• Title/Summary/Keyword: severity Index

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Preliminary Study on Developing Test Items of Swallowing & Communication Screening Protocols for Patients with Head and Neck Burns (안면부 및 경부 화상 환자의 삼킴 및 의사소통능력 선별 프로토콜 개발을 위한 예비 연구)

  • Kim, JungWan;Lee, HyoJin;Lee, Hyun-Joung
    • 재활복지
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    • v.21 no.2
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    • pp.217-231
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    • 2017
  • We have to consider two parts of the evaluation and treatment for the patients with head and neck burns. The primary consideration is swallowing function for nutrition supply for them and the next is speech function for efficient communication and aesthetic impression of them. The purpose of this study is to summarize the preliminary questions of Communication Screening Protocols which can help understand comprehensively on swallowing disorder, motor speech disorder and voice disorder of patients with head and neck burns. We divided the evaluation into 4 evaluation areas including 'oral mechanism', 'respiration/voice', 'articulation', and 'swallowing' by referring to overseas studies dealing with various communication disorders caused by burns, and prepared the final questionnaires by conducting the content validity verification by five expert (speech & language pathologist). The range of Content Validity Index was shown relatively appropriate with .50~.84. There was a conflict of opinions in experts whether the items in the areas of respiration/voice and swallowing may be appropriate, whereas there was no different view of the oral mechanism and articulation area. Through the different characteristics of communication difficulties of patients with head and neck burns, we expect it will be modified appropriately according to the patients through evaluation of burn patients by type and severity.

Role of the Baseline Heart Rate Variability to the Effect of the Huanglian-Jie-Du Granule in Hwa-Byung Patients: Supplementary Analysis from the Randomized Trial Comparing Huanglian-Jie-Du Granule and Placebo for Hwa-Byung (화병 환자의 심박변이도 차이에 따른 황련해독탕의 효과: 화병에 대한 무작위 대조 비교임상시험 결과의 추가 분석)

  • Choi, Yu-Jin;Cho, Seung-Hun
    • Stress
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    • v.26 no.4
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    • pp.305-311
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    • 2018
  • Background: The purpose of the study was to explore whether the effect of Huanglian-jie-du granule depends on the baseline heart rate variability in patients with Hwa-byung. Methods: We used the supplementary data from a randomized, double-blind, placebo-controlled trial of Huanglian-jie-du granule for Hwa-byung patients. Study drugs were taken orally three times per day for one week. Heart rate variability was measured three times; before the treatment, after the treatment, and month follow-up period. Spearman's rho test was done to explore the role of the baseline heart rate variability to the effect of Huanglian-jie-du granule. Results: Baseline low frequency power of heart rate variability was negatively correlated with the reduction of the insomnia severity index in experimental group (r=-0.493 p=0.02). Also, Huanglian-jie-de granule significantly decreased the low frequency power of heart rate variability in patients with Hwa-byung compared to placebo (mean difference 266 [95% CI: 29~503], p=0.028). In Hwa-byung symptoms, stuffy, pushing up in the chest, and flush of anger were correlated with low frequency power of heart rate variability (p=0.010, p=0.000, and p=0.016, respectively). Conclusions: The effect of the Huanglian-jie-de granule for insomnia seems to be lower when the baseline low frequency power of heart rate variability is higher in Hwa-byung patients. Also, Huanglian-jie-de granule is likely to decrease the sympathetic activity in patients with Hwa-byung. Measurement of heart rate variability may be the useful to understand the state of Hwa-byung patients.

Control Effect of Alternative Fungicide Spraying System on Powdery Mildew Caused by Podosphaera xanthii on Greenhouse Cucumber (약제교호살포에 따른 시설재배 오이 흰가루병(Podosphaera xanthii) 방제효과)

  • Park, Se-Keun;Park, Bue-yong;Jeong, In-Hong;Jeon, Sung-wook;Ryu, Hyun-ju;Lee, Sang-bum
    • Korean Journal of Environmental Biology
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    • v.36 no.4
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    • pp.538-543
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    • 2018
  • Powdery mildew caused by Podosphaera xanthii is a disease in cucurbit crops especially in green house. The objective of this study was to determine the effect of alternative fungicide spraying system for control of powdery mildew disease. We selected four fungicides with different mode of action and made three treatment combinations of each fungicide in 2017. Pyraclostrobin-flutianyl-penthiopyrad treatment showed the highest control value (87%) while, pyraclostrobin-pyraclostrobin-pyraclostrobin treatment showed the lowest control value (32.5%). So it seemed like the treatment was not suitable for control of powdery mildew. In 2018, pyraclostrobin of pyraclostrobin-flutianyl-penthiopyrad was replaced to contact fungicide called iminoctadine-tris-albesilate and compared control effect of two treatments. Two of the treatments showed similar control value (87.0% for pyraclostrobin, 89.0% for iminoctadine-tris-albesilate). These two tests in 2017 and 2018 indicated that alternative treatment of different fungicides is essential for controlling of powdery mildew and inhibiting development of fungicide resistance.

