• Title/Summary/Keyword: selected patients

검색결과 3,946건 처리시간 0.033초

Comparative volumetric and clinical evaluation of peri-implant sulcular fluid and gingival crevicular fluid

  • Bhardwaj, Smiti;Prabhuji, Munivenkatappa Lakshmaiah Venkatesh
    • Journal of Periodontal and Implant Science
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    • 제43권5호
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    • pp.233-242
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    • 2013
  • Purpose: Peri-implant sulcular fluid (PISF) has a production mechanism similar to gingival crevicular fluid (GCF). However, limited research has been performed comparing their behavior in response to inflammation. Hence, the aim of the present study was to comparatively evaluate PISF and GCF volume with varying degrees of clinical inflammatory parameters. Methods: Screening of patients was conducted. Based on the perimucosal inflammatory status, 39 loaded implant sites were selected from 24 patients, with equal numbers of sites in healthy, peri-implant mucositis, and peri-implantitis subgroups. GCF collection was done from age- and sex-matched dentate patients, selected with gingival inflammatory status corresponding to the implant sites. Assessment of the inflammatory status for dental/implant sites was performed using probing depth (PD), plaque index/modified plaque index (PI/mPI), gingival index/simplified gingival index (GI/sGI), and modified sulcular bleeding index (BI). Sample collection was done using standardized absorbent paper strips with volumetric evaluation performed via an electronic volume quantification device. Results: Positive correlation of the PISF and GCF volume was seen with increasing PD and clinical inflammatory parameters. A higher correlation of GCF with PD (0.843) was found when compared to PISF (0.771). PISF expressed a higher covariation with increasing grades of sGI (0.885), BI (0.841), and mPI (0.734), while GCF established a moderately positive correlation with GI (0.694), BI (0.696), and PI (0.729). Conclusions: Within the limitations of this study, except for minor fluctuations, GCF and PISF volumes demonstrated a similar nature and volumetric pattern through increasing grades of inflammation, with PISF showing better correlation with the clinical parameters.

장애인 무료 치과 진료소에서의 진료 기록 평가 (THE EVALUATION OF DENTAL TREATMENT RECORDS IN CHARITY DENTAL CLINIC FOR THE DISABLED PEOPLE)

  • 김선영;최성철;박재홍;김광철
    • 대한장애인치과학회지
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    • 제9권1호
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    • pp.25-29
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    • 2013
  • Most of disabled people face hardness in caring their general oral hygiene by themselves. So that, they are once involved in dental caries or periodontal disease, they have much bigger chance of aggressive progress. Therefore preventive dentistry is more important to disabled one than non-disabled. They need to be checked with routine periodic dental examination and by that, oral disease must be found at initial stage. We selected 37 patients from newly visited 237 patients who had dental treatment at the free dental clinic, Gangnam district, Seoul, between 2000 and 2001. This study is a comparative evaluation of first 2 years' treatment records of selected 37 patients (male 28, female 9) with that of their last 2 years. 24 of 37 have mental retardation, 9 have autistic disorder, 2 have auditory disorder, 1 has brain disorder and 1 has crippled disorder. Their dental treatment records categorized by 4 level; score 4 stands for endodontic treatment, score 3 stands for general conservative treatment, score 2 stands for preventive treatment, such as sealant and score 1 stands for routine check. In first 2 years of treatment, average score was 2.85 which score means approximately general conservative treatment. And that of last 2 years was 1.44, which means routine check. In early time of their visit, they will receive the treatment due to their chief complaint. And after that early time, they can have a routine check so that they can be treated before the disease get worse. The patient's oral health can remain decent only by a simple treatment.

Quality of Same-Day Sputum Smears Microscopy and Presumptive Tuberculosis Patients Drop-out at Health Facilities of Addis Ababa, Ethiopia

