• Title/Summary/Keyword: Primary medical institute

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Cross Sectional Assessment of Health Related Quality of Life (HRQoL) among Patients with Cancer in Malaysia

  • Farooqui, Maryam;Hassali, Mohamed Azmi;Knight, Aishah;Shafie, Asrul Akmal;Farooqui, Muhammad Aslam;Saleem, Fahad;ul Haq, Noman;Othman, Che Noriah;Aljadhey, Hisham
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.3017-3021
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    • 2013
  • Background: Health Related Quality of Life (HRQoL) is an important aspect in identifying cancer patients' perceptions of being diagnosed with cancer and the assessment of treatment outcomes. The present study aimedto assess the profile and predicators of HRQoL of Malaysian oncology patients. Materials and Methods: A cross sectional study adopting the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was conducted. All cancer patients attending Penang General Hospital between August-November 2011 were approached. Descriptive statistics were used to assess demographic and disease related characteristics of the patients. All analyses were performed using SPSS v 16.0. Results: Three hundred and ninety three cancer patients met the inclusion criteria and were enrolled in the study. The mean age was 53.9 ($SD{\pm}13$) years. The cohort was dominated by females (n=260, 66.2%). Nearly half (n=190, 48.3%) of the participants were of Malay ethnicity, practicing Islam as their religion (n=194, 494%). Two hundred and ninety six (n=296, 75.3%) had beene diagnosed with cancer within six months to 3 years previously. The most common primary cancer site was breast (n=143, 36.4%). The mean Global Health Status (GHS) score was 60.7 (SD=21.3). Females (mean GHS score of 62.3, p=0.035) with Malay ethnicity (mean GHS score of 63.8, p=0.047), practicing Islam as their religion (mean GHS score of 63.0, p=0.011) had better GHS scores. Patients having medical insurance had good scores (mean 65.6, p-0.021). Marital status was significantly associated with GHS scores (p=0.022). Bone cancer patientshad the lowest mean GHS score of 49.2 (p=0.044). Patients at very advanced stages of cancer featured a low GHS mean score of 52.2 (p<0.001). Conclusions: The present study identified many demographic and disease related factors which may contribute to the HRQoL of cancer patients, pointing to the necessity for improved management of disease symptoms and provision of psychological and financial support.

KAAACI Evidence-Based Clinical Practice Guidelines for Chronic Cough in Adults and Children in Korea

  • Song, Dae Jin;Song, Woo-Jung;Kwon, Jae-Woo;Kim, Gun-Woo;Kim, Mi-Ae;Kim, Mi-Yeong;Kim, Min-Hye;Kim, Sang-Ha;Kim, Sang-Heon;Kim, Sang Hyuck;Kim, Sun-Tae;Kim, Sae-Hoon;Kim, Ja Kyoung;Kim, Joo-Hee;Kim, Hyun Jung;Kim, Hyo-Bin;Park, Kyung-Hee;Yoon, Jae Kyun;Lee, Byung-Jae;Lee, Seung-Eun;Lee, Young Mok;Lee, Yong Ju;Lim, Kyung-Hwan;Jeon, You Hoon;Jo, Eun-Jung;Jee, Young-Koo;Jin, Hyun Jung;Choi, Sun Hee;Hur, Gyu Young;Cho, Sang-Heon;Kim, Sang-Hoon;Lim, Dae Hyun
    • Allergy, Asthma & Immunology Research
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    • v.10 no.6
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    • pp.591-613
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    • 2018
  • Chronic cough is common in the community and causes significant morbidity. Several factors may underlie this problem, but comorbid conditions located at sensory nerve endings that regulate the cough reflex, including rhinitis, rhinosinusitis, asthma, eosinophilic bronchitis, and gastroesophageal reflux disease, are considered important. However, chronic cough is frequently non-specific and accompanied by not easily identifiable causes during the initial evaluation. Therefore, there are unmet needs for developing empirical treatment and practical diagnostic approaches that can be applied in primary clinics. Meanwhile, in referral clinics, a considerable proportion of adult patients with chronic cough are unexplained or refractory to conventional treatment. The present clinical practice guidelines aim to address major clinical questions regarding empirical treatment, practical diagnostic tools for non-specific chronic cough, and available therapeutic options for chronic wet cough in children and unexplained chronic cough in adults in Korea.

