• 제목/요약/키워드: cardiovascular depression

검색결과 138건 처리시간 0.027초

소아치과의사를 위한 심폐소생술과 소아고급생명구조술 (Cardiopulmonary Resuscitation and Pediatric Advanced Life Support for Pediatric Dentist)

  • 김종빈
    • 대한소아치과학회지
    • /
    • 제44권2호
    • /
    • pp.243-255
    • /
    • 2017
  • 심폐소생술(cardiopulmonary resuscitation, CPR)은 심장의 기능이 정지하거나 호흡이 멈추었을 때 인공적으로 혈액을 순환시키고 호흡을 보조해 주는 응급처치이다. 심폐소생술은 기본생명구조술(basic life support, BLS)과 전문소생술(advanced life support, ALS)로 나눌 수 있다. 기본생명구조술은 주요 조직으로 혈류 공급을 강제적으로 하기 위한 흉부압박과 호흡정지 환자에게 구조호흡(rescue breathing) 그리고 심실세동을 개선해 주기 위한 자동제세동기(automated external defibrillator, AED)이 포함된다. 전문소생술의 범주는 성인을 대상으로 하는 고급생명구조술(advanced cardiovascular life support, ACLS)과 소아를 대상으로 하는 소아고급생명구조술(pediatric advanced life support, PALS)이 있다. 치과 치료에 극심한 공포를 가지며, 여러 이유로 치과 진료에 협조를 얻기 어려운 소아를 대상으로 하는 치료환경에서는 약물을 이용한 진정법이 고려된다. 이는 심정지를 포함한 응급상황이 발생할 가능성이 증가하는 이유가 된다. 소아고급생명구조술은 기본생명구조술을 포함하며, 심정지에 이를 수 있는 원인을 호흡, 순환장애 그리고 심인성으로 나누어 대처하는 체계적인 방법을 제시한다. 소아는 성인에 비해 심인성의 원인은 낮지만, 해부학적인 약점으로 인해 호흡이나, 순환장애에 의한 심정지의 가능성은 높다. 따라서, 스트레스를 많이 받은 아이를 치료하거나 진정법을 시행하는 소아치과의사는 소아고급생명구조술을 익힘으로써 응급상황에 적절히 대처할 수 있는 역량을 갖출 수 있으리라 사료된다.

흡연, 음주, 운동과 건강생활양식 (The health lifestyle of adults related to smoking, drinking and exercise)