Association between physical activity and health - related quality of life in Korean patients with COPD (만성폐쇄성폐질환의 신체활동수준과 삶의 질 간의 관련성)

  • Mok, Hyungkyun;Jo, Kyu-hee
    • The Journal of Korean Society for School & Community Health Education
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    • v.20 no.1
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    • pp.15-27
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    • 2019
  • Objective: Patients with COPD have a lower overall quality of life than normal people. If patients with COPD do not regularly perform physical activities, their exercise capacity is reduced. It could lead to muscle loss, and negatively affect their general physical, social, and psycho-social status. The purpose of this study was to examine association with physical activity, sedentary life time and health-related quality of life in patients with COPD. Method: Of the total of 22,948 participants surveyed in Korean National Health and Nutrition Examination Survey (KNHANES 2013-2015), 8,626 participants were used for this study. Of these, under 40 years, over 80 years, missing values and abnormal values were excluded. Study variables included physical activity level, sedentary time and health-related quality of life variables. The physical activity level assessment tool was measured using International Physical Activity Questionnaire (IPAQ). Sedentary time referred to the amount of sitting time without moving the body. EQ-5D (Euro Quality of Life-5 Dimensions) was used as an index of health-related quality of life. Control variables were age, gender, income level, education level, marital status, comorbidity, smoking, BMI, cough, sputum, COPD severity. For this study, descriptive analysis, T-test, ANOVA and multivariate regression analysis were performed. Results: Of the 1,092 patients with COPD, 76.1% (n=831) were male and 23.9% (n=261) were female, while 39.0% (n=2,939) were male and 61.0% (n=4,595) were female in the comparison group without COPD. The COPD group with high level of physical activity showed a high level of EQ-5D scores ($0.9349{\pm}0.11$, p <0.001). Among patients with COPD, after adjusting for control variables, physical activity and sedentary time (physical activity level, Β=0.047, p <.001), (sedentary time, Β=-0.017, p <.05) were associated with health-related quality of life. Conclusion: Patients with COPD have a higher quality of life as their physical activity increases and the quality of life decreases as the time spent sitting increases. This study suggests that public health experts should consider improving COPD patient physical activity.

Risk factors for hospital admission in revisiting patients to the emergency department with abdominal pain

  • Bae, Jung Kwang;Kim, Hye Jin;Ryu, Seokyong;Choi, Seung Woon;Kang, Tae Kyung;Oh, Sung Chan;Cho, Suk Jin;Lee, Sun Hwa
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.6
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    • pp.679-686
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    • 2018
  • Objective: The aim of this study was to identify the clinical characteristics and risk factors associated with the admission of patients in the emergency department (ED) within 30 days after discharge. Methods: A retrospective, observational study was conducted on adult patients presenting with abdominal pain to the ED of a single, urban, university hospital, between January 2014 and December 2015, who revisited the ED within 30 days after discharge. Data was collected on the emergency severity index level, time to contact doctors, physical examination, laboratory tests, use of computed tomography (CT), and patient disposition on revisitation. The primary outcome was hospital admission following an ED revisit in the 30-day period after the first visit. Results: During the study period, 19,480 patients visited the ED with the chief complaint of abdominal pain, and 13,577 were discharged. A total of 251 patients (1.29%) revisited the ED within 30 days, of which 89 were eligible for the study. The primary outcome was associated with not performing a CT scan on the initial visit and an increased C-reactive protein (CRP) value. Receiver operating characteristic curve analysis showed that a cut-off baseline CRP value of >0.35 mg/dL can predict the primary outcome with a sensitivity and specificity of 75% and 62.1%, respectively (area under the curve, 0.701; 95% confidence interval, 0.569-0.833; P=0.007). Conclusion: An increased CRP value and not performing abdominal CT were associated with a higher rate of admission following ED revisits of patients with abdominal pain. Future prospective studies on the role of abdominal CT imaging in patients presenting to the ED with abdominal pain will be needed.