  • Taddese, Boja Dufera;Misganaw, Abay Sisay
    • Tuberculosis and Respiratory Diseases
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    • 제83권1호
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    • pp.89-95
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    • 2020
  • Background: Same-day sputum microcopy is recommended in areas where sputum smear microscopy external quality assessment (EQA) is effectively implemented and sturdy. In Addis Ababa, the status of EQA and drop-out of same-day sputum smear microcopy has not yet been assessed. The objective of this study was to assess the quality of same-day sputum smear microscopy and diagnostic drop-out of presumptive tuberculosis (TB) patients in health facilities (HFs) across Addis Ababa, Ethiopia. Methods: Amulti-analysis was conducted from September 2016 to July 2017 to determine the status of external quality assessment and diagnostic drop-out of presumptive TB patients registered for same-day sputum smear microscopy. Data was coded and entered in Microsoft Excel, and subsequently transferred and analyzed using SPSS version 20.0. Results: The drop-out of same-day sputum smear microscopy was 209 (6.2%). More than 33% of the specimens collected for purposes of same-day sputum smears were of poor quality. Among the selected HFs for the study: 13 (46.4%) used filter reagents prior to sputum smear staining while 75% of the selected HFs for the study used smear microscopy services interruption in a year. The sensitivity and specificity of the HFs participating in regional quality assessment scheme for the diagnosis of TB was 97.4% and 99.6%, respectively. Conclusion: The diagnostic drop-out of same-day sputum smear microscopy was high in Addis Ababa. Strengthening EQA, competency-based laboratory professionals training on sputum smear microscopy might reduce the reading errors in sputum smear. Awareness creation of the community on the benefits gained from completion of specimen provision for the same-day approach decreases diagnostic drop-out and enhances TB control program.

노인장기요양보험제도가 노인진료비에 미치는 영향 (Effect of the Long-term Care Insurance Policy on Medical Expenditures for the Elderly)

  • 한남경;정우진;김노을;임승지;박종연
    • 보건행정학회지
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    • 제23권2호
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    • pp.132-144
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    • 2013
  • Background: The purpose of this study was to analyze the medical expense change and influencing factors after introducing longterm care insurance system. The study period was 2 years before and after introduction of the system. Methods: We analyzed data collected from two divided group lived in Incheon. Four hundred and eighty-five elderly who received long-term care wage for one year were selected for experimental group. For control group, 1,940 elderly were selected by gender and age stratified random sampling. Difference-In-difference analyses was used for evaluating policy effectiveness. Also multiple regression analyses were conducted to identify the factors associated with total medical expenditures. The control variables were demographic variables, economic status, diseases, and medical examination variables. Results: Difference-in-difference analyses showed that total average medical expenses among long-term patients has decreased by 61.85%. Of these, the hospitalization expenses have decreased by 91.63% and the drug expenses have increased by 31.85%. Multiple regression analyses results showed that total average medical expenses among long-term patients have significantly decreased by 46.5% after introducing the long-term care insurance. The hospitalization expenses have significantly decreased by 148.5%, whereas the drug expenses have increased by 53.6%. And outpatient expenses have increased by 10.4%, but the differences were not statistically significant. Conclusion: The results showed that total medical expenses and hospitalization expenses have decreased after introducing the long-term care insurance. These results could support the opinion that the health insurance spending among long-term patients will be reduced gradually by long-term care insurance through changing medical demand.

편두통 환자의 한약치료 임상연구에 대한 고찰 (Review of Clinical Research on Herbal Medicine Treatment of Migraine)

  • 이수영;윤종민;문병순
    • 대한한방내과학회지
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    • 제39권4호
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    • pp.550-569
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    • 2018
  • Objectives: The purpose of this study was to investigate the effects of herbal medicine treatment for patients with migraine and to suggest research methods for herbal medicine treatment on migraine. Methods: In this study, a search was conducted through several academic sites using a combination of terms '편두통', 'Migraine', '한약', '한약치료', 'Herbal medicine', 'Herbal medicines', 'Herb', 'Traditional Chinese Medicine', and 'TCM'. Randomized controlled trials using herbal medicine treatments for adult patients with migraine were selected. Results: Ultimately, 46 papers were selected and analyzed. A statistically significant improvement was noted in the treatment group in terms of clinical migraine symptoms and other migraine evaluation tools before and after the herbal medicine treatment. Herbal medicines were administered in decoction, pill, and granule formulations. Many kinds of medicinal herbs, such as 解表藥類, 補益藥類, 淸熱藥類, 活血祛瘀藥類, and 平肝藥類, have been used for migraine. Among them, 川芎, belonging to 活血祛瘀藥類, is mentioned 36 times and is the most frequently used medicine. Herbal medicine was used safely for migraine treatment, without major adverse reactions, and the recurrence rate was significantly lower in the treatment group than in the control group. Conclusions: In conclusion, the herbal medicine treatment for patients with migraine showed a statistically significant improvement in 46 papers. Future studies should utilize standardized and objective evaluation tools, along with appropriate experimental design. The relevant articles should be increased to a significant level to verify the effect of herbal medicine treatments on migraine.

