• Title/Summary/Keyword: geriatric medical center

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Effects of sleep deprivation on coronary heart disease

  • Wei, Ran;Duan, Xiaoye;Guo, Lixin
    • The Korean Journal of Physiology and Pharmacology
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    • v.26 no.5
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    • pp.297-305
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    • 2022
  • The presence of artificial light enables humans to be active 24 h a day. Many people across the globe live in a social culture that encourages staying up late to meet the demands of various activities, such as work and school. Sleep deprivation (SD) is a severe health problem in modern society. Meanwhile, as with cardiometabolic disease, there was an obvious tendency that coronary heart disease (CHD) to become a global epidemic chronic disease. Specifically, SD can significantly increase the morbidity and mortality of CHD. However, the underlying mechanisms responsible for the effects of SD on CHD are multilayered and complex. Inflammatory response, lipid metabolism, oxidative stress, and endothelial function all contribute to cardiovascular lesions. In this review, the effects of SD on CHD development are summarized, and SD-related pathogenesis of coronary artery lesions is discussed. In general, early assessment of SD played a vital role in preventing the harmful consequences of CHD.

Perioperative Risk Factors Related to Lumbar Spine Fusion Surgery in Korean Geriatric Patients

  • Lee, Jung-Hyun;Chun, Hyoung-Joon;Yi, Hyeong-Joong;Bak, Koang-Hum;Ko, Yong;Lee, Yoon-Kyoung
    • Journal of Korean Neurosurgical Society
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    • v.51 no.6
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    • pp.350-358
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    • 2012
  • Objective : Life expectancy for humans has increased dramatically and with this there has been a considerable increase in the number of patients suffering from lumbar spine disease. Symptomatic lumbar spinal disease should be treated, even in the elderly, and surgical procedures such as fusion surgery are needed for moderate to severe lumbar spinal disease. However, various perioperative complications are associated with fusion surgery. The aim of this study was to examine perioperative complications and assess risk factors associated with lumbar spinal fusion, focusing on geriatric patients at least 70 years of age in the Republic of Korea. Methods : We retrospectively investigated 489 patients with various lumbar spinal diseases who underwent lumbar spinal fusion surgery between 2003 and 2007 at our institution. Three fusion procedures and the number of fused segments were analyzed in this study. Chronic diseases were also evaluated. Risk factors for complications and their association with age were analyzed. Results : In this study, 74 patients experienced complications (15%). The rate of perioperative complications was significantly higher in patients 70 years of age or older than in other age groups (univariate analysis, p=0.001; multivariate analysis, p=0.004). However, perioperative complications were not significantly associated with the other factors tested (sex, comorbidities, operation procedures, fusion segments involved). Conclusion : Increasing age was an important risk factor for perioperative complications in patients undergoing lumbar spinal fusion surgery whereas other factors were not significant. We recommend good clinical judgment and careful selection of geriatric patients undergoing lumbar spinal fusion surgery.

A CLINICAL STUDY ON THE CARE OF ODONTOGENIC INFECTIONS IN THE ADMISSION PATIENTS WITH AGE-RELELATED GERIATRIC DISEASES (노인성 전신질환 입원환자에서 치성감염 관리에 관한 임상적 연구)

  • Yoo, Jae-Ha;Choi, Byung-Ho;Han, Sang-Kwon;Chung, Won-Gyun;Noh, Hie-Jin;Jang, Sun-Ok;Kim, Jong-Bae;Nam, Ki-Young;Chung, Jae-Hyung;Kim, Byung-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.5
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    • pp.414-421
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    • 2004
  • This is a reprospective study on the care of odontogenic infections in admission patients with geriatric diseases. The study was based on a series of 480 patients at Dong San Medical Center, Wonju Christian Hospital and Il San Health Insurance Hospital, From Jan. 1, 2000, to Dec. 31, 2002. The Obtained results were as follows: 1. The systemic malignant tumor was the most frequent cause of the geriatric diseases with odontogenic infectious diseases, and refractory lung disease, systemic heart disease, type II diabetes mellitus, cerebrovascular disease, bone & joint disease, senile psychologic disease were next in order of frequency. 2. Male prediction(57.5%) was existed in the odontogenic infectious patients with geriatric diseases. But, there were female prediction in senile psychologic disease, systemic heart disease and cerebrovascular disease. 3. The most common age group of the odontogenic infectious patient with geriatric disease was the sixty decade(47.9%), followed by the seventy & eighty decade in order. 4. In the contents of chief complaints on the odontogenic infectious patients with geriatric disease, peak incidence was occurred as toothache(52.7%), followed by extraction wish, tooth mobility, oral bleeding, oral ulcer, fracture of restoration, gingival swelling in order. 5. In the diagnosis group of odontogenic infectious diseases, periodontitis, pulpitis & periapical abscess were more common. 6. In the treatment group of odontogenic infectious diseases, the most frequent incidence(34.2%) was showed in primary endodontic treatment (pulp extirpation, occlusal reduction and canal opening drainage) and followed by scaling, incision & drainage, only drugs, pulp capping, restoration in order.

