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Sample records for korean hospitals treated

  1. Global health care trends and innovation in Korean hospitals.

    PubMed

    Jun, Lee Wang

    2013-01-01

    Health care is one of the most significant global issues. The Korean health care systems, which has both good and bad features, is grabbing international attention because of its cost effectiveness. However, it is also facing a lot of challenges such as a rapidly ageing population, increases in expenditure and too many competing acute hospitals. Therefore, many Korean hospitals have been trying to find innovative ways to survive. This article introduces some possible answers such as expansion and consolidation strategies, quality assureance, converging ICT and health care, attracting foreign patients, research-driven hospitals, public-private partnerships and a focus on service design and patient experience.

  2. [The medical assistance of Swedish Red Cross Field Hospital in Busan during and after the Korean war].

    PubMed

    Park, Jiwook

    2010-06-30

    After the outbreak of the Korean war, the Kingdom of Sweden, a permanent neutral nation, dispatched the Swedish Red Cross Field Hospital(SRCFH) instead of armed forces for humanitarian support to the allied forces in South Korea. The Hospital consisted of about 170 Swedes, all volunteers. From the early part of the Korean War, SRCFH took part in the medical assistance in Busan. When the frontline advanced to northern Korea, the number of inflowing casualties to this field hospital decreased. At that time, earnest medical aid for civilians commenced, and many Koreans were treated in available beds in SRCFH. After the armistice in July 1953, SRCFH became the Swedish Hospital in Busan, serving not only the military but also civilians, and continued its humanitarian mission until April 1957 for the Korean who were suffering from a collapsed medical system in the midst of war. When the Hospital returned to Sweden, it had treated over two million patients from twenty countries, including wounded UN allied force, Korean (south and north), Chinese prisoner of war and Korean civilian. Moreover, it left a transformative legacy, the National Medical Center in Seoul which was established in collaboration with other Scandinavian countries who dispatched medical assistance during the Korean War.

  3. Disparities in Potentially Preventable Hospitalizations for Chronic Conditions Among Korean Americans, Hawaii, 2010-2012.

    PubMed

    Heo, Hyun-Hee; Sentell, Tetine L; Li, Dongmei; Ahn, Hyeong Jun; Miyamura, Jill; Braun, Kathryn

    2015-09-17

    Korean Americans are a growing but understudied population group in the United States. High rates of potentially preventable hospitalizations suggest that primary care is underutilized. We compared preventable hospitalizations for chronic conditions in aggregate and for congestive heart failure (CHF) for Korean Americans and whites in Hawaii. Discharge data from 2010 to 2012 for all hospitalizations of adults in Hawaii for preventable hospitalizations in aggregate and for CHF included 4,345 among Korean Americans and 81,570 among whites. Preventable hospitalization rates for chronic conditions and CHF were calculated for Korean Americans and whites by sex and age group (18-64 y vs ≥65 y). Unadjusted rate ratios for Korean Americans were calculated relative to whites. Multivariate models, controlling for insurance type and comorbidity, provided adjusted rate ratios (aRRs). Korean American women and men aged 65 or older were at greater risk of preventable hospitalization overall than white women (aRR, 2.48; P = .003) and white men (aRR, 1.82; P = .049). Korean American men aged 65 or older also were at greater risk of hospitalization for CHF relative to white men (aRR, 1.87; P = .04) and for older Korean American women (aRR, 1.75; P = .07). Younger age groups did not differ significantly. Older Korean American patients may have significant disparities in preventable hospitalizations, which suggests poor access to or poor quality of primary health care. Improving primary care for Korean Americans may prevent unnecessary hospitalizations, improve quality of life for Korean Americans with chronic illness, and reduce health care costs.

  4. Disparities in Potentially Preventable Hospitalizations for Chronic Conditions Among Korean Americans, Hawaii, 2010–2012

    PubMed Central

    Sentell, Tetine L.; Li, Dongmei; Ahn, Hyeong Jun; Miyamura, Jill; Braun, Kathryn

    2015-01-01

    Introduction Korean Americans are a growing but understudied population group in the United States. High rates of potentially preventable hospitalizations suggest that primary care is underutilized. We compared preventable hospitalizations for chronic conditions in aggregate and for congestive heart failure (CHF) for Korean Americans and whites in Hawaii. Methods Discharge data from 2010 to 2012 for all hospitalizations of adults in Hawaii for preventable hospitalizations in aggregate and for CHF included 4,345 among Korean Americans and 81,570 among whites. Preventable hospitalization rates for chronic conditions and CHF were calculated for Korean Americans and whites by sex and age group (18–64 y vs ≥65 y). Unadjusted rate ratios for Korean Americans were calculated relative to whites. Multivariate models, controlling for insurance type and comorbidity, provided adjusted rate ratios (aRRs). Results Korean American women and men aged 65 or older were at greater risk of preventable hospitalization overall than white women (aRR, 2.48; P = .003) and white men (aRR, 1.82; P = .049). Korean American men aged 65 or older also were at greater risk of hospitalization for CHF relative to white men (aRR, 1.87; P = .04) and for older Korean American women (aRR, 1.75; P = .07). Younger age groups did not differ significantly. Conclusion Older Korean American patients may have significant disparities in preventable hospitalizations, which suggests poor access to or poor quality of primary health care. Improving primary care for Korean Americans may prevent unnecessary hospitalizations, improve quality of life for Korean Americans with chronic illness, and reduce health care costs. PMID:26378898

  5. Psychometric assessment of the Emotional Reactions Instrument-Korean (ERI-K) to measure Korean children's emotional reaction to hospitalization.

    PubMed

    Kim, Jin-Sun; Park, Jeong-Hwan; Foster, Roxie L; Cheng, Sufen

    2011-01-01

    The purpose of this study was to test psychometric properties of the Emotional Reactions Instrument-Korean (ERI-K). A convenience sample of 170 hospitalized Korean children was recruited. Each child was asked to describe how she or he felt during hospitalization, through the ERI-K and the Facial Affective Scale. Surprisingly, children reported lower levels of negative emotions and physical discomfort and a moderate level of positive emotion (Happy, Good). Internal consistency reliability of .88 for the 14-item scale provides strong support for reliability. Construct validity was supported by item-to-total correlations ranging between .42 and .65. Exploratory factor analysis identified two factors that explained 54% of the variance. Further testing of the ERI-K is recommended to provide additional evidence of psychometric adequacy across Korean populations.

  6. Teamwork and clinical error reporting among nurses in Korean hospitals.

    PubMed

    Hwang, Jee-In; Ahn, Jeonghoon

    2015-03-01

    To examine levels of teamwork and its relationships with clinical error reporting among Korean hospital nurses. The study employed a cross-sectional survey design. We distributed a questionnaire to 674 nurses in two teaching hospitals in Korea. The questionnaire included items on teamwork and the reporting of clinical errors. We measured teamwork using the Teamwork Perceptions Questionnaire, which has five subscales including team structure, leadership, situation monitoring, mutual support, and communication. Using logistic regression analysis, we determined the relationships between teamwork and error reporting. The response rate was 85.5%. The mean score of teamwork was 3.5 out of 5. At the subscale level, mutual support was rated highest, while leadership was rated lowest. Of the participating nurses, 522 responded that they had experienced at least one clinical error in the last 6 months. Among those, only 53.0% responded that they always or usually reported clinical errors to their managers and/or the patient safety department. Teamwork was significantly associated with better error reporting. Specifically, nurses with a higher team communication score were more likely to report clinical errors to their managers and the patient safety department (odds ratio = 1.82, 95% confidence intervals [1.05, 3.14]). Teamwork was rated as moderate and was positively associated with nurses' error reporting performance. Hospital executives and nurse managers should make substantial efforts to enhance teamwork, which will contribute to encouraging the reporting of errors and improving patient safety. Copyright © 2015. Published by Elsevier B.V.

  7. Korean nurses' adjustment to hospitals in the United States of America.

    PubMed

    Yi, M; Jezewski, M A

    2000-09-01

    Korean nurses' adjustment to hospitals in the United States of America Due to shortage of nurses, more nurses from other countries are employed in health care settings in the United States of America (USA). Little attention has been paid to understanding how culturally different international nurses adjust to USA hospitals. The purpose of this study was to investigate how Korean nurses adjust to USA hospital settings. Grounded theory method was used for sampling procedure, data collection and analysis in order to describe Korean nurses' experiences from their perspective and to develop a substantive theory that explains their process of adjustment. Data were collected using semi-structured formal interviews with a purposive sample of 12 Korean nurses. The interviews were audio-taped and transcribed. Analysis of data, using the constant comparative method, revealed 'adjustment to USA hospitals' as the basic social psychological process. Five categories composed the process: (1) relieving psychological stress; (2) overcoming the language barrier; (3) accepting USA nursing practice; (4) adopting the styles of USA problem-solving strategies; and (5) adopting the styles of USA interpersonal relationships. These five categories capture the essential aspects of the adjustment process and each category contains a set of sub-categories that describe Korean nurses' day-to-day experiences that are critical and also problematic to their adjustment. The process evolves in two stages. In the initial stage, the first three of the five categories greatly influenced the nurses' adjustment. From the perspective of the nurses in the study, the initial stage lasts about 2 to 3 years. The remaining two categories are principal components of the later stage. It takes an additional 5 to 10 years to complete this stage. This model highlights both distress and accomplishments of Korean nurses during their adjustment to USA hospitals. The results of the study may help USA nurses gain

  8. Relationships between compassion fatigue, burnout, and turnover intention in Korean hospital nurses.

    PubMed

    Sung, Kiwol; Seo, Youngsook; Kim, Jee Hee

    2012-12-01

    This study aimed to identify relationships between compassion fatigue, burnout, and turnover intention in Korean hospital nurses. In total, 142 hospital nurses were surveyed as part of data collection. Data related to compassion fatigue, burnout, and turnover intention were collected using a questionnaire between May 2011 and September 2011. The data analysis was performed using PASW 19.0 program, which included one-way ANOVA, independent t-tests, Pearson's correlation coefficient, and hierarchical regression analysis. This study detected a positive correlation between compassion fatigue and burnout(r=.37, p<.001), and turnover intention(r=.55, p<.001). Compassion fatigue accounted for 29.6% of the variance for turnover intention among Korean hospital nurses. The results indicate that it is necessary to reduce compassion fatigue, and turnover intention among Korean hospital nurses.

  9. A Survey on the Status of Nutrition Care Process Implementation in Korean Hospitals

    PubMed Central

    Baek, Hee Joon

    2013-01-01

    The Nutrition Care Process (NCP), developed by the American Dietetic Association, is a significant issue to dietetic professionals in many countries and there are rising needs for NCP implementation in Korea. We surveyed clinical nutrition managers of Korean general hospitals regarding the perception of NCP, the status of NCP implementation, and the opinions on NCP. The questionnaire was collected from 35 hospitals. Most clinical nutrition managers perceived NCP, but NCP implementation in hospital was at early stage. NCP was implemented in a fourth of the surveyed hospitals and many clinical nutrition managers responded that the lack of knowledge and the concern on increasing working time were major barriers to implementing NCP. To successfully implement NCP in Korean hospital, ongoing education and training programs should be developed to provide adequate knowledge and help dietitians to cope with the barriers. PMID:23908981

  10. Korean Sa-Ahm Acupuncture for Treating Canine Oral Fibrosarcoma.

    PubMed

    Choi, Keum Hwa; Flynn, Kristi

    2017-06-01

    A nine-year-old male neutered Golden Retriever presented with oral fibrosarcoma. Sa-Ahm Traditional Korean acupuncture was provided along with medicinal herb treatment. Based on Sa-Ahm's theory, the constitution of this case was hypoactive Large-Intestine (LI) meridian qi. The acupuncture treatment was focused on reinforcing LI meridian qi along with reinforcing Small-Intestine and Liver meridian qi. The necrosis of the tumor started from 8 months after treatments and was completely necrotized around 1 month after initiation of tumor necrosis. Karnofsky Performance Status score was 80 to 100 % throughout the treatment except during the active stage of tumor necrosis having KPS of 50%. In this study, oral fibrosarcoma was managed well by both Sa-Ahm acupuncture and medicinal herb treatment. The result suggested that Sa-Ahm acupuncture along with herbal treatment could be a potential medical option for canine oral FSA therapy. Copyright © 2017. Published by Elsevier B.V.

  11. [Clinical Work Experience of Korean Immigrant Nurses in U.S. Hospitals].

    PubMed

    Seo, Kumsook; Kim, Miyoung

    2016-04-01

    The purpose of this qualitative study was to explore the meaning of the experience of Korean immigrant nurses working in US hospitals. Purposive sampling yielded 15 Korean immigrant nurses who had more than one year of clinical experience in US hospitals. Data were collected from March to August 2012 through in-depth interviews and thematic analysis was conducted using van Manen's hermeneutic phenomenological approach. The findings were classified into eight themes: 'struggling from staff at workplace being territorial to outsiders', 'feeling oppressed due to language barrier', 'accepting rational and horizontal relationships at work', 'staying alert in the environment where lawsuits are rife', 'feeling a sense of stability from the social system that values human dignity', 'maintaining self-confidence from prominent nursing practices and senior Korean nurses' professional reputation', 'performing essential comprehensive nursing care', 'promoting self-development to be equipped with professionalism.' The findings indicate that the Korean immigrant nurses were able to excel in their workplace when their clinical experience at US hospitals was combined with the lived space in US politics and environment, lived time of patience, lived body to be alert, and lived others with multi cultural characteristics.

  12. Work climate perception and turnover intention among Korean hospital staff.

    PubMed

    Hwang, J-I; Chang, H

    2009-03-01

    To examine the impact of work climate perception (WCP) on turnover intention among public hospital personnel in Korea. With increased competition and high staff turnover in hospitals, managers focus on human resource management. Positive work climate is considered as a strategy to retain valued staff, but previous studies have shown occupationally different relationships between turnover intention and work environment characteristics as perceived by staff. A cross-sectional questionnaire survey was conducted of employees (n = 852) in four public hospitals in Korea to gather information about WCP, intention to leave and demographics. The work climate was measured by 32 items categorized into 13 factors in five dimensions. For each occupation, logistic regression analyses were performed to determine the significant factors of WCP that influenced turnover intention. Positive WCP inversely influenced turnover intention. For all occupations, the most significant factor was 'workgroup friendliness and warmth' (OR = 0.01-0.21). For the nursing group, an additional significant factor was 'adherence to job standard' (OR = 0.63). In contrast, there were different significant factors for other hospital staff: 'workgroup esprit de corps' (OR = 0.16) and 'role clarity' (OR = 0.19) for physicians, 'adherence to job standard' (OR = 3.08) and 'role adaptation' (OR = 2.23) for paramedicals, and 'flexibility and innovation' (OR = 0.14) and 'interdepartmental cooperation' (OR = 0.19) for administrators. Nurses with perceptions of work climate emphasizing 'workgroup friendliness and warmth' and 'adherence to job standard' had lower turnover intention. Physicians, paramedicals and administrators have different WCPs. To retain qualified personnel, hospitals should focus on human relations, maintaining a consideration for occupation-specific characteristics.

  13. Clinical Characteristics of Diabetic Patients Transferred to Korean Referral Hospitals

    PubMed Central

    Oh, Min Young; Kim, Sang Soo; Lee, In Kyu; Baek, Hong Sun; Lee, Hyoung Woo; Chung, Min Young

    2014-01-01

    Background We evaluated the disease profile and clinical management, including the status of both glycemic control and complications, in patients with diabetes who were transferred to referral hospitals in Korea. Methods Patients referred to 20 referral hospitals in Gyeongsangnam/Gyeongsangbuk-do and Jeollanam/Jeollabuk-do with at least a 1-year history of diabetes between January and June 2011 were retrospectively reviewed using medical records, laboratory tests, and questionnaires. Results A total of 654 patients were enrolled in the study. In total, 437 patients (67%) were transferred from clinics and 197 (30%) patients were transferred from hospitals. A total of 279 patients (43%) visited higher medical institutions without a written medical request. The main reason for the referral was glycemic control in 433 patients (66%). Seventy-three patients (11%) had received more than one session of diabetic education. Only 177 patients (27%) had been routinely self-monitoring blood glucose, and 146 patients (22%) were monitoring hemoglobin A1c. In addition, proper evaluations for diabetic complications were performed for 74 patients (11%). The most common complication was neuropathy (32%) followed by nephropathy (31%). In total, 538 patients (82%) had been taking oral hypoglycemic agents. A relatively large number of patients (44%) had been taking antihypertensive medications. Conclusion We investigated the clinical characteristics of diabetic patients and identified specific problems in diabetic management prior to the transfer. We also found several problems in the medical system, which were divided into three medical institutions having different roles in Korea. Our findings suggested that the relationships among medical institutions have to be improved, particularly for diabetes. PMID:25349826

  14. Reasons for Delayed Orchiopexies in a Korean Tertiary Care Hospital

    PubMed Central

    Ahn, Hyunsoo; Lee, Hahn Ey; Choi, Hwang

    2014-01-01

    Purpose Since the 1990s, it has been well known that orchiopexies should be performed by no later than 2 years of age. Nevertheless, studies from other countries report a substantial number of delayed orchiopexies. On the basis of an analysis of a tertiary care hospital database, we aimed to investigate the incidence of delayed orchiopexies performed in patients after 5 years of age and to understand the causes of such delays and the possible consequences. Materials and Methods We retrospectively analyzed the surgical database of Seoul National University Hospital between 2004 and 2012 and detected patients who underwent orchiopexy later than 5 years of age. Reasons for delayed orchiopexies were studied and the possible consequences of delayed orchiopexies were assessed with respect to surgical difficulty and testicular volume. Results We found 160 cases of delayed orchiopexies, which accounted for about 15% of all orchiopexies performed. Two major reasons for delay were related to the parents of the child: parental delay and parental request for the treatment of persistent retractile testis. Acquired cryptorchidism was found in 21 cases (13.1%), mainly associated with hypospadias. Surgical difficulty, especially owing to a short testicular cord, was encountered in 48 cases (30.2%), and a comparison with age-matched normative values showed substantially smaller testicular volume. Conclusions Despite well-established guidelines for the optimal age of surgery, 15% of orchiopexies were not performed at a proper time. Improved propagation of an optimal age limit is necessary to reduce the rate of delayed orchiopexies considering increases in surgical difficulty and potential testicular growth retardation. PMID:24466401

  15. Molecular epidemiology and antimicrobial susceptibility of Clostridium difficile isolates from two Korean hospitals

    PubMed Central

    Lee, Won-Kil; Selasi, Gati Noble; Na, Seok Hyeon; Kwon, Hyo Il; Kim, Yoo Jeong; Lee, Hae Sook; Song, Kyung Eun; Shin, Jeong Hwan; Lee, Je Chul

    2017-01-01

    Clostridium difficile is one of the main etiological agents causing antibiotic-associated diarrhea. This study investigated the genetic diversity of 70 toxigenic C. difficile isolates from two Korean hospitals by employing toxinotyping, ribotyping, multilocus sequence typing (MLST), and pulsed-field gel electrophoresis (PFGE). Toxin gene amplification resulted in 68 A⁺B⁺ and two A-B+ isolates. Most isolates (95.7–100%) were susceptible to daptomycin, metronidazole, and vancomycin. Seventy C. difficile isolates were classified into five toxinotypes, 19 ribotypes, 16 sequence types (STs), and 33 arbitrary pulsotypes. All C. difficile isolates of ribotype 018 (n = 38) were classified into ST17, which was the most prevalent ST in both hospitals. However, C. difficile isolates of ST17 (ribotype 018) exhibited pulsotypes that differed by hospital. ST2 (ribotype 014/020), 8 (ribotypes 002), 17 (ribotype 018), and 35 (ribotypes 015) were detected in both hospitals, whereas other STs were unique to each hospital. Statistical comparison of the different typing methods revealed that ribotyping and PFGE were highly predictive of STs. In conclusion, our epidemiological study indicates that C. difficile infections in both hospitals are associated with the persistence of endemic clones coupled with the emergence of many unique clones. A combination of MLST with PFGE or ribotyping could be useful for monitoring epidemic C. difficile strains and the emergence of new clones in hospitals. PMID:28355266

  16. Adverse Events in Korean Traditional Medicine Hospitals: A Retrospective Medical Record Review.

    PubMed

    Hwang, Jee-In; Kim, Jinsung; Park, Jae-Woo

    2015-05-21

    Traditional medicine has been used worldwide in recent decades. The aim of this study was to determine the incidence of adverse events (AEs) in traditional medicine hospitals and investigate patient and health-care utilization factors associated with AE occurrence. A 2-stage review of 1152 randomly sampled charts in 2 teaching Korean traditional medicine hospitals was conducted. Three physicians and a quality improvement specialist identified AE occurrence, severity, and preventability using the Global Trigger Tool (Appendix 1, Supplemental Digital Content, http://links.lww.com/JPS/A19). Two traditional Korean medicine professors validated the findings. Logistic regression analysis was performed to determine factors associated with AE occurrence. One hundred twenty-two admissions (10.6%) had at least one AE (7.39 events per 1000 patient days and 14.5 events per 100 admissions). Among 167 AEs, 73.7% were mild and 70.7% were judged preventable. Procedure-related AEs were most common. After considering other patient and health-care utilization characteristics, factors associated with AE occurrence were altered mental status on admission (OR, 3.86; 95% confidence interval [CI], 1.20-12.44), use of various traditional medicine therapies (OR, 1.69; 95% CI, 1.32-2.15), length of stay (OR, 1.02; 95% CI, 1.01-1.03), and number of unique triggers (OR, 6.35; 95% CI, 4.54-8.89). Approximately 11% of inpatients in traditional medicine hospitals experienced AEs. Because patients have a higher risk of AEs, special attention should be paid to those with altered mental status on admission, receiving various traditional medicine therapies, staying for a longer period, and having various positive triggers.

  17. Epidemiology of Hospital-Treated Injuries Sustained by Fitness Participants

    ERIC Educational Resources Information Center

    Gray, Shannon E.; Finch, Caroline F.

    2015-01-01

    Purpose: The purpose of this study was to provide an epidemiological profile of injuries sustained by participants in fitness activities in Victoria, Australia, based on hospital admissions and emergency department (ED) presentations and to identify the most common types, causes, and sites of these injuries. Method: Hospital-treated fitness…

  18. Epidemiology of Hospital-Treated Injuries Sustained by Fitness Participants

    ERIC Educational Resources Information Center

    Gray, Shannon E.; Finch, Caroline F.

    2015-01-01

    Purpose: The purpose of this study was to provide an epidemiological profile of injuries sustained by participants in fitness activities in Victoria, Australia, based on hospital admissions and emergency department (ED) presentations and to identify the most common types, causes, and sites of these injuries. Method: Hospital-treated fitness…

  19. The rate of and risk factors for frequent hospitalization in systemic lupus erythematosus: results from the Korean lupus network registry.

    PubMed

    Lee, J W; Park, D J; Kang, J H; Choi, S E; Yim, Y R; Kim, J E; Lee, K E; Wen, L; Kim, T J; Park, Y W; Sung, Y K; Lee, S S

    2016-11-01

    Objectives The survival rate of patients with systemic lupus erythematosus has improved in the last few decades, but the rate of hospitalization and health care costs for these patients remain higher than in the general population. Thus, we evaluated the rate of hospitalization and associated risk factors in an inception cohort of Korean patients with lupus. Methods Of the 507 patients with systemic lupus erythematosus enrolled in the KORean lupus NETwork, we investigated an inception cohort consisting of 196 patients with systemic lupus erythematosus presenting within 6 months of diagnosis based on the American College of Rheumatology classification criteria. We evaluated the causes of hospitalization, demographic characteristics, and laboratory and clinical data at the time of systemic lupus erythematosus diagnosis of hospitalized patients and during a follow-up period. We calculated the hospitalization rate as the number of total hospitalizations divided by the disease duration, and defined "frequent hospitalization" as hospitalization more than once per year. Results Of the 196 patients, 117 (59.6%) were admitted to hospital a total of 257 times during the 8-year follow-up period. Moreover, 22 (11.2%) patients were hospitalized frequently. The most common reasons for hospitalization included disease flares, infection, and pregnancy-related morbidity. In the univariate regression analysis, malar rash, arthritis, pericarditis, renal involvement, fever, systemic lupus erythematosus disease activity index > 12, hemoglobin level < 10 mg/dl, albumin level < 3.5 mg/dl, and anti-Sjögren's syndrome A positivity were associated with frequent hospitalization. Finally, multivariate analysis showed that arthritis, pericarditis, and anti-Sjögren's syndrome A antibody positivity at the time of diagnosis were risk factors for frequent hospitalization. Conclusions Our results showed that frequent hospitalization occurred in 11.2% of hospitalized patients and

  20. A population pharmacokinetic analysis of the influence of nutritional status of digoxin in hospitalized Korean patients.

    PubMed

    Choi, Soo An; Yun, Hwi-yeol; Lee, Eun Sook; Shin, Wan Gyoon

    2014-03-01

    Safe and effective use of digoxin in hospitalized populations requires information about the drug's pharmacokinetics and the influence of various factors on drug disposition. However, no attempts have been made to link an individual's digoxin requirements with nutritional status. The main goal of this study was to estimate the population pharmacokinetics of digoxin and to identify the nutritional status that explains pharmacokinetic variability in hospitalized Korean patients. Routine therapeutic drug-monitoring data from 106 patients who received oral digoxin at Seoul National University Bundang Hospital were retrospectively collected. The pharmacokinetics of digoxin were analyzed with a 1-compartment, open-label pharmacokinetic model by using a nonlinear mixed-effects modeling tool (NONMEM) and a multiple trough screening approach. The effect of demographic characteristics and biochemical and nutritional indices were explored. Estimates generated by using NONMEM indicated that the CL/F of digoxin was influenced by renal function, serum potassium, age, and percentage of ideal body weight (PIBW). These influences could be modeled by following the equation CL/F (L/h) = 1.36 × (creatinine clearance/50)(1.580) × K(0.835) × 0.055 × (age/65) × (PIBW/100)(0.403). The interindividual %CV for CL/F was 34.3%, and the residual variability (SD) between observed and predicted concentrations was 0.225 μg/L. The median estimates from a bootstrap procedure were comparable and within 5% of the estimates from NONMEM. Correlation analysis with the validation group showed a linear correlation between observed and predicted values. The use of this model in routine therapeutic drug monitoring requires that certain conditions be met which are consistent with the conditions of the subpopulations in the present study. Therefore, further studies are needed to clarify the effects of nutritional status on digoxin pharmacokinetics. The present study established important sources of

  1. [Life experiences of Korean patients with Hansen's disease in Sorok Island Hospital].

    PubMed

    Yang, Ya Ki

    2014-12-01

    The purpose of this study was to identify life experiences of Korean patients with Hansen's disease (leprosy). For this study, 5 participants from Sorok Island Hospital were purposively chosen. Data were collected through in-depth individual interviews from June to July 2014. Data analysis method was based on Colaizzi's approach. The study results showed that experiences of patients with Hansen's disease consisted of 14 themes and six theme clusters: 1) Bad disease approaching as fate; 2) Family breakup and far from the village; 3) New life in Sorok Island Hospital; 4) Treatment of Hansen's disease and disability; 5) Life in the disease community; 6) Comfort and hope of life. The findings of this study indicate that health care professionals should pay attention to patients with Hansen's disease not only to reduce their physical and psychological suffering, but also to help the community and public culture to reduce the social stigma surrounding this disease and causing suffering for the patients. The results of the present study can help us to have a better understanding of various aspects of patients' lived experiences.

  2. Mapping of nursing records into the NIC and the ICNP in a Korean oriental-medicine hospital.

    PubMed

    Lee, Eunjoo; Lee, Mikyoung; Jung, Ok Bun

    2006-01-01

    This study uses mapping methodology to examine the applicability of the Nursing Interventions Classification and the International Classification of Nursing Practice to nursing practice in a Korean Oriental-medicine hospital. Data were collected from the nursing records of 56 stroke patients in one unit, and intervention statements were mapped into NIC and ICNP. Of 147 unique nursing intervention statements extracted, 136 (92.52%) could be mapped into NIC and 99 (67.35%) statements could be completely mapped into ICNP. Using mapping methodology, this study validates that both NIC and ICNP would be useful for documenting nursing care in a Korean hospital, but it also identifies additional concepts that need to be represented in both of these standardized nursing languages. It is recommended that nurses be more careful in documenting their interventions and also that SNLs be developed further to more completely represent nursing practice.

  3. Experiences of a hospital in Thailand in treating tsunami patients.

    PubMed

    2005-01-01

    No one was prepared when the tsunami hit on that sunny Sunday morning of 26 December 2004--not the villagers, not the hotel employees, not the tourists on holiday enjoying the clear skies and calm waters. Yet days later, Bumrungrad International Hospital (BI), a Joint Commission International-accredited, 554-bed medical centre in Bangkok, Thailand, quickly became prepared as it began treating patients from the tsunami. This article highlights the efforts of Bumrungrad International Hospital in treating tsunami patients. Information for this article has been provided by Bumrungrad International's Senior Management team.

  4. Risk of hospitalization for hypoglycemia among older Korean people with diabetes mellitus: Interactions between treatment modalities and comorbidities.

    PubMed

    Kim, Hyun Min; Seong, Jong-Mi; Kim, Jaetaek

    2016-10-01

    The objective of this study was to carry out a large population-based study to understand the factors associated with hypoglycemia-related hospitalizations among older Korean adults with diabetes mellitus.This study analyzed data from a subset of the 2013 Health Insurance and Review and Assessment service-Adult Patient Sample. A total of 307,170 subjects, comprising 41.7% men and 58.3% women, had diabetes mellitus. Hypertension (80.8%) was the most common comorbidity, and dyslipidemia (59.0%) and ischemic heart disease (21.3%) were also prevalent. Approximately half of the patients with diabetes had >2 comorbidities, and two-thirds of the patients had >3 comorbidities. The proportion of patients taking insulin or sulfonylureas was 54.9%, and 23.2% of the patients were taking other medications. About 21.9% of the patients were treated nonpharmacologically. A total of 2867 hypoglycemia-related admission occurred, the incident rate was 9.33 per 1000 person. The risk was higher among female patients and older patients with several comorbidities, including cardiovascular disease, cerebrovascular disease, chronic liver disease, chronic kidney disease, dementia, and malignancies. Treatment modalities, including insulin and sulfonylureas, were associated with a high risk of hypoglycemia. After adjustments for age, sex, the different comorbidities, and the treatment modalities, we determined that chronic kidney disease and dementia were associated with a high risk of hypoglycemia-related hospitalization (odds ratio [OR] = 2.52 and OR = 1.93, respectively). Furthermore, patients with chronic kidney disease or dementia who were treated with sulfonylureas and insulin had very high risks of hypoglycemia, and the incident rate was 66.6 and 63.75 per 1000 person, respectively.In conclusion, the presence of comorbidities, especially chronic kidney disease and dementia, increased the risk of hypoglycemia-associated hospitalization within this population of older patients

  5. Violence-related injuries treated in hospital emergency departments.

    PubMed

    Rand, M R; Strom, K

    1997-08-01

    The Study of Injured Victims of Violence included a survey to estimate the number of persons treated in US hospital emergency departments (EDs) for nonfatal injuries from violence. This study serves as a supplement to the National Electronic Injury Surveillance System, in a nationally representative, one-third sample of 31 hospitals having EDs. Six of the main key findings were: 1) in 1994, about 1.4 million people were treated for nonfatal injuries sustained in intentional or possibly intentional acts of violence; 2) about 94% of the patients were injured during an assault, 2% during robbery, and 5% during rape or sexual assault; 3) three-fifths of all persons treated were males; 4) Blacks, who constitute about 13% of the population, comprised 24% of those treated for violence-related injuries; 5) a higher percentage of women were treated for injuries inflicted by persons they are intimate with, such as a spouse, boyfriend, or girlfriend, while men were more likely to be injured by acquaintances or strangers; and 6) about 92% of violence victims treated in EDs were immediately released after treatment, whereas 8% were hospitalized for further treatment.

  6. Risk Factors for Thyroid Cancer: A Hospital-Based Case-Control Study in Korean Adults

    PubMed Central

    Myung, Seung-Kwon; Lee, Chan Wha; Lee, Jeonghee; Kim, Jeongseon; Kim, Hyeon Suk

    2017-01-01

    Purpose Although the incidence of thyroid cancer in Korea has rapidly increased over the past decade, few studies have investigated its risk factors. This study examined the risk factors for thyroid cancer in Korean adults. Materials and Methods The study design was a hospital-based case-control study. Between August 2002 and December 2011, a total of 802 thyroid cancer cases out of 34,211 patients screened from the Cancer Screenee. Cohort of the National Cancer Center in South Korea were included in the analysis. A total of 802 control cases were selected from the same cohort, and matched individually (1:1) by age (±2 years) and area of residence for control group 1 and additionally by sex for control group 2. Results Multivariate conditional logistic regression analysis using the control group 1 showed that females and those with a family history of thyroid cancer had an increased risk of thyroid cancer, whereas ever-smokers and those with a higher monthly household income had a decreased risk of thyroid cancer. On the other hand, the analysis using control group 2 showed that a family history of cancer and alcohol consumption were associated with a decreased risk of thyroid cancer, whereas higher body mass index (BMI) and family history of thyroid cancer were associated with an increased risk of thyroid cancer. Conclusion These findings suggest that females, those with a family history of thyroid cancer, those with a higher BMI, non-smokers, non-drinkers, and those with a lower monthly household income have an increased risk of developing thyroid cancer. PMID:27338034

  7. Acquired uterine vascular abnormalities associated with persistent human chorionic gonadotropin: Experience at a Korean teaching hospital.

    PubMed

    Ju, Da Hye; Yi, Sang Wook; Sohn, Woo Seok; Lee, Sang Soo

    2015-12-01

    The aim of this study was to describe our experience with the diagnosis and management of acquired uterine vascular abnormalities associated with persistent human chorionic gonadotropin (hCG). Through this case series, we sought to establish our protocol for the treatment and follow-up of uterine vascular lesions associated with persistent hCG. We examined the clinical presentations of 28 Korean women with acquired vascular uterine abnormalities associated with persistent hCG who were seen in the Department of Obstetrics and Gynecology of the Gangneung Asan Teaching Hospital, Gangneung-si, Korea between October 2006 and July 2012 and retrospectively reviewed their medical records. The mean patient age was 32.5 ± 6.4 years, and the mean parity was 1.4 ± 1.2. The mean size of the vascular lesions in color Doppler sonography and multidetector computed tomography with angiography was 3.1 ± 1.6 cm and 3.9 ± 1.6 cm, respectively. Multidetector computed tomography revealed arteriovenous malformation-like vascular lesions (n = 15) and pseudoaneurysms (n = 3). Treatments included clinical observation (n = 11), uterine artery embolization (n = 11), hysterectomy (n = 4), and chemotherapy, including single methotrexate (MTX) treatment and combination chemotherapy (n = 9). When the uterine vascular lesion is not decreased, or if weekly clinical follow-up reveals that the serum β-hCG level is persistently elevated or sustained in conjunction with vaginal hemorrhage, a proper management strategy is required. Copyright © 2015. Published by Elsevier B.V.

  8. Children Treated at an Expeditionary Military Hospital in Iraq

    DTIC Science & Technology

    2006-09-01

    ARTICLE Children Treated at an Expeditionary Military Hospital in Iraq Lt Col Christopher P. Coppola, USAF, MC; Maj Brian E. Leininger , USAF, MC; Lt...Contributions: Study concept and design: Coppola. Acquisition of data: Coppola, Leininger , Rasmussen, and Smith. Analysis and interpretation of data...Coppola. Draft- ing of the manuscript: Coppola. Critical revision of the manu- script for important intellectual content: Coppola, Leininger , Rasmussen

  9. [Children with injuries treated in hospital emergency departments].

    PubMed

    Mestrović, Julije; Milunović, Pjer; Skelin, Ana; Carija, Robert; Catipović, Tatjana; Mestrović, Marija; Mujkić, Aida

    2012-01-01

    The aim of this study was to determine characteristics of injuries of children admitted to the Emergency Department (ED) of University Hospital Split, and also to define the mechanisms of injuries, as well as the type and severity of injuries. We evaluated 3,221 children with injuries treated in the ED of the University Hospital of Split in the period from January to July 2009. The following indicators were analyzed: age, gender, anatomic distribution of injuries, mechanism, Injury Severity Score (ISS) and the need for hospital and intensive care admission. Chi-square and Mann-Whitney tests were used in order to determine statistical relevance of the results. Boys were more often injured than girls (65.6%), and most of the injured children were older than 13 years (41.7%). The majority of patients (96%) had minor injuries (ISS < 10), and only 3.7% of patients were hospitalized. The majority of injuries were caused by falls (71.3%), and limbs were the most frequently injured body region (67.1%). However, road traffic accidents (RTA) required hospitalization more often than any other mechanism (25% of patients), and the leading injury in RTA victims was head injury (38% of patients). Older children were more susceptible to RTAs (64.5%), and the majority of children were injured as passengers in cars (36.4%). Children with head injuries, and those injured in RTAs, were more often hospitalized and more often admitted to intensive care unit than other patients. The most frequently injured body region in children treated in ED are limbs, and the most frequent mechanism of injury is fall. However, the most severe are head injuries, and the majority of severe injuries are caused by RTAs. These data are important for programs of injury prevention.

  10. Comparing the probability of stroke by the Framingham risk score in hypertensive Korean patients visiting private clinics and tertiary hospitals.

    PubMed

    Choi, Cheol Ung; Park, Chang Gyu

    2010-09-08

    The purpose of this study was to investigate the pattern of distribution of risk factors for stroke and the 10-year probability of stroke by the Framingham risk score in hypertensive patients visiting private clinics vs. tertiary hospitals. A total of 2,490 hypertensive patients who attended 61 private clinics (1088 patients) and 37 tertiary hospitals (1402 patients) were enrolled. The risk factors for stroke were evaluated using a series of laboratory tests and physical examinations, and the 10-year probability of stroke was determined by applying the Framingham stroke risk equation. The proportion of patients who had uncontrolled hypertension despite the use of antihypertensive agents was 49% (66 and 36% of patients cared for at private clinics and tertiary hospitals, respectively; p < 0.001). The average 10-year probability of stroke by the Framingham risk score in hypertensive patients was 21% (approximately 2.2 times higher than of the risk of stroke in the Korean Cancer Prevention Study [KCPS] cohort) and was higher in patients attending tertiary hospitals compared to private clinics (16 and 24% of patients attending private clinics and tertiary hospitals, respectively; p < 0.001). Since the 10-year probability of stroke by the Framingham risk score in hypertensive patients attending tertiary hospitals was higher than the risk for patients attending private clinics. We suggest that the more aggressive interventions are needed to prevent and early detect an attack of stroke in hypertensive patients attending tertiary hospitals.

  11. The Use of Korean Medicine to Treat Patients with Spinobulbar Muscular Atrophy, Kennedy’s Disease - A Case Study

    PubMed Central

    Lee, Seongjin; Cha, Eunhye; Lee, Jongcheol; Lee, Jongdeok; Song, Inja

    2017-01-01

    Objectives: Studies involving patients with spinobulbar muscular atrophy (SBMA), which is often referred to as Kennedy’s disease, similar to those involving patients with progressive muscular disease (PMD), are rare. This paper reports a case study involving the use of Korean medicine to treat a patient with SBMA. Methods: We treated a patient with SBMA with unique symptoms by using various kinds of pharmacopuncture and herbal medicines for about two and a half years. After the treatment had ended, we evaluated the patient’s conditions and the side effects of the treatment. Results: After treatment, the patient’s symptoms were stabilized, and the patient suffered no abnormalities or side effects. No special changes in condition were noted during treatment period, and the patient was very satisfied with his response to treatment. Conclusion: Existing treatments have some considerable after effects and are difficult to apply in domestic clinics. In this regard, our findings should open possibilities for new clinical guidelines. Nevertheless, the limitations associated with this case study should be resolved, and more studies need to be conducted. PMID:28392964

  12. [Treating accident or chemical attack casualties in hospital].

    PubMed

    Bastide, Théophile; Auguet, Vanessa; Dupille, Stéphanie; Rivière, Sébastien; Wilk, Anaëlle; Chemouny, Myriam; Egido, Antoine; Boncourt, Philippe

    2015-02-01

    It is mandatory for all hospitals to be prepared for the occurrence of a chemical biological, radiological or nuclear (CBRN) event. This preparation requires specific investment on the part of the hospital management, as well as from the nursing teams on the frontline. Teams from Lariboisière hospital in Paris have been working on these risks for several years.

  13. Lessons Learned from Development of De-identification System for Biomedical Research in a Korean Tertiary Hospital.

    PubMed

    Shin, Soo-Yong; Lyu, Yongman; Shin, Yongdon; Choi, Hyo Joung; Park, Jihyun; Kim, Woo-Sung; Lee, Jae Ho

    2013-06-01

    The Korean government has enacted two laws, namely, the Personal Information Protection Act and the Bioethics and Safety Act to prevent the unauthorized use of medical information. To protect patients' privacy by complying with governmental regulations and improve the convenience of research, Asan Medical Center has been developing a de-identification system for biomedical research. We reviewed Korean regulations to define the scope of the de-identification methods and well-known previous biomedical research platforms to extract the functionalities of the systems. Based on these review results, we implemented necessary programs based on the Asan Medical Center Information System framework which was built using the Microsoft. NET Framework and C#. The developed de-identification system comprises three main components: a de-identification tool, a search tool, and a chart review tool. The de-identification tool can substitute a randomly assigned research ID for a hospital patient ID, remove the identifiers in the structured format, and mask them in the unstructured format, i.e., texts. This tool achieved 98.14% precision and 97.39% recall for 6,520 clinical notes. The search tool can find the number of patients which satisfies given search criteria. The chart review tool can provide de-identified patient's clinical data for review purposes. We found that a clinical data warehouse was essential for successful implementation of the de-identification system, and this system should be tightly linked to an electronic Institutional Review Board system for easy operation of honest brokers. Additionally, we found that a secure cloud environment could be adopted to protect patients' privacy more thoroughly.

  14. Antimicrobial susceptibility patterns and macrolide resistance genes of beta-hemolytic viridans group streptococci in a tertiary Korean hospital.

    PubMed

    Uh, Young; Hwang, Gyu Yel; Jang, In Ho; Kwon, Ohgun; Kim, Hyo Youl; Yoon, Kap Jun

    2007-10-01

    The aim of this study was to investigate antimicrobial susceptibilities and macrolide resistance mechanisms of beta-hemolytic viridans group streptococci (VGS) in a tertiary Korean hospital. Minimum inhibitory concentrations (MICs) of seven antimicrobials were determined for 103 beta-hemolytic VGS isolated from various specimens. The macrolide resistance mechanisms of erythromycin-resistant isolates were studied by the double disk test and polymerase chain reaction (PCR). The overall resistance rates of beta-hemolytic VGS were found to be 47.5% to tetracycline, 3.9% to chloramphenicol, 9.7% to erythromycin, and 6.8% to clindamycin, whereas all isolates were susceptible to penicillin G, ceftriaxone, and vancomycin. Among ten erythromycin-resistant isolates, six isolates expressed a constitutive MLS(B) (cMLS(B)) phenotype, and each of the two isolates expressed the M phenotype, and the inducible MLS(B) (iMLS(B)) phenotype. The resistance rates to erythromycin and clindamycin of beta-hemolytic VGS seemed to be lower than those of non-beta-hemolytic VGS in our hospital, although cMLSB phenotype carrying erm(B) was dominant in beta-hemolytic VGS.

  15. Antimicrobial Susceptibility Patterns and Macrolide Resistance Genes of β-Hemolytic Viridans Group Streptococci in a Tertiary Korean Hospital

    PubMed Central

    Hwang, Gyu Yel; Jang, In Ho; Kwon, Ohgun; Kim, Hyo Youl; Yoon, Kap Jun

    2007-01-01

    The aim of this study was to investigate antimicrobial susceptibilities and macrolide resistance mechanisms of β-hemolytic viridans group streptococci (VGS) in a tertiary Korean hospital. Minimum inhibitory concentrations (MICs) of seven antimicrobials were determined for 103 β-hemolytic VGS isolated from various specimens. The macrolide resistance mechanisms of erythromycin-resistant isolates were studied by the double disk test and polymerase chain reaction (PCR). The overall resistance rates of β-hemolytic VGS were found to be 47.5% to tetracycline, 3.9% to chloramphenicol, 9.7% to erythromycin, and 6.8% to clindamycin, whereas all isolates were susceptible to penicillin G, ceftriaxone, and vancomycin. Among ten erythromycin-resistant isolates, six isolates expressed a constitutive MLSB (cMLSB) phenotype, and each of the two isolates expressed the M phenotype, and the inducible MLSB (iMLSB) phenotype. The resistance rates to erythromycin and clindamycin of β-hemolytic VGS seemed to be lower than those of non-β-hemolytic VGS in our hospital, although cMLSB phenotype carrying erm(B) was dominant in β-hemolytic VGS. PMID:17982224

  16. Prevalence and Risk Factors for the Weight Loss during Hospitalization in Children: A Single Korean Children’s Hospital Experience

    PubMed Central

    Hwang, Eun Ha; Park, Jae Hong; Chun, Peter

    2016-01-01

    Purpose Undernutrition during hospitalization increases the risk of nosocomial infection and lengthens the disease courses. The aim of this study was to evaluate the risk factors of weight loss during hospitalization in children. Methods All the patients who were admitted in general wards between April and May 2014 were enrolled. Patients aged >18 years and discharged within 2 days were excluded. Weight loss during hospitalization was defined as a decrease in body weight of >2% in 8 hospital days or on the day of discharge. Patients who lost body weight during hospitalization were compared with patients who maintained their body weights. Significant parameters were evaluated by using the multivariate logistic regression analysis. Results We enrolled 602 patients, of whom 149 (24.8%) lost >2% of their body weight. Complaint of pain (p=0.004), admission to the surgical department (p=0.001), undergoing surgery (p=0.044), undergoing abdominal surgery (p=0.034), and nil per os (NPO) durations (p=0.003) were related to weight loss during hospitalization. The patients who had high weight-for-age tended to lose more body weight (p=0.001). Admission to the surgical department (odds ratio [OR], 1.668; 95% confidence interval [CI], 1.054-2.637; p=0.029) and long NPO durations (OR, 1.496; 95% CI, 1.102-2.031; p=0.010) were independent risk factors of weight loss during hospitalization. The patients with high weight-for-age tended to lose more weight during hospitalization (OR, 1.188; 95% CI, 1.029-1.371; p=0.019). Conclusion Greater care in terms of nutrition should be taken for patients who are admitted in the surgical department and have prolonged duration of nothing by mouth. PMID:28090472

  17. Deterioration of ancient Korean paper (Hanji), treated with beeswax: a mechanistic study.

    PubMed

    Jeong, Myung-Joon; Bogolitsyna, Anna; Jo, Byoung-Muk; Kang, Kyu-Young; Rosenau, Thomas; Potthast, Antje

    2014-01-30

    In the early 15th century, beeswax coating was applied to some of the cellulosic documents in a futile attempt to better conserve the paper. However, this treatment caused much more severe degradation compared to untreated Hanji. In the current study, the degradation pathway of this beeswax-treated Hanji has been clarified for the first time. The degradation of cellulose was investigated by labeling of oxidized groups combined with gel permeation chromatography, providing profiles of carbonyl and carboxyl groups relative to the molar mass distribution. The beeswax caused purely hydrolytic damage, leading to a decrease in molar mass to about one fifth of the original value. Oxidative degradation, by contrast, did not occur to any significant extent. Hydrolysis was not caused by acids but by microorganism feeding on the beeswax and excreting cellulolytic enzymes, which cause similar cellulose damage patterns. The hydrolytic enzymes were identified by typical metabolites present in the Hanji. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Barriers to the Operation of Patient Safety Incident Reporting Systems in Korean General Hospitals

    PubMed Central

    Hwang, Jee-In; Lee, Sang-IL

    2012-01-01

    Objectives This study aimed to explore the barriers to and factors facilitating the operation of patient safety incident reporting systems. Methods A qualitative study that used a methodological triangulation method was conducted. Participants were those who were involved in or responsible for managing incident reporting at hospitals, and they were recruited via a snowballing sampling method. Data were collected via interviews or emails from 42 nurses at 42 general hospitals. A qualitative content analysis was performed to derive the major themes related to barriers to and factors facilitating incident reporting. Results Participants suggested 96 barriers to incident reporting in their hospitals at the organizational and individual levels. Low reporting rates, especially for near misses, were the most commonly reported issue, followed by poorly designed incident reporting systems and a lack of adequate patient safety leadership by mid-level managers. To resolve and overcome these barriers, 104 recommendations were suggested. The high-priority recommendations included introducing reward systems; improving incident reporting systems, by for instance implementing a variety of reporting channels and ensuring reporter anonymity; and creating a strong safety culture. Conclusions The barriers to and factors facilitating incident reporting include various organizational and individual factors. As an important way to address these challenging issues and to improve the incident reporting systems in hospitals, we suggest several feasible methods of doing so. PMID:23346479

  19. Resource Requirements Planning for Hospitals Treating Serious Infectious Disease Cases

    SciTech Connect

    Vugrin, Eric D.; Verzi, Stephen Joseph; Finley, Patrick D.; Turnquist, Mark A.; Wyte-Lake, Tamar; Griffin, Ann R.; Ricci, Karen J.; Plotinsky, Rachel

    2015-02-01

    This report presents a mathematical model of the way in which a hospital uses a variety of resources, utilities and consumables to provide care to a set of in-patients, and how that hospital might adapt to provide treatment to a few patients with a serious infectious disease, like the Ebola virus. The intended purpose of the model is to support requirements planning studies, so that hospitals may be better prepared for situations that are likely to strain their available resources. The current model is a prototype designed to present the basic structural elements of a requirements planning analysis. Some simple illustrati ve experiments establish the mo del's general capabilities. With additional inve stment in model enhancement a nd calibration, this prototype could be developed into a useful planning tool for ho spital administrators and health care policy makers.

  20. Dissemination of multidrug-resistant Escherichia coli in Korean veterinary hospitals.

    PubMed

    So, Jeong Hwa; Kim, Juwon; Bae, Il Kwon; Jeong, Seok Hoon; Kim, So Hyun; Lim, Suk-kyung; Park, Yong Ho; Lee, Kyungwon

    2012-06-01

    This study was performed to investigate the prevalence of rectal colonization with multidrug-resistant Escherichia coli in dogs hospitalized at veterinary hospitals in Korea and to assess the molecular epidemiologic traits of this organism. A total of 63 unique E. coli isolates obtained from the rectal swabs of hospitalized dogs were analyzed. Genes encoding CTX-M extended-spectrum β-lactamases (ESBLs) and AmpC enzymes were detected in 21 (33.3%) and 15 (23.8%) canine E. coli isolates, respectively. Twelve canine E. coli isolates harbored both the genes encoding the CTX-M and AmpC enzymes. Six ESBL-producing E. coli isolates also carried the rmtB gene. All 24 E. coli isolates producing CTX-M ESBL and/or CMY-2 were resistant to ciprofloxacin. Furthermore, mutations were found in the gyrA and the parC genes. In most cases, the bla genes of the CTX-M ESBL and AmpC enzymes and the rmtB gene were localized to incompatibility group F (IncF) plasmids. Possible small clonal outbreaks are suggested because some E. coli isolates recovered in the same veterinary hospital were identified as identical sequence types and showed identical banding patterns in repetitive sequence-based polymerase chain reaction. The horizontal transfer of IncF plasmids and the clonal transfer of E. coli strains are suggested to play a role in the dissemination of antimicrobial resistance genes, and this transfer may occur across host species (i.e., between humans and dogs).

  1. Factors associated with the hospital admission of consumer product-related injuries treated in U.S. hospital emergency departments.

    PubMed

    Schroeder, Thomas J; Rodgers, Gregory B

    2013-10-01

    While unintentional injuries and hazard patterns involving consumer products have been studied extensively in recent years, little attention has focused on the characteristics of those who are hospitalized after treatment in emergency departments, as opposed to those treated and released. This study quantifies the impact of the age and sex of the injury victims, and other factors, on the likelihood of hospitalization. The analysis focuses on consumer product injuries, and was based on approximately 400,000 injury cases reported through the U.S. Consumer Product Safety Commission's National Electronic Injury Surveillance System, a national probability sample of U.S. hospital emergency departments. Logistic regression was used to quantify the factors associated with the likelihood of hospitalization. The analysis suggests a smooth U-shaped relationship between the age of the victim and the likelihood of hospitalization, declining from about 3.4% for children under age 5 years to 1.9% for 15-24 year-olds, but then rising to more than 25% for those ages 75 years and older. The likelihood of hospitalization was also significantly affected by the victim's sex, as well as by the types of products involved, fire involvement, and the size and type of hospital at which the injury was treated. This study shows that the probability of hospitalization is strongly correlated with the characteristics of those who are injured, as well as other factors.

  2. Tweeting and Treating: How Hospitals Use Twitter to Improve Care.

    PubMed

    Gomes, Christian; Coustasse, Alberto

    2015-01-01

    Hospitals that have adopted Twitter primarily use it to share organizational news, provide general health care information, advertise upcoming community events, and foster networking. The purpose of this study was to explore the benefits that Twitter utilization has had in improving quality of care, access to care, patient satisfaction, and community footprint while assessing the barriers to its implementation. The methodology used was a qualitative study with a semistructured interview combined with a literature review, which followed the basic principles of a systematic review. The utilization of Twitter by hospitals suggest that it leads to savings of resources, enhanced employee and patient communication, and expanded patient reach in the community. Savings opportunities are generated by preventing unnecessary office visits, producing billable patient encounters, and eliminating high recruiting costs. Communication is enhanced using Twitter by sharing organizational content, news, and health promotions and can be also a useful tool during crises. The utilization of Twitter in the hospital setting has been more beneficial than detrimental in its ability to generate opportunities for cost savings, recruiting, communication with employees and patients, and community reach.

