• 제목/요약/키워드: the stage of elderly

검색결과 271건 처리시간 0.031초

Breast and Cervical Cancer Screening and Associated Factors among Older Adult Women in South Africa

  • Peltzer, Karl;Phaswana-Mafuya, Nancy
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권6호
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    • pp.2473-2476
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    • 2014
  • Background: Little is known about the cancer screening prevalence and correlates in older adults from different racial backgrounds. In the context of heightened efforts for prevention and early diagnosis, we collected information on screening for two major types of cancers: cervical and breast cancer in order to establish their prevalence estimates and correlates among older South African women who participated in the Study of Global Ageing and Adults Health (SAGE) in 2008. Materials and Methods: We conducted a national population-based cross-sectional study with a multi-stage stratified cluster sample of 3,840 individuals aged 50 years or older in South Africa in 2008. In this analysis, we only considered the female subsample of (n=2202). The measures used included socio-demographic characteristics, health variables, anthropometric and blood pressure measurements. Multivariable regression analysis was performed to assess the association of socio-demographic factors, health variables and cancer screening. Results: Overall, regarding cervical cancer screening, 24.3% ever had a Papanicolaou (PAP) smear test, and regarding breast cancer screening, 15.5% ever had a mammography. In multivariate logistic regression analysis, younger age, higher education, being from the White or Coloured population group, urban residence, greater wealth, and suffering from two or more chronic conditions were associated with cervical cancer screening, and higher education, being from the White or Indian/Asian population group, greater wealth, having a health insurance, and suffering from two or more chronic condtions were associated with breast cancer screening. Conclusions: Cancer screening coverage remains low among elderly women in South Africa in spite of the national guideline recommendations for regular screening in order to reduce the risk of dying from these cancers if not detected early. There is a need to improve accessibility and affordability of early cervical and breast cancer screening for all women to ensure effective prevention and management of cervical and breast cancer.

두 가지 유형의 바이오마커를 이용한 파킨슨병의 진단과 신경섬유 경로의 특징 분석 (Diagnosis of Parkinson's Disease Using Two Types of Biomarkers and Characterization of Fiber Pathways)

  • 강신태;이욱;박병규;한경숙
    • 정보처리학회논문지:소프트웨어 및 데이터공학
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    • 제3권10호
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    • pp.421-428
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    • 2014
  • 파킨슨병은 뇌의 흑질 영역에서 도파민계 신경이 파괴되는 질병으로 알츠하이머병과 함께 대표적인 퇴행성 뇌 질환이다. 현재까지 병을 완치시킬 수 있는 치료법은 없지만 병의 진행을 완화시킬 수 있는 치료법이 존재하기 때문에 병의 진단이 굉장히 중요하다. 파킨슨병을 진단하기 위한 과거의 연구는 대부분 단일 바이오마커를 이용한 것으로 이러한 방법은 파킨슨병 환자를 높은 정확도로 진단할 수 있지만 정상인에 대한 진단은 상대적으로 낮은 성능의 한계성이 존재한다. 따라서 본 연구에서는 생화학적 바이오마커인 뇌척수액 내의 ${\alpha}$-synuclein 단백질 수치와 영상학적 바이오마커인 확산 텐서 영상의 여러 모수들을 결합하여 특징으로 사용하는 파킨슨병 진단 모델을 개발하고 성능을 평가하였다. 진단을 위해 개발된 모든 모델은 10-fold cross validation 성능평가에서 정확도가 최고 91.3%의 높은 성능을 보였으며, test 성능평가에서는 확산 텐서 영상의 모수들 중 FA와 ${\alpha}$-synuclein 단백질 수치가 결합된 모델, MO와 ${\alpha}$-synuclein 단백질 수치가 결합된 두 모델에서 최고 72%의 정확도 성능을 보여 파킨슨병의 진단에 유용하게 사용될 수 있는 가능성을 제시하였다. 파킨슨병의 진단을 위해 개발된 모델의 영상학적 특징 벡터를 통하여 파킨슨병 환자와 정상인의 신경섬유 경로의 특징을 분석하였다.