Does epidural analgesia delay the vaginal delivery of nulliparous women compared with non-epidural analgesia?: Retrospective observational study (경막외 진통은 비경막외 진통에 비해 초산부의 분만을 지연시키는가?: 후향성 관찰 연구)

  • Jang, So Young;Lee, Ae Ryoung;Yun, So-hui;Choi, Yun Suk;Park, Jong Cook;Cho, Woo Jin
    • Journal of Medicine and Life Science
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    • v.15 no.2
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    • pp.95-100
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    • 2018
  • We conduct this study to compare the difference in duration of labor in nulliparous women received epidural analgesia or non-epidural analgesia for labor pain. This retrospective, observational study based on the review of the medical records from February 2014 to July 2017. Epidural analgesia was initiated with a 10 mL epidural bolus of 1% lidocaine and was maintained with a 0.1% mixture of ropivacaine with fentanyl. Non-epidural analgesia was initiated with pethidine 12.5 mg bolus, followed by additional boluses as needed. The primary outcome was the duration of the labor. 149 healthy nulliparous women at term pregnancies with no evidence of fetal distress were enrolled in this study. 92 women received non-epidural analgesia (Group NE) and 57 women received epidural analgesia (Group E). There were no significant differences between the two groups in maternal demographic characteristics. Using a Kaplan-Meier survival analysis, there was no significant difference in the overall duration of the labor(P=0.233). The duration of the first stage of labor was $187.6{\pm}167.3min$ in Group NE, $248.6{\pm}168.7min$ in Group E (Mean${\pm}$SD, P=0.032). The duration of the second stage of labor was $67.1{\pm}57.8min$ in Group NE, $64.1{\pm}47.5min$ in Group E (Mean${\pm}$SD, P=0.693). Epidural analgesia delayed the first stage of labor in this study. But there were no significant differences between the two groups in the duration of the second stage and the total duration of labor.

Development of the Korean Developmental Screening Test for Infants and Children (K-DST)

  • Chung, Hee Jung;Yang, Donghwa;Kim, Gun-Ha;Kim, Sung Koo;Kim, Seoung Woo;Kim, Young Key;Kim, Young Ah;Kim, Joon Sik;Kim, Jin Kyung;Kim, Cheongtag;Sung, In-Kyung;Shin, Son Moon;Oh, Kyung Ja;Yoo, Hee-Jeong;Yu, Hee Joon;Lim, Seoung-Joon;Lee, Jeehun;Jeong, Hae-Ik;Choi, Jieun;Kwon, Jeong-Yi;Eun, Baik-Lin
    • Clinical and Experimental Pediatrics
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    • v.63 no.11
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    • pp.438-446
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    • 2020
  • Background: Most developmental screening tools in Korea are adopted from foreign tests. To ensure efficient screening of infants and children in Korea, a nationwide screening tool with high reliability and validity is needed. Purpose: This study aimed to independently develop, standardize, and validate the Korean Developmental Screening Test for Infants and Children (K-DST) for screening infants and children for neurodevelopmental disorders in Korea. Methods: The standardization and validation conducted in 2012-2014 of 3,284 subjects (4-71 months of age) resulted in the first edition of the K-DST. The restandardization and revalidation performed in 2015-2016 of 3.06 million attendees of the National Health Screening Program for Infants and Children resulted in the revised K-DST. We analyzed inter-item consistency and test-retest reliability for the reliability analysis. Regarding the validation of K-DST, we examined the construct validity, sensitivity and specificity, receiver operating characteristic curve analysis, and a criterion-related validity analysis. Results: We ultimately selected 8 questions in 6 developmental domains. For most age groups and each domain, internal consistency was 0.73-0.93 and test-retest reliability was 0.77-0.88. The revised K-DST had high discriminatory ability with a sensitivity of 0.833 and specificity of 0.979. The test supported construct validity by distinguishing between normal and neurodevelopmentally delayed groups. The language and cognition domain of the revised K-DST was highly correlated with the K-Bayley Scales of Infant Development-II's Mental Age Quotient (r=0.766, 0.739), while the gross and fine motor domains were highly correlated with Motor Age Quotient (r=0.695, 0.668), respectively. The Verbal Intelligence Quotient of Korean Wechsler Preschool and Primary Scales of Intelligence was highly correlated with the K-DST cognition and language domains (r=0.701, 0.770), as was the performance intelligence quotient with the fine motor domain (r=0.700). Conclusion: The K-DST is reliable and valid, suggesting its good potential as an effective screening tool for infants and children with neurodevelopmental disorders in Korea.

