• 제목/요약/키워드: Primary medical care

검색결과 657건 처리시간 0.027초

노인성 전신질환 입원환자에서 치성감염 관리에 관한 임상적 연구 (A CLINICAL STUDY ON THE CARE OF ODONTOGENIC INFECTIONS IN THE ADMISSION PATIENTS WITH AGE-RELELATED GERIATRIC DISEASES)

  • 유재하;최병호;한상권;정원균;노희진;장선옥;김종배;남기영;정재형;김병욱
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제30권5호
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    • pp.414-421
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    • 2004
  • This is a reprospective study on the care of odontogenic infections in admission patients with geriatric diseases. The study was based on a series of 480 patients at Dong San Medical Center, Wonju Christian Hospital and Il San Health Insurance Hospital, From Jan. 1, 2000, to Dec. 31, 2002. The Obtained results were as follows: 1. The systemic malignant tumor was the most frequent cause of the geriatric diseases with odontogenic infectious diseases, and refractory lung disease, systemic heart disease, type II diabetes mellitus, cerebrovascular disease, bone & joint disease, senile psychologic disease were next in order of frequency. 2. Male prediction(57.5%) was existed in the odontogenic infectious patients with geriatric diseases. But, there were female prediction in senile psychologic disease, systemic heart disease and cerebrovascular disease. 3. The most common age group of the odontogenic infectious patient with geriatric disease was the sixty decade(47.9%), followed by the seventy & eighty decade in order. 4. In the contents of chief complaints on the odontogenic infectious patients with geriatric disease, peak incidence was occurred as toothache(52.7%), followed by extraction wish, tooth mobility, oral bleeding, oral ulcer, fracture of restoration, gingival swelling in order. 5. In the diagnosis group of odontogenic infectious diseases, periodontitis, pulpitis & periapical abscess were more common. 6. In the treatment group of odontogenic infectious diseases, the most frequent incidence(34.2%) was showed in primary endodontic treatment (pulp extirpation, occlusal reduction and canal opening drainage) and followed by scaling, incision & drainage, only drugs, pulp capping, restoration in order.

한 농촌지역에서 실시한 소아 급성호흡기감염 관리사업의 평가 -항생제 사용을 중심으로- (Evaluation of Acute Respiratory Infections(ARI) Control Programme in a Korean Rural Community -The Patterns of Antibiotic Prescription-)

  • 이영성;김창엽;김용익;신영수;고재욱
    • 농촌의학ㆍ지역보건
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    • 제18권2호
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    • pp.105-119
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    • 1993
  • The purpose of this study was to evaluate the program for the control of acute respiratory infections(ARI) in children in a Korean rural area(Yonchon county). Evaluating the program, we focused on the pattern of prescription and appropriateness of antibiotics prescribed by the health personnel who had participated in the ARI Control Program. It was implemented at the primary health care setting in rural area, such as district hospital, health subcenters, and health posts. During six-months programme monitoring period, medical records were reviewed and collected data were analysed by the pediatrician, research coordinator of this study. The baseline data were collected from medical records of the same period(six months) of one year before the implementation of the ARI programme. The study results were as follow : 1. Common cold was the most prevalent disease(78.7%. 594 cases) among the all ARI cases (755 cases). The less frequent cases were bronchitis(11.9%), acute pharyngitis(5.2%), and pneumonia(1.8%). 2. Significant reduction in the use of antibiotics was observed after the programme implementation. Ninety three(15.7%) of 594 common cold cases were received antibiotics compared with 282(35.2%) of 802 in the baseline period. In the cases of bronchitis and acute pharyngitis, the reduction rates were 15.1% and 23.2% respectively compared to the baseline period. 3. Mean duration of antibiotics prescription was 1.81-1.75 days, similar to the baseline data. 4. The appropriateness rate of antibiotics prescriptions were 84.3%(common cold), 35.6% (bronchitis) and 28.2%(acute pharyngitis). In the case of pneumonia, the antibiotics prescription was compatible to the criteria developed. 5. Pediatrician prescribed antibiotics more appropriately for all cases than general practitioners in health sub-center, and nurse practitioners in health posts. 6. Antibiotics therapy was shown to be of no effect in the treatment of the all ARI cases. At the 5 and 10 days check-up of common cold cases after visits, proportion of improved patients were 58.3% in the antibiotics-used group and 51.4% in the control group. In the other cases of ARI, the patterns of response were similar to common cold. None of the differences in outcome between the antibiotics-used and control group was statistically significant. This ARI programme may have substantial a substantial impact on antibiotics use at the public health institutions(district hospital, health subcenters, health posts) which are of major domain for primary health care in Korean rural areas.

