• 제목/요약/키워드: medication consultation

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국소마취하 상악 측절치 치근단 절제술 후 인식된 신경병성 비정형 치통 1예 -증례 보고- (A Neuropathic Atypical Odontalgia Recognized after the Apicoectomy under Local Anesthesia on the Maxillary Lateral Incisor -A Case Report-)

  • 모동엽;유재하;최병호;김하랑;이천의;김종배
    • 대한치과마취과학회지
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    • 제10권1호
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    • pp.20-26
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    • 2010
  • This type of neuropathic pain(atypical odontalgia) is seen most often in middle-aged women or men after dentoalveolar operation. Atypical odontalgia probably is caused by deafferentation leading to intraneural changes in the medullary dorsal horn. Treatment of this problem is difficult, but some success has been reported in uncontrolled, open-labeled studies using high doses of tricyclic antidepressants. This is the management report of a patient case, that had a neuropathic atypical odontalgia recognized with the right maxillary lateral incisor. The patient was consulted to the Department of Pain Clinics, ENT & Neurology and diagnosed the adenoid cystic carcinoma on left cerebellum and right paranasal sinus with extension to the cavernous sinus. In spite of the osteoplastic craniotomy, neurosurgical mass removal and radiation therapy were done with chemotherapy, atypical odontalgia was continued. In addition to the consultation to Psychology, stress management and antidepressant medication were done and improved slowly.

고혈압관리에서의 스마트케어 서비스의 효과 (The effect of Smart Care ubiquitous health service on hypertension management)

  • 정영순;문미경;이창희
    • 한국산학기술학회논문지
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    • 제14권3호
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    • pp.1213-1220
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    • 2013
  • 본 연구는 지식경제부가 주도한 u-Health 공공시범 사업의 하나인 스마트케어서비스의 효과를 분석하고자 시도되었다. 2011년 12월 1일부터 2012년 8월 30일 까지 연구에 동의한 51명의 고혈압 대상자(수축기압 140mmHg이상)들은 기존의 1차 의료기관의 내원진료와 투약을 유지하면서 원격모니터링을 포함한 24주간의 원격건강관리서비스를 받았다. 24 주 동안의 평균 자가 측정 혈압 모니터링 횟수와 원격 상담횟수는 121회와 14.8회였다. 24주 스마트케어 서비스 후 수축기와 이완기혈압은 유의하게 감소하였으며, 서비스 초기 수축기압이 140mmHg 이상이던 전체 대상자의 86.3%가 24주후 정상 수축기혈압을 유지하였다. 스마트케어서비스는 고혈압대상자의 혈압변화에 있어 긍정적인 영향을 미치는 것으로 나타났다.

의약분업 이후 병원 약제부서의 업무내용 및 인력구조 변화 분석 (An Analysis of the Change in Job Contents and Personnel Structure of Hospital Pharmacy Services after the Implementation of the Separation of Prescription and Drug Dispensing Policy)

  • 윤경일;류시원
    • 한국병원경영학회지
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    • 제7권2호
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    • pp.37-51
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    • 2002
  • It has been 2 years since the implementation of the separation of prescription and drug dispensing policy. This study analyzes the effects of the policy on the job contents and personnel structure of hospital pharmacy. The main purposes of the analysis are to determine if the policy has causes the increase of professional activities of pharmacists in hospital and to investigate whether the hospital pharmacy is equipped with enough manpower to provide high quality pharmaceutical service as intended by the policy. The level of professionality of pharmacists' activities is measured by the number of activities of direct involvement in inpatient care such as participation in patient rounding, medication consultation, the number of hospital committee the pharmacists involved and the number of continuous education pharmacists took. The adequacy of personnel structure to provide high quality pharmaceutical care is measured by the level of compliance to the governmental standard of hospital pharmacy personnel. In order to collect the data, surveys were performed for two periods: year 1999 (before the implementation of the policy) and year 2001 (after the implementation of the policy). The results show that the pharmacists' participation in inpatient rounding decreased and that the inpatient medication history management activities, operation of ward pharmacy, participation in hospital committee increased. In personnel structure, the average number of pharmacist per hospital decreased and the number of prescription processing per pharmacist increased. Based on the results this study concludes that the professional activities of hospital pharmacists has increased a little and there were structural changes in hospital pharmacy service activities to increase the professionalism in providing care. However, the pharmacy departments were understaffed hampering the strive to increase the provision of professional pharmaceutical service in hospitals.