Implementation of Patient Experience Assessment and Subsequent Changes at the Ground Level in Health Care: Patient Experience Employees' Perspective (환자경험 평가와 의료 현장의 변화: 의료기관 환자경험 업무 담당자의 관점)

  • Song, Yeong-Chae;Yoon, Eun-Sil;Han, Se-Young;Tae, Ji-Yeon;You, Soo-Kyeong;Do, Young-Kyung
    • Quality Improvement in Health Care
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    • v.28 no.1
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    • pp.14-33
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    • 2022
  • Purpose: To examine whether the Patient Experience Assessment (PEA) has led to perceptible changes at the ground level of health care, as a way of evaluating PEA as a policy intervention for quality improvement. Methods: Four focus group discussions (FGDs) were conducted, each comprising six to eight participants who were employees responsible for patient experience at their respective hospitals. The primary focus of the FGDs was on questions such as: 1) How do hospitals respond to PEA? 2) What significant changes were observed after the implementation of PEA? 3) What were the unintended consequences of implementing PEA, if any? 4) What areas of improvement have been identified for maximizing the potential of PEA? Results: Two broad themes emerged out of the FGDs: changes observed post implementation of PEA, and areas for improvement of PEA. Four significant changes were reported by participants: changes in perception and attitude regarding patient experience in hospital employees, increased active involvement by the hospital leadership, enhanced efforts to improve patient experience, and increased cooperation between such activities. Furthermore, eight areas of improvement were identified, which have been grouped in three categories: improving the process of data collection for PEA, introducing additional catalysts to facilitate further changes, and paying attention to structure- and patient-level constraints that must be addressed in parallel. Conclusion: The implementation of PEA led to perceptible changes within hospitals, which implies that it can serve as an effective catalyst for improving patient experience. A number of areas of improvement that would aid in maximizing the potential of PEA were also identified.

Silk fibroin/hyaluronic acid blend sponge accelerates the wound healing in full-thickness skin injury model of rat (전층피부창상에서 실크피브로인과 하이알론산 혼합 스폰지의 창상치유효과)

  • Kang, Seuk-Yun;Roh, Dae-Hyun;Kim, Hyun-Woo;Yoon, Seo-Yeon;Kwon, Young-Bae;Kweon, HaeYong;Lee, Kwang-Gill;Park, Young-Hwan;Lee, Jang-Hern
    • Korean Journal of Veterinary Research
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    • v.46 no.4
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    • pp.305-313
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    • 2006
  • The primary goal of the wound healing is rapid wound closure. Recent advances in cellular and molecular biology have greatly expanded our understanding of the biologic processes involved in wound repair and tissue regeneration. This study was conducted to develop a new sponge type of biomaterial to be used for either wound dressing or scaffold for tissue engineering. We designed to make a comparative study of the wound healing effect of silk fibroin/hyaluronic acid (SF/HA) blend sponge in full-thickness dermal injury model of rat. Two full-thickness excisions were made on the back of the experimental animals. The excised wound was covered with either the silk fibroin (SF), hyaluronic acid (HA) or SF/HA (7 : 3 or 5 : 5 ratio) blend sponge. On the postoperative days of 3, 7, 10 and 14, the wound area was calculated by image analysis software. Simultaneously, the tissues were stained with Hematoxylin-Eosin and Masson's trichrome methods to measure the area of regenerated epithelium and collagen deposition. In addition, we evaluated the degree of the epithelial cell proliferation using immunohistochemistry for proliferating cell nuclear antigen (PCNA). We found that the half healing time ($HT_{50}$) of SF/HA blend sponge treated groups were significantly decreased as compared with either those of SF or HA treatment group. Furthermore, SF/HA blend sponges significantly increased the size of epithelialization and collagen deposition as well as the number of PCNA positive cells on epidermal basement membrane as compared with those of control treatment. Especially, the 5 : 5 ratio group of SF/HA among all treatment groups was most effective on wound healing rate and histological studies. These results suggest that SF/HA blend sponges could accelerate the wound healing process through the increase of epithelialization, collagen deposition and basal cell proliferation in full thickness skin injury.