  3. Korean Hemorrhagic Fever.

    DTIC Science & Technology

    1980-03-01

    AD-A<m 761 KOREA UNIV SEOUL COLL OF MEDICINE KOREAN HEM0RRHA6IC FEVER.(U) MAR 80 H W LEE UNCLASSIFIED ICFI F/6 6/5 DAM017-79-6-9<*55 NL...I» > I,,iu. •Uli ••-. SUMMARY There were 364 hospitalized cases of Korean hemorrhagic fever (KHF) in 1979 in Korea . Lee et al...STANDARDS-1963-A ?H "LEVEtf® AD <o KOREAN HEMORRHAGIC F EVER A D A 09 47 Final Report HO WANG LEE, M. D. March 1980 i MIL. IIB«I . Mm k iw

  4. Drug utilization review of mupirocin ointment in a Korean university-affiliated hospital

    PubMed Central

    Youn, Sung Hee; Kim, Sukyeon; Lee, Jeong-a; Kim, Bum Joon; Kim, Jounghee; Han, Hye-kyung; Kim, Jae-Seok

    2015-01-01

    Background/Aims Intranasal mupirocin and chlorhexidine bathing are candidate strategies to prevent healthcare-associated infections caused by methicillin-resistant Staphylococcus aureus (MRSA). In Korea, intranasal mupirocin is not available, and mupirocin ointment, an over-the-counter drug, has been used indiscriminately. Furthermore, because it is covered by health insurance, mupirocin is easy to prescribe within hospitals. Methods We performed a mupirocin drug utilization review (DUR) within Hallym University Sacred Heart Hospital. Annual use of mupirocin was investigated between 2003 and 2013, and monthly consumption of mupirocin was assessed during the final 2-year period. The DUR focused on August 2012, the period of highest use of mupirocin. Also, we investigated trends in mupirocin resistance in MRSA between 2011 and 2013. Results Annual consumption of mupirocin increased from 3,529 tubes in 2003 to 6,475 tubes in 2013. During August 2012, 817 tubes were prescribed to 598 patients; of these, 84.9% were prescribed to outpatients, and 77.6% at the dermatology department. The most common indication was prevention of skin infections (84.9%), and the ointment was combined with systemic antibiotics in 62.9% of cases. The average duration of systemic antibiotic administration was about 7.8 days. The rate of low-level mupirocin resistance in MRSA increased from 8.0% to 22.0%, and that of high-level mupirocin resistance increased from about 4.0% to about 7.5%. Conclusions Inappropriate use of mupirocin is prevalent. Considering the increase in resistance and the future application of intranasal mupirocin, prophylactic use of mupirocin in dermatology departments should be reconsidered. PMID:26161018

  5. Factors associated with ability to treat pediatric emergencies in US hospitals.

    PubMed

    Burt, Catharine W; Middleton, Kimberly R

    2007-10-01

    The purpose of this analysis is to investigate hospital and community factors associated with the availability of pediatric services, expertise, and supplies in US hospitals for treating pediatric emergencies. Data from the Emergency Pediatric Services and Equipment Supplement, a component of the 2002-2003 National Hospital Ambulatory Medical Care Survey, were merged with hospital and community characteristics to model preparedness to treat pediatric emergencies. The National Hospital Ambulatory Medical Care Survey samples nonfederal, short-stay, and general hospitals in the United States. The Emergency Pediatric Services and Equipment Supplement was based on the 2001 guidelines developed by the American Academy of Pediatrics and the American College of Emergency Physicians. Estimates were weighted to produce unbiased national estimates of pediatric services, expertise, and equipment availability in emergency departments. Logistic regression was used to model the probability of being better prepared based on the above guidelines. Bivariate analyses showed that hospital inpatient pediatric structure was linearly related to availability of supplies. However, inpatient structure was not associated with presence of a pediatric trauma service or written transfer agreement. Logistic regressions with each preparedness measure indicated that, after adjusting for hospital and community factors, pediatric volume, teaching hospital status, geographic region, and per capita income of the community were strongly related to being better prepared on each of the preparedness measures. To meet the 2001 guidelines, emergency departments need to improve their inventory of pediatric supplies, and hospitals that do not have specialized inpatient services need to implement written transfer agreements with other hospitals.

  6. Disability-Adjusted Life Years (DALYs) for Injuries Using Death Certificates and Hospital Discharge Survey by the Korean Burden of Disease Study 2012

    PubMed Central

    2016-01-01

    A system for assessing the burdens imposed by disease and injury was developed to meet healthcare, priority setting, and policy planning needs. The first such system, the Global Burden of Disease (GBD), was implemented in 1990. However, problems associated with limited data and assumed disability weightings remain to be resolved. The purpose of the present study was to estimate national burdens of injuries in Korea using more reliable data and disability weightings. The incidences of injuries were estimated using the Korean National Hospital Discharge Survey and the mortality data from the Korean National Statistical Office in 2010. Additionally, durations of injuries and age at injury onset were used to calculate disability-adjusted life years (DALY) using disability weightings derived from the Korean Burden of Disease (KBD) study. Korea had 1,581,072 DALYs resulting from injuries (3,170 per 100,000), which was 22.9% higher than found by the GBD 2010 study. Males had almost twice as heavy an injury burden as females. Road injury, fall, and self-harm ranked 1st, 2nd, and 3rd in terms of burden of injury in 2010. Total injury burden peaked in the forties, while burden per person declined gradually from early adulthood. We hope that this study contributes to the reliable evaluation of injury burden and a better understanding of injury-related health status using nation-specific, dependable data. PMID:27775258

  7. In vitro activity of tedizolid against gram-positive bacteria in patients with skin and skin structure infections and hospital-acquired pneumonia: a Korean multicenter study.

    PubMed

    Lee, Yangsoon; Hong, Sung Kuk; Choi, Sunghak; Im, Weonbin; Yong, Dongeun; Lee, Kyungwon

    2015-09-01

    We compared the activities of tedizolid to those of linezolid and other commonly used antimicrobial agents against gram-positive cocci recovered from patients with skin and skin structure infections (SSSIs) and hospital-acquired pneumonia (HAP) in Korean hospitals. Gram-positive isolates were collected from 356 patients with SSSIs and 144 patients with HAP at eight hospitals in Korea from 2011 to 2014. SSSIs included impetigo, cellulitis, erysipelas, furuncles, abscesses, and infected burns. Antimicrobial susceptibility was tested by using the CLSI agar dilution method. All of the gram-positive isolates were inhibited by ≤1 μg/mL tedizolid. The minimum inhibitory concentration [MIC]₉₀ of tedizolid was 0.5 μg/mL for methicillin-resistant Staphylococcus aureus, which was 4-fold lower than that of linezolid. Tedizolid may become a useful option for the treatment of SSSIs and HAP caused by gram-positive bacteria.

  8. Extremity gunshot injuries treated in an urban children's hospital.

    PubMed

    Victoroff, B N; Robertson, W W; Eichelberger, M R; Wright, C

    1994-02-01

    In the years 1985 to 1989 75 children and adolescents presented to an urban children's hospital for treatment of 76 incidents of extremity gunshot wounds. Although the population ranged widely, the "typical" patient was a preteen or teenager (n = 70) who was shot in the lower extremity (n = 53) with a low velocity handgun (n = 74). No vascular injuries and only two transient nerve injuries accompanied the wounds. Only 30% of the shots caused fractures. Many (43%) of the patients had other relevant psychosocial or medical problems. Previous treatment for other gunshot wounds or trauma had occurred in 27 patients. Although follow-up was not good, no consequent infections were identified. Outpatient local wound irrigation with minimal debridement sufficed as treatment for entry/exit wounds without contamination or fracture. Intravenous antibiotics are necessary in these wounds only for short-term prophylactic coverage of fractures. Larger soft tissue wounds, intraarticular foreign bodies, and fracture stabilization require operative treatment.

  9. A survey of dental treatment under general anesthesia in a Korean university hospital pediatric dental clinic

    PubMed Central

    Shin, Bisol; Yoo, Seunghoon; Kim, Jongsoo; Kim, Seungoh

    2016-01-01

    Background In South Korea, the number of cases of dental treatment for the disabled is gradually increasing, primarily at regional dental clinics for the disabled. This study investigated pediatric patients at a treatment clinic for the disabled within a university hospital who received dental treatment under general anesthesia. This data could assist those that provide dental treatment for the disabled and guide future treatment directions and new policies. Methods This study was a retrospective analysis of 263 cases in which patients received dental treatment under general anesthesia from January 2011 to May 2016. The variables examined were gender, age, reason for anesthesia, type of disability, time under anesthesia, duration of treatment, type of procedure, treatment details, and annual trends in the use of general anesthesia. Results Among pediatric patients with disabilities who received dental treatment under general anesthesia, the most prevalent age group was 5–8 years old (124 patients, 47.1%), and the primary reason for administering anesthesia was dental anxiety or phobia. The mean time under anesthesia was 132.7 ± 77.6 min, and the mean duration of treatment was 101.9 ± 71.2 min. The most common type of treatment was restoration, accounting for 158 of the 380 treatments performed. Conclusions Due to increasing demand, the number of cases of dental treatment performed under general anesthesia is expected to continue increasing, and it can be a useful method of treatment in patients with dental anxiety or phobia. PMID:28884154

  10. A survey of dental treatment under general anesthesia in a Korean university hospital pediatric dental clinic.

    PubMed

    Shin, Bisol; Yoo, Seunghoon; Kim, Jongsoo; Kim, Seungoh; Kim, Jongbin

    2016-09-01

    In South Korea, the number of cases of dental treatment for the disabled is gradually increasing, primarily at regional dental clinics for the disabled. This study investigated pediatric patients at a treatment clinic for the disabled within a university hospital who received dental treatment under general anesthesia. This data could assist those that provide dental treatment for the disabled and guide future treatment directions and new policies. This study was a retrospective analysis of 263 cases in which patients received dental treatment under general anesthesia from January 2011 to May 2016. The variables examined were gender, age, reason for anesthesia, type of disability, time under anesthesia, duration of treatment, type of procedure, treatment details, and annual trends in the use of general anesthesia. Among pediatric patients with disabilities who received dental treatment under general anesthesia, the most prevalent age group was 5-8 years old (124 patients, 47.1%), and the primary reason for administering anesthesia was dental anxiety or phobia. The mean time under anesthesia was 132.7 ± 77.6 min, and the mean duration of treatment was 101.9 ± 71.2 min. The most common type of treatment was restoration, accounting for 158 of the 380 treatments performed. Due to increasing demand, the number of cases of dental treatment performed under general anesthesia is expected to continue increasing, and it can be a useful method of treatment in patients with dental anxiety or phobia.

  11. Clinical characteristics and rehabilitation of hospitalised cancer patients in a Korean tertiary hospital.

    PubMed

    Uhm, Kyeong Eun; Yoon, Tae Hee; Hwang, Ji Hye

    2017-08-01

    With the increase in the patient survival rates of many types of cancers, a greater proportion of cancer patients live with disease-related problems that diminish their quality of life. This study aimed to investigate the clinical characteristics and rehabilitation of hospitalised cancer patients who were referred to the Department of Physical and Rehabilitation Medicine (PRM) at Samsung Medical Center, a tertiary university hospital in Seoul, Korea. Hospitalised cancer patients aged > 18 years who were referred to the Department of PRM from January to December 2012 were enrolled in this retrospective study. We reviewed the clinical characteristics of the patients, the principal reasons for their referral and relevant details of their rehabilitative management. A total of 1,340 cases were included. The most common primary cancer was lung cancer (19.0%) and 28.6% of the cases had solid organ metastasis. The most common reason for referral was deconditioning (31.7%), followed by weakness (23.1%) and respiratory problems (14.5%). Bedside exercise was prescribed to 28.4% of the patients, exercise in the rehabilitation therapy unit to 28.0% and pulmonary rehabilitation to 14.3%. Among the 1,340 cases, 107 (8.0%) were transferred to the Department of PRM for comprehensive rehabilitation. The 32 patients with an identifiable Modified Barthel Index score showed significant functional improvement. The findings of the present study contribute to a better understanding of rehabilitation for hospitalised cancer patients. The information obtained will also be helpful in the development of appropriate cancer rehabilitation strategies.

  12. Positive correlation between regional emergency medical resources and mortality in severely injured patients: results from the Korean National Hospital Discharge In-depth Survey.

    PubMed

    Lee, Hyo Jung; Ju, Yeong Jun; Park, Eun-Cheol

    2016-12-15

    In South Korea, injury is a public health problem due to its high incidence and high mortality. To improve emergency medical systems, the government announced plans to increase the emergency medical resources for each region. This study investigated the association between regional emergency medical resources and mortality during hospitalization in severely injured inpatients. To analyse mortality for severely injured inpatients, we used the Korean National Hospital Discharge In-depth Survey data, consisting of 18,621 hospitalizations from 2005-2012. Generalized estimating equations were analysed to examine the association between mortality during hospitalization and both individual and regional variables. Mortality during hospitalization occurred in 913 (4.9%) cases. Patients in regions with a higher number of emergency departments (odds ratio [OR]=0.94, 95% confidence interval [CI]: 0.91-0.98), a higher number of ambulances (OR=0.99, 95% CI: 0.98-0.99), and a higher number of registered nurses per emergency department (OR=0.88, 95% CI: 0.83-0.94) had a lower risk of mortality during hospitalization. Our findings suggest that regional emergency medical resources are associated with a lower risk of mortality during hospitalization in severely injured patients. Thus, health care policymakers need to determine the proper distribution of emergency medical resources for each region and the function of emergency departments to provide a superior quality of emergency medical services to patients.

  13. Risk Adjusting Survival Outcomes in Hospitals That Treat Patients With Cancer Without Information on Cancer Stage.

    PubMed

    Pfister, David G; Rubin, David M; Elkin, Elena B; Neill, Ushma S; Duck, Elaine; Radzyner, Mark; Bach, Peter B

    2015-12-01

    Instituting widespread measurement of outcomes for cancer hospitals using administrative data is difficult owing to lack of cancer-specific information such as disease stage. To evaluate the performance of hospitals that treat patients with cancer using Medicare data for outcome ascertainment and risk adjustment and to assess whether hospital rankings based on these measures are altered by the addition of cancer-specific information. Risk-adjusted cumulative mortality rates of patients with cancer were captured in Medicare claims data from 2005 through 2009 nationally and assessed at the hospital level. Similar analyses were conducted using Surveillance, Epidemiology, and End Results (SEER)-Medicare data for the subset of the United States covered by the SEER program to determine whether the inclusion of cancer-specific information (only available in cancer registries) in risk adjustment altered measured hospital performance. Data were from 729 279 fee-for-service Medicare beneficiaries treated for cancer in 2006 at hospitals treating 10 or more patients with each of the following cancers, according to Medicare claims: lung, prostate, breast, colon, and other. An additional sample of 18 677 similar patients were included from the SEER-Medicare administrative data. Risk-adjusted mortality overall and by cancer category, stratified by type of hospital; measures of correlation and agreement between hospital-level outcomes risk adjusted using Medicare data alone and Medicare data with SEER data. There were large survival differences between different types of hospitals that treat Medicare patients with cancer. At 1 year, mortality for patients treated by hospitals exempt from the Medicare prospective payment system was 10% lower than at community hospitals (18% vs 28%) across all cancers, and the pattern persisted through 5 years of follow-up and within specific cancer categories. Performance ranking of hospitals was consistent with or without SEER-Medicare disease

  14. MORTALITY AFTER ACUTE MYOCARDIAL INFARCTION IN HOSPITALS THAT DISPROPORTIONATELY TREAT AFRICAN-AMERICANS

    PubMed Central

    Skinner, Jonathan; Chandra, Amitabh; Staiger, Douglas; Lee, Julie; McClellan, Mark

    2006-01-01

    Background African-Americans are more likely be seen by physicians with less clinical training or treated at hospitals with deficient times to acute reperfusion therapies. Less is known about differences in health outcomes. This paper compares risk-adjusted mortality following Acute Myocardial Infarction (AMI) between U.S. hospitals with high and low fractions of elderly black AMI patients. Methods and Results A prospective cohort study was performed for fee-for-service Medicare patients hospitalized for AMI during 1997–2001 (N = 1,136,736). Hospitals (N =4289) were classified into approximate deciles depending on the extent to which the hospital served the African-American population. The lowest category (12.5 percent of AMI patients) included hospitals without any African-American AMI admissions during 1997–2001. Decile 10 (10 percent of AMI patients) included hospitals with the highest fraction of black AMI patients (33.6 percent). The main outcome measures were 90-day and 30-day mortality following AMI. Patients admitted to hospitals disproportionately serving African-Americans experienced no greater level of morbidities or severity of the infarction. Yet hospitals in Decile 10 experienced risk-adjusted 90-day mortality rate of 23.7 percent (95% CI: 23.2–24.2) compared to 20.1 percent (95% CI: 19.7–20.4) in Decile 1 hospitals. Differences in outcomes between hospitals were not explained by income, hospital ownership status, hospital volume, Census region, urban status, or hospital surgical treatment intensity. Conclusions Risk-adjusted mortality following AMI is significantly higher in U.S. hospitals that disproportionately serve African-Americans. A reduction in overall mortality at these hospitals could reduce dramatically black-white disparities in health care outcomes. PMID:16246963

  15. Risk adjusting survival outcomes of hospitals that treat cancer patients without information on cancer stage

    PubMed Central

    Pfister, David G.; Rubin, David M.; Elkin, Elena B.; Neill, Ushma S.; Duck, Elaine; Radzyner, Mark; Bach, Peter B.

    2016-01-01

    Importance Instituting widespread measurement of outcomes for cancer hospitals using administrative data is difficult due to the lack of cancer specific information such as disease stage. Objective To evaluate the performance of hospitals that treat cancer patients using Medicare data for outcome ascertainment and risk adjustment, and to assess whether hospital rankings based on these measures are influenced by the addition of cancer-specific information. Design Risk adjusted cumulative mortality of patients with cancer captured in Medicare claims from 2005–2009 nationally were assessed at the hospital level. Similar analyses were conducted in the Surveillance, Epidemiology and End Result (SEER)-Medicare data for the subset of the US covered by the SEER program to determine whether the exclusion of cancer specific information (only available in cancer registries) from risk adjustment altered measured hospital performance. Setting Administrative claims data and SEER cancer registry data Participants Sample of 729,279 fee-for-service Medicare beneficiaries treated for cancer in 2006 at hospitals treating 10+ patients with each of the following cancers, according to Medicare claims: lung, prostate, breast, colon. An additional sample of 18,677 similar patients in SEER-Medicare administrative data. Main Outcomes and Measures Risk-adjusted mortality overall and by cancer type, stratified by type of hospital; measures of correlation and agreement between hospital-level outcomes risk adjusted using Medicare data alone and Medicare data with SEER data. Results There were large outcome differences between different types of hospitals that treat Medicare patients with cancer. At one year, cumulative mortality for Medicare-prospective-payment-system exempt hospitals was 10% lower than at community hospitals (18% versus 28%) across all cancers, the pattern persisted through five years of follow-up and within specific cancer types. Performance ranking of hospitals was

  16. Reduction in Clostridium difficile environmental contamination by hospitalized patients treated with fidaxomicin.

    PubMed

    Biswas, J S; Patel, A; Otter, J A; Wade, P; Newsholme, W; van Kleef, E; Goldenberg, S D

    2015-07-01

    Fidaxomicin is sporicidal and may be associated with a reduced time to resolution of diarrhoea when used to treat patients with Clostridium difficile infection (CDI). This study investigated whether fidaxomicin for treatment of all patients with CDI reduced C. difficile environmental contamination. Surfaces in the rooms of 66 hospitalized patients treated with metronidazole and/or vancomycin and 68 hospitalized patients treated with fidaxomicin were sampled. Patients treated with fidaxomicin were less likely to contaminate their environment (25/68, 36.8%) than patients treated with metronidazole and/or vancomycin (38/66 57.6%) (P = 0.02). Treatment with fidaxomicin was associated with reduced environmental contamination with C. difficile. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. EPIDEMIOLOGICAL PROFILE OF PATIENTS WITH PROXIMAL HUMERUS FRACTURE TREATED AT HOSPITAL SÃO PAULO, BRAZIL

    PubMed Central

    de Oliveira, Ana Paula Cortes; Mestieri, Mariana Christovam; Pontin, José Carlos Baldocchi

    2015-01-01

    ABSTRACT Objective: To analyze the epidemiological aspects of proximal humerus fractures and describe the profile of patients with proximal humerus fractures hospitalized and treated at Hospital São Paulo, between 2008 and 2013. Methods: Hospital records were retrospectively analyzed for surgically treated patients diagnosed with proximal humerus fracture. Age, gender, injury mechanism, length of hospital stay, performed treatment and associated diseases were considered. Results: From all patients studied, 52 were female at their sixth decade of life. As for the injury mechanism, fall from height was the main cause for women (88.46%) and for man it was motorcycle accidents (31.42%). Fixation with locked plate was the most frequently used treatment. Conclusion: Most patients were female in their fifth decade of life, injured mainly by fall from height. Fixation with locked plate was the most frequently used treatment and the patients were admitted for 7 days, on average. Level of Evidence II, Retrospective Study. PMID:26981037

  18. Time delays in treating dental trauma at a children's hospital and private pediatric dental practice.

    PubMed

    Wagle, Elke; Allred, Elizabeth N; Needleman, Howard L

    2014-01-01

    The purpose of this study was to compare the time interval between a child sustaining a dental injury and the rendering of treatment in a hospital setting and a private pediatric dental practice. Data were collected from the patient records of children treated for dental trauma at a children's hospital emergency department, a children's hospital dental clinic, and a private pediatric dental practice. Data included demographics and the time, date, type of injury, and its treatment. Injuries were more severe, treatment was more complex, and the time interval between injury and treatment was longer for those children treated in the hospital setting versus private practice, regardless of distance traveled. Children treated at their dental home experienced fewer treatment delays. Insurance status, medical complexity, and associated injuries were not related to treatment delays. Children who seek emergency care for traumatic dental injuries in a hospital setting experience greater delays in treatment compared to those seeking care in a private practice setting. These findings might not be generalizable to other hospital settings or private practices due to the inherently unique characteristics of the sites used in this study.

  19. [Early gastric cancer surgically treated at Rebagliati Hospital: study of 76 cases during 5 years].

    PubMed

    Portanova, Michel; Mena, Victor; Yábar, Alejandro

    2010-01-01

    This report describes the characteristics of early gastric cancer surgically treated in the Gastric Cancer Unit at Rebagliati National Hospital between January 2004 and December 2008. Mean age was 68 years; males, distal location, submucosa infiltration and intestinal histological type predominate in these patients. Lymph node involvement was 13%.

  20. External Qi therapy to treat symptoms of Agent Orange Sequelae in Korean combat veterans of the Vietnam War.

    PubMed

    Lee, Myeong Soo; Woo, Won-Hong; Lim, Hyun-Ja; Hong, Sung-Soo; Kim, Hye-Jung; Moon, Sun-Rock

    2004-01-01

    We investigated the efficacy of Qi therapy as a non-pharmacological treatment for various symptoms presented by Korean combat veterans of the Vietnam War with Agent Orange Sequelae. Nine subjects volunteered to receive 30 minutes of Qi therapy, twice per day for 7 days. There was marked improvement in 89% of the patients with impaired physical activity, 86% of those with psychological disorder, 78% of those with heavy drug use, and 67% of those with fatigue, indigestion and high blood glucose levels. This data suggests that Qi therapy combined with conventional treatment has positive effects in reducing and managing the pain, psychosomatic disorders, and substance abuse in patients with Agent Orange Sequelae. We cannot completely discount the possible influence of the placebo effect, and more objective, clinical measures are needed to study the long-term effects of Qi therapy.

  1. Clinical profiles of adverse drug reactions spontaneously reported at a single Korean hospital dedicated to children with complex chronic conditions

    PubMed Central

    Kim, Bomi; Kim, Sunwha Zara; Lee, Jin; Jung, Ae Hee; Jung, Sun-Hoi; Hahn, Hyeon-Joo; Kang, Hye Ryun

    2017-01-01

    Children with complex chronic conditions (CCC) are presumed to be vulnerable to adverse drug reactions (ADRs). The clinical profiles of ADRs in CCC are not well known. Herein, we aim to describe the ADR profiles in CCC with regard to typical presentations and vulnerable groups. We accessed the ADR yearly reports at a tertiary children's hospital whose practice is mainly dedicated to CCC and descriptively analyzed their clinical profiles according to the presence of a complex chronic condition, ADR severity, and age groups. A total of 1841 cases were analyzed, among which 1258 (68.3%) were mild, 493 (26.8%) moderate, and 90 (4.9%) cases were severe. A total of 1581 (85.9%) cases of complex chronic condition were reported. The proportion of CCC in each severity group increased as the ADR becomes more severe. In CCC, ADRs were most frequently reported by nurses in the adolescent group and in cases where the symptoms involved the gastrointestinal system. The class of antineoplastic and immunomodulating drugs was the most commonly suspected of causing an ADR, followed by one of the antibiotics. When we focus on the trend across the age groups, the ratio of severe-to-total ADRs decreased with older age. Among severe cases, the ratio of off-label prescription-related cases was the highest in the infant/toddler group and decreased as the groups aged. In conclusion, ADRs of CCCs admitted to a tertiary children’s hospital have a unique profile. These groups are vulnerable to ADRs and thus they should be monitored closely, especially when they are infants or toddlers, so that severe ADRs can be identified and treated immediately. PMID:28199420

  2. Clinical Presentation of Herpes Zoster in Immunocompetent and Immunocompromised Hospitalized Children Treated With Acyclovir.

    PubMed

    Kuchar, Ernest; Szenborn, Leszek; Lis, Izabela; Jaroszewska, Anna; Czeladzka, Justyna

    2016-07-01

    Herpes zoster, defined as the reactivation of a latent varicella-zoster virus (VZV) infection, used to be a serious disease in immunocompromised children until recently. The aim of this study was to describe the clinical presentation of herpes zoster in hospitalized immunocompromised children compared with hospitalized immunocompetent counterparts. We reviewed the hospital charts of 72 children aged 6 months to 18 years diagnosed with herpes zoster and treated with acyclovir in our department covering a 19-year period. Forty-six of the children were immunocompromised which was mainly due to hematologic diseases. There were no differences in the age at which herpes zoster occurred, length of hospitalization, and the location or extent of the skin eruption. General symptoms were observed more frequently in the hospitalized immunocompetent patients compared with the hospitalized immunocompromised children (80% vs. 56%). The average age at which primary VZV infection occurred was higher among the immunocompromised children than the immunocompetent children with the latter group suffering from significantly more primary VZV infections during infancy. The presentation of herpes zoster in immunocompromised children is similar to that of herpes zoster in hospitalized immunocompetent children.

  3. Comparison of Hospital Mortality and Readmission Rates for Medicare Patients Treated by Male vs Female Physicians

    PubMed Central

    Tsugawa, Yusuke; Jena, Anupam B.; Figueroa, Jose F.; Orav, E. John; Blumenthal, Daniel M.; Jha, Ashish K.

    2017-01-01

    IMPORTANCE Studies have found differences in practice patterns between male and female physicians, with female physicians more likely to adhere to clinical guidelines and evidence-based practice. However, whether patient outcomes differ between male and female physicians is largely unknown. OBJECTIVE To determine whether mortality and readmission rates differ between patients treated by male or female physicians. DESIGN, SETTING, AND PARTICIPANTS We analyzed a 20% random sample of Medicare fee-for-service beneficiaries 65 years or older hospitalized with a medical condition and treated by general internists from January 1, 2011, to December 31, 2014. We examined the association between physician sex and 30-day mortality and readmission rates, adjusted for patient and physician characteristics and hospital fixed effects (effectively comparing female and male physicians within the same hospital). As a sensitivity analysis, we examined only physicians focusing on hospital care (hospitalists), among whom patients are plausibly quasi-randomized to physicians based on the physician’s specific work schedules. We also investigated whether differences in patient outcomes varied by specific condition or by underlying severity of illness. MAIN OUTCOMES AND MEASURES Patients’ 30-day mortality and readmission rates. RESULTS A total of 1 583 028 hospitalizations were used for analyses of 30-day mortality (mean [SD] patient age, 80.2 [8.5] years; 621 412 men and 961 616 women) and 1 540 797 were used for analyses of readmission (mean [SD] patient age, 80.1 [8.5] years; 602 115 men and 938 682 women). Patients treated by female physicians had lower 30-day mortality (adjusted mortality, 11.07% vs 11.49%; adjusted risk difference, −0.43%; 95% CI, −0.57% to −0.28%; P < .001; number needed to treat to prevent 1 death, 233) and lower 30-day readmissions (adjusted readmissions, 15.02% vs 15.57%; adjusted risk difference, −0.55%; 95% CI, −0.71% to −0.39%; P < .001; number

  4. Costs, Trends, and Related Factors in Treating Lung Cancer Patients in 67 Hospitals in Guangxi, China.

    PubMed

    Zhou, Li-Fang; Zhang, Mao-Xin; Kong, Ling-Qian; Lyman, Gary H; Wang, Ke; Lu, Wei; Feng, Qi-Ming; Wei, Bo; Zhao, Lue Ping

    2017-05-28

    Lung cancer is a common disease with high mortality in China. Recent economic advances have led to improved medical capabilities, while costs associated with treating this disease have increased. Such change contributes to a commonly held belief that healthcare costs are out of control. However, few studies have examined this issue. Here, we use 34,678 hospitalization summary reports from 67 Guangxi hospitals (period 2013-2016) to document costs, temporal trends, and associated factors. Findings from this study are surprising in that they debunk the myth of uncontrolled healthcare costs. In addition, results and experiences from Guangxi are informative for other comparable regions.

  5. Under-diagnosing and under-treating iron deficiency in hospitalized patients with gastrointestinal bleeding

    PubMed Central

    El-Halabi, Mustapha M; Green, Michael S; Jones, Christopher; Salyers Jr, William J

    2016-01-01

    AIM: To determine whether patients hospitalized with gastrointestinal (GI) blood loss anemia are being checked and treated for iron deficiency. METHODS: Retrospective chart review was conducted for all patients admitted to a single tertiary care hospital between 11/1/2011 and 1/31/2012 for any type of GI bleeding. The primary endpoint was the percentage of patients who had their iron studies checked during a hospitalization for GI blood loss anemia. Secondary outcomes included percentage of anemic GI bleeders who had adequate documentation of anemia and iron deficiency, and those who were treated for their iron deficiency. Then we tried to identify possible predictors of checking iron studies in an attempt to understand the thought process that physicians go through when managing these patients. Iron deficiency was defined as Iron saturation less than 15% or ferritin level less than 45 μg/L. Anemia was defined as hemoglobin level less than 13 g/dL for males and 12 g/dL for females. RESULTS: Three hundred and seven GI bleeders were hospitalized during the study period, and 282 of those (91.9%) had anemia during their hospital stay. Ninety-five patients (30.9%) had iron studies performed during hospitalization, and 45 of those (47.4%) were actually found to be iron deficient. Only 29 of those 45 iron deficient patients were discharged home on iron supplements. Of the 282 patients that had anemia during hospitalization, 50 (17.7%) had no documentation of the anemia in their hospital chart. Of the 45 patients that had lab proven iron deficiency anemia (IDA), only 22 (48.5%) had documentation of IDA in at least one note in their chart. Predictors of checking iron studies in anemic GI bleeders were lower mean corpuscular volume, documentation of anemia, having fecal occult blood testing, not having hematemesis or past history of GI bleeding. There were no significant differences between the teaching and non-teaching services in any patient characteristics or outcomes

  6. Hospital hydrotherapy pools treated with ultra violet light: bad bacteriological quality and presence of thermophilic Naegleria.

    PubMed Central

    De Jonckheere, J. F.

    1982-01-01

    The microbiological quality of eight halogenated and two u.v.-treated hydrotherapy pools in hospitals was investigated. The microbiological quality of halogenated hydrotherapy pools was comparable to halogenated public swimming pools, although in some Pseudomonas aeruginosa and faecal pollution indicators were more frequent due to bad management. On the other hand u.v.-treated hydrotherapy pools had very bad microbiological quality. Apart from faecal pollution indicators, P. aeruginosa was present in very high numbers. Halogenated hydrotherapy pools were not highly contaminated with amoebae, and Naegleria spp. were never detected. On the other hand u.v.-treated pools contained very high numbers of thermophilic Naegleria. The Naegleria isolated were identified as N. lovaniensis, a species commonly found in association with N. fowleri. Isoenzyme analysis showed a different type of N. lovaniensis was present in each of two u.v.-treated pools. Images Plate 1 PMID:7061835

  7. Multidrug-resistant bacteria among patients treated in foreign hospitals: management considerations during medical repatriation.

    PubMed

    Josseaume, Julien; Verner, Laurent; Brady, William J; Duchateau, François-Xavier

    2013-01-01

    The repatriation of patients from foreign hospitals can foster the emergence and spread of multidrug-resistant bacteria (MRB). We aimed to evaluate the incidence of MRB in patients treated in foreign hospitals and repatriated by international inter-hospital air transport in order to better manage these patients and adjust our procedures. The records from all consecutive aeromedical evacuations and overseas repatriations carried out by Mondial Assistance France between December 2010 and November 2011 were reviewed for this study. Only inter-hospital transfers with inpatient destination of an acute care unit were considered. Patients were allocated to one of two groups: those identified as MRB carriers at their arrival in France and those who were not identified as such (either negative for MRB or not tested). Data were compared between the two groups. Analysis was performed on 223 patients: 16 patients (7%) were identified as MRB carriers. Compared with confirmed non-MRB patients, MRB carriers came more frequently from a high-risk unit (88% vs 59%, p = 0.05) and had a longer foreign hospital stay [13 (3-20) vs 8 (6-14) d, p = 0.01]. The occurrence of MRB among patients repatriated from foreign hospitals is noted in a significant minority of such individuals transferred back to their home country. The typical MRB patient was admitted to a high-risk unit in a foreign hospital prior to repatriation with longer foreign hospital admissions. The prospective identification of these patients prior to transport is difficult. While these factors are associated with MRB presence, their absence does not rule out highly resistant bacterial colonization. A systematic review of this important medical issue is warranted with the development of guidelines. © 2012 International Society of Travel Medicine.

  8. Outcome of adult horses with botulism treated at a veterinary hospital: 92 cases (1989-2013).

    PubMed

    Johnson, A L; McAdams-Gallagher, S C; Aceto, H

    2015-01-01

    There are no studies evaluating a large population of adult horses treated for botulism. Reported survival rates in outbreak situations are low; however, many horses in outbreaks do not receive treatment. That adult horses treated at a veterinary hospital would have improved survival compared to outbreak situations. Additional aims included identification of predictors of nonsurvival. All horses greater than 6 months of age with a final diagnosis of botulism admitted to a veterinary teaching hospital between 1989 and 2013 were included. Retrospective study. Historical, admission, and hospitalization data were retrieved from medical records and associations between variables and nonsurvival were identified using logistic regression. Two multivariable models were developed pertaining to (1) information available at admission and (2) clinical findings during hospitalization. Ninety-two records met inclusion criteria. Retained variables for the two models indicated that higher rectal temperature (OR, 1.94; CI, 1.19-3.17) and dysphagia (OR, 4.04; CI, 1.01-16.17) observed at admission increased the odds of survival, as did treatment with antitoxin (OR, 121.30; CI, 9.94-1,480.65). Horses with abnormal respiratory effort or inability to stand had decreased odds of survival. Overall survival was 48% but was significantly higher (67%, P = .011) for horses that arrived standing, and even higher (95%, P < .001) for horses that remained able to stand throughout hospitalization. Complications occurred in 62% of horses but were not associated with nonsurvival. Horses that lose the ability to stand have a poor chance of survival. Complications are common in treated horses but do not reduce survival. Copyright © 2014 by the American College of Veterinary Internal Medicine.

  9. Clinical Effects and Antivenom Use for Snake Bite Victims Treated at Three US Hospitals in Afghanistan

    DTIC Science & Technology

    2013-01-01

    WILDERNESS & ENVIRONMENTAL MEDICINE, 24, 412–416 (2013) BRIEF REPORT Clinical Effects and Antivenom Use for Snake Bite Victims Treated at Three US... bite details and complications, laboratory results, antivenom use and adverse effects, procedures performed, and hospital course. Results.—Of 17 cases...median patient age was 20 years (interquartile range [IQR], 12–30), 16 were male, and 82% were Afghans. All bites were to an extremity, and median

  10. Challenges of Treating Adenovirus Infection: Application of a Deployable Rapid-Assembly Shelter Hospital.

    PubMed

    Bai, Song; Yu, Bao-Guo; Zhang, Yong-Zhong; Ding, Hui; Wu, Zhou-Wei; Fan, Bin; Fan, Hao-Jun; Hou, Shi-Ke; Chen, Feng

    2017-03-06

    This article outlines the evolution of a rescue team in responding to adenovirus prevention with a deployable field hospital. The local governments mobilized a shelter hospital and a rescue team consisting of 59 members to assist with rescue and response efforts after an epidemic outbreak of adenovirus. We describe and evaluate the challenges of preparing for deployment, field hospital maintenance, treatment mode, and primary treatment methods. The field hospital established at the rescue scene consisted of a medical command vehicle, a computed tomography shelter, an X-ray shelter, a special laboratory shelter, an oxygen and electricity supply vehicle, and epidemic prevention and protection equipment. The rescue team comprised paramedics, physicians, X-ray technicians, respiratory therapists, and logistical personnel. In 22 days, more than 3000 patients with suspected adenovirus infection underwent initial examinations. All patients were properly treated, and no deaths occurred. After emergency measures were implemented, the spread of adenovirus was eventually controlled. An emergency involving infectious diseases in less-developed regions demands the rapid development of a field facility with specialized medical personnel when local hospital facilities are either unavailable or unusable. An appropriate and detailed prearranged action plan is important for infectious diseases prevention. (Disaster Med Public Health Preparedness. 2017;page 1 of 6).

  11. Thrombolysis in the air. Air-ambulance paramedics flying to remote communities treat patients before hospitalization.

    PubMed Central

    Kapasi, H.; Kelly, L.; Morgan, J.

    2000-01-01

    PROBLEM ADDRESSED: First Nations* communities in the North have a high prevalence of coronary artery disease and type 2 diabetes and face an increasing incidence of myocardial infarction (MI). Many conditions delay timely administration of thrombolysis, including long times between when patients first experience symptoms and when they present to community nursing stations, delays in air transfers to treating hospitals, uncertainty about when planes are available, and poor flying conditions. OBJECTIVE OF PROGRAM: To develop a program for administration of thrombolysis on the way to hospital by air ambulance paramedics flying to remote communities to provide more rapid thrombolytic therapy to northern patients experiencing acute MIs. COMPONENTS OF PROGRAM: Critical care flight paramedics fly to northern communities from Sioux Lookout, Ont; assess patients; communicate with base hospital physicians; review an exclusion criteria checklist; and administer thrombolytics according to the Sioux Lookout District Health Centre/Base Hospital Policy and Procedure Manual. Patients are then flown to hospitals in Sioux Lookout; Winnipeg, Man; or Thunder Bay, Ont. CONCLUSION: This thrombolysis program is being pilot tested, and further evaluation and development is anticipated. Images p1316-a p1317-a p1317-b PMID:10907571

  12. Emergence of quinolone resistance in the microbiota of hospitalized patients treated or not with a fluoroquinolone.

    PubMed

    de Lastours, Victoire; Chau, Françoise; Roy, Carine; Larroque, Beatrice; Fantin, Bruno

    2014-12-01

    Quinolone resistance is a major global clinical problem. It primarily emerges in microbiota under selective pressure. Studies evaluating the incidence and risk factors for carrying quinolone-resistant bacteria in hospitalized patients treated with fluoroquinolones (FQs) are lacking. We prospectively included hospitalized patients treated with FQs. Nasal, throat and rectal swabs were performed before FQ treatment, at the end of FQ treatment and 30 days later. A 'reference group' of patients not receiving FQs was also included to determine the rates of quinolone resistance acquisition not linked to FQ treatment. Prevalence and incidence of quinolone-resistant strains of nasal coagulase-negative staphylococci (CoNS) and Staphylococcus aureus, pharyngeal α-haemolytic streptococci and faecal Escherichia coli, and risk factors for emergence of quinolone resistance in FQ-treated patients were assessed. Four-hundred and fifty-one FQ-treated patients were included, as well as 119 subjects in the 'reference group'. Emergence of quinolone resistance occurred in 110/213 (51.6%), 50/336 (14.9%), 53/290 (18.3%) and 46/336 (13.7%) of FQ-treated patients for CoNS, S. aureus, α-haemolytic streptococci and E. coli, respectively, significantly more than for reference patients for CoNS (23/65; P < 0.05), S. aureus (5/91; P < 0.02) and E. coli (4/84; P < 0.05), but not for α-haemolytic streptococci (15/70; P = 0.55). Emergence of resistance was not associated with the type of FQ received, the duration of therapy or the duration of hospital stay, but was associated with host factors such as immunosuppression and altered performance status. FQs received during hospitalization account for high rates of emergence of resistance to FQs in clinically relevant bacteria from human microbiota, reflecting the important ecological impact of FQs. Host factors outweighed treatment or hospitalization characteristics as risk factors for carrying quinolone-resistant strains. © The Author 2014

  13. Resistance of Escherichia coli urinary isolates in ED-treated patients from a community hospital.

    PubMed

    Fleming, Virginia H; White, Bryan P; Southwood, Robin

    2014-08-01

    The purpose of this study is to provide resistance data for Escherichia coli isolates causing urinary tract infections in emergency department (ED) patients not requiring admission and explore if differences between this subpopulation and the hospital antibiogram exist. Differences between community-acquired urinary tract infection (CA-UTI) and health care-associated (HA-UTI) subgroups were also investigated. Patients with a positive urine culture treated and discharged from the ED of a 200-bed community hospital were reviewed. Patients with urinary isolates of more than 100000 colony-forming unit/mL and documented intention to treat were included. Patients who required admission, were pregnant, less than the age of 18 years, or who had a positive culture but without any evidence of intention to treat were excluded. Only the initial visit was included for patients who returned to the ED within 7 days. Overall, 308 visits were screened, and 217 were included. Of these, 78.3% were CA-UTI, and 21.7% were HA-UTI. Females comprised 88.5% of all patients. E coli was the most common pathogen overall and in both subgroups. E coli resistance to levofloxacin was 13.5% overall, 9.2% for CA-UTI, and 38.5% for HA-UTI compared with 27% on the hospital antibiogram. E coli resistance to sulfamethoxazole/trimethoprim was 26.9% overall, 25.2% for CA-UTI, and 34.6% for HA-UTI vs 26% on the antibiogram. E coli susceptibility for ED patients not requiring admission may not be accurately represented by hospital antibiograms that contain culture data from various patient types, sites of infection, or patients with varying illness severity. Separation of the ED population into CA-UTI and HA-UTI subgroups may be helpful when selecting empiric antibiotic therapy. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. [Effectiveness of lifestyle intervention program in persons with obesity treated in a day hospital].

    PubMed

    Carral San Laureano, F; Cabo Navarro, D; Ayala Ortega, C; Gómez Rodríguez, F; Piñero Zaldivar, A; Prieto Ferrón, M; Jiménez Millán, A I; Sanz Sanz, A; García Calzado, C

    2013-01-01

    Obesity is a chronic disease that affects approximately 25% of the Spanish population, causing high morbidity and associated healthcare costs. To evaluate the effectiveness of an intervention program on lifestyles in obese patients treated in a day hospital scheme. A prospective non- controlled intervention study was conducted on obese patients treated in the Endocrinology and Nutrition day hospital, Puerto Real University Hospital, and included in program of lifestyle modification to achieve a weight loss of ≥ 5% minimum. We studied 262 patients with a mean age of 44.6±16.0 years (71% women) with an initial weight, body mass index and waist circumference of 110.4±21.1kg, 41.6±6.6Kg/m(2) and 120.5±13.2cm, respectively. Patients who continued in the study lost an average of 4.8±4.8kg (n=165) and 7.0±6.2kg (n=48) at three and six months, respectively, with 51.5% (n=135) patients reaching the weight loss goal of ≥ 5%. There were no statistically differences in weight loss between any clinical or follow-up variables analysed. 43.5% of patients voluntarily left the study without reaching the weight loss goal. The intervention on lifestyles in obese patients treated in a day hospital achieves moderate weight loss in the medium term, with half of patients achieving a weight loss ≥5%. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

  15. [Clinical characteristics research of shenmai injection treating tumor based on hospital information system in real world].

    PubMed

    Hu, Yuan-Chun; Xie, Yan-Ming; Yang, Wei; Wang, Yong-Yan; Wang, Lian-Xin; Tang, Hao; Zhuang, Yan

    2014-09-01

    The study was to research the clinical characteristics of Shenmai injection treating tumor based on hospital information system, including the characteristics of the age, the sex, the dosage, the course of the treatment and the combination drugs. The data of tumor patients injected with Shenmai injection was analyzed. The information was collected from the hospital information system (HIS) in twenty hospitals of grade III-A. The method of frequencies and association rules was used in this reaearch. The patients over 45 years old were up to 3 338, about 79.36% of the whole. The ratio of male and female was 1.73: 1. The hospitalization day between 15 and 28 was most. The complications of the hypertension and coronary heart disease happened most. The support was 5.939% and 5.099% respectively. Fifty-five patients had the traditional Chinese medicine (TCM) syndrome of Qi-Yin deficiency, about 14.78% of the whole. There were 8 491 patients treated with the single dose of 81 to 100 mL, about 48.70% of the whole. The main combination drugs were dexamethasone, tropisetron and maxolon. The confidence was 44.63%, 31.22% and 20.53% respectively. The information from HIS showed that tumor patients used Shenmai injection were most quinquagenarian with smooth condition. The dose of the Shenmai injection sometimes was higher than that of the drug use instructions in clinical. Shenmai injection was most often combined with glucocorticoid, antemetic and nutritional support medicine when treating tumor in clinical.

  16. Equipment to prevent, diagnose, and treat hypothermia: a survey of Norwegian pre-hospital services

    PubMed Central

    2013-01-01

    Introduction Hypothermia is associated with increased morbidity and mortality in trauma patients and poses a challenge in pre-hospital treatment. The aim of this study was to identify equipment to prevent, diagnose, and treat hypothermia in Norwegian pre-hospital services. Method In the period of April-August 2011, we conducted a survey of 42 respondents representing a total of 543 pre-hospital units, which included all the national ground ambulance services, the fixed wing and helicopter air ambulance service, and the national search and rescue service. The survey explored available insulation materials, active warming devices, and the presence of protocols describing wrapping methods, temperature monitoring, and the use of warm i.v. fluids. Results Throughout the services, hospital duvets, cotton blankets and plastic “bubble-wrap” were the most common insulation materials. Active warming devices were to a small degree available in vehicle ambulances (14%) and the fixed wing ambulance service (44%) but were more common in the helicopter services (58-70%). Suitable thermometers for diagnosing hypothermia were lacking in the vehicle ambulance services (12%). Protocols describing how to insulate patients were present for 73% of vehicle ambulances and 70% of Search and Rescue helicopters. The minority of Helicopter Emergency Medical Services (42%) and Fixed Wing (22%) units was reported to have such protocols. Conclusion The most common equipment types to treat and prevent hypothermia in Norwegian pre-hospital services are duvets, plastic “bubble wrap”, and cotton blankets. Active external heating devices and suitable thermometers are not available in most vehicle ambulance units. PMID:23938145

  17. [A study on Horace N. Allen's medicine and recognition of Korean body].

    PubMed

    Lee, Young Ah

    2011-12-31

    Je Jung Won was the first modern-style Government hospital built by the Korean King Ko-Jong in April 1885, and it was the medical missionary Horace Newton Allen(1858~1932) who made one of the greatest contributions to the establishment of the hospital. Allen was an American missionary. He graduated from Ohio Wesleyan University with a degree in theology in 1881, and completed one-yearcourse at Miami Medical College. In Korea and America he worked as a physician, a missionary, an American diplomatic minister to Korea and a Korean minister's secretary to America. While acting as a mediator between Korea and America, he knew and recorded the domestic and foreign situation of Korea during Gaehwagi(the civilized and enlightened age). Thus to study him is to understand Korea's Gaehwagi as well as to research American medical missionaries. During his stay in Korea(1884~1905), Allen steadily wrote diaries and letters about Korean politics, diplomacy, society, culture, and medicine. Thus his public/private record through diaries and letters(the quantity of these materials amounts to several thousands) supplements the Korean early modern era's historical record. However, until now these materials have received little scholarly attention from researchers except for a few historians of missionary work between Korea and America, or of Korean modern medicine. I intended to use these materials to suggest a new perspective on the study of Korean Gaehwagi. Allen, along with John W. Heron, who came to Seoul on June 21st 1885, treated about 10,460 Korean patients in the first year of the opening of JeJungWon. They made "the first annual report of the Korean Government Hospital". This report explained how Allen and Heron regarded and treated Korean patients. Allen's diaries, letters and other writings offer a realistic view of how the western people actually recognized the Korean people at that time. As a western doctor, Allen had an ambivalent attitude toward Korean medical concepts

  18. The hospital costs of treating work-related sawmill injuries in British Columbia.

    PubMed

    Alamgir, Hasanat; Tompa, Emile; Koehoorn, Mieke; Ostry, Aleck; Demers, Paul A

    2007-05-01

    This study estimates the hospital costs of treating work-related injury among a cohort of sawmill workers in British Columbia. Hospital discharge records were extracted from 1989 to 1998 for a cohort of 5,876 actively employed sawmill workers. Injury cases were identified as work-related from these records using ICD-9 external cause of injury codes that indicate place of occurrence and the responsibility of payment schedule that identifies workers' compensation as being responsible for payment. The hospitals in British Columbia have a standard ward rate chart prepared annually by the provincial Ministry of Health to bill and collect payment from agency like workers' compensation agency. Costs were calculated from the hospital perspective using this billing chart. All costs were expressed in 1995 Canadian dollars. The workers' compensation claim records for this study population were extracted and matched with the hospitalised work-related injury records. Costs were also calculated for work-related hospitalisations that the hospital did not appear to be reimbursed for by the workers' compensation system. There were 173 injuries requiring hospitalisation during the 10-year followup period. The median stay in hospitals was 3 days and the median hospital costs were $847. The most costly cause of injury categories were fire, flame, natural and environmental and struck against with median costs of $10,575 and $1,206, respectively, while the least costly category was cutting and piercing with median costs of $296. The most costly nature of injury categories were burns and fracture of lower limb with median costs of $10,575 and $1,800, respectively, while the least costly category was dislocation, sprains and strains with median costs of $437. The total hospital costs for all the work-related injuries were $434,990. Out of a total hospital cost of $434,990 for the 173 work-related injuries, the provincial compensation agency apparently did not compensate $50,663 (12

  19. Botulinum toxin A for treating spasticity in adults: costly for French hospitals?

    PubMed

    Schnitzler, A; Ruet, A; Baron, S; Buzzi, J-C; Genet, F

    2015-10-01

    Intramuscular injection of botulinum toxin (BoNTA) is one of the primary treatments for focal spasticity. This treatment is considered costly and the level of reimbursement by health insurance has been decreasing in many countries for several years. The aim of this study was to determine the real cost of treating spasticity with BoNTA and to compare this with the level of reimbursement by the national health insurance in France in 2008 and with a new fee, specific to the injection of BoNTA in ambulatory services. A single-center, retrospective study using the 2008 database from a French secondary-care day-hospital unit (treating spasticity in adults with sequelae of stroke, multiple sclerosis or traumatic brain injuries). The level of reimbursement by the French ministry of health for BoNTA treatment for adults with spasticity constituted the "calculated cost" and corresponded to the hospital's "budget". The "real cost" (incurred by the hospital) included the sum of staffing and material costs as well as the number of toxin vials used. The calculated costs for 2009 and 2013 were based on the levels of reimbursement during those years. The difference between real and calculated cost for 2009 and 2013 was estimated considering that the real cost of 2008 was stable. In 2008, 364 patients received BoNTA, resulting in 870 day-hospital admissions. The calculated cost was 459,056€/year and the real cost was 567,438€/year (equivalent to 4.27€/day/patient). The total budget deficit (hospital income minus hospital costs) was 108,383€. The deficit was estimated at 222,892€ in 2009 and 241,188€ in 2013. The daily cost of BoNTA treatment for spasticity is reasonable; however, because of the level of reimbursement by the national health insurance in France, the treatment is costly for French hospitals. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  20. Development of Peer-Group-Classification Criteria for the Comparison of Cost Efficiency among General Hospitals under the Korean NHI Program

    PubMed Central

    Kang, Hee-Chung; Hong, Jae-Seok; Park, Heon-Jin

    2012-01-01

    Objectives To classify general hospitals into homogeneous systematic-risk groups in order to compare cost efficiency and propose peer-group-classification criteria. Data Sources Health care institution registration data and inpatient-episode-based claims data submitted by the Korea National Health Insurance system to the Health Insurance Review and Assessment Service from July 2007 to December 2009. Study Design Cluster analysis was performed to classify general hospitals into peer groups based on similarities in hospital characteristics, case mix complexity, and service-distribution characteristics. Classification criteria reflecting clustering were developed. To test whether the new peer groups better adjusted for differences in systematic risks among peer groups, we compared the R2 statistics of the current and proposed peer groups according to total variations in medical costs per episode and case mix indices influencing the cost efficiency. Data Collection A total of 1,236,471 inpatient episodes were constructed for 222 general hospitals in 2008. Principal Findings New criteria were developed to classify general hospitals into three peer groups (large general hospitals, small and medium general hospitals treating severe cases, and small and medium general hospitals) according to size and case mix index. Conclusions This study provides information about using peer grouping to enhance fairness in the performance assessment of health care providers. PMID:22356558

  1. Development of peer-group-classification criteria for the comparison of cost efficiency among general hospitals under the Korean NHI program.

    PubMed

    Kang, Hee-Chung; Hong, Jae-Seok; Park, Heon-Jin

    2012-08-01

    To classify general hospitals into homogeneous systematic-risk groups in order to compare cost efficiency and propose peer-group-classification criteria. Health care institution registration data and inpatient-episode-based claims data submitted by the Korea National Health Insurance system to the Health Insurance Review and Assessment Service from July 2007 to December 2009. Cluster analysis was performed to classify general hospitals into peer groups based on similarities in hospital characteristics, case mix complexity, and service-distribution characteristics. Classification criteria reflecting clustering were developed. To test whether the new peer groups better adjusted for differences in systematic risks among peer groups, we compared the R(2) statistics of the current and proposed peer groups according to total variations in medical costs per episode and case mix indices influencing the cost efficiency. A total of 1,236,471 inpatient episodes were constructed for 222 general hospitals in 2008. New criteria were developed to classify general hospitals into three peer groups (large general hospitals, small and medium general hospitals treating severe cases, and small and medium general hospitals) according to size and case mix index. This study provides information about using peer grouping to enhance fairness in the performance assessment of health care providers. © Health Research and Educational Trust.