  • 소희영;이미라;정미숙
    • 한국보건간호학회지
    • /
    • 제12권2호
    • /
    • pp.221-235
    • /
    • 1998
  • This study is a descriptive survey to explore the health lifestyle of adults. The study subjects are teachers of elementary. middle and high school. and staffs of research institutes located in Chungchung Province and Daejon city. The data was collected from Jan. to march 1997 through self reporte for structured questionnaire. Fantastic check list of Wilson and Ciliska for Health Lifestyle Assessment and DSM-III-R for somatic symptom were used as tools. Data was analysed by frequency, $X^2_test$, t-test and Anova using SAS program. The results are as follows: 1. There were statistically significant differences In drinking(t=7.75, P=.000), exercise(t=-2.99, P=.003)and interpersonal relationship(t=2.22, P=.027) among 10 health lifestyle between smoking group and non-smoking group, in drinking(t=17.98, P=.000), exercise(-4.71. P=.000), and job satisfaction(t=2.22, P=.027) between drinking group and non-drinking group, and in eating habit(t=-2.00, P=.045), drinking (t=4.47, P=000), exercise (t= -16.49, P=000), keeping traffic law(t= -2.68, P=.007), personality (t= -2.05, P=.040) and anxiety/depression(t=-3.47, P=.000) between exercise group and non-exercise group. 2. There was statistically significant difference in cardiovascular symptom(F=4.22, P=.0l) among somatic symptoms of subjects according to exercise level. 3. There was statistically significance difference in lifestyle according to smoking level(F=, 3.33, P=.011), drinking level(F=9.17, P=.0001) and exercise level(F=11.93, P=.000l), and in somatic symptom according to sex(t=-3.93, P=.0001), weight(F=3.83, P=.022), exercise level (F=3.29, P=.03) among general characteristics. 4. There was statistically significant difference between sex in general (t= -3.64, P=.0001), gastrointestinal(t=-2.21, P=.02), musculoskeletal(t=-3.92, P=.001), and total symptom (t= -3.92, P=.0001). 5. There was statistically very highly signigicant difference In weight according to smoking($x^2=25.18,\; P=.001)$ and exercise$(x^2=16.46,\; P=001)$. 6. There was statistically significant difference in frequency between smoking group, drinking group and exercise group$(x^2=24.52,\;P=.001)$. Among a number of habit, smoking, drinking and exercise are important factors of human health to prevent related disease morbidity and death. It is essential for industrial health nurse to committ in this subject considering the influence of those factors and lifestyle on health. There is also a relationship of weight with smoking and exercise, the frequency of overweight/obesiy in smoking/ no-exercise group were high. It is quite necessary for the people having cardiovascular symptom to exercise to lower morbidity and mortality. The industrial health nurse has to keep In mind on this point and consider of time and facilities of fitness of employee. It needs to explore the cause by further research on somatic symptom of women. This research shows that concerning the relationship between smoking, drinking, and exercise, health care provider must take not only management of disease, but health behaviors and lifestyle into consideration.

  • PDF

Osteosarcopenic Obesity in Elderly: The Cascade of Bone, Muscle, and Fat in Inflammatory Process

  • Du, Yang;Oh, Chorong;No, Jae-kyung
    • 한국조리학회지
    • /
    • 제23권6호
    • /
    • pp.173-183
    • /
    • 2017
  • Conditions related to body composition and aging, such as osteopenic obesity, sarcopenia/ sarcopenic obesity, and the newly termed osteosarcopenic obesity(triad of bone, muscle and adipose tissue impairment), are beginning to gain recognition. Currently, it has begun to attract the attention of scholars from all over the world, however, for this disease, it still needs a more clear understanding and perception. Therefore, this article considered the osteoporosis, muscle depression, and obesity, these diseases as a gate to study the relationship among muscle, bone, and fat. In addition, in the aging process, the formation of IGF-cortisol, testosterone, and estrogen is sensitive. These hormones can not only absorb muscle protein metabolism, but also affect alienation. The decrease in IGF-cortisol in the elderly resulted in increased visceral fat, decreased muscle mass and bone mineral density, and then affected decreased skeletal muscle atrophy and decreased quality. The reduction of skeletal muscle quality and strength and increase body fat affected the adipose tissue to produce inflammatory cytokines, thereby reduced skeletal muscle, promoted cardiovascular disease, metabolic syndrome and insulin resistance in chronic diseases. Almost all chronic inflammatory diseases were associated with bone, muscle and fat. These mechanisms were complex and interrelated. Inflammation reduces bone formation, increases fat and reduces muscle mass. And thus not only had a significant impact on the motor system, but also made the incidence increase of fracture, osteoporosis, fragile syndrome, fall, osteomalacia and other bone disease. This article aimed to start from the interaction between the muscles and bones of the elderly, extended to obesity, muscle deficiency, osteoporosis and other diseases, finally, from a nutritional point of view, to discuss how to treat osteoporosis obesity.

