• Title/Summary/Keyword: poor elderly

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Operative Treatment for Hallux Valgus with Proximal Metatarsal Osteotomy in Patients over 55 Years Old (55세 이상 무지외반증 환자의 근위부 절골술을 이용한 치료)

  • Park, Han-Sung;Park, Hyung-Taek;Lee, Ghun-Shik;Kim, Sang-Hyo;Lee, Kyung-Tai
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.69-73
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    • 2005
  • Purpose: The purpose of our report was to evaluate the result of operative treatment of hallux valgus in old age patients. Materials and Methods: We studied about the clinical & radiologic results of the 31 patients over 55 years old, who had operative treatment of hallux valgus. Clinical evaluation, such as pain, activity limitation, footwear requirement, 1st metatarsophalangeal joint motion, and callosity, was done using AOFAS scale and preoperative and postoperative radiologic parameters, such as hallux valgus angle, intermetatarsal angle, tibial sesamoid position, 1st metatarsal shortening, were evaluated by conventional methods. Results: Objectively, according to AOFAS, the score improved from average of 57.8 to 71.5 postoperatively. The range of motion of first metatarsophalangeal joint was decreased from average of 60.7 to 56.8 degrees. Radiologically, the hallux valgus angle improved from average of 35 to 6.5 degrees and the first intermetatarsal angle improved from average of 14.2 to 4.4 degrees. The position of sesamoid was collected from an average of grade 3.6 to grade 2.2. Conclusion: The combination of proximal metatarsal osteotomy, distal soft tissue procedure and Akin osteotomy may yield rather satisfactory clinacal result in severe elderly hallux valgus patients with massive degenerative change and poor soft tissue condition.

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A Case of Severe Bleomycin-Induced Pneumonitis at Non-Hodgkin's Lymphoma (비호즈킨 림프종 환자에서 저용량의 Bleomycin에 의해 발생한 급성 중증 폐독성 1예)

  • Han, Dong-Ha;Min, Young-Joo;Yoon, Je-Hyun;Park, Jong-Ho;Ahn, Jong-Joon;Lee, Ki-Man;Park, Jae-Hoo
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.3
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    • pp.260-264
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    • 2002
  • Bleomycin-induced pulmonary toxicity usually occurs in the elderly patients (greater than 70 years old), patients with a cumulative dose above 400 units, previous chest radiotherapy, oxygen therapy, and renal failure. However, there are some reports of severe pneumonitis that developed after administering low bleomycin doses(less than 100 units). In severe bleomycin-induced pneumonitis in non-Hodgkin's lymphoma patients, the response to corticosteroid is poor and the mortality rate is very high, approximately 83%. Therefore, clinicians should have a low threshold for investigating and treating bleomycin-induced pneumonitis. Here, we report a case of severe bleomycin-induced pneumonitis as a complication of a non-Hodgkin's lymphoma treatment.

Field Survey of Insulation Performance Analysis in Rural Houses (농촌주택 단열성능 분석 현장연구)

  • Kwon, Soon chan;Kim, Eun Ja;Lim, Chang Su;Park, Mi Jeong;Choi, Jin Ah
    • The Korean Journal of Community Living Science
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    • v.27 no.spc
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    • pp.703-714
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    • 2016
  • Dwelling environments that can help elderly farmers to live more safely, independently, and conveniently are becoming more and more important. Many rural houses are built without any particular architectural or energy-related criteria, so most of them have poor insulation. The construction technology used is also not precise, which increases the loads for heating and cooling. Therefore, rural houses need to be improved. Also, there is more and more need for plans to realize eco-friendly dwellings, so the principle of nature-oriented plans related to the direction, insulation, or landscaping of a house is being emphasized. Insulation is one of the most effective ways to save energy for heating and cooling. This preliminary study to improve the insulation of rural houses examined three regions in South Korea: the central region, the southern region, and the Jeju Island. A field investigation was conducted on a total of 18 houses, including six from each town in the selected regions. The information was used to figure out the current status of rural houses and the characteristics of the buildings. The main living spaces are the living room for the central region and the main room in the southern region and Jeju Island. The southern regions are plane shapes surrounded by rooms, and all ventilation is accomplished by windows. The studied houses were mostly masonry structures with slate rooftops. Additions and improvements included room expansions and bathroom interior installations.