  2. [Cancer of the uterus treated at the Maribor Hospital from 1961 to 1978].

    PubMed

    Gorisek, B

    1983-01-01

    From 1961-1978, 218 patients with the carcinoma of the corpus uteri were treated in the hospital of Maribor . They were on average 60 years old. In most of the cases (87%) the disease was classified as stage I. Only the operation was performed in 15.6% of the patients, only radiation in 11.5%, and in the rest of patients a combined therapy was used. The patients survived a 5-year period in 75%; the best prognosis was observed in stage I a-84%.

  3. Hemorrhagic Fever with Renal Syndrome (Korean Hemorrhagic Fever).

    DTIC Science & Technology

    1986-07-23

    13 Table 5. Monthly incidence of HFRS among Korean in the Republic of Korea , 1966-1985 . . . . . . . 14 A Table 6. Incidence of HFRS by...GRANT SUPPORT .. ........ 57.... 5 INTRODUCTION During the Korean War more than 3,000 United Nations .00 troops in Korea developed a rare hemorrhagic...8217;.-.* * S.’ . " 10 ... Table 1. Hospitalized cases of Hemorrhagic fever with renal syndrome patients in the Republic of Korea Year US Korean Korean

  4. Reduction in hospitalization costs, morbidity, disability, and mortality in patients with aids treated with protease inhibitors.

    PubMed

    Lavalle, C; Aguilar, J C; Peña, F; Estrada-Aguilar, J L; Aviña-Zubieta, J A; Madrazo, M

    2000-01-01

    The objective of this study was to analyze hospitalization costs, morbidity, disability, and mortality in patients with acquired immunodeficiency syndrome (AIDS) treated with protease inhibitors (PI). This is a self-controlled, ambispective study of a total of 581 patients with human immunodeficiency virus (HIV)/AIDS seen at the Hospital de Infectología, Centro Médico La Raza, IMSS, in Mexico City during 1997. A total of 210 (36.14%) patients initiated protease inhibitor (PI) treatment at the onset of the study. Thirty-eight patients satisfied the inclusion criteria for this study and were analyzed retrospectively during the year prior to PI treatment, and then prospectively throughout the year on PI treatment. As concerns main outcome measures, financial costs, number of hospitalizations, number of infections, and productivity and laboratory parameters (CD4(+) counts and viral load) were analyzed during the year prior to PI treatment and then prospectively during the year on PI prescription. Our hypothesis was that the hospital costs, morbidity, disability, and mortality of patients with AIDS decreased while on PI treatment. During the year prior to PI prescription, the 38 patients enrolled in the study were admitted on a total of 59 occasions (1.55 hospitalizations/patient), whereas during the year on PI therapy, all 38 patients had only seven admissions (0.18 hospitalizations/patient). Hospitalization costs decreased 35% when annual PI costs for the 38 patients studied were taken into account. The number of microorganisms detected during hospitalization decreased from 24 prior to PI to five on PI. The number of disability days involved in patients on PI decreased significantly (p <0.0002). None of the 38 patients studied died during the year of follow-up under PI treatment. Mortality decreased significantly, from 116/481 (23.2%) in 1996, to 77/581 (13.2%) in 1997, to 40/740 (6.4%) in 1998. There were no deaths among the 38 patients studied during the 1-year

  5. Frequency and trends of hospital treated pesticide poisonings in Germany 2000-2014.

    PubMed

    Moebus, Susanne; Boedeker, Wolfgang

    2017-01-01

    Objectives: To analyze the occurrence, trends, and patterns of hospital treated pesticide poisonings in Germany Methods: Data from the German diagnoses statistics of hospital discharges are analyzed for the years 2000-2014. ICD code specific numbers of cases as well as rates per one million and case-fatality ratios are calculated. The number of fatal pesticides poisonings is compared to the official German causes-of-death statistics. Results: During 2000 and 2014 overall 2,871 pesticides poisonings were treated in hospitals with 191 cases per year on average. The rate per 1 million dropped from 2.74 in 2000 to 1.38 in 2014. On average 5% of pesticides poisonings were fatal, this percentage also approximately halved from 2000 to 2014. The majority of pesticide poisonings occurred in men. In both sexes about 70% of all pesticide poisonings occurred below 55 years and one third of patients were younger than 25 years. With respect to fatal poisonings men shared almost 80% of incidents and more than 70% of cases occurred above 55 years of age. There is poor agreement between the different data sources studied. On average only 24% of the fatal pesticide poisoning in the mortality statistics were seen in the diagnoses statistics of hospital discharges. Conclusions: This study shows that the decrease of pesticide poisonings in Germany applies to fatal and non-fatal incidents. There seems to be a decrease also in the case fatality ratio which might point to positive preventive effects by reducing the availability of toxic pesticides. Fatal pesticides poisonings prevails in elder men while non-fatal pesticide poisoning more often affects the younger population. These different patterns should be addressed when improving preventive strategies. The discrepancy between the different data bases with respect to fatal poisoning might be explained by intoxications not admitted to a hospital. However, the difference seems rather high and calls for a deeper investigation. The ICD

  6. Risk factors of all-cause in-hospital mortality among Korean elderly bacteremic urinary tract infection (UTI) patients.

    PubMed

    Chin, Bum Sik; Kim, Myung Soo; Han, Sang Hoon; Shin, So Youn; Choi, Hee Kyung; Chae, Yun Tae; Jin, Sung Joon; Baek, Ji-Hyeon; Choi, Jun Yong; Song, Young Goo; Kim, Chang Oh; Kim, June Myung

    2011-01-01

    Urinary tract infection (UTI) is the most frequent cause of bacteremia/sepsis in elderly people and increasing antimicrobial resistance in uropathogens has been observed. To describe the characteristics of bacteremic UTI in elderly patients and to identify the independent risk factors of all-cause in-hospital mortality, a retrospective cohort study of bacteremic UTI patients of age over 65 was performed at a single 2000-bed tertiary hospital. Bacteremic UTI was defined as the isolation of the same organism from both urine and blood within 48 h. Eighty-six elderly bacteremic UTI patients were enrolled. Community-acquired infection was the case for most patients (79.1%), and Escherichia coli accounted for 88.6% (70/79) among Gram-negative organisms. Non-E. coli Gram-negative organisms were more frequent in hospital-acquired cases and male patients while chronic urinary catheter insertion was related with Gram-positive urosepsis. The antibiotic susceptibility among Gram-negative organisms was not different depending on the source of bacteremic UTI, while non-E. coli Gram-negative organisms were less frequently susceptible for cefotaxime, cefoperazone/sulbactam, and aztreonam. All-cause in-hospital mortality was 11.6%, and functional dependency (adjusted hazard ratio=HR=10.9, 95% confidence interval=95%CI=2.2-54.6) and low serum albumin (adjusted HR=27.0, 95%CI=2.0-361.2) were independently related with increased all-cause in-hospital mortality. Crown Copyright © 2010. Published by Elsevier Ireland Ltd. All rights reserved.

  7. Age-Stratified Treatment Response Rates in Hospitalized Patients with Clostridium difficile Infection Treated with Metronidazole.

    PubMed

    Pham, Vy P; Luce, Andrea M; Ruppelt, Sara C; Wei, Wenjing; Aitken, Samuel L; Musick, William L; Roux, Ryan K; Garey, Kevin W

    2015-10-01

    Consensus on the optimal treatment of Clostridium difficile infection (CDI) is rapidly changing. Treatment with metronidazole has been associated with increased clinical failure rates; however, the reasons for this are unclear. The purpose of this study was to assess age-related treatment response rates in hospitalized patients with CDI treated with metronidazole. This was a retrospective, multicenter cohort study of hospitalized patients with CDI. Patients were assessed for refractory CDI, defined as persistent diarrhea after 7 days of metronidazole therapy, and stratified by age and clinical characteristics. A total of 242 individuals, aged 60 ± 18 years (Charlson comorbidity index, 3.8 ± 2.4; Horn's index, 1.7 ± 1.0) were included. One hundred twenty-eight patients (53%) had severe CDI. Seventy patients (29%) had refractory CDI, a percentage that increased from 22% to 28% and to 37% for patients aged less than 50 years, for patients from 50 to 70 years, and for patients aged >70 years, respectively (P = 0.05). In multivariate analysis, Horn's index (odds ratio [OR], 2.04; 95% confidence interval [CI], 1.50 to 2.77; P < 0.001), severe CDI (OR, 2.25; 95% CI, 1.15 to 4.41; P = 0.018), and continued use of antibiotics (OR, 2.65; 95% CI, 1.30 to 5.39; P = 0.0072) were identified as significant predictors of refractory CDI. Age was not identified as an independent risk factor for refractory CDI. Therefore, hospitalized elderly patients with CDI treated with metronidazole had increased refractory CDI rates likely due to increased underlying severity of illness, severity of CDI, and concomitant antibiotic use. These results may help identify patients that may benefit from alternative C. difficile treatments other than metronidazole. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  8. Age-Stratified Treatment Response Rates in Hospitalized Patients with Clostridium difficile Infection Treated with Metronidazole

    PubMed Central

    Pham, Vy P.; Luce, Andrea M.; Ruppelt, Sara C.; Wei, Wenjing; Aitken, Samuel L.; Musick, William L.; Roux, Ryan K.

    2015-01-01

    Consensus on the optimal treatment of Clostridium difficile infection (CDI) is rapidly changing. Treatment with metronidazole has been associated with increased clinical failure rates; however, the reasons for this are unclear. The purpose of this study was to assess age-related treatment response rates in hospitalized patients with CDI treated with metronidazole. This was a retrospective, multicenter cohort study of hospitalized patients with CDI. Patients were assessed for refractory CDI, defined as persistent diarrhea after 7 days of metronidazole therapy, and stratified by age and clinical characteristics. A total of 242 individuals, aged 60 ± 18 years (Charlson comorbidity index, 3.8 ± 2.4; Horn's index, 1.7 ± 1.0) were included. One hundred twenty-eight patients (53%) had severe CDI. Seventy patients (29%) had refractory CDI, a percentage that increased from 22% to 28% and to 37% for patients aged less than 50 years, for patients from 50 to 70 years, and for patients aged >70 years, respectively (P = 0.05). In multivariate analysis, Horn's index (odds ratio [OR], 2.04; 95% confidence interval [CI], 1.50 to 2.77; P < 0.001), severe CDI (OR, 2.25; 95% CI, 1.15 to 4.41; P = 0.018), and continued use of antibiotics (OR, 2.65; 95% CI, 1.30 to 5.39; P = 0.0072) were identified as significant predictors of refractory CDI. Age was not identified as an independent risk factor for refractory CDI. Therefore, hospitalized elderly patients with CDI treated with metronidazole had increased refractory CDI rates likely due to increased underlying severity of illness, severity of CDI, and concomitant antibiotic use. These results may help identify patients that may benefit from alternative C. difficile treatments other than metronidazole. PMID:26195522

  9. The paradox of public holidays: Hospital-treated self-harm and associated factors.

    PubMed

    Griffin, Eve; Dillon, Christina B; O'Regan, Grace; Corcoran, Paul; Perry, Ivan J; Arensman, Ella

    2017-08-15

    Recent research on the patterns of self-harm around public holidays is lacking. This study used national data to examine the patterns of hospital-treated self-harm during public holidays, and to examine associated factors. Data on self-harm presentations to all emergency departments were obtained from the National Self-Harm Registry Ireland. The association between self-harm presentations and public holidays was examined using univariate and multivariate Poisson regression analyses. A total of 104,371 presentations of self-harm were recorded between 2007 and 2015. The mean number of self-harm presentations was 32 on public holidays. St. Patrick's Day had the highest number of presentations compared to all other public holidays, with a daily mean of 44 presentations. Across all years, self-harm presentations during public holidays had a 24% increased risk of involving alcohol consumption compared to all other days and this effect was most pronounced during the Christmas period. The association with alcohol remained significant at a multivariate level. Presentations on public holidays were more likely to attend out of normal working hours. An increase in male presentations involving self-cutting was observed on public holidays and there was an over-representation of males presenting for the first time. It is likely that extent of alcohol involvement in self-harm presentations reported here is an underestimate, as it was dependent on the information being recorded by the attending clinician. Public holidays are associated with an elevated number of self-harm presentations to hospital, with presentations to hospital involving alcohol significantly increased on these days. Hospital resources should be targeted to address increases during public holidays, including during out-of-hours. Involvement of alcohol may delay delivery of care to these patients in emergency settings. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Inpatient treatment effect and Minnesota Multiphasic Personality Inventory characteristics of motor vehicle collision injuries in a traditional korean medicine hospital: Retrospective chart review.

    PubMed

    Song, Min-Yeong; Jo, Hee-Guen; Sul, Jae-Uk; Kim, Seong-Tae; Bae, Kil-Joon; Kim, Tae-Gwang; Kim, Jae-Hong; Choi, Jin-Bong

    2016-11-03

    To examine the changes in pain, disability, and quality of life in motor vehicle collision injury (MVCI) patients after treatment with traditional Korean medicine (TKM), and to investigate the psychological characteristics of these patients. Forty-one patients with MVCI were treated with TKM including acupuncture, pharmacopuncture, moxibustion, cupping, herbal medication, chuna manual therapy, and physical therapy. Numeric Rating Scale (NRS), Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), Neck Disability Index (NDI), Oswestry Disability Index (ODI), and Lysholm Knee Scoring Scale were assessed at admission and discharge. The Minnesota Multiphasic Personality Inventory (MMPI) was assessed at admission. After treatment, NRS scores for headache, cervical pain, and lumbar pain were significantly decreased (P<0.05); NDI, ODI scores were significantly decreased, and Lysholm score was signifificantly increased (P<0.05). The following SF-36 scores were signifificantly increased: physical and mental component summary, bodily pain, role-physical, role-emotional, social functioning, and mental health scores (all P<0.05). MMPI identifified 3-1 profifile conversion V shape. Treatment of MVCI with TKM provided effective management of complex symptoms such as pain, disability, and loss of quality of life. A comprehensive plan must be implemented for treatment and research in cases of MVCIs owing to the correlation between physical symptoms and psychological profifiles.

  11. Report on the first 1000 patients treated at St Thomas' Hospital by extracorporeal shockwave lithotripsy.

    PubMed

    Palfrey, E L; Bultitude, M I; Challah, S; Pemberton, J; Shuttleworth, K E

    1986-12-01

    Since March 1985, over 1000 patients have been treated on the lithotripter at St Thomas' Hospital. Since it is the only machine in the country offering treatment to National Health Service patients at no cost to the referring Health Authority, there has been a heavy demand for treatment and 97% of referrals have been accepted. Analysis of the first 1000 patients shows extracorporeal shockwave lithotripsy (ESWL) to be a safe procedure with a low morbidity rate and no mortality. The number of patients who were stone-free 3 months after treatment was low (44.1%) compared with the numbers reported in other series. The most likely reasons for this are the poor follow-up rate (48.9%), the stringent criteria for the diagnosis of "stone-free" and a possible skewed referral and follow-up pattern.

  12. Microwave oven-related injuries treated in hospital EDs in the United States, 1990 to 2010.

    PubMed

    Thambiraj, Dana F; Chounthirath, Thiphalak; Smith, Gary A

    2013-06-01

    The widespread availability of microwave ovens has sparked interest in injuries resulting from their use. Using a retrospective cohort design, the objective of this study is to investigate the epidemiology of microwave oven-related injuries treated in United States emergency departments (EDs) from 1990 through 2010 by analyzing data from the National Electronic Injury Surveillance System. An estimated 155959 (95% confidence interval [CI], 133515-178402) individuals with microwave oven-related injuries were treated in US hospital EDs from 1990 through 2010, which equals an average of 21 individuals per day; 60.7% were female; 63.3% were adults (≥18 years); 98.1% of injury events occurred at home; and 3.9% of patients were hospitalized. During the 21-year study period, the number and rate of microwave oven-related injuries increased significantly by 93.3% and 50.0%, respectively. The most common mechanism of injury was a spill (31.3%), and the most common body region injured was the hand and fingers (32.4%). Patients younger than 18 years were more likely to sustain an injury to their head and neck (relative risk: 1.65; 95% CI, 1.39-1.96) than adults. To our knowledge, this is the first study to investigate microwave oven-related injuries on a national scale. Microwave ovens are an important source of injury in the home in the United States. The large increases in the number and rate of these injuries underscore the need for increased prevention efforts, especially among young children. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Patients' experience and perception of hospital-treated Clostridium difficile infections: a qualitative study.

    PubMed

    Guillemin, Isabelle; Marrel, Alexia; Lambert, Jérémy; Beriot-Mathiot, Axelle; Doucet, Carole; Kazoglou, Odysseas; Luxemburger, Christine; Reygrobellet, Camille; Arnould, Benoit

    2014-01-01

    Clostridium difficile is the leading cause of antibiotic-associated diarrhea and an important source of nosocomial infection. Clinical manifestations can range from mild diarrhea to lethal pseudomembranous colitis. Little is known about the burden of C. difficile infections (CDI) in patients. This qualitative study explored the impact of hospital-treated CDI on patients' lives from the first occurrence of CDI symptoms, through their hospital stay, and after discharge. Semi-structured interviews with 12 US and 12 French patients who had experienced CDI were conducted using an interview guide that was developed on the basis of a thorough literature review. Transcripts from these interviews were analyzed to identify concepts related to the research question. CDI affected numerous aspects of patients' lives. Patients reported that the continuous, watery, and uncontrollable diarrhea characteristic of CDI had the most impact on their daily lives. Diarrhea prevented them from participating in usual daily activities; this caused the collapse of their social lives. Patients felt humiliated and embarrassed. Patients' emotional distress worsened once hospitalized; they reported feelings of loneliness and worry when placed in isolation. From discharge to the time of the interview, patients reported both psychological and physical improvement. However, despite continuing improvement, most patients reported persistent worry and fear of recurrent episodes, and they were thus more careful about their diet and hygiene. As one patient in this study explained, CDI is "the worst of everything that I've had." The emotional distress and extreme physical exhaustion associated with CDI result in a traumatic and frightening experience for patients. This trauma persists after recovery and includes lingering fears of a recurrent episode.

  14. Hospital-treated suicide attempts among Finnish fire setters: a follow-up study.

    PubMed

    Thomson, Annika; Tiihonen, Jari; Miettunen, Jouko; Virkkunen, Matti; Lindberg, Nina

    2016-12-01

    High rates of attempted and completed suicide have been reported among offenders, but there has been little attention in this respect to fire setters specifically. Aim Our aim was to investigate hospital-treated suicide attempts among male fire setters. For each of a consecutive series of 441 pre-trial fire setters, four controls matched for age, gender and place of birth were randomly selected from the Central Population Register. Data on hospitalisation and causes of death over a 39-year period were obtained from the Finnish national registers. The prevalence of suicide attempts was significantly higher among fire setters than among controls. Approximately every fifth fire setter had made at least one suicide attempt which had required hospital treatment. The most common method chosen was intentional self-poisoning or exposure to noxious substances. More than 1 in 10 fire setters with at least one hospitalisation for suicide-related behaviour eventually completed suicide. More attention should be paid to detecting and managing suicidal behaviours among fire setters as they are a high-risk group and accurate identification of their needs in this respect may not only be life-saving but also reduce recidivism. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  15. Closing Italian Forensic Psychiatry Hospitals in Favor of Treating Insanity Acquittees in the Community.

    PubMed

    Carabellese, Felice; Felthous, Alan R

    2016-03-01

    Originally a hedge against the death penalty, the insanity defense came to offer hospitalization as an alternative to imprisonment. In the late 19th century Italy opened inpatient services first for mentally ill prisoners and then for offenders found not guilty by reason of insanity. Within the past decade, a series of decrees has resulted in transferring the responsibility for treating NGRI acquittees and "dangerous" mentally ill prisoners from the Department of Justice to the Department of Health, and their treatment from Italy's high security forensic psychiatric hospitals (OPGs) to community regional facilities (REMSs, Residences for the Execution of Security Measures), community mental health facilities, one of which is located in each region of Italy. Today community REMSs provide the treatment and management of socially dangerous offenders. The dynamic evolution of Italy's progressive mental health system for insanity acquittees, to our knowledge the most libertarian, community oriented approach of any country, is retraced. Discussion includes cautionary concerns as well as potential opportunities for improvements in mental health services. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  16. The cost-effectiveness of identifying and treating malnutrition in hospitals: a systematic review.

    PubMed

    Mitchell, H; Porter, J

    2016-04-01

    Disease-related malnutrition is known to have significant clinical and economic consequences. This systematic review of recent evidence aimed to establish the cost-effectiveness of identifying and treating malnutrition in the hospital setting. A search of four electronic databases and the Internet was conducted for relevant publications from 2003 to 2013. The search strategy considered both nutritional care and healthcare costs. Hospitalised adults with, or at risk of malnutrition, were the focus of the review. Eligibility criteria included publications of original research to identify or treat malnutrition through usual care. Studies with a focus on enteral and parenteral nutrition interventions were beyond the scope of the review. Methodological quality was assessed using the Consensus on Health Economic Criteria checklist. Of the 1174 records identified through database searching, 19 full-text articles were assessed for eligibility. Three studies were included in the final review, highlighting the absence of recent high quality cost-effectiveness studies in this field. One economic modelling study and two prospective clinical trials were included of moderate to high methodological quality. Definite conclusions could not be drawn regarding the cost-effectiveness of individual interventions because of the heterogeneity of treatments, controls and populations. The present review highlights an evidence gap in the care of malnourished hospitalised adults, limiting the ability of clinicians and healthcare managers to make informed, cost-effective treatment decisions. Further economic evaluations are needed and should be considered as a routine component of future research. © 2015 The British Dietetic Association Ltd.

  17. Similar long-term survival of consecutive in-hospital and out-of-hospital cardiac arrest patients treated with targeted temperature management

    PubMed Central

    Engsig, Magaly; Søholm, Helle; Folke, Fredrik; Gadegaard, Peter J; Wiis, Julie Therese; Molin, Rune; Mohr, Thomas; Engsig, Frederik N

    2016-01-01

    Objective The long-term survival of in-hospital cardiac arrest (IHCA) patients treated with targeted temperature management (TTM) is poorly described. The aim of this study was to compare the outcomes of consecutive IHCA with out-of-hospital cardiac arrest (OHCA) patients treated with TTM. Design, setting, and patients Retrospectively collected data on all consecutive adult patients treated with TTM at a university tertiary heart center between 2005 and 2011 were analyzed. Measurements Primary endpoints were survival to hospital discharge and long-term survival. Secondary endpoint was neurological outcome assessed using the Pittsburgh cerebral performance category (CPC). Results A total of 282 patients were included in this study; 233 (83%) OHCA and 49 (17%) IHCA. The IHCA group presented more often with asystole, received bystander cardiopulmonary resuscitation (CPR) in all cases, and had shorter time to return of spontaneous circulation (ROSC). Survival to hospital discharge was 54% for OHCA and 53% for IHCA (adjusted odds ratio 0.98 [95% confidence interval {CI}; 0.43–2.24]). Age ≤60 years, bystander CPR, time to ROSC ≤10 min, and shockable rhythm at presentation were associated with survival to hospital discharge. Good neurologic outcome among survivors was achieved by 86% of OHCA and 92% of IHCA (P=0.83). After a median follow-up time of >5 years, 83% of OHCA and 77% of IHCA were alive (adjusted hazard ratio [HR] 1.51 [95% CI; 0.59–3.91]). Age ≤60 years was the only factor associated with long-term survival (adjusted HR 2.73 [95% CI; 1.36–5.52]). Conclusion There was no difference in short- and long-term survival and no difference in neurologic outcome to hospital discharge between IHCA and OHCA patients treated with TTM despite higher frequency of asystole in IHCA. PMID:27877067

  18. Clinical and microbiologic characteristics of children treated at the Fort de France university hospital after the 2010 Haiti earthquake.

    PubMed

    Arquès, Isabelle; Vincent, Martine; Olive, Claude; Cabié, André; Canivet, Isabelle; Hochedez, Patrick

    2013-05-01

    Few data related to the care of children injured in an earthquake are available. The objective of our study was to analyze the results of clinical and microbiologic characteristics of children treated in a Fort de France hospital after the Haiti earthquake. Bacteria were mainly Gram-negative bacteria. Some of these infections seemed to be environmental; a significant portion was related to acquisition during hospitalization.

  19. Missed or Delayed Cervical Spine or Spinal Cord Injuries Treated at a Tertiary Referral Hospital in Rwanda.

    PubMed

    Nkusi, Agabe Emmy; Muneza, Sévérien; Hakizimana, David; Nshuti, Steven; Munyemana, Paulin

    2016-03-01

    This study was aimed at 1) reporting cases of missed cervical spine injuries treated at a tertiary-level hospital, King Faisal Hospital, Rwanda (KFH-R), and 2) identifying the causes of delaying the diagnosis. We prospectively collected data from patients with a missed or delayed cervical spine and/or cord injury treated at King Faisal Hospital, Kigali for a 12-month period (January 2012 to December 2012). The total number of cervical spine injury patients treated at our center was retrieved from the hospital admission registry. Forty-two patients with cervical spine or spinal cord injuries were treated at KFH-R in 2012, and 4 of them had a missed or delayed diagnosis. Clinical and radiologic findings of all 4 patients are presented, and the reasons for delaying diagnosis are identified. This study found that the cervical spine injuries were missed in 9.5% of the cervical spine trauma patients and resulted in a longer hospital stay for all 4 patients and severe disability in 1 patient (25%). The reasons for missed diagnoses in this study were 1) lack of cervical spine radiographic evaluation, 2) inadequate cervical spine radiographs to show the level of injury, 3) poor sensitivity of cervical spine plain radiography, 4) poor physical examination, 5) the presence of a distracting injury, and 6) poor sensitivity of radiographs and computed tomography scans for soft tissue injuries. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. [Cost-analysis of treating patients with multiple injuries in a reference hospital in Spain].

    PubMed

    Auñón Martín, Ismael; Caba Doussoux, Pedro; Mora Sambricio, Ana; Guimera García, Vicente; Yuste García, Pedro; Resines Erasun, Carlos

    2012-11-01

    The aim of this study is to analyse the costs of the treatment of a group of patients with severe injuries. The distribution of the costs between the different departments involved in the management of these patients is also investigated. The data from patients who suffered severe injuries, and recorded in the Traumasur data base, were prospectively gathered to be used in the study. The data from a total of 131 patients treated in the year 2008 were collected. Data obtained from the hospital finance office were also used, providing the overall cost as well as the separate costs of each of the departments involved in the treatment. The injury severity score (ISS) and the new injury severity score (NISS) mean values were 31.8 and 39.4, respectively. The mortality rate was 17.5%. The overall costs of the patients was 3,791,879.3 €, with a mean cost per patient of 28,945 €. The mean percentage of the overall costs of the treatment incurred by the ICU and the ward was 62% and 12.7%, respectively. The cost of the ICU admission increased up to 68.4% in patients with an ISS>40. Although the patients who died had more serious injuries, they had a lower cost in all areas. Patients with multiple injuries represent a significant health cost, with the greater percentage being due to the hospital stay, particularly that in ICU. Other cost areas involve a lower percentage of the cost. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.

  1. [Can we decrease cesarean rate at a university hospital treating high risk pregnancies?].

    PubMed

    Lembrouck, C; Mottet, N; Bourtembourg, A; Ramanah, R; Riethmuller, D

    2016-06-01

    To determine which clinical practice changes were responsible for a decrease in cesarean rate from 19.2% in 2003 to 15.5% in 2012 at our university hospital treating high risk pregnancies, while verifying the absence of any increase in neonatal morbidity and death. A descriptive retrospective study was undertaken at our labour ward including all patients delivering in 2003 and in 2012. Maternal, obstetrical and neonatal characteristics of the two populations were compared. Cesarean rates were analysed following : (1) Robson classification, (2) some maternal and obstetrical characteristics, and (3) indications for cesarean. Mean age, BMI and rate of scarred uterus significantly increased in 2012. The two populations remained comparable in terms of other criteria studied. The main cause responsible for decrease in cesarean rate was breech presentations (p<0.05). Furthermore, significantly less cesareans were performed after labour induction (p=0.04). We also significantly decreased our elective cesarean rate by more than 3% without increasing cesarean sections during labour, showing a rise in successful vaginal delivery trials. The impact of in utero transfers on the global rate of cesarean is highly significant since the latter has been divided by half in 10 years in this population considered to be of high risk for cesareans. These significant decreases reflect our experience in allowing vaginal deliveries in breech presentations, and also a better selection of patients for labour induction. Furthermore, it should be noted that increasing vaginal delivery trials in various obstetrical situations participated in this decrease. We clearly found that some indications for elective cesarean can be avoided, such as multiple pregnancies and scarred uterus, thus showing the importance of restricting the first indication for cesarean. Finally, the decrease in cesarean rate had no negative effect on neonatal outcome. Decreasing cesarean rate is possible in a university

  2. Korean Dermatological Association.

    PubMed

    Ro, B I

    1998-12-01

    The Korean Dermatological Association (KDA) was founded on October 27, 1945. The first annual meeting was held on November 15, 1947, and meetings have been held twice a year since 1975. The KDA 50th Annual Spring Meeting was on April 15-16, 1998. Korean Journal of Dermatology, the official journal of the KDA, was first published in 1960 and has been published bimonthly since 1978. Annals of Dermatology (Seoul), the English journal, was first published in 1989 and has been published quarterly since 1995. The American residency and specialty board system was introduced in 1954. Board specialty examination of dermatology candidates by the KDA requires four years of residency. Three hundred and twenty residents are now in the training course in the fifty-nine resident training approved hospitals this year. KDA has seven regional dermatological societies; Seoul, Pusan, Taegu, Honam, Chungchong, Jeonbuk, and Kangwon. KDA has had eleven research subcommittees since 1981. There are two associated societies of the KDA; the Korean Society for Investigative Dermatology was founded in 1991, and the Korean Society for Medical Mycology was founded in 1994. The Korea-Japan Joint Meeting of Dermatology has been held every two years since 1979 and the Korea-China Joint Meeting of Dermatology and Mycology has been held since 1996. About three hundred papers were presented at the 49th Annual Autumn Meeting on October 21-23, 1997. These included special lectures, invited lectures, educational lectures, oral presentations, and posters. About five hundred dermatologists participated in that meeting. KDA joined the International League of Dermatological Societies in 1973 with forty-seven members. There are around 1200 members of the KDA including 320 residents in 1998.

  3. Outcome of pyometra in female dogs and predictors of peritonitis and prolonged postoperative hospitalization in surgically treated cases

    PubMed Central

    2014-01-01

    Background One of the most common diseases in intact bitches is pyometra– a potentially life-threatening disease associated with a variety of clinical and laboratory findings. The aims of the present study were to describe complications of the disease and to investigate clinically useful indicators associated with peritonitis and/or prolonged postoperative hospitalization. Results A retrospective study was performed using records from 356 bitches diagnosed with pyometra during the years 2006–2007 at the University Animal Hospital, Swedish University of Agricultural Sciences, Uppsala, Sweden. Of the 356 bitches, 315 were surgically treated by ovariohysterectomy, 9 were medically treated and 32 were euthanized without treatment. In the surgically treated bitches, univariable associations between clinical and laboratory data, risk for prolonged hospitalization (≥ 3 days) and/or signs of peritonitis, were analyzed by Chi-square and Fisher’s exact test. Logistic regression models were used to assess multivariable associations. The most common complication observed in surgically treated bitches was peritonitis (40 bitches), followed by urinary tract infection (19 bitches), wound infection (8 bitches), uveitis (6 bitches), and cardiac arrhythmia (5 bitches). Leucopenia and fever/hypothermia were associated with increased risk for peritonitis (18-fold and three-fold, respectively). Moderate to severe depression of the general condition, pale mucous membranes and leucopenia were associated with increased risk (seven-fold, three-fold, and over three-point-five-fold, respectively) for prolonged postoperative hospitalization. Conclusions Several clinically useful indicators were identified. Leucopenia was the most important marker, associated with 18-fold increased risk for peritonitis and an over three-point-five increased risk for prolonged hospitalization. Fever/hypothermia, depression and pale mucous membranes were associated with increased risk for peritonitis and

  4. Milrinone and homeostasis to treat cerebral vasospasm associated with subarachnoid hemorrhage: the Montreal Neurological Hospital protocol.

    PubMed

    Lannes, Marcelo; Teitelbaum, Jeanne; del Pilar Cortés, Maria; Cardoso, Mauro; Angle, Mark

    2012-06-01

    For the treatment of cerebral vasospasm, current therapies have focused on increasing blood flow through blood pressure augmentation, hypervolemia, the use of intra-arterial vasodilators, and angioplasty of proximal cerebral vessels. Through a large case series, we present our experience of treating cerebral vasospasm with a protocol based on maintenance of homeostasis (correction of electrolyte and glucose disturbances, prevention and treatment of hyperthermia, replacement of fluid losses), and the use of intravenous milrinone to improve microcirculation (the Montreal Neurological Hospital protocol). Our objective is to describe the use milrinone in our practice and the neurological outcomes associated with this approach. Large case series based on the review of all patients diagnosed with delayed ischemic neurologic deficits after aneurysmal subarachnoid hemorrhage between April 1999 and April 2006. 88 patients were followed for a mean time of 44.6 months. An intravenous milrinone infusion was used for a mean of 9.8 days without any significant side effects. No medical complications associated with this protocol were observed. There were five deaths; of the surviving patients, 48.9 % were able to go back to their previous baseline and 75 % had a good functional outcome (modified Rankin scale ≤ 2). A protocol using intravenous milrinone, and the maintenance of homeostasis is simple to use and requires less intensive monitoring and resources than the standard triple H therapy. Despite the obvious limitations of this study's design, we believe that it would be now appropriate to proceed with formal prospective studies of this protocol.

  5. [Scorpion envenomation treated in the Infectious and Tropical Diseases at the Donka National Hospital, Guinea].

    PubMed

    Sako, F B; Bangoura, E F; Traoré, F A; Soumah, M M; Tounkara, T M; Djessanglar, R; Baldé, H; Baldé, O

    2014-12-01

    A retrospective descriptive study was conducted from 1(st) October 2010 to 30 November 2012 on the records of patients admitted for scorpion envenomation in the Department of Infectious and Tropical Diseases at the Donka National Hospital. The objective of this study is to describe the epidemiological profile and clinical characteristics of scorpion envenomation in Maritime Guinea, from scorpion stings recently covered in this service. We collected 75 cases of scorpion envenomation. The median age was 21.5 with interquartile 8 and 20 and sex ratio was 1.29. The upper limbs were involved in 55% of cases, followed by the lower limbs (35%), trunk (6%), head and neck (4%). We observed 63% of patients with local signs, 30% mild and general clinical signs of 7% severe systemic symptoms. All patients received an analgesic and a heterologous antitoxin, associated with an antibiotic (87% of patients), a corticosteroid (72%), diazepam (13%) and furosemide (34.6%). The incidence of scorpion envenomation is not negligible despite underreporting of cases, most often treated in traditional medicine.

  6. [Survival of lung cancer patients treated at a referral hospital in Zaragoza (Spain)].

    PubMed

    Barbosa, I R; Bernal Pérez, M M; Costa, Í C C; Jerez-Roig, J; Souza, D L B de

    2016-09-01

    The aim of this work is to study the survival of lung cancer patients treated at a referral hospital in Zaragoza (Spain). The Kaplan-Meier test was used to calculate observed survival. The automatic calculation of the Catalan Institute of Oncology was used to analyse relative survival. Mean survival time was 25.74 months. There was no difference when comparing age groups (P=.151), gender (P=.369), and histological type of tumour (P=.086). Survival by stage of the disease at diagnosis revealed statistically significant differences (P<.001). Relative survival 5 years after diagnosis for the group analysed was 14%. Survival was higher for men (15.5%), in patients under 60 (16.7%) and squamous tumours (18.7%). Survival by tumour stage was in line with the TNM Staging System for Lung Cancer. These results suggest that overall survival rate for lung cancer in Zaragoza remains very low in the long term, and this depends on the stage of the disease at diagnosis. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Pediatric Playground-Related Injuries Treated in Hospital Emergency Departments in the United States.

    PubMed

    Adelson, Sarah L; Chounthirath, Thitphalak; Hodges, Nichole L; Collins, Christy L; Smith, Gary A

    2017-09-01

    This study analyzed pediatric playground-related injuries data from the National Electronic Injury Surveillance System. An estimated 5 025 440 children <18 years were treated in US emergency departments for playground-related injuries during 1990-2012, averaging 218 497 children annually. The average patient age was 6.5 years. The overall annual injury rate declined during 1990-2007 ( P < .001) and then increased during 2007-2012 ( P < .001). The climbing equipment-related injury rate remained constant during 1990-2009 and then increased during 2007-2012 ( P = .014). The concussion/closed head injury rate increased during 1990-2008 ( P < .002) with the rate almost doubling from 2008-2012 ( P < .001). Falls accounted for 76.7% of all injuries and 87.7% of injuries to the upper extremities. Injuries resulted in hospitalization for 4.3% of patients. Despite current playground safety standards and guidelines, a large number of playground-related injuries continue to occur. Revised impact attenuation criteria for playground surfacing materials should be implemented and evaluated to more adequately prevent fall-related upper extremity fractures.

  8. Collaborative DTM reduces hospitalization and healthcare costs in patients with diabetes treated with polypharmacy.

    PubMed

    Brophy, Lauren; Williams, Amanda; Berman, Eric J; Keleti, David; Michael, Karen E; Shepherd, Margaret; Fox, Scott A; Jacobs, Christine; Tan-Torres, Susan; Gelzer, Andrea D; Tegenu, Mesfin

    2014-03-01

    To evaluate the effects of a collaborative pharmacy benefits manager (PBM)/ health plan-administered drug therapy management (DTM) program on healthcare utilization and costs in patients with diabetes treated with polypharmacy. Retrospective quasi-experimental design with comparison group. This DTM program was a collaborative effort between the PBM, PerformRx, and the care management departments of Keystone First (KF) and AmeriHealth Caritas Pennsylvania (ACP) care management departments, targeting patients with diabetes using >15 medications. Pharmacists reviewed member profiles and made evidencebased prescriber and patient interventions, working directly with prescribers and indirectly with members, via care managers. Care managers provided additional services not otherwise within the scope of DTM. The study group consisted of 954 DTM participants reviewed by a pharmacist between November 1, 2010, and July 31, 2011. The control group consisted of 810 matched DTM participants not reviewed by a pharmacist. Intervention acceptance rates for KF and ACP were 33% and 26%, respectively. The study group demonstrated lower inpatient admissions and emergency department utilization rates, although only the KF study group inpatient admission rate achieved statistical significance (76.4%; P = .0002). The study groups realized statistically significant total cost savings (pharmacy + medical) compared with their corresponding control groups (47.8% KF, P = .0039; 50.7% ACP, P = .0497) despite non-statistically significant increases in pharmacy costs. A collaborative pharmacist-driven DTM program with a care manager-executed patient outreach component results in reduced hospital utilization and significant healthcare cost savings.

  9. Cost savings of home bortezomib injection in patients with multiple myeloma treated by a combination care in Outpatient Hospital and Hospital care at Home.

    PubMed

    Touati, Mohamed; Lamarsalle, Ludovic; Moreau, Stéphane; Vergnenègre, Françoise; Lefort, Sophie; Brillat, Catherine; Jeannet, Laetitia; Lagarde, Aline; Daulange, Annick; Jaccard, Arnaud; Vergnenègre, Alain; Bordessoule, Dominique

    2016-12-01

    At home injectable chemotherapy for patients receiving treatment for hematological diseases is still in debate. Given the expense of new innovative medicines, at home treatment has been proposed as a suitable option for improving patient quality of life and decreasing treatment costs. We decided to assess the cost of bortezomib administration in France among multiple myeloma patients from an economic standpoint. Patients in this study were treated within a regional hematological network combining outpatient hospital care and Hospital care at Home administration. To make the cost comparison, our team simulated outpatient hospital care expenses. Fifty-four consecutive multiple myeloma patients who received at least one injection of bortezomib in Hospital care at Home from January 2009 to December 2011 were included in the study. The median number of injections was 12 (range 1-44) at home and 6 (range 0-30) in the outpatient care unit. When compared with the cost simulation of outpatient hospital care alone, bortezomib administration with combined care was significantly less expensive for the National Health Insurance (NHI) budget. The mean total cost per patient and per injection was 954.20 € for combined outpatient and Hospital care at Home vs 1143.42 € for outpatient hospital care alone. This resulted in an estimated 16.5 % cost saving (Wilcoxon signed-rank test, p < 0.0001). The greatest savings were observed in administration costs (37.5 % less) and transportation costs (68.1 % less). This study reflects results for a regionally implemented program for multiple myeloma patients treated with bortezomib in routine practice in a large rural area.

  10. Treating Long-Stay Patients in Acute Hospital Beds: An Economic Diagnosis.

    ERIC Educational Resources Information Center

    Hochstein, Alan

    1985-01-01

    A study of 105 medical files from three Montreal hospitals suggests that long-stay patients are inactive users of many hospital services; estimated reduction in cost per day for these patients due to their earlier discharge is only about 24-30 percent of the hospital's per diem.

  11. Effect of ivabradine on numbers needed to treat for the prevention of recurrent hospitalizations in heart failure patients.

    PubMed

    Rogers, Jennifer K; Kielhorn, Adrian; Borer, Jeffrey S; Ford, Ian; Pocock, Stuart J

    2015-01-01

    Ivabradine, a specific heart rate lowering agent, was shown in the SHIFT study to reduce time to first hospitalization for worsening heart failure (HF) in chronic systolic HF patients and also to reduce recurrent/total hospitalizations over the study interval. We assessed the effects of adding ivabradine in patients with systolic HF on the number needed to treat (NNT) to reduce recurrent hospitalizations. The SHIFT trial included 6505 patients with symptomatic HF (NYHA II-IV), left ventricular ejection fraction ≤35% and heart rate ≥70 bpm in sinus rhythm. Patients were randomized to either ivabradine or placebo in addition to guidelines-based drug therapy. The times to first hospitalization were analyzed using a univariate Cox proportional-hazards model; the associated NNT was calculated using Kaplan-Meier estimates of the time-to-event curves at 1 year in each treatment arm. Recurrent hospitalizations were analyzed using a negative binomial and the estimated annual event rates used to calculate the associated patient-time NNTs respectively. The estimated NNT (number needed to initiate treatment with ivabradine to prevent one first HF hospitalization within 1 year) was 27 (estimated hazard ratio: 0.75, P < 0.0001). For recurrent HF hospitalizations, one event would be prevented on average per 14 patient-years for any year of follow-up over the course of SHIFT (estimated rate ratio: 0.71, P < 0.0001). A key limitation of this analysis is that it did not account for a relationship between recurrent HF hospitalizations and subsequent mortality. In chronic systolic HF the effect of ivabradine on reducing recurrent HF hospitalizations results in a lower NNT compared to the effect on the time for first hospitalization. The effect of ivabradine on recurrent hospitalizations, in addition to first events, may be a more appropriate measure when considering the impact of a treatment with ivabradine on healthcare resource utilization.

  12. Characterisation of patients treated at the Red Cross field hospital in Kashmir during the first three weeks of operation

    PubMed Central

    Helminen, M; Saarela, E; Salmela, J

    2006-01-01

    Objective To evaluate the characteristics of patients treated at a field hospital in the first month after a major earthquake. Methods Age, sex, diagnosis, and operations performed on patients admitted to the field hospital of the International Committee of the Red Cross in Pakistani Kashmir between 21 October and 10 November 2005 were recorded and the data analysed. Results During the three week period of this study, 316 patients were treated at the hospital; 246 were women and children (77.9%). Two thirds were hospitalised, over 90% because of the need for surgery or surgical consultation. Altogether 345 operations were performed on 157 patients. The majority of patients had infected wounds with or without fractures. Conclusions Most patients need medical evaluation in consequence of earthquake‐related trauma even weeks after the catastrophe, especially in areas difficult of access. PMID:16858109

  13. Suicide death and hospital-treated suicidal behaviour in asylum seekers in the Netherlands: a national registry-based study

    PubMed Central

    2011-01-01

    Background Several suicide and suicidal behaviour risk factors are highly prevalent in asylum seekers, but there is little insight into the suicide death rate and the suicidal behaviour incidence in this population. The main objective of this study is to assess the burden of suicide and hospital-treated non-fatal suicidal behaviour in asylum seekers in the Netherlands and to identify factors that could guide prevention. Methods We obtained data on cases of suicide and suicidal behaviour from all asylum seeker reception centres in the Netherlands (period 2002-2007, age 15+). The suicide death rates in this population and in subgroups by sex, age and region of origin were compared with the rate in the Dutch population; the rates of hospital-treated suicidal behaviour were compared with that in the population of The Hague using indirect age group standardization. Results The study included 35 suicide deaths and 290 cases of hospital-treated suicidal behaviour. The suicide death rate and the incidence of hospital-treated suicidal behaviour differed between subgroups by sex and region of origin. For male asylum seekers, the suicide death rate was higher than that of the Dutch population (N = 32; RR = 2.0, 95%CI 1.37-2.83). No difference was found between suicide mortality in female asylum seekers and in the female general population of the Netherlands (N = 3; RR = 0.73; 95%CI 0.15-2.07). The incidence of hospital-treated suicidal behaviour was high in comparison with the population of The Hague for males and females from Europe and the Middle East/South West Asia, and low for males and females from Africa. Health professionals knew about mental health problems prior to the suicidal behaviour for 80% of the hospital-treated suicidal behaviour cases in asylum seekers. Conclusions In this study the suicide death rate was higher in male asylum seekers than in males in the reference population. The incidence of hospital-treated suicidal behaviour was higher in several

  14. Reducing hospital presentations for opioid overdose in patients treated with sustained release naltrexone implants

    PubMed Central

    Hulse, Gary K.; Tait, Robert J.; Comer, Sandra D.; Sullivan, Maria A.; Jacobs, Ian G.; Arnold-Reed, Diane

    2006-01-01

    Background Non-fatal overdoses represent a significant morbidity for regular heroin users. Naltrexone is an opioid antagonist capable of blocking the effects of heroin, thereby preventing accidental overdose. However, treatment with oral naltrexone is often associated with non-compliance. An alternative is the use of a sustained release preparation of naltrexone. The aim of this study was to assess the change in number of opioid and other drug overdoses in a large cohort of heroin dependent persons (n = 361; 218 males) before and after treatment with a sustained release naltrexone implant. A sub-group of this cohort (n = 146; 83 males) had previously received treatment with oral naltrexone, which also allowed a comparison of overdoses pre- and post-oral and also post-implant treatments. Method We used a pre–post design, with data prospectively collected via the West Australian Health Services Research Linked Database, and the Emergency Department Information System. Participants were treated under the Australian Therapeutic Goods Administration’s special access guidelines. Results Most (336, 93%) of the cohort was in one or both databases. We identified 21 opioid overdoses involving 20 persons in the 6 months pre-treatment that required emergency department presentation or hospital admission: none were observed in the 6 months post-treatment. This is consistent with the existing pharmacokinetic data on this implant, which indicates maintenance of blood naltrexone levels at or above 2 ng/ml for approximately 6 months. A reduced number of opioid overdoses were also observed 7–12 months post-implant. The study found a significant increase in sedative “overdoses”, some of which occurred in the 10 days following implant treatment and were likely associated with opioid withdrawal and/or implant treatment. For those previously treated with oral naltrexone, more opioid overdoses occurred in both the 6-months prior to and after oral compared to the 6-months post

  15. Clinical outcomes of stage I endometrial carcinoma patients treated with surgery alone: Siriraj Hospital experiences

    PubMed Central

    2016-01-01

    Objective To evaluate the recurrence rates and patterns of failure in patients with stage I endometrial carcinoma after surgical staging without adjuvant therapy. Methods Medical records of 229 patients with stage I endometrial carcinoma, treated with surgery alone between 2002 and 2010 at Siriraj Hospital were retrospectively reviewed. The primary objective of this study was recurrence rates. The secondary objectives were patterns of failure, disease-free survival, overall survival, and prognostic factors related to outcomes. Results During median follow-up time of 53.3 months, 11 recurrences (4.8%) occurred with a median time to recurrence of 21.2 months (range, 7.7 to 77.8 months). Vaginal recurrence was the most common pattern of failure (8/11 patients, 72.7%). Other recurrences were pelvic, abdominal and multiple metastases. Factors that appeared to be prognostic factors on univariate analyses were age and having high intermediate risk (HIR) (Gynecologic Oncology Group [GOG] 99 criteria), none of which showed significance in multivariate analysis. The recurrence rates were higher in the patients with HIR criteria (22.2% vs. 4.1%, p=0.013) or patients with stage IB, grade 2 endometrioid carcinoma (9.4% vs. 4.3%, p=0.199). Five-year disease-free survival and 5-year overall survival were 93.9% (95% CI, 89.9 to 5.86) and 99.5% (95% CI, 97.0 to 99.9), respectively. Conclusion The patients with low risk stage I endometrial carcinoma had excellent outcomes with surgery alone. Our study showed that no single factor was demonstrated to be an independent predictor for recurrence. PMID:27329196

  16. Non-suicidal deaths following hospital-treated self-poisoning.

    PubMed

    Carter, Greg; Reith, David M; Whyte, Ian M; McPherson, Michelle

    2005-01-01

    To quantify the non-suicidal mortality subsequent to hospital treated self-poisoning, and to identify risk factors for non-suicidal death. A prospective longitudinal cohort design was used, with data-linkage between the Hunter Area Toxicology Service database and the National Death Index. All patients with deliberate self-poisoning for a 10-year period (1991-2000) were studied and the first episode in the period was used as the index episode. The outcomes were: accidental, 'natural' and non-suicidal death, with follow-up for the study duration. There were 4044 patients studied, and 170 (4.2%) of these had non-suicidal death; 64 were accidental and 106 were 'natural' cause deaths. The standardized mortality ratio (95% CI) for non-suicidal death for males, females and combined were 4.98 (4.08-6.07), 3.78 (3.0-4.75) and 4.20 (3.62-4.88), respectively. The increased mortality was apparent for both males and females, and was more marked in the younger age groups. For non-suicidal death the adjusted hazard ratio (95% CI) for increased risk were: increasing age 1.07 (1.06-1.08), male gender 1.77 (1.24-2.52), psychiatric diagnosis of substance related disorder 1.49 (1.03-2.16), prescription of a respiratory drug 2.69 (1.31-5.55), and prescription of an anti-diabetic drug 1.95 (0.93-4.07), while psychiatric diagnosis of adjustment disorder 0.64 (0.38-1.053) was associated with decreased risk. Patients who present with self-poisoning have increased mortality from accidental and 'natural' causes. Long-term treatment goals for these patients need to address non-suicide mortality in addition to suicide mortality.

  17. Estimating the five-year survival of cervical cancer patients treated in hospital universiti sains malaysia.

    PubMed

    Razak, Nuradhiathy Abd; Mn, Khattak; Zubairi, Yong Zulina; Naing, Nyi Nyi; Zaki, Nik Mohamed

    2013-01-01

    The objective of this study was to determine the five-year survival among patients with cervical cancer treated in Hospital Universiti Sains Malaysia. One hundred and twenty cervical cancer patients diagnosed between 1st July 1995 and 30th June 2007 were identified. Data were obtained from medical records. The survival probability was determined using the Kaplan-Meier method and the log-rank test was applied to compare the survival distribution between groups. The overall five-year survival was 39.7% [95%CI (Confidence Interval): 30.7, 51.3] with a median survival time of 40.8 (95%CI: 34.0, 62.0) months. The log-rank test showed that there were survival differences between the groups for the following variables: stage at diagnosis (p=0.005); and primary treatment (p=0.0242). Patients who were diagnosed at the latest stage (III-IV) were found to have the lowest survival, 18.4% (95%CI: 6.75, 50.1), compared to stage I and II where the five-year survival was 54.7% (95%CI: 38.7, 77.2) and 40.8% (95%CI: 27.7, 60.3), respectively. The five-year survival was higher in patients who received surgery [52.6% (95%CI: 37.5, 73.6)] as a primary treatment compared to the non-surgical group [33.3% (95%CI: 22.9, 48.4)]. The five-year survival of cervical cancer patients in this study was low. The survival of those diagnosed at an advanced stage was low compared to early stages. In addition, those who underwent surgery had higher survival than those who had no surgery for primary treatment.

  18. Treating Family Violence in a Pediatric Hospital: A Program of Training, Research, and Services.

    ERIC Educational Resources Information Center

    White, Kathleen M.; And Others

    This monograph describes a project developed at Children's Hospital of Boston as an innovative, exemplary program of training, research, and services for the treatment of family violence in a pediatric hospital, with a particular focus on child abuse and neglect. Chapter 1 explains why it is important to study the area of family violence,…

  19. [Follow-up of patients treated by VKA: Interest of a pharmaceutical link between the hospital and the retail pharmacies].