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간세포암종의 안와 전이 1예 (A Case of Metastatic Hepatocellular Carcinoma of the Orbit)

  • 양영주;배승현;장일영;전미정;정지원;안지현;심주현
    • Journal of Yeungnam Medical Science
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    • 제30권2호
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    • pp.152-155
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    • 2013
  • Orbital metastasis from hepatocellular carcinoma is very rare, with only 14 biopsy-proven cases from hepa tocellular carcinoma cases reported in English literature and three cases reported in Korea. Common symptoms of orbital metastasis are proptosis, visual loss, ocular pain and oculomotor dysfunction. For its precise diagnosis, we can perform fine needle aspiration biopsy, orbit CT or MRI, and ultrasonography. Radiotherapy is the mainstay in the treatment of orbital metastasis. In addition, chemotherapy, hormonal therapy and surgical intervention can play a role in the treatment of orbital metastasis according to the primary cancer and symptoms. However, the prognosis of orbital metastasis is poor. We report herein a rare case of a patient with orbital metastasis from hepatocellular carcinoma, which was treated with various modalities that included resection, and who had good clinical and radiological responses to radiation therapy and sorafenib (Nexavar, Bayer HealthCare).

Predictors Affecting Breast Self-Examination Practice among Turkish Women

  • Doganer, Yusuf C.;Aydogan, Umit;Kilbas, Zafer;Rohrer, James E.;Sari, Oktay;Usterme, Necibe;Yuksel, Servet;Akbulut, Halil;Balkan, Salih M.;Saglam, Kenan;Tufan, Turgut
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권20호
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    • pp.9021-9025
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    • 2014
  • Background: Breast cancer (BC) is the most common cancer among females in Turkey. Predictors affecting the breast self-examination (BSE) performance vary in developing countries. Objective: To determine the frequency of BSE performance and predictors of self-reported BSEs among women in the capital city of Turkey. Materials and Methods: This cross-sectional study was conducted on 376 Turkish women using a self-administered questionnaire covering socio-demographic variables and BSE-related features. Results: Of the participants, 78.7% (N=296) reported practicing BSE, whereas 9.5% (N=28) were implementing BSE regularly on a monthly basis, and only 5.7% (N=17) were performing BSE regularly within a week after each menstrual cycle. Multivariate logistic regression modeling revealed that BSE performance was more likely in younger age groups [20-39 years] (p=0.018, OR=3.215) and [40-49 years] (p=0.009, OR=3.162), women having a family history of breast disease (p=0.038, OR=2.028), and housewives (p=0.013, OR=0.353). Conclusions: Although it appears that the rates of BSE performers are high, the number of women conducting appropriate BSE on a regular time interval basis is lower than expected. Younger age groups, family history of breast diseases and not being employed were identified as significant predictors of practicing BSE appropriately. Older age and employment were risk factors for not performing BSE in this sample.

의료기술직 종사자의 피로도에 영향을 미치는 요인과 피로조절행위 (Fatigue among Medical Technicians in Hospital and Actions to Control Fatigue)