Repurposing Auranofin, an Anti-Rheumatic Gold Compound, to Treat Acne Vulgaris by Targeting the NLRP3 Inflammasome

  • Yang, Gabsik;Lee, Seon Joo;Kang, Han Chang;Cho, Yong-Yeon;Lee, Hye Suk;Zouboulis, Christos C.;Han, Sin-Hee;Ma, Kyung-Ho;Jang, Jae-Ki;Lee, Joo Young
    • Biomolecules & Therapeutics
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    • v.28 no.5
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    • pp.437-442
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    • 2020
  • Activation of the NLRP3 inflammasome is critical for host defense as well as the progression of inflammatory diseases through the production of the proinflammatory cytokine IL-1β, which is cleaved by active caspase-1. It has been reported that overactivation of the NLRP3 inflammasome contributes to the development and pathology of acne vulgaris. Therefore, inhibiting activation of the NLRP3 inflammasome may provide a new therapeutic strategy for acne vulgaris. In this study, we investigated whether auranofin, an anti-rheumatoid arthritis agent, inhibited NLRP3 inflammasome activation, thereby effectively treating acne vulgaris. Auranofin suppressed NLRP3 inflammasome activation induced by Propionibacterium acnes, reducing the production of IL-1β in primary mouse macrophages and human sebocytes. In a P. acnes-induced acne mouse model, injection of P. acnes into the ears of mice induced acne symptoms such as redness, swelling, and neutrophil infiltration. Topical application of auranofin (0.5 or 1%) to mouse ears significantly reduced the inflammatory symptoms of acne vulgaris induced by P. acnes injection. Topical application of auranofin led to the downregulation of the NLRP3 inflammasome activated by P. acnes in mouse ear skin. These results show that auranofin inhibits the NLRP3 inflammasome, the activation of which is associated with acne symptoms. The results further suggest that topical application of auranofin could be a new therapeutic strategy for treating acne vulgaris by targeting the NLRP3 inflammasome.

A Case Series of Polycystic Ovary Syndrome with Improved Hyperandrogenism Treated with Korean Medicine (한방 치료로 고안드로겐혈증을 개선한 다낭성 난소 증후군 연속증례연구)

  • Shin, Haegue;Bae, Ji-Yong;Ji, Young-Geun;Ahn, Hae In;Yoon, Youngheum;Kim, Namkwen
    • The Journal of Korean Obstetrics and Gynecology
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    • v.34 no.3
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    • pp.175-191
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    • 2021
  • Objectives: This study aims to analyze the medical record of eight cases of polycystic ovary syndrome (PCOS) in a local Korean medicine clinic, in order to provide evidence on Korean medicine treatment of PCOS and to suggest the direction of future studies. Methods: The medical records of eight cases diagnosed with PCOS based on 2003 Rotterdam Criteria and whose total testosterone level was 0.53 ng/ml and over were retrospectively analyzed. The primary outcome was total testosterone level, and the secondary outcomes included luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels, LH/FSH ratio, weight, last mentrual period (LMP), numerical rating scale (NRS) score of dysmenorrhea, and other associated symptoms pre- and post-treatment. Korean medicine treatment consists of the complex herbal prescription consisting of Yukmijihwang-tang, Baekho-tang, Daesiho-tang, and Gyejibokryeong-hwan, modified according to symptoms; acupuncture and electroacupuncture on 中脘 (CV12), 下脘 (CV10), 關元 (CV4), 石門 (CV5), 合谷 (LI4), 太衝 (LR3), 三陰交 (SP6), and 懸鍾 (GB39); and indirect moxibustion on 神闕 (CV8). Results: The average total testosterone level lowered statistically significantly after the treatment. The average FSH and LH levels lowered with insignificance, while the average LH/FSH ratio and weight lowered statistically significantly. During the treatment period of three to six months, every patient had the menstrual cycle shortened except for one case; and two cases with infertility problem succeeded in being pregnant. There was no adverse event. Conclusions: The Korean medicine treatment was found effective in treating PCOS, especially regarding hyperandrogenism, amenorrhea or oligomenorrhea, and infertility.

