• 제목/요약/키워드: Risk Presentation

검색결과 223건 처리시간 0.027초

방문간호를 통한 일상생활동작 수행능력 개선에 대한 사례보고: 오마하시스템을 활용하여 (Improvement of Activities of Daily Living through Visiting Nursing Care under Long-Term Care Insurance: A Case Report using the OMAHA System)

  • 송연이;박은진
    • 한국농촌간호학회지
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    • 제15권2호
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    • pp.66-73
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    • 2020
  • Purpose: This study was done to report nursing case for ADL improvement of elders who have CVA(Cerebrovascular Accident) sequelae. Methods: The client had registered in the C visiting nursing center after being decided a long-term care Grade 2. Data were collected through consultation logs for recipients, Activities of Daily Living (ADL) records, fall risk assessment (Huhn) sheets, decubitus ulcer risk assessment (Braden Scale) sheets, cognition assessment (K-MMSE) sheets, long-term care benefit provision records, and interviews with visiting nurse. Data were collected and analyzed according to the Omaha System problem classification. The intervention scheme and the problem rating scale for performance were applied to present the case for home-visit nursing. Results: The client registered in August, 2018, was provided home-visit nursing care once a week as of September 2020. ADL, cognitive levels and decubitus ulcer risks were found to have improved. Conclusion: This case report presents the value of classifying nursing problems and checking nursing intervention provided to patients with problems of ADL. The presentation of home-visit nursing cases applying a standardized nursing problem classification scheme for clients with various problems showed that a high quality level of care is guaranteed and evidence-based nursing can be provided by visiting nurses.

Cemento-osseous dysplasia: clinical presentation and symptoms

  • Nam, Inhye;Ryu, Jihye;Shin, Sang-Hun;Kim, Yong-Deok;Lee, Jae-Yeol
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제48권2호
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    • pp.79-84
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    • 2022
  • Objectives: The purpose of this study was to evaluate risk factors and symptoms in cemento-osseous dysplasia (COD) patients. Materials and Methods: In this study, 62 patients who were diagnosed histologically with COD were investigated from 2010 to 2020 at the author's institution. We compared clinical and radiological characteristics of symptomatic and asymptomatic patients. The factors were sex, age, lesion size, site, radiologic stage of lesion, apical involvement, sign of infection, and history of tooth extraction. Statistical analysis was performed using Fisher's exact test and the chi-square test. Results: COD was more prevalent in female patients. With the exception of three cases, all were focal COD. The majority of patients presented with symptoms when the lesion was smaller than 1.5 cm in size. Symptoms were observed when the apex of the tooth was included in the lesion or there was a local infection around the lesion. The history of tooth extraction and previous endodontic treatment were evaluated, and history was not a significant predictor for the onset of symptoms. Conclusion: In this study, risk factors associated with symptomatic patients were size of lesion, apical involvement, and local infection.

Heart Failure With Preserved Ejection Fraction and Frailty: From Young to Superaged Coexisting HFpEF and Frailty

  • Amina Rakisheva;Anzhela Soloveva;Anastasia Shchendrygina;Ilya Giverts
    • International Journal of Heart Failure
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    • 제6권3호
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    • pp.93-106
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    • 2024
  • Being commonly diagnosed in elderly women and associated with comorbidities as well as ageing-related cardio-vascular changes, heart failure with preserved ejection fraction (HFpEF) has been recently considered as a distinct cardiogeriatric syndrome. Frailty is another frequent geriatric syndrome. HFpEF and frailty share common underlying mechanisms, often co-exist, and represent each other's risk factors. A threshold of 65 years old is usually used to screen patients for both frailty and HFpEF in research and clinical settings. However, both HFpEF and frailty are very heterogenous conditions that may develop at younger ages. In this review we aim to provide a broader overview on the coexistence of HFpEF and frailty throughout the lifetime. We hypothesize that HFpEF and frailty patients' profiles (young, elderly, superaged) represent a continuum of the common ageing process modified by cumulative exposure to risk factors resulting to a presentation of HFpEF and frailty at different ages. We believe, that suggested approach might stimulate assessment of frailty in HFpEF assessment and vice versa regardless of age and early implementation of targeted interventions. Future studies of pathophysiology, clinical features, and outcomes of frailty in HFpEF by age are needed.

