• Title/Summary/Keyword: Regional medical centers

Search Result 123, Processing Time 0.024 seconds

Factors Contributing to Mortality for Patients at a Newly-designated Regional Trauma Center (중증 외상 특성화 센터에서 사망률에 영향을 미치는 인자 분석)

  • Chang, Ikwan;Kim, Hoon;Shin, Hee Jun;Joen, Woo Chan;Park, Joon Min;Shin, Dong Wun;Park, Jun Seok;Kim, Kyung Hwan;Park, Je Hoon;Choi, Seung Woon
    • Journal of Trauma and Injury
    • /
    • v.25 no.4
    • /
    • pp.188-195
    • /
    • 2012
  • Purpose: An increase in the demand for specialized Trauma Centers led to a government-driven campaign, that began in 2009. Our hospital was selected as one of the Trauma Centers, and we reviewed data on trauma patients in order to correlate the mortality at a regional Trauma Center with its contributing factors, such as the severity of the injury, the means of arrival, and the time duration before arrival at our center. Methods: Data on the patients who visited our Trauma Center from January 2010 to November 2011 were retrospectively reviewed using electronic medical records. The patients who had revised trauma scores (RTSs) less than 7 or injury severity scores (ISSs) greater than 15 were included. The patients were categorized as survivors and non-survivors, and the means of arrival as transferred or visited directly. Time durations before arrival of less than one hour were also taken intoconsideration. Results: Two hundred(200) patients were enrolled, and the mortality rate was 36.5%. The most common cause of the accident was an automobile accident, and the most common cause of death was brain injury. The RTSs and the ISSs were significantly different in the non-survivor and the survivor groups. The mortality rate of the patients who were transferred was not statistically different from that of patients who visited directly. However, a time duration before arrival of less than one hour was statistically meaningful. Conclusion: The prognosis of the trauma patients were correlated with the severity of the trauma as can be expected, but the time between the incidence of accident and the arrival at hospital and whether the presence of transfer to trauma center were not statistically significant to the prognosis.

Kimura's Disease of the Distal Arm - A Case Report - (상완 원위부에 발생한 기무라씨 병 - 증례 보고 -)

  • Yoon, Jong-Pil;Jo, Ki-Hyun;Min, Hak-Jin;Yoon, Ui-Seoung;Seo, Jae-Seong;Kim, Jin-Soo;Baak, Cheol-Hee
    • Clinics in Shoulder and Elbow
    • /
    • v.11 no.2
    • /
    • pp.196-200
    • /
    • 2008
  • Kimura's Disease is a very rare, chronic inflammatory disorder with an unknown etiology, and this illness is primarily seen in young Asian males. The typical clinical features consist of painless subcutaneous masses in the head or neck region, and especially in the salivary gland and submandibular region. It is often accompanied with a regional lymphadenopathy, peripheral blood eosinophilia and elevated serum IgE levels. Histologically, it is characterized by prominent germinal centers in the involved lymph nodes, together with eosinophilic infiltration in these lymph nodes. The treatment modalities for this disease are steroid therapy, radiation therapy and surgical excision. Its clinical course is of a benign nature. We report here on a case of a 28 year old man who had a soft tissue mass in his left arm. We excised this mass and the microscopy confirmed that he suffered from Kimura's disease on microscopic examination in his left distal arm.

Associated Injuries in Spine Trauma Patients: A Single-Center Experience

  • Yu, Seunghan;Choi, Hyuk Jin;Lee, Jung Hwan;Kim, Byung Chul;Ha, Mahnjeong;Han, In Ho
    • Journal of Trauma and Injury
    • /
    • v.33 no.4
    • /
    • pp.242-247
    • /
    • 2020
  • Purpose: The purpose of this study was to determine the incidence and characteristics of associated injuries in patients with spine trauma. Methods: Data of 3,920 consecutive patients admitted to a regional trauma center during a 3-year period were analyzed retrospectively. Results: Of the 3,920 patients who were admitted to the trauma center during the 3-year study period, 389 (9.9%) had major spinal injuries. Among these 389 patients, 303 (77.9%) had associated injuries outside the spine. The most common body region of associated injuries was the extremities or pelvis (194 cases, 49.4%), followed by the chest (154 cases, 39.6%) and face (127 cases, 32.6%). Of these 303 patients, 149 (64%) had associated injuries that required surgical treatment such as laparotomy or internal fixation. Associated injuries were more common in patients with lumbar injuries (93.3%) or multiple spinal injuries (100%) than in those with lower cervical injuries (67.4%). There was a significant correlation between the location of the spinal injury and the body region of the associated injury. However, distant associated injuries were also common. Conclusions: Associated injuries were very common in spinal injury patients. Based on demographic groups, the trauma mechanism, and the location of spinal injury, an associated injury should be suspected until proven otherwise. Using a multidisciplinary and integrated approach to treat trauma victims is of the paramount importance.