    PubMed

    Bidon, D; Lecoeur, A; Segui, E; Seguette, N; Le Mercier, F; Bauler, S

    2017-01-01

    Vitamin K antagonists (VKA) are used by 1,7% of the French population. Patient education and monitoring can decrease the number of iatrogenic hospitalizations due to VKA. We assessed the impact of a communication between hospital and retail pharmacists about patient's knowledge on VKA. The aim of our study has been to evaluate the value added by the link between the hospital pharmacist and the community pharmacist on the follow-up of patients treated by vitamin K antagonist. Patient information about VKA treatment is offered to inpatients in our hospital. An information form is filled for each patient treated by VKA. Patient's knowledge is assessed on the document (Name of VKA, cause of treatment, monitoring, risks of overdose, compliance…). This form is sent to the community pharmacist after the training when the patient leaves the hospital (by fax or by email). The form is sent back by the community pharmacist after the second training. Sixty-eight patients received the training, 48 forms have been sent to the retail pharmacists and 43 forms have been sent back to the hospital. Seven retail pharmacists replied spontaneously. Twenty-eight patients increased their knowledge (in average+21%) and 12 patients stabilized their knowledge. The best-known concepts were the INR target, the time of drug intake, the risks of overdose and the information of the family. The improvement of knowledge is significant for the name of VKA, the cause of treatment, efficacy assessment and signs of overdose. The implementation of a communication between the hospital and the retail pharmacies is time-consuming but the follow-up of those patients seems essential to keep a good knowledge. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

  20. Comparison of Baseline Characteristics between Community-based and Hospital-based Suicidal Ideators and Its Implications for Tailoring Strategies for Suicide Prevention: Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior

    PubMed Central

    2017-01-01

    In this cross-sectional study, we aimed to identify distinguishing factors between populations with suicidal ideation recruited from hospitals and communities to make an efficient allocation of limited anti-suicidal resources according to group differences. We analyzed the baseline data from 120 individuals in a community-based cohort (CC) and 137 individuals in a hospital-based cohort (HC) with suicidal ideation obtained from the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior (K-COMPASS) study. First, their sociodemographic factors, histories of medical and psychiatric illnesses, and suicidal behaviors were compared. Second, diagnosis by the Korean version of the Mini International Neuropsychiatric Interview, scores of psychometric scales were used to assess differences in clinical severity between the groups. The results revealed that the HC had more severe clinical features: more psychiatric diagnosis including current and recurrent major depressive episodes (odds ratio [OR], 4.054; P < 0.001 and OR, 11.432; P < 0.001, respectively), current suicide risk (OR, 4.817; P < 0.001), past manic episodes (OR, 9.500; P < 0.001), past hypomanic episodes (OR, 4.108; P = 0.008), current alcohol abuse (OR, 3.566; P = 0.020), and current mood disorder with psychotic features (OR, 20.342; P < 0.001) besides significantly higher scores in depression, anxiety, alcohol problems, impulsivity, and stress. By comparison, old age, single households, and low socioeconomic status were significantly associated with the CC. These findings indicate the necessity of more clinically oriented support for hospital visitors and more socioeconomic aid for community-dwellers with suicidality. PMID:28776350

  1. Retrospective analysis of case series of patients with vascular war injury treated in a district hospital.

    PubMed

    Salamon, Tal; Lerner, Alexander; Rothem, David; Altshuler, Alexander; Karmeli, Ron; Solomonov, Evgeny; Biswas, Seema

    2016-04-01

    As the Syrian civil war continues, medical care of the injured remains a priority for health facilities receiving casualties. Ziv Medical Centre, the closest hospital in Israel to the Syrian border, has received 500 casualties since February 2013. Seventeen of these patients had vascular injuries. This research reports the care of these seventeen patients and explores the challenges of treatment in patients with little antecedent clinical history and improvised initial care that may be complicated by delay to definitive care, sepsis and limb ischaemia. Electronic and paper patient records were examined. Descriptive case series data are presented. Fifteen of the 17 patients were male. The mean age was 20 years (range 8-30 years). Causes of injury included gunshot wounds (4 patients), shrapnel (multi-fragment) injury (12 patients), and 1 patient was run over and dragged behind a car. The time from injury to transfer to definitive care ranged from 5h to 7 days (mean 43 h). All but one patient had associated non-vascular multiple-trauma. Thirteen patients presented with limb ischaemia. Four patients had arterio-venous fistula (AVF) or pseudoaneurysm. There were 5 upper and 10 lower limb major vascular injuries. Three patients had neck vessel injuries. All patients were investigated with CT angiography and underwent surgical or endovascular intervention. In 12 patients, 4 vessels were debrided and re-anastomosed and 13 vessels bypassed. Endovascular repair was performed in 4 patients. After initial revascularisation, 4 patients went on to amputation. There were no deaths. The injuries treated are heterogeneous, and reflect the range of high energy vascular trauma expected in conflict. The broad range of vascular solutions required to optimise outcomes, in particular, limb salvage, in turn, reflect the challenges of dealing with such injuries, especially within the context of sepsis, ischaemia and delay. As war continues, there is a pressing need to address the needs of

  2. The policy on paying for treating hospital-acquired conditions: CMS officials respond.

    PubMed

    Straube, Barry; Blum, Jonathan D

    2009-01-01

    Policies that decline payment in the event of hospital-acquired conditions have generated considerable public attention. Although the projected payment reductions are not large, small payment penalties have been effective in changing human behavior and ultimately in improving the hospital care experience for patients. Many state Medicaid programs and commercial payers have adopted similar policies. Medicare payment reductions for hospital-acquired conditions are only one component of several efforts to reduce their incidence. The Centers for Medicare and Medicaid Services (CMS) will refine these policies as appropriate. Other CMS strategies to reduce hospital-acquired conditions include public reporting, quality improvement initiatives, value-based purchasing, quality metrics and guidelines development, and national coverage decisions.

  3. In Hospital and 3-Month Mortality and Functional Recovery Rate in Patients Treated for Hip Fracture by a Multidisciplinary Team

    PubMed Central

    Rostagno, Carlo; Buzzi, Roberto; Campanacci, Domenico; Boccacini, Alberto; Cartei, Alessandro; Virgili, Gianni; Belardinelli, Andrea; Matarrese, Daniela; Ungar, Andrea; Rafanelli, Martina; Gusinu, Roberto; Marchionni, Niccolò

    2016-01-01

    Objectives Medical comorbidities affect outcome in elderly patients with hip fracture. This study was designed to preliminarily evaluate the usefulness of a hip-fracture unit led by an internal medicine specialist. Methods In-hospital and 3-month outcomes in patients with hip fracture were prospectively evaluated in 121 consecutive patients assessed before and followed after surgery by a multidisciplinary team led by internal medicine specialist; 337 consecutive patients were recalled from ICD-9 discharge records and considered for comparison regarding in-hospital mortality. Results In the intervention period, patients treated within 48 hours were 54% vs. 26% in the historical cohort (P<0.0001). In-hospital mortality remained stable at about 2.3 per 1000 person-days. At 3 months, 10.3% of discharged patients had died, though less than 8% of patients developed postoperative complications (mainly pneumonia and respiratory failure). The presence of more than 2 major comorbidities and the loss of 3 or more BADL were independent predictors of death. 50/105 patients recovered previous functional capacity, but no independent predictor of functional recovery could be identified. Mean length of hospital stay significantly decreased in comparison to the historical cohort (13.6± 4.7 vs 17 ± 5 days, p = 0.0001). Combined end-point of mortality and length of hospitalization < 12 days was significantly lower in study period (27 vs 34%, p <0.0132). Conclusions Identification and stabilization of concomitant clinical problems by internal medicine specialists may safely decrease time to surgery in frail subjects with hip fracture. Moreover, integrated perioperative clinical management may shorten hospital stay with no apparent increase in in-hospital mortality and ultimately improve the outcome. These results are to be confirmed by a larger study presently ongoing at our institution. PMID:27389193

  4. Hospital-admitted COPD patients treated at home using telemedicine technology in The Virtual Hospital Trial: methods of a randomized effectiveness trial

    PubMed Central

    2013-01-01

    Background Recent reviews suggest that telemedicine solutions for patients with chronic obstructive pulmonary disease (COPD) may prevent hospital readmissions and emergency room visits and improve health-related quality of life. However, the studies are few and only involve COPD patients who are in a stable phase or in-patients who are ready for discharge. COPD patients hospitalized with an acute exacerbation may also benefit from telemedicine solutions. The overall aim is to investigate a telemedicine-based treatment solution for patients with acute exacerbation of COPD at home as compared to conventional hospital treatment measured according to first treatment failure, which is defined as readmission due to COPD within 30 days after discharge. Methods COPD patients with acute exacerbation who fulfilled the eligibility criteria and were from two university hospitals in Denmark were randomized (1:1) by computer-generated tables that allocated treatments in blocks of four to receive either standard treatment at the hospital or the same standard treatment at home using telemedicine technology (that is, a video conference system with a touch screen and webcam and monitoring equipment (spirometer, thermometer, and pulse oximeter)). Patients treated in the telemedicine group were backed up by an organizational setting securing 24/7/365 online access to the hospital, as well as access to oxygen, nebulizer therapy, oral medical therapy and surveillance of vital parameters from home monitoring devices. Patients in both groups were discharged when clinically stable and when fulfilling five pre-specified discharge criteria. Follow-up was performed at 1, 3 and 6 months after discharge. The primary outcome was treatment failure defined as readmission due to exacerbation in COPD within 30 days. Secondary outcomes were death from any cause, prescription of additional antibiotics or steroids, need of intubation or non-invasive ventilation, emergency room visits, visits to the

  5. Epidemiology of mandibular fractures treated at Kaunas University of Medicine Hospital, Lithuania.

    PubMed

    Kubilius, Ricardas; Keizeris, Tadas

    2009-01-01

    Fractures of the mandible are one of the most common maxillofacial injuries. Because the pattern and incidence of mandibular fractures vary in different countries, there is a need to evaluate aspects of mandibular trauma in Lithuania's population. In this retrospective study hospital files of Oral and maxillofacial surgery unit of Kaunas University of Medicine Hospital were examined. The data that we collected included age, gender, hospitalization time, trauma mechanism, site of fracture, associated injuries, diagnostic and treatment methods. 87.1% of patients were male and they predominated in all age groups with a male to female ratio of 6.8:1. The highest incidence of mandibular fractures in male patients was in the 16-30 year age group and 31-45 year group for females. Interpersonal violence was the main cause of mandibular fractures, followed by falls and road traffic accidents. The incidence of falls in the <16 year age group was higher than expected. The angle was the most common fracture site (34.8%) and 51.7% patients experienced multiple fractures. The mean hospitalization time was 7.34+/-9.02 days. 55% of patients required Kirschner wire osteosynthesis, open reduction with miniplate osteosynthesis or a combination of both methods.

  6. Clinical factors and comorbidities affecting the cost of hospital-treated COPD

    PubMed Central

    Deniz, Sami; Şengül, Aysun; Aydemir, Yusuf; Çeldir Emre, Jülide; Özhan, Mustafa Hikmet

    2016-01-01

    Purpose We aimed to assess the effects of comorbidities on COPD costs and to investigate the relationship between comorbidities and clinical variables. Patients and methods All patients hospitalized with a diagnosis of COPD exacerbation between January 1, 2014, and December 31, 2014, at all state hospitals of Aydın province, a city located in the western part of Turkey, were included in this study. The costs examined in the study pertained to medications, laboratory tests, hospital stays, and other treatment-related factors, such as consumption of materials, doctor visits, and consultation fees. Results A total of 3,095 patients with 5,237 exacerbations (mean age, 71.9±10.5 years; 2,434 males and 661 females) were evaluated. For 880 of the patients (28.9%), or 3,852 of the exacerbations (73.1%), at least one comorbid disease was recorded. The mean cost of each exacerbation was $808.5±1,586, including $325.1±879.9 (40.7%) for hospital stays, $223.1±1,300.9 (27.6%) for medications, $46.3±49.6 (0.9%) for laboratory expenditures, and $214±1,068 (26.5%) for other treatment-related factors, such as consumption of materials, doctor visits, and consultation fees. The cost of each exacerbation was $1,014.9 in patients with at least one comorbidity, whereas it was $233.6 in patients without comorbidity (P<0.001). Age >65 years, female gender, hospitalization in an intensive care unit, invasive or noninvasive mechanical ventilation, and a long duration of hospitalization were all found to be significant factors in increasing total costs during the exacerbations requiring hospitalization (P<0.05 for all). Conclusion Comorbidities have an important role in the total costs of acute exacerbations of COPD. Strategies for the prevention, diagnosis, and effective management of comorbidities would decrease the overall financial burden associated with acute exacerbations of COPD. PMID:27980399

  7. History of Korean Neurosurgery.

    PubMed

    Hwang, Sung-nam

    2015-08-01

    The year 2012 was the 50th anniversary of the Korean Neurosurgical Society, and in 2013, the 15th World Congress of Neurosurgery took place in Seoul, Korea. Thus, it is an appropriate occasion to introduce the world to the history of the Korean Neurosurgical Society and the foundation, development, and growth of Korean neurosurgery. Historical materials and pictures were collected and reviewed from the history book and photo albums of the Korean Neurosurgical Society. During the last 50 years, the Korean Neurosurgical Society and Korean neurosurgery have developed and grown enormously not only in quantity but also in quality. In every aspect, the turning point from the old to the new era of the Korean Neurosurgical Society and Korean neurosurgery was the year 1980. Copyright © 2015. Published by Elsevier Inc.

  8. Wheeze in preschool children: who is followed-up, who is treated and who is hospitalized?

    PubMed

    Luyt, D K; Bourke, A M; Lambert, P; Burton, P; Simpson, H

    1995-10-01

    This study determined the proportions of children < or = 5 yrs of age with reported wheeze who were undergoing medical follow-up, receiving anti-asthma medication, or admitted to hospital; and investigated factors important in determining which children would receive these treatments. The symptomatic children represented a wheeze prevalence of 16% of the study sample of 1,422 children. The cumulative incidence of treatment and hospitalization and point prevalence of current medical follow-up were determined using a parent-answered postal questionnaire study of a population-based random sample of 222 children. Odds ratios (OR) were calculated for wheeze severity, environmental, social, familial and demographic factors found to affect the likelihood of these treatment end-points. Among 222 children with wheeze, 99 (35%) were under current medical review, 165 (75%) had received medication, and 48 (22%) reported being hospitalized. Current follow-up was more likely in girls (OR 2.22; 95% confidence interval (95% CI) 1.12-4.38), with more than three attacks of wheeze in the last year (OR 17.44; 95% CI 5.22-58.3), or with a household pet (cat or dog) where inhalants were wheeze precipitants (OR 13.65; 95% CI 3.16-58.94). Treatment became more likely in older children (OR 3.91; 95% CI 1.10-12.71), with inhalants as wheeze precipitants (OR 4.66; 95% CI 1.08-20.14) or with a household pet (OR 2.28; 95% CI 1.04-5.03). Hospitalization was less likely with frequent wheeze (OR 0.30; 95% CI 0.12-0.77), but more likely if shortness of breath occurred with wheeze. Medical follow-up and treatment are related to wheeze severity and exposure to inhaled precipitants, whereas hospital admission occurred in children with attacks causing shortness of breath, and with decreasing frequency of attacks per year.

  9. Early Korean War Coverage.

    ERIC Educational Resources Information Center

    Lee, Raymond S. H.

    1978-01-01

    Examines the themes of the war front news reported in certain South Korean and United States newspapers during the first 16 days of the Korean War; attempts to determine significant differences in the themes of war front news between the Korean and United States papers. (Author/GT)

  10. Costs of treating diarrhoea in a children's hospital in Mexico City.

    PubMed Central

    Phillips, M.; Kumate-Rodríguez, J.; Mota-Hernández, F.

    1989-01-01

    The treatment received by children aged under 5 years with diarrhoea was studied in the Hospital Infantil de México (Federico Goméz), Mexico City. The costs of treatment were calculated and estimates were made of how these had changed since the establishment of an oral rehydration unit in the hospital in 1985. The results indicate that drug treatment of outpatients was generally appropriate and inexpensive. In contrast, the cost of drugs for inpatients was considerably higher. The seriousness of the cases justified much of this additional expense for inpatients, but there is evidence that the costs could be reduced further without jeopardizing the quality of the care. Diagnostic tests were relatively expensive, frequently failed to identify diarrhoeal etiology, and their results correlated poorly with the treatment prescribed. The oral rehydration unit resulted in significant savings by causing a 25% fall in the number of inpatients with diarrhoea. PMID:2766450

  11. [Analysis of the antibiotics resistance in the patients treated in the Ternopyl university hospital].

    PubMed

    Olĭnyk, O V; Krasiĭ, N I

    2013-10-01

    The results of monitoring of the microorganisms resistance to antibiotics in departments of anesthesiology and abdominal surgery of the Ternopyl University Hospital are adduced. The data obtained permit to estimate possibilities for application of antimicrobic preparations in empiric therapy. Taking into account a large quantity of multiresistant isolates in a certain stationary, administration of empiric therapy in the treatment of intrahospital infection must be conducted, basing on the local data, concerning the microflora sensitivity to antibiotics.

  12. Cost-utility analysis of treating out of hospital cardiac arrests in Jerusalem.

    PubMed

    Ginsberg, Gary M; Kark, Jeremy D; Einav, Sharon

    2015-01-01

    Out-of-hospital cardiac arrest (OHCA) initiates a chain of responses including emergency medical service mobilization and medical treatment, transfer and admission first to a hospital Emergency Department (ED) and then usually to an intensive care unit and ward. Costly pre- and in-hospital care may be followed by prolonged post discharge expenditure on treatment of patients with severe neurological sequelae. We assessed the cost-effectiveness of treatment of OHCA by calculating the cost per Disability Adjusted Life Year (DALY) averted. We studied 3355 consecutive non-traumatic OHCAs (2005-2010) in Jerusalem, Israel, supplemented by hospital utilization data extracted from patient files (n = 570) and post-discharge follow-up (n = 196). Demographic, utilization and economic data were incorporated into a spreadsheet model to calculate the cost-utility ratio. Advanced life support was administered to 2264 of the 3355 OHCAs (67.5%) and 1048 (45.6%) patients were transferred to the ED. Of 676 (20.1%) patients who survived the ED and were admitted, there were 206 (6.1%) survivors to discharge, among them only 113 (3.4%) neurologically intact. Total cost ($39,100,000) per DALY averted (1353) was $28,864. The current package of OHCA interventions in Jerusalem appears to be very cost-effective as the cost per averted DALY of $28,864 is less than the Gross Domestic Product per capita ($33,261). This paper provides a basis for studying the effects of potential interventions that can be evaluated in terms of their incremental costs per averted DALY for treatment of OHCA. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  13. Bottle-blowing in hospital-treated patients with community-acquired pneumonia.

    PubMed

    Björkqvist, M; Wiberg, B; Bodin, L; Bárány, M; Holmberg, H

    1997-01-01

    A study was carried out to determine whether bottle-blowing has any positive effects in patients with pneumonia. In a prospective open study 145 adults with untreated community-acquired pneumonia requiring hospitalization were randomized to early mobilization (group A), to sit up and take 20 deep breaths on 10 occasions daily (group B), or to sit up and to blow bubbles in a bottle containing 10 cm water through a plastic tube 20 times on 10 occasions daily (group C). Peak expiratory flow (PEF), vital capacity (VC), forced expiratory volume in 1 sec (FEV1) and serum concentration of C-reactive protein (CRP) were determined on admission, and on days 4 and 42. Fever duration and hospital stay were recorded. In a subset of 16 patients, single breath diffusion capacity of carbon monoxide was measured on 3 occasions. The patients in group A were hospitalized for a mean of 5.3 days, group B for 4.6 days and group C for 3.9 days. Treatment was a significant factor (p = 0.037) in a Cox regression model, with group C significantly better than group A (p = 0.01). The number of days with fever was 2.3, 1.7 and 1.6 in groups A, B and C respectively. These differences were not significant (p = 0.28). No significant differences were found between the groups regarding CRP, PEF, VC, FEV1, or diffusion capacity. Intensive bottle-blowing shortens the hospital stay in patients with pneumonia. The underlying mechanism is not clear.

  14. The new bundled payment program for joint replacement may unfairly penalize hospitals that treat patients with medical comorbidities

    PubMed Central

    Ellimoottil, Chad; Ryan, Andrew M.; Hou, Hechuan; Dupree, James M.; Hallstrom, Brian; Miller, David C.

    2017-01-01

    The Centers for Medicare & Medicaid Services (CMS) recently implemented the Comprehensive Care for Joint Replacement (CJR) model. While many stakeholders are enthusiastic that the program will reduce spending for joint replacement, others are concerned that the program will unintentionally penalize hospitals that treat medically complex patients. This concern stems from the fact that the program may not include a mechanism to sufficiently account for patient complexity (i.e., risk adjustment). Using Medicare claims, we examined this concern and found an inverse association between patient complexity and year-end bonuses (i.e., reconciliation payments). Specifically, reconciliation payments were reduced by $827 per episode for each standard deviation increase in a hospital’s patient complexity (p<0.01). Moreover, we found that risk adjustment could increase reconciliation payments to some hospitals by as much as $114,184 annually. Our findings suggest that CMS should include risk adjustment in the CJR model and future bundled payment programs. PMID:27605647

  15. Radial forearm flaps as durable soft tissue coverage for local nationals being treated in the field hospital setting.

    PubMed

    Hanna, Kh; Jeffery, Sla

    2013-03-01

    The current conflict in Afghanistan has seen the increasing use of Improvised Explosive Devices (IED) in insurgency attacks. In addition to the coalition forces killed and injured from these devices, local national civilians are also injured. Injuries often include amputations, open fractures and large areas of skin affected by fragmentation. Local national access to long-term care after an IED injury is limited, and often when the patient leaves a coalition hospital this concludes the care the patient will receive. Definitive, durable treatment options are needed for these patients. In the IED-injured patient with open extremity wounds and open metacarpal fractures, pedicled radial forearm flaps offer a suitable soft tissue coverage option. Four cases are reported on IED- injured Afghan patients treated at a Role 3 hospital facility.

  16. Ambulatory care of children treated with anticonvulsants - pitfalls after discharge from hospital.

    PubMed

    Bertsche, A; Dahse, A-J; Neininger, M P; Bernhard, M K; Syrbe, S; Frontini, R; Kiess, W; Merkenschlager, A; Bertsche, T

    2013-09-01

    Anticonvulsants require special consideration particularly at the interface from hospital to ambulatory care. Observational study for 6 months with prospectively enrolled consecutive patients in a neuropediatric ward of a university hospital (age 0-<18 years) with long-term therapy of at least one anticonvulsant. Assessment of outpatient prescriptions after discharge. Parent interviews for emergency treatment for acute seizures and safety precautions. We identified changes of the brand in 19/82 (23%) patients caused by hospital's discharge letters (4/82; 5%) or in ambulatory care (15/82; 18%). In 37/76 (49%) of patients who were deemed to require rescue medication, no recommendation for such a medication was included in the discharge letters. 17/76 (22%) of the respective parents stated that they had no immediate access to rescue medication. Safety precautions were applicable in 44 epilepsy patients. We identified knowledge deficits in 27/44 (61%) of parents. Switching of brands after discharge was frequent. In the discharge letters, rescue medications were insufficiently recommended. Additionally, parents frequently displayed knowledge deficits in risk management. © Georg Thieme Verlag KG Stuttgart · New York.

  17. Cost Analysis of 48 Burn Patients in a Mass Casualty Explosion Treated at Chang Gung Memorial Hospital.

    PubMed

    Mathews, Alexandra L; Cheng, Ming-Huei; Muller, John-Michael; Lin, Miffy Chia-Yu; Chang, Kate W C; Chung, Kevin C

    2017-01-01

    Little is known about the costs of treating burn patients after a mass casualty event. A devastating Color Dust explosion that injured 499 patients occurred on June 27, 2015 in Taiwan. This study was performed to investigate the economic effects of treating burn patients at a single medical center after an explosion disaster. A detailed retrospective analysis on 48 patient expense records at Chang Gung Memorial Hospital after the Color Dust explosion was performed. Data were collected during the acute treatment period between June 27, 2015 and September 30, 2015. The distribution of cost drivers for the entire patient cohort (n=48), patients with a percent total body surface area burn (%TBSA)≥50 (n=20), and those with %TBSA <50 (n=28) were analyzed. The total cost of 48 burn patients over the acute 3-month time period was $2,440,688, with a mean cost per patient of $50,848 ±36,438. Inpatient ward fees (30%), therapeutic treatment fees (22%), and medication fees (11%) were found to be the three highest cost drivers. The 20 patients with a %TBSA ≥50 consumed $1,559,300 (63.8%) of the total expenses, at an average cost of $77,965±34,226 per patient. The 28 patients with a %TBSA <50 consumed $881,387 (36.1%) of care expenses, at an average cost of $31,478±23,518 per patient. In response to this mass casualty event, inpatient ward fees represented the largest expense. Hospitals can reduce this fee by ensuring wound dressing and skin substitute materials are regionally stocked and accessible. Medication fees may be higher than expected when treating a mass burn cohort. In preparation for a future event, hospitals should anticipate patients with a %TBSA≥50 will contribute the majority of inpatient expenses. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Thinking Outside the Box: Treating Acute Heart Failure Outside the Hospital to Improve Care and Reduce Admissions.

    PubMed

    DeVore, Adam D; Allen, Larry A; Eapen, Zubin J

    2015-08-01

    The management of acute heart failure is shifting toward treatment approaches outside of a traditional hospital setting. Many heart failure providers are now treating patients in less familiar health care settings, such as acute care clinics, emergency departments, and skilled nursing facilities. In this review we describe the current pressures driving change in the delivery of acute heart failure and summarize the evidence regarding treatments for acute heart failure outside of the inpatient setting. We also provide considerations for the design of future treatment strategies to be implemented in alternative care settings.

  19. [The surgically treated gunshot injury. Securing evidence in hospitals without primary participation of police or legal medicine].

    PubMed

    Zack, F; Manhart, J; Rummel, J; Büttner, A

    2015-05-01

    Against the background of a problematic reconstruction of a hunting accident, the question arises how such cases can be handled in hospitals and how exhibits can be adequately dealt with. After evaluating a questionnaire on current conditions of securing evidence in cases of surgically treated gunshot wounds from 26 surgical institutions in Mecklenburg-Western Pomerania and in consideration of the certified advanced training in the field of legal medicine, recommendations are given regarding the securing of evidence within the clinical setting without primary involvement of police or legal medicine.

  20. Factors associated with in-hospital delays in treating acute stroke with intravenous thrombolysis in a tertiary centre.

    PubMed

    Iglesias Mohedano, A M; García Pastor, A; García Arratibel, A; Sobrino García, P; Díaz Otero, F; Romero Delgado, F; Domínguez Rubio, R; Muñoz González, A; Vázquez Alen, P; Fernández Bullido, Y; Villanueva Osorio, J A; Gil Núñez, A

    2016-09-01

    This study aims to determine which factors are associated with delays in door-to needle (DTN) time in our hospital. This will help us design future strategies to shorten time to treatment with intravenous thrombolysis (IVT). Retrospective analysis of a prospective cohort of patients with ischaemic stroke treated with IVT in our hospital between 2009 and 2012. We analysed the relationship between DTN time and the following variables: age, sex, personal medical history, onset-to-door time, pre-hospital stroke code activation, blood pressure and blood glucose level, National Institutes of Health Stroke Scale (NIHSS), computed tomography angiography (CTA) and/or doppler/duplex ultrasound (DUS) performed before IVT, time to hospital arrival, and day of the week and year of stroke. Our hospital treated 239 patients. Median time to treatment in minutes (IQR): onset-to-door, 84 (60-120); door-to-CT, 17 (13-24.75); CT-to needle, 34 (26-47); door-to-needle, 52 (43-70); onset-to-needle, 145 (120-180). Door-to-needle time was significantly shorter when code stroke was activated, at 51 vs. 72min (P=0.008), and longer when CTA was performed, at 59 vs. 48.5min (P=0.004); it was also longer with an onset-to-door time<90min, at 58 vs. 48min (P=0.003). The multivariate linear regression analysis detected 2 factors affecting DTN: code stroke activation (26.3% reduction; P<0.001) and onset-to-door time (every 30min of onset-to-door delay corresponded to a 4.7min increase in DTN time [P=0.02]). On the other hand, CTA resulted in a 13.4% increase in DTN (P=0.03). No other factors had a significant influence on door-to-needle time. This study enabled us to identify CTA and the «3-hour effect» as the 2 factors that delay IVT in our hospital. In contrast, activating code stroke clearly reduces DTN. This information will be useful in our future attempts to reduce door-to-needle times. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights

  1. Korean women's breast cancer experience.

    PubMed

    Im, Eun-Ok; Lee, Eun Ok; Park, Young Sook

    2002-11-01

    The purpose of this study was to explore cultural meanings of breast cancer among Korean women in South Korea. A descriptive longitudinal study using methodological triangulation was conducted, and only qualitative findings are presented in this article. Ten Korean women who were newly diagnosed with a plan of surgery and subsequent chemotherapy, who did have severe fatigue at the time of recruitment, were recruited through Seoul National University Hospital. Data were collected using in-depth, 2-hour interviews and analyzed using thematic analysis. The themes emerged through the analysis process included: (a) "I did wrong," (b) "I cannot ask male physicians." (c) "I don't want to show the operation site to my husband." and (d) "I do household tasks by myself." The overriding theme was marginalization of the women within the context of their patriarchal culture. The findings suggest that culture is an important context circumscribing women's health/illness experience.

  2. Intrapersonal positive future thinking predicts repeat suicide attempts in hospital-treated suicide attempters.

    PubMed

    O'Connor, Rory C; Smyth, Roger; Williams, J Mark G

    2015-02-01

    Although there is clear evidence that low levels of positive future thinking (anticipation of positive experiences in the future) and hopelessness are associated with suicide risk, the relationship between the content of positive future thinking and suicidal behavior has yet to be investigated. This is the first study to determine whether the positive future thinking-suicide attempt relationship varies as a function of the content of the thoughts and whether positive future thinking predicts suicide attempts over time. A total of 388 patients hospitalized following a suicide attempt completed a range of clinical and psychological measures (depression, hopelessness, suicidal ideation, suicidal intent and positive future thinking). Fifteen months later, a nationally linked database was used to determine who had been hospitalized again after a suicide attempt. During follow-up, 25.6% of linked participants were readmitted to hospital following a suicide attempt. In univariate logistic regression analyses, previous suicide attempts, suicidal ideation, hopelessness, and depression-as well as low levels of achievement, low levels of financial positive future thoughts, and high levels of intrapersonal (thoughts about the individual and no one else) positive future thoughts predicted repeat suicide attempts. However, only previous suicide attempts, suicidal ideation, and high levels of intrapersonal positive future thinking were significant predictors in multivariate analyses. Positive future thinking has predictive utility over time; however, the content of the thinking affects the direction and strength of the positive future thinking-suicidal behavior relationship. Future research is required to understand the mechanisms that link high levels of intrapersonal positive future thinking to suicide risk and how intrapersonal thinking should be targeted in treatment interventions. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  3. Intrapersonal Positive Future Thinking Predicts Repeat Suicide Attempts in Hospital-Treated Suicide Attempters

    PubMed Central

    2014-01-01

    Objective: Although there is clear evidence that low levels of positive future thinking (anticipation of positive experiences in the future) and hopelessness are associated with suicide risk, the relationship between the content of positive future thinking and suicidal behavior has yet to be investigated. This is the first study to determine whether the positive future thinking–suicide attempt relationship varies as a function of the content of the thoughts and whether positive future thinking predicts suicide attempts over time. Method: A total of 388 patients hospitalized following a suicide attempt completed a range of clinical and psychological measures (depression, hopelessness, suicidal ideation, suicidal intent and positive future thinking). Fifteen months later, a nationally linked database was used to determine who had been hospitalized again after a suicide attempt. Results: During follow-up, 25.6% of linked participants were readmitted to hospital following a suicide attempt. In univariate logistic regression analyses, previous suicide attempts, suicidal ideation, hopelessness, and depression—as well as low levels of achievement, low levels of financial positive future thoughts, and high levels of intrapersonal (thoughts about the individual and no one else) positive future thoughts predicted repeat suicide attempts. However, only previous suicide attempts, suicidal ideation, and high levels of intrapersonal positive future thinking were significant predictors in multivariate analyses. Discussion: Positive future thinking has predictive utility over time; however, the content of the thinking affects the direction and strength of the positive future thinking–suicidal behavior relationship. Future research is required to understand the mechanisms that link high levels of intrapersonal positive future thinking to suicide risk and how intrapersonal thinking should be targeted in treatment interventions. PMID:25181026

  4. The Hospital Course of a Successfully Treated Patient with Respiratory Failure: Beginning to End!

    PubMed

    Callister, T Brian

    The successful treatment of a patient with acute respiratory failure is a complex undertaking that requires clinical competence, evidence-based interventions, seamless coordination of care transitions, and transparent open communication among all members of the health care team. Many of the processes of care in these critically ill patients are reassuringly consistent across services, across hospitals, across health systems, and even across the country. Although the clinical course of such complicated patients can be extremely unpredictable, we are fortunate that the professional, technical, and psychosocial aspects of care for these patients can be relatively orderly, evidence-based, and transparent.

  5. Community-onset extended-spectrum-β-lactamase-producing Escherichia coli sequence type 131 at two Korean community hospitals: The spread of multidrug-resistant E. coli to the community via healthcare facilities.

    PubMed

    Kim, Young Ah; Kim, Jin Ju; Kim, Heejung; Lee, Kyungwon

    2017-01-01

    The recent molecular epidemiology of ESBL-producing Escherichia coli infection in two Korean community hospitals was evaluated in this prospective observational study. We collected non-duplicated E. coli isolates from consecutive, sequentially encountered patients with community-onset episodes between March and April 2016 in two community hospitals in Gyeonggi-do province, Korea. We studied the prevalence, clinical characteristics and molecular epidemiology of E. coli sequence type 131 (ST131) isolated from the community. From a total of 213 E. coli isolates collected from the community, 94 (44.1%) were community-onset healthcare-associated isolates and 119 (55.9%) were community-associated isolates, of which urinary tract infection was the majority. A total of 55 (25.8%) of the 213 E. coli isolates were confirmed to have ESBL genes, which were mainly CTX-M types such as CTX-M-14 and CTX-M-15. There was no difference in the proportion of globally epidemic ST131 clones or that of O25, O16, H30, or H30Rx subclones between community-associated and community-onset healthcare-associated isolates. In this study, considerable ST131 E. coli isolations in the community were observed and about half of them were related to the history of a visit to the healthcare facilities, indicating the spread of multidrug-resistant E. coli to the community via healthcare facilities. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  6. Temporal Trends of In-Hospital Mortality in Patients Treated with Intra-Aortic Balloon Pumping: A Nationwide Population Study in Taiwan, 1998-2008.

    PubMed

    Ho, Chung-Han; Chen, Zhih-Cherng; Chu, Chin-Chen; Wang, Jhi-Joung; Chiang, Chun-Yen

    2015-01-01

    Intra-aortic balloon pumping (IABP) is widely used for hemodynamic support in critical patients with cardiogenic shock (CS). We examined whether the in-hospital mortality of patients in Taiwan treated with IABP has recently declined. We used Taiwan's National Health Insurance Research Database to retrospectively review the in-hospital all-cause mortality of 9952 (7146 men [71.8%]) 18-year-old and older patients treated with IABP between 1998 and 2008. The mortality rate was 13.84% (n = 1377). The urbanization levels of the hospitals, and the number of days in the intensive care unit, of hospitalization, and of IABP treatment, and prior percutaneous coronary intervention (PCI) were associated with mortality. Seven thousand six hundred thirty-five patients (76.72%) underwent coronary artery bypass grafting (CABG) surgery, and 576 (5.79%) underwent high-risk PCI with IABP treatment. The number of patients treated with IABP significantly increased during this decade (ptrend < 0.0001), the in-hospital all-cause mortality for patients treated with IABP significantly decreased (ptrend = 0.0243), but the in-hospital all-cause mortality of patients who underwent CABG and PCI plus IABP did not decrease. In conclusion, the in-hospital mortality rate of IABP treatment decreased annually in Taiwan during the study period. However, high-risk patients who underwent coronary revascularization with IABP had a higher and unstable in-hospital mortality rate.

  7. Home care versus hospital care in patients with multiple myeloma treated with pamidronate.

    PubMed

    Smith, Alastair G; Soutar, Richard L; Schey, Steven; Andrews, Christopher D; Baister, Elizabeth R; Bilbrough, Carol; Connelly, Marie; Joyce, Ann; Child, J Anthony

    2004-03-01

    Long-term bisphosphonate therapy has been shown to offer clinical benefit in the management of multiple myeloma. This study sought to explore the feasibility and potential advantages of monthly home-based intravenous infusions of pamidronate in patients with multiple myeloma. In a prospective crossover, multicentre trial, 37 patients were randomly allocated to receive 3 months of treatment with pamidronate given in the home followed by 3 months of treatment with pamidronate given in hospital or vice versa. Results from a patient preference questionnaire indicated most patients preferred treatment at home. Quality-of-life measurement was undertaken using the EORTC QLQ-C30 questionnaire. The results indicated a small, generally consistent, although not statistically significant, trend in favour of home care treatment. Extra nursing specialist time was required for home therapy. Home therapy with pamidronate in patients with multiple myeloma appeared feasible and safe and was preferred by patients in this study.

  8. Review of patients with multiple injuries treated at University Hospital, Kuala Lumpur.

    PubMed

    Silva, J F

    1984-06-01

    This study has analyzed 260 patients with multiple injuries sustained in road accidents admitted to the University Hospital during the period July 1967 to July 1976, in relation to age, sex, and ethnic distribution. The types of injuries sustained have been discussed to highlight their effects on the community in a developing country. The extremities have been most frequently involved, while head injuries followed closely. The causative factors of multiple injury-producing accidents have been evaluated. The categories of victims most liable to multiple injuries have been discussed. The significance of understanding the mechanism of these accidents and the effect of such knowledge in minimizing diagnostic errors, thus enabling management and the urgent need for regional accident services in developing countries, have been stressed.

  9. The job analysis of Korean nurses as a strategy to improve the Korean Nursing Licensing Examination

    PubMed Central

    2016-01-01

    Purpose: This study aimed at characterizing Korean nurses’ occupational responsibilities to apply the results for improvement of the Korean Nursing Licensing Examination. Methods: First, the contents of nursing job were defined based on a focus group interview of 15 nurses. Developing a Curriculum (DACOM) method was used to examine those results and produce the questionnaire by 13 experts. After that, the questionnaire survey to 5,065 hospital nurses was done. Results: The occupational responsibilities of nurses were characterized as involving 8 duties, 49 tasks, and 303 task elements. Those 8 duties are nursing management and professional development, safety and infection control, the management of potential risk factors, basic nursing and caring, the maintenance of physiological integrity, medication and parenteral treatments, socio-psychological integrity, and the maintenance and improvement of health. Conclusion: The content of Korean Nursing Licensing Examination should be improved based on 8 duties and 49 tasks of the occupational responsibilities of Korean nurses. PMID:27270987

  10. The job analysis of Korean nurses as a strategy to improve the Korean Nursing Licensing Examination.

    PubMed

    Park, In Sook; Suh, Yeon Ok; Park, Hae Sook; Ahn, Soo Yeon; Kang, So Young; Ko, Il Sun

    2016-01-01

    This study aimed at characterizing Korean nurses' occupational responsibilities to apply the results for improvement of the Korean Nursing Licensing Examination. First, the contents of nursing job were defined based on a focus group interview of 15 nurses. Developing a Curriculum (DACOM) method was used to examine those results and produce the questionnaire by 13 experts. After that, the questionnaire survey to 5,065 hospital nurses was done. The occupational responsibilities of nurses were characterized as involving 8 duties, 49 tasks, and 303 task elements. Those 8 duties are nursing management and professional development, safety and infection control, the management of potential risk factors, basic nursing and caring, the maintenance of physiological integrity, medication and parenteral treatments, socio-psychological integrity, and the maintenance and improvement of health. The content of Korean Nursing Licensing Examination should be improved based on 8 duties and 49 tasks of the occupational responsibilities of Korean nurses.

  11. Cost of neurocysticercosis patients treated in two referral hospitals in Mexico City, Mexico.

    PubMed

    Bhattarai, Rachana; Carabin, Hélène; Proaño, Jefferson V; Flores-Rivera, Jose; Corona, Teresa; Flisser, Ana; Budke, Christine M

    2015-08-01

    To estimate annual costs related to the diagnosis, treatment and productivity losses among patients with neurocysticercosis (NCC) receiving treatment at two referral hospitals, the Instituto Nacional de Neurologia y Neurocirugia (INNN) and the Hospital de Especialidades of the Instituto Mexicano del Seguro Social (HE-IMSS), in Mexico City from July 2007 to August 2008. Information on presenting clinical manifestations, diagnostic tests, hospitalisations, surgical procedures and other treatments received by NCC outpatients was collected from medical charts, and supplemented by an individual questionnaire regarding productivity losses and out-of-pocket expenses related to NCC. The annual average per-patient direct costs were US$ 503 (95% CI: 414-592) and US$ 438 (95% CI: 322-571) for patients without a history of hospitalisation and/or surgery seen at the INNN and the HE-IMSS, respectively. These costs increased to US$ 2506 (95% CI: 1797-3215) and US$ 2170 (95% CI: 1303-3037), respectively, for patients with a history of hospitalisation and/or surgery. The average annual per-patient indirect costs were US$ 246 (95% CI: 165-324) and US$ 114 (95% CI: 51-178), respectively, using minimum salary wages for individuals not officially employed. The total annual cost for patients who had and had not been hospitalised and/or undergone a surgical procedure for the diagnosis or treatment of NCC corresponded to 212% and 41% of an annual minimum wage salary, respectively. The disease tends to affect rural socioeconomically disadvantaged populations and creates health disparities and significant economic losses in Mexico. © 2015 John Wiley & Sons Ltd.

  12. Copper-silver ionization at a US hospital: interaction of treated ...

    EPA Pesticide Factsheets

    Tap water sampling and surface analysis of copper pipe/bathroom porcelain were performed to explore the fate of copper and silver during the first nine months of copper-silver ionization (CSI) applied to cold and hot water at a hospital in Cincinnati, Ohio. Ions dosed by CSI into the water at its point of entry to the hospital were inadvertently removed from hot water by a cation-exchange softener in one building (average removal of 72% copper and 51% silver). Copper at the tap was replenished from corrosion of the building’s copper pipes but was typically unable to reach 200 µg/L in first-draw and flushed hot and cold water samples. Unlike copper, silver solubility was not restricted by the incoming water’s high pH of 8.5. Cold water lines had >20 µg/L silver at most of the taps that were sampled, which further increased after flushing. However, silver plating onto copper pipe surfaces (particularly in the hot water line) prevented reaching 20 µg/L silver in hot water of many taps. Aesthetically displeasing purple/grey stains in bathroom porcelain were attributed to chlorargyrite [AgCl(s)], an insoluble precipitate that formed when CSI-dosed Ag+ ions combined with Cl- ions that were present in the incoming water. Overall, CSI aims to control Legionella bacteria in drinking water, but plumbing material interactions, aesthetics and other implications also deserve consideration to holistically evaluate in-building drinking water disinfection. To inform the

  13. Reading Right: Korean Translation Manual. English for Special Purposes Series: Nursing Aide.

    ERIC Educational Resources Information Center

    Park, Yong-Ok

    This Korean translation manual for nursing aides is designed to improve reading skills of U.S. immigrants. After short readings in Korean and English translations of vocabulary/phrases, comprehension, grammar, and language usage exercises are presented. Topical areas include: food, the hospital staff, body language, cleanliness in the hospital,…

  14. Microbial inhibition on hospital garments treated with Dow Corning 5700 antimicrobial agent.

    PubMed Central

    Murray, P R; Niles, A C; Heeren, R L

    1988-01-01

    We evaluated the efficacy of the antimicrobial activity of cotton-polyester fabric treated with 3-(trimethoxysilyl)propyldimethyloctadecyl ammonium chloride (DC 5700), a quaternary ammonium compound bound irreversibly to the material. Significant antimicrobial activity was observed with 58 of 61 gram-positive cocci but with only 1 of 35 gram-negative bacilli and 0 of 5 yeasts. No inhibition of bacilli or yeasts was observed when the DC 5700 concentration ranged from 0.05 to 1.0% or when antimicrobial activity was assayed by the agar overlay bioassay or broth agitation methods. Images PMID:3141471

  15. [Nutritional assessment of alcoholic liver cirrhotic patients treated in the liver Clinic of the Mexico's General Hospital].

    PubMed

    Landa-Galván, H V; Milke-García, Ma P; León-Oviedo, C; Gutiérrez-Reyes, G; Higuera-de la Tijera, F; Pérez-Hernández, J L; Serralde-Zúñiga, A E

    2012-01-01

    Malnutrition in the cirrhotic patient is associated to a higher morbidity and mortality rate; however, the diagnosis is complex, so the study objective was to assess the nutritional status using different methods. Adult patients with alcoholic liver cirrhosis treated in the Liver Clinic of the Mexico's General Hospital were evaluated. Anthropometric measurements and a 24 hours recall were made; screening tools (Malnutrition Universal Screening Tool, Nutritional Risk Screening-2002) and a method for assessing nutritional status specifically in cirrhotic patients (Royal Free Hospital Global Assessment) were used. We included 62 patients, 51.6% of them were men. Malnutrition by arm muscle area was 31.3% in men and 10% in women, and by arm fat area was 23.3% in women and 3.1% in men (p < 0.05). With the screening tools the percentages of malnutrition risk were 43.5% and 54.8% respectively, vs. 1.6% identified as "low weight" with the Body Mass Index. With the Royal Free Hospital Global Assessment tool the percentage of malnutrition was 45.2%. Patients with malnutrition had an energy and protein intake significantly lower than the well-nourished: 19.7 kcal/kg and 0.89 g/kg vs 30 kcal/kg and 1.25 g/kg (p < 0.005). Malnutrition is a common complication in patients with liver cirrhosis. Men have higher depletion of muscle mass and women a higher loss of body fat. The Body Mass Index is not a reliable tool for assessing malnutrition. It's advisable to use tools with indicators of body composition such as the Royal Free Hospital Global Assessment.

  16. Nitrofurantoin safety and effectiveness in treating acute uncomplicated cystitis (AUC) in hospitalized adults with renal insufficiency: antibiotic stewardship implications.

    PubMed

    Cunha, B A; Cunha, C B; Lam, B; Giuga, J; Chin, J; Zafonte, V F; Gerson, S

    2017-02-02

    Nitrofurantoin remains a key oral antibiotic stewardship program (ASP) option in the treatment of acute uncomplicated cystitis (AUC) due to multi-drug resistant (MDR) Gram negative bacilli (GNB). However, there have been concerns regarding decreased nitrofurantoin efficacy with renal insufficiency. In our experience over the past three decades, nitrofurantoin has been safe and effective in treating AUC in hospitalized adults with renal insufficiency. Accordingly, we retrospectively reviewed our recent experience treating AUC in hospitalized adults with decreased renal function (CrCl < 60 ml/min) with nitrofurantoin. Excluded were complicated urinary tract infections. Urinary isolated susceptibility testing was done by micro broth dilution (MBD). Treatment duration was 5-7 days. Cure was defined as eradication of the uropathogen and failure was defined as minimal/no decrease in urine colony counts. Of 26 evaluable patients with renal insufficiency (CrCl < 60 ml/min), nitrofurantoin eradicated the uropathogen in 18/26 (69%) of patients, and failed in 8/26 (31%). Of the eight failures, five were due to intrinsically resistant uropathogens, e.g., Proteus sp., and one failure was related to an alkaline urine. Of the treatment failures, only two were due to renal insufficiency, i.e., CrCl < 30 ml/min. Since there are few oral antibiotics available to treat AUC due to MDR GNB uropathogens, these results have important ASP implications. Currently, nitfurantoin is not recommended if CrCl < 60 ml/min. In our experience, used appropriately against susceptible uropathogens, nitrofurantoin was highly effective in nearly all patients with CrCl = 30-60 ml/min., and only failed in two patients due to renal insufficiency (CrCl < 30 ml/ml).

  17. Aetiology of adult burns treated from 2000 to 2012 in a Swiss University Hospital.

    PubMed

    Müller, M; Moser, E M; Pfortmueller, C A; Olariu, R; Lehmann, B; Exadaktylos, A K

    2016-06-01

    Burns in Switzerland are frequent and lead to high economic and social costs. However, little is known about the aetiology of burns suffered by patients seeking treatment in hospital emergency departments. This knowledge could be used to develop preventive measures. This retrospective analysis included all patients (≥16 years old) with acute thermal injuries of known cause admitted to the adult emergency department in Bern University Hospital (Switzerland, not a specialised burns unit) between 2000 and 2012. Clinical and sociodemographic data were extracted from medical records, i.e. the environment in which the burn occurred, as well as details of burn severity and aetiology. Seven hundred and one (701) patients with a mean age of 35.0±14.5 years (56% men) were included in the analysis. The winter season and the days around Christmas, turn of the year and Swiss National Day were identified as times with high risk of burns. Household (45%) and workplace (31%) were the most common locations/settings in which the burns occurred. Approximately every second burn was caused by scald, every fourth by flame and every seventh by hot objects. The analysis identified cooking, tar and electricity in workplace accidents, barbecues and the use of gasoline as aetiological factors in burns in leisure time, together with water in domestic thermal injuries. Burns occurred predominantly on non-protected skin on the hand and arms. The most severe burns were seen in electrical and flame burns. Men suffered more severe burns than women in all settings except psychopathology. The data suggest that the incidence and severity of burns in Switzerland could be reduced by preventive strategies and public campaigns, including education on fire protection systems, raising awareness about the times and locations where the risks of burns are greater, further improvement in workplace safety, particularly with cooking facilities and electrical equipment, and the development of innovative safety

  18. Pattern of traumatic brain injury treated by general surgeons in a tertiary referral hospital.

    PubMed

    Chattopadhyay, Shankar Das; Karmakar, Nisith Chandra; Sengupta, Ritankar; SenGupta, Tamal Kanti; Ray, Debasis; Basus, Shibaji

    2013-09-01

    The number of polytrauma patient with associated brain injury or commonly referred as 'head injury' has increased tremendously in recent times courtesy to road traffic accident or other causes. This prospective observational study was conducted in patients of head injury admitted through emergency in the department of general surgery in NRS Medical College, Kolkata during the year 2011 to determine the pattern of head injury patients admitted and nature of intervention. A total number of 3861 patients were admitted in a single year. Obviously this represents the tip of the iceburg. Traumatic brain injury was the highest in the age group of 31-40 years (33.5%) followed by 21-30 years (29.1%) in the most fruitful phase of life. The traumatic brain injury death was more common in males. The maximum number of cases was from rural areas ie, farmers and labours. To minimise the morbidity and mortality resulting from head injury there is need for better maintenance of roads, improvement of road visibility and lighting, rigid enforcement of traffic rules and imparting road safety education to school children. Despite valiant efforts and advancement in medical sciences and infrastructure in the form of neurosurgery departments and trauma care units to cope with the changing world of trauma, there still remains a huge responsibility and a definite part to be played by the general surgeons to manage head injury patient even in tertiary hospitals.

  19. Follow-up study of renal transplant recipients treated at the Guatemalan Social Security Hospital.

    PubMed

    Sánchez-Polo, V; Lou-Meda, R; Castillo, M; Herrera, C; Mollinedo, A

    2004-03-01

    Guatemala is Central America's westernmost country, with a ratio of 500,000 inhabitants per nephrologist. Yearly reports show an average of 150 new end-stage renal disease patients and 40 renal transplants, which are performed at two public health care facilities. The aim of this study was to describe the results of the transplant program at one of these centers (Social Security Hospital of Guatemala). Our program began in 1986, performing an average of 17 transplants per year. Cyclosporine has been used since 1992, and since 2001, C2 has been routinely monitored. Data on 255 patients (of 293) were available for analysis. Male-to-female ratio was 7:1, with 94% having received hemodialysis as their replacement therapy. The mean age at transplant was 35 years and living related donors used in 95%. The average duration of follow-up was 7 years. The mean creatinine and C2 level at most recent visit were 1.36 mg/dL and 864 ng/mL, respectively. A significant reduction in the incidence of acute rejection episodes was seen after the initiation of C2 monitoring (3% vs 1.2%). In general, these results are similar to data in other countries. The number of transplants performed must be increased to meet the current demand, and the cadaveric source of donation is the obvious way to do so. C2 monitoring is an example of technical improvements directed to optimize available resources.

  20. Post-earthquake injuries treated at a field hospital --- Haiti, 2010.

    PubMed

    2011-01-07

    On January 12, 2010, a 7.0-magnitude earthquake struck Haiti, resulting in an estimated 222,570 deaths and 300,000 persons with injuries. The University of Miami Global Institute/Project Medishare (UMGI/PM) established the first field hospital in Port-au-Prince, Haiti, after the earthquake. To characterize injuries and surgical procedures performed by UMGI/PM and assess specialized medical, surgical, and rehabilitation needs, UMGI/PM and CDC conducted a retrospective medical record review of all available inpatient records for the period January 13-May 28, 2010. This report describes the results of that review, which indicated that, during the study period (when a total of 1,369 admissions occurred), injury-related diagnoses were recorded for 581 (42%) admitted patients, of whom 346 (60%) required a surgical procedure. The most common injury diagnoses were fractures/dislocations, wound infections, and head, face, and brain injuries. The most common injury-related surgical procedures were wound debridement/skin grafting, treatment for orthopedic trauma, and surgical amputation. Among patient records with documented injury-related mechanisms, 162 (28%) indicated earthquake-related injuries. Earthquake preparedness planning for densely populated areas in resource-limited settings such as Haiti should account for injury-related medical, surgical, and rehabilitation needs that must be met immediately after the event and during the recovery phase, when altered physical and social environments can contribute to a continued elevated need for inpatient management of injuries.

  1. A clinical appraisal of patients with psoriasis treated in Seremban General Hospital, Malaysia.

    PubMed

    Siow, K Y; Safdar, N A Mohd; Chong, K H; Chua, K B

    2004-08-01

    A prospective clinical study of 181 patients with psoriasis seen in Seremban General Hospital showed the incidence of psoriasis among dermatology outpatients was 2.15%. A significantly higher proportion of male patients were affected, with a male to female ratio of 1.7:1. Within the racial groups; 63 were Malays, 37 Chinese, and 81 Indians. There was a significantly higher proportion of Indians affected as compared with the races. The mean age of patients in this study was 43.7 years old but the mean age of onset of psoriasis in these patients was 33.1 years old. Thirty-one (17.1%) patients gave a positive family history of psoriasis and the mean age of onset of psoriasis was lower (29.3 years old) for patients with a positive family history. Plaque psoriasis was the commonest type of clinical presentation with the scalp being the commonest site affected. Psoriatic arthropathy was seen in 35 (19.3%) patients. Ninety-five (52.5%) patients gave a positive history of factors exacerbating their pre-existing disease and stress was singled out as the most common exacerbating factor.

  2. [Prevalence and risk factors for otomycosis treated in the hospital setting in Abidjan (Ivory Coast)].