Pneumonia Severity Index에 따른 원외획득폐렴 환자의 치료 현황 및 성과 (Current Treatment and Clinical Outcomes of Community Acquired Pneumonia According to Pneumonia Severity Index)

  • 박현희;지은희;이영숙
    • 한국임상약학회지
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    • 제21권2호
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    • pp.170-181
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    • 2011
  • Purpose: There is considerable variability in rates of hospitalization for patients with community-acquired pneumonia (CAP) in part because of physicians' uncertainty in assessing the severity of illness at presentation. The purpose of the study was to examine the current treatment patterns and factors influencing the Pneumonia Severity Index (PSI) and clinical outcomes in the patient with CAP. Method: The retrospective data collection of the patients with CAP was conducted and the data were reviewed. The collected data included demographic, clinical, laboratory and microbiological medical information. All patients were stratified into three risk groups according to PSI: low risk (PSI score I-II), moderate risk (III) and high risk (IV-V) groups. The examined treatment patterns were the appropriateness of admissions, category of antibiotics used. The prognostic factors associated with PSI and clinical outcomes were examined. Results: One hundred and six patients' medical data were reviewed. The overall appropriateness of admissions was low presenting many of patients were admitted or intensely treated in the hospital despite of lower risk of prognosis and treated with intravenous antibiotics instead of oral fluoroquinolones. Primary pneumonia pathogens were Klebsiella pneumoniae (27%) and Streptococcus pneumoniae (21.6%). Mean LOS was 8.5 days and was significantly longer (10.0days) (p<0.001) in high risk group. The patients with age >65 (p<0.001), diabetes mellitus (p<0.001), mental alteration (p<0.001), and/or $PaO_2$ <60 mmHg (p<0.001) had a tendency to have higher PSI. The prognostic factors associated with longer LOS were age >65 years (p=0.008), mental status alteration (p<0.001), dyspnea (p=0.002) and PSI score (p=0.001). The prognostic factors associated with mortality were congestive heart failure (p=0.038), systolic blood pressure <90 mmHg (p=0.002) and arterial pH <7.35 (p=0.013). Conclusion: Most of patients were found to over-utilize medical service according to appropriateness of admissions. The elderly, mentally altered patients with low $PaO_2$ had higher PSI score with increased risk of LOS. The mortality could be increased in the patient with disease state of congestive heart failure, high blood pressure, and/or acidosis.

Spontaneous Anterior Cerebral Artery Dissection Presenting with Simultaneous Subarachnoid Hemorrhage and Cerebral Infarction in a Patient with Multiple Extracranial Arterial Dissections

  • Park, Yung Ki;Yi, Hyeong-Joong;Lee, Young Jun;Kim, Young-Seo
    • Journal of Korean Neurosurgical Society
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    • 제53권2호
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    • pp.115-117
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    • 2013
  • Simultaneous subarachnoid hemorrhage and infarction is a quite rare presentation in a patient with a spontaneous dissecting aneurysm of the anterior cerebral artery. Identifying relevant radiographic features and serial angiographic surveillance as well as mode of clinical manifestation, either hemorrhage or infarction, could sufficiently determine appropriate treatment. Enlargement of ruptured aneurysm and progressing arterial stenosis around the aneurysm indicates impending risk of subsequent stroke. In this setting, prompt treatment with stent-assisted endovascular embolization can be a reliable alternative to direct surgery. When multiple arterial dissections are coexistent, management strategy often became complicated. However, satisfactory clinical results can be obtained by acknowledging responsible arterial site with careful radiographic inspection and antiplatelet medication.

소아의 신성 고혈압 (Renal and Renovascular Hypertension in Children)

  • 한혜원
    • Childhood Kidney Diseases
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    • 제15권1호
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    • pp.1-13
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    • 2011
  • Hypertension is a major risk factor of atherosclerosis which results in cardiovascular disease, and remains a major health problem worldwide. While children are more likely to have secondary hypertension, recent studies support the theory that the prevalence of essential hypertension in children and adolescents is increasing with the global epidemic of childhood obesity, and close attention is needed. Evaluation of hypertension in the pediatric age group should be guided by the age at presentation, and renal diseases must be considered in every child with hypertension, because of the prevalence of renovascular and renal parenchymal disorders as the etiology in any age group. The majority of children with chronic kidney disease are hypertensive, and many have associated end organ damage. Thus, once hypertension has been confirmed, end organ care as well as pharmacologic therapy must be continued. In renovascular hypertension, as cure could be gained with surgical/endovascular intervention, accurate diagnosis is important and it is recommended that every suspected child should undergo angiography.

