• Title/Summary/Keyword: adult patients

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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.

Sudden Deafness (돌발적난청)

  • 조중환;류태현
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1976.06a
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    • pp.85.3-86
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    • 1976
  • Sudden deafness requires immediate investigation and treat if there is to be any prospect of salvaging the hearing. It present an otological emergency and a diagnostic challenge. Sn Sudden sensorineural deafness can be caused by a wide variety of pathologies. A battery of tests and investigations must be performed forthwith if treatment is to be started without further delay. The concept that nothing can be done for the patient with sensori-neural deafness must be abandoned. Some pathologies causing sudden deafness are not amenable to therapy or can show only partial reversibility. But there are several causes, showing little or no spontaneous recovery, which do responed to appropriate treatment. It is important to identify them and concentrate on their management. The age and sex ratios and the unilaterral or bilateral nature of the lesion are related to the etiology and depend upon which type of case is included in the series. Though individually rare, collecting for about 2.5 per cent of new otoloical patients. Some 70 per cent of cases are unilateral. Viral, bacterial and treponemal infections accounted for about 30 per cent of the cases. Some 16 per cent were due to vascular lesions of the cochlea. In almost 22 per cent there was no obvious cause (idiopathic), they occurred in young adult and were either sensory or neural. About 12 per cent were traumatic and 9 per cent were ototoxic in origin. The remaining 11 per cent were due to a group of rarities. The two vital factors are the site of the lesion and the duration of the hearing loss. The earlier these are diagnosed and treated the better the response. The etiology, pathology and treatment are reviewed.

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Korean Medication Algorithm Project for Bipolar Disorder 2018 (KMAP-BP 2018): Fourth Revision

  • Woo, Young Sup;Bahk, Won-Myong;Lee, Jung Goo;Jeong, Jong-Hyun;Kim, Moon-Doo;Sohn, InKi;Shim, Se-Hoon;Jon, Duk-In;Seo, Jeong Seok;Min, Kyung Joon;Kim, Won;Song, Hoo-Rim;Yoon, Bo-Hyun
    • Clinical Psychopharmacology and Neuroscience
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    • v.16 no.4
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    • pp.434-448
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    • 2018
  • Objective: The Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was first published in 2002 through an expert consensus of opinion, and updated in 2006, 2010, and 2014. This study constitutes the fourth revision of the KMAP-BP. Methods: A 50-item questionnaire was used to obtain the consensus of experts regarding pharmacological treatment strategies for various phases of adult bipolar disorder and six items for pediatric bipolar disorder. The review committee included 84 Korean psychiatrists and 43 child and adolescent psychiatry experts. Results: The preferred first-step strategies for acute mania were the combination of a mood stabilizer (MS) and an atypical antipsychotic (AAP), MS monotherapy, and AAP monotherapy. A combination of a MS and an AAP, and AAP monotherapy were preferred for psychotic mania. The first-step strategies for mild to moderate bipolar depression were monotherapy with MS, AAP, or lamotrigine (LMT), and the combination of a MS and an AAP or LMT, or a combination of an AAP and LMT. The combination of two among a MS, AAP, and LMT were preferred for non-psychotic severe depression. A combination of a MS and an AAP or the combination of an AAP with an antidepressant or LMT were the first-line options for psychotic severe depression. Conclusion: The recommendations of the KMAP-BP 2018 have changed from the previous version by reflecting recent developments in pharmacotherapy for bipolar disorder. KMAP-BP 2018 provides clinicians with a wealth of information regarding appropriate strategies for treating patients with bipolar disorder.

The Effects of Symptoms of the Dementia Elderly on the Primary Caregivers' Care-Stress: The Expert Support and the Family Support as a Moderator (주부양자가 인지한 치매환자의 증상정도가 케어스트레스에 미치는 영향: 전문가지지 및 가족지지의 보호효과 검증)

  • Kim, Jaeyop;Kwak, Juyeon;Choi, Yoonhee
    • 한국노년학
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    • v.38 no.4
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    • pp.1127-1148
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    • 2018
  • Care-stress among the dementia caregivers has been an important issue. The purpose of this study is to examine the effects of the dementia elderly's symptoms on the primary caregivers'care -stress. In addition, the moderators, the expert support and the family support, were used to examine the moderating effects between the symptoms and the care-stress. The data was obtained at 10 day-care facilities and services in Seoul, Gyeonggi and Busan province in South Korea. A total of 191 participants were analyzed. They were the spouses or the adult children of the dementia elderly who were diagnosed with dementia within five years. This study was conducted in multiple regression analysis. The main findings are as follows. First of all, the symptoms that the dementia elderly show were significantly associated with the primary caregivers' care-stress. Also, the interactive variable with the expert support was statistically significant. However, it was not significant with the family support. This means that only the expert support from doctors, nurses or social workers decreased the caregivers' care-stress. The implications of this study are 1) the necessities of the education that covers the specific symptoms of the dementia patients', 2) the extension of the supportive policies for caregivers' care-stress, 3) the necessities of more allocation of the dementia specialists in the practical settings and cooperative systems among the dementia specialists in various fields, and 4) the enhancement of the family function among families who have a dementia elderly as a family member.