The characteristics and clinical outcomes of trauma patients transferred by a physician-staffed helicopter emergency medical service in Korea: a retrospective study

  • Myung Jin Jang;Woo Sung Choi;Jung Nam Lee;Won Bin Park
    • Journal of Trauma and Injury
    • /
    • v.37 no.2
    • /
    • pp.106-113
    • /
    • 2024
  • Purpose: Helicopter transport with medical teams has been proven to be effective, with improvements in patient survival rates. This study compared and analyzed the clinical characteristics and treatment outcomes of trauma patients transported by doctor helicopters according to whether patients were transferred after a clinical evaluation or without a clinical evaluation. Methods: This study retrospectively reviewed data from the Korean Trauma Data Bank of trauma patients who arrived at a regional trauma center through doctor helicopters from January 1, 2014, to December 31, 2022. The patients were divided into two groups: doctor helicopter transport before evaluation (DHTBE) and doctor helicopter transport after evaluation (DHTAE). These groups were compared. Results: The study population included 351 cases. At the time of arrival at the trauma center, the systolic blood pressure was significantly lower in the DHTAE group than in the DHTBE group (P=0.018). The Injury Severity Score was significantly higher in the DHTAE group (P<0.001), and the accident to trauma center arrival time was significantly shorter in the DHTBE group (P<0.001). Mortality did not show a statistically significant between-group difference (P=0.094). Surgical cases in the DHTAE group had a longer time from the accident scene to trauma center arrival (P=0.002). The time from the accident to the operation room or from the accident to angioembolization showed no statistically significant differences. Conclusions: DHTAE was associated with significantly longer transport times to the trauma center, as well as nonstatistically significant trends for delays in receiving surgery and procedures, as well as higher mortality. If severe trauma is suspected, air transport to a trauma center should be requested immediately after a simple screening test (e.g., mechanism of injury, Glasgow Coma Scale, or Focused Assessment with Sonography in Trauma), which may help reduce the time to definitive treatment.

Analysis of Village Safety Index using Accessibility to Public Facilities (공공시설 접근성을 통한 마을단위 안전지수 분석)

  • Jeon, Jeongbae;Kim, Solhee;Suh, Kyo;Yoon, Seongsoo
    • Journal of Korean Society of Rural Planning
    • /
    • v.22 no.2
    • /
    • pp.121-129
    • /
    • 2016
  • A disaster can be defined in many ways based on perspectives, in addition, its types are able to classify differently by various standards. Considering the different perspectives, the disaster can be occurred by natural phenomenon that is like typhoon, earthquake, flood, and drought, and by the accident that is like collapse of facilities, traffic accidents, and environmental pollution, etc. Into the modern society, moreover, the disaster includes the damages by diffusion of epidemic and infectious disease in domestic animals. The disaster was defined by natural and man-made hazards in the past. As societies grew with changes of paradigm, social factors have been included in the concept of the disaster according to new types unexpected by new disease and scientific technology. Change the concept of social disasters, Ministry of Public Safety and Security (MPSS) has provided the regional safety index, which measures the safety level of a local government. However, this regional safety index has some limitation to use because this index provides the information for city unit which is a unit of administrative districts of urban. Since these administrative districts units are on a different level with urban and rural areas, the regional safety index provided by MPSS is not be able to direct apply to the rural areas. The purpose of this study is to determine the regional safety index targeting rural areas. To estimate the safety index, we was used for 3 indicators of the MPSS, a fire, a crime, and an infectious disease which are evaluable the regional safety index using an accessibility analysis. For determining the regional safety index using accessibility from community centers to public facilities, the safety index of fire, crime, and infectious disease used access time to fire station, police office, and medical facility, respectively. An integrated Cheongju, targeting areas in this study, is mixed region with urban and rural areas. The results of regional safety index about urban and rural areas, the safety index in rural area is relatively higher than in the urban. Neverthless the investment would be needed to improve the safety in the rural areas.

Interregional Variant Factor Analysis of Hypertension Treatment Rate in COVID-19 (코로나19에서 고혈압 치료율의 지역 간 변이요인 분석)