심장판막 질환 성형술에 대한 임상적 고찰 (Reconstructive Procedures Combined with or Without Prosthetic Valve Replacement for Cardiac Valvular Lesions)

  • 김윤;조범구;홍승록
    • Journal of Chest Surgery
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    • 제9권2호
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    • pp.207-214
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    • 1976
  • Operations for cardiac valvular disease has been progressed in various ways. Since 1949 when Lord Russel operated mitral stenosis by closed technique at Johns Hopkins Hospital then much progress has been achieved and that nowadays severely diseased cardiac valve has been replaced by prosthetic valve, which is almost ideal in hemodynamic aspect, but still it has many problems such as thromboembolism, destruction of red blood cell, pressure gradient, and disturbance of left ventricular function, so in case of delicate situations, valve replacement should be decided carefully. Besides prosthetic valve, there are some kinds of reconstructive procedures and these have been resulted in better prognosis than prosthetic valve replacement in selected cases. So, authors have reviewed 61 Cases of cardiac patients who have been operated reconstructive valvular surgery by cardiopulmonary bypass, at Yonsei University, from Jan. 1963 to Mar. 1976. Out of 61 cases, 9 patients were replaced by prosthetic valve and rest of the patients were operated upon in various reconstructive procedures such as commissurotomy, valvotomy, valvuloplasty, and annuloplasty. Twenty cases of congenital heart diseases with valvular lesion, which had been operated for valvular lesion were also included in this statistics. Out of 9 cases of prosthetic valvular replacement five cases of prosthetic valvular replacement was done combined with other reconstructive procedures after attempted valvuloplasty. Comparative prognosis of both procedures are somewhat variable by reporters, average 19% of mortality after reconstructive surgery and 38% of mortality after prosthetic valve replacement in long term results. Most common cause of death in postoperative period was low output syndrome in both cases. It seems that good preoperative evaluation and proper reconstructive surgery will afford good prognosis in selected cardiac valvular diseased patient.

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화병치료에 대한 침과 한약의 효과에 대한 메타분석 (The Effects of Acupuncture and Herbal Medicine for the Treatment of Whabyung: A Meta-analysis)

  • 김예리;정선용;최은지;조은
    • 한국임상약학회지
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    • 제27권4호
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    • pp.267-275
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    • 2017
  • Background and Objective: Whabyung is a Korean cultural disorder characterized by a combination of emotional stress and physical symptoms. Acupuncture, herbal medicines and other complementary medicinal treatments are used to treat the symptoms of whabyung. The purpose of this study is to investigate the effects of acupuncture treatment and herbal medicine treatments on anger, anxiety and depression of whabyung. Methods: Using PubMed, CENTRAL, AMED, MEDLINE, EMBASE, MEDLINE, CINAHL, Cnii, CNKI, J-SATGE, PsycArticles, KISS, KoreaMed, kmbase, NDSL, RISS, OASIS and Korean Traditional Knowledge Portal, articles published by March 2017 for whabyung or whabyung-related syndrome were searched. The quality of selected articles was evaluated using RoB and RoBANS. The effects of acupuncture and herbal medicines on anger, anxiety, and depression levels of whabyung patients were considered for meta-analyses. Results: Of the total 2408 articles retrieved from the database, 11 were finally selected and 4 articles were used for meta-analyses. Acupuncture reduced whabyung patients' anger and anxiety. Especially, the state anxiety was significantly reduced (effect size= -0.676, p= .026). Herbal medicine had effects on reducing anxiety and state anger while trait anger was increased without statistical significance. Conclusion: The present study showed the effectiveness of acupuncture and herbal medicines for whabyung patients in general. However, considering the limited availability of articles and the heterogeneity between them included for the meta-analysis, the results should be generalized with caution. In the future, more studies within the structure of evidence-based medicine need to be conducted to generate objective and valid evidences of korean medicine.

만성피로증후군의 증상관리를 위한 추나요법의 유용성: 체계적인 문헌고찰과 메타분석 (Benefit of chuna for managing symptoms in chronic fatigue syndrome patients: A systematic review and meta-analysis)