An Elderly Man with Fatal Respiratory Failure after Eating a Poisonous Mushroom Podostroma cornu-damae

  • Jang, Juah;Kim, Cheol-Hong;Yoo, Jun Jae;Kim, Mi Kang;Lee, Jae Eun;Lim, Ah Leum;Choi, Jeong-Hee;Hyun, In Gyu;Shim, Jung Weon;Shin, Ho-Seung;Han, Joungho;Seok, Soon Ja
    • Tuberculosis and Respiratory Diseases
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    • 제75권6호
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    • pp.264-268
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    • 2013
  • A 73-year-old, previously healthy man presented with nausea, vomiting, diarrhea, dry mouth and febrile sensation 3 hours after eating boiled wild mushrooms. After admission, he showed progressive severe respiratory distress, pancytopenia, azotemia, hypotension, hypoxemia and consolidation of the entire left lung on chest radiography. With a preliminary diagnosis of necrotizing pneumonia, he underwent left pneumonectomy in order to remove all necrotic lung tissue. Lung histology showed extensive hemorrhagic necrosis, massive inflammatory cell infiltration, prominent proliferation of young fibroblasts and the formation of an early-stage hyaline membrane along the alveolar wall. Despite aggressive treatment, including mechanical ventilation, continuous renal replacement therapy and administration of granulocyte colony stimulating factor and broad spectrum antibiotics, he died on hospitalization day 13. Subsequently, the mushroom was identified as Podostroma cornu-damae. This is the first case of a histological evidence of lung involvement by Podostroma cornu-damae poisoning in Korea.

노인요양시설 간호사의 거주노인 잔존기능관리: 개념개발연구 (Nurses' Management of Nursing Home Residents' Remaining Functional Ability: Concept Development)

  • 임선영;장성옥;김수진;김현주;최정은;박민선
    • 기본간호학회지
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    • 제21권1호
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    • pp.57-68
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    • 2014
  • Purpose: Nurses' management of Nursing Home residents' remaining functional ability is phenomena emphasizing as the main practice focus in long term care and has specific meanings within the context of quality of life for fragile and disabled elderly people in nursing homes. This study was conducted to clarify and to conceptualize the phenomena of nurses' management of nursing home residents' remaining functional ability. Method: The Hybrid Model of concept development was applied to develop a concept of nurses' management of residents' remaining functional ability. Results: This concept of nurse' management emerged as a phenomenon having meanings in two different dimensions, deliberation and enactment for five types of residents: residents with declining function and dementia requiring nursing assistance, bed-ridden residents with moderate dementia, residents with advanced dementia and behavior problems, but good physical health, residents at the end of life stage, and bed-ridden residents with intact mental health. Conclusions: Results indicate that nurses' management of remaining functional ability of residents in nursing homes is a concept having types of needs that should be treated in specified ways. Interventions should have a positive impacts on practical applications in nursing homes and on enhancing residents' remaining function.

T2N0M0 비소세포성 폐암의 근치적 방사선치료 (Curative Radiation Therapy for T2N0M0 Non-small Cell Lung Cancer)

  • 박인규;김재철
    • Radiation Oncology Journal
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    • 제13권1호
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    • pp.19-26
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    • 1995
  • Purpose : Surgery is the treatment of choice for resectable non-small cell lung cancer. For patients who are medically unable to tolerate a surgical resection or who refuse surgery, radiation therapy is an acceptable alternative. A retrospective analysis of Patients with stage I non-samll cell lung cancer treated with curative radiation therapy was performed to determine the results of curative radiation therapy and patterns of failure, and to identify factors that may influence survival. Materials and Methods : From 1986 through 1993, 39 Patients with T2N0M0 non-small cell lung cancer were treated with curative radiation therapy at department of radiation oncology, Kyungpook national university hospital. All Patients were not candidates for surgical resection because of either Patient refusal (16 patients), poor pulmonary function (12 patients), old age (7 patients), Poor Performance (2 patients) or coexisting medical disease (2 patients). Median age of patients was 67 years. Histologic cell type was squamous cell carcinoma in 36, adenocarcinoma in 1, large cell carcinoma in 1 and mucoepidermoid carcinoma in 1. All patients were treated with megavoltage irradiation and radiation dose ranged from 5000cgy to 6150cGy with a median dose of 6000cGy. The median follow-up was 17 months with a range of 4 to 82 months, Survival was measured from the date therapy initiated. Results : The overall survival rate for entire Patients was $40.6\%$ at 2 years and $27.7\%$ at 3 years, with a median survival time of 21 months. The disease-free survival at 2 and 3 years was $51.7\%$ and $25.8\%$, respectively. Of evaluable 20 patients with complete response, 15 patients were considered to have failed. Of these, 13 patients showed local failure and 2 patients failed distantly. Response to treatment (p=0.0001), tumor size (p=0.0019) and age (p=0.0247) were favorably associated with overall survival. Only age was predictive for disease-free survival (p = 0.0452). Conclusion : Radiation therapy is an effective treatment for small (less than 3cm) tumors, and should be offered as an alternative to surgery in elderly or infirm patients. Since local failure is the prominent Patterns of relapse, potential methods to improve local control with radiation therapy are discussed.