    PubMed

    Yavo, W; Kassi, R R; Kiki-Barro, P C; Bamba, A; Kplé, T; Menan, E I; Ehouo, F; Koné, M

    2004-01-01

    Otomycosis is frequently encountered in tropical and subtropical zones. In Ivory Coast diagnosis of this disease is often based solely on the clinical symptoms. The objectives of this study were to determine the prevalence, predisposing factors, and etiologic agents associated with otomycosis at the Treichville University Hospital Center in Abidjan, Ivory Coast. Mycological examinations were performed on specimens obtained from 115 patients presenting with external otitis at the d'Oto-Rhino-Laryngology Department. Fungi-positive cultures were obtained in 49 patients for an overall otomycosis prevalence of 42.6 (95% Confidence Interval (CI), 34.4-52.2). Univariate analysis showed that the predisposing factors for otomycosis were frequent swimming in natural or artificial pools (Relative Risk (RR) 3.7; CI 1.7-8.1), daily ear cleaning (RR 3.5; CI 1.8-6.8) and excessive use of eardrops containing antibiotics and corticoids (RR = 9.3; IC95% = 4.3-20.1). The most common etiologic agents were Aspergillus flavus (20.4%), Candida albicans (16.3%), Candida parapsilosis (14.3%), and Aspergillus niger (12.2%). A combination of two agents was found in five cases. These data show that otomycosis is endemic in Ivory Coast. Management of otomycosis must include mycological examination for diagnosis as well as changing behavior patterns leading to infection.

  3. Space to care and treat safely in acute hospitals: recommendations from 1866 to 2008.

    PubMed

    Hignett, Sue; Lu, Jun

    2010-09-01

    This paper will explore and discuss the spatial recommendations, and the supporting research evidence, for in-patient bed spaces. The bed space is defined as the area around an individual bed that offers privacy either as a single room or a cubicle. A document review from 1866 to 2008 found that the recommendations for bed space width had increased by 1.1m over 44 years, from 2.4m (1961) to 3.6m (2005). However, a small scoping project in the United Kingdom revealed that the bed space areas in recently built hospitals (medical and surgical wards) were less than the recommendations. These data are discussed in the context of healthcare Evidence-Based Design to consider three patient safety issues (falls, noise and infection transmission). A role for ergonomics is proposed in the design, planning and evaluation stages as a methodology bridge between clinicians and architects (participatory ergonomics) and as an expert adviser to address design issues of patient safety and environmental functionality.

  4. Modified components separation technique: experience treating large, complex ventral hernias at a University Hospital.

    PubMed

    Torregrosa-Gallud, A; Sancho Muriel, J; Bueno-Lledó, J; García Pastor, P; Iserte-Hernandez, J; Bonafé-Diana, S; Carreño-Sáenz, O; Carbonell-Tatay, F

    2017-08-01

    An increasing number of patients have large or complex abdominal wall defects. Component separation technique (CST) is a very effective method for reconstructing complex midline abdominal wall defects in a manner that restores innervated muscle function without excessive tension. Our goal is to show our results by a modified CST for treating large ventral hernias. A total of 351 patients with complex ventral hernias have been treated over a 10-year period. Pre- and postoperative CT scans were performed in all patients. All ventral hernias were W3, according to the EHS classification 1. We analyzed demographic variables, co-morbidities, hernia characteristics, operative, and postoperative variables. One hundred and seventy patients (48.4%) were men; the average age of the study population was 51.6 ± 23.2 years with an average BMI of 32.3 ± 1.3. The hernia was located in the midline in 321 cases (91.5%) versus the flank in 30 (8.5%). In 45 patients, preoperative botulinum toxin (BT) and progressive pneumoperitoneum (PPP) were needed due to giant hernia defects when the VIH/VAC ratio was >20%. Postoperative complications related to the surgical site were seroma (35.1%), hematoma (9.1%), infection (7.2%), and wound necrosis (8.8%). Complications related to the repair were evisceration in 3 patients (1.1%), small bowel fistula in 4 patients (1.5%), 11 cases of mesh infection (2.9%), and abdominal compartment syndrome (ACS) in 2 patients. There were 29 hernia recurrences (8.2%) with a mean follow-up of 31.6 ± 8.1 months. The modified CST is an effective strategy for managing complex ventral hernias that enables primary fascial closure with low rates of morbidity and hernia recurrence.

  5. Association of serum lactate with outcome after out-of-hospital cardiac arrest treated with therapeutic hypothermia

    PubMed Central

    Novain, Michaël; Cattet, Florian; Plattier, Rémi; Nefzaoui, Mohamed; Hyvernat, Hervé; Raguin, Olivier; Kaidomar, Michel; Kerever, Sébastien; Ichai, Carole

    2017-01-01

    Aims Lactate reflects hypoxic insult in many conditions and is considered as a prognosis factor. But, after cardiac arrest, its interest is still debated. Our study aimed to assess the prognosis value of lactate in out-of-hospital cardiac arrest patients treated with therapeutic hypothermia. Methods This retrospective observational study included out-of-hospital cardiac arrest patients treated with therapeutic hypothermia in four ICUs. Lactate levels were compared at different times during the first 24 hours according to outcome at ICU discharge and to the type of death (multiorgan or neurologic failure). Results Two hundred and seventy-two patients were included, 89 good outcome and 183 poor outcome. In the latter group, 171 patients died, from multiorgan failure in 30% and neurologic failure in 70%. Lactate levels were higher in the poor compared to the good outcome patients at admission (5.4 (3.3–9.4) vs. 2.2 (1.5–3.6) mmol/L; p<0.01), 12 hours (2.5 (1.6–4.7) vs. 1.4 (1.0–2.2) mmol/L; p<0.01) and 24 hours (1.8 (1.1–2.8) vs. 1.3 (0.9–2.1) mmol/L; p<0.01). Patients succumbing from multiorgan failure exhibited higher lactate levels compared to those dying from neurologic failure at admission (7.9 (3.9–12.0) vs. 5.2 (3.3–8.8) mmol/L; p<0.01), H12 (4.9 (2.1–8.9) vs. 2.2 (1.4–3.4) mmol/L; p<0.01) and H24 (3.3 (1.8–5.5) vs. 1.4 (1.1–2.5) mmol/L; p<0.01). Initial lactate levels showed an increasing proportion of poor outcome from the first to fourth quartile. Conclusions After out-of-hospital cardiac arrest treated with therapeutic hypothermia, lactate levels during the first 24 hours seem linked with ICU outcome. Patients dying from multiorgan failure exhibit higher initial lactate concentrations than patients succumbing from neurological failure. PMID:28282398

  6. [The buccal-dental health of drug addicts treated in the University hospital centre in Nice].

    PubMed

    Madinier, Isabelle; Harrosch, Joseph; Dugourd, Michel; Giraud-Morin, Chantal; Fosse, Thierry

    2003-06-07

    Drug-addicts often suffer from rapidly progressive extensive dental decay. The objectives of this study were to determine the impact of illicit drugs on buccal and dental health and the use of illicit drugs for toothache. Two groups of intravenous and non-intravenous drug-addicts were compared with two control groups of age matched non-addicted subjects. During a routine dental examination, medical and addictive history, periodontal and dental health and dental complaints were recorded. This study showed that intravenous heroin was responsible for rapidly progressive dental decay, even in four drug-addicts with satisfactory dental hygiene. Intravenous heroin users (14 women, 38 men, mean age 35) had a mean number of 10 missing and 10 decayed teeth, 6 of them to be extracted, and needed two dentures with 8 teeth each. Their masticatory function (45%) and smile did not permit normal alimentation or social life. Non-intravenous drug users (9 women, 29 men, mean age 26) had a mean number of one missing tooth and 4 decayed teeth to be treated. When compared to control groups, drug users of both categories exhibited more decayed teeth, reduced masticatory function and a lower periodontal health correlated with inadequate dental hygiene. Finally, 52% of heroin users and 21% of other illicit drug users admitted the use of illicit drugs as analgesics for toothache. The management of toothache should be proposed in the cessation protocols and dentures provided to intravenous drug-addicts, before any attempt at social reinsertion.

  7. The direct cost of treating bronchial asthma in a teaching hospital in Malaysia.

    PubMed

    Chan, P W K; Hussain, S; Ghani, N H; Debruyne, J A; Liam, C K

    2002-09-01

    A pilot study to evaluate the direct cost of treating 51 adults and 50 children with bronchial asthma was conducted. All aspects of the medical care provided over a 6-month period were considered. The mean treatment costs per month were US dollars 22.97 (adults) and US dollars 15.56 (children). The cost of maintenance therapy accounted for 55.5% and 73.4% of the total direct cost treatment for adults and children respectively. Only 27 (52.9%) adults and 17 (34.0%) children paid for their inhaled prophylactic drugs, amounting to 12.3% of the total maintenance therapy costs. Thirteen (25.4%) adults and 9 (18.0%) children were using alternative therapy at a monthly cost of US dollars 41.50 and US dollars 16.77 respectively. A substantial proportion of the direct cost of asthma treatment is heavily subsidized in Malaysia. Adequate attention to the allocation of the health budget, to ensure the optimal provision of health care, is warranted.

  8. [Orbital tumors treated at the University Hospital Otolaryngology Clinic in Kraków between 1997 and 2011].

    PubMed

    Wróbel, Agnieszka; Składzień, Jacek; Gawlik, Jolanta; Oleś, Krzysztof; Szaleniec, Joanna; Leszczyńska, Joanna; Bojanowska, Emilia

    2013-01-01

    The main aim of the study was to establish the frequency of orbital tumor occurrence in the patients of the University Hospital Otolaryngology Clinic in Kraków as well as to analyze the clinical features, location in the orbit and to identify the group of patients with the highest risk of orbital tumor. The authors retrospectively analyzed 46 patients (29 women and 17 men) between the ages of 23 and 87. This group of patients was compared to a group of 80 patients who were surgically treated at the same clinic 10 years ago and to a group of 70 patients treated 15 years ago. We established that the tumors localized in the orbit were mainly benign. A variety of histological types of tumors arises in the orbit but it was significant that inflammatory pseudotumors were the most common cases in all three groups of patients treated in our clinic now, about 10 and about 15 years ago. Referring to the group of patients at the highest risk, we established that orbital tumors are definitely most common in women than men. It has turned out to be statistically significant that benign tumors were most common in younger patients and malignant in older people. That suggests the conclusion that being female is a risk factor for orbital tumors and age is a risk factor for them being malignant. Comparing different approaches for the resection of orbital tumors, we established that the lateral orbitotomy provides access to orbital tumors in the most common locations (intraconal and in the top corner of the orbit). Malignant and extensive tumors have to be treated by orbital exenteration.

  9. Korean Hemorrhagic Fever.

    DTIC Science & Technology

    1982-05-01

    Medicine Seoul, Korea * S 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SUM ARY Urban rats captured in Seoul and four nearby Korean cities were found to have...rattus, urban Korean cities, 1980. . . . 15 Table 2. Isolation of Hantaan virus from antigen-positive wild house rats, Korea , 1980 .... ........... .. 16...Figures Figure 1. Map of Seoul City, South Korea and metropolitan area showing locations of urban Korean hemorrhagic fever cases, andRattu s positive

  10. Prospects from Korean Reunification

    DTIC Science & Technology

    2008-04-01

    South Korea , China, the United States and, to a lesser extent, Japan and Russia will be examined to determine prospects from Korean reunification...the “tilt” of a unified Korea , and with it, the future Northeast Asian strategic environment. 1 PROSPECTS FROM KOREAN REUNIFCATION Throughout most of...the 20th century, the Korean people have yearned for the establishment of an independent and unified Korea . Before World War II, this was denied to

  11. National Estimates of Noncanine Bite and Sting Injuries Treated in US Hospital Emergency Departments, 2001–2010

    PubMed Central

    Langley, Ricky; Mack, Karin; Haileyesus, Tadesse; Proescholdbell, Scott; Annest, Joseph L.

    2015-01-01

    Objective Injuries resulting from contact with animals and insects are a significant public health concern. This study quantifies nonfatal bite and sting injuries by noncanine sources using data from the National Electronic Injury Surveillance System–All Injury Program (NEISS-AIP). Methods The NEISS-AIP is an ongoing nationally representative surveillance system used to monitor all types and causes of injuries treated in US hospital emergency departments (EDs). Cases were coded by trained hospital coders using information from medical records on animal and insect sources of bite and sting injuries being treated. Data were weighted to produce national annualized estimates, percentages, and rates based on the US population. Results From 2001 to 2010 an estimated 10.1 million people visited EDs for noncanine bite and sting injuries, based on an unweighted case count of 169,010. This translates to a rate of 340.1 per 100,000 people (95% CI, 232.9–447.3). Insects accounted for 67.5% (95% CI, 45.8–89.2) of bite and sting injuries, followed by arachnids 20.8% (95% CI, 13.8–27.9). The estimated number of ED visits for bedbug bite injuries increased more than 7-fold—from 2156 visits in 2007 to 15,945 visits in 2010. Conclusions This study provides an update of national estimates of noncanine bite and sting injuries and describes the diversity of animal exposures based on a national sample of EDs. Treatment of nonfatal bite and sting injuries are costly to society. Direct medical and work time lost translates to an estimated $7.5 billion annually. PMID:24433776

  12. The prevalence of trichomoniasis and associated factors among women treated at a university hospital in southern Brazil

    PubMed Central

    2017-01-01

    Background Trichomoniasis is the most prevalent non-viral sexually transmitted disease (STD) in the world; however, it remains a neglected parasitic disease. This study aimed to determine the prevalence of trichomoniasis and its associated epidemiological factors among women treated at a hospital in southern Brazil. Methodology/Principal findings A cross-sectional study was performed to determine the prevalence of this infection in women treated at Hospital Universitário (HU) in Rio Grande, Rio Grande do Sul, Brazil, between January 2012 and January 2015. This study consisted a self-administered questionnaire regarding demographic, clinical, and behavioural data and a molecular diagnosis with polymerase chain reaction (PCR) using the TVK3/7 primer set, which was confirmed with sequence analysis. Of the 345 women surveyed, the overall prevalence of Trichomonas vaginalis (T. vaginalis) was 4.1% (14/345). The prevalence rates were 5.9% among pregnant women, 8.5% among HIV-positive women, and 10.1% among HIV-positive pregnant women. The rates for groups with other significant demographic and clinical features were as follows: 6.6% among women with white skin, 12.3% among women with an income below the minimum monthly wage, 7.4% among women with a vaginal pH greater than or equal to 4.6, and 7.9% among women with a comorbid STD. The multivariate analysis confirmed that pregnant women who were HIV-positive (p = 0.001) and had low incomes (p = 0.026) were the most likely to have this infection. Conclusions A multivariate analysis confirmed that HIV-positive pregnant women with low incomes were the participants most likely to have trichomoniasis. These results are important because this Brazilian region presents a high prevalence of HIV-1 subtype C, which is associated with greater transmissibility. Additionally, low family income reveals a socioeconomic fragility that might favour the transmission of this STD. PMID:28346531

  13. National estimates of noncanine bite and sting injuries treated in US Hospital Emergency Departments, 2001-2010.

    PubMed

    Langley, Ricky; Mack, Karin; Haileyesus, Tadesse; Proescholdbell, Scott; Annest, Joseph L

    2014-03-01

    Injuries resulting from contact with animals and insects are a significant public health concern. This study quantifies nonfatal bite and sting injuries by noncanine sources using data from the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP). The NEISS-AIP is an ongoing nationally representative surveillance system used to monitor all types and causes of injuries treated in US hospital emergency departments (EDs). Cases were coded by trained hospital coders using information from medical records on animal and insect sources of bite and sting injuries being treated. Data were weighted to produce national annualized estimates, percentages, and rates based on the US population. From 2001 to 2010 an estimated 10.1 million people visited EDs for noncanine bite and sting injuries, based on an unweighted case count of 169,010. This translates to a rate of 340.1 per 100,000 people (95% CI, 232.9-447.3). Insects accounted for 67.5% (95% CI, 45.8-89.2) of bite and sting injuries, followed by arachnids 20.8% (95% CI, 13.8-27.9). The estimated number of ED visits for bedbug bite injuries increased more than 7-fold-from 2156 visits in 2007 to 15,945 visits in 2010. This study provides an update of national estimates of noncanine bite and sting injuries and describes the diversity of animal exposures based on a national sample of EDs. Treatment of nonfatal bite and sting injuries are costly to society. Direct medical and work time lost translates to an estimated $7.5 billion annually. © 2013 Wilderness Medical Society Published by Wilderness Medical Society All rights reserved.

  14. Optional thinking ability among hospital-treated deliberate self-harm patients: a 1-year follow-up study.

    PubMed

    McAuliffe, Carmel; Corcoran, Paul; Hickey, Portia; McLeavey, Breda C

    2008-03-01

    To investigate the association between optional thinking (the ability to generate alternative solutions to interpersonal problems) in deliberate self-harm (DSH) patients and repeated self-harm. A prospective study of the association between optional thinking in interpersonal problem solving and repeated DSH within 12 months. A non-consecutive sample (N=152) of DSH patients presenting to the Accident and Emergency department of an acute hospital in Cork city, Ireland, was assessed using a structured interview schedule including the Suicide Intent Scale, the Hopelessness Scale, and the Optional Thinking Test. Repetition within 1 year was established by checking Accident and Emergency records at all three city hospitals. Participants were categorized as repeaters if they engaged in at least one further hospital-treated DSH episode, or non-repeaters. Approximately two-thirds (63.1%) of the sample had engaged in at least one act of DSH prior to their index episode. During follow-up 31 individuals (20.4%) repeated. History of self-harm was significantly associated with prospective repetition when considered alongside all the other predictor variables. Among first evers, low scores on the optional thinking test were significantly associated with the increased risk of repetition within 12 months. Among those with previous DSH, there was no evidence of an association between optional thinking and repetition within 12 months. Poor optional thinking is associated with increased risk of repeated deliberate self-harm in those who present with a first self-harm episode. Interventions to improve optional thinking skills, delivered soon after a first DSH presentation, may be useful in preventing repetition.

  15. Determinants of Glycemic Control among Insulin Treated Diabetic Patients in Southwest Ethiopia: Hospital Based Cross Sectional Study

    PubMed Central

    Angamo, Mulugeta Tarekegn; Melese, Belete Habte; Ayen, Wubeante Yenet

    2013-01-01

    Background Good glycemic control reduces the risk of diabetic complications. Despite this, achieving good glycemic control remains a challenge in diabetic patients. The objective of this study is to identify determinants of glycemic control among insulin treated diabetic patients at Jimma University Hospital, Southwest Ethiopia. Methods Hospital-based cross-sectional study was conducted on systematically sampled 284 insulin-treated diabetic patients with a regular follow up. Data was collected by interviewing patients during hospital visits and reviewing respective databases of September 2010 to December 2011. Data collection took place from February 20 to May 20, 2012. Poor glycemic control was defined as fasting blood sugar (FBS) ≥126 mg/dL. Binary logistic regression analysis was conducted to identify predictors of poor glycemic control. Results Patients had a mean age of 41.37 (±15.08) years, 58.5% were males, the mean duration of insulin treatment was 4.9 (±5.1) years, 18.3% achieved good glycemic control (FBS≤126 mg/dL), 95% self-reported repeated use of disposable insulin syringe-needle and 48% correctly rotating insulin injection sites. Most (83.1%) of study participants had one or more complications. On multivariable logistic regression analyses, body weight of >70 Kg (AOR = 0.21; P<0.001), total daily dose of insulin ≤35 IU/day (AOR = 0.26; P<0.001), total daily dose variation without checking glycemic level (AOR = 3.39; P = 0.020), knowledge deficit about signs and symptoms of hyperglycemia (AOR = 3.60; P = 0.004), and non-adherence to dietary management (AOR = 0.35; P = 0.005) were independent predictors of poor glycemic control. Conclusions The proportion of patients with poor glycemic control was high, which resulted in the development of one or more complications regardless of duration on insulin treatment. Hence, appropriate management of patients focusing on the relevant associated factors and independent

  16. Korean. London Oriental and African Language Library.

    ERIC Educational Resources Information Center

    Chang, Suk-Jin

    The grammar of the Korean language presented here is descriptive and structural, and does not align with any particular theory. An introductory chapter gives some background information about the language and related research. Subsequent chapters treat: writing and sound systems, including some sound rules and suprasegmental features; morphology…

  17. [Development and validation of the Korean Nursing Delirium Scale].

    PubMed

    Kim, Kyoung-Nam; Kim, Cheol-Ho; Kim, Kwang-Il; Yoo, Hyun-Jung; Park, Si-Young; Park, Yeon-Hwan

    2012-06-01

    The aims of this study were to develop and test the validity of the Korean Nursing Delirium Scale (Nu-DESC) for older patients in hospital. The Korean Nu-DESC was developed based on the Nu-DESC (Gaudreau, 2005), and revised according to nursing records related to signs and symptoms of older patients with delirium (n=361) and the results of a pilot study (n=42) in one general hospital. To test the validity of the Korean Nu-DESC, 75 older patients whom nurses suspected of delirium from 731 older patients from 12 nursing units were assessed by bedside nurses using the Korean Nu-DESC. A Receiver Operating Characteristic Curve of the Korean Nu-DESC was constructed with an accompanying Area Under the Curve (AUC). Specific examples such as irritable, kidding, sleeping tendency, which were observed by bedside nurses in Korea, were identified in the five features of signs and symptoms of delirium in the instrument. The Korean Nu-DESC was psycho-metrically valid and had a sensitivity and specificity of .81-.76 and .97-.73, respectively. The AUC were .89, .74. Results of this study indicate that the Korean Nu-DESC is well-suited for widespread clinical use in busy inpatients settings and shows promise as a research instrument.

  18. Population pharmacokinetics of aripiprazole in healthy Korean subjects.

    PubMed

    Jeon, Ji-Young; Chae, Soo-Wan; Kim, Min-Gul

    2016-04-01

    Aripiprazole is widely used to treat schizophrenia and bipolar disorder. This study aimed to develop a combined population pharmacokinetic model for aripiprazole in healthy Korean subjects and to identify the significant covariates in the pharmacokinetic variability of aripiprazole. Aripiprazole plasma concentrations and demographic data were collected retrospectively from previous bioequivalence studies that were conducted in Chonbuk National University Hospital. Informed consent was obtained from subjects for cytochrome P450 (CYP) genotyping. The population pharmacokinetic parameters of aripiprazole were estimated using nonlinear mixed-effect modeling with first-order conditional estimation with interaction method. The effects of age, sex, weight, height, and CYP genotype were assessed as covariates. A total of 1,508 samples from 88 subjects in three bioequivalence studies were collected. The two-compartment model was adopted, and the final population model showed that the CYP2D6 genotype polymorphism, height and weight significantly affect aripiprazole disposition. The bootstrap and visual predictive check results were evaluated, showing that the accuracy of the pharmacokinetic model was acceptable. A population pharmacokinetic model of aripiprazole was developed for Korean subjects. CYP2D6 genotype polymorphism, weight, and height were included as significant factors affecting aripiprazole disposition. The population pharmacokinetic parameters of aripiprazole estimated in the present study may be useful for individualizing clinical dosages and for studying the concentration-effect relationship of the drug.

  19. The Incremental Hospital Cost and Length-of-Stay Associated With Treating Adverse Events Among Medicare Beneficiaries Undergoing THA During Fiscal Year 2013.

    PubMed

    Culler, Steven D; Jevsevar, David S; Shea, Kevin G; McGuire, Kevin J; Wright, Kimberly K; Simon, April W

    2016-01-01

    This paper estimates the incremental hospital resource consumption associated with treating selected adverse events experienced by Medicare beneficiaries (MBs) undergoing total hip arthroplasty (THA). This retrospective study, using the Medicare Provider Analysis and Review file, identified 174,167 MBs who underwent THA in 2013. Overall, 20.16% of MB undergoing THA experienced at least one adverse event. MB experiencing any adverse event consumed significantly higher hospital cost ($3429) and had longer length of stays (1.0 day). The risk-adjusted incremental cost of treating adverse events ranged from a high of $27,116 (pneumonia) to a low of $2626 (hemorrhage or post-operative shock requiring transfusion). Most major adverse events occurred infrequently, however when adverse events occurred, they add substantially to the hospital resource costs of treating MB.

  20. Spoken Korean: Book One.

    ERIC Educational Resources Information Center

    Lukoff, Fred

    This text is designed for students planning to learn spoken Korean. Ten lessons and two review sections based on cultural experiences commonly shared by Koreans are included in the text. Grouped in series of five lessons, the instructional materials include (1) basic sentences, (2) word study and review of basic sentences, (3) listening…

  1. Korean Basic Course.

    ERIC Educational Resources Information Center

    Defense Language Inst., Washington, DC.

    These 11 volumes of the Korean Basic Course comprise 112 lesson units designed to train native English language speakers to Level 3 proficiency in comprehension and speaking and Level 2 proficiency in reading and writing Korean. (Level 5 on this scale is native-speaker level.) Intended for classroom use in the Defense Language Institute intensive…

  2. Korean Hemorrhagic Fever.

    DTIC Science & Technology

    Korean hemorrhagic fever (KHF) occurred for the first time in Korea , 1951, although it had previously been known to both the Japanese and Russians...After Korean war, the disease has been fixed in the areas of DMZ as an endemic one, and from 100 to 400 cases have been being reportee every year

  3. Korean Basic Course.

    ERIC Educational Resources Information Center

    Defense Language Inst., Washington, DC.

    These 11 volumes of the Korean Basic Course comprise 112 lesson units designed to train native English language speakers to Level 3 proficiency in comprehension and speaking and Level 2 proficiency in reading and writing Korean. (Level 5 on this scale is native-speaker level.) Intended for classroom use in the Defense Language Institute intensive…

  4. Koreans in Business

    ERIC Educational Resources Information Center

    Bonacich, Edna; And Others

    1977-01-01

    Two questions about Koreans in business are left unanswered in this article. First, what will happen to Korean entrepreneurship if monopoly capitalism continues to extend its influence into all branches of the economy. The second question concerns the issue of race relations. (Author/AM)

  5. Bendamustine in heavily pre-treated multiple myeloma patients: Results of a retrospective analysis from the Korean Multiple Myeloma Working Party

    PubMed Central

    Kim, Seok Jin; Bang, Soo-Mee; Choi, Yoon Seok; Jo, Deog-Yeon; Kim, Jin Seok; Lee, Hyewon; Eom, Hyeon Seok; Yoon, Dok Hyun; Suh, Cheolwon; Lee, Je-Jung; Hong, Junshik; Lee, Jae Hoon; Koh, Youngil; Kim, Kihyun

    2016-01-01

    Background Bendamustine may be a potential treatment option for patients with myeloma, but little is known about the utility of bendamustine as a salvage treatment, especially in Asian patients. Methods We performed a multicenter retrospective study of patients with relapsed or refractory myeloma who received bendamustine and prednisone. Results The records of 65 heavily pre-treated patients, who had undergone bortezomib and lenalidomide treatment (median number of previous treatments: 5), were analyzed. The median time from diagnosis to bendamustine treatment was 3.8 years, and the median patient age was 63 years (range, 38‒77 yr). The responses to the last treatment before bendamustine were refractory disease (N=52, 80%) or disease progression from partial response (N=13, 20%). Twenty-three patients responded to the treatment, with an overall response rate of 35% (23/65), and the median number of bendamustine treatment cycles was two (range, 1‒5 cycles). The median overall survival after bendamustine treatment was 5.5 months and the overall survival rate in responders to bendamustine was significantly better than that in non-responders (P=0.036). Conclusion Bendamustine may be a potential salvage treatment to extend survival in a select group of heavily pre-treated patients with relapsed or refractory myeloma. PMID:27722131

  6. Comparison of diagnostic accuracy between endometrial curettage and pipelle aspiration biopsy in patients treated with progestin for endometrial hyperplasia: a Korean Gynecologic Oncology Group Study (KGOG 2019).

    PubMed

    Kim, Mi Kyoung; Seong, Seok Ju; Lee, Taek Sang; Ki, Kyung-Do; Lim, Myong Cheol; Kim, Yun Hwan; Kim, Kidong; Joo, Won Duk

    2015-10-01

    A prospective multicenter trial has been started in Korea to evaluate the diagnostic accuracy of endometrial aspiration biopsy compared with dilatation and curettage in patients treated with progestin for endometrial hyperplasia. For conservative treatment of endometrial hyperplasia, orally administered progestins are most commonly used method with various treatment regimens and more recently, the levonorgestrel-releasing intrauterine system also has been used successfully to treat endometrial hyperplasia. However, there is no report about the accuracy of endometrial sampling during hormonal treatment for follow-up evaluation of endometrial hyperplasia. Patients with histologically confirmed endometrial hyperplasia are offered hormonal treatment with any one of the following three options: oral medroxyprogesterone acetate 10 mg/day for 14 days per cycle, continuous oral medroxyprogesterone acetate 10 mg/day or insertion of levonorgestrel-releasing intrauterine system. Histological surveillance is performed at 3 months or 6 months following initial treatment. Endometrial tissues are obtained via endometrial aspiration biopsy using a pipelle and dilatation and curettage. In the case of levonorgestrel-releasing intrauterine system, endometrial aspiration biopsy will be done with levonorgestrel-releasing intrauterine system in uterus and then, after the removal of levonorgestrel-releasing intrauterine system, dilatation and curettage will be done. The biopsy findings will be compared. The primary endpoint is to compare the pathological outcome of endometrial aspiration with dilatation and curettage. The secondary endpoint is the response rate with three types of progestin treatment at 6 months.

  7. Treating Dehydration at Home Avoids Healthcare Costs Associated With Emergency Department Visits and Hospital Readmissions for Adult Patients Receiving Home Parenteral Support.

    PubMed

    Konrad, Denise; Roberts, Scott; Corrigan, Mandy L; Hamilton, Cindy; Steiger, Ezra; Kirby, Donald F

    2017-06-01

    Administration of home parenteral support (HPS) has proven to be cost-effective over hospital care. Avoiding hospital readmissions became more of a focus for healthcare institutions in 2012 with the implementation of the Affordable Care Act. In 2010, our service developed a protocol to treat dehydration at home for HPS patients by ordering additional intravenous fluids to be kept on hand and to focus patient education on the symptoms of dehydration. A retrospective analysis was completed through a clinical management database to identify HPS patients with dehydration. The hospital finance department and homecare pharmacy were utilized to determine potential cost avoidance. In 2009, 64 episodes (77%) of dehydration were successfully treated at home versus 6 emergency department (ED) visits (7.5%) and 13 readmissions (15.5%). In 2010, we successfully treated 170 episodes (84.5%) at home, with 9 episodes (4.5%) requiring ED visits and 22 hospital readmissions (11%). The number of dehydration episodes per patient was significantly higher in 2010 ( P < .001) and may be attributed to a shift in the patient population, with more patients having malabsorption as the indication for therapy in 2010 ( P = .003). There were more than twice as many episodes of dehydration identified and treated at home in 2010 versus 2009. Our protocol helped educate and provide the resources required to resolve dehydration at home when early signs were recognized. By reducing ED visits and hospital readmissions, healthcare costs were avoided by a factor of 29 when home treatment was successful.

  8. Outcomes for Emergency Department Patients With Recent-Onset Atrial Fibrillation and Flutter Treated in Canadian Hospitals.

    PubMed

    Stiell, Ian G; Clement, Catherine M; Rowe, Brian H; Brison, Robert J; Wyse, D George; Birnie, David; Dorian, Paul; Lang, Eddy; Perry, Jeffrey J; Borgundvaag, Bjug; Eagles, Debra; Redfearn, Damian; Brinkhurst, Jennifer; Wells, George A

    2017-05-01

    Recent-onset atrial fibrillation and flutter are the most common arrhythmias managed in the emergency department (ED). We evaluate the management and 30-day outcomes for recent-onset atrial fibrillation and flutter patients in Canadian EDs, where cardioversion is commonly practiced. We conducted a prospective cohort study in 6 academic hospital EDs and enrolled patients who had atrial fibrillation and flutter onset within 48 hours. Patients were followed for 30 days by health records review and telephone. Adverse events included death, stroke, acute coronary syndrome, heart failure, subsequent admission, or ED electrocardioversion. We enrolled 1,091 patients with mean age 63.9 years, atrial fibrillation 84.7%, atrial flutter 15.3%, hospital admission 9.0%, and converted to sinus rhythm 80.1%. Although 10.5% of recent-onset atrial fibrillation and flutter patients had adverse events within 30 days, there were no related deaths and 1 stroke (0.1%). Adjusted odds ratios for factors associated with adverse event were hours from onset (1.03/hour; 95% confidence interval [CI] 1.01 to 1.05), history of stroke or transient ischemic attack (2.09; 95% CI 1.01 to 4.36), and pulmonary congestion on chest radiograph (7.37; 95% CI 2.40 to 22.64). Patients who left the ED in sinus rhythm were much less likely to experience an adverse event (P<.001). Although most recent-onset atrial fibrillation and flutter patients were treated aggressively in the ED, there were few 30-day serious outcomes. Physicians underprescribed oral anticoagulants. Potential risk factors for adverse events include longer duration from arrhythmia onset, previous stroke or transient ischemic attack, pulmonary congestion on chest radiograph, and not being in sinus rhythm at discharge. An ED strategy of sinus rhythm restoration and discharge in most patients is effective and safe. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  9. The Most Common Detected Bacteria in Sputum of Patients with Community Acquired Pneumonia (CAP) Treated In Hospital

    PubMed Central

    Cukic, Vesna; Hadzic, Armin

    2016-01-01

    Introduction: Community acquired pneumonia (CAP) is the most common infective pulmonary disease. Objective: To show the most common detected bacteria in bacterial culture of sputum in patients with CAP hospitalized in Clinic for Pulmonary Diseases and TB “Podhrastovi” in four-year period: from 2012 to 2015. Material and methods: This is the retrospective analysis. Each patient gave sputum 3 days in a row when admitted to hospital. Sputum has been examined: bacterial culture with antibiotics sensitivity, Gram stain, Mycobacterium tuberculosis; in cases with high temperature blood cultures were done; when we were suspicious about bronchial carcinoma bronchoscopy with BAL (bronchoalveolar lavage) was done. We show analyzed patients according to age, sex, whether they had pneumonia or bronchopneumonia, bacteria isolated in sputum and in BAL. Results: 360 patients with CAP were treated in four-year period (247 males and 113 females). 167 or 43, 39 % had pneumonia (119 males and 48 females). Number of males was significantly bigger (χ2 = 30,186; p<0,001). 193 or 53, 61 % had bronchopneumonia (128 males and 65 females). Number of males was significantly bigger (χ2 = 20,556; p<0,001). Number of patients with negative bacterial culture of sputum (131–78, 44%) was significantly bigger than number of patients with positive culture (36–21, 56%) (χ2 = 50,042; p<0,001) in pneumonia. Number of patients with negative bacterial culture of sputum (154- 79, 79%) was significantly bigger than number of patients with positive culture (39- 20, 21%) (χ2 = 68,523; p<0,001) in bronchopneumonia. Streptococcus pneumoniae was significantly most common detected bacterium compared with the number of other isolated bacteria; in pneumonia (χ2 =33,222; p<0,001) and in bronchopneumonia (χ2 =51,231; p<0,001). Conclusion: It is very important to detect the bacterial cause of CAP to administrate the targeted antibiotic therapy. PMID:27994296

  10. Are hospitals in Japan with larger patient volume treating younger and earlier-stage cancer patients? An analysis of hospital-based cancer registry data in Japan.

    PubMed

    Tsukada, Yoichiro; Nakamura, Fumiaki; Iwamoto, Momoko; Nishimoto, Hiroshi; Emori, Yoshiko; Terahara, Atsuro; Higashi, Takahiro

    2015-08-01

    Differences in hospital case-mix have not been adequately accounted for in hospital volume and patient outcome studies in Japan. We aimed to examine whether differences may exist by investigating the distribution of patients' stage and age across designated cancer treatment hospitals of varying patient volume across Japan. We analyzed data of gastric, breast, colorectal, lung and liver cancer patients who were included in the national database of hospital-based cancer registries between 2008 and 2011. We investigated the association between hospital volume, cancer stage and patient age. Hospitals were classified into five groups according to patient volume. In total, 676 713 patients met the inclusion criteria. The proportion of patients with early-stage (tumor-node-metastasis Stage 0 or I) cancer was higher among high-volume hospitals for all cancer types except small cell lung cancer. The proportion of older patients (age >75 years) was smaller among high-volume hospitals for all cancer types. The difference in the proportion of patients with early-stage cancers between very low-volume and very high-volume hospitals was greatest for non-small cell lung cancer (26.5% for very low and 43.5% for very high). This difference for the proportion of older patients was also greatest for non-small cell lung cancer (48.9% for very low and 30.3% for very high). We showed that the proportions of early-stage cancer patients and younger patients are greater in higher-volume hospitals compared with lower-volume hospitals in Japan. Researchers conducting volume-outcome studies and policymakers analyzing hospital performance should be cautious when making interhospital comparisons. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  11. Infective endocarditis in a Finnish teaching hospital: a study on 326 episodes treated during 1980–2004

    PubMed Central

    Heiro, M; Helenius, H; Mäkilä, S; Hohenthal, U; Savunen, T; Engblom, E; Nikoskelainen, J; Kotilainen, P

    2006-01-01

    Objectives To evaluate potential changes of infective endocarditis (IE) in patients treated in a Finnish teaching hospital during the past 25 years. Patients 326 episodes of IE in 303 patients treated during 1980–2004 were evaluated for clinical characteristics and their changes over time. Results The mean age of the patients increased with time (from 47.2 to 54.5 years, p  =  0.003). Twenty‐five (7.7%) episodes were associated with intravenous drug use (IVDU), with a significant increase of these episodes after 1996 (from 0 to 19 (20%), p < 0.001). Viridans streptococci were the most common causative agents of IE during 1980–1994, but after that Staphylococcus aureus was the most common pathogen (p  =  0.015). The proportion of IE of the aortic valve decreased during the study (from 30 (49%) to 26 (27%), whereas the proportions of mitral (11 (18%) to 33 (35%) and tricuspid valve IE (0 to 13 (14%) increased correspondingly (p  =  0.001). This was mainly due to more patients with IVDU. Chronic dialysis for renal failure as an underlying condition increased over time (from 0 to 7 (7.4%), p  =  0.015) but no other predisposing conditions changed. Complications such as neurological manifestations and heart failure did not change in frequency, but the incidence of lung emboli increased (from 0% to 10.5%, p < 0.001); 83% of these emboli occurred in patients with IVDU. The proportion of patients requiring surgical treatment and mortality due to IE did not change. Conclusions During these 25 years, the causative agents, affected valves and complications of IE changed to some degree. These changes were mainly attributed to the increase of IVDU‐associated IE. Except for the increase in age, the clinical presentation and outcome in non‐addicts remained substantially unchanged. PMID:16644858

  12. Insulin requirement profiles in Japanese hospitalized subjects with type 2 diabetes treated with basal-bolus insulin therapy.

    PubMed

    Shimoda, Seiya; Okubo, Mina; Koga, Kotaro; Sekigami, Taiji; Kawashima, Junji; Kukidome, Daisuke; Igata, Motoyuki; Ishii, Norio; Shimakawa, Akiko; Matsumura, Takeshi; Motoshima, Hiroyuki; Furukawa, Noboru; Nishida, Kenro; Araki, Eiichi

    2015-01-01

    To assess the total daily inulin dose (TDD) and contribution of basal insulin to TDD and to identify the predictive factors for insulin requirement profiles in subjects with type 2 diabetes, we retrospectively examined insulin requirement profiles of 275 hospitalized subjects treated with basal-bolus insulin therapy (BBT) (mean age, 60.1 ± 12.9 years; HbA1c, 10.2 ± 4.5%). Target plasma glucose level was set between 80 and 129 mg/dL before breakfast and between 80 and 179 mg/dL at 2-hour after each meal without causing hypoglycemia. We also analyzed the relationship between the insulin requirement profiles (TDD and basal/total daily insulin ratio [B/TD ratio]) and insulin-associated clinical parameters. The mean TDD was 0.463 ± 0.190 unit/kg/day (range, 0.16-1.13 unit/kg/day). The mean B/TD ratio was 0.300 ± 0.099 (range, 0.091-0.667). A positive correlation of TDD with B/TD ratio was revealed by linear regression analysis (r=0.129, p=0.03). Stepwise multiple regression analysis identified post-breakfast glucose levels before titrating insulin as an independent determinant of the insulin requirement profile [Std β (standard regression coefficient) = 0.228, p<0.01 for TDD, Std β = -0.189, p<0.01 for B/TD ratio]. The TDD was <0.6 unit/kg/day and the B/TD ratio was <0.4 in the majority (70.2%) of subjects in the present study. These findings may have relevance in improving glycemic control and decreasing the risk of hypoglycemia and weight gain in subjects with type 2 diabetes treated with BBT.

  13. Incremental Hospital Cost and Length-of-Stay Associated With Treating Adverse Events Among Medicare Beneficiaries Undergoing Lumbar Spinal Fusion During Fiscal Year 2013.

    PubMed

    Culler, Steven D; Jevsevar, David S; Shea, Kevin G; McGuire, Kevin J; Schlosser, Michael; Wright, Kimberly K; Simon, April W

    2016-10-15

    A retrospective study. To report the incremental hospital resource consumption associated with treating selected adverse events experienced by Medicare beneficiaries undergoing a two- or three-level lumbar spinal fusion. Hospitals are increasingly at financial risk for the incremental resources consumed in treating patients experiencing adverse events because of public and private third-party payers' efforts to base hospital reimbursement on "pay for performance" measures. However, little is known about average incremental resources consumed in treating patients experiencing adverse events following lumbar spinal fusions. The 2013 fiscal year Medicare Provider Analysis and Review file was used to identify 83,658 Medicare beneficiaries who underwent two- or three vertebrae-level lumbar spinal fusion. International Classification of Diseases-9th-Clinical Modification diagnostic and procedure codes were used to identify the frequencies of nine adverse events. This study estimated both the observed and risk-adjusted incremental hospital resources consumed (cost and length of stay [LOS]) in treating Medicare beneficiaries experiencing each adverse event. Overall, 17.7% of Medicare beneficiaries undergoing lumbar spinal fusion experienced at least one of the study's adverse events. Medicare beneficiaries experiencing any complication consumed significantly more hospital resources (incremental cost of $8911) and had longer LOS (incremental stays of 5.7 days). After adjusting for patient demographics and comorbid conditions, incremental cost of treating adverse events ranged from a high of $32,049 (infection) to a low of $9976 (transfusion). Adverse events frequently occur and add substantially to the hospital resource costs of patients undergoing spinal fusion. Shared decision-making instruments should clearly provide these risk estimates to the patient before surgical consideration. Investment in activities that have been shown to reduce specific adverse events is

  14. Removal of antibiotics in sponge membrane bioreactors treating hospital wastewater: Comparison between hollow fiber and flat sheet membrane systems.

    PubMed

    Nguyen, Thanh-Tin; Bui, Xuan-Thanh; Luu, Vinh-Phuc; Nguyen, Phuoc-Dan; Guo, Wenshan; Ngo, Huu-Hao

    2017-09-01

    Hollow fiber (HF) and flat sheet (FS) Sponge MBRs were operated at 10-20 LMH flux treating hospital wastewater. Simultaneous nitrification denitrification (SND) occurred considerably with TN removal rate of 0.011-0.020mg TN mgVSS(-1)d(-1). Furthermore, there was a remarkable removal of antibiotics in both Sponge MBRs, namely Norfloxacin (93-99% (FS); 62-86% (HF)), Ofloxacin (73-93% (FS); 68-93% (HF)), Ciprofloxacin (76-93% (FS); 54-70% (HF)), Tetracycline (approximately 100% for both FS and HF) and Trimethoprim (60-97% (FS); 47-93% (HF). Whereas there was a quite high removal efficiency of Erythromycin in Sponge MBRs, with 67-78% (FS) and 22-48% (HF). Moreover, a slightly higher removal of antibiotics in FS than in HF achieved, with the removal rate being of 0.67-32.40 and 0.44-30.42µgmgVSS(-1)d(-1), respectively. In addition, a significant reduction of membrane fouling of 2-50 times was achieved in HF-Sponge MBR for the flux range. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Efficacy of drug-eluting stents for treating in-stent restenosis of drug-eluting stents (from the Korean DES ISR multicenter registry study [KISS]).

    PubMed

    Ko, Young-Guk; Kim, Jung-Sun; Kim, Byeong-Keuk; Choi, Donghoon; Hong, Myeong-Ki; Jeon, Dong Woon; Yang, Joo-Young; Ahn, Young Keun; Jeong, Myung Ho; Yu, Cheol Woong; Yun, Kyeong-Ho; Lim, Do-Sun; Jang, Yangsoo

    2012-03-01

    There is currently no established standard treatment for in-stent restenosis (ISR) after the implantation of a drug-eluting stent (DES). The aim of this study was to investigate the efficacy of DES versus balloon angioplasty (BA) for the treatment of DES ISR in a multicenter registry cohort. After matching propensity scores of 805 patients with DES ISR treated with either DES (n = 422) or BA (n = 383), 268 matched pairs were selected and analyzed for major adverse cardiac events, a composite of death, myocardial infarction, and target-vessel revascularization, as the primary end point. Baseline clinical and lesion characteristics of the matched pairs were similar. Survival free of major adverse cardiac events at 2 years was higher with DES compared to BA (88.9% vs 78.7%, p <0.001), mainly because of higher TVR-free survival (92.4% vs 81.0%, p <0.001). Among various baseline variables, BA (hazard ratio 2.546, 95% confidence interval 1.412 to 4.593, p = 0.002) was the most important independent risk factor for recurrent target vessel revascularization, followed by acute coronary syndromes as the clinical presentation of DES ISR, and previous implantation of a sirolimus-eluting stent. Survival free of death, myocardial infarction, or stent thrombosis did not differ between the 2 groups. Whereas there was no significant difference in survival free of target vessel revascularization between DES and BA for focal ISR lesions, DES was superior to BA in diffuse ISR lesions (94.3% vs 75.2% at 2 years, p <0.001). In conclusion, compared to BA, the implantation of DES was safe and more effective in the treatment of DES ISR.

  16. Longitudinal monitoring of EGFR mutations in plasma predicts outcomes of NSCLC patients treated with EGFR TKIs: Korean Lung Cancer Consortium (KLCC-12-02).

    PubMed

    Lee, Ji Yun; Qing, Xu; Xiumin, Wei; Yali, Bai; Chi, Sangah; Bak, So Hyeon; Lee, Ho Yun; Sun, Jong-Mu; Lee, Se-Hoon; Ahn, Jin Seok; Cho, Eun Kyung; Kim, Dong-Wan; Kim, Hye Ryun; Min, Young Joo; Jung, Sin-Ho; Park, Keunchil; Mao, Mao; Ahn, Myung-Ju

    2016-02-09

    We hypothesized that plasma-based EGFR mutation analysis for NSCLC may be feasible for monitoring treatment response to EGFR TKIs and also predict drug resistance.Clinically relevant mutations including exon 19 deletion (ex19del), L858R and T790M were analyzed using droplet digital PCR (ddPCR) in longitudinally collected plasma samples (n = 367) from 81 NSCLC patients treated with EGFR TKI. Of a total 58 baseline cell-free DNA (cfDNA) samples available for ddPCR analysis, 43 (74.1%) had the same mutation in the matched tumors (clinical sensitivity: 70.8% [17/24] for L858R and 76.5% [26/34] for ex19del). The concordance rates of plasma with tissue-based results of EGFR mutations were 87.9% for L858R and 86.2% for ex19del. All 40 patients who were detected EGFR mutations at baseline showed a dramatic decrease of mutant copies (>50%) in plasma during the first two months after treatment. Median progression-free survival (PFS) was 10.1 months for patients with undetectable EGFR v 6.3 months for detectable EGFR mutations in blood after two-month treatment (HR 3.88, 95% CI 1.48-10.19, P = 0.006). We observed emerging resistance with early detection of T790M as a secondary mutation in 14 (28.6%) of 49 patients. Plasma-based EGFR mutation analysis using ddPCR can monitor treatment response to EGFR TKIs and can lead to early detection of EGFR TKIs resistance. Further studies confirming clinical implications of EGFR mutation in plasma are warranted to guide optimal therapeutic strategies upon knowledge of treatment response and resistance.

  17. Comparison of treatment persistence, hospital utilization and costs among major depressive disorder geriatric patients treated with escitalopram versus other SSRI/SNRI antidepressants.

    PubMed

    Wu, Eric; Greenberg, Paul; Yang, Elaine; Yu, Andrew; Ben-Hamadi, Rym; Erder, M Haim

    2008-10-01

    To assess treatment persistence, hospitalization outcomes and mean healthcare costs of geriatric major depressive disorder (MDD) patients treated with escitalopram compared to other selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs). Patients aged > or = 65 years with at least one inpatient claim or two independent claims associated with MDD diagnosis were identified in the IHCIS National Managed Care Database (2003-2005). Patients were continuously enrolled for at least > or = 12 months, filled at least one prescription for an SSRI/SNRI and did not use any second-generation antidepressant during the 6 months pre-index date. Unadjusted and multivariate analyses adjusting for baseline characteristics were conducted. Treatment persistence, hospitalization utilization, and average prescription drug, medical, and total healthcare costs were compared between patients initiated on escitalopram versus other SSRI/SNRIs. Escitalopram-treated patients (N = 459) were less likely to discontinue treatment (HR = 0.85, p = 0.012) or switch to another second-generation antidepressant (HR = 0.76, p = 0.006) compared to patients treated with other SSRI/SNRIs (N = 1517). Escitalopram-treated patients had 39% fewer hospitalization days (p = 0.004). Both groups had similar mean prescription drug costs ($1659 vs. $1630, p = 0.687). After controlling for baseline characteristics, escitalopram-treated patients had lower mean total medical service costs ($9425 vs. $12,703, p < 0.001) and mean total healthcare costs ($11,043 vs. $14,163, p < 0.001). This study's limitations include its small sample size, short observational periods and exclusivity of indirect costs. Geriatric patients treated with escitalopram had higher treatment persistence, fewer hospitalization days and lower total healthcare costs than patients on other SSRI/SNRIs after controlling for baseline characteristics. Most of the cost savings were due to reductions in

  18. Molecular epidemiology of an outbreak of imipenem-resistant Acinetobacter baumannii carrying the ISAba1-bla(OXA-51-like) genes in a Korean hospital.

    PubMed

    Chaulagain, Bidur Prasad; Jang, Sook Jin; Ahn, Gyuu Yeol; Ryu, So Yeon; Kim, Dong Min; Park, Geon; Kim, Won Yong; Shin, Jong Hee; Kook, Joong Ki; Kang, Seong-Ho; Moon, Dae Soo; Park, Young Jin

    2012-01-01

    Between January 2004 and December 2004, an outbreak of imipenem-resistant Acinetobacter baumannii (IRAB) in 2 intensive care units (ICU) of Chosun University Hospital, Korea affected 77 patients. A case-control study revealed that the time spent in the hospital and mechanical ventilation practices were risk factors. IRAB was isolated from the hands of 4% (5/124) of healthcare workers; 27.3% (21/77) of the samples obtained from the ICU environment. A pulsed-field gel electrophoresis analysis showed that 82.1% (23/28) of clinical IRAB isolates and 85.7% (6/7) of environmental IRAB isolates were type A. The ISAba1F/OXA-51-likeR PCR showed that 93.7% (30/32) of IRAB strains had the ISAba1 gene upstream of the bla(OXA-51-like) gene. Two ISAba1F/OXA-51-likeR PCR-negative IRAB strains were bla(IMP-1) positive. All of the IRAB strains tested by PCR were negative for bla(VIM), bla(SIM), bla(GIM-1), bla(SPM-1), bla(GES), bla(OXA-23-like), bla(OXA-24-like), and bla(OXA-58-like) carbapenemase genes. After implementing an infection control strategy, a steady reduction in the attack rate of IRAB infection was observed.

  19. Low serum total cholesterol level is a surrogate marker, but not a risk factor, for poor outcome in patients hospitalized with acute heart failure: a report from the Korean Heart Failure Registry.

    PubMed

    Yoon, Chang-Hwan; Youn, Tae-Jin; Ahn, Soyeon; Choi, Dong-Ju; Cho, Goo-Young; Chae, In-Ho; Choi, Ji; Cho, Hyungjun; Han, Seongwoo; Cho, Myeong-Chan; Jeon, Eun-Seok; Chae, Shung Chull; Kim, Jae-Joong; Ryu, Kyu-Hyung; Oh, Byung-Hee

    2012-03-01

    Hypercholesterolemia is a major risk factor for incident coronary artery disease and the prevalence of heart failure (HF). The causal relationship between low total cholesterol (TC) levels and poor clinical outcome in patients with acute HF has not been investigated. This study evaluated the effect of cholesterol levels on the long-term outcome in patients hospitalized due to acute HF. We analyzed a cohort of 2,797 HF patients who were eligible for analysis in 3,200 patients of the Korean Heart Failure Registry. Patients were stratified into quartiles of TC (Q1 <133, Q2 133-158, Q3 159-190, and Q4 >190 mg/dL). Propensity score matching was performed with the patients in Q1 and Q4. Patients with lower serum TC had lower blood pressure, lower hemoglobin, lower serum sodium, and higher natriuretic peptide levels than patients with higher TC levels. Low TC was associated with increased risks for death and readmission due to HF; the adjusted hazard ratio (HR) of Q1 compared with Q4 was 1.57 (95% confidence interval [CI] 1.30-1.90). However, propensity score matching analysis revealed that low cholesterol itself did not affect outcome (HR 1.12, 95% CI 0.85-1.48). Low TC is strongly associated with mortality and morbidity in patients with HF. However, low TC seemed to be a secondary result of the patient's state rather than an independent risk factor for poor outcome. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Long-Term Clinical Outcomes of Final Kissing Ballooning in Coronary Bifurcation Lesions Treated With the 1-Stent Technique: Results From the COBIS II Registry (Korean Coronary Bifurcation Stenting Registry).