All about pain pharmacology: what pain physicians should know

  • Kim, Kyung-Hoon;Seo, Hyo-Jung;Abdi, Salahadin;Huh, Billy
    • The Korean Journal of Pain
    • /
    • 제33권2호
    • /
    • pp.108-120
    • /
    • 2020
  • From the perspective of the definition of pain, pain can be divided into emotional and sensory components, which originate from potential and actual tissue damage, respectively. The pharmacologic treatment of the emotional pain component includes antianxiety drugs, antidepressants, and antipsychotics. The anti-anxiety drugs have anti-anxious, sedative, and somnolent effects. The antipsychotics are effective in patients with positive symptoms of psychosis. On the other hand, the sensory pain component can be divided into nociceptive and neuropathic pain. Non-steroidal anti-inflammatory drugs (NSAIDs) and opioids are usually applied for somatic and visceral nociceptive pain, respectively; anticonvulsants and antidepressants are administered for the treatment of neuropathic pain with positive and negative symptoms, respectively. The NSAIDs, which inhibit the cyclo-oxygenase pathway, exhibit anti-inflammatory, antipyretic, and analgesic effects; however, they have a therapeutic ceiling. The adverse reactions (ADRs) of the NSAIDs include gastrointestinal problems, generalized edema, and increased bleeding tendency. The opioids, which bind to the opioid receptors, present an analgesic effect only, without anti-inflammatory, antipyretic, or ceiling effects. The ADRs of the opioids start from itching and nausea/vomiting to cardiovascular and respiratory depression, as well as constipation. The anticonvulsants include carbamazepine, related to sodium channel blockade, and gabapentin and pregabalin, related to calcium blockade. The antidepressants show their analgesic actions mainly through inhibiting the reuptake of serotonin or norepinephrine. Most drugs, except NSAIDs, need an updose titration period. The principle of polypharmacy for analgesia in case of mixed components of pain is increasing therapeutic effects while reducing ADRs, based on the origin of the pain.

약물대사효소의 유전적 다형성 및 임상적 응용 (Clinical Pharmacogenomics of Drug Metabolizing Enzymes and its Clinical Application)

  • 김경임;김승희;박지은;채한정;최지선;신완균;손인자;오정미
    • 한국임상약학회지
    • /
    • 제16권2호
    • /
    • pp.155-164
    • /
    • 2006
  • Great inter-variability in drug response and adverse drug reactions is related to inter-variability of drug bioavailability, drug interaction and patient's disease and physyological state that cause change in absorption, distribution, metabolism and excretion of drugs. However, these alone do not sufficiently predict and explain inter-variability in drug response. In recent studies, it is reported that inter-variability in drug response and adverse drug reactions may largely resulted from genetically determined differences in drug absoption, distribution, metabolism and drug target proteins. Especially, the major human drug-metabolizing enzymes such as CYP450, N-acetyl tranferase, thiopurine S-methyl transferase, glutathione S-transferase are identified as the major gene variants that cause inter-individual variability in drug's response and adverse drug reactions. These variations may have most significant implications for those drugs that have narrow therapeutic index and serious adverse drug reactions. Therefore, the genetic variation such as polymorphisms in drug metabolizing enzymes can affect the response of individuals to drugs that are used in the treatment of depression, psychosis, cancer, cardiovascular disorders, ulcer and gastrointestinal disorders, pain and epilepsy, among others. This review describes the pharmacogenomics of the drug metabolizing enzymes associated with the drug response and its clinical applications.

  • PDF

체외순환후 급성 심부전에 대한 신대체요법의 임삼적 검토 (Clinical study on Renal Replacement Therapy for Acute Renal Failure following Cardiopulmonary Bypass)