  • 박남근;박재용;한창현
    • 보건의료산업학회지
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    • 제5권2호
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    • pp.119-129
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    • 2011
  • A researcher examined 158 medical technologists and 140 radiologists who are working at 9 general hospitals in Gyeongsangbuk-do area using structured questionnaire to find out degree of fatigue of health professionals, the primary factors that have effect on them, and actions to control their fatigue on December 1 through December 20, 2008. The average complaining rate of fatigue subjective symptom by syndromes was overall 17.24 points, and medical technologists scored 16.48 points while radiologists scored 18.09 points. There were significant difference in the average fatigue complaining score of both medical technologists and radiologists such as when the younger their age is, when they are single, when the lower their monthly salary is, when the shorter their total working period is, and when the current status is staff at work. As a result of multiple regression analysis which sets fatigue score as dependent variable, there were significant difference on both syndromes such as satisfaction on work, work stress, and sleeping condition. It was the highest on relaxation, which was 76.6%, among the 15 questions on actions to control fatigue, and the next was enough sleep and controlling stress. And the lowest was help from medical professionals, which was 7.3%. It was the highest on enough sleep, which was 1.98 points, and next was relaxation and controlling stress, and the lowest points were help from medical professionals and taking medicine in the effective score of fatigue control action. In consequence of research, it is necessary to develop program and health education to control health professionals' various fatigue such as stress management and sleeping, and it is considered to find out the plan about effective work system.

빅데이터를 활용한 근골격계 표준의료용어에 대한 키워드 네트워크 분석 (A Keyword Network Analysis of Standard Medical Terminology for Musculoskeletal System Using Big Data)

  • 최병관;최은아;남문희
    • 디지털융복합연구
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    • 제20권5호
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    • pp.681-693
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    • 2022
  • 본 연구는 근골격계 질환으로 입원한 환자의 의무기록지 키워드 네트워크 분석을 통해 근골격계와 관련된 표준의료용어를 유추하여 보건의료현장의 비정형화된 데이터 활용 방안을 제시하기 위함이다. 분석 대상은 2010년부터 2019년까지 근골격계 질환 환자의 입퇴원요약지 145부로, 더아이엠씨(The IMC)에서 개발한 빅데이터 분석 솔루션인 TEXTOM을 활용하여 분석하였다. 1차·2차 정제과정을 통해 도출된 177개의 근골격계 관련 용어를 최종 분석하였다. 연구결과 다빈도 용어는 'Metastasis', 의료용어 체계별 분석 결과에서 임상소견은 'Metastasis', 증상은 'Weakness', 진단은 'Hepatitis', 처치는 'Remove', 신체구조는 'Spine', 약물은 'Oxycodone'이 가장 많이 사용되었다. 이러한 결과를 바탕으로 정형화되지 않은 의료데이터의 분석과 활용 및 관리 방안에 대한 시사점을 제안하고자 한다.

Adjunctive recombinant human parathyroid hormone agents for the treatment of medication-related osteonecrosis of the jaw: a report of three cases

  • Soo Young Choi;Dami Yoon;Kang-Min Kim;Sun-Jong Kim;Heon-Young Kim;Jin-Woo Kim;Jung-Hyun Park
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제50권2호
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    • pp.103-109
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    • 2024
  • Teriparatide has been effective in treating people diagnosed with medication-related osteonecrosis of the jaw (MRONJ). However, its efficacy is not well established to be accepted as a standard of care. The objective of this paper was to investigate the efficacy of recombinant human parathyroid hormone for the treatment of MRONJ. We report three cases of MRONJ patients with osteoporosis as the primary disease who were treated with a teriparatide agent along with other adjunctive measures. Each patient was administered a teriparatide injection subcutaneously for 16 weeks, 36 weeks, or 60 weeks. Surgical intervention including partial resection, sequestrectomy, decortication, and saucerization took place during the teriparatide administration. Complete lesion resolution was identified clinically and radiographically in all three patients. In patients diagnosed with MRONJ, teriparatide therapy is an efficacious and safe therapeutic option to improve healing of bone lesions. These findings demonstrate that teriparatide in combination with another therapy, especially bone morphogenetic protein, platelet-rich fibrin, or antibiotic therapy, can be an effective protocol for MRONJ.