    PubMed

    Yu, Cheol Woong; Yang, Jeong Hoon; Song, Young Bin; Hahn, Joo-Yong; Choi, Seung-Hyuk; Choi, Jin-Ho; Lee, Hyun Jong; Oh, Ju Hyeon; Koo, Bon-Kwon; Rha, Seung Woon; Jeong, Jin-Ok; Jeong, Myung-Ho; Yoon, Jung Han; Jang, Yangsoo; Tahk, Seung-Jea; Kim, Hyo-Soo; Gwon, Hyeon-Cheol

    2015-08-24

    This study investigated the impact of final kissing ballooning (FKB) after main vessel (MV) stenting on outcomes in patients with coronary bifurcation lesions after application of the 1-stent technique. Although FKB has been established as the standard method for bifurcation lesions treated with a 2-stent strategy, its efficacy in a 1-stent approach is highly controversial. This study enrolled 1,901 patients with a bifurcation lesion with a side branch diameter ≥2.3 mm, treated solely with the 1-stent technique using a drug-eluting stent from 18 centers in Korea between January 1, 2003 and December 31, 2009. The primary outcome was major adverse cardiac events (MACE)-cardiac death, myocardial infarction, or target lesion revascularization. Propensity score-matching analysis was also performed. FKB was performed in 620 patients and the post minimal lumen diameter of the MV and side branch was larger in the FKB group than in the non-FKB group. During follow-up (median 36 months), the incidence of MACE (adjusted hazard ratio [HR]: 0.68, 95% confidence interval [CI]: 0.46 to 0.99; p = 0.048) was lower in the FKB group than the non-FKB group. After propensity score matching (545 pairs), the FKB group had a lower incidence of MACE (adjusted HR: 0.50, 95% CI: 0.30 to 0.85; p = 0.01), and target lesion revascularization in the MV (adjusted HR: 0.51, 95% CI: 0.28 to 0.93; p = 0.03) and both vessels (adjusted HR: 0.47, 95% CI: 0.25 to 0.90; p = 0.02) than in the non-FKB group. In coronary bifurcation lesions, we demonstrated that the 1-stent technique with FKB was associated with a favorable long-term clinical outcome, mainly driven by the reduction of target lesion revascularization in the MV or both vessels as a result of an increase in minimal lumen diameter. (Korean Coronary Bifurcation Stenting Registry II [COBIS II]: NCT01642992). Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  1. Secondary stroke in patients with polytrauma and traumatic brain injury treated in an Intensive Care Unit, Karlovac General Hospital, Croatia.

    PubMed

    Belavić, M; Jančić, E; Mišković, P; Brozović-Krijan, A; Bakota, B; Žunić, J

    2015-11-01

    Traumatic brain injury (TBI) is divided into primary and secondary brain injury. Primary brain injury occurs at the time of injury and is the direct consequence of kinetic energy acting on the brain tissue. Secondary brain injury occurs several hours or days after primary brain injury and is the result of factors including shock, systemic hypotension, hypoxia, hypothermia or hyperthermia, intracranial hypertension, cerebral oedema, intracranial bleeding or inflammation. The aim of this retrospective analysis of a prospective database was to determine the prevalence of secondary stroke and stroke-related mortality, causes of secondary stroke, treatment and length of stay in the ICU and hospital. This study included patients with TBI with or without other injuries who were hospitalised in a general ICU over a five-year period. The following parameters were assessed: demographics (age, sex), scores (Glasgow Coma Score, APACHE II, SOFA), secondary stroke (prevalence, time of occurrence after primary brain injury, causes of stroke and associated mortality), length of stay in the ICU and hospital, vital parameters (state of consciousness, cardiac function, respiration, circulation, thermoregulation, diuresis) and laboratory values (leukocytes, C-reactive protein [CRP], blood glucose, blood gas analysis, urea, creatinine). Medical data were analysed for 306 patients with TBI (median age 56 years, range 18-93 years) who were treated in the general ICU. Secondary stroke occurred in 23 patients (7.5%), 10 of whom died, which gives a mortality rate of 43.4%. Three patients were excluded as the cause of the injury was missile trauma. The study data indicate that inflammation is the most important cause of secondary insults. Levels of CRP were elevated in 65% of patients with secondary brain injury; leukocytosis was present in 87% of these patients, and blood glucose was elevated in 73%. The lungs and urinary tract were the most common sites of infection. In conclusion

  2. The Clinical Research Center for Depression Study: Baseline Characteristics of a Korean Long-Term Hospital-Based Observational Collaborative Prospective Cohort Study

    PubMed Central

    Kim, Tae-Suk; Jeong, Seung Hee; Kim, Jung-Bum; Lee, Min-Soo; Kim, Jae-Min; Yim, Hyeon-Woo

    2011-01-01

    Objective The Clinical Research Center for Depression (CRESCEND) study is a 9-year observational collaborative prospective cohort study for the clinical outcomes in participants with depressive disorders in Korea. In this study, we examined the baseline characteristics of the depressive participants as the hospital-based cohort. Methods Participants were assessed using various instruments including the Clinical Global Impression scale, 17-item Hamilton Depression Rating Scale (HDRS-17), Hamilton Anxiety Rating Scale, Brief Psychiatric Rating Scale, Social and Occupational Functioning Assessment Scale, Beck Depression Inventory-Second Edition, Scale for Suicide Ideation, and World Health Organization Quality of Life assessment instruments-abbreviated version. Also, personal histories of medical and psychiatric illnesses and the range of socio-epidemiologic and clinical data were collected from each participant. Results One thousand one hundred eighty three participants were recruited from 18 hospitals. The mean age of the participants was 47.9±15.9 year-old, 74.4% were female, 82.9% had been diagnosed of major depressive disorder, 40.9% were experiencing their first depressive episode, and 21.4% had a past history of suicide attempts. The majority (85.3%) of the participants were moderately to severely ill. The average HDRS-17 was 19.8±6.1. Significant gender differences at baseline were shown in age, education, marriage, employment, religion, and first depressive episode. Conclusion The baseline findings in the CRESCEND study showed some different characteristics of depression in Korea, suggesting a possibility of ethnic and cultural factors in depression. PMID:21519530

  3. Comparison of stress experienced by family members of patients treated in hospital at home with that of those receiving traditional acute hospital care.

    PubMed

    Leff, Bruce; Burton, Lynda; Mader, Scott L; Naughton, Bruce; Burl, Jeffrey; Koehn, Debbie; Clark, Rebecca; Greenough, William B; Guido, Susan; Steinwachs, Donald; Burton, John R

    2008-01-01

    To compare differences in the stress experienced by family members of patients cared for in a physician-led substitutive Hospital at Home (HaH) and those receiving traditional acute hospital care. Survey questionnaire completed as a component of a prospective, nonrandomized clinical trial of a substitutive HaH care model. Three Medicare managed care health systems and a Veterans Affairs Medical Center. Two hundred fourteen community-dwelling elderly patients who required acute hospital admission for community-acquired pneumonia, exacerbation of chronic heart failure, exacerbation of chronic obstructive pulmonary disease, or cellulitis. Treatment in a substitutive HaH model. Fifteen-question survey questionnaire asking family members whether they experienced a potentially stressful situation and, if so, whether stress was associated with the situation while the patient received care. The mean and median number of experiences, of a possible 15, that caused stress for family members of HaH patients was significantly lower than for family members of acute care hospital patients (mean +/- standard deviation 1.7 +/- 1.8 vs 4.3 +/- 3.1, P<.001; median 1 vs 4, P<.001). HaH care was associated with lower odds of developing mean levels of family member stress (adjusted odds ratio=0.12, 95% confidence interval=0.05-0.30). HaH is associated with lower levels of family member stress than traditional acute hospital care and does not appear to shift the burden of care from hospital staff to family members.

  4. [A study on Korean concepts of relaxation].

    PubMed

    Park, J S

    1992-01-01

    Relaxation technique is an independent nursing intervention used in various stressful situations. The concept of relaxation must be explored for the meaning given by the people in their traditional thought and philosophy. Korean relaxation technique, wanting to become culturally acceptable and effective, is learning to recognize and develop Korean concepts, experiences, and musics of relaxation. This study was aimed at discovering Korean concepts, experiences and musics of relaxation and contributing the development of the relaxation technique for Korean people. The subjects were 59 nursing students, 39 hospitalized patients, 61 housewives, 21 rural residents and 16 researchers. Data were collected from September 4th to October 24th, 1991 by interviews or questionnaires. The data analysis was done by qualitative research method, and validity assured by conformation of the concept and category by 2 nursing scientists who had written a Master's thesis on the relaxation technique. The results of the study were summarized as follows; 1. The meaning of the relaxation concept; From 298 statements, 107 concepts were extracted and then 5 categories "Physical domain", "Psychological domain", "Complex domain", "Situation", and "environment" were organized. 'Don't have discomforts, 'don't have muscle tension', 'don't have energy (him in Korean)', 'don't have activities' subcategories were included in "Physical domain". 'Don't have anxiety', 'feel good', 'emotional stability', 'don't have wordly thoughts', 'feel one's brain muddled', 'loss of desire' subcategories were included in "physical domain" 'Comfort body and mind', 'don't have tension of body and mind', 'be sagged' 'liveliness of thoughts' subcategories were included in "Complex domain". 'Rest', 'sleep', 'others' subcategories were included in "Situation domain". And 'quite environment' & 'comfortable environment' subcategories were included in "Environmental domain". 2. The experiences of the relaxation; From 151

  5. Nonfatal construction industry-related injuries treated in hospital emergency departments in the United States, 1998-2005.

    PubMed

    Schoenfisch, Ashley L; Lipscomb, Hester J; Shishlov, Kirill; Myers, Douglas J

    2010-06-01

    This study documented the burden of nonfatal construction industry work-related injuries treated in hospital emergency departments in the United States (US) from 1998 through 2005 and described injured worker demographics and injury characteristics. Data from the National Electronic Injury Surveillance System work-related injury supplement (NEISS-Work) were used to identify and describe construction industry-related injuries. Rates were estimated using data from the Current Population Survey. An estimated 3,216,800 (95% CI 2,241,400-4,192,200) construction industry-related injuries were seen in US emergency departments during the 8-year period; this represented an injury rate of 410/10,000 full-time equivalents and suggests that there are a greater number of construction injuries than reported through the Bureau of Labor Statistics' Survey of Occupational Injuries and Illnesses (BLS SOII). Common characteristics included diagnoses of laceration, sprain/strain, and contusion/abrasion; events of contact with an object/equipment, bodily reaction/exertion, and falls; and sources of injury of parts/materials; structures/surfaces; and tools/instruments/equipment. The upper extremities were most often affected. These data highlight the high burden of nonfatal construction industry-related injuries. The limitations of national occupational injury data sources inherent in relying on OSHA logs highlight the utility of NEISS-Work data in occupational injury research. While data captured from emergency departments are not immune to factors that influence whether a worker or an employer reports an injury as work-related or files a workers' compensation claim, emergency department data as collected through NEISS-Work do not rely on employer involvement in order to be classified as work-related. 2010 Wiley-Liss, Inc.

  6. [Types of anxiety of couples treated with assisted fertilization regarding hypothetical donation of embryos at Clinical Hospital of Chile University].

    PubMed

    Alvarez Díaz, Jorge Alberto

    2005-04-01

    There are no empirical studies which have explored the experimentation with human embryos in Latin America. In general, there are no frameworks that regulate neither lawful matters of assisted reproduction nor the possibility of experimentation with human embryos, and the ethical frames are limited to those adopted by each center. Currently, to think about the real possibilities of experimentation with embryos goes beyond a legal frame, since the opinion of the potential actors is not known either (gamete or embryo donors). The experimentation with embryos is practically a reality in developed nations and Latin America continues appearing almost only as a potential market for the scientific advance. To determine the anxiety types of the couples treated with assisted fertilization before hypothetical donation of embryos for investigation, by a mixed quantitative and qualitative methodology. An oral semistructured interview was made individually to ten participants (seven women and three men) who had gone like patients of the Assisted Fertilization Program of the Gynecology and Obstetrics Service of the Clinical Hospital of the University of Chile. The scale of anxiety of the analysis of the verbal conduct method of Gottschalk and collaborators was applied to them. The most frequently associated types of anxiety to the hypothetical situation of donation of embryos for scientific research were the fault, separation, and mutilation anxiety. It is recommended to develop educative programs regarding the culture of embryo donation for treatment of couples with fertility problems, as well as for investigation, and to develop educative programs about the meaning of relationship and of embryo status.

  7. Neurocognitive Recovery After Hospital-Treated Deliberate Self-Poisoning With Central Nervous System Depressant Drugs: A Longitudinal Cohort Study.

    PubMed

    Oxley, Stewart O C; Dassanayake, Tharaka L; Carter, Gregory L; Whyte, Ian; Jones, Alison L; Cooper, Gavin; Michie, Patricia T

    2015-12-01

    Hospital-treated deliberate self-poisoning (DSP) by central nervous system depressant drugs (CNS-D) has been associated with impairments in cognitive and psychomotor functions at the time of discharge. We aimed to replicate this finding and to compare recovery in the first month after discharge for CNS-D and CNS nondepressant drug ingestions. We also examined a series of multivariate explanatory models of recovery of neurocognitive outcomes over time. The CNS-D group was impaired at discharge compared with the CNS-nondepressant group in cognitive flexibility, cognitive efficiency, and working memory. There were no significant differences at discharge in visual attention, processing speed, visuomotor speed, or inhibition speed. Both groups improved in the latter measures over 1 month of follow-up. However, the CNS-D group's recovery was significantly slower for key neurocognitive domains underlying driving in complex traffic situations, namely, cognitive flexibility, cognitive efficiency, and working memory. Patients discharged after DSP with CNS-D drugs have impairments of some critical cognitive functions that may require up to 1 month to recover. Although more pre- than post-DSP variables were retained as explanatory models of neurocognitive performance overall, recovery over time could not be explained by any one of the measured covariates. Tests of cognitive flexibility could be used in clinical settings as a proxy measure for recovery of driving ability. Regulatory authorities should also consider the implications of these results for the period of nondriving advised after ingestion of CNS-D in overdose. Future research, with adequate sample size, should examine contributions of other variables to the pattern of recovery over time.

  8. The frequency and outcome of neuropathies among HIV/AIDS adults treated at a tertiary hospital in Kaduna State, Nigeria.

    PubMed

    Obiako, O R; Ogoina, D; Abubakar, S A; Muktar, H M; Sheikh, T L; Tabi-Ajayi, E; Kehinde, J A; Iwuozo, E U; Musa, B O P

    2014-12-01

    Highly active antiretroviral therapy (HAART) has been shown to reduce AIDS- defining illnesses, including neuropathies. However, it has been postulated that an increase in age -, HIV- and HAART- related neurological complications will occur as HIV-infected persons live longer. This study investigated the frequency and outcome of neuropathies in relation to CD4+ cell count and HAART status of hospitalised HIV/AIDS patients in Shika. Consecutive adult (e"15 years) non pregnant HIV- infected patients treated at Ahmadu Bello University Teaching Hospital Shika-Zaria from January 2006 to May 2013 with neuropathies were studied. Non HIV-infected patients with neurological disorders and HIV-infected patients without neuropathies were excluded. Of 5240 HIV/AIDS patients seen , 11% (566) presented with neuropathy at median CD4+ cell counts of 200 cells / ul, with yearly reduction of the frequency of patients with neuropathy from 3.9% in 2006 to 0.06% in 2013. Male: female ratio was 2:1 and respective mean years were 41.9±10.1: 45.3±17.4 (p<0.00). 253 (45%) were on HAART at presentation. 40 patients died and the mortality was associated with recurrent seizures, CD4+ cell counts d" 100 / ul, male sex, HAART-naivety and presence of co-morbidity and complications. The progressive reduction in the yearly frequency of neuropathy among HIV/AIDS patients suggests a beneficial effect of HAART on neuropathies. However, late presentation, low CD4+ cell counts and failure of patients to start HAART early were responsible for AIDS-related mortality thus highlighting the importance of early HIV screening and treatment.

  9. Hospital length-of-stay and costs among pulmonary embolism patients treated with rivaroxaban versus parenteral bridging to warfarin.

    PubMed

    Weeda, Erin R; Wells, Philip S; Peacock, W Frank; Fermann, Gregory J; Baugh, Christopher W; Ashton, Veronica; Crivera, Concetta; Wildgoose, Peter; Schein, Jeff R; Coleman, Craig I

    2017-04-01

    We sought to compare length-of-stay (LOS), total hospital costs, and readmissions among pulmonary embolism (PE) patients treated with rivaroxaban versus parenterally bridged warfarin. We identified adult PE (primary diagnostic code = 415.1x) patients in the Premier Database (11/2012-9/2015), and included those with ≥1 PE diagnostic test on days 0-2. Rivaroxaban users (allowing ≤2 days of prior parenteral therapy) were 1:1 propensity score matched to patients parenterally bridged to warfarin. LOS, total costs, and readmission for venous thromboembolism (VTE) or major bleeding within the same or subsequent 2 months were compared between cohorts. Separate analyses were performed in low-risk PE patients. Rivaroxaban use was associated with a 1.4-day [95 % confidence interval (CI) -1.47 to -1.28] shorter LOS, and $2322 (95 % CI -$2499 to -$2146) reduction in costs compared to parenterally bridged warfarin (p < 0.001 for both). There was no difference in readmission for VTE (1.5 versus 1.7 %) or major bleeding (0.3 versus 0.2 %) between the rivaroxaban and parenterally bridged warfarin cohorts (p ≥ 0.27 for both). Results were similar in low-risk patients (0.2-1.0 day and $251-$1751 reductions in LOS and costs, respectively, p ≤ 0.01 for all). In patients with PE, rivaroxaban was associated with reduced LOS and costs, without increased risk of readmission versus parenterally bridged warfarin. Similar results were observed in low-risk PE patients.

  10. A mixed methods pilot study to investigate the impact of a hospital-specific iPhone application (iTreat) within a British junior doctor cohort.

    PubMed

    Payne, Karl Fb; Weeks, Lucy; Dunning, Paul

    2014-03-01

    We present a pilot study to investigate the impact of introducing a hospital-specific smartphone application into a cohort of British junior doctors. We created the iPhone application 'iTreat' that contained disease management and antibiotic dosing guidelines specific to our hospital, together with a postgraduate education department really simple syndication feed, a contact number phonebook and a favourites section. This intervention was trialled in a group of 39 foundation grade junior doctors, in a UK hospital, for a time period of 4 months. Mixed methods data capture, utilising survey and semi-structured interviews, was used to evaluate application usage patterns and potential barriers to endorsement of smartphone technology in the hospital setting. Sixty eight per cent of participants felt the application saved them time during clinical activities, with a decrease in the frequency of participants not referring to hospital clinical guidelines. The findings from this pilot study point towards the internal hospital environment as having a major impact upon smartphone usage. Participants viewed smartphone use as unprofessional in the ward-based setting, with a perceived negative attitude from other healthcare staff. An understanding of how healthcare staff choose to utilise smartphones in the clinical environment is crucial to enable the successful assimilation of smartphone technology into the hospital setting. This pilot study provides experience and parameters for future substantive studies being carried out by this group.

  11. Korean Affairs Report

    DTIC Science & Technology

    2007-11-02

    publications contain information primarily from foreign newspapers, periodicals and books, but also from news agency transmissions and broadcasts...Pyongyang Domestic Service, 23 Dec 86) l Commentary on White Paper About Kumgangsan Dam (Cho Tu-ul; Pyongyang Domestic Service, 26 Dec 86) 3 Party...ruin. /8309 CSO: 4110/056 INTER-KOREAN AFFAIRS COMMENTARY ON WHITE PAPER ABOUT KUMGANGSAN DAM SK280105 Pyongyang Domestic Service in Korean 1150

  12. Korean Affairs Report.

    DTIC Science & Technology

    2007-11-02

    Korea has fortified all the frontline areas, building underground positions and concealing various weapons. It is even constructing gun positions...also noted that North Korean Frog missiles and self-propelled guns posted just north of the DMZ can hit Seoul directly. North Korean engineer...being major figures in radical student movement. They include U Su- chin , 22, of Songgyung- wan University who is also chairman of the radical student

  13. [Ways to make cooperation between hospital nurse and home visiting nurse in treating a final stage cancer patient at home].

    PubMed

    Nagai, Hamae; Ohori, Yoko; Shino, Satoko; Marutani, Harumi; Numata, Kumiko; Sato, Yasutomo

    2005-12-01

    Due to a payment system based on Comprehensive Medical Evaluation has been adopted, both a shorter hospitalization and the use of home nursing care have been increasing. A good cooperation between hospital and home visiting nurses is desired in order to transfer continued nursing. Regarding a home nursing care service for the most terminal cancer patients, we conducted a survey of 459 home visiting nurses with twelve questions in five categories: (1) Before transferring to home care, (2) Right after the transfer to home care, (3) Patient in a stable period, (4) Time of near death and (5) Other (Requests to hospital nurses). The following issues became clearer in terms of how hospital and home visiting nurses should be cooperating with the handling of last stage terminal cancer patients: (1) A home visiting nurse should have a coordinating role with a hospital nurse when the patient is discharged from the hospital. (2) A participation of home visiting nurses on the coordination guidance at the time of a patient discharge is influenced by a manpower of the nursing station. (3) Even though home visiting nurses found a discrepancy between the hospital information and what patients and their families were getting from the hospital, home visiting nurses have learned through the job to clarify what patient and family needs were, and they responded accordingly. (4) A coordination between hospital and home visiting nurses was needed quite often when the patient's time has come to die at home.

  14. blaVIM-2 Cassette-Containing Novel Integrons in Metallo-β-Lactamase-Producing Pseudomonas aeruginosa and Pseudomonas putida Isolates Disseminated in a Korean Hospital

    PubMed Central

    Lee, Kyungwon; Lim, Jong Back; Yum, Jong Hwa; Yong, Dongeun; Chong, Yunsop; Kim, June Myung; Livermore, David M.

    2002-01-01

    We investigated the phenotypic and genetic properties of metallo-β-lactamase-producing Pseudomonas isolates collected at a tertiary-care hospital in Korea since 1995. The prevalence of imipenem resistance among Pseudomonas aeruginosa isolates reached 16% in 1997, when 9% of the resistant organisms were found to produce VIM-2 β-lactamase, a class B enzyme previously found only in P. aeruginosa isolates from Europe. VIM-2-producing isolates of Pseudomonas putida were also detected. Resistance was transferable from both these species to P. aeruginosa PAO4089Rp by filter mating, although the resistance determinant could not be found on any detectable plasmid. Serotyping showed that many of the VIM-2-producing P. aeruginosa isolates belonged to serotypes O:11 and O:12, and pulsed-field gel electrophoresis of XbaI-digested genomic DNA revealed that many had identical profiles, whereas the P. putida isolates were diverse. Sequencing showed that the blaVIM-2 genes resided as cassettes in class 1 integrons. In contrast to previous VIM-encoding integrons, the integron sequenced from a P. aeruginosa isolate had blaVIM located downstream of a variant of aacA4. blaVIM also lay in a class 1 integron in a representative P. putida strain, but the organization of this integron was different from that sequenced from the P. aeruginosa strain. In conclusion, the metallo-β-lactamase produced by these imipenem-resistant Pseudomonas isolates was VIM-2, and the accumulation of producers reflected clonal dissemination as well as horizontal spread. Strict measures are required in order to control a further spread of resistance. PMID:11897589

  15. Koreans in Japan: Their Influence on Korean-Japanese Relations.

    DTIC Science & Technology

    1979-09-01

    realization that their homeland was a far cry from heaven. More and more people came to see 23 the reality, that food and shelter were not readily available...exclusive or militant but are strongly individualistic and perservering , and they are adaptable and disunited. 84 The Korean disposition is attributed to the...District in China are surprised that they maintain the Korean style of living almost completely, speaking Korean, eating Korean food , living in ondol

  16. A retrospective study of length of hospital stay in infants treated for neonatal abstinence syndrome with methadone versus oral morphine preparations.

    PubMed

    Lainwala, Shabnam; Brown, Elizabeth R; Weinschenk, Nancy P; Blackwell, Mary T; Hagadorn, James I

    2005-10-01

    Length of hospital stay (LOS) of infants treated for neonatal abstinence syndrome (NAS) with methadone was compared to LOS of those treated with an oral morphine preparation (OMP, neonatal morphine solution, or deodorized tincture of opium). A retrospective review of medical records of infants treated for NAS due to in utero exposure to methadone and/or illicit drugs such as heroin or morphine was performed for birthweight, neonatal abstinence scores, infant and maternal illicit drug exposure history, maternal methadone dose (if any), and details of treatment. Length of stay was the primary outcome measure. Forty-six infants met the inclusion criteria. The median LOS of infants treated with methadone versus OMP was not significant (P > 0.05). Prolonged LOS was associated with larger pharmacological treatment doses required to control withdrawal symptoms, larger maternal methadone dose, and increased birthweight. After adjusting for these factors, exposure to opioids in utero, maternal nicotine use, hospital of treatment, severity of withdrawal symptoms, and foster care placement were not significantly associated with LOS in univariate or multivariate analyses. These results suggest that infants treated with OMP or methadone have similar LOS. Longer LOS is associated with both higher maternal methadone doses and higher opioid treatment dose requirements after birth. The potential effect of maternal methadone dose on neonatal LOS should be considered when treating expectant mothers on methadone maintenance therapy.

  17. The Incremental Hospital Cost and Length-of-Stay Associated with Treating Adverse Events Among Medicare Beneficiaries Undergoing Cervical Spinal Fusion during Fiscal Year 2013 and 2014.

    PubMed

    Culler, Steven D; McGuire, Kevin J; Little, Kenneth M; Jevsevar, David; Shea, Kevin; Schlosser, Michael; Ambrose, Karen E; Simon, April W

    2017-06-06

    A retrospective study. To report the incremental hospital resources consumed with treating adverse events experienced by Medicare beneficiaries undergoing a two or three vertebrae level cervical spinal fusion. Hospitals are increasingly at financial risk for patients experiencing adverse events due "pay for performance". Little is known about incremental resources consumed when treating patients who experienced an adverse event following cervical spinal fusions. Fiscal years 2013 and 2014 Medicare Provider Analysis and Review file was used to identify 86,265 beneficiaries who underwent 2 or 3 vertebrae level cervical spinal fusion. International Classification of Diseases-9-Clinical Modification diagnostic and procedure codes were used to identify ten adverse events. This study estimated both the observed and risk-adjusted incremental hospital resources consumed (cost (2014 US $) and length-of-stay [LOS]) in treating beneficiaries experiencing each adverse event. Overall, 6.2% of beneficiaries undergoing cervical spinal fusion experienced at least one of the study's adverse events. Beneficiaries experiencing any complication consumed significantly more hospital resources (incremental cost of $28,638) and had longer LOS (incremental stays of 9.1 days). After adjusting for patient demographics and comorbid conditions, incremental cost of treating adverse events ranged from a high of $42,358 (infection) to a low of $10,100 (dural tear). Adverse events frequently occur and add substantially to the hospital costs of patients undergoing cervical spinal fusion. Shared decision-making instruments should clearly provide these risk estimates to the patient prior to surgical consideration. Investment in activities that have been shown to reduce specific adverse events is warranted, and this study may allow health systems to prioritize performance improvement areas. 3.

  18. Pre-hospital midazolam for benzodiazepine-treated seizures before and after the Rapid Anticonvulsant Medication Prior to Arrival Trial: A national observational cohort study

    PubMed Central

    Silbergleit, Robert

    2017-01-01

    Background Implementation of evidence-based treatment for pre-hospital status epilepticus can improve outcomes. We hypothesized that publication of a pivotal pre-hospital clinical trial (RAMPART), demonstrating superiority of intramuscular midazolam over intravenous lorazepam, altered the national utilization rates of midazolam for pre-hospital benzodiazepine-treated seizures, while upholding its safety and efficacy outside the trial setting. Methods and findings This is a retrospective, observational cohort study of pre-hospital patient encounters throughout the United States in the National Emergency Medicine Services Information System database, from January 2010 through December 2014. We compared the rates and odds of midazolam use as first-line treatment among all adult and pediatric benzodiazepine-treated seizures before and after RAMPART publication (February 2012). Secondary analyses were conducted for rates of airway interventions and rescue therapy, as proxies for safety and efficacy of seizure termination. 156,539 benzodiazepine-treated seizures were identified. Midazolam use increased from 26.1% in January 2010 to 61.7% in December 2014 (difference +35.6%, 95% CI, 32.7%-38.4%). The annual rate of midazolam adoption increased significantly from 5.9% per year to 8.9% per year after the publication of RAMPART (difference +3.0% per year; 95%CI, 1.6%-4.5% per year; adjusted OR 1.24; 95%CI, 1.17–1.32). Overall frequency of rescue therapy and airway interventions changed little after the publication of RAMPART. Conclusions These data are consistent with effective, ongoing, but incomplete clinical translation of the RAMPART results. The effects of the trial, however, cannot be isolated. The study was limited by broad inclusion of all benzodiazepine-treated seizures as well as a lack of information on route of drug of administration. The safety and effectiveness of midazolam for benzodiazepine-treated seizures in prehospital clinical practice appear consistent

  19. Pre-hospital midazolam for benzodiazepine-treated seizures before and after the Rapid Anticonvulsant Medication Prior to Arrival Trial: A national observational cohort study.

    PubMed

    Shtull-Leber, Eytan; Silbergleit, Robert; Meurer, William J

    2017-01-01

    Implementation of evidence-based treatment for pre-hospital status epilepticus can improve outcomes. We hypothesized that publication of a pivotal pre-hospital clinical trial (RAMPART), demonstrating superiority of intramuscular midazolam over intravenous lorazepam, altered the national utilization rates of midazolam for pre-hospital benzodiazepine-treated seizures, while upholding its safety and efficacy outside the trial setting. This is a retrospective, observational cohort study of pre-hospital patient encounters throughout the United States in the National Emergency Medicine Services Information System database, from January 2010 through December 2014. We compared the rates and odds of midazolam use as first-line treatment among all adult and pediatric benzodiazepine-treated seizures before and after RAMPART publication (February 2012). Secondary analyses were conducted for rates of airway interventions and rescue therapy, as proxies for safety and efficacy of seizure termination. 156,539 benzodiazepine-treated seizures were identified. Midazolam use increased from 26.1% in January 2010 to 61.7% in December 2014 (difference +35.6%, 95% CI, 32.7%-38.4%). The annual rate of midazolam adoption increased significantly from 5.9% per year to 8.9% per year after the publication of RAMPART (difference +3.0% per year; 95%CI, 1.6%-4.5% per year; adjusted OR 1.24; 95%CI, 1.17-1.32). Overall frequency of rescue therapy and airway interventions changed little after the publication of RAMPART. These data are consistent with effective, ongoing, but incomplete clinical translation of the RAMPART results. The effects of the trial, however, cannot be isolated. The study was limited by broad inclusion of all benzodiazepine-treated seizures as well as a lack of information on route of drug of administration. The safety and effectiveness of midazolam for benzodiazepine-treated seizures in prehospital clinical practice appear consistent with trial data, which should encourage

  20. A Survey of Pediatric CT Protocols and Radiation Doses in South Korean Hospitals to Optimize the Radiation Dose for Pediatric CT Scanning.

    PubMed

    Hwang, Jae-Yeon; Do, Kyung-Hyun; Yang, Dong Hyun; Cho, Young Ah; Yoon, Hye-Kyung; Lee, Jin Seong; Koo, Hyun Jung

    2015-12-01

    Children are at greater risk of radiation exposure than adults because the rapidly dividing cells of children tend to be more radiosensitive and they have a longer expected life time in which to develop potential radiation injury. Some studies have surveyed computed tomography (CT) radiation doses and several studies have established diagnostic reference levels according to patient age or body size; however, no survey of CT radiation doses with a large number of patients has yet been carried out in South Korea. The aim of the present study was to investigate the radiation dose in pediatric CT examinations performed throughout South Korea. From 512 CT (222 brain CT, 105 chest CT, and 185 abdominopelvic CT) scans that were referred to our tertiary hospital, a dose report sheet was available for retrospective analysis of CT scan protocols and dose, including the volumetric CT dose index (CTDIvol), dose-length product (DLP), effective dose, and size-specific dose estimates (SSDE). At 55.2%, multiphase CT was the most frequently performed protocol for abdominopelvic CT. Tube current modulation was applied most often in abdominopelvic CT and chest CT, accounting for 70.1% and 62.7%, respectively. Regarding the CT dose, the interquartile ranges of the CTDIvol were 11.1 to 22.5 (newborns), 16.6 to 39.1 (≤1 year), 14.6 to 41.7 (2-5 years), 23.5 to 44.1 (6-10 years), and 31.4 to 55.3 (≤15 years) for brain CT; 1.3 to 5.7 (≤1 year), 3.9 to 6.8 (2-5 years), 3.9 to 9.3 (6-10 years), and 7.7 to 13.8 (≤15 years) for chest CT; and 4.0 to 7.5 (≤1 year), 4.2 to 8.9 (2-5 years), 5.7 to 12.4 (6-10 years), and 7.6 to 16.6 (≤15 years) for abdominopelvic CT. The SSDE and CTDIvol were well correlated for patients <5 years old, whereas the CTDIvol was lower in patients ≥6 years old. Our study describes the various parameters and dosimetry metrics of pediatric CT in South Korea. The CTDIvol, DLP, and effective dose were generally lower than in German and UK surveys, except in

  1. American Influence on Korean Education.

    ERIC Educational Resources Information Center

    Kim, Hyung-chan

    1982-01-01

    Discusses American influences on Korean education, considering the influence of American Protestant missionaries (1886-1945), relationship between American military government and Korean education, and educational cooperation between Korea and America since 1948. (JN)

  2. Health service utilization costs for borderline personality disorder patients treated with psychoanalytically oriented partial hospitalization versus general psychiatric care.

    PubMed

    Bateman, Anthony; Fonagy, Peter

    2003-01-01

    The authors assessed health care costs associated with psychoanalytically oriented partial hospital treatment for borderline personality disorder compared with treatment as usual within general psychiatric services. Health care utilization of all borderline personality disorder patients who participated in a previous trial of partial hospital treatment compared with treatment as usual was assessed by using information from case notes and service providers. Costs were compared for the 6 months before treatment, 18 months of treatment, and an 18-month follow-up period. There were no cost differences between the groups during pretreatment or treatment. Costs of partial hospital treatment were offset by less psychiatric inpatient care and reduced emergency room treatment. The trend for costs to decrease in the partial hospitalization group during the follow-up period was not apparent in the treatment-as-usual group. Specialist partial hospital treatment for borderline personality disorder is no more expensive than treatment as usual and shows considerable cost savings after treatment.

  3. Forced arterial suction thrombectomy with the penumbra reperfusion catheter in acute basilar artery occlusion: a retrospective comparison study in 2 Korean university hospitals.

    PubMed

    Eom, Y-I; Hwang, Y-H; Hong, J M; Choi, J W; Lim, Y C; Kang, D-H; Kim, Y-W; Kim, Y-S; Kim, S Y; Lee, J S

    2014-12-01

    A performance of forced arterial suction thrombectomy was not reported for the treatment of acute basilar artery occlusion. This study compared revascularization performance between intra-arterial fibrinolytic treatment and forced arterial suction thrombectomy with a Penumbra reperfusion catheter in patients with acute basilar artery occlusion. Fifty-seven patients with acute basilar artery occlusion were treated with intra-arterial fibrinolysis (n = 25) or forced arterial suction thrombectomy (n = 32). Baseline characteristics, successful revascularization rate, and clinical outcomes were compared between the groups. Baseline characteristics, the frequency of patients receiving intravenous recombinant tissue plasminogen activator, and mean time interval between symptom onset and femoral puncture did not differ between groups. The forced arterial suction thrombectomy group had a shorter procedure duration (75.5 minutes versus 113.3 minutes, P = .016) and higher successful revascularization rate (88% versus 60%, P = .017) than the fibrinolysis group. Fair outcome, indicated by a modified Rankin Scale 0-3, at 3 months was achieved in 34% of patients undergoing forced arterial suction thrombectomy and 8% of patients undergoing fibrinolysis (P = .019), and the mortality rate was significantly higher in the fibrinolysis group (25% versus 68%, P = .001). Multiple logistic regression analysis identified the forced arterial suction thrombectomy method as an independent predictor of fair outcome with adjustment for age, sex, initial NIHSS score, and the use of intravenous recombinant tissue plasminogen activator (odds ratio, 7.768; 95% CI, 1.246-48.416; P = .028). In acute basilar artery occlusion, forced arterial suction thrombectomy demonstrated a higher revascularization rate and improved clinical outcome compared with traditional intra-arterial fibrinolysis. Further clinical trials with the newer Penumbra catheter are warranted. © 2014 by American Journal of

  4. Exposure to an atomic bomb explosion is a risk factor for in-hospital death after esophagectomy to treat esophageal cancer.

    PubMed

    Nakashima, Y; Takeishi, K; Guntani, A; Tsujita, E; Yoshinaga, K; Matsuyama, A; Hamatake, M; Maeda, T; Tsutsui, S; Matsuda, H; Ishida, T

    2015-01-01

    Esophagectomy, one of the most invasive of all gastrointestinal operations, is associated with a high frequency of postoperative complications and in-hospital mortality. The purpose of the present study was to determine whether exposure to the atomic bomb explosion at Hiroshima in 1945 might be a preoperative risk factor for in-hospital mortality after esophagectomy in esophageal cancer patients. We thus reviewed the outcomes of esophagectomy in 31 atomic bomb survivors with esophageal cancer and 96 controls (also with cancer but without atomic bomb exposure). We compared the incidences of postoperative complications and in-hospital mortality. Of the clinicopathological features studied, mean patient age was significantly higher in atomic bomb survivors than in controls. Of the postoperative complications noted, atomic bomb survivors experienced a longer mean period of endotracheal intubation and higher incidences of severe pulmonary complications, severe anastomotic leakage, and surgical site infection. The factors associated with in-hospital mortality were exposure to the atomic bomb explosion, pulmonary comorbidities, and electrocardiographic abnormalities. Multivariate analysis revealed that exposure to the atomic bomb explosion was an independent significant preoperative risk factor for in-hospital mortality. Exposure to the atomic bomb explosion is thus a preoperative risk factor for in-hospital death after esophagectomy to treat esophageal cancer. © 2013 Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.

  5. Baseball-related injuries to children treated in hospital emergency departments in the United States, 1994-2006.

    PubMed

    Lawson, Bradley R; Comstock, R Dawn; Smith, Gary A

    2009-06-01

    To describe the epidemiology of baseball-related injuries among children in the United States. This was a retrospective analysis of data for children younger than 18 years of age from the National Electronic Injury Surveillance System (NEISS) of the Consumer Product Safety Commission from 1994 through 2006. Sample weights provided by the NEISS were used to calculate national estimates of baseball-related injuries. Injury rates were calculated according to age group by using both population and baseball-participation data. An estimated 1 596 000 (95% confidence interval: 1 330 100-1 861 800) children younger than 18 years were treated in US hospital emergency departments for baseball-related injuries during the 13-year period from 1994 through 2006. During the study period, the annual number of injuries declined by 24.9%, and the annual injury rate for children younger than 18 years decreased significantly (P < .000). The most commonly injured body parts were the face (33.5%) and the upper extremity (32.4%). The most common injury diagnoses were soft tissue injury (34.3%) and fracture (18.4%). The most common mechanism of injury was being hit by the baseball (46.0%). Children in the 9- to 12-year age group had the highest injury rate (2.4 per 1000 population). When injury rates were calculated by using baseball-participation data (2003), children in the 12- to 17-year age group had a higher injury rate (19.8 per 1000 participants) than those in the 6- to 11-year age group (12.1 per 1000 participants). Youth baseball is a relatively safe sport for children. Although injury rates and the total number of injuries declined during the study period, our findings indicate that there are opportunities for making baseball an even safer sport for children. We recommend that all youth baseball players wear properly fitted mouth guards, that all leagues, schools, and parks install safety bases, that all batters use helmets with face shields, and that all players use safety

  6. Current status of diabetic peripheral neuropathy in Korea: report of a hospital-based study of type 2 diabetic patients in Korea by the diabetic neuropathy study group of the korean diabetes association.

    PubMed

    Won, Jong Chul; Kim, Sang Soo; Ko, Kyung Soo; Cha, Bong-Yun

    2014-02-01

    Diabetic peripheral neuropathy (DPN) is the most common complication associated with diabetes. DPN can present as a loss of sensation, may lead to neuropathic ulcers, and is a leading cause of amputation. Reported estimates of the prevalence of DPN vary due to differences in study populations and diagnostic criteria. Furthermore, the epidemiology and clinical characteristics of DPN in Korean patients with type 2 diabetes mellitus (T2DM) are not as well understood as those of other complications of diabetes such as retinal and renal disease. Recently, the Diabetic Neuropathy Study Group of the Korean Diabetes Association (KDA) conducted a study investigating the impact of DPN on disease burden and quality of life in patients with T2DM and has published some data that are representative of the nation. This review investigated the prevalence and associated clinical implications of DPN in Korean patients with diabetes based on the KDA study.

  7. "You Don't Need to Be Mean. We're Friends, Right?": Young Korean-American Children's Conflicts and References to Friendship

    ERIC Educational Resources Information Center

    Kim, Jinhee

    2014-01-01

    In the eyes of adults, conflicts between children are often treated as problematic social interactions that should be prevented. This study describes how young Korean-American children's conflict negotiation was a central part of their peer culture at a Korean heritage language school in the United States. Eleven young Korean-American children…

  8. Impact of chronic obstructive pulmonary disease on in-hospital morbidity and mortality in patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention.

    PubMed

    Șerban, Răzvan Constantin; Hadadi, Laszlo; Șuș, Ioana; Lakatos, Eva Katalin; Demjen, Zoltan; Scridon, Alina

    2017-09-15

    Patients with chronic obstructive pulmonary disease (COPD) presenting with ST-segment elevation myocardial infarction (STEMI) are less likely to beneficiate of primary percutaneous coronary intervention (pPCI), and have poorer prognosis. We aimed to evaluate the impact of COPD on the in-hospital outcomes of pPCI-treated STEMI patients. Data were collected from 418 STEMI patients treated by pPCI. Inotropics and diuretics usage, cardiogenic shock, asystole, kidney dysfunction, and left ventricular ejection fraction were used as markers of hemodynamic complications. Atrial and ventricular fibrillation, conduction disorders, and antiarrhythmics usage were used as markers of arrhythmic complications. In-hospital mortality was evaluated. The associations between these parameters and COPD were assessed. COPD was present in 7.42% of STEMI patients. COPD patients were older (p=0.02) and less likely to receive beta-blockers (OR 0.29; 95%CI 0.13-0.64; p<0.01). They had higher Killip class on admission (p<0.001), received more often inotropics (p<0.001) and diuretics (p<0.01), and presented more often atrial (p=0.01) and ventricular fibrillation (p=0.02). Unadjusted in-hospital mortality was higher in COPD patients (OR 4.18, 95%CI 1.55-11.30, p<0.01). After adjustment for potentially confounding factors except beta-blockers, COPD remained an independent predictor of in-hospital mortality (p=0.02). After further adjustment with beta-blocker therapy, no excess mortality was noted in COPD patients. Despite being treated by pPCI, COPD patients with STEMI are more likely to develop hemodynamic and arrhythmic complications, and have higher in-hospital mortality. This appears to be due to lower beta-blockers usage in COPD patients. Increasing beta-blockers usage in COPD patients with STEMI may improve survival. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  9. Safety-net versus private hospital setting for brain metastasis patients treated with radiosurgery alone: Disparities in follow-up care and outcomes.

    PubMed

    Diao, Kevin; Sun, Yanqing; Yoo, Stella K; Yu, Cheng; Ye, Jason C; Trakul, Nicholas; Jennelle, Richard L; Kim, Paul E; Zada, Gabriel; Gruen, John P; Chang, Eric L

    2017-09-13

    Stereotactic radiosurgery (SRS) alone is an increasingly accepted treatment for brain metastases, but it requires adherence to frequently scheduled follow-up neuroimaging because of the risk of distant brain metastasis. The effect of disparities in access to follow-up care on outcomes after SRS alone is unknown. This retrospective study included 153 brain metastasis patients treated consecutively with SRS alone from 2010 through 2016 at an academic medical center and a safety-net hospital (SNH) located in Los Angeles, California. Outcomes included neurologic symptoms, hospitalization, steroid use and dependency, salvage SRS, salvage whole-brain radiotherapy, salvage neurosurgery, and overall survival. Ninety-three of the 153 patients were private hospital (PH) patients, and 60 were SNH patients. The median follow-up time was 7.7 months. SNH patients received fewer follow-up neuroimaging studies (1.5 vs 3; P = .008). In a multivariate analysis, the SNH setting was a significant risk factor for salvage neurosurgery (hazard ratio [HR], 13.65; P < .001), neurologic symptoms (HR, 3.74; P = .002), and hospitalization due to brain metastases (HR, 6.25; P < .001). More clinical visits were protective against hospitalizations due to brain metastases (HR, 0.75; P = .002), whereas more neuroimaging studies were protective against death (HR, 0.65; P < .001). SNH patients with brain metastases treated with SRS alone had fewer follow-up neuroimaging studies and were at higher risk for neurologic symptoms, hospitalization for brain metastases, and salvage neurosurgery in comparison with PH patients. Clinicians should consider the practice setting and patient access to follow-up care when they are deciding on the optimal strategy for the treatment of brain metastases. Cancer 2017;. © 2017 American Cancer Society. © 2017 American Cancer Society.

  10. Involving physicians in TQM. To gain physician support for quality management, hospital administrators must treat physicians as customers.

    PubMed

    McCarthy, G J

    1993-12-01

    The process of integrating physicians into a hospital's total quality management (TQM) program is not simple. Physicians will not view TQM as an acceptable strategy in the absence of a positive working relationship with hospital managers. Physicians must see hospital managers as colleagues who can help improve their medical practices both in efficiency and patient care. The first step in involving physicians in TQM is creating an environment that enhances physician relationships. The CEO should be actively involved with the medical staff, and senior hospital managers should work at cultivating physician relationships. Physician needs and the centrality of the physician-management relationship should enter into every management discussion. Also, managers must solicit physician feedback regularly. Managers can introduce physicians to TQM by accompanying them to off-site TQM programs for a few days. Managers should also coordinate a continuing education program at the hospital, inviting a physician to address medical staff about TQM. Physicians are more likely to respond positively to one of their peers than they would to a consultant or business manager. Managers should then invite hospital-based physicians to participate on TQM interdisciplinary teams to resolve a problem chosen by the senior medical staff. The problem should be one that promises to be a quick fix, thereby ensuring demonstrable success of TQM and allaying any doubts. After an initial demonstration of TQM's success, the cycle is repeated. A year or two later, managers should invite off-site clinicians to join interdisciplinary teams on issues important to them.

  11. Lower Body Mass Index is a Risk Factor for In-Hospital Mortality of Elderly Japanese Patients Treated with Ampicillin/sulbactam.

    PubMed

    Miura, Makoto; Kuwahara, Akiko; Tomozawa, Akinori; Omae, Naoki; Yamamori, Motohiro; Kadoyama, Kaori; Sakaeda, Toshiyuki

    2016-01-01

    Objectives: A retrospective examination was conducted to identify risk factors for in-hospital mortality of elderly patients (65 years or older) treated with the beta-lactam/beta-lactamase inhibitor combination antibiotic, ampicillin/sulbactam (ABPC/SBT). Methods: Clinical data from 96 patients who were hospitalized with infectious diseases and treated with ABPC/SBT (9 g/day or 12 g/day) were analyzed. Risk factors examined included demographic and clinical laboratory parameters. Parameter values prior to treatment and changes after treatment were compared between survivors and non-survivors. Results: The study patients had an average age of 81.9±8.4 years (±SD) and body mass index (BMI) of 19.9±4.2 kg/m(2). They were characterized by anemia (low hemoglobin and hematocrit levels), inflammation (high leukocyte count, neutrophil count, C-reactive protein level, and body temperature), and hepatic and renal dysfunction (high aspartate aminotransferase, alanine aminotransferase and blood urea nitrogen levels). The BMI of non-survivors, 16.2±2.9 kg/m(2), was lower than that of survivors, 20.4±4.1 kg/m(2). In addition, the hematological parameters deteriorated more remarkably, inflammation markers were not altered (or the decrease was marginal), and hepatic function was not improved, in non-survivors. Conclusions: A lower BMI value is a risk factor for in-hospital mortality of elderly patients treated with ABPC/SBT.

  12. [Dentistry in Korean during the Japanese occupation].

    PubMed

    Shin, Jae-Eu

    2004-12-01

    The Japanese introduction of dentistry into Korea was for treating the Japanese residing in Korea Noda-Oji was the first Japanese dentist for Japanese people in Korea in 1893, and Narajaki doyoyo, an invited dentist was posted in the Korean headquarter of Japanese army in September, 1905. The imperialist Japan licensed the dental technicians (yipchisa) without limit and controlled them generously so they could practice dentistry freely. This measure was contrary to that in Japan. (In Japan no new dental technician was licensed.) Komori, a dental technician opened his laboratory at Chungmuro in 1902. The dental technician had outnumbered by 1920. In 1907, the first Korean dental technician Sung-Ryong Choi practiced dentistry in Jongno. The imperialist Japan made the regulations for dental technicians to set a limit to the advertisement and medical practice of dental technicians. The first Korean dentists Suk-Tae Ham was register No. 1 in the dentist license. The Kyungsung dental school was established by Nagira Dasoni for the purpose of educating some Korean people that contributed to Japanese colonization. It made progress with the help of Japan, it was was given the approval of the establishment of the professional school in January the 25th, 1929. It was intended to produce Korean dentists in the first place but became the school for Japanese students later on. The association of Chosun dentist, which had been founded by Narajaki doyoyo, was managed by Japanese dentists in favor of the colonial ruling. The Hansung Association of Dentists established in 1925 was the organization made by the necessity of the association for Koreans only. The Japanese forcefully annexed the Association of Hansung Dentists (Koreans only) to the Association of Kyungsung Dentists to avoid collective actions of Korean dentists in the name of 'Naesunilche' -- 'Japan and Korea and one'. Their invading intention was shown in the event of 'decayed tooth preventive day'. Japanese controlled

  13. Depression and Korean American immigrants.

    PubMed

    Park, So-Youn; Bernstein, Kunsook Song

    2008-02-01

    Koreans are a relatively new and fast-growing immigrant group in the United States. Research has shown that immigration experiences are associated with depression, whereas acculturation and social support are moderating factors. Korean culture is informed by Confucianism, which emphasizes family integrity, group conformity, and traditional gender roles, and has influenced how Korean immigrants conceptualize depression, express depressive symptoms, and demonstrate help-seeking behavior. An understanding of Korean patterns of manifesting and expressing depression will be helpful to provide culturally appropriate mental health services to Korean American immigrants.

  14. Korean Hemorrhagic Fever.

    DTIC Science & Technology

    Korean hemorrhagic fever (KHF) occurred for the first time in Korea , 1951, although it had previously been known to both the Japanese and Russians...After Korean war, the disease has been fixed in the areas of DMZ as an endemic one, and from 100 to 300 cases have been reported every year. The aims...but in 1971 affected the middle districts and in 1972 invaded the southern parts of South Korea . The number of patients and the areas of KHF in 1972

  15. [Vacuum assisted closure therapy in dehiscence of abdominal wound after cesarean section treated in a hospital-at-home].

    PubMed

    Sánchez-Cabezón, Carmen; Montes-Olangua, Maria Isabel; García-Suarez, Sara; García-Carretero, Rafael

    2013-01-01

    The Hospital at Home is a range of hospital care provided to patients in the comfort of their own homes, so patient and family can actively participate in the process. Cesarean section is a surgical procedure that requires a short hospital stay. However if complications arise during the process, such as a dehiscence of surgical wound, the hospital stay is prolonged, delaying mother-child bonding, which is very important for the growth of the child. Nursing care in wound healing by secondary intention is a priority for the patient's recovery. VAC therapy (vacuum assisted closure) promotes a rapid recovery, although it requires dressings and active medical surveillance, as well as training by the nursing staff for carrying it out at home. We describe the outcome and the process of the healing of a surgical wound after cesarean section, not only because of a complex wound, but the previously mentioned factors that make us consider the Hospital at Home as the best alternative care.

  16. Incidence of and risk factors for newly diagnosed hyperkalemia after hospital discharge in non-dialysis-dependent CKD patients treated with RAS inhibitors

    PubMed Central

    Saito, Yuki; Nakajima, Hideki; Takahashi, Osamu; Komatsu, Yasuhiro

    2017-01-01

    Introduction Renin-angiotensin system (RAS) inhibitors have been increasingly prescribed due to their beneficial effects on end-organ protection. Iatrogenic hyperkalemia is a well-known life-threatening complication of RAS inhibitor use in chronic kidney disease (CKD) patients. We hypothesized that CKD patients treated with RAS inhibitors frequently develop hyperkalemia after hospital discharge even if they were normokalemic during their hospitalization because their lifestyles change substantially after discharge. The present study aimed to examine the incidence of newly diagnosed hyperkalemia, the timing of hyperkalemia, and its risk factors in CKD patients treated with RAS inhibitors at the time of hospital discharge. Methods We retrospectively enrolled patients aged 20 years or older with CKD G3-5 (estimated glomerular filtration rate < 60 mL/min/1.73 m2) and who were treated with RAS inhibitors and discharged from St. Luke’s International Hospital between July 2011 and December 2015. Patients who were under maintenance dialysis or had hyperkalemic events before discharge were excluded. Data regarding the patients’ age, sex, CKD stage, diabetes mellitus status, malignancy status, combined use of RAS inhibitors, concurrent medication, and hyperkalemic events after discharge were extracted from the hospital database. Our primary outcome was hyperkalemia, defined as serum potassium ≥ 5.5 mEq/L. Multiple logistic regression and Kaplan-Meier analyses were performed to identify the risk factors for and the timing of hyperkalemia, respectively. Results Among the 986 patients, 121 (12.3%) developed hyperkalemia after discharge. In the regression analysis, relative to CKD G3a, G3b [odds ratio (OR): 1.88, 95% confidence interval 1.20–2.97] and G4-5 (OR: 3.40, 1.99–5.81) were significantly associated with hyperkalemia. The use of RAS inhibitor combinations (OR: 1.92, 1.19–3.10), malignancy status (OR: 2.10, 1.14–3.86), and baseline serum potassium (OR: 1

  17. Risk Factors for Bleeding in Hospitalized at Risk Patients With an INR of 5 or More Treated With Vitamin K Antagonists

    PubMed Central

    Liabeuf, Sophie; Scaltieux, Lucie-Marie; Masmoudi, Kamel; Roussel, Bertrand; Moragny, Julien; Andrejak, Michel; Gras-Champel, Valérie

    2015-01-01

    Abstract Various predictive scores for vitamin K antagonist (VKA)-related bleeding have been developed and validated in outpatients and in patients treated for specific indications (when VKAs are used under optimal therapeutic conditions). However, there are few published data on the evaluation of bleeding risk factors in hospitalized, at-risk patients (with a high international normalized ratio [INR]) treated with VKAs. The objective of the present study was to identify the most relevant bleeding risk factors in 906 VKA-treated patients with an INR of 5 or more hospitalized in a French university medical center. Over a 2-year period, we screened all consecutive VKA-treated adults with a risk of major bleeding (defined as an INR ≥ 5 on admission). Demographic and clinical characteristics, medications, and bleeding characteristics were recorded prospectively. The overall incidence of bleeding was 26.6% (serious bleeding: 21.4%; fatal bleeding: 5.4%). An INR ≥ 8.5, a history of recent digestive tract lesions, trauma in the preceding 2 weeks, and known noncompliance were independent risk factors for bleeding and serious bleeding. Our present findings emphasize that VKAs should not be prescribed to patients with a high risk of bleeding (noncompliant patients and those with recent trauma or recent gastrointestinal lesions). It is essential to monitor the INR on a frequent basis and adjust oral anticoagulant treatment appropriately. PMID:26717378

  18. Risk Factors for Bleeding in Hospitalized at Risk Patients With an INR of 5 or More Treated With Vitamin K Antagonists.