Calculation of the Costs and Optimal profits per Inpatient-day of the Geriatric Hospitals (노인병원의 재원환자 1인당 일평균 원가 및 적정이윤 계산)

  • Hwang, In-Kyoung;Kim, Jai-Sun;Choi, Whang-Gyu
    • Korea Journal of Hospital Management
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    • v.8 no.4
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    • pp.149-181
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    • 2003
  • It has been asserted that per diem payment system should be introduced, in place of the current fee-for-service system, for payment of the inpatient services of the geriatric hospitals, Based on the assentation, this study aims at calculating costs and profits per inpatient-day of the geriatric hospitals, and thereby at contributing to the managerial improvement from the both sides of the Government and the hospitals. Relevant data of the three months, May to August, 2002 were collected from the five geriatric hospitals, and per inpatient-day costs and profits were calculated for the three disease groups. Major results and conclusions are as follow : Firstly, total costs per insured inpatient-day of the geriatric hospitals are 65, 389 won for dementia (including optimal profit of 3,858 won), 69,730 won for stroke (including optimal profit of 4,117 won), and 70,085 won for other diseases (including optimal profit of 4,134 won). Secondly, the amount of the non-insured costs per inpatient-day occupies 34.5% of the total costs for dementia, 30.3% for stroke, and 30.1% for other diseases. Thirdly, the total amount of the per inpatient-day costs calculated including the optimal profits is, on the average, higher by 12% than the present price level calculated for the current fee-far-service system. This implies that the present price level should rise by 12% when the current fee-far-service payment system be maintained, and Finally, introduction of a sliding-scale payment system should be considered for the inpatient medical management fees for the length of stay over six months or more that are being cut in the claim examination process by the insurance corporation.

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Predictive Factors for Medication Adherence in a Geriatric Assessment Program in Korea (노인환자의 복약순응도 현황 및 영향인자 분석)

  • Kim, Minso;Choi, Nayae;Suh, Yewon;Park, Jinyoung;Lee, Junghwa;Lee, Eunsook;Lee, Euni;Kim, Sun-wook;Kim, Kwang-Il;Kim, Cheol-Ho
    • Journal of Korean Society of Health-System Pharmacists
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    • v.35 no.4
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    • pp.418-429
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    • 2018
  • Background : To improve medication adherence in elderly patients, the role of pharmacists in teambased services has been highlighted in the literature. However, not much is known about the role and the service elements involved in comprehensive geriatric programs in South Korea. This study was designed to describe the current status of medication adherence in geriatric patients based on the comprehensive geriatric assessment program and analyze the predictive factors for medication adherence in a tertiary teaching hospital. Methods : A retrospective cohort study was performed using electronic medical records of 247 patients from March 1st, 2015 to August 31st, 2015. Medication adherence and the types of non-adherence were also collected. Predictive factors for adherence were evaluated by including factors related to demographics, medications, illness, and patterns of medical usage. Results : The mean age of the study population was 81.2 years (range 65~98 years) and they were taking 9.7 drugs on an average (SD 5.0 drugs). The overall rate of non-adherence was 34%. About 48% of the patients had any forms of assistance in the medication administration. The most common type of non-adherence was "self-adjustment". The multivariate analyses revealed that age (adjusted odds ratio, 0.87 [95% CI, 0.80-0.96]; p 0.05) and the number of inappropriate medications (adjusted odds ratio, 0.59 [95% CI, 0.40-0.89]; p 0.05) were strong predictors for non-adherence. Conclusions : These results indicate that strategic considerations of the predictors of non-adherence should be improved in medication counseling services targeting elderly patients.