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Impact of PSA and DRE on Histologic Findings at Prostate Biopsy in Turkish Men Over 75 Years of Age

  • Verim, Levent;Yildirim, Asif;Basok, Erem Kaan;Peltekoglu, Erol;Pelit, Eyup Sabri;Zemheri, Ebru;Tokuc, Resit
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권10호
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    • pp.6085-6088
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    • 2013
  • Prostate specidic antigen (PSA) and digital rectal examination (DRE) are the known predictive factors for positive prostate biopsies differing according to the age, region and race. There have been only very limited studies about the impact of PSA on histological findings at prostate biopsy in Turkey. The aim of this study was to evaluate the impact of PSA and clinical stage on histologic findings of prostate biopsy in men older than 75 years of age as a first study in the Turkish population. A total of 1,645 consecutive prostate biopsies were included, with 194 men aged 75 or older. Cancer was identified in 104 patients (53.6%). Of the 104 positive biopsies, Gleason scores were less than 7 in 53 (49%) patients, 7 or greater in 51 (51%) patients. Positive prostate biopsies were significantly correlated with advanced age (p=0.0001), abnormal DRE (p=0.0001) and raised PSA (p=0.0001). The prostate volume was significantly correlated with advanced age especially in prostate cancer patients over 75 years, compared with those under 75 (p=0.0001). These results are useful for counseling men older than 75 years for prostate cancer detection. However, PCa screening decisions are currently based on urologist judgment and detection of latent asymptomatic disease is an important concern regarding costs, overdiagnosis, overtreatment and quality of life (QOL) for men aged 75 years and older. Healthy old patients with a long life expectancy need to be carefully evaluated for eligibility for PCa screening.

특발성 파킨슨병 환자의 하지 완서증 정량화를 위한 발 두드리기 동작의 각속도 분석 (Analysis of Angular Velocity during Toe Tapping for the Quantification of the Lower Limb Bradykinesia in Patients with Idiopathic Parkinson's Disease)

  • 김지원;권유리;엄광문;김형식;이정한;권도영;고성범;박병규;권대규
    • 전기학회논문지
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    • 제59권11호
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    • pp.2114-2118
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    • 2010
  • The purpose of this study was to analyze bradykinesia of toe tapping movement in patients with Parkinson's disease (PD) as compared to those of normal subjects. 39 PD patients (age: $65.5{\pm}11.2$ yrs, H&Y stage:$2.3{\pm}0.5$), 14 eldelry subjects with comparable mean age ($65.0{\pm}3.9$ yrs) and 17 healthy young subjects ($24.1{\pm}2.1$ yrs) participated in this study. Angular velocity during repetitive toe tapping movement was measured in both feet using a gyro sensor system. Suggested quantitative measures of bradykinesia were root-mean-squared (RMS) angular velocity, RMS angle, peak power and total power which were derived from the angular velocity signal. ANOVA showed that all measures were significantly different among three groups (p<0.001). Subsequent post-hoc test revealed that all measures in PD patients were significantly smaller than in healthy elderly and healthy young subjects (p<0.02). All measures were significantly correlated with UPDRS scores(r=-0.689~-0.825). These results suggest that the developed system can be used as quantitative measures of the lower limb bradykinesia in PD patients.

알츠하이머 질병 진단을 위한 혈액 바이오마커 검출용 바이오칩 센서 개발 (Development of Biochip Sensors for Blood Biomarkers Specific to Alzheimer's Disease Diagnostics)

  • 김수희;이상혁;이혜진
    • 공업화학
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    • 제28권4호
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    • pp.397-403
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    • 2017
  • 해마다 증가하는 알츠하이머 질병에 걸린 환자 수는 전체 노인 인구의 15%에 다다르고 있다. 인지장애를 유발하는 심각한 알츠하이머 질병을 조기에 진단하는 것은 중요한 일이지만 MRI, PET, 척수액 진단법과 같은 기존 진단법은 고비용뿐만 아니라 장시간의 진단으로 환자에게 부담을 줄 수 있다. 이러한 기존 알츠하이머 질병 진단법의 단점을 극복하기 위하여 소량의 환자 시료(예 : 혈액)만으로 신속하게 알츠하이머 질병을 조기에 진단할 수 있는 다양한 바이오센싱 기술을 개발하는 연구가 지속되고 있다. 본 미니총설에서는 알츠하이머 질병 진단에 유용하게 활용될 수 있는 혈액 바이오마커를 정성 및 정량적으로 검출할 수 있는 바이오칩 기반의 센서 기술과 이를 통한 조기진단 기술에 대해 간략하게 서술하고, 이와 관련한 최신 연구현황과 발전방향에 대해 논의하고자 한다.