    PubMed

    Liabeuf, Sophie; Scaltieux, Lucie-Marie; Masmoudi, Kamel; Roussel, Bertrand; Moragny, Julien; Andrejak, Michel; Gras-Champel, Valérie

    2015-12-01

    Various predictive scores for vitamin K antagonist (VKA)-related bleeding have been developed and validated in outpatients and in patients treated for specific indications (when VKAs are used under optimal therapeutic conditions). However, there are few published data on the evaluation of bleeding risk factors in hospitalized, at-risk patients (with a high international normalized ratio [INR]) treated with VKAs. The objective of the present study was to identify the most relevant bleeding risk factors in 906 VKA-treated patients with an INR of 5 or more hospitalized in a French university medical center.Over a 2-year period, we screened all consecutive VKA-treated adults with a risk of major bleeding (defined as an INR ≥ 5 on admission). Demographic and clinical characteristics, medications, and bleeding characteristics were recorded prospectively.The overall incidence of bleeding was 26.6% (serious bleeding: 21.4%; fatal bleeding: 5.4%). An INR ≥ 8.5, a history of recent digestive tract lesions, trauma in the preceding 2 weeks, and known noncompliance were independent risk factors for bleeding and serious bleeding.Our present findings emphasize that VKAs should not be prescribed to patients with a high risk of bleeding (noncompliant patients and those with recent trauma or recent gastrointestinal lesions). It is essential to monitor the INR on a frequent basis and adjust oral anticoagulant treatment appropriately.

  19. Comparison of anal cancer outcomes in public and private hospital patients treated at a single radiation oncology center

    PubMed Central

    Bitterman, Danielle S.; Grew, David; Gu, Ping; Cohen, Richard F.; Sanfilippo, Nicholas J.; Leichman, Cynthia G.; Leichman, Lawrence P.; Moore, Harvey G.; Gold, Heather T.

    2015-01-01

    Objective To compare clinical and treatment characteristics and outcomes in locally advanced anal cancer, a potentially curable disease, in patients referred from a public or private hospital. Methods We retrospectively reviewed 112 anal cancer patients from a public and a private hospital who received definitive chemoradiotherapy at the same cancer center between 2004 and 2013. Tumor stage, radiotherapy delay, radiotherapy duration, and unplanned treatment breaks ≥10 days were compared using t-test and χ2 test. Overall survival (OS), disease free survival (DFS), and colostomy free survival (CFS) were examined using the Kaplan-Meier method and compared with the log-rank test. Cox proportional hazard models for OS and DFS were developed. Results The follow-up was 14.9 months (range, 0.7-94.8 months). Public hospital patients presented with significantly higher clinical T stage (P<0.05) and clinical stage group (P<0.05), had significantly longer radiotherapy delays (P<0.05) and radiotherapy duration (P<0.05), and had more frequent radiation therapy (RT) breaks ≥10 days (P<0.05). Three-year OS showed a marked trend in favor of private hospital patients for 3-year OS (72.8% vs. 48.9%; P=0.171), 3-year DFS (66.3% vs. 42.7%, P=0.352), and 3-year CFS (86.4% vs. 68.9%, P=0.299). Referral hospital was not predictive of OS or DFS on multivariate analysis. Conclusions Public hospital patients presented at later stage and experienced more delays in initiating and completing radiotherapy, which may contribute to the trend in poorer DFS and OS. These findings emphasize the need for identifying clinical and treatment factors that contribute to decreased survival in low socioeconomic status (SES) populations. PMID:26487947

  20. Glycemic control after hospital discharge in insulin-treated type 2 diabetes: a randomized pilot study of daily remote glucose monitoring.

    PubMed

    Wei, Nancy J; Nathan, David M; Wexler, Deborah J

    2015-02-01

    Little is known about glycemic control in type 2 diabetes patients treated with insulin in the high-risk period between hospital discharge and follow-up. We sought to assess the impact of remote glucose monitoring on postdischarge glycemic control and insulin titration. We randomly assigned 28 hospitalized type 2 diabetes patients who were discharged home on insulin therapy to routine specialty care (RSC) or RSC with daily remote glucose monitoring (RGM). We compared the primary outcome of mean blood glucose and exploratory outcomes of hypoglycemia/hyperglycemia rates, change in hemoglobin A1c and glycated albumin, and insulin titration frequency between groups. Mean blood glucose was not significantly different between the treatment arms (144 ± 34 mg/dL in the RSC group and 172 ± 41 mg/dL in the RGM group; not significant), nor were there significant differences in any of the other measures of glycemia during the month after discharge. Hypoglycemia (glucometer reading <60 mg/dL) was common, occurring in 46% of subjects, with no difference between groups. In as-treated analysis, insulin dose adjustments (29% with an increase and 43% with decrease in insulin dose) occurred more frequently in the patients who used RGM (average of 2.8 vs. 1.2 dose adjustments; P = .03). In this pilot trial in insulin-treated type 2 diabetes, RGM did not affect glycemic control after hospital discharge; however, the high rate of hypoglycemia in the postdischarge transition period and the higher frequency of insulin titration in patients who used RGM suggest a safety role for such monitoring in the transition from hospital to home.

  1. [The life of Dr. RO Kishun, a reflection of modern Korean medical history of the borders].

    PubMed

    Shin, Young-Jeon; Park, Se-Hong

    2009-06-01

    RO Kishun was born on February 2, 1893 in Ongjin County, Hwanghae Province of Joseon Korea. He graduated from the Medical Training Center, a campus associated with the Joseon Government-General Hospital, in 1915, and from Kyushu Imperial University School of Medicine in 1917. He continued his medical study at the university in 1929, majoring in biochemistry, and earned a doctorate in medicine in 1932. Dr. RO, one of the earliest pioneers in Korean biochemistry, was active in his research, publishing four studies in the Japanese Journal of Biochemistry between 1931 and 1932. After returning from Japan in 1932, Dr. RO opened a medical practice in Mokpo and Busan, port cities situated on the southern tip of Korea. Later in 1936, he moved north to Manchuria (northeast China) to practice medicine at the International Hospital in Mukden (present-day Shenyang). He also served as president of Tumen Public Hospital between 1942 and 1946. When Japan signed unconditional surrender bringing World War II to an end, Dr. RO relocated to Yanbian and began providing medical training to ethnic Koreans. In October 1946, he was appointed dean of the First Branch School of China Medical University in Longjing, and in October 1948 the first dean of Yanbian Medical School, the predecessor of Yanbian University College of Medicine. Dr. RO dedicated his life to medical practice, teaching and training students, and mentoring younger faculty. A brilliant clinician, he also inspired and helped his colleagues with his outstanding ability to diagnose and treat patients. He was one of the founding members of Yanbian University College of Medicine. RO Kishun died on June 7, 1957 at age 64. Ethnic Koreans hailed him as Sinui (literally, the physician of God), and a bronze statue of himself was erected in front of the medical college in 1988. Dr. RO's life brings modern historians' attention to the issue of determining geographical territories and nationality, in that his life unfolded at the

  2. Short-term and one-year outcome of infective endocarditis in adult patients treated in a Finnish teaching hospital during 1980–2004

    PubMed Central

    Heiro, Maija; Helenius, Hans; Hurme, Saija; Savunen, Timo; Engblom, Erik; Nikoskelainen, Jukka; Kotilainen, Pirkko

    2007-01-01

    Background Previous studies on factors predicting the prognosis of infective endocarditis have given somewhat conflicting results. Our aim was to define the factors predicting the outcome of patients treated in a Finnish teaching hospital. Methods A total of 326 episodes of infective endocarditis in 303 patients treated during 1980–2004 were evaluated for short-term and 1-year outcome and complications. Results Infection of 2 native valves and the occurrence of neurological complications, peripheral emboli, or heart failure significantly predicted both in-hospital and 1-year mortality, while age ≥65 years or the presence of a major criterion or vegetation on echocardiography predicted death within 1 year. A significant trend was observed between the level of serum C-reactive protein (CRP) on admission and both the short-term and 1-year outcome. In the patients who had CRP values ≥100 mg/l on admission, the hazard ratio for in-hospital death was 2.9-fold and the hazard ratio for 1-year death was 3.9-fold as compared to those with lower CRP values. Male sex and age < 64 years significantly predicted a need for both in-hospital and 1-year surgery, as did the development of heart failure or the presence of a major criterion or vegetation on echocardiography. Peripheral emboli were associated with a need for in-hospital surgery, while Streptococcus pneumoniae as the causative agent or infection of 2 native valves predicted a need for surgery within 1 year from admission. Conclusion Some of the factors (e.g. heart failure, neurological complications, peripheral emboli) predicting a poor prognosis and/or need for surgery were the same observed in previous studies. A new finding was that high CRP values (≥100 mg/l) on admission significantly predicted both short-term and 1-year mortality. PMID:17640339

  3. Reliability and validity of the Korean version of the community balance and mobility scale in patients with hemiplegia after stroke.

    PubMed

    Lee, Kyoung-Bo; Lee, Paul; Yoo, Sang-Won; Kim, Young-Dong

    2016-08-01

    [Purpose] The aim of this study was to translate and adapt the Community Balance and Mobility Scale (CB&M) into Korean (K-CB&M) and to verify the reliability and validity of scores obtained with Korean patients. [Subjects and Methods] A total of 16 subjects were recruited from St. Vincent's Hospital in South Korea. At each testing session, subjects completed the K-CB&M, Berg balance scale (BBS), timed up and go test (TUG), and functional reaching test. All tests were administered by a physical therapist, and subjects completed the tests in an identical standardized order during all testing sessions. [Results] The inter- and intra-rater reliability coefficients were high for most subscores, while moderate inter-rater reliability was observed for the items "walking and looking" and "walk, look, and carry", and moderate intra-rater reliability was observed for "forward to backward walking". There was a positive correlation between the K-CB&M and BBS and a negative correlation between the K-CB&M and TUG in the convergent validity assessments. [Conclusion] The reliability and validity of the K-CB&M was high, suggesting that clinical practitioners treating Korean patients with hemiplegia can use this material for assessing static and dynamic balance.

  4. Reliability and validity of the Korean version of the community balance and mobility scale in patients with hemiplegia after stroke

    PubMed Central

    Lee, Kyoung-bo; Lee, Paul; Yoo, Sang-won; Kim, Young-dong

    2016-01-01

    [Purpose] The aim of this study was to translate and adapt the Community Balance and Mobility Scale (CB&M) into Korean (K-CB&M) and to verify the reliability and validity of scores obtained with Korean patients. [Subjects and Methods] A total of 16 subjects were recruited from St. Vincent’s Hospital in South Korea. At each testing session, subjects completed the K-CB&M, Berg balance scale (BBS), timed up and go test (TUG), and functional reaching test. All tests were administered by a physical therapist, and subjects completed the tests in an identical standardized order during all testing sessions. [Results] The inter- and intra-rater reliability coefficients were high for most subscores, while moderate inter-rater reliability was observed for the items “walking and looking” and “walk, look, and carry”, and moderate intra-rater reliability was observed for “forward to backward walking”. There was a positive correlation between the K-CB&M and BBS and a negative correlation between the K-CB&M and TUG in the convergent validity assessments. [Conclusion] The reliability and validity of the K-CB&M was high, suggesting that clinical practitioners treating Korean patients with hemiplegia can use this material for assessing static and dynamic balance. PMID:27630420

  5. Impact of a financial incentive policy on Korean nurse staffing.

    PubMed

    Kim, Y; Kim, J

    2015-06-01

    This study was designed to determine (1) the impact of policy on longitudinal changes in nurse staffing levels and (2) the characteristics of policy-responsive Korean hospitals. A policy of varying nursing fees according to staffing grade by measuring the nurse-to-bed ratio has been implemented in Korean hospitals since 1999 with the aim of satisfying patient care needs and providing safe and high-quality nursing care. Nurse staffing hospital characteristics data were collected from Korean Hospital Nurses Association yearbooks for the period 1996-2011. The obtained time series nurse staffing data were analysed by assessing the nurse-to-bed ratio. Graphs were used to view nurse staffing trends in various nursing units by hospital type during the study period. Mixed repeated-measures modelling was used to analyse nurse staffing and hospital characteristics, with year categorized as a dummy variable. There were 585 and 1239 observations related to measurements of nurse staffing grade in 44 tertiary and 193 general hospitals, respectively. For measuring the nurse staffing grade in intensive care units, the number of observations for general hospitals was decreased to 1170. Long-term nurse staffing in general and intensive care units was improved post-policy compared with pre-policy in both tertiary and general hospitals. Nurse staffing was improved more in Seoul than in other areas and was significantly better for hospitals with more beds for both hospital types. Although the financial incentive policy implemented in Korea has had an overall positive result on nurse staffing, the effect was not assure in small-sized hospitals in rural area. A more refined method for calculating nurse staffing and increasing financial incentives relative to staffing grade is needed to improve hospital nurse staffing. © 2014 International Council of Nurses.

  6. Healing at home: Comparing cohorts of children with medium-sized burns treated as outpatients with in-hospital applied Acticoat to those children treated as inpatients with silver sulfadiazine.

    PubMed

    Peters, Daniel A; Verchere, Cynthia

    2006-01-01

    Using Acticoat (Smith & Nephew, London, UK), a dressing that requires changing only twice per week, we are able to discharge children with medium-sized burns for the majority of their acute care. In sizeable wounds, early burn care is often too painful to do at home and, therefore, sedative analgesia or anesthesia can be provided by the burn unity as necessary. In the interval between dressings, the patients remain at home. A cohort of 30 patients treated in this fashion between 2000 and 2002 were compared with 73 matched historical controls kept as inpatients and treated with silver sulfadiazine. Children treated with Acticoat spent, on average, 0.83 days admitted in hospital whereas those treated with silver sulfadiazine averaged 13.85 days (P < .001). There was a reduction in complications in patients treated with Acticoat and the need for skin grafting was not increased. We have been able to facilitate earlier discharges while continuing to provide safe and effective comprehensive burn care.

  7. Copper-silver ionization at a US hospital: interaction of treated drinking water with plumbing materials, aesthetics and other considerations

    EPA Science Inventory

    Tap water sampling and surface analysis of copper pipe/bathroom porcelain were performed to explore the fate of copper and silver during the first nine months of copper-silver ionization (CSI) applied to cold and hot water at a hospital in Cincinnati, Ohio. Ions dosed by CSI into...

  8. Copper-silver ionization at a US hospital: interaction of treated drinking water with plumbing materials, aesthetics and other considerations

    EPA Science Inventory

    Tap water sampling and surface analysis of copper pipe/bathroom porcelain were performed to explore the fate of copper and silver during the first nine months of copper-silver ionization (CSI) applied to cold and hot water at a hospital in Cincinnati, Ohio. Ions dosed by CSI into...

  9. Is Treating Oral and Maxillofacial Trauma Profitable? An Analysis of Hospital and Surgeon Reimbursement at an Academic Medical Center.

    PubMed

    DeLuke, Dean M; Agarwal, Vickas; Holleman, Trevor; Carrico, Caroline K; Laskin, Daniel M

    2017-02-01

    During the past 2 decades, there has been a marked decrease in the willingness of community-based oral and maxillofacial surgeons to participate in trauma call. Although many factors can influence the decision not to take trauma call, 1 primary disincentive is the perception that managing facial trauma might be profitable for the hospital, but not profitable for the surgeon. The purpose of this study was to compare the profitability of facial trauma management for the hospital and the surgeon at the Virginia Commonwealth University (VCU) Medical Center (Richmond, VA). In this retrospective cohort study, records were collected for patients who were seen for primary trauma management by the Department of Oral and Maxillofacial Surgery at VCU (VCUOMS) from June 2011 through July 2014. Cost and reimbursement data were analyzed for these patients from the VCU Health System (VCUHS) and the VCUOMS. For the hospital, actual cost data were provided; for the surgeon, cost was calculated based on an average overhead of 50%. For uniformity, patients were excluded if they remained in the hospital for longer than a 23-hour observation period. Patients younger than 18 years also were excluded. In total, 169 patients met the inclusion criteria. There was a statistically relevant difference in the percentage of costs recouped and the actual profit. The average percentage of costs recouped was 230% for the VCUHS versus 47% for the VCUOMS. This amounts to an average profit per case of $3,461 for the hospital versus a loss of $1,162 for the surgeon. The results of this study indicate that in the VCU Medical Center, maxillofacial trauma yields a net profit for the hospital and a net loss for the operating surgeon. Although the results are limited to outpatient management at 1 academic institution, they suggest that hospitals in some settings might be in a position to incentivize surgeons for trauma management. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons

  10. Regional Variation in 30-Day Ischemic Stroke Outcomes for Medicare Beneficiaries Treated in Get With The Guidelines-Stroke Hospitals.

    PubMed

    Thompson, Michael P; Zhao, Xin; Bekelis, Kimon; Gottlieb, Daniel J; Fonarow, Gregg C; Schulte, Phillip J; Xian, Ying; Lytle, Barbara L; Schwamm, Lee H; Smith, Eric E; Reeves, Mathew J

    2017-08-01

    We explored regional variation in 30-day ischemic stroke mortality and readmission rates and the extent to which regional differences in patients, hospitals, healthcare resources, and a quality of care composite care measure explain the observed variation. This ecological analysis aggregated patient and hospital characteristics from the Get With The Guidelines-Stroke registry (2007-2011), healthcare resource data from the Dartmouth Atlas of Health Care (2006), and Medicare fee-for-service data on 30-day mortality and readmissions (2007-2011) to the hospital referral region (HRR) level. We used linear regression to estimate adjusted HRR-level 30-day outcomes, to identify HRR-level characteristics associated with 30-day outcomes, and to describe which characteristics explained variation in 30-day outcomes. The mean adjusted HRR-level 30-day mortality and readmission rates were 10.3% (SD=1.1%) and 13.1% (SD=1.1%), respectively; a modest, negative correlation (r=-0.17; P=0.003) was found between one another. Demographics explained more variation in readmissions than mortality (25% versus 6%), but after accounting for demographics, comorbidities accounted for more variation in mortality compared with readmission rates (17% versus 7%). The combination of hospital characteristics and healthcare resources explained 11% and 16% of the variance in mortality and readmission rates, beyond patient characteristics. Most of the regional variation in mortality (65%) and readmission (50%) rates remained unexplained. Thirty-day mortality and readmission rates vary substantially across HRRs and exhibit an inverse relationship. While regional variation in 30-day outcomes were explained by patient and hospital factors differently, much of the regional variation in both outcomes remains unexplained. © 2017 American Heart Association, Inc.

  11. Korean Affairs Report

    DTIC Science & Technology

    2007-11-02

    JAPAN Report on 30th Anniversary of Chongnyon (KCNA, 24, 31 May 85) " NODONG SINMUN Report 99 Anniversary Marked Abroad 10° Briefs Taekwondo ...KOREA/KOREANS IN JAPAN BRIEFS TAEKWONDO FEDERATION HEAD LEAVES—Pyongyang, 29 May (KCNA)--Mr Choe Hong-hui, president of the International Taegwondo

  12. Korean Phrase Book.

    ERIC Educational Resources Information Center

    Peace Corps, Washington, DC.

    This is a brief guide to Korean pronunciation and phrases, prepared for U.S. Navy personnel. Expressions are grouped according to the following headings: (1) emergency expressions; (2) general expressions; (3) personal needs; (4) location and terrain; (5) roads and transportation; (6) communications; (7) letters, numbers, size, time, etc.; (8)…

  13. Finite Control in Korean

    ERIC Educational Resources Information Center

    Lee, Kum Young

    2009-01-01

    This thesis explores finite control in Korean. An overview of the previous studies of control shows that the mainstream literature on control has consistently argued that referential dependence between an overt matrix argument and an embedded null subject is characteristic of non-finite clauses which contain a PRO subject. Moreover, although some…

  14. ACOUSTIC PHONETICS OF KOREAN,

    DTIC Science & Technology

    utilize the spectrographic data and subsequent analysis in a better description of the phonology of Korean. Although the scope of the present...automatic speech recognition require accurate knowledge of the phonology of the language as a theoretical basis. The present study aims to develop a phonology which will provide such a basis for the advanced studies. (Author)

  15. Analysis of wounds incurred by U.S. Army Seventh Corps personnel treated in Corps hospitals during Operation Desert Storm, February 20 to March 10, 1991.

    PubMed

    Carey, M E

    1996-03-01

    One hundred and forty-three soldiers who received ballistic injury were actively treated at U.S. Army Seventh Corps hospitals during Operation Desert Storm. Ninety-five percent were wounded by fragments, 5% by bullets. Many had wounds of several body parts, including 17.3% who received a head wound; 4.3% a neck wound; 5.8% a chest wound; 9.3% an abdominal wound; and 90% who had extremity wounds. Three hospital deaths occurred--a 2.1% mortality rate. Only two soldiers sustained a brain wound; in both, the missile entered below the skull area protected by the Kevlar helmet. One brainwounded individual was treated and lived; the other died from hemorrhage and shock from concomitant traumatic lower-extremity amputations. The current U.S. helmet appears to provide significant protection from fragmenting ordnance as does the armored vest. Hemorrhage from proximal extremity wounds caused hospital deaths. Treatment of such wounds will have to be improved to reduce future combat mortality.

  16. Smoking Topography in Korean American and White Men: Preliminary Findings

    PubMed Central

    Chung, Sangkeun; Kim, Sun S; Kini, Nisha; Fang, Hua J; Kalman, David; Ziedonis, Douglas M.

    2013-01-01

    Introduction This is the first study of Korean Americans’ smoking behavior using a topography device. Korean American men smoke at higher rates than the general U.S. population. Methods Korean American and White men were compared based on standard tobacco assessment and smoking topography measures. They smoked their preferred brand of cigarettes ad libitum with a portable smoking topography device for 24 hours. Results Compared to White men (N = 26), Korean American men (N = 27) were more likely to smoke low nicotine-yield cigarettes (p < 0.001) and have lower Fagerstrom nicotine dependence scores (p = 0.04). Koreans smoked fewer cigarettes with the device (p = 0.01) than Whites. Controlling for the number of cigarettes smoked, Koreans smoked with higher average puff flows (p = 0.05), greater peak puff flows (p = 0.02), and shorter interpuff intervals (p < 0.001) than Whites. Puff counts, puff volumes, and puff durations did not differ between the two groups. Conclusions This study offers preliminary insight into unique smoking patterns among Korean American men who are likely to smoke low nicotine-yield cigarettes. We found that Korean American men compensated their lower number and low nicotine-yield cigarettes by smoking more frequently with greater puff flows than White men, which may suggest exposures to similar amounts of nicotine and harmful tobacco toxins by both groups. Clinicians will need to consider in identifying and treating smokers in a mutually aggressive manner, irrespective of cigarette type and number of cigarette smoked per day. PMID:24068611

  17. A randomised controlled trial to assess the relative benefits of large volume spacers and nebulisers to treat acute asthma in hospital

    PubMed Central

    Dewar, A; Stewart, A; Cogswell, J; Connett, G

    1999-01-01

    OBJECTIVES—To compare the clinical effectiveness, acceptability, and cost benefit of administering β2 agonists by means of a metered dose inhaler and large volume spacer with conventional nebulisers to children admitted to hospital with acute asthma.
METHODS—A randomised controlled trial was conducted over five months. Sixty one children older than 3 years admitted to a large teaching hospital and a district general hospital with acute asthma completed the study. Children received either 5 mg of salbutamol up to one hourly by jet nebuliser, or up to 10 puffs of salbutamol 100 µg by means of a metered dose inhaler and spacer up to one hourly.
RESULTS—Median hospital stay was 40 hours in the nebuliser group and 36.5 hours in the spacer group. Asthma disability scores at two weeks after discharge were significantly improved in the spacer group. Drug costs were £14.62 less for each patient in the spacer group.
CONCLUSIONS—Large volume spacers are an acceptable, cost effective alternative to nebulisers in treating children admitted with acute asthma, provided that the children can use the mouthpiece, and symptoms are not severe. Their use facilitates effective home treatment by parents, with subsequent reduction in morbidity and re-admission rates.

 PMID:10208945

  18. A randomised controlled trial to assess the relative benefits of large volume spacers and nebulisers to treat acute asthma in hospital.

    PubMed

    Dewar, A L; Stewart, A; Cogswell, J J; Connett, G J

    1999-05-01

    To compare the clinical effectiveness, acceptability, and cost benefit of administering beta2 agonists by means of a metered dose inhaler and large volume spacer with conventional nebulisers to children admitted to hospital with acute asthma. A randomised controlled trial was conducted over five months. Sixty one children older than 3 years admitted to a large teaching hospital and a district general hospital with acute asthma completed the study. Children received either 5 mg of salbutamol up to one hourly by jet nebuliser, or up to 10 puffs of salbutamol 100 microg by means of a metered dose inhaler and spacer up to one hourly. Median hospital stay was 40 hours in the nebuliser group and 36.5 hours in the spacer group. Asthma disability scores at two weeks after discharge were significantly improved in the spacer group. Drug costs were pound 14.62 less for each patient in the spacer group. Large volume spacers are an acceptable, cost effective alternative to nebulisers in treating children admitted with acute asthma, provided that the children can use the mouthpiece, and symptoms are not severe. Their use facilitates effective home treatment by parents, with subsequent reduction in morbidity and re-admission rates.

  19. [Missionary Medicine of Canadian Presbytery and Korean Doctors under Japanese Occupation--focusing Sung-jin and Ham-heung].

    PubMed

    Heo, Yun-Jung; Cho, Young-Soo

    2015-12-01

    . Korean doctors and assistants who worked at the mission hospitals had seen the spread of Protestantism in their youth; had received modern education; had experienced the fall of own country in 1910 and nationwide protest against Japan in 1919. The majority of them were graduates of Severance Medical College, the hub of missionary medicine at the time. After the resignation from the mission hospitals, 80 percent of them became self-employed general practitioners. The operations of the mission hospitals began to contract in 1930 due to tightened control by Imperial Japan. Shrine worship imposed on Christians caused internal conflict and division among missionaries and brought about changes in the form and contents of the mission organization. The incidence of the assault of Dr. Grieson brought about the dissolution of Sung-jin mission base and the interruption of the operation of Je-dong Hospital. As the Pacific War expanded, missionaries were driven out of Korea and returned home. In conclusion, the missions work by Canadian Presbytery missionaries had greatly impacted Protestantism in Korea. The characteristics of Canadian Presbytery were manifested in their support of Korean nationalism movement, openness for Social Gospel, and maintaining equal footing with Korean Christians. Specifically we note the influence of these characteristics in Chosun doctors who had worked in the mission hospitals. They operated their own hospitals or clinics in a manner similar to the mission hospitals by providing treatment for poor patients free of charge or for a nominal fee and treating the patients in a kind and humanistic way. After the 1945 Liberation, Korean doctors'career paths split into two directions. most of them defected to South Korea and chose the path to work as general practitioners. A few of them remained in North Korea and became educator of new doctors. It is meaningful that former doctors of Canadian missionary hosptal became dean of 2 medical colleges among 3 of all

  20. North Korean Paradoxes. Circumstances, Costs, and Consequences of Korean Unification

    DTIC Science & Technology

    2005-01-01

    paper) 1. Korean reunification question (1945- ) 2. Korea (North)-Economic policy. 3. Korea (North)--Politics and government. 4. Security, International...order@rand.org Preface This monograph, focusing on North Korea , analyzes some of the economic, political, and security issues associated with Korean ...Northeast Asia. iii iv North Korean Paradoxes This research was performed within the International Security and Defense Policy Center of the RAND National

  1. Nonfatal occupational injuries from slips, trips, and falls among older workers treated in hospital emergency departments, United States 1998.

    PubMed

    Layne, Larry A; Pollack, Keshia M

    2004-07-01

    Falls are a leading cause of injury among older adults. As the workforce demographics shift to an older population, the dearth of information on occupational falls among older adults must be addressed. A national probability sample of hospital emergency departments (EDs) (National Electronic Injury Surveillance System) was utilized to characterize falls at work. Older workers were found not to be at increased risk of a fall injury, but were more likely than younger workers to be hospitalized post-injury. Same-level falls were the most common type of incident among older workers. Falls from height were more prevalent among men than women. The narrative case descriptions for same-level falls to the floor primarily implicated floor contamination and tripping hazards. Fall prevention programs targeted to older workers must examine extrinsic sources of falls, particularly surface traction, contaminant control, and footwear. Copyright 2004 Wiley-Liss, Inc.

  2. [The way the quality of health services is perceived and treated by the managerial personnel of public hospitals].

    PubMed

    Rybarczyk-Szwajkowska, Anna; Cichońska, Dominika; Holly, Romuald

    Managerial knowledge and skills as well as profound understanding of goals and objectives of management determine the effectiveness and efficiency in all areas of managerial activities. In particular, this applies to the quality of healthcare services, perceived as a compliance between the effects (of medical treatment) and the assumed relevant objectives (defined/desired health condition). The aim of the research was to distinguish and define the way the health service quality is perceived by the hospital managerial personnel. The questionnaire was mailed to 836 members of the managerial personnel of public hospitals in the Łódź province. Of this number 122 questionnaires were returned. Only 22 (18.49%) of respondents presented the definition of quality. Attempts to meet patients' expectations and to satisfy them were found to be the prevailing perception of the healthcare quality and 96.64% of respondents considered competences of medical staff contributory. Almost 64% of respondents disagree with the opinion that the number of medical staff does not affect the service quality. According to the respondents, a 46% increase in financial resources on average could significantly improve the quality of healthcare services. More than half (66.76%) of respondents claim that healthcare services that are available cover 82% of patients' needs. Almost 57% (56.52%) of respondents consider that the subordinate- superior relationship influences their work involvement. According to 42.61% of respondents, the offered incentives encourage actions for the quality improvement. The results of the research indicate the need to develop a clear cut definition of the health service quality by the managerial personnel of public hospitals and to change their understanding, perception and treatment of the discussed issue, which provides a basis for the effective and efficient hospital management. Med Pr 2016;67(3):365-373. This work is available in Open Access model and licensed under

  3. Socioeconomic inequality and road traffic accidents in Thailand: comparing cases treated in government hospitals inside and outside of Bangkok.

    PubMed

    Yongchaitrakul, Teerachai; Juntakarn, Chantip; Prasartritha, Thavat

    2012-05-01

    The study aims to report annual demographic characteristics and to compare the differences of socioeconomic inequality, type of motor vehicles, and seating relating to major bone injuries among hospitals in and outside Bangkok. Six public hospitals in Bangkok and six regional hospitals in the provinces were studied over a one year period (2008-2009). There were 3,650 cases: 3,596 injured patients and 54 deaths. Patients with a lower education level accounted for the largest number of cases, both in the provinces (46.3%) and Bangkok (17.1%). Their incomes were less than THB 10,000/yearly. Total number of motorcycle cases (3,360) was higher (11.6:1) than 290 cases of motor vehicles. Pickup cars were used more commonly. Riding a motorcycle was likely to be fatal. The front seat was the most common involvement. Passengers occupying the middle and rear seat of the motorcycle were involved in 16.0% and 1.0% cases, respectively. Long bone and joints were the most common injuries. The results strongly confirmed the striking contribution of motorcycles and pickups to road traffic accidents. People with a low educational level, in conjunction with low income, and in areas outside of Bangkok were more at risk. Specific education on road safety should be delivered, preferably in primary schools.

  4. Upper gastrointestinal haemorrhage: predictive factors of in-hospital mortality in patients treated in the medical intensive care unit.

    PubMed

    Skok, P; Sinkovič, A

    2011-01-01

    This prospective, cohort study assessed the independent predictors of in-hospital mortality in patients with acute upper gastrointestinal haemorrhage admitted to the medical intensive care unit (MICU) at the University Clinical Centre Maribor, Slovenia. Using univariate, multivariate and logistic regression methods the predictors of mortality in 54 upper gastrointestinal haemorrhage patients (47 men, mean ± SD age 61.6 ± 14.2 years) were investigated. The mean ± SD duration of treatment in the MICU was 2.8 ± 2.9 days and the mortality rate was 31.5%. Significant differences between nonsurvivors and survivors were observed in haemorrhagic shock, heart failure, infection, diastolic blood pressure at admission, haemoglobin and red blood cell count at admission, and lowest haemoglobin and red blood cell count during treatment. Heart failure (odds ratio 59.13) was the most significant independent predictor of in-hospital mortality. Haemorrhagic shock and the lowest red blood cell count during treatment were also important independent predictive factors of in-hospital mortality.

  5. Comparative assessment of in-hospital trauma mortality at a South African trauma center and matched patients treated in the United States.

    PubMed

    Spence, Richard T; Scott, John W; Haider, Adil; Navsaria, Pradeep H; Nicol, Andrew J

    2017-09-01

    The unacceptably high rate of death and disability due to injury in Sub-Saharan Africa is alarming. The objective of this work was to compare mortality rates between severely injured trauma patients at a high-volume trauma center in South Africa with matched patients in the United States. Clinical databases from the Groote Schuur Hospital for patients treated in Cape Town, South Africa and the American College of Surgeon's National Trauma Databank for patients treated at large academic trauma centers in the United States were used. Coarsened exact matching identified the most comparable patient populations based on sex, age, intent, injury type, injury mechanism, Injury Severity Score, Glasgow Coma Score, and systolic blood pressure. Conditional logistic regression generated odds ratios for mortality among the entire sample and clinically relevant subgroups. Coarsened exact matching matched 97.9% of the Groote Schuur Hospital patient sample, resulting in 3,206 matched-pairs between the Groote Schuur Hospital and National Trauma Databank cohorts. Conditional logistic regression revealed an odds ratio of mortality of 1.67 (95% confidence interval, 1.10-2.52) for patients at Groote Schuur Hospital compared with matched patients from the National Trauma Databank. Subset analyses revealed significantly increased odds of mortality among patients with blunt injuries (odds ratio 3.40, 95% confidence interval, 1.68-6.88) and patients with a Glasgow Coma Score of 8 or lower (odds ratio 4.33, 95% confidence interval, 2.10-8.95). No statistically significant difference was identified among patients with penetrating injuries or with a Glasgow Coma Score >8 (P value .90 and .39, respectively). International comparisons of interhospital variation in risk-adjusted outcomes following trauma can identify opportunities for quality improvement and have the potential to measure the impact of any corrective strategy implemented. Copyright © 2017. Published by Elsevier Inc.

  6. Admissions to hospital due to fracture in England in patients with prostate cancer treated with androgen-deprivation therapy - do we have to worry about the hormones?

    PubMed

    Jefferies, Edward R; Bahl, Amit; Hounsome, Luke; Eylert, Maike F; Verne, Julia; Persad, Raj A

    2016-09-01

    To investigate the association between androgen-deprivation therapy (ADT) and fracture risk in men with prostate cancer in England. Using the Hospital Episodes Statistics database, which contains all the information about National Health Service (NHS) and NHS-funded hospital admissions in England, for the years 2004-2008, 8 902 patients were found to have had prostate cancer and an admission to hospital with a fracture. Of these patients, 3 372 (37.8%) were identified as being treated with ADT, whilst 5 530 (62.2%) were not. There was a total of 228 852 admissions in the background population. The risk of a fracture requiring hospitalisation increased from 1.12 to 1.41 per 100 person-years in a man with prostate cancer treated with ADT compared with those without ADT, an absolute increase of only 0.29 per 100 person-years. When compared with the background population, there was an increase from 0.58 to 1.41 per 100 person-years, a relative rate ratio increase of 2.4 (P < 0.01) with an absolute increase of 0.83 per 100 person-years. In England there was a small but statistically significant increased risk of fracture in men who had been treated with ADT. Men with prostate cancer, with or without ADT, were at an increased risk of fracture compared with the background population. We therefore suggest that if bone health is to be taken seriously in men with prostate cancer that all these men should be risk assessed (FRAX(®) or Qfracture(®) tools, as National Institute for Health and Care Excellence advised), as all men with prostate cancer have an increased risk of fracture, with those on ADT having slightly higher risk. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

  7. Prevalence of Adverse Drug Reactions in CAD STEMI Patients Treated in the Cardiac Intensive Care Unit at the Public Hospital in Bandung, Indonesia.

    PubMed

    Amalia, Lia; Anggadireja, Kusnandar; Aprami, Toni M; Septiani, Vina

    2016-01-01

    Adverse drug reactions (ADRs) are associated with morbidity, mortality, and can contribute to increased healthcare costs. This study was conducted to identify the occurence, types, and management of ADRs, as well as analyze the causal relationship, severity, and preventability of ADRs. The study was observational analysis with concurrent data collection from patients with Coronary Artery Disease-ST segment Elevation Myocardial Infarction (CAD-STEMI) treated in the Cardiac Intensive Care Unit (CICU) at a hospital in Bandung Indonesia, during the period of December 2013 to March 2014. The occurence of identified ADRs was assessed using the probability scale of Naranjo, while the severity by the scale of Hartwig and their preventability was evaluated using the scale of Schumock-Thornton. 49 ADRs were identified in 29 patients. Organ systems most affected by the ADRs were the cardiovascular and body electrolyte, each accounting for 20.41%. The hematology and gastrointestinal systems each contributed 18.37% to ADR occurrences. The causal relationship was mostly classified as "probable," accounting for 69.39%. With regard to severity, most ADRs were classified as "moderate" at level 3, contributing to 53.06% of the occurence. In terms of preventability, most of the ADRs fell into the "non-preventable" category (79.59%). The most widely applied ADRs management was administration of an antidote or other treatments (40.82%). Further analysis revealed that the average number of drug types and duration of hospitalization significantly affected the presence of ADRs. Taken together, most patients with CAD STEMI treated in the CICU of the studied hospital experienced non-preventable ADRs and were treated with antidote or other treatments.

  8. A Pharmacoeconomic Analysis of In-Hospital Costs Resulting from Reintubation in Preterm Infants Treated with Lucinactant, Beractant, or Poractant Alfa

    PubMed Central

    Guardia, Carlos G.; Moya, Fernando R.; Sinha, Sunil; Simmons, Phillip D.; Segal, Robert; Greenspan, Jay S.

    2012-01-01

    OBJECTIVES Reintubation and subsequent mechanical ventilation (MV) in preterm infants after surfactant replacement therapy are associated with excess morbidity and mortality and likely increase in-hospital costs. Specific surfactant therapy selection for prevention of respiratory distress syndrome (RDS) in preterm infants receiving conventional MV may impact not only clinical outcomes but also pharmacoeconomic outcomes. METHODS We conducted a pharmacoeconomic analysis of the impact of surfactant selection and reintubation and subsequent MV of preterm infants on health care resource utilization. Rates of reintubation and duration of MV after reintubation were determined from 1546 preterm infants enrolled in two surfactant trials comparing lucinactant to beractant and poractant alfa. Hospital costs were obtained from a 2010 US database from 1564 preterm infants with RDS, with a direct cost of $2637 per day for MV in the neonatal intensive care unit. Cost of reintubation by study and treatment was estimated as the incidence of reintubation multiplied by days on MV therapy after reintubation multiplied by cost per day for direct MV costs, standardized per 100 surfactant-treated infants. RESULTS There were no differences between studies or treatment groups in the overall extubation rate. Average MV duration following reintubation was similar between groups in both trials; however, reintubation rates were significantly lower (p<0 05) for infants treated with lucinactant than for those receiving beractant or poractant alfa. The observed differences in reintubation rates resulted in a projected cost saving of $160,013 to $252,203 per 100 infants treated with lucinactant versus animal-derived surfactants. CONCLUSIONS In this analysis, higher reintubation rates following successful extubation in preterm infants receiving animal-derived surfactant preparations significantly increased estimated in-hospital costs, primarily due to excess costs associated with MV. This analysis

  9. Naval Cooperation After Korean Unification,

    DTIC Science & Technology

    1996-05-01

    Korean Unification _ ’ - < ~ ■::-■;-■’ "’&■ ■ *>’ -■ ■’■ I Analyses for Defense Analyses Center for Korea ... Korea Institute for Defense Analyses (KIDA) held a workshop in Washington, DC, from December 4 to 6, 1995, to examine the prospects for U.S.- Korean ... Korean Navy, coastal missions are certain to continue. Korea will still require defense of its coastlines; regulatory missions to enforce

  10. [Epidemiology, microbiology, and outcomes of septicemia in children treated at the Charles de Gaulle University Pediatric Hospital in Burkina Faso].

    PubMed

    Ouédraogo, Abdoul-Salam; Dakouré-Kissou, Aimée; Poda, Gandaaza Euthyme Armel; Koueta, Fla; Yé-Ouattara, Diarra; Ouédraogo-Traoré, Rasmata

    2011-01-01

    The aim of this study is to describe the epidemiological and microbiological characteristics and outcome of children with septicemia at the Charles de Gaulle University Pediatric Hospital of Ouagadougou to help improve probabilistic antibiotic therapy in this type of infection. This retrospective descriptive study covered all the children from 0 to 15 years old seen over a period of 7 years in any hospital department with suspected bacteriemia and for whom the bacteriology laboratory performed a blood culture. During the study period, the laboratory received 842 requests for blood cultures and found 154 (18.3%) of them to be positive. Files for 81 of the 154 patients could be found and examined. The distribution according to age showed septicemia was most frequent among those aged 6-15 years (61.7% of the cases). Microbial identification showed the dominant species to be Salmonella enterica (serovars paratyphi and typhi) (58%) followed by Staphylococcus aureus (12.3%). The salmonella isolates had a high rate of resistance to amoxicillin, chloramphenicol and cotrimoxazole. Staphylococci were always sensitive to the antibiotics with which they were tested, although to a lesser extent for penicillin G. All patients routinely received antibiotic treatment, and 81.5% (n=66) were cured (5 children died and 10 left the hospital against medical advice). This study shows that the bacterial epidemiology of septicemia in our setting is dominated by salmonella. Trends in bacterial resistance to antibiotics showed that common antibiotics such as amoxicillin and cotrimoxazole are no longer acceptable as probabilist therapy here. They should be replaced in this type of infection by injectable third generation cephalosporin alone or combined with aminoglycosides.

  11. Virological Failure and HIV-1 Drug Resistance Mutations among Naive and Antiretroviral Pre-Treated Patients Entering the ESTHER Program of Calmette Hospital in Cambodia

    PubMed Central

    Limsreng, Setha; Him, Sovanvatey; Nouhin, Janin; Hak, Chanroeurn; Srun, Chanvatey; Viretto, Gerald; Ouk, Vara; Delfraissy, Jean Francois; Ségéral, Olivier

    2014-01-01

    Introduction In resource limited settings, patients entering an antiretroviral therapy (ART) program comprise ART naive and ART pre-treated patients who may show differential virological outcomes. Methods This retrospective study, conducted in 2010–2012 in the HIV clinic of Calmette Hospital located in Phnom Penh (Cambodia) assessed virological failure (VF) rates and patterns of drug resistance of naive and pre-treated patients. Naive and ART pre-treated patients were included when a Viral Load (VL) was performed during the first year of ART for naive subjects or at the first consultation for pre-treated individuals. Patients showing Virological failure (VF) (>1,000 copies/ml) underwent HIV DR genotyping testing. Interpretation of drug resistance mutations was done according to 2013 version 23 ANRS algorithms. Results On a total of 209 patients, 164 (78.4%) were naive and 45 (21.5%) were ART pre-treated. Their median initial CD4 counts were 74 cells/mm3 (IQR: 30–194) and 279 cells/mm3 (IQR: 103–455) (p<0.001), respectively. Twenty seven patients (12.9%) exhibited VF (95% CI: 8.6–18.2%), including 10 naive (10/164, 6.0%) and 17 pre-treated (17/45, 37.8%) patients (p<0.001). Among these viremic patients, twenty-two (81.4%) were sequenced in reverse transcriptase and protease coding regions. Overall, 19 (86.3%) harbored ≥1 drug resistance mutations (DRMs) whereas 3 (all belonging to pre-treated patients) harbored wild-types viruses. The most frequent DRMs were M184V (86.3%), K103N (45.5%) and thymidine analog mutations (TAMs) (40.9%). Two (13.3%) pre-treated patients harbored viruses that showed a multi-nucleos(t)ide resistance including Q151M, K65R, E33A/D, E44A/D mutations. Conclusion In Cambodia, VF rates were low for naive patients but the emergence of DRMs to NNRTI and 3TC occurred relatively quickly in this subgroup. In pre-treated patients, VF rates were much higher and TAMs were relatively common. HIV genotypic assays before ART initiation and for

  12. Copper-silver ionization at a US hospital: Interaction of treated drinking water with plumbing materials, aesthetics and other considerations.

    PubMed

    Triantafyllidou, Simoni; Lytle, Darren; Muhlen, Christy; Swertfeger, Jeff

    2016-10-01

    Tap water sampling and surface analysis of copper pipe/bathroom porcelain were performed to explore the fate of copper and silver during the first nine months of copper-silver ionization (CSI) applied to cold and hot water at a hospital in Cincinnati, Ohio. Ions dosed by CSI into the water at its point of entry to the hospital were inadvertently removed from hot water by a cation-exchange softener in one building (average removal of 72% copper and 51% silver). Copper at the tap was replenished from corrosion of the building's copper pipes but was typically unable to reach 200 μg/L in first-draw and flushed hot and cold water samples. Cold water lines had >20 μg/L silver at most of the taps that were sampled, which further increased after flushing. However, silver plating onto copper pipe surfaces (in the cold water line but particularly in the hot water line) prevented reaching 20 μg/L silver in cold and/or hot water of some taps. Aesthetically displeasing purple/grey stains in bathroom porcelain were attributed to chlorargyrite [AgCl(s)], an insoluble precipitate that formed when CSI-dosed Ag(+) ions combined with Cl(-) ions that were present in the incoming water. Overall, CSI aims to control Legionella bacteria in drinking water, but plumbing material interactions, aesthetics and other implications also deserve consideration to holistically evaluate in-building drinking water disinfection.

  13. Ovarian carcinoma of low maligant potential treated at the Jewish General Hospital, Montreal, between 1973 and 1997

    PubMed Central

    Hinke, Vera; Martin, Markus C.

    1999-01-01

    Objective To review the epidemiologic and pathological characteristics and the management of ovarian cancer of low malignant potential (LMP) at a university teaching institution. Data source Hospital charts from 1973 to 1997. Data extraction The authors carried out a manual study of the individual hospital charts covering the study period. Data synthesis The findings of this review revealed that the mean age of the 30 women in the study was 48.7 years and was similar in the subgroups of women having serous (18) and mucinous (9) types. In those women for whom staging information was available, all had either stage I disease (12 serous, 7 mucinous) or stage III disease (4 serous, 1 mucinous). Treatment consisted of: total abdominal hysterectomy (TAH) and bilateral salpingo-oophorectomy (BSO) with or without omentectomy (OM); BSO, unilateral oophorectomy or ovarian cystectomy alone; or TAH, OM and left salpingo-oophorectomy in women with stage I tumours. All women with stage III tumours underwent TAH, BSO and OM. The recurrence rate was low. Only 1 of 22 stage I tumours but 3 of 5 stage III tumours recurred. Conclusions Appropriate postoperative treatment for women with this type of ovarian cancer should be conservative. However, the management of higher stage disease remains controversial. PMID:10459324

  14. Fungal diversity and presence of potentially pathogenic fungi in a hospital hot water system treated with on-site monochloramine.

    PubMed

    Ma, Xiao; Baron, Julianne L; Vikram, Amit; Stout, Janet E; Bibby, Kyle

    2015-03-15

    Currently, our knowledge of fungal ecology in engineered drinking water systems is limited, despite the potential for these systems to serve as a reservoir for opportunistic pathogens. In this study, hot water samples were collected both prior to and following the addition of monochloramine as an on-site disinfectant in a hospital hot water system. Fungal ecology was then analyzed by high throughput sequencing of the fungal ITS1 region. The results demonstrate that the genera Penicillium, Aspergillus, Peniophora, Cladosporium and Rhodosporidium comprised the core fungal biome of the hospital hot water system. Penicillium dominated the fungal community with an average relative abundance of 88.89% (±6.37%). ITS1 sequences of fungal genera containing potential pathogens such as Aspergillus, Candida, and Fusarium were also detected in this study. No significant change in fungal community structure was observed before and after the initiation of on-site monochloramine water treatment. This work represents the first report of the effects of on-site secondary water disinfection on fungal ecology in premise plumbing system, and demonstrates the necessity of considering opportunistic fungal pathogens during the evaluation of secondary premise plumbing disinfection systems. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Hospitalization for pain in patients with sickle cell disease treated with sildenafil for elevated TRV and low exercise capacity

    PubMed Central

    Machado, Roberto F.; Barst, Robyn J.; Yovetich, Nancy A.; Hassell, Kathryn L.; Kato, Gregory J.; Gordeuk, Victor R.; Gibbs, J. Simon R.; Little, Jane A.; Schraufnagel, Dean E.; Krishnamurti, Lakshmanan; Girgis, Reda E.; Morris, Claudia R.; Rosenzweig, Erika B.; Badesch, David B.; Lanzkron, Sophie; Onyekwere, Onyinye; Castro, Oswaldo L.; Sachdev, Vandana; Waclawiw, Myron A.; Woolson, Rob; Goldsmith, Jonathan C.

    2011-01-01

    In adults with sickle cell disease (SCD), an increased tricuspid regurgitation velocity (TRV) by Doppler echocardiography is associated with increased morbidity and mortality. Although sildenafil has been shown to improve exercise capacity in patients with pulmonary arterial hypertension, it has not been evaluated in SCD. We therefore sought to determine whether sildenafil could improve exercise capacity in SCD patients with increased TRV and a low exercise capacity. A TRV ≥ 2.7 m/s and a 6-minute walk distance (6MWD) between 150 and 500 m were required for enrollment in this 16-week, double-blind, placebo-controlled sildenafil trial. After 74 of the screened subjects were randomized, the study was stopped early due to a higher percentage of subjects experiencing serious adverse events in the sildenafil arm (45% of sildenafil, 22% of placebo, P = .022). Subject hospitalization for pain was the predominant cause for this difference: 35% with sildenafil compared with 14% with placebo (P = .029). There was no evidence of a treatment effect on 6MWD (placebo-corrected effect −9 m; 95% confidence interval [95% CI] −56-38; P = .703), TRV (P = .503), or N-terminal pro-brain natriuretic peptide (P = .410). Sildenafil appeared to increase hospitalization rates for pain in patients with SCD. This study is registered at www.clinicaltrials.gov as NCT00492531. PMID:21527519

  16. Hospitalization for pain in patients with sickle cell disease treated with sildenafil for elevated TRV and low exercise capacity.

    PubMed

    Machado, Roberto F; Barst, Robyn J; Yovetich, Nancy A; Hassell, Kathryn L; Kato, Gregory J; Gordeuk, Victor R; Gibbs, J Simon R; Little, Jane A; Schraufnagel, Dean E; Krishnamurti, Lakshmanan; Girgis, Reda E; Morris, Claudia R; Rosenzweig, Erika B; Badesch, David B; Lanzkron, Sophie; Onyekwere, Onyinye; Castro, Oswaldo L; Sachdev, Vandana; Waclawiw, Myron A; Woolson, Rob; Goldsmith, Jonathan C; Gladwin, Mark T

    2011-07-28

    In adults with sickle cell disease (SCD), an increased tricuspid regurgitation velocity (TRV) by Doppler echocardiography is associated with increased morbidity and mortality. Although sildenafil has been shown to improve exercise capacity in patients with pulmonary arterial hypertension, it has not been evaluated in SCD. We therefore sought to determine whether sildenafil could improve exercise capacity in SCD patients with increased TRV and a low exercise capacity. A TRV ≥ 2.7 m/s and a 6-minute walk distance (6MWD) between 150 and 500 m were required for enrollment in this 16-week, double-blind, placebo-controlled sildenafil trial. After 74 of the screened subjects were randomized, the study was stopped early due to a higher percentage of subjects experiencing serious adverse events in the sildenafil arm (45% of sildenafil, 22% of placebo, P = .022). Subject hospitalization for pain was the predominant cause for this difference: 35% with sildenafil compared with 14% with placebo (P = .029). There was no evidence of a treatment effect on 6MWD (placebo-corrected effect -9 m; 95% confidence interval [95% CI] -56-38; P = .703), TRV (P = .503), or N-terminal pro-brain natriuretic peptide (P = .410). Sildenafil appeared to increase hospitalization rates for pain in patients with SCD. This study is registered at www.clinicaltrials.gov as NCT00492531.