Bronchoesophageal fistula in a patient with Crohn's disease receiving anti-tumor necrosis factor therapy

  • Kyunghwan Oh;Kee Don Choi;Hyeong Ryul Kim;Tae Sun Shim;Byong Duk Ye;Suk-Kyun Yang;Sang Hyoung Park
    • Clinical Endoscopy
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    • 제56권2호
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    • pp.239-244
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    • 2023
  • Tuberculosis is an adverse event in patients with Crohn's disease receiving anti-tumor necrosis factor (TNF) therapy. However, tuberculosis presenting as a bronchoesophageal fistula (BEF) is rare. We report a case of tuberculosis and BEF in a patient with Crohn's disease who received anti-TNF therapy. A 33-year-old Korean woman developed fever and cough 2 months after initiation of anti-TNF therapy. And the symptoms persisted for 1 months, so she visited the emergency room. Chest computed tomography was performed upon visiting the emergency room, which showed BEF with aspiration pneumonia. Esophagogastroduodenoscopy with biopsy and endobronchial ultrasound with transbronchial needle aspiration confirmed that the cause of BEF was tuberculosis. Anti-tuberculosis medications were administered, and esophageal stent insertion through endoscopy was performed to manage the BEF. However, the patient's condition did not improve; therefore, fistulectomy with primary closure was performed. After fistulectomy, the anastomosis site healing was delayed due to severe inflammation, a second esophageal stent and gastrostomy tube were inserted. Nine months after the diagnosis, the fistula disappeared without recurrence, and the esophageal stent and gastrostomy tube were removed.

Pancreas-preserving limited duodenal resection: Minimizing morbidity without compromising oncological adequacy

  • Ajay Sharma;Anand Nagar;Peeyush Varshney;Maunil Tomar;Shashwat Sarin;Rajendra Prasad Choubey;V. K. Kapoor
    • 한국간담췌외과학회지
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    • 제26권2호
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    • pp.149-158
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    • 2022
  • Backgrounds/Aims: Pancreaticoduodenectomy is the most common procedure for the management of duodenal pathologies. However, it is associated with substantial morbidity and a low risk of mortality. Pancreas-preserving limited duodenal resection (PPLDR) can be performed under specific scenarios. We share our experience with PPLDR and its outcome. Methods: We retrospectively analyzed a prospectively maintained database of patients undergoing limited duodenal resection in the form of wedge (sleeve) resection or segmental resection of one or more duodenal segments from March 2016 to March 2021 at a tertiary care center in North India. Results: During the study period, 10 patients (including 9 males) underwent PPLDR. Five of these 10 patients showed primary duodenal or proximal jejunal pathology, while the remaining five had duodenal pathology involving an adjacent organ tumor. Four patients underwent wedge (sleeve) resection, while the remaining six underwent segmental duodenal resection of one or more duodenal segments. Mean hospital stay was 6 days (range, 3-11 days) without 30-day mortality. Morbidity occurred in 4 patients (Grade I-II, n = 3; Grade III, n = 1). All patients were alive and disease-free at the time of last follow-up. The mean follow-up duration was 23 months (range, 2-48 months). Conclusions: PPLDR is a safe and effective alternative for pancreaticoduodenectomy when selected carefully for specific tumor types and location.

만성적인 신체질환이 있는 노인 환자의 우울증 조기발견을 위한 병원기반 모델 (A General Hospital-Based Model for Early Detection of Depression in the Geriatric Patients with Chronic Medical Diseases)

  • 박선철;이화영;이동우;한상우;박상호;김여주;최재성;정성원;이소영;나경세;권영준
    • 생물정신의학
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    • 제20권2호
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    • pp.31-39
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    • 2013
  • The geriatric patients with chronic physical diseases are frequently associated with the continuous clusters of depression including nonpathological sadness, subsyndromal depression, minor depressive disorder, and major depressive disorder. Because of the complex and reciprocal relationships among depression, elderly, and chronic physical diseases, screening approaches with specific nosological methods should be needed in the realm of early detection of depression. Cognitive decline is frequently manifested in geriatric depression with medical or neurological diseases. Also, somatic symptoms of depression or emotional symptoms of physical diseases can play a role as a hampering factor in the early detection of depression. Furthermore, after-care has been regarded as an essential factor of depression screening in the geriatric patients with chronic physical diseases. We reviewed the most popular examples of integrated medicine for depression in primary care. Thus, we propose a general hospital-based model for early detection of depression which includes favorable response loop between screening and therapeutic intervention. Our model can be a basis for evidence-based detection and after-care for depression in the geriatric patients with chronic medical diseases.