Case Report of the Pityriasis Rosea Patient with Pruritus Treated by Korean Medicine Treatment alone (소양감이 동반된 장미색 비강진 환자의 한방단독치료 보고)

  • Lee, Kyoungeun;Kim, Jungpil;Jeong, Seonhyung;Ahn, Joon;Jeong, Hyein;Kim, Kyounghan;Jang, Insoo;Choi, Yoomin;Oh, Yongtaek
    • Herbal Formula Science
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    • v.30 no.1
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    • pp.27-36
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    • 2022
  • Objective : The purpose of this study is to present a case report with the adult patient who needed active treatment of pityriasis rosea with severe pruritus, and did not respond to steroid treatment in the preceding month. Methods : The subject is an adult patient with pityriasis rosea over the age of 40 without any other diseases. We administered Korean medicine treatment with Bangpungtongseong-san (防⾵通聖散) and acupuncture. The effects of the treatment were evaluated via scales including Pruritus score, Pityriasis Rosea Severity Score (PRSS), and picture. Results : After the treatment Pruritus score/PRSS index of the case changed from 8/20 to 0/0. No other severe adverse reactions were reported. No more recurrence or pruritus was confirmed in follow-up. Conclusions : Korean medicine treatment with Bangpungtongseong-san showed marked improvement in pruritus and skin symptoms of pityriasis rosea in need of active care. With the lack of existing clinical reports of pityriasis rosea, we found that Korean medicine treatment could be an effective way, and it is expected that Bangpungtongseong-san could be administered to pityriasis rosea patients. Randomized-controlled trial for further evaluation will be needed in the future.

Detecting of Proximal Caries in Primary Molars using Pen-type QLF Device (펜-타입 QLF 장비의 임상적 유구치 인접면 우식 탐지 성능)

  • Cho, Hyejin;Kim, Hyuntae;Song, Ji-Soo;Shin, Teo Jeon;Kim, Jung-Wook;Jang, Ki-Taeg;Kim, Young-Jae
    • Journal of the korean academy of Pediatric Dentistry
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    • v.48 no.4
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    • pp.405-413
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    • 2021
  • The purpose of this in vivo study was to assess the clinical screening performance of a quantitative light-induced fluorescence (QLF) device in detecting proximal caries in primary molars. Fluorescence loss, red autofluorescence and a simplified QLF score for proximal caries (QS-proximal) were evaluated for their validity in detecting proximal caries in primary molars compared to bitewing radiography. Three hundred and forty-four primary molar surfaces were included in the study. Carious lesions were scored according to lesion severity assessed by visual-tactile and radiographic examinations. The QLF images were analyzed for two quantitative parameters, fluorescence loss and red autofluorescence, as well as for QS-proximal. For both quantitative parameters and QS-proximal, the sensitivity, specificity and area under receiver operating curve (AUROC) were calculated as a function of the radiographic scoring index at enamel and dentin caries levels. Both quantitative parameters showed fair AUROC values for detecting dentine level caries (△F = 0.794, △R = 0.750). QS-proximal showed higher AUROC values (0.757 - 0.769) than that of visual-tactile scores (0.653) in detecting dentine level caries. The QLF device showed fair screening performance in detecting proximal caries in primary molars compared to bitewing radiography.

Association of Korean Medicine Pattern Identifications and Liver Blood Markers with the Severity of Cognitive Impairment in an Elderly Population (경도인지장애와 경도치매 단계에서의 한의 변증 및 간 혈액지표 연관성 탐색 연구)

  • Kahye Kim;Jiyun Cha;Seul Gee Kim;Hyung-Won Kang;Yeoung-Su Lyu;In Chul Jung;Jaeuk U. Ki
    • Journal of Oriental Neuropsychiatry
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    • v.34 no.3
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    • pp.141-150
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    • 2023
  • Objectives: This study aimed to comprehend the characteristics of Korean medicine patterns in relation to varying degrees of cognitive impairment in an elderly population. Methods: The dataset included 127 elderly individuals with cognitive impairment obtained from three Korean medicine hospitals between 2018 and 2021. The participants were categorized into two groups based on Clinical Dementia Rating-Sum of Boxes (CDR-SB) scores: those with questionable impairment (QI) and those with very mild dementia (VMD). A diagnostic framework for Korean medicine patterns encompassing Qi deficiency, Yin deficiency, Phlegm dampness, and Heat-fire was employed. Liver blood markers, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), and the AST/ALT ratio, were also analyzed. Results: The scores of the cognitive assessment tools (MoCA-K, MMSE-DS, and K-IADL) of the QI group significantly differed from those of the VMD group. CDR-SB exhibited a positive correlation with the scores of each pattern of Qi deficiency, Yin deficiency, Phlegm dampness, and Heat-fire, whereas ALT and AST values displayed negative correlations. Binomial logistic analysis, controlling for potential confounders, such as age, education years, body mass index, the presence of chronic disease, and the presence of medication, verified that the VMD group showed higher pattern scores and lower ALT and AST values than the QI group. Conclusions: Increases in pattern scores along with decreased AST and ALT levels might be indicative of more severe cognitive impairment.