Effects of Physical Activity on Glycemic Control in Type 2 Diabetics (제2형 당뇨병 환자의 신체활동이 혈당조절에 미치는 영향)

  • Choi, Eun-Jin
    • Korean Journal of Adult Nursing
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    • v.23 no.3
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    • pp.298-307
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    • 2011
  • Purpose: The purpose of this study was to examine the effects of physical activity on glycemic control among Koreans with type 2 diabetes. Methods: A total of 215 patients with type 2 diabetes (82 male and 133 female) were recruited (mean age = $59.0{\pm}9.7$ years). The amounts of physical activity was assessed using the physical activity scale for elderly (PASE). Fasting blood glucose (FBG), Hemoglobin A1c ($HbA_1c$), and 2 hours post-prandial glucose (2hrPG) were measured. Results: The highest PASE score was housework-related physical activity. However, the amounts of walking was significantly higher in good FBG level (Z = 1.39, p=.041) and the amounts of leisure-time physical activity was higher in good HbA1 and 2hrPG level than in the poor glycemic control group (Z = 2.29, p<.001; Z = 1.99, p=.001). A logistic regression analysis showed that patients with leisure-time physical activity in the top quartile more likely presented with good glycemic control in $HbA_1c$, OR=3.84 (95% Confidence Interval (CI) = 1.65~8.95) and in 2hrPG, OR=4.06 (95%CI = 1.77~9.27), compared to patients in the lowest quartile. Conclusion: Leisure-time physical activity is effective for controlling the glucose levels, especially $HbA_1c$ and 2hrPG among type 2 diabetic patients. It is suggested that health providers need to more focus on providing aggressive recommendations on physical activity considering physical activity patterns by individuals.

Predictors of Mortality in Patients with COVID-19: A Systematic Review and Meta-analysis (코로나바이러스감염증-19 (COVID-19) 환자들의 사망관련 인자에 대한 연구: 체계적 문헌고찰 및 메타분석)

  • Kim, Woorim;Han, Ji Min;Lee, Kyung Eun
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.3
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    • pp.169-176
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    • 2020
  • Background: Most meta-analyses of risk factors for severe or critical outcomes in patients with COVID-19 only included studies conducted in China and this causes difficulties in generalization. Therefore, this study aimed to systematically evaluate the risk factors in patients with COVID-19 from various countries. Methods: PubMed, Embase, and Web of Science were searched for studies published on the mortality risk in patients with COVID-19 from January 1 to May 7, 2020. Pooled estimates were calculated as odds ratio (OR) with 95% confidence interval (CI) using the random-effects model. Results: We analyzed data from seven studies involving 26,542 patients in total in this systematic review and meta-analysis. Among the patients, 2,337 deaths were recorded (8.8%). Elderly patients and males showed significantly higher mortality rates than young patients and females; the OR values were 3.6 (95% CI 2.5-5.1) and 1.2 (95% CI 1.0-1.3), respectively. Among comorbidities, hypertension (OR 2.3, 95% CI 1.1-4.6), diabetes (OR 2.2, 95% CI 1.2-3.9), cardiovascular disease (OR 3.1, 95% CI 1.5-6.3), chronic obstructive pulmonary disease (OR 4.4, 95% CI 1.7-11.5), and chronic kidney disease (OR 4.2, 95% CI 2.0-8.6) were significantly associated with increased mortalities. Conclusion: This meta-analysis, involving a huge global sample, employed a systematic method for synthesizing quantitative results of studies on the risk factors for mortality in patients with COVID-19. It is helpful for clinicians to identify patients with poor prognosis and improve the allocation of health resources to patients who need them most.