  • Park, Jong-Ho;Kim, Ji-Hye
    • Journal of Digital Convergence
    • /
    • v.20 no.4
    • /
    • pp.469-482
    • /
    • 2022
  • The purpose of this study is to analyze regional variation factors of hypertension treatment rate in COVID-19 based on the analysis results based on ecological methodology. To this end, data suitable for ecological analysis were collected from the Korea Centers for Disease Control and Prevention's regional health statistics, local government COVID-19 confirmed cases, National Health Insurance Corporation, Health Insurance Review and Assessment Service's welfare statistics, and Korea Transport Institute's traffic access index. Descriptive statistics and correlation analysis were conducted using SPSS Statistics 23 for regional variation and related factors in hypertension treatment rate, and geographical weighted regression analysis was conducted using Arc GIS for regional variation factors. As a result of the study, the overall explanatory power of the calculated geo-weighted regression model was 27.6%, distributed from 23.1% to 33.4% by region. As factors affecting the treatment rate of hypertension, the higher the rate of basic living security medical benefits, diabetes treatment rate, and health institutions per 100,000 population, the higher the rate of hypertension treatment, the lower the number of COVID-19 confirmed patients, the lower the rate of physical activity, and the alcohol consumption. Percentage of alcohol consumption decreased due to COVID-19 pandemic. It was analyzed that the lower the ratio, the higher the treatment rate for hypertension. Based on these results, the analysis of regional variables in the treatment rate of hypertension in COVID-19 can be expected to be effective in managing the treatment rate of hypertension, and furthermore, it is expected to be used to establish community-centered health promotion policies.

Nutrient Intake of the Rural Elderly Living in Kyungnam -Focusing on Health and Aging Status, and Life-Satisfaction- (경남 일부지역 농촌노인의 영양섭취조사 -건강과 노화상태 및 생활만족도를 중심으로 -)

  • 이경혜;박미영
    • Korean Journal of Community Nutrition
    • /
    • v.6 no.5
    • /
    • pp.773-788
    • /
    • 2001
  • The purpose of this study was to investigate the difference in nutrient intake according to the level of self-perception of health status, aging status and life satisfaction of the rural elderly. The factors for the study were surveyed by interview method. The subjects were 270 people(71 male, 129 female) aged over 65 years(73.5 $\pm$ 5.6ys) in the Ham-an area. The obtained results as follows : By evaluation of self-perception of health status, 57.5% of subjects answered they are in a bad health condition. The 91.5% of subjects had diseases(rheumatitis & arthritis 31.4%, cardiovascular disease 20.2%, gastric disease 10.2%). The women had more diseases than the men(p < 0.01). The subjects took medical treatment in private hospital(40.5%) and public health centers(35.0%). The men showed better level of aging status(p < 0.001) and life satisfaction index(p < 0.01) than the worsen. Living with spouse influenced the aging status(p < 0.05) and the more pocket money influenced life satisfaction(p < 0.05) and aging status(p < 0.05). The elderly who eat regularly 3 times a day(p < 0.05) and have a good appetite(p < 0.001) appeared to have positive effect on the self perception of health status and aging status. An increasing level of the self-perception of health status and regular exercise worked to improve aging status(p < 0.001). The habits of smoking and alcohol drinking, however had no effect on any index. The self-perception of health status affected the nutrient intake, but only in female elderly. The aging status and the life satisfaction index related overall positively to the intake of nutrients. In conclusion, the study shows that gender did influence nutrient intake in the elderly. The women who live alone rated lowest in social resources and health condition therefore their nutrient intake was also extremely in deficit. For successful aging, a program for rural elderly is needed, i.e. actions to provide minimum economic life, food delivery and psychological/physical health care through regional public health centers.

  • PDF

Global Health Project for Maternal Child Health in a Developing Country: Case Study in Tigray, Ethiopia (저개발국 모자보건 수준 향상을 위한 국제보건사업 전략 : 에티오피아 티그라이주 사례를 중심으로)

  • Bang, Kyung-Sook;Lee, Insook;Park, Young-Sook;Chae, Sun-Mi;Kang, Hyunju;Yu, Juyoun;Park, Ji-Sun;Oh, Sang-Jun
    • Perspectives in Nursing Science
    • /
    • v.11 no.1
    • /
    • pp.1-9
    • /
    • 2014
  • Purpose: The purpose of this study was to demonstrate a two-year global health project to improve maternal and child health (MCH) in Ethiopia. Methods: This is a descriptive case study. The target area is Kilte Awlaelo Woreda in Tigray Regional State, Ethiopia. A baseline survey was conducted to identify the needs of community residents and health care professionals. A MCH program was developed according to a project design matrix that included: infrastructure renovation of health centers; continuing education for midwives, nurses, and health extension workers (HEWs); and improvement of residents' MCH awareness. Project evaluation will examine the structure, process, and outcomes of the program. Results: The baseline survey showed low rates of family planning (31%) and antenatal and postnatal care use (36.1% and 69%, respectively). The institutional birth rate was 13.5%. Midwives and nurses received 2~4 educational programs about family planning and perinatal care. HEWs were also given practical education. Water and electrical infrastructure of all five health centers in the Kilte Awlaelo Woreda were renovated. Additionally, medical supplies and equipment were provided. Community health education on perinatal care, family planning, and personal hygiene was presented. Conclusion: This study highlights the role of nursing in global health and provides basic information on the development and outcomes of the global health project.