  • 서경필
    • Journal of Chest Surgery
    • /
    • 제25권3호
    • /
    • pp.232-239
    • /
    • 1992
  • Acute renal failure is a well known serious complication following open heart surgery and is associated with a significant increase in morbidity and mortality rate. From 1984 to 1990, 33 patients who had acute renal failure following cardiopulmonary bypass received renal replacement therapy. PD[Peritonial dialysis] was employed in 11 patients and CAVH[continous arteriovenous hemofiltration] was employed in 22 patients. Their age ranged from 3 months to 64 years[mean 25.5$\pm$7.8 years]. The disease entities included congenital cardiac anomaly in 18, valvular heart disease in 15 and aorta disease in 2 cases. Low cardiac output was thought as a primary cause of ARF except two redo valve cases who showed severe Aemolysis k depressed renal function preoperatively. Mean serum BUN and creatinine level at the onset renal replacement therapy were 65$\pm$8 mg/dl and 3.5$\pm$0.4 mg/dl respectively, declining only after reaching peak level 7&10 days following the onset of therapy. Overall hospital mortality was 72.7%[24/33]; 81%[9/11] in PD group and 68.2% [15/22] in CAVH group respectively. The primary cause of death was low cardiac output & hemodynamic depression in all the cases. The fatal complications included multiorgan failure in 7, disseminated intravascular coagulation and sepsis in 6, neurologic damage in 4 and mediastinitis in 3 cases. No measurable differences were observed between CAVH and PD group upon consequence of acute renal failure and disease per se. The age at operation, BUN/Cr level at the onset of bypass and highest BUN/Cr level and the consequence of low output status were regarded as important risk factors, determining outcome of ARF and success of renal replacement therapy. Thus, we concluded that althoght the prognosis is largely determined by severity of low cardiac output status and other organ complication, early institution of renal replacement therapy with other intensive supportive measures could improve salvage rate in established ARF patients following CPB.

  • PDF

미다졸람의 비강내 분무를 이용한 의식진정에 대한 증례보고 (CLINICAL STUDY ON THE CONSCIOUS SEDATION WITH MIDAZOLAM INTRANASAL SPRAY)

  • 김현식;최정림;이창섭;이상호
    • 대한소아치과학회지
    • /
    • 제25권4호
    • /
    • pp.782-787
    • /
    • 1998
  • Midazolam의 비강내 분무를 이용한 소아치과 환자의 의식진정하 치과치료 결과, 아래와 같은 특징들이 발견되었으며, 기존의 비강내 점적의 대표적인 단점인 posterior dripping이 대부분 제거되었음에도 불구하고, 상기도감염 등의 경우 보이는 비강내 충혈, 잦은 비루등의 경우에서는 이의 사용이 제한됨을 알 수 있었다. 1. 투여시 불편감의 감소 2. 점적의 경우보다 빠른 약효의 발현 및 회복 3. 점적시 보였던 rhinorrhea등 부작용의 감소 4. 점적시보다 개선된 행동양상의 표현

  • PDF

CMI에 의한 여대생의 건강문제 평가 (Evaluation of the mental and physical health status of university woman students using the Cornell Medical Index)

  • 모경빈
    • 대한간호학회지
    • /
    • 제12권2호
    • /
    • pp.45-56
    • /
    • 1982
  • This study was carried out during the month of september 1982 to analyse and evaluate of the mental and physical health status of University woman students using the Cornell Medical index. The purpose of the study was to provide basic data required by the University health program for planning related health need of woman students. The study sample is consisted of 486 students living in the dormitory enrolled for the fall semester 1982 in a Women's University in Seoul. The instrument used for the collection of data was an abridged version of a modified Cornell Medical Index. The questionarre includes 35 items related to physical health complaints and 22 items related to mental health complaints. The data was treated by a computer(SPSS) using one way analysis, and The Fishers' ratio and Chi-square test at the 5% level were also adjusted for the test for statistical significance. The interpretation of this study is limited due to the sample which was restricted to one University and not randomly selected. The followings are the results of the foundings so far achieved. 1. More than 60% of the Woman students have physical health problems in digestive system, cardiovascular system, nervous system, respiratory system, and musculo skeletal system in the order named. 2. More than 50% of the woman students have mental problems because of anger inadequacy sensitivity tension, depression and anxiety in the order named. 3. There were no statistically significant differences among woman students in mental and physical health problems caused by year groups, major groups, growing regional groups. 4. There were significant differences caused by the number of brothers and sisters in the aspect of appealing mental and physical problems. 5. There were significant differences caused by the rate of satisfaction in the living cost, and the lower the rate of the satisfaction in the living cost goes, the higher tile frequency rate of the appealing mental and physical health problems is. 6. There were significant differences caused by the rate of satisfaction of the living in the aspect of appealing mental and physical health problems. There fore, the lower the rate of the satisfaction of the living goes, the higher the frequency rate of the appealing mental and physical health problems is, and the more the complaints are, the more frequent the appealing of the problems of digestive system, circulating system and fatigue is.