Clinical presentations of critical cardiac defects in the newborn: Decision making and initial management

  • Lee, Jae-Young
    • Clinical and Experimental Pediatrics
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    • 제53권6호
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    • pp.669-679
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    • 2010
  • The risk of mortality and morbidity of patients with congenital heart defects (CHDs) is highest during neonatal period and increases when diagnosis and proper management are delayed. Neonates with critical CHDs may present with severe cyanosis, respiratory distress, shock, or collapse, all of which are also frequent clinical presentations of various respiratory problems or sepsis in the newborn. Early diagnosis and stabilization and timely referral to a tertiary cardiac center are crucial to improve the outcomes in neonates with CHDs. In this review, the clinical presentation of critical and potentially life-threatening CHDs is discussed along with brief case reviews to help understand the hemodynamics of these defects and ensure proper decision-making in critically ill patients.

Incoterms 2000 개정의 필요성과 개정방향 (A Study on Need and Directions of Modification of Incoterms 2000)

  • 오세창
    • 무역상무연구
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    • 제42권
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    • pp.3-32
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    • 2009
  • As we know, Incoterms are reflecting only the greatest common measure of practice in int'l trade. Therefore we can think them as the commercial practice most widely used in trade. They contain a number of detail under converse mirror image terms because they connect each other like a thread as to all oversea's commercial transactions between importing buyers and exporting sellers. Therefore they afford convenience to exporters and importers in the world because they tell the parties what to do as to transfer of risk and costs, responsibilities in connection with delivery of the goods. Nonetheless, since Incoterms 1936, they have been periodically revising in order to represent contemporary commercial practice. Therefore, according to change of Int'l trade environment, ICC plans to modify to the 2000 Incoterms. I hope to contribute to revising works by reference of above mentioned revision, that to say, aspects of provision, reflection of prevailing most commonly used, promotion of status as uniform rules, provision of convenience of int'l buyers and sellers. harmony with existing int'l instruments, presentation of criteria in variation of Incoterms.

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화산쇄설암 분포지역 내 절토사면 안정성 사례연구 (The Case Study of Cut-Slope Stability in Pyroclastic-Rock Area)

  • 이정엽;구호본;김승현
    • 한국지반공학회:학술대회논문집
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    • 한국지반공학회 2008년도 춘계 학술발표회 초청강연 및 논문집
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    • pp.884-893
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    • 2008
  • The purpose of this case study is cut-slope stability in pyroclastic-rock area. Pyroclastic-rock is very vulerable by Chemical and physical weathering. And risk increase of Pyroclastic-rock proportional to exposure time. This case of cut-slope located in Jeollabuk-do Jinan-gun and reserch order is topography character research, geological character research, field survey, measure method presentation.

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방사선조사가 골무기질함량에 미치는 영양에 관한 실험적 연구 (AN EXPERIMENTAL STUDY ON THE CHANGE OF BONE MINERAL METABOLISM AFTER IRRADIATION)

  • 진해윤;이상래
    • 치과방사선
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    • 제18권1호
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    • pp.53-66
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    • 1988
  • Irradiation is widely used for the treatment of malignant diseases, and possibly cause the osteoporosis. The bone densitometry and bone scintigraphy are valuable when used to monitor the patients longitudinally to access the progression of osteoporosis and risk of osteoradionecrosis. To evaluate the osteoporosis after irradiation of cobalt-60 gamma ray on the lumbar spines of New Zealand white rabbits, bone densitometry by dual photon absortiometry and bone scintigraphy were performed weekly. The decrease of bone density began at the first week after irradiation, and were in the nadir at 4-6th week. The osteoblastic activity measured by bone scintigraphy decreased in the first week, and was in the nadir at 4-6th week. The severity of these changes were related to the radiation dose. In conclusion, the osteoporosis before presentation of the osteoradionecrosis can be developed at low dose irradiation and confirmed by bone densitometry, bone scanning, and histopathology.

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