Reforming the Rural Health Insurance Programs in Korea (농촌의료보험의 당면과제와 개선방향)

  • Moon, Ok-Ryun
    • Journal of agricultural medicine and community health
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    • v.16 no.2
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    • pp.179-194
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    • 1991
  • Despite its universal coverage of health insurance, the rural health insurance program(RHIP) stands at the crossroads in Korea. The RHIP has weaknesses in stability of financing, problems of inequities in the provision of health services and has suffered from high cost of running the program. The author has analyzed these problems from the perspective of health insurance policy and presented several options for improvement. First of all, this study urged the importance of a firm Governmental commitment of RHIP with the 50% subsidization of contributions as the Government had promised, instead of the current 40%. This can be justified from the 20% subsidization by the Government for the contributions of private school teachers and their dependents, who belong to richer segments of the population. Second, various cost containment measures ought to be sought curbing the rising demand for medical through strengthening health education and increasing individual responsibility, and tightening the claim review process. Third, this study requires the Government to run a demonstration project on the introduction of case payment system for primary health care. Fourth introducing an income-related cost sharing scheme is another possibility. Reforming the cost sharing formula for large medical expenditures is recommendable for a beginning. This measure can take the form of tax credit for medical expenditures of the poor. Fifth, the degree of financial adjustment among health insurance plans should be levelled up for enhancing stability of RHIP and social solidarity. Sixth, health policy should be redirected toward development of rural health resources and higher priority should be put on relieving difficulties in access to care. Seventh. the insurance plan owned-hospital needs to be developed or provision of health services in the medically underserved areas, and the need of such facilities is particularly acute for geriatric care, rehabilitation and renal dialysis, etc. Eighth, more generous insurance benefits are required of the elderly who are suffering the most : elimination of the maximum 180 days of benefit period and provision of glasses and artificial dentures, etc. Ninth. the economies of scale principle is working for the operating expenses of regional self-employed insurance plan. Thus, measures should be instituted to pursue an optimum size of health insurance plans. Lastly, excessive dependence on exclusion items is an evil so that some radical remedies are urgently required to cut them.

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Colorectal Cancer in the Central Region of Thailand

  • Phiphatpatthamaamphan, Kittichet;Vilaichone, Ratha-Korn
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3647-3650
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    • 2016
  • Background: Colorectal cancer is one of the major health problems worldwide. However, limited studies have been reported from ASEAN countries. This study was conducted to evaluate clinical characteristics and survival of colorectal cancer cases aged <65 years and ${\geq}65$ years in the central region of Thailand. Materials and Methods: Clinical information, histological features, endoscopic findings and treatment outcome were collected and reviewed from Thammasat University Hospital, Pathumthani, Thailand between November 2011 and October 2015. Results: A total of 121 colorectal cancer patients, comprising 69 men and 52 women with a mean age of 65.8 years, were included. There were 57 aged <65 years and 64 aged ${\geq}65$ years. Common presenting symptoms were abdominal pain (37%), weight loss (34%) and anemia (32%). Mean duration of symptoms prior to diagnosis was 173 days. However, longer diagnosis time was demonstrated in patients aged <65 years than age more than ${\geq}65$ years (119.4 vs 58.4 days, P-value=0.30). Colonic fungating mass was the most common endoscopic finding (64.4%) and the location was significantly more commonly left than right side of the colon, both in younger and elderly groups (87.7% vs 12.3%, P=0.02 and 70.3% vs 29.7%, P=0.02, respectively). Adenocarcinoma with moderated differentiated was the most common histology (67.3%). More than half of the patients presented with advanced stage (28.9% with TNM stage 3 and 38.8% TNM stage 4, respectively). Overall 1-year and 5-year survival rates were 76.9% and 5%. Conclusions: Most colorectal cancer patients in Thailand have adenocarcinomas and present at advanced stage with poor prognosis. Screening of high risk patients and early detection might be essential factors to improve the treatment outcome and overall survival rate of colon cancer patients in Thailand and other ASEAN countries.