  • PDF

근감소 및 염증 예방을 위한 운동과 인터루킨(IL-interleukin)의 역할 (The role of myokine(interleukin) and exercise for the prevention of scarcopenia and anti-inflammation)

  • 변용현;박우영
    • 한국응용과학기술학회지
    • /
    • 제35권2호
    • /
    • pp.509-518
    • /
    • 2018
  • 이 연구의 목적은 신체활동이 마이오카인 발현에 미치는 영향을 보고자 문헌고찰을 하였다. 신체적인 활동은 제2형 당뇨, 심혈관질환, 대장암, 치매 및 우울증과 같은 질환을 예방하는 역할을 하고 있다. 그리고 마이오카인(myokine)은 운동 훈련에 의해 분비되는 호르몬으로 뇌성장이나 알츠하이머 같은 질환 예방에 도움을 준다. 운동수행과정에서 수축하는 근육으로부터 분비되는 항염증 마이오카인의 생성과 대사 조절에 필요한 분비 활성화가 건강증진에 중요한 요인으로 보고 있다. 인체 골격근에서 분비되는 마이오카인 가운데 IL-4, IL-6, IL-7, IL-8, IL-15 등은 근육비대(hypertrophy)와 세포(myogenesis) 및 혈관생성(angiogenesis) 등의 조절에 관여한다. IL-6는 AMPK 활성화로 인한 대사중 지방 산화를 촉진시키는 작용을 하고, IL-1Ra, IL-10 과 sTNF-R 는 염증성 싸이토카인 $TNF-{\alpha}$의 분비를 억제한다. IL-15는 저항 운동시 근수축을 통한 발현량이 증가하어 근육 성장의 중요 합성요인으로 작용한다. 한편 IL-7 및 IL-8도 신호 전달 수용체 C-X-C를 통해 혈관신생을 촉진시킨다.

맞춤형 지지교육이 심부전증 환자의 신체, 정서적 상태 및 삶의 질에 미치는 효과 (Effects of Tailored Supportive Education on Physical, Emotional Status and Quality of Life in Patients with Congestive Heart Failure)

  • 이은숙;신은숙;황선영;채명정;정명호
    • 성인간호학회지
    • /
    • 제25권1호
    • /
    • pp.62-73
    • /
    • 2013
  • Purpose: This study was conducted to examine the effects of tailored supportive education on physical, psychological status and quality of life in the patients with congestive heart failure (CHF) who had not participated previously in cardiac rehabilitation program. Methods: This study was used a non-equivalent control pre-post design, conducted on 64 CHF patients under medical treatment in a hospital. The experimental group (n=31) received the tailored supportive educational program (once 1~2 days before discharge and 6 times after discharge through outpatient visits or telephone contact: once every week for the first 4 weeks after discharge and once every 2 weeks for the remaining 4 weeks). The control group (n=33) received a traditional discharge education. Data were analyzed using descriptive statistics, ${\chi}^2$-test, Fisher's exact test, t-test and repeated measure ANOVA using the SPSS/ WIN 18.0 program. Results: Participants in the experimental group showed the significantly increased scores of the quality of life (F=16.01, p<.001), and the significantly decreased scores of physical function (F=7.27, p=.009), depression (F=8.25, p=.006) and anxiety (F=4.11, p=.047), when compared to those of the control group. Conclusion: The findings indicated tailored supportive education was an effective intervention care in physical, emotional status and quality of life for CHF patients.