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일 병원 정신건강의학과로 자문의뢰 된 HIV 감염/후천성면역결핍증 환자의 임상적 특성과 향정신약물 사용 (Clinical Characteristics and Use of Psychotropic Agents among HIV-Infected/AIDS Patients Referred for Psychiatric Consultation)

  • 신상호;김현정;유소영;신형식;원성두;이소희
    • 정신신체의학
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    • 제22권1호
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    • pp.31-39
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    • 2014
  • 연구목적 이 연구는 2년 6개월 동안 일 병원에 입원 중인 HIV감염/AIDS환자에 대한 정신건강의학과 자문 의뢰를 분석하였다. 방법 일 병원에서 2011년 1월 1일부터 2013년 6월 30일까지 자문 의뢰된 97명의 HIV감염/AIDS 환자와 282개의 자문 의뢰를 대상으로 후향적 의무기록 연구를 수행하였다. 결과 97명의 HIV감염/AIDS 환자 중 91명(93.8%)이 남자였으며, 평균연령은 48세, 연구 기간 동안 평균 1인당 자문건수는 2.8건이었다. 주로 호소한 증상으로는 우울 102건(55.3%), 불면 60건(14.0%), 불안감 31건(7.2%) 등이었으며, 최초 자문의뢰 시 진단된 정신과적 질환은 우울장애 37명(37.0%), 인지장애 11명(11.0%), 섬망 9명(9.0%) 등 이었고 투약 권고된 향정신병 약물은 Lorazepam 99건(17.2%), Escitalopram 90건(15.7%), Quetiapine 84건(14.6%) 순이었다. 결론 HIV감염/AIDS 입원 환자들은 '우울감', '불면', '자살사고/시도' 등을 주문제로 정신건강의학과로 자문의뢰 되었고, 자문의뢰 환자의 85명(93.3%)에서 정신장애로 진단을 받았다 그러나 자문의뢰 환자의 16.9%만 퇴원 후 본원 정신건강의학과로 외래 추적 진료가 이루어져, 향후, 정신건강문제가 HIV감염 및 AIDS의 치료 순응도, 예후, 전파에 미치는 영향에 대한 장기적 연구가 필요할 것으로 보인다.

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119구급차로 이송된 환자의 병원 전 전문응급처치에 관한 조사 (A Analysis of Prehospital care on the patients Transported via 119System)

  • 박진옥;이경희;노상균;최청숙
    • 한국응급구조학회지
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    • 제7권1호
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    • pp.127-134
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    • 2003
  • An analysis was performed to evaluate the prehospital advanced emergency care in Emergency Medical Service system(EMS) through the review of the 119 transfort chart of 190 patients who visited to Jecheon Seoul hospital emergency center at Chungbuk Jecheon via 119 system during the period from October 2002 to September 2003. The results were obtained as follows: 1. Among 190 patients, male were 127(66.8%) and female were 63(33.2%) and nontraumatic patients were 81(42.6%) and traumatic patients were 109(57.4%). 2. The analysis of prehospital care by Emergency Medical Technician(EMT) revealed that Airway maintenance and keeping oral airway(37.7%), oxygen supply(75.9%), Tourniquett or MAST(18.9%), Immobilization of neck or spine(94.7%), Immobilization of extremities (51.4%), wound bandage and dressing(25.0%), BCLS(12.1%) and Application of AED(2 patients). 3. The analysis of prehospital care by EMT revealed prehospital care was limited to keep of intubation or LMA, medication and IV insertion, insertion of gastric tube and ACLS. 4. There was no case of the notification to medical institute or consultation to doctor.

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모(某) 한방병원(韓方病院) 소아과(小兒科)에 내원(來院)한 영아기(?兒期) 환아(患兒)에 대한 임상적(臨床的) 고찰(考察) (A clinical study on infancy patients who had visited Oriental Medicine Hospital)

  • 강미선;김장현
    • 대한한방소아과학회지
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    • 제16권2호
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    • pp.129-141
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    • 2002
  • The Purpose of this study was to investigate infancy patients who had visited Oriental Medicine Hospital, and so to consider a counterplan by oriental medicine. The study was composed of 101 new infancy patients who had visited Dongguk Kyeongju Oriental Medicine Hospital during 1 year from January 2001 to December 2001. The results were as follows : 1. Male children are 65(64.3%), female children are 36(35.6%), male to female ratio is 1.8: 1. 2. In age distribution, 1 month 5.9% ; 2 month 10.9%, 3 month 4.0%, 4 month 11.9%, 5 month 5.9%, 6 month 9.9%, 7 month 10.9%, 8 month 10.9%, 9 month 10.9%, 10 month 14.8%, 11 month 4.0%. 3. According to systematic division of the chief complaint, respiratory diseases are 37.6%, digestive diseases are 25.7%, nervous diseases are 21.8%, urogenital diseases are 1.0%, musculoskeletal diseases are 1.0%, dermatologic diseases are 7.9%, infirmity diseases are 3.0%. 4. In treatment, herb-medication is 86.1%, consultation is 7.9%, acupuncture is 17.8%, moxibution is 2.0%, venesection is 14.8%, aromatherapy is 4.9%, chimsband is 16.8%.