Effect of Self-Rated Health Awareness and Oral Health Care Behavior on Dental Fear in Some Areas Adult Patients (일부지역 성인 환자의 주관적 건강인식과 구강건강관리행태가 치과공포감에 미치는 영향)

  • Park, Chung-Mu;Yoon, Hyun-Seo
    • Journal of the Korea Convergence Society
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    • v.9 no.12
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    • pp.401-409
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    • 2018
  • The purpose of this study was to examine the oral health care and self-rated health status of adults visiting dental clinics in the region of Busan and influential factors for their dental fear from January to May, 2017, in an effort to obtain some information on how to relieve fear. As for dental fear, adults who were in their 30s, who were homemakers and whose monthly income ranged from 4 to 4.99 million won. In regard to fear according to oral health care, dental fear caused by the treatment avoidance factor was stronger among the adults who didn't receive dental checkups and who brushed their teeth in the wrong way. Dental fear that was attributed to the physiological reaction factor and the stimuli-inducing factor was severer among the adults who didn't receive dental checkups and who had no scaling experience. Overall fear was severer among the adults who didn't receive dental checkups and who changed their toothbrushes every four or more months. The factors that affected dental fear were self-rated health status, self-rated oral health status, gender, age, whether to receive dental checkups on a regular basis or not, and oral health education experience. Therefore in order to alleviate dental fear, self-rated health status should be improved, and the kind of system that encourages regular dental checkups and provides oral health education should be prepared.

DENTAL MANAGEMENT OF A 46-MONTH-OLD CHILD WITH PRADER-WILLI SYNDROME : A CASE REPORT (프래더-윌리 증후군을 가진 46개월 소아의 치과치료 : 증례보고)

  • Choi, Kyung Hwa;Kim, Mi Sun;Nam, Ok Hyung;Lee, Hyo-Seol;Choi, Sung Chul;Kim, Kwangchul
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.29-34
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    • 2019
  • Prader-Willi Syndrome (PWS) is a rare neurologic disorder with a prevalence 1/10,000-30,000. The cause of PWS is an abnormalities of chromosome 15q11.2-q13 which is an imprinting gene. Obesity and hyperphagia are characteristic features on a PWS adult. On the other hand, the birth weight, height and body mass index (BMI) of PWS infants are 15-20% lower than those of normal babies and there is a failure to thrive until 24-month-old. Most of PWS patients are treated under general anesthesia and conscious sedation. This case is a treatment of severe caries in a PWS 46 month-old child without general anesthesia and conscious sedation. He came to the Department of Pediatric Dentistry, Kyung Hee University Dental Hospital at Gangdong, Seoul, Korea with a trauma history. He had a medical history with heart surgery and needed to take antibiotics prophylaxis. The luxated left upper primary tooth were removed and caries treatment were done as an outpatient without general anesthesia, conscious sedation.

Temporary replacement of congenital missing incisors on mandible using temporary anchorage devices in growing patient: 2-year follow-up (성장기 아동에서 교정용 골성 고정원을 이용한 선천 결손 하악 전치의 임시 보철 수복: 2년 경과 관찰)

  • Choi, Youn-kyung;Kwon, Eun-Young;Jung, Kyung-Hwa;Choi, Na-Rae;Park, Soo-Byung;Kim, Seong-sik;Kim, Yong-il
    • Journal of Dental Rehabilitation and Applied Science
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    • v.36 no.4
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    • pp.272-281
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    • 2020
  • Agenesis of permanent tooth in adolescent patients can be treated either by orthodontic treatment for space closure or by maintaining the space until implant restoration can be carried out in adult. However, gradual atrophy of alveolar bone width makes it difficult to restore the prosthesis in the future or may cause unaesthetic results. Therefore, maintaining of not only the missing space but also the alveolar bone width should be considered. This case is a treatment whereby a temporary replacement of missing 2 mandibular incisors in adolescent patient was carried out using 2 temporary anchorage devices (TADs). Two TADs were placed horizontally 2 - 3 mm below the top of alveolar ridge, and fixed with artificial teeth by stainless steel wires extended. During the 2 year follow-up, neither gingival inflammation nor loss of the TADs have occurred. In the radiographic evaluation, the growth of the adjacent alveolar bone was not inhibited, and the width of the alveolar bone was maintained.