Interactions of Vascular Risk Factors and Apolipoprotein E4 on Geriatric Depression (노년기 우울증에서 혈관성 위험인자와 아포지단백 E4의 상호작용)

  • Park, Hye-Young;Kim, Jae-Min;Shin, Il-Seon;Yang, Su-Jin;Kim, Sung-Wan;Kim, Seon-Young;Shin, Hee-Young;Yoon, Jin-Sang
    • Korean Journal of Biological Psychiatry
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    • v.13 no.2
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    • pp.103-109
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    • 2006
  • Objective : Associations of vascular risk/disease or apolipoprotein E ${\varepsilon}4$(APOE4) with geriatric depression has been unclear at a population level. This study aimed to evaluate whether there would be interactions of vascular risk/disease and APOE4 on depression in a Korean elderly population. Methods : 732 community residents aged 65 or over were assessed for depression(GMS), information on vascular risk/disease(reported stroke, transient ishemic attack, heart disease, hypertension, diabetes, smoking), examinations for vascular risk/disease(blood pressure, blood tests for glucose and lipid profiles, body size), APOE genotypes, demographic characteristics(age, gender, education), physical health, and cognitive function(MMSE). Results : Previous stroke and lower level of high density lipoprotein(HDL) cholesterol were significantly associated with geriatric depression independent of demographic characteristics, physical illnesses, and cognitive function. These associations were statistically significant only in those with APOE4, although the interaction terms didn't reach to statistical significance. Conclusion : Associations between vascular risk/disease and geriatric depression might be more prominent in those with APOE4. However further research would be needed to clarify this issue.

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EFFECT OF IMMEDIATE RUBBER DRAINAGE ON THE DENTAL APICOECTOMY IN GERIATRIC CANCER PATIENTS : REPORT OF CASES (악성종양 노인환자에서 치근단 절제술 시 즉시 고무배농법의 효과 : 증례보고)

  • Yoo, Jae-Ha;Han, Sang-Kwon;Chung, Won-Gyun;Noh, Hie-Jin;Kim, Young-Nam;Jang, Sun-Ok;Jeon, Hyun-Sun;Kim, Jong-Bae;Nam, Ki-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.6
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    • pp.536-539
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    • 2004
  • The apicoectomy is an operation in which the root apex is removed and the adjacent periapical pathologic tissue is curetted. In this operation, there are several factors that may lead to the surgical wound infection, such as, local, systemic, environmental, endogenous and surgical factor. The systemic medical and surgical factor that may compromise patients defense are more important cause of the wound infection. The postoperative infection is likely to occur owing to poor systemic condition(especially geriatric cancer patient with operation, radiotherapy and chemotherapy), postoperative accumulation of hematoma & seroma and other contaminated factors. So, the authors established the immediate rubber drainage into the sutured wound of dental apicoectomy for the prevention of postoperative infection. The results are more favorable without the wound infection in total 31 cases of the dentistry of Dong San Medical Center & Wonju Christian Hospital.

Relationship between Knowledge of Dementia Care, Attitude toward Dementia and Person-centered Care among Nurses in Geriatric Hospitals (요양병원 간호사의 치매간호지식, 치매태도 및 인간중심 돌봄과의 관계)

  • Lee, Mi Kyoung;Jung, Hyang Mi
    • Journal of East-West Nursing Research
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    • v.25 no.2
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    • pp.128-137
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    • 2019
  • Purpose: The purpose of the study was to investigate the relationships between knowledge of dementia care, attitude toward dementia and person-centered care among nurses in geriatric hospitals. Methods: Participants were 115 nurses from the seven geriatric hospitals. Data were collected from September $5^{th}$ through $21^{st}$ in 2018 and analyzed using t-test, ANOVA, Pearson's correlation coefficients and hierarchical multiple regression. Results: Person-centered care was significantly different according to satisfaction with income, career of geriatric hospital, application of their opinions, and the satisfaction with hospital managers, administrators and nurse managers. Also person-centered care showed a significant positive correlation with the attitude toward dementia. Predictors of person-centered care were the satisfaction with hospital managers and the attitude toward dementia, which explained 23.0% of the variance. Conclusion: The findings of this study indicate that the attitude toward dementia and the satisfaction with the hospital organization were related to the person-centered care in geriatric hospitals. Therefore, the strategies to improve the attitude towards dementia should be carried out to enhance the person-centered care among nurses in geriatric hospital.