Factors Influencing Intensive Care Unit Length of Stay of Patients with Critical Illness (성인 중환자실에 입실한 환자의 중환자실 체류기간에 영향을 미치는 요인 탐색)

  • Son, Youn-Jung;Song, Hyo-Suk;Won, Mi Hwa;Yang, Sun Hee
    • Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
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    • v.7 no.11
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    • pp.525-536
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    • 2017
  • Purpose: The aim of this study was to identify the factors influencing ICU (intensive care units) length of stay of adult patients with critical illness. Methods: This study was adopted descriptive design. 270 patients who were admitted to ICU in general hospital, Seoul were analyzed. Results: A total of 270 patients, 116 (43%) patients had stayed more than 5 days. The length of stay of intensive care unit was significant positive correlation with the FCI(Functional Comobidity Index) score(r=0.33, p<.001) and APACHE(Aacute Physiology and Chronic Health Evlauaion) II(r=0.19, p=.001). In multiple logistic regression, the predictors of ICU length of stay were admission route (p=0.013), FCI score (p<0.001), APACHE II(p=0.012). Conclusions: Heatlh care providers in ICU should be aware that patients who admit to emergency departments and have higher disease severity are more considered to reduce their ICU length of stays.

Risk Factors for Prevertebral Soft Tissue Swelling Following Single-level Anterior Cervical Spine Surgery

  • Junsang Park;Sang Mook Kang;Yu Deok Won;Myung-Hoon Han;Jin Hwan Cheong;Byeong-Jin Ha;Je Il Ryu
    • Journal of Korean Neurosurgical Society
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    • v.66 no.6
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    • pp.716-725
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    • 2023
  • Objective : Anterior cervical spine surgery (ACSS) is a common surgical procedure used to treat cervical spinal degenerative diseases. One of the complications associated with ACSS is prevertebral soft tissue swelling (PSTS), which can result in airway obstruction, dysphagia, and other adverse outcomes. This study aims to investigate the correlation between various cervical sagittal parameters and PSTS following single-level ACSS, as well as to identify independent risk factors for PSTS. Methods : A retrospective study conducted at a single institution. The study population included all patients who underwent single-level ACSS between January 2014 and December 2022. Patients with a history of cervical spine surgery or trauma were excluded from the study. The presence and severity of PSTS was assessed by reviewing pre- and postoperative imaging studies. The potential risk factors for PSTS that were examined include patient age, sex, body mass index, tobacco use, comorbidities, serum albumin levels, operative time, implant type, implanted level, and various cervical spine sagittal parameters. Multivariate linear regression analysis was performed to identify the independent risk factors for PSTS. Results : A total of 62 consecutive patients who underwent single-level ACSS over a 8-year period at a single institution were enrolled in this study. Only preoperative segmental angle showed positive correlation with PSTS among various cervical spine sagittal parameters (r=0.36, p=0.005). Artificial disc replacement showed a negative correlation with PSTS (β=-0.38, p=0.002), whereas the use of demineralized bone matrix (DBM) had a positive impact on PSTS (β=0.33, p=0.009). We found that male sex, lower preoperative serum albumin, and implantation of upper cervical level (above C5) were independent predictors for PSTS after single-level ACSS (β=1.21; 95% confidence interval [CI], 0.27 to 2.15; p=0.012; β=-1.63; 95% CI, -2.91 to -0.34; p=0.014; β=1.44; 95% CI, 0.38 to 2.49; p=0.008, respectively). Conclusion : Our study identified male sex, lower preoperative serum albumin levels, and upper cervical level involvement as independent risk factors for PSTS after single-level ACSS. These findings can help clinicians monitor high-risk patients and take preventive measures to reduce complications. Further research with larger sample sizes and prospective designs is needed to validate these findings.