The efficacy of ultrasound-guided erector spinae plane block after mastectomy and immediate breast reconstruction with a tissue expander: a randomized clinical trial

  • Park, Sukhee;Park, Joohyun;Choi, Ji Won;Bang, Yu Jeong;Oh, Eun Jung;Park, Jiyeon;Hong, Kwan Young;Sim, Woo Seog
    • The Korean Journal of Pain
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    • v.34 no.1
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    • pp.106-113
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    • 2021
  • Background: We aimed to investigate the analgesic efficacy of an erector spinae plane block (ESPB) in immediate breast reconstruction (IBR) with a tissue expander. Methods: Adult women undergoing IBR with a tissue expander after mastectomy were randomly assigned to either intravenous patient-controlled analgesia (IV-PCA) alone (group P) or IV-PCA plus ESPB (group E). The primary outcome was the total amount of opioid consumption during 24 hours postoperatively between the two groups. Secondary outcomes were patient satisfaction, pain score at rest and on shoulder movement using numerical rating scale, incidences of postoperative nausea and vomiting (PONV), and a short form of the brief pain inventory (BPI-SF) at 3 and 6 months after surgery between the groups. Results: Fifty eight patients completed the study. At 24 hours postoperatively, total opioid consumption was significantly less in group E than in group P (285.0 ± 92.0, 95% confidence interval [CI]: 250.1 to 320.0 vs. 223.2 ± 83.4, 95% CI: 191.5 to 254.9, P = 0.005). Intraoperative and cumulative PCA fentanyl consumption at 3, 6, 9, and 24 hours were also less in group E than in group P (P = 0.004, P = 0.048, P = 0.020, P = 0.036, and P < 0.001, respectively). Patient satisfaction was higher in group E (6.9 ± 1.8 vs. 7.8 ± 1.4, P = 0.042). The incidences of PONV was similar. Conclusions: The ESPB decreased postoperative opioid consumption and increased patient satisfaction without significant complications after IBR with a tissue expander after mastectomy.

The Effects of Depression on Fear of Recurrence and Health-related Quality of Life in Young Adults with Stroke (젊은 뇌졸중 환자의 우울감이 재발염려와 건강관련 삶의 질에 미치는 영향)

  • Yoon, Su-Sie;Han, Sang-Ho
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.4
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    • pp.371-380
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    • 2020
  • This study was conducted to investigate the effects of depression on fear of stroke recurrence and health-related quality of life in Young Adults with Stroke. The subjects of this study were 240 young stroke patients who visited the outpatient department of neurology at a tertiary hospital in C province and J university hospital from July 24, 2018, to November 22, 2018. The collected data were analyzed for statistical significance and hypothesis verification using SPSS 24.0 and SmartPLS 3.0. The results showed that guilt and mental depression in depression factors had an effect on fear of stroke recurrence, and mental depression had a statistically significant impact on health-related quality of life. Also, fear of recurrence has a significant impact on health-related quality of life. The results of this study suggest that overcoming fear of stroke recurrence by interventions that reduce guilt and mental depression through early assessment of their depression, thus it can significantly contribute to improving health-related quality of life in young adults with stroke.

National Patterns and Characteristics in Pediatric Dental Emergency Visits for Dental Conditions (치과를 주소로 응급실에 내원한 소아청소년의 특성과 경향성)

  • Seongeun, Mo;Myeongkwan, Jih;Jewoo, Lee;Jaegon, Kim;Yeonmi, Yang;Van Nhat Thang, Le;Daewoo, Lee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.49 no.2
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    • pp.188-196
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    • 2022
  • The purpose of this study was to investigate pediatric emergency department visits patterns and characteristics of children and adolescents under the age of 20 in South Korea from 2002 to 2015 due to dental conditions. This study used a stratified sample of approximately 1 million people from the Health Insurance Review and Assessment Service Database. The age, region, household income, and treatment cost were included for the patient characteristic analysis. Pediatric patients were compared to the adult group (over 20 years old). In children and adolescents, the rate of emergency department visits due to dental conditions was higher for traumatic conditions than for non-traumatic conditions. Children and adolescents with higher household income visited the emergency department more often than those with lower household income. The region with the highest number of children and adolescents visiting the emergency department for dental conditions was Busan (per 100,000 population). Although this study could not confirm the annual trend of children and adolescents' dental emergency visits due to the sample size limitation, the characteristics of children and adolescents' dental emergency visits were compared with those of adults using a stratified sample.