A Case of Mucinous Adenocarcinoma of the Sigmoid Colon in a Child (소아의 결장에서 발생한 원발성 선암종 1예)

  • Jung, Jae-Youl;Seo, Yu-Koyng;Kim, Ae-Suk;Lee, Sun-Ju;Cho, Sung-Min;Lee, Dong-Seok;Kim, Doo-Kwun;Choi, Sung-Min;Kim, Dong-Hoon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.1
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    • pp.81-85
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    • 2007
  • Colorectal carcinomas occur primarily in elderly people and are rare in children. Unlike adult colorectal carcinomas, the overall prognosis is very poor because of the usual delay in diagnosis and advanced stages at presentation or initial diagnosis, and a high incidence of aggressive tumor pathology such as mucinous adenocarcinoma. Colon cancer should not be excluded in children only based on age or barium enema results. Therefore, colonoscopy should be performed in pediatric patients with unexplained rectal bleeding and abdominal pain. We report a rare case of a child with a mucinous adenocarcinoma of the sigmoid colon in a 12-year-old boy, who presented with an abdominal mass and abdominal pain and review the medical literature.

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A Study on Revitalization of Library Service for the Alienated Class (정보취약계층을 위한 도서관 서비스 활성화 방안에 관한 연구)

  • Nam, Young-Joon
    • Journal of the Korean Society for Library and Information Science
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    • v.41 no.4
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    • pp.49-68
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    • 2007
  • To promote information service and to encourage active participation from the group categorized as the alienated class(group of people) this study suggests the basic concepts and strategy for the information services to alienated class who does not have full public library services. The paper classifies three separate groups of alienated groups, handicapped. poor(economically unfortunate group) and elderly group. The service shall consider their needs from their own Point of concern and interests. There are three distinctive considerations, infra structure(facility building, space. place). administrative consideration, and equipments. Infra-structure includes the planning of the space to facilitate the equipments and reference materials which will be control)ed and moderated by a librarian. Administrative service includes the development for the educational system between the end users and external experts. It also includes the individualized education system for each group Material and equipment consideration should include the each group's specific needs such as the infra-structures which is provided for the handicapped person.

Awareness and satisfaction on dental implant treatment (임플란트 시술에 대한 인지도 및 만족도)

  • Kim, Soo-Kyung;Kim, Sun-Yi;Jeon, Hee-Young;Lee, Kyeong-Hee
    • Journal of Korean society of Dental Hygiene
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    • v.13 no.3
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    • pp.395-401
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    • 2013
  • Objectives : The purpose of this research was to investigate the awareness of an adult on implants and the relevant factors which affect the satisfaction of a patient after an implant treatment. Methods : This study was conducted to 407 adult subjects in Seoul and Gyeonggi. A total of 384 data were analyzed except the questionnaires having poor responses or errors. Results : The acquaintance route of implant was TV advertisements, self-knowledge, internet, news, and newspapers. Dentist's ability to practice implant was the most important factor in patient's choice. The responents answered the expected lifespan of an implant was more than 5 years to 10 years. In terms of dental health management behavior on implants, the average response of the highest 4.07 points of 5 Likert scale. Generally women are more concerned with implant than men(p<0.01). The highly educated and elderly patients had tendency to receive more treatment(p<0.0001). Patients were more satisfactory after receiving regular checkups after treatment(p<0.05). The low expenses of implant satisfied the patients(p<0.05). Conclusions : As implant technology advances, the concern of patients on implants also increase. So reduction of cost can make the patients have access to the dentist and the patients' oral health must be improved through continuous dental care.