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원격의료의 법률관계 및 법제개선방안 (A Study on the Civil Liability of Telemedicine and Some Legislative Proposals)

  • 정용엽
    • 의료법학
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    • 제7권1호
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    • pp.323-386
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    • 2006
  • A combination of information technology and medical care has given rise to a new type of medicine, i.e., telemedicine. Broadly defined, telemedicine is the transfer of electronic medical data from one location to another. Both at home and abroad, telemedicine has come to success in establishing appropriate equipment and solutions for such non-conventional medicine. Sooner or later, telemedicine is believed to find itself as one of the universal treatments. In order to facilitate the full-fledged development of telemedicine, a number of legal and institutional problems have to be settled. In Korea, the Medical Act was amended to include such provisions as telemedicine, electronic medical records, electronic prescriptions, etc. and the Act came into force on March 31, 2002. Telemedicine is in common with the conventional medicine in that a physician treats a patient. However, telemedicine is basically differentiated in the followings: - The offer and acceptance of treatment and medication are usually made on-line; - Telemedicine is inherently dangerous because a physician cannot meet face-to-face with a patient; and - Joint and several liability is borne by all the physicians involved in a telemedical consultation. As a result, telemedicine is vulnerable in nature to medical malpractice. Accordingly, there must be some new theories and arguments in the formation of contract and torts. The discussion on the civil liability covers the above-mentioned issues, and would give an insight or guidelines in the concerted operation of provisions with respect to telemedicine. This study delves into the civil liability of physicians involved in telemedical consultations and treatments based upon the conventional malpractice theory.

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한방병원 입원환자의 진료비 구조 분석 (Medical Expenses Structure on Hospitalized Patients of an Oriental Medical University Hospital)

  • 서미경;이석구
    • 보건행정학회지
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    • 제6권2호
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    • pp.115-130
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    • 1996
  • This study was performed to investigate the practical oriental medical expenses by the use of internal data of an oriental hospital due to the bias of medical insurance program data. The purpose of this study was to describe prevalent diseases of clinical department in the studied hospital, to analyze medical expenses structure and to verify the each cost share ration of expenses on insurer to insuree. Under this purpose, we analyzed actual medical expenses data of 1,611 hospitalized patients of the oriental medical university hospital with 150 beds that can be approached to internal data from Jan. 1, 1994 to Dec. 31, 1994. The major findings are as follows : 1. Upper five of most frequent diseases of admitted patients were Joul-Jung-Pung(55.5%), Yoo-Kak-Tong(7.3%), Yoo-/Tong(7.1%), Gu-An-Wa-Sa(2.7%) and sequale of Joul- Jung-Pung(2.4%) 2. In medical expenses structure, hospital ward fee was 47.1%, medication fee 41.3%, fee for procedure(acupuncture, moxibustion, negative therapy, physical therapy, etc) 11.1% and consultation fee 0.5%. In addition to the cost share ration of insuree & that of insurer was 75:25 respectly.

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약국의 공간 특성과 근무자 만족도 연구 (A Study on the Spatial Characteristics of the Pharmacy and Worker's Satisfaction about Interior Design)

  • 주수언;신경주
    • 한국실내디자인학회논문집
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    • 제15권2호
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    • pp.37-47
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    • 2006
  • The purpose of this study was to provide basic data for better design of Pharmacy after introducing the new system of separation of dispensing from prescribing medicine. To analyze characteristics of interior design in pharmacy and to measure worker satisfaction, a survey was conducted with 255 workers who serve at any Pharmacies located in Busan, Korea. For data analysis, descriptive statistics, t-test, One-way ANOV A were performed with the SPSS Win program(Ver. 10.0). The major findings were as follows: 1) As a result of analyzing the role and functions of the pharmacist is to be classified into many items such as entrance, a waiting room, a dispensary, a medication & consultation area, a drug storage and a worker's room. 2) Natural substances should be used more widely instead of using chemical substances for the pharmacy interior design as finishing materials 3) Pharmacy worker's satisfaction with dispensary is specially low among the total satisfaction which is :slightly higher than the average. 4) The degree of satisfaction between pharmacy workers from different groups varied depending on work hours, and especially long time(over 10hrs) workers showed dissatisfaction. Pharmacy managers need to consider the option of expanding convenience facilities. 5) According to the satisfaction analysis for each pharmacy conditions, the group who worked in 30-pyeong spaces were most satisfied. Since the 30-pyeong space is most standardized space research should be conducted.

Radiographic changes of mandibular cortical bone in bisphosphonate drug holiday

  • Lee, Dae-Hoon;Seo, Ja-In;Song, Seung-Il;Lee, Jeong-Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제48권4호
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    • pp.219-224
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    • 2022
  • Objectives: There have been few studies to date on the residual effect of bisphosphonate. This study investigated the radiographic changes of mandibular cortical thickness upon bisphosphonate drug holiday. Materials and Methods: This retrospective study includes 36 patients diagnosed with MRONJ (medication-related osteonecrosis of the jaw) at Ajou University Dental Hospital in 2010-2021. All patients stopped taking bisphosphonate under consultation with the prescribing physicians. Panoramic radiographs were taken at the start of discontinuation (T0), 12 months after (T1), and 18 months after (T2) discontinuation of bisphosphonate, respectively. Mental index and panoramic mandibular index were calculated using Ledgerton's method. Paired t-tests were used to analyze differences over time. Results: The difference in indices (mental index and panoramic mandibular index) between T0 and T1 was not statistically significant (paired t-test, P>0.05). However, the difference in these indices between T1 and T2 was statistically significant (paired t-test, P<0.05). Conclusion: The cortical thickness of the mandible decreased in the late stage (after 18 months) as observed by panoramic radiograph.