A study for the factors on choosing hospitals and patients satisfaction between Geriatric Hospitals and General Hospitals (노인병원과 종합병원의 선택요인 및 환자만족도 분석)

  • Yoon, Seo-Jung;Yu, Seung-Hum;Kim, Young-Hoon;Lee, Ji-Jeon
    • Korea Journal of Hospital Management
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    • v.9 no.2
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    • pp.46-75
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    • 2004
  • This research anticipated on acknowledging the inpatients factors in choosing which hospital for the geriatric hospital and general hospital they would prefer to go to the analization of different factors in patients satisfaction, and the relation between satisfactory standards and the patients intentions on recommendation or re-visiting the hospital. The statistical data was based upon the 359 question and answer papers that were done by inpatients that were hospitalized in two geriatric hospitals and two general hospitals, and the methods used for analyzing were frequency, t-test, factor analysis, and hierarchical multiple regression. The results are as follows. 1. The factors on choosing hospitals between geriatric hospital and general hospitals were different. The priority for the geriatrics was kindness, and then considerate nursing, and the reliance of treatment. The patients of general hospitals looked first for reliance of treatment, reputation and history of the hospital, and the kindness of the staff. The kindness of the staff, good nursing, and easy procedures were the primary factors of choosing geriatric hospital. 2. The four primary factors in choosing which hospital patients would go to were the predominance of the facilities, kindness and convenience, the reliance and proximity of medical treatment, and recommendation. The patients in the geriatric hospital first looked for kindness and convenience, second the reliance and proximity of medical treatment, third predominance of facilities, and last recommendation. The general hospitals main priority was the reliance and proximity of medical care, second predominance of facilities, kindness and hospitality, and last recommendation. 3. The satisfaction rate was higher in the geriatric hospital compared to general hospitals, but the satisfactory of factors were very similar. Patients in the geriatric hospital were pleased with the hospital staffs kindness, quick nursing and the improvement of inconvenient matters, and clear diagnosis of the doctors. The general hospital patients were satisfied with the hospital staffs clear explanation and accurate diagnosis 4. The analysis in the satisfactory factors turned out to be the environment of the hospital, kindness of the staff, and convenience. Both the patients of the geriatric hospital and general hospitals were very pleased with the kindness of the hospital staff. Ranking second and third was convenience and service for the geriatric hospital, and environment of the hospital and convenience for the general hospital. 5. According to a rank of multiple recurrent analysis of the patients satisfaction and the intention of re-visiting in addition to intention of solicitation, in the case of a geriatric hospital, when the intention of re-visiting is the dependent variable, the first stage shows that the less insurance the patient has, the higher was the intention of re-visiting. In the second stage, the more satisfied the patient is of the staffs kindness, the higher was the intention of re-visiting. Further more, when the intention of solicitation is the dependent variable, the first stage shows that not all the independent variables were significant, but the second stage shows that the more satisfied the patient is of the staffs kindness and the hospital along with the medical treatment expenses, the higher was the intention of solicitation. 6. In the first stage of a rank of multiple recurrent analysis of the satisfaction of the general hospital and the intention of re-visiting, not all the variables were significant, but in the second stage, all the satisfaction by factors were significant. Moreover, when the intention of solicitation was the dependent variable, the first stage shows not all the variables were significant, but in the second stage, all the satisfaction by factors were significant. That is to say, in the case of a general hospital, the satisfaction of the hospital and the medical treatment expenses were high, and the more satisfied the patient is of the hospitals environment and the staffs kindness, the intention of re-visiting and the intention of solicitation was higher.

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