  • PDF

Clinical implications of the newly defined concept of ventilator-associated events in trauma patients

  • Lee, Tae Yeon;Oh, Jeong Woo;Lee, Min Koo;Kim, Joong Suck;Sohn, Jeong Eun;Wi, Jeong Hwan
    • Journal of Trauma and Injury
    • /
    • v.35 no.2
    • /
    • pp.76-83
    • /
    • 2022
  • Purpose: Ventilator-associated pneumonia is the most common nosocomial infection in patients with mechanical ventilation. In 2013, the new concept of ventilator-associated events (VAEs) replaced the traditional concept of ventilator-associated pneumonia. We analyzed risk factors for VAE occurrence and in-hospital mortality in trauma patients who received mechanical ventilatory support. Methods: In this retrospective review, the study population comprised patients admitted to the Jeju Regional Trauma Center from January 2020 to January 2021. Data on demographics, injury characteristics, and clinical findings were collected from medical records. The subjects were categorized into VAE and no-VAE groups according to the Centers for Disease Control and Prevention/National Healthcare Safety Network VAE criteria. We identified risk factors for VAE occurrence and in-hospital mortality. Results: Among 491 trauma patients admitted to the trauma center, 73 patients who received ventilator care were analyzed. Patients with a chest Abbreviated Injury Scale (AIS) score ≥3 had a 4.7-fold higher VAE rate (odds ratio [OR], 4.73; 95% confidence interval [CI], 1.46-17.9), and those with a glomerular filtration rate (GFR) <75 mL/min/1.73 m2 had 4.1-fold higher odds of VAE occurrence (OR, 4.15; 95% CI, 1.32-14.1) and a nearly 4.2-fold higher risk for in-hospital mortality (OR, 4.19; 95% CI, 1.30-14.3). The median VAE-free duration of patients with chest AIS ≥3 was significantly shorter than that of patients with chest AIS <3 (P=0.013). Conclusions: Trauma patients with chest AIS ≥3 or GFR <75 mL/min/1.73 m2 on admission should be intensively monitored to detect at-risk patients for VAEs and modify the care plan accordingly. VAEs should be closely monitored to identify infections early and to achieve desirable results. We should also actively consider modalities to shorten mechanical ventilation in patients with chest AIS ≥3 to reduce VAE occurrence.

Distribution of High Risk Human Papillomavirus Types in Western Kazakhstan - Retrospective Analysis of PCR Data

  • Bekmukhambetov, YZ;Balmagambetova, SK;Jarkenov, TA;Nurtayeva, SM;Mukashev, TZ;Koyshybaev, AK
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.17 no.5
    • /
    • pp.2667-2672
    • /
    • 2016
  • Background: Virtually all cases of cervical cancer are caused by persistent infections with a restricted set of human papillomaviruses (HPV). Cancer of the cervix is the third or even the second most common cancer in women worldwide, more than 85% of the cases occurring in developing countries, such as China and India, including the Republic of Kazakhstan. The purpose was to determine the HPV type distribution to evaluate efficacy of vaccination and adjust cancer prevention strategy in Western Kazakhstan in the future. Materials and Methods: A retrospective analysis was conducted of data obtained from PCR laboratories in 4 regional centers for the time period covering 12 months, 2013-2014, using AmpliSens$^{(R)}$ Real-Time PCR kits for HPV testing of 12 genotypes (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59). Results: A total of 1,661 persons were HPV tested within 2013-14, but a proprotion examined for 16 and 18 genotypes only (563) was not been included for statistic analysis of distribution and ratio of the most common genotypes. Males accounted for only a small number (N=90 in total). Conclusions: Total number of the HPV-positive appeared to be 26.0%, or 286 of N=1098. Types distribution was as follows: type 16 (10.7%), 39 (5.83%), 51 (5.27%), 31 (4.85%), 56 (4.58%), 18 (3.61%), 59 (2.64%), 58 (2.22%), 35 (1.94%), 33 (1.25%). Overall the HPV infection was highest in 16-29 years old (62.4%) and decreased with age. Total prevalence of the HR-HPVs amongst male population was 21.4% with top five types 16, 18, 39, 51, 31. Trends forcorrelations between Aktau site and type 33 (Cramer's V 0.2029), between Caucasian ethnicity and type 33 (Cramer's V .1716), and between European ethnicities in Uralsk and type 45 (Cramer's V .1752) were found. Of N 563 tested separately for 16 or 18 types, 13.6% were positive. As a whole, the distribution of 16/18 types had a ratio of 3.53:1. Given the vaccine-targeted type 16 is widely spread amongst this regional population, HPV immunization program of adolescent girls 10-13 years should be implemented appropriately.