  • 송정윤;김준열;남동현
    • 대한한의학회지
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    • 제41권3호
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    • pp.205-220
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    • 2020
  • Objectives: The aim of this review is to assess the clinical benefit of chuna for managing symptoms in chronic fatigue syndrome (CFS) Methods: We searched eligible studies from the following 11 databases with no language restriction: Pubmed, CENTRAL, Embase, CNKI, CQVIP, Wanfang, CiNii, OASIS, RISS and Koreamed. We selected randomized controlled trial (RCT), quasi-randomized controlled trial (Quasi-RCT) and controlled clinical trial (CCT) in which patients with chronic fatigue syndrome were treated with chuna. The results of the included studies were synthesized through meta-analysis, and their risk of bias were also assessed. Results: We searched 914 potentially relevant studies, and only 20 studies were selected for this systematic review. Meta-analysis showed that chuna was more effective in improving general symptoms (n=291, RR 0.19 [95% CI 0.11 to 0.32], Z=6.08, p<0.00001, I2=0%), fatigue (n=487, SMD -0.95 [95% CI -1.19 to -0.71], Z=7.76, p<0.00001, I2=37%) and sleep disorder (n=139, SMD -0.58 [95% CI -0.92 to -0.24], Z=3.36, p=0.0008, I2=0%) compared to health supplements or usual care. When chuna was used as an added intervention, it was more effective in improving general symptoms(n=729, RR 0.25 [95% CI 0.15 to 0.42], Z=5.19, p<0.00001, I2=0%) and fatigue severity alone(n=217, SMD -1.21 [95% CI -1.53 to -0.89], Z=7.45, p<0.00001, I2=15%) compared to control. Conclusion: We found that chuna was beneficial for improving severity of general symptoms and fatigue at post treatment in CFS patients.

통증위치에 따른 자세 치우침의 차이비교 (Changes in Postural Deviation Caused by the Pain Area)

  • 방상분;정호발
    • 대한물리치료과학회지
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    • 제9권3호
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    • pp.97-106
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    • 2002
  • Purpose. This study was tried to compare the effect of the change in postural deviation caused by the pain side Subjects and Methods. Inpatients and outpatients (n=71) were selected from I hospital who have a musculoskeletal low back pain and shoulder pain without any history of the central nervous system (CNS) lesions, orthopaedic problems of the both lower extremities, or the vestibular and the visual default. For the control group, normal and healthy subjects (n=30) were selected without any history of weight bearing disorders. the weight bearing was rated by the computerized force plate. Results. 1) Postural deviation was not significant difference between patients and control group(p<0.01). But postural deviation in patients was more pronounced than control group. 2) There was significant difference of postural deviation between in patients according to the pain side(p<0.01). When the pain side was on the left side, postural deviation tended to the right. When the pain side was on the right side and vertebral body, postural deviation tended to the left. 3) There was no significant difference of postural deviation between regional pain in shoulder and regional pain in low back(p<0.01). Discussions and Conclusion. As a result, the pain, for sure, affected the good posture and its keeping process directly or/and indirectly. Therefore, as the postural deviation increases, the additional energy consumption increased by the works of the muscles to keep the good posture. Preponderated postural deviation, furthermore, could load too much to the musculoskeletal system, leading to increase the pain. The postural deviation, a result of the pain, can cause a secondary deformity of the distal area as a compensatory reaction, and this compensation actually become a cause of the musculoskeletal symptom back in a cycle. Therefore, the appropriate treatment of the musculoskeletal problem and the education of the posture correction should be given to decrease the pain, preventing the secondary deformities, and increasing muscle energy efficiency of the posture remaining muscles.

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Can Granisetron Injection Used as Primary Prophylaxis Improve the Control of Nausea and Vomiting with Low-Emetogenic Chemotherapy?

  • Keat, Chan Huan;Phua, Gillian;Kassim, Mohd Shainol Abdul;Poh, Wong Kar;Sriraman, Malathi
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권1호
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    • pp.469-473
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    • 2013
  • Background: The purpose of this study is to examine the risk of uncontrolled chemotherapy-induced nausea and vomiting (CINV) among patients receiving low emetogenic chemotherapy (LEC) with and without granisetron injection as the primary prophylaxis in addition to dexamethasone and metochlopramide. Materials and Methods: This was a single-centre, prospective cohort study. A total of 96 patients receiving LEC (52 with and 42 without granisetron) were randomly selected from the full patient list generated using the e-Hospital Information System (e-His). The rates of complete control (no CINV from days 1 to 5) and complete response (no nausea or vomiting in both acute and delayed phases) were identified through patient diaries which were adapted from the MASCC Antiemesis Tool (MAT). Selected covariates including gender, age, active alcohol consumption, morning sickness and previous chemotherapy history were controlled using the multiple logistic regression analyses. Results: Both groups showed significant difference with LEC regimens (p<0.001). No differences were found in age, gender, ethnic group and other baseline characteristics. The granisetron group indicated a higher complete response rate in acute emesis (adjusted OR: 0.1; 95%CI 0.02-0.85; p=0.034) than did the non-granisetron group. Both groups showed similar complete control and complete response rates for acute nausea, delayed nausea and delayed emesis. Conclusions: Granisetron injection used as the primary prophylaxis in LEC demonstrated limited roles in CINV control. Optimization of the guideline-recommended antiemetic regimens may serve as a less costly alternative to protect patients from uncontrolled acute emesis.