Ultrasound-Guided Percutaneous Biopsy With Needle Track Plugging in Patients With Focal Liver Lesions on an Outpatient Basis: A Randomized Controlled Trial

  • Ja Kyung Yoon;Choong-kun Lee;Hongjeong Yoon;Hye Jin Choi;Seung-seob Kim
    • Korean Journal of Radiology
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    • v.25 no.10
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    • pp.902-912
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    • 2024
  • Objective: The increasing utilization of various molecular tests for diagnosing and selecting treatments for patients with malignancies has led to a rising trend in both the frequency of biopsies and the required tissue volume. We aimed to compare the safety of outpatient ultrasound (US)-guided percutaneous liver biopsy (PLB) between the coaxial method with needle track plugging (NTP) and the conventional method. Materials and Methods: This single-center, prospective, randomized controlled study was conducted from October 2022 to May 2023. Patients referred for US-guided PLB with target liver lesions measuring ≥1 cm and requiring ≥3 tissue cores were enrolled. Patients with severe coagulopathy or a substantial volume of ascites were excluded. Patients were randomly assigned to undergo PLB using either the coaxial method with NTP or the conventional method, in a 1:1 ratio, and were subsequently discharged after 2 hours. The primary endpoint was the presence of a patent track sign, defined as a linear color flow along the biopsy track on Doppler US, as an indication of bleeding. The secondary endpoints included clinically significant bleeding, delayed bleeding after discharge, and diagnostic yield. The incidences of these endpoints were compared between the two methods. Results: A total of 107 patients completed the study protocol. Patent track signs were observed significantly less frequently in the coaxial method with NTP group than in the conventional method group: 16.7% (9/54) vs. 35.8% (19/53; P = 0.042). Clinically significant bleeding and delayed bleeding did not occur in either group, and both methods achieved a high diagnostic yield: 94.4% (51/54) vs. 98.1% (52/53; P = 0.624). Conclusion: Compared with the conventional method, the coaxial method with NTP may potentially be safer, with a reduced risk of overall bleeding complications after PLB when retrieving ≥3 tissue cores. The coaxial method with NTP could be considered a viable option for acquiring multiple liver tissues on an outpatient basis.

The Health and Occupation Research Network: An Evolving Surveillance System

  • Carder, Melanie;Hussey, Louise;Money, Annemarie;Gittins, Matthew;McNamee, Roseanne;Stocks, Susan Jill;Sen, Dil;Agius, Raymond M.
    • Safety and Health at Work
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    • v.8 no.3
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    • pp.231-236
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    • 2017
  • Vital to the prevention of work-related ill-health (WRIH) is the availability of good quality data regarding WRIH burden and risks. Physician-based surveillance systems such as The Health and Occupation Research (THOR) network in the UK are often established in response to limitations of statutory, compensation-based systems for addressing certain epidemiological aspects of disease surveillance. However, to fulfil their purpose, THOR and others need to have methodologic rigor in capturing and ascertaining cases. This article describes how data collected by THOR and analogous systems can inform WRIH incidence, trends, and other determinants. An overview of the different strands of THOR research is provided, including methodologic advancements facilitated by increased data quantity/quality over time and the value of the research outputs for informing Government and other policy makers. In doing so, the utility of data collected by systems such as THOR to address a wide range of research questions, both in relation to WRIH and to wider issues of public and social health, is demonstrated.