후기성인학습자를 위한 수리문해 프로그램 개발 (A Study for Numeracy program Development of the elderly generation)

  • 이형주;고호경
    • 한국수학교육학회지시리즈E:수학교육논문집
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    • 제32권4호
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    • pp.519-536
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    • 2018
  • 본 연구는 후기성인학습자를 위한 수리문해 프로그램 개발 연구이다. 이를 위하여 먼저, 수리문해의 성격을 조명하고 이를 통해 후기성인학습자들을 위한 수리문해 학습 내용을 선정하였다. 또한 선별한 수학 내용을 후기성인학습자의 경험에 기반한 실생활과 연관 지어 교수학습 자료를 개발하였다. 이러한 수리문해 프로그램을 후기성인학습자들에게 적용한 결과 학습초기 흥미와 같은 정의적 영역의 변화를 동반하며 학습이 지속됨에 따라 수학적 정형화 단계를 거쳐 수학적 정교화가 발현되는 양상을 관찰할 수 있었다. 본 연구는 후기성인들의 경험에 기반하여 후기성인을 위한 산술을 수리문해 측면에서 재정의함으로서, 비형식적인 후기성인학습자들의 문제해결과정을 정교한 수학적 문제해결 해결로 정당화시킬 수 있도록 후기성인학습자의 수학적 정교화에 기여할 수 있었다는 점에서 그 의의가 있다.

치매노인의 거주형태 및 서비스유형에 따른 간호관리의 효과분석 (A Study on the Effectiveness of Care of Patients with Alzheimer s Disease According to Residence Arrangement and Types of Services)

  • 홍여신;박현애;조남옥
    • 대한간호학회지
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    • 제26권4호
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    • pp.768-781
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    • 1996
  • The problem of care of patients and families with Alzheimer's disease has become a conscious raising social policy issue in Korea. The government of the Republic of Korea has become cognizant of the situation and has begun searching for ways to remedy it. Thus, there is a need for a comprehensive under-standing of the situation in which patients and their families are struggling and the enormous problems of care. With a realization of the urgent need, this study was done to investigate the situation and the care needs of families with patients with Alzheimer's Disease, and to compare the effectiveness of services utilized by the families in terms of cost and effects on patient's conditions and on family live. The Subjects for the study were 29 families with hospitalized patients, 25 families utilizing hospital outpatient clinics, 14 families utilizing day care facilities, and 16 families with homebound patients. A total of 84 families were interviewed by four trained interviewers using structured and semistructured questionnaires. The data produced from these interviews included : the patient's stage of Alzheimer's disease, patient's bizarre behavior, hours spent on patient care per day, family burden and quality of life, direct and indirect costs encountered in the care of patients, and the families' evaluation of the effectiveness of the services received. The data were analyzed to determine the relationships between family charactersistics, patient's conditions and services utilization. The effectiveness of each of the service entities was assessed through families evaluation and hoped for service and comparisons were made between services in terms of the cost-effectiveness ratios. After initial comparison of cost-effectiveness ratios, further analysis was done to compare between groups for incremental effectiveness for each incremental unit of cost to determine the most cost-effective service entities. The findings of the study are as fellows : 1. The choice of living arrangement and the types of services are a function of the stage of Alzheimer's condition and the economic status of the family. 2. Comparision of the cost of care showed that most expenses were encountered in by families with hospitalization, families using outpatient services, and families using day care services in that order. The least expense was involved in the care of homebound patients. The economic burden felt by families was in the same order as expenses. 3. The average number of hours spent on daily patient care was 9.9 hours for the outpatient clinic users, 9.7 hours for homebound patients, and 5.4 hours for day care users. 4. There were significant differences in the patient's conditions (CDRL), bizarre behaviors and the families's burden by living arrangement and /or types of service. However, no significant difference was found between groups in the family's quality of life. 5. The families rated the services of day care center as most effective for the care of the patients and families, except for a few families who had experienced some improvement in the patient's conditions. The outpatient clinic users expressed psychological comforts mainly in that the patient was being taken care of. For those hospitalized patients, families expressed the comfort of being relieved of the burden of care and that the patient is being professionally cared for. Form the analysis of the costs, hours of patient care, patient's bizarre behaviors, family's quality of life and burdens, and family's evaluation of services, it is concluded that up to the mid stage of Alzheimer's condition, the utilization of day care center services is found to be the most cost-effective, and toward the end stage of the Alzheimer's disease, it is hoped that there will be a establishment of long term or short term in-patient facilities for the protection of patients and preservation of the integrity of families for less cost. Thus. it was concluded that the family centered system of care is the most effective for Korea with systematic support systems developed for the care of patients and their families according to the needs of families as the patient's condition deteriorates.

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