) a needs assessment has been carried out by a literature review, survey and interview with osteoarthritis patients; ii) on the basis of the needs assessment, identification of expected outcomes and change objectives for the target population; iii) selection of theory-based methods and practical applications to influence self-management and the determinants of behavior; iv) design of the intervention by developing activities and materials such as osteoarthritis self-management guide and smart patient pocket book. The activities were integrated into an existing healthcare activities; v) implementation and evaluation plan has been developed. Results: The program is aimed at improving health status through activating patients by a patient-centered and tailored intervention for patients with osteoarthritis; consists of 8 sessions with coaching and cognitive emotional psychological skills; includes smart patient, communication, osteoarthritis, medication adherence, pain control, depressive mood control, physical activity and healthy diet. Conclusion: The IM is a systematic and feasible method for developing the program. The next step is to evaluate the impact of the intervention on activation, and health status.

An Integrative Approach to Precision Cancer Medicine Using Patient-Derived Xenografts

  • Cho, Sung-Yup;Kang, Wonyoung;Han, Jee Yun;Min, Seoyeon;Kang, Jinjoo;Lee, Ahra;Kwon, Jee Young;Lee, Charles;Park, Hansoo
    • Molecules and Cells
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    • 제39권2호
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    • pp.77-86
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    • 2016
  • Cancer is a heterogeneous disease caused by diverse genomic alterations in oncogenes and tumor suppressor genes. Despite recent advances in high-throughput sequencing technologies and development of targeted therapies, novel cancer drug development is limited due to the high attrition rate from clinical studies. Patient-derived xenografts (PDX), which are established by the transfer of patient tumors into immunodeficient mice, serve as a platform for co-clinical trials by enabling the integration of clinical data, genomic profiles, and drug responsiveness data to determine precisely targeted therapies. PDX models retain many of the key characteristics of patients' tumors including histology, genomic signature, cellular heterogeneity, and drug responsiveness. These models can also be applied to the development of biomarkers for drug responsiveness and personalized drug selection. This review summarizes our current knowledge of this field, including methodologic aspects, applications in drug development, challenges and limitations, and utilization for precision cancer medicine.