  17. Korean Affairs Report.

    DTIC Science & Technology

    1987-02-23

    Clique’s Crimes Against Taekwondo Group Exposed (KCNA, 18 Jan. 87) 45 SOUTH KOREA POLITICS AND GOVERNMENT Editorial Denounces Two Kims Control of...meeting. It said, "In order to prevent another war and consolidate peace on the penin- sula, the meeting should be realized as early as possible." Kim...military confrontation and tension prevailing on the Korean peninsula, promote trust and unity between the north and the south, prevent war, ensure peace

  18. Korean Affairs Report.

    DTIC Science & Technology

    2007-11-02

    Ship To Investigate Krill Fishing in Antarctic (YONHAP, 24 Nov 86) , 77 INTERNATIONAL COMMENTARY Daily on U.S.-Beijing, Pyongyang-Moscow Relations...maintenance of friendly relations is the "supreme objective," he added. /12913 CSO: 4100/061 76 S. KOREA/FOREIGN RELATIONS SHIP TO INVESTIGATE KRILL ...the Southern Korean port city of Pusan for the Antarctic Ocean to investigate possibilities of fishing for Krill , the fisheries office announced. The

  19. Korean Affairs Report.

    DTIC Science & Technology

    1985-06-25

    enormous political offensive, will carry out parliamentary democracy._ We ought to know clearly that they possibly do not care whether societ^a V^ X ...uphold. Such advocacy is at best an act of abusing parliamentar - ians’ right to immunity from censuring on the Assembly floor. They echo the demands of...wives at Chongwadae, the presidential residence. Chon chatted with the foreign diplomats on the South-North Korean Red Cross talks held in Seoul Tuesday

  20. Korean Affairs Report.

    DTIC Science & Technology

    1985-06-13

    socialist state. The Korean people who attend him as their great leader are the happiest and most proud people . 79 Johannese Pilane, chief of the northern...happiness of the people and per- formed immortal feats for the accomplishment of the cause of making the whole world independent in a long period of...Anniversary Banquet Held 70 - d - Briefs Chongnyon Traders Arrive 72 FOREIGN RELATIONS Solidarity With Palestinian People , Struggle Noted (KCNA

  1. Korean Affairs Report

    DTIC Science & Technology

    2007-11-02

    needed in.the production of var- ious guns and tanks to the South Korean puppets and have had Japanese war munition monopolist enterprises directly...emergency measures or from guns and bayonets. The puppet’s oppressive frenzy is the manifestation of his extreme fear and uneasiness. Today, the...the long-term office of the dictatorial regime and those who can survive only by smashing this scheme. A gun -and-bayonet suppressive offense is the

  2. Audit and Feedback-Focused approach to Evidence-based Care in Treating patients with pneumonia in hospital (AFFECT Study).

    PubMed

    Halpape, Katelyn; Sulz, Linda; Schuster, Brenda; Taylor, Ron

    2014-01-01

    Pneumonia is the eighth leading cause of death in Canada. Use of guideline-concordant therapy tempers the development of resistance, decreases health care costs, and reduces morbidity and mortality. The purpose of this study was to optimize the treatment of patients with pneumonia under hospitalist care by focusing on best practice and local antibiogram data. The objectives were to collaborate with a hospitalist representative to optimize in-hospital treatment of patients with community-acquired, hospital-acquired, and health care-associated pneumonia; to complete a baseline audit to determine the proportion of antibiotic orders adhering to the strategy; to present the strategy and baseline audit findings to the hospitalists; to perform a post-intervention audit, with comparison to baseline, and to present results to the hospitalists; to expedite de-escalation to a narrower-spectrum antibiotic; to expedite parenteral-to-oral step-down therapy and promote appropriate duration of therapy; and to determine if a pneumonia scoring system was used. An audit and feedback intervention focusing on pre- and post-intervention retrospective chart audits was completed. Review of pneumonia guidelines and the local antibiogram assisted in identifying the study strategy. A presentation to the hospitalists outlined antimicrobial stewardship principles and described the findings of the baseline audit. Pre- and post-intervention audit results were compared. Local best-practice treatment algorithms were developed for community-acquired pneumonia and for hospital-acquired and health care-associated pneumonia. The pre-intervention audit covered the period December 2011 to January 2012, with subsequent education and audit results presented to the hospitalists in November 2012. The post-intervention audit covered the period December 2012 to January 2013. Adherence to the treatment algorithms increased from 10% (2/21) in the pre-intervention audit to 38% (5/13) in the post

  3. Audit and Feedback-Focused approach to Evidence-based Care in Treating patients with pneumonia in hospital (AFFECT Study)

    PubMed Central

    Halpape, Katelyn; Sulz, Linda; Schuster, Brenda; Taylor, Ron

    2014-01-01

    Background: Pneumonia is the eighth leading cause of death in Canada. Use of guideline-concordant therapy tempers the development of resistance, decreases health care costs, and reduces morbidity and mortality. Objectives: The purpose of this study was to optimize the treatment of patients with pneumonia under hospitalist care by focusing on best practice and local antibiogram data. The objectives were to collaborate with a hospitalist representative to optimize in-hospital treatment of patients with community-acquired, hospital-acquired, and health care–associated pneumonia; to complete a baseline audit to determine the proportion of antibiotic orders adhering to the strategy; to present the strategy and baseline audit findings to the hospitalists; to perform a post-intervention audit, with comparison to baseline, and to present results to the hospitalists; to expedite de-escalation to a narrower-spectrum antibiotic; to expedite parenteral-to-oral step-down therapy and promote appropriate duration of therapy; and to determine if a pneumonia scoring system was used. Methods: An audit and feedback intervention focusing on pre- and post-intervention retrospective chart audits was completed. Review of pneumonia guidelines and the local antibiogram assisted in identifying the study strategy. A presentation to the hospitalists outlined antimicrobial stewardship principles and described the findings of the baseline audit. Pre- and post-intervention audit results were compared. Results: Local best-practice treatment algorithms were developed for community-acquired pneumonia and for hospital-acquired and health care–associated pneumonia. The pre-intervention audit covered the period December 2011 to January 2012, with subsequent education and audit results presented to the hospitalists in November 2012. The post-intervention audit covered the period December 2012 to January 2013. Adherence to the treatment algorithms increased from 10% (2/21) in the pre

  4. Pegfilgrastim reduces the length of hospitalization and the time to engraftment in multiple myeloma patients treated with melphalan 200 and auto-SCT compared with filgrastim.

    PubMed

    Samaras, Panagiotis; Blickenstorfer, Marcel; Siciliano, Raffaele Daniele; Haile, Sarah R; Buset, Elefteri M; Petrausch, Ulf; Mischo, Axel; Honegger, Hanspeter; Schanz, Urs; Stussi, Georg; Stahel, Rolf A; Knuth, Alexander; Stenner-Liewen, Frank; Renner, Christoph

    2011-01-01

    To reduce the duration of neutropenia after conditioning chemotherapy and autologous peripheral blood stem cell transplantation (APBSCT), granulocyte-colony stimulating factors (G-CSF) are commonly administered. We retrospectively evaluated the impact of pegfilgrastim compared to filgrastim on neutrophil engraftment, hospital stay, and supportive measures in patients with multiple myeloma after conditioning with Melphalan 200 (Mel200) followed by APBSCT. Ninety-two APBSCT after Mel200 treatment were performed in 72 patients between January 2006 and December 2009 at our institution. Patients received either single-dose pegfilgrastim (n = 46; 50%), or daily filgrastim (n = 46; 50%) after APBSCT (median duration of filgrastim use, 9 days; range, 3-14 days). Duration of neutropenia grade IV was shorter with pegfilgrastim compared with filgrastim (median, 5 days (range, 3-14 days) versus 6 days (range, 3-9 days), p = 0.0079). The length of hospitalization differed significantly (pegfilgrastim (median, 14.5 days; range, 11-47 days) versus filgrastim (median, 15.5 days; range, 12-64 days), p = 0.024). Pegfilgrastim-treated patients had less red blood cell transfusions (median, 0 transfusions (range, 0-10) versus 0.5 transfusions (range, 0-9), p = 0.00065). Pegfilgrastim was associated with reduced cost of the treatment procedure compared with filgrastim (p = 0.031). Pegfilgrastim appears to be at least equivalent to filgrastim without additional expenditure in myeloma patients treated with Mel200 and APBSCT.

  5. Relevance of the test content of the Korean Nursing Licensing Examination to nursing job.

    PubMed

    Park, In Sook; Suh, Yeon Ok; Park, Hae Sook; Ahn, Soo Yeon; Kang, So Young; Kim, Kwang Sung

    2016-01-01

    This study aimed at identifying if there is a relevance of content of the Korean Nursing Licensing Examination (KNLE) revised in 2014 to nursing job. It will be able to provide the validity of revised content of the KNLE. From October 13 to November 13, 2015, print version of 8 duties with 49-tasks, 155-job item questionnaires were distributed to 1,305 hospital nurses and 202 nursing faculties in Korea. Results were treated by descriptive statistics and comparison analysis. There were responses from 946 nurses or professors (72.5%). The relevance of test content of KNLE to nursing job was shown to be valid with over 3 points out of 4 point Likert scale in all items: from 3.23 at lowest to 3.64 at top. Above results showed that the revised version of KNLE in 2014 was valid to test the nursing students' knowledge for job performance.

  6. Relevance of the test content of the Korean Nursing Licensing Examination to nursing job

    PubMed Central

    2016-01-01

    Purpose: This study aimed at identifying if there is a relevance of content of the Korean Nursing Licensing Examination (KNLE) revised in 2014 to nursing job. It will be able to provide the validity of revised content of the KNLE. Methods: From October 13 to November 13, 2015, print version of 8 duties with 49-tasks, 155-job item questionnaires were distributed to 1,305 hospital nurses and 202 nursing faculties in Korea. Results were treated by descriptive statistics and comparison analysis. There were responses from 946 nurses or professors (72.5%). Results: The relevance of test content of KNLE to nursing job was shown to be valid with over 3 points out of 4 point Likert scale in all items: from 3.23 at lowest to 3.64 at top. Conclusion: Above results showed that the revised version of KNLE in 2014 was valid to test the nursing students’ knowledge for job performance. PMID:27270986

  7. Recurrent Hospitalization Among Patients With Atrial Fibrillation Undergoing Intracoronary Stenting Treated With 2 Treatment Strategies of Rivaroxaban or a Dose-Adjusted Oral Vitamin K Antagonist Treatment Strategy

    PubMed Central

    Pinto, Duane S.; Chi, Gerald; Arbetter, Douglas; Yee, Megan; Mehran, Roxana; Bode, Christoph; Halperin, Jonathan; Verheugt, Freek W.A.; Wildgoose, Peter; Burton, Paul; van Eickels, Martin; Korjian, Serge; Daaboul, Yazan; Jain, Purva; Lip, Gregory Y.H.; Cohen, Marc; Peterson, Eric D.; Fox, Keith A.A.

    2017-01-01

    Background: Patients with atrial fibrillation who undergo intracoronary stenting traditionally are treated with a vitamin K antagonist (VKA) plus dual antiplatelet therapy (DAPT), yet this treatment leads to high risks of bleeding. We hypothesized that a regimen of rivaroxaban plus a P2Y12 inhibitor monotherapy or rivaroxaban plus DAPT could reduce bleeding and thereby have a favorable impact on all-cause mortality and the need for rehospitalization. Methods: Stented subjects with nonvalvular atrial fibrillation (n=2124) were randomized 1:1:1 to administration of reduced-dose rivaroxaban 15 mg daily plus a P2Y12 inhibitor for 12 months (group 1); rivaroxaban 2.5 mg twice daily with stratification to a prespecified duration of DAPT of 1, 6, or 12 months (group 2); or the reference arm of dose-adjusted VKA daily with a similar DAPT stratification (group 3). The present post hoc analysis assessed the end point of all-cause mortality or recurrent hospitalization for an adverse event, which was further classified as the result of bleeding, a cardiovascular cause, or another cause blinded to treatment assignment. Results: The risk of all-cause mortality or recurrent hospitalization was 34.9% in group 1 (hazard ratio=0.79; 95% confidence interval, 0.66–0.94; P=0.008 versus group 3; number needed to treat=15), 31.9% in group 2 (hazard ratio=0.75; 95% confidence interval, 0.62–0.90; P=0.002 versus group 3; number needed to treat=10), and 41.9% in group 3 (VKA+DAPT). Both all-cause death plus hospitalization potentially resulting from bleeding (group 1=8.6% [P=0.032 versus group 3], group 2=8.0% [P=0.012 versus group 3], and group 3=12.4%) and all-cause death plus rehospitalization potentially resulting from a cardiovascular cause (group 1=21.4% [P=0.001 versus group 3], group 2=21.7% [P=0.011 versus group 3], and group 3=29.3%) were reduced in the rivaroxaban arms compared with the VKA arm, but other forms of rehospitalization were not. Conclusions: Among patients with

  8. Outcomes of Adult In-Hospital Cardiac Arrest Treated with Targeted Temperature Management: A Retrospective Cohort Study

    PubMed Central

    Chang, Wei-Tien; Tsai, Min-Shan; Yu, Ping-Hsun; Wu, Yen-Wen; Chen, Wen-Jone

    2016-01-01

    Aim Targeted temperature management (TTM) for in-hospital cardiac arrest (IHCA) is given different recommendation levels within international resuscitation guidelines. We aimed to identify whether TTM would be associated with favourable outcomes following IHCA and to determine which factors would influence the decision to implement TTM. Methods We conducted a retrospective observational study in a single medical centre. We included adult patients suffering IHCA between 2006 and 2014. We used multivariable logistic regression analysis to evaluate associations between independent variables and outcomes. Results We included a total of 678 patients in our analysis; only 22 (3.2%) patients received TTM. Most (81.1%) patients met at least one exclusion criteria for TTM. In all, 144 (21.2%) patients survived to hospital discharge; among them, 60 (8.8%) patients displayed favourable neurological status at discharge. TTM use was significantly associated with favourable neurological outcome (OR: 3.74, 95% confidence interval [CI]: 1.19–11.00; p-value = 0.02), but it was not associated with survival (OR: 1.41, 95% CI: 0.54–3.66; p-value = 0.48). Arrest in the emergency department was positively associated with TTM use (OR: 22.48, 95% CI: 8.40–67.64; p value < 0.001) and having vasopressors in place at the time of arrest was inversely associated with TTM use (OR: 0.08, 95% CI: 0.004–0.42; p-value = 0.02). Conclusion TTM might be associated with favourable neurological outcome of IHCA patients, irrespective of arrest rhythms. The prevalence of proposed exclusion criteria for TTM was high among IHCA patients, but these factors did not influence the use of TTM in clinical practice or neurological outcomes after IHCA. PMID:27820847

  9. Association between suicidal symptoms and repeat suicidal behaviour within a sample of hospital-treated suicide attempters

    PubMed Central

    van Borkulo, Claudia D.; O’Connor, Rory C.

    2017-01-01

    Background Suicidal behaviour is the end result of the complex relation between many factors which are biological, psychological and environmental in nature. Network analysis is a novel method that may help us better understand the complex association between different factors. Aims To examine the relationship between suicidal symptoms as assessed by the Beck Scale for Suicide Ideation and future suicidal behaviour in patients admitted to hospital following a suicide attempt, using network analysis. Method Secondary analysis was conducted on previously collected data from a sample of 366 patients who were admitted to a Scottish hospital following a suicide attempt. Network models were estimated to visualise and test the association between baseline symptom network structure and suicidal behaviour at 15-month follow-up. Results Network analysis showed that the desire for an active attempt was found to be the most central, strongly related suicide symptom. Of the 19 suicide symptoms that were assessed at baseline, 10 symptoms were directly related to repeat suicidal behaviour. When comparing baseline network structure of repeaters (n=94) with the network of non-repeaters (n=272), no significant differences were found. Conclusions Network analysis can help us better understand suicidal behaviour by visualising the complex relation between relevant symptoms and by indicating which symptoms are most central within the network. These insights have theoretical implications as well as informing the assessment and treatment of suicidal behaviour. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license. PMID:28507771

  10. Ventricular ectopic burden in comatose survivors of out-of-hospital cardiac arrest treated with targeted temperature management at 33°C and 36°C.

    PubMed

    Thomsen, Jakob Hartvig; Kjaergaard, Jesper; Graff, Claus; Pehrson, Steen; Erlinge, David; Wanscher, Michael; Køber, Lars; Bro-Jeppesen, John; Søholm, Helle; Winther-Jensen, Matilde; Hassager, Christian

    2016-05-01

    Life threatening arrhythmias are increasingly frequent with lower body temperature. While targeted temperature management (TTM) with mild hypothermia following out-of-hospital cardiac arrest (OHCA) is generally considered safe and has been suggested as a potential antiarrhythmic add-on therapy, it is unknown whether the level of TTM affects the burden of ventricular ectopic activity. We sought to assess the ventricular ectopic burden between patients treated with TTM at 33°C or 36°C for 24h. Continuous 12-lead digital Holter electrocardiograms performed during the intervention were analyzed blinded to treatment allocation in 115 comatose OHCA-survivors from a single center of the TTM-trial. The main study showed no difference with regards to mortality. Fifty-eight patients were randomized to 33°C and 57 to 36°C. Cardiac arrest characteristics were similar between the groups. The number of isolated ventricular ectopic beats (VEB) per hour was similar at the beginning of the maintenance phase of TTM and decreased over time in both groups (both ptime<0.001). The reduction in VEB per hour was significantly affected by target temperature (pinteraction<0.0001), with fewer VEB in the 36°C-group. The total number of isolated, couplets and number of runs of VEB per hour showed similar results, with less ventricular ectopic activity in the 36°C-group (pinteraction<0.0001). Increasing numbers of pre-hospital defibrillations (log2) were associated with a 46% increase in ventricular ectopic activity (p<0.01), adjusted for potential confounders. Ventricular ectopic activity was reduced in comatose OHCA-survivors treated with TTM at 36°C compared to 33°C. Higher numbers of pre-hospital defibrillations were associated with higher incidence of ventricular ectopic activity. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Low trihalomethane formation in Korean drinking water.

    PubMed

    Yoon, Jeyong; Choi, Youshik; Cho, Soonhang; Lee, Dongsoo

    2003-01-20

    Organics in water have the potential to generate harmful disinfection by-products (DBPs) such as trihalomethanes (THMs) during the chlorination process. To clarify the regulatory implications of Korean THMs levels which appear to be significantly lower than those in the US where the Stage 1 and 2 D/DBPs rule has been promulgated, the characteristics of THMs formation were investigated on five major river waters in Korea. Water samples were taken from 12 water treatment plants on five major rivers that serve as drinking water sources for more than 90% of the Korean population. Trihalomethane formation potential (THMFP), total organic halide formation potential (TOXFP) and ultraviolet absorbance at 254 nm (UV(254)) were determined and compared with those from US data. A survey of existing data [J Korean Soc Water Qual; 16(4) 2000b 431-443] provided evidence that THMs levels in treated drinking water in Korea were one-third of those reported in the US. The lower THMs levels were mainly attributable to the differences in the level and THMFP of dissolved organic carbon (DOC). The DOC levels and the THMFP normalized to DOC were approximately 60% of those in the US. Results which combined could quantitatively account for the lower THMs levels (i.e. 0.6 x 0.6 approximately 1/3) in Korea. The observed Korean THMs levels were over-predicted by the THMs model () developed in the US. The level of THMFP was found to be similar if normalized for aromaticity as measured by UV(254). These findings suggest that: (i) the case for more stringent THMs control is not likely to be a high priority among issues of drinking water quality in Korea; and (ii) significant variation of THMFP level may exist over different geographic regions; hence (iii) independent THMs models should be developed to make accurate predictions for different regions.

  12. Hospital Workload for Weapon-Wounded Females Treated by the International Committee of the Red Cross: More Work Needed than for Males.

    PubMed

    Andersson, Peter; Muhrbeck, Måns; Veen, Harald; Osman, Zaher; von Schreeb, Johan

    2017-08-09

    Civilians constitute 33-51% of victims in armed conflicts. Several reports on civilian injuries exist, but few have focused on injuries afflicting females. We analyzed routinely collected data on weapon-related injuries from the International Committee of the Red Cross (ICRC) hospital in northwestern Pakistan in order to define injury patterns and types of surgical treatment for females. A total of 3028 patient files (376 females) from consecutively admitted patients to the ICRC-hospital in Peshawar from February 2009 to May 2012 were included. Information regarding injury-mechanism, time since injury, vital parameters at admission, type of injury, treatment and basic outcome was extracted from the files and analyzed. Comparisons between gender and age-groups were done by cross-table analyses or nonparametric tests. Females were younger than males (20 vs. 25 years), arrived sooner after injury (24 vs. 48 h) (p < 0.001 for both) and were victims of bombs and missiles more frequently (64.4 vs. 54.6%) (p < 0.001). Vital parameters such as systolic blood pressure (110 vs. 113 mmHg) and pulse rate (100 vs. 86) were more affected at admission (p < 0.001 for both). Females were subjected to surgery (83.0 vs. 77.4%) (p < 0.05) and were given blood transfusions more often (18.8 vs. 13.6%) (p < 0.01). No differences in amputations or in-hospital mortality were found. Females treated at the ICRC-hospital in northwestern Pakistan are markedly affected by indiscriminate weapons such as bombs and missiles. Their average consumption of surgery is greater than for males, and this might be relevant in planning for staffing and facility needs in similar contexts.

  13. The effect of hydroxyzine on treating bruxism of 2- to 14-year-old children admitted to the clinic of Bandar Abbas Children Hospital in 2013-2014

    PubMed Central

    Rahmati, M; Moayedi, A; Zakery Shahvari, S; Golmirzaei, J; Zahirinea, M; Abbasi, B

    2015-01-01

    Introduction. Bruxism is to press or grind teeth against each other in non-physiologic cases, when an individual does not swallow or chew. If not treated, teeth problems, stress, mental disorders, frequent night waking, and headache is expected. This research aimed to study the effect of hydroxyzine on treating bruxism of 2- to 14-year-old children admitted to the clinic of Bandar Abbas Children Hospital. Methodology. In this clinical trial, 143 children with the ages between 4-12 years were admitted to the Children Hospital and were divided randomly into test and control groups. The test group consisted of 88 hydroxyzine-treated children and the control group consisted of 55 children who used hot towels. Both groups were examined in some stages including the pre-test stages or the stage before starting treatments at two, four, and six weeks and four months after stopping the treatment. The effects of each treatment on reducing bruxism symptoms were assessed by a questionnaire. The data were analyzed by using SPSS in descriptive statistics, t-test, and ANOVA. Results. As far as bruxism severity was concerned, the results showed a significant difference between the test group members who received hydroxyzine and the control group members who received no medication. T-test results showed a statistically significant difference between the test and the control groups in the second post-test (four weeks later) (p. value ≤ 0.05). Mean of the scores of bruxism severity in the test group has changed significantly in the post-test (at two weeks, four weeks, and six weeks later) as compared to the pre-test. Whereas, as far as the response to the treatment, no significant difference was recorded between the control group and the test group 4 weeks after the treatment. Discussion. The results showed that prescribing hydroxyzine for 4 weeks had a considerable effect in diminishing bruxism severity between the test groups.

  14. The effect of hydroxyzine on treating bruxism of 2- to 14-year-old children admitted to the clinic of Bandar Abbas Children Hospital in 2013-2014.

    PubMed

    Rahmati, M; Moayedi, A; Zakery Shahvari, S; Golmirzaei, J; Zahirinea, M; Abbasi, B

    2015-01-01

    Introduction. Bruxism is to press or grind teeth against each other in non-physiologic cases, when an individual does not swallow or chew. If not treated, teeth problems, stress, mental disorders, frequent night waking, and headache is expected. This research aimed to study the effect of hydroxyzine on treating bruxism of 2- to 14-year-old children admitted to the clinic of Bandar Abbas Children Hospital. Methodology. In this clinical trial, 143 children with the ages between 4-12 years were admitted to the Children Hospital and were divided randomly into test and control groups. The test group consisted of 88 hydroxyzine-treated children and the control group consisted of 55 children who used hot towels. Both groups were examined in some stages including the pre-test stages or the stage before starting treatments at two, four, and six weeks and four months after stopping the treatment. The effects of each treatment on reducing bruxism symptoms were assessed by a questionnaire. The data were analyzed by using SPSS in descriptive statistics, t-test, and ANOVA. Results. As far as bruxism severity was concerned, the results showed a significant difference between the test group members who received hydroxyzine and the control group members who received no medication. T-test results showed a statistically significant difference between the test and the control groups in the second post-test (four weeks later) (p. value ≤ 0.05). Mean of the scores of bruxism severity in the test group has changed significantly in the post-test (at two weeks, four weeks, and six weeks later) as compared to the pre-test. Whereas, as far as the response to the treatment, no significant difference was recorded between the control group and the test group 4 weeks after the treatment. Discussion. The results showed that prescribing hydroxyzine for 4 weeks had a considerable effect in diminishing bruxism severity between the test groups.

  15. Classifying Korean Adolescents' Career Preparedness

    ERIC Educational Resources Information Center

    Lee, In Heok; Rojewski, Jay W.; Hill, Roger B.

    2013-01-01

    Latent class analysis was used to examine the career preparation of 5,227 11th-grade Korean adolescents taken from the Korean Education Longitudinal Study of 2005 (KELS:2005). Three career preparedness groups were identified, to reflecting Skorikov's ("J Vocat Behav" 70:8-24, 2007) conceptualization of career preparedness: prepared,…

  16. Teaching English Pronunciation to Koreans.

    ERIC Educational Resources Information Center

    Robson, Barbara

    This guide provides teachers of Korean children and adults with information on the problems Koreans encounter in learning to pronounce English. Principles of contrastive analysis and error analysis are used to give insight into these pronunciation problems. The first section dealing with problem sounds covers the following: (1) an explanation of…

  17. Korean/Korean American Adolescents' Responses to Young Adult Fiction and Media Created by Korean/Korean Americans

    ERIC Educational Resources Information Center

    Kim, Eunhyun

    2010-01-01

    Multicultural children's and young adult literature provides readers with various opportunities: to mirror their lives and reflect the meanings of their own experiences; to gain insight on social issues as well as personal issues; and to enhance cross-cultural awareness. How might Korean/Korean American youth cope with everyday life as a minority…

  18. Korean Advanced Course, Volume I.

    ERIC Educational Resources Information Center

    Defense Language Inst., Washington, DC.

    This is the first of 7 readers for continuation training in Korean after the completion of the "Korean Basic Course" prepared by the Defense Language Institute. Units 1-11 are practical situation dialogues written for the course and center on topics related to sports, social events, police administration, and dialects. Interviews with key…

  19. Korean Advanced Course: Volume V.

    ERIC Educational Resources Information Center

    Defense Language Inst., Washington, DC.

    This is the fifth in a series of seven readers designed for continuation training in the Defense Language Institute's Basic Course in Korean. Twelve articles, drawn from several readers published by the Ministry of Education of the Republic of Korea in 1970, focus on Korean letters, life, and customs. The reader is to be used for development of…

  20. Korean Advanced Course: Volume II.

    ERIC Educational Resources Information Center

    Defense Language Inst., Washington, DC.

    This is the second of seven readers, prepared by the Defense Language Institute, for continuation training in Korean after the Basic Course. The 20 reading lessons, printed in Korean script, have been drawn from several readers published by the Ministry of Education of the Republic of Korea in 1970. Each unit concludes with a set of questions and…

  1. Survey of integrative lumbar spinal stenosis treatment in Korean medicine doctors: preliminary data for clinical practice guidelines.

    PubMed

    Lee, Yoon Jae; Shin, Joon-Shik; Lee, Jinho; Kim, Me-Riong; Ahn, Yong-Jun; Shin, Ye-Sle; Park, Ki Byung; Shin, Byung-Cheul; Lee, Myeong Soo; Kim, Joo-Hee; Cho, Jae-Heung; Ha, In-Hyuk

    2017-08-29

    Considering that large variations exist amongst practitioners in lumbar disorder management and the significant costs that lumbar disorders incur, determining clinical practice patterns to provide preliminary data for standardization should be given higher priority. Lumbar spinal stenosis (LSS) is commonly treated using integrative non-surgical methods by Korean medicine doctors (KMDs) in Korea, and this is the first study to assess current Korean medicine practice trends for LSS. A survey on KMD diagnosis, treatment, prognosis and decision-making in LSS treatment was developed in a 3-step procedure of preliminary drafting, revision based on extramural expert opinion, and final editing. The survey was conducted at the internal conference of a spine-specialty Korean medicine hospital on January 25th, 2015. The response rate was high at 79.19% (n = 118/149). Participants replied that they treated 7.3 ± 6.8 LSS patients/day using a multimodal treatment method consisting of acupuncture, pharmacopuncture, herbal medicine, Chuna manipulation, and electroacupuncture. Acupuncture mainly used Ashi points and MSAT, and pharmacopuncture mainly Shinbaro solution. The most frequently prescribed herbal medicine was Chungpa-jun, and the most commonly applied Chuna techniques were sidelying lumbar extension dysfunction correction technique, and prone lumbosacral joint distraction method. Radiological findings were mainly referred to for diagnosis, and clinical symptoms, age, radiological findings, and medical history were regarded to be important for prognosis. Participants replied that 7.8 ± 3.3 weeks were required for 50% reduction in pain, and 16.1 ± 7.7 weeks for 80% reduction. These results suggest that KMDs in Korea combine a conventional approach to LSS and a Korean medicine approach to low back pain for integration of empirical- and evidence-based diagnosis and treatment. The findings may contribute in bridging the divide between evidence and clinical practice

  2. Korean Heritage Language Maintenance and Language Ideology

    ERIC Educational Resources Information Center

    Jeon, Mihyon

    2008-01-01

    This paper explores ways in which language ideology is linked to maintenance of Korean as a heritage language by Koreans in America. The data for this ethnographic study come from three separate sources: 1) a Korean language program at an American university; 2) a community-based ESL program for Korean seniors; and 3) a recently immigrated Korean…

  3. Acculturation of Korean Residents in Georgia.

    ERIC Educational Resources Information Center

    Lee, Don Chang

    This report explores the acculturation of Korean residents; both Korean families and Korean American families who reside in an academic community (Athens, Georgia) and an urban community (Atlanta, Georgia). The study is based on the view that Korean residents in the United States are a distinctive subgroup that has not yet been studied in terms of…

  4. Psychosocial care of severely malnourished children. A hospital in Haiti has greatly improved the prospects for the children it treats.

    PubMed

    Goodfriend, Marlene

    2004-10-01

    The psychosocial intervention program for malnourished children at Hôpital Albert Schweitzer has evolved over several years and now consists of daily interventions including music on the unit, cooking and feeding instruction, exercise sessions, supervised play sessions, daily massage of children by their parents, toy making, and singing and dancing. The interventions are supervised by Haitian personnel and have been developed according to what is interesting and stimulating for Haitian parents and their children. These interventions appear to have greatly improved the moods of the parents and their children. They seem happier. There is more interaction between the parents and the children throughout the day, including touching, playing, and talking. The feeding situation has improved. Parents feed their children; there is more socializing and eye contact during meals. Our experience supports the concept that the rehabilitation of the malnourished child is facilitated by interventions that restore a positive parent-child relationship. These interventions should be tailored to the local culture. Future studies could evaluate the effect of such interventions on the parent-child interaction at the beginning and end of the hospitalization, as well as on parameters such as mortality, rate of weight gain, length of stay, and readmission rates.

  5. Considerations for clinics and practitioners treating foreign patients with assisted reproductive technology: lessons from experiences at Ghent University Hospital, Belgium.

    PubMed

    De Sutter, Petra

    2011-11-01

    Cross-border reproductive care (CBRC) is not a new concept, having been around since the beginning of assisted reproductive technology. Countries having taken the lead in developing new technologies have seen an influx of patients from other countries, because of legal limitations or the unavailability of good-quality care in their home country. This paper describes the experience of the Ghent University Hospital fertility centre with Dutch and French patients and tries to set out standards of care for CBRC patients. Dutch patients usually have longer histories, more complex pathology and are better informed, more outspoken and more financially secure. Thus, the care for these patients is challenging. The standards of care should be the same for local patients and CBRC patients; however, the nature of the complexity of the problems they come with will necessitate more time investment. Experience shows that many patients who have no access to treatment in their own country obtain reasonably good results. Some of them, however, are beyond possible help and these patients need a high standard of psychological care. All should be done to avoid that cross-border patients compromise the local care system. Special arrangements should be taken to manage possible complications following treatment. Copyright © 2011 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  6. Ocular trauma from land mines among soldiers treated at a University Hospital in Medellín, Colombia

    PubMed Central

    Velasquez, Luis F; Restrepo, Carlos A; Paulo, Jose D; Donado, Jorge; Muñoz, Marta L; Aristizabal, John J

    2013-01-01

    Introduction: Currently ocular combat injuries are complex and associated with poor visual outcomes. Our objective is to characterize the military population that suffer land mine combat ocular trauma in Colombia and identify the type of wound, treatment and visual outcomes. Methods: Retrospectively review of medical history of soldiers evaluated in Pablo Tobon Uribe Hospital, whom had land mine trauma during January of 2004 and December 2012. Results: 635 soldiers had land mine trauma, 153 of them had ocular trauma (226 eyes). Open ocular trauma was observed in 29.6%. The Ocular Trauma Score was calculated in 183 eyes, the initial visual acuity was not possible to be reported in the rest of them; the 45% of the eyes were classified in category 3. Three patients had no light perception in both eyes. 97.3% of the eyes received medical treatment and 49.1% had surgery also. Primary evisceration was made in 5.8% and enucleation in 1.8%. Intraocular foreign body was observed by ultrasonography in 11.1% and in 5.8% by orbital tomography. Eleven patients were legally blind at discharge. Conclusions: The ocular trauma related to a land mine is highly destructive at an ocular level. The treatments associated with better visual outcomes are primary closure of globe and systemic antibiotics; although the characteristics of the wound itself are the main prognostic factor. The Ocular trauma score is a useful tool for determining visual outcome in combat ocular trauma. PMID:24892238

  7. Utilization Patterns of Korean Medicine: An Analysis of the National Health Insurance Cohort Database from 2002 to 2013.

    PubMed

    Park, Sunju; Oh, In-Hwan; Jang, Bo-Hyoung; Park, Minjung; Shin, YongCheol; Moon, Kanghee; Ko, Seong-Gyu

    2016-10-01

    Although Korean Medicine (KM) is an important part of the Korean healthcare system and plays a significant role in chronic and incurable diseases, there is insufficient information about KM utilization. The aim of the study was to identify KM utilization patterns using a national representative sample data. KM users aged 0-80 years and older from the nationally representative sample in the National Health Insurance Service-National Sample Cohort of 778,506 KM users between 2002 and 2013 (were analyzed. Annual changes in utilization patterns were analyzed by sex, nine age groups, five income levels, and numbers of visits and hospitalizations. Utilization patterns by the type of healthcare institution and the top 10 major diseases were studied. Frequencies of KM use differed according to analyses of patients and claims. Women used KM 1.5 times more than did men. Patients in their 40s and 50s made up one third of KM users. In contrast to other studies, high-income groups used KM more than did low-income groups. More than 96% of ambulatory patients used mostly KM clinics, and more than 76% of inpatients used KM hospitals. Musculoskeletal disorders were the main disease treated, which conformed to the results of previous studies. The results suggest that women, people in their 40s and 50s, and people with a relatively high income use KM more often than other patients. Further comparison studies of both Western medicine in Korea and other countries should be conducted.

  8. [Long-term survival related to cognitive performance in older adults treated at a tertiary hospital level].

    PubMed

    Gutiérrez-Robledo, Luis Miguel; Villalpando-Berumen, Juan Manuel; García-Cruz, Juan Carlos; Reyes-Guerrero, Jorge Antonio; Villa, Antonio Rafael

    2009-01-01

    To determine the association between cognitive performance and long-term survival in an elderly Mexican population sample. In this retrospective, retrolective and observational study elderly subjects were assessed in the Geriatrics Clinic of the Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" between January 1994 and August 1999 using a comprehensive geriatric assessment. All 2544 subjects for whom vitality status was known up to September 2002 were included in the analysis. Socio-demographic and health-related information was gathered during the clinical interview, and their emotional and functional status was determined using the Katz, Lawton and GDS scales. Cognition was measured using the Mini-Mental State Examination (MMSE), grouping the subjects according to their performance into four groups: normal-high performance, normal-low performance, mild-to-moderate impairment and moderate-to-severe impairment. Vitality status was determined by searching the hospital's clinical records or by telephonic contact with the patient or primary caregiver when needed. Long-term mortality rates increased in a linear fashion as MMSE scores decreased (p < 0.001), even for MMSE scores over 24. This association persisted even after adjustment for comorbidity, depression, functional status and socio-demographic factors. Patients showed a progressive decline in long-term survival according to their cognitive performances. MMSE scores between 24 and 27 were also associated with an increased mortality and should not be considered as normal, even if they are not sensitive enough to detect impairment.

  9. Going to the Hospital

    MedlinePlus

    ... Happens in the Operating Room? Going to the Hospital KidsHealth > For Kids > Going to the Hospital Print ... you flowers, balloons, or other treats! previous continue Hospital People You'll meet lots of people in ...

  10. Apoptosis gene polymorphisms and risk of prostate cancer: a hospital-based study of German patients treated with brachytherapy.

    PubMed

    Meyer, Andreas; Coinac, Irina; Bogdanova, Natalia; Dubrowinskaja, Natalia; Turmanov, Nurzhan; Haubold, Sabine; Schürmann, Peter; Imkamp, Florian; von Klot, Christoph; Merseburger, Axel S; Machtens, Stefan; Bremer, Michael; Hillemanns, Peter; Kuczyk, Markus A; Karstens, Johann H; Serth, Jürgen; Dörk, Thilo

    2013-01-01

    Prostate cancer has a genetic component, and single nucleotide polymorphisms (SNPs) can contribute to the risk. We aimed to investigate the role of polymorphisms in 10 candidate genes with a key function in apoptosis. Eight coding SNPs were chosen in ATM (Ser49Cys), BID (Ser56Cys), CASP8 (Asp302His), CASP10 (Val410Ile), LGALS3 (Pro64His), RASSF1 (Ser133Ala), TP53 (Arg72Pro), and TP53AIP1 (Ala7Val), and two non-coding SNPs were selected in BCL2 (-938C/A) and HDM2 (SNP309). A hospital-based case-control series of 510 prostate cancer patients and 490 healthy males from Northern Germany were genotyped for these polymorphisms. SNP rs4644 in LGALS3 showed evidence for a protective effect of the minor allele, encoding the His64 variant (OR 0.82, 95% CI 0.69;0.99, P = 0.04). Carriers were underrepresented among cases under a dominant model (OR 0.71; 95% CI 0.54;0.92; P = 0.01), and the effect appeared more pronounced in patients diagnosed before the age of 60 years (OR 0.52; 95% CI 0.31;0.85, P = 0.01). The other nine polymorphisms did not vary significantly between cases and controls, though subtle trends were noted for BCL2 (P = 0.07) and CASP10 (P = 0.08). The Asp302His variant of CASP8 tended to associate with a protective effect in the group with higher Gleason score under a dominant model (P = 0.03). Carriers of either the CASP8 or the CASP10 variants were underrepresented in the prostate cancer series (P = 0.02). These results provide first evidence to implicate the functional Pro64His variant of galectin-3 (LGALS3) in the genetic susceptibility towards prostate cancer. The potential role of polymorphisms in BCL2, CASP8, and CASP10 merits further investigation. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Erythropoiesis-Stimulating Agent (ESA) Practice Patterns in Patients With Chemotherapy-Induced Anemia (CIA) Treated at Hospital Oncology Clinics.

    PubMed

    Reitan, John F; van Breda, Arletta; Shreay, Sanatan; Corey-Lisle, Patricia K; Cong, Ze

    2013-02-01

    To characterize erythropoiesis-stimulating agent (ESA) usage initiated in hospital outpatient oncology centers that employ weekly (QW) and every-3-week (Q3W) ESA dosing regimens; describe the frequency of ESA dosing, transfusions, hemoglobin determinations, and anemia-related visits between these 2 regimens; and compare the rates at which inpatient ESA doses are administered on QW versus Q3W schedules. This was a retrospective, observational record review evaluating ESA usage in 641 patients from 8 outpatient oncology clinics throughout the United States. Adult patients who initiated myelosuppressive chemotherapy for a documented solid tumor between August 1, 2007 and June 30, 2009 and received their first 3 consecutive outpatient ESA doses on a QW or Q3W schedule were eligible for study inclusion. During a single course of chemotherapy, ESA administrations were recorded as long as ESA therapy was continued on the initial regimen. ESA doses were captured until termination of ESA therapy, until 9 months had elapsed since the first ESA dose, until the patient was switched to another ESA regimen, or until death. ESA administration during inpatient admissions was also recorded. ESA utilization varied between the dosing groups, with fewer ESA doses administered per follow-up month in patients receiving Q3W versus QW ESA therapy (mean, 1 vs 2 doses). Compared to weekly administration, extended-dose ESA therapy also reduced the number of hemoglobin determinations and anemia-related visits without chemotherapy required per follow-up month. Neither the number of transfusions nor the number of packed red blood cell units administered per follow-up month differed between treatment groups. Compared to weekly ESA therapy, Q3W administration reduced costs associated with ESA prescribing and utilization. Extended-dose ESA therapy (Q3W dosing) may improve practice efficiency and may be associated with reduced frequencies of hemoglobin determinations and ESA doses required. Q3W

  12. Combined proton and photon irradiation for craniopharyngioma: Long-term results of the early cohort of patients treated at Harvard Cyclotron Laboratory and Massachusetts General Hospital

    SciTech Connect

    Fitzek, Markus M.; Linggood, Rita M.; Adams, Judy; Munzenrider, John E. . E-mail: jmunzenrider@partners.org

    2006-04-01

    Purpose: We report the results of the early cohort of patients treated for craniopharyngioma with combined proton-photon irradiation at the Massachusetts General Hospital and the Harvard Cyclotron Laboratory. Methods and Materials: Between 1981 and 1988, 15 patients with craniopharyngioma were treated in part or entirely with fractionated 160 MeV proton beam therapy. The group consisted of 5 children (median age, 15.9 years) and 10 adults (median age, 36.2 years). Median dose prescribed to the tumor was 56.9 cobalt Gray equivalent (CGE; 1 proton Gray = 1.1 CGE). The median proton component was 26.9 CGE. Patients were treated after documented recurrence after initial surgery (n = 6) or after subtotal resection or biopsy (n = 9). None had had prior radiation therapy. Results: Median observation period of surviving patients (n = 11) was 13.1 years from radiotherapy. One patient was lost to follow-up with tumor control after 5.2 years. Actuarial 10-year survival rate was 72%. Four patients have died 5-9.1 years after treatment, two from local failure. Actuarial 5- and 10-year local control rates were 93% and 85%, respectively. The functional status of the living adult patients is unaltered from their preradiotherapy status; all of them continued leading normal or near normal working lives. None of the patients treated as a child had experienced recurrence of tumor. One child shows learning difficulties and slight retardation, comparable to his preradiotherapy status. The others have professional achievements within the normal range. Conclusion: Results in terms of survival and local control are comparable with other contemporary series. Although no formal neuropsychological testing was performed, the surrogate measures of lifestyle and professional accomplishments appear to be satisfactory.

  13. Obesity and Hyperglycemia in Korean Men with Klinefelter Syndrome: The Korean Endocrine Society Registry

    PubMed Central

    Han, Seung Jin; Kim, Kyung-Soo; Kim, Wonjin; Kim, Jung Hee; Lee, Yong-ho; Nam, Ji Sun; Seo, Ji A; Kim, Bu Kyung; Lee, Jihyun; Chung, Jin Ook; Kim, Min-Hee; Sohn, Tae-Seo; Choi, Han Seok; Hong, Seong Bin

    2016-01-01

    Background The aim of this study was to investigate the prevalence of obesity in Korean men with Klinefelter syndrome (KS) and the associated risk factors for obesity and hyperglycemia. Methods Data were collected retrospectively from medical records from 11 university hospitals in Korea between 1994 and 2014. Subjects aged ≥18 years with newly diagnosed KS were enrolled. The following parameters were recorded at baseline before treatment: chief complaint, height, weight, fasting glucose level, lipid panel, blood pressure, testosterone, luteinizing hormone, follicle-stimulating hormone, karyotyping patterns, and history of hypertension, diabetes, and dyslipidemia. Results Data were analyzed from 376 of 544 initially enrolled patients. The rate of the 47 XXY chromosomal pattern was 94.1%. The prevalence of obesity (body mass index ≥25 kg/m2) in Korean men with KS was 42.6%. The testosterone level was an independent risk factor for obesity and hyperglycemia. Conclusion Obesity is common in Korean men with KS. Hypogonadism in patients with KS was associated with obesity and hyperglycemia. PMID:28029029

  14. Prevalence of osteonecrosis of the jaw and oral characteristics of oncologic patients treated with bisphosphonates at the General Hospital of Mexico

    PubMed Central

    2016-01-01

    Objectives To determine the prevalence and oral characteristics of cancer patients treated with bisphosphonates in the oncology and maxillofacial prosthesis departments of the General Hospital of Mexico between 2011 and 2013. Materials and Methods This cross-sectional study included patients who received prior treatment with bisphosphonates; an intraoral examination was performed by 2 standardized examiners. Results The prevalence of bisphosphonate-related necrosis in 75 patients was 2.6%; the most common malignancy was breast cancer (84.0%), followed by prostate cancer (16.0%). Exostosis was present in 9.3% of patients and the mean Decayed, Missing, Filled Teeth index was 4.64; 44.0% of the study group had a Community Periodontal Index value between 2 and 2.9 (mean, 0.60). Conclusion A detailed intraoral assessment must be performed before initiating treatment with bisphosphonates to identify risk factors for osteonecrosis. PMID:28053907

  15. Prevalence of osteonecrosis of the jaw and oral characteristics of oncologic patients treated with bisphosphonates at the General Hospital of Mexico.

    PubMed

    Cuevas-González, María Verónica; Díaz-Aguirre, Celia Minerva; Echevarría-Y-Pérez, Enrique; Cuevas-González, Juan Carlos

    2016-12-01

    To determine the prevalence and oral characteristics of cancer patients treated with bisphosphonates in the oncology and maxillofacial prosthesis departments of the General Hospital of Mexico between 2011 and 2013. This cross-sectional study included patients who received prior treatment with bisphosphonates; an intraoral examination was performed by 2 standardized examiners. The prevalence of bisphosphonate-related necrosis in 75 patients was 2.6%; the most common malignancy was breast cancer (84.0%), followed by prostate cancer (16.0%). Exostosis was present in 9.3% of patients and the mean Decayed, Missing, Filled Teeth index was 4.64; 44.0% of the study group had a Community Periodontal Index value between 2 and 2.9 (mean, 0.60). A detailed intraoral assessment must be performed before initiating treatment with bisphosphonates to identify risk factors for osteonecrosis.

  16. A Case of Blunt Traumatic Cardiac Tamponade Successfully Treated by Out-of-hospital Pericardial Drainage in a "Doctor-helicopter" Ambulance Staffed by Skilled Emergency Physicians.

    PubMed

    Otsuka, Hiroyuki; Sato, Toshiki; Morita, Seiji; Nakagawa, Yoshihide; Inokuchi, Sadaki

    2016-03-20

    We report a 55-year-old man who relapsed into a state of shock in an ambulance before arriving at our critical care center after a fall injury. The diagnosis of cardiac tamponade was made by portable ultrasound, and immediate pericardiocentesis and drainage were performed at the heliport. He was then transported immediately to our hospital with continuous drainage and surgery was performed. After surgery, the patient was transferred to the intensive care unit in stable condition. After undergoing rehabilitation, he made a full recovery and was discharged. This case illustrates that such patients can be treated reliably by pericardial drainage performed by skilled emergency physicians in the field by making use of the "doctor-helicopter" ambulance transportation system, followed by emergency surgery in a critical care center.

  17. Korean atomic bomb victims.

    PubMed

    Sasamoto, Yukuo

    2009-01-01

    After colonizing Korea, Japan invaded China, and subsequently initiated the Pacific War against the United States, Britain, and their allies. Towards the end of the war, U.S. warplanes dropped atomic bombs on Hiroshima and Nagasaki, which resulted in a large number of Koreans who lived in Hiroshima and Nagasaki suffering from the effects of the bombs. The objective of this paper is to examine the history of Korea atomic bomb victims who were caught in between the U.S., Japan, the Republic of Korea (South Korea) and the Democratic People's Republic of Korea (North Korea).

  18. Prospects from Korean Reunification

    DTIC Science & Technology

    2008-03-29

    Samuel S. Kim (New York, NY: Palgrave Macmillan Press, 2004), 1-2. 2 Seung -Ho Joo, “Korean Foreign Relations Toward The Twenty-First Century...Reunification,” Asian Affairs: An American Review (Winter 1999): 195-207. 53 Seung -Ho Joo, American Asian Review, 131 54 Pollack and Lee, 87. 55 Suk- hee ...S. Kim , The Two Koreas And The Great Powers, 98. 74 Snyder, NBR Analysis, 54. 75 Suk- hee Han, 137-139. 76 Victor D. Cha, “Defensive Realism and

  19. Comparative Effectiveness of In-Hospital Trauma Resuscitation at a French Trauma Center and Matched Patients Treated in the United States

    PubMed Central

    Haider, Adil H.; David, Jean-Stephane; Zafar, Syed Nabeel; Gueugniaud, Pierre-Yves; Efron, David T.; Floccard, Bernard; MacKenzie, Ellen J.; Voiglio, Eric

    2013-01-01

    Objective The objective of this paper is to compare mortality outcomes between patients treated at a trauma center in France and matched patients in the United States. Summary Background Data Although trauma systems in France and the U.S. differ significantly in pre-hospital and in-hospital management, previous comparisons have been challenged by lack of comparable data. Methods Coarsened exact matching identified matching patients between a single center trauma database from Lyon, France and the National Trauma Data Bank (NTDB) of the U.S. Moderate to severely injured (ISS >8) adult patients (age ≥16) presenting alive to level-1 trauma centers from 2002–2005 with blunt or penetrating injuries were included. After matching patients, multivariate regression analyses were performed to determine difference in mortality between patients in Lyon and the NTDB. Results A total of 1,043 significantly injured patients presented to the Lyon center. Matching eligible patients with complete records were sought from 219,985 patients in the NTDB. The unadjusted odds of mortality at the Lyon center was 2.5 times higher than that of the NTDB (95% CI =2.18, 2.98). However, the Lyon center received patients with higher ISS, lower GCS and lower SBP (all p<0.001). After 1:1 matching 858 patient pairs were produced, and the odds of mortality became equivalent (OR= 1.3, 95% CI =0.91, 1.73). Similar results were found on multiple subset analyses. Conclusions Trauma patients admitted to a single French trauma center had an equal chance of survival compared to similarly injured patients treated at U.S. trauma centers. PMID:23478519

  20. Blood pressure control status and relationship between salt intake and lifestyle including diet in hypertensive outpatients treated at a general hospital.

    PubMed

    Ohta, Yuko; Kimura, Yorio; Kitaoka, Chie; Sakata, Tomoko; Abe, Isao; Kawano, Yuhei

    2017-01-01

    The purpose of the present study was to investigate blood pressure (BP) control and salt intake in hypertensive outpatients treated at a general hospital and to examine the relationship between their lifestyles and amount of salt intake. Subjects comprised 429 hypertensive patients (206 males, 223 females, and average age of 71 ± 11 years). We estimated 24-hour salt excretion using spot urine samples and assessed lifestyle using a self-description questionnaire. Average clinic BP and the number of antihypertensive drugs were 132 ± 11/73 ± 8 mmHg and 1.8 ± 0.9, respectively. In all subjects, average estimated salt intake was 9.2 ± 2.8 g/day and the rate of achievement of the estimated salt intake of <6 g/day was 11.2%. In patients with chronic kidney disease or cardiovascular disease, these values were 8.6 ± 2.6 g/day and 15.5%, and 9.1 ± 3.3 g/day and 18.2%, respectively. Estimated salt intake was lower in patients living alone than in those with a family. In a multivariate analysis, estimated salt intake correlated positively with body mass index and negatively with age. Among patients with an excessive salt intake (≥10 g/day), 75.2% answered that they made an effort to reduce their salt intake. The amount of food and processed food consumption correlated with estimated salt intake. In conclusion, the rate of achievement of salt restriction was low in hypertensive patients treated at a general hospital. It may be important to provide data on actual salt intake and guide salt restriction in the individual management of hypertension.

  1. Epidemiology and mortality of burned patients treated in the University Hospital Center in Tirana, Albania: an analysis of 2337 cases during the period 1998-2008.

    PubMed

    Belba, Monika Kristaq; Petrela, Elizana Ylber

    2012-03-01

    The basis for qualitative changes concerning everyday clinical practice are created from epidemiological studies, which not only generalize situations but at the same time provide specific details of the country's features; especially during periods of social transition. The aim of this study was to present demographic and epidemiological features of severe burns treated in the Service of Burns in UHC (University Hospital Center) in Albania and to analyze burn mortality as an important outcome measure. The data used was obtained by the analysis of the medical records of 2337 patients hospitalized in Burns Service ICU near in Tirana, Albania during 1998-2008. Statistical analysis is done with SPSS 15 software. Descriptive analyses, inferential statistics and Chi-square test and Kendall's tau_b are calculated. Logistic regression is used for the prediction of death probability by two risk variables, BSA burned and age. The severe burn incidence was 7 patients per 100,000 persons/year. The overall mean estimated BSA (%) is 22.8±14.7. The main causes of the burn were found to be the scalds in 61.8% of the cases followed by flame (23%), chemicals (10.7%) and electrical injury in 4.5% of the cases. The mean hospital period is 11.6±10. The overall mortality is 10.5%. Based on probability of death, we noticed that older age and larger burn size were associated with a higher likelihood of mortality. The long-term studies and the comparison of our results with the ones of other burn centers has allowed us to determine the actual level of care and as well as to build up contemporary protocols in order to improve the treatment with the objection of decreasing the mortality. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

  2. [Frequency and mortality by rebleeding in cirrhotic patients treated for bleeding esophagic varices in two hospitals in Lima Peru during years 2009 to 2011].

    PubMed

    Pichilingue Reto, Catherina; Queirolo Rodriguez, Fiorella Sabrinna; Ruiz Llenque, José Jonathan; Bravo Paredes, Eduar; Guzmán Rojas, Patricia; Gallegos López, Roxana; Corzo Maldonado, Manuel Alejandro; Valdivia Roldán, Mario

    2013-01-01

    During the first 6 weeks after a variceal hemorrhage there is a 30-40% of probability of recurrence and those who rebleed 20- 30% die. Passed this period, the risk of rebleeding is of 60% and reaches a mortality of 60-70% in two years without treatment. Describe the frequency of rebleeding and mortality due to rebleeding in cirrhotic patients treated for variceal hemorrhage at Endoscopic Centers of Hospital Nacional Cayetano Heredia, Lima, Peru and Hospital Nacional Arzobispo Loayza, Lima, Peru during the years 2009-2011. The study type is a transversal, periodic and retrospective one in which were included 176 cirrhotic patients older than 14 years who have bleed for esophageal varices and that have received endoscopic therapy. The instruments used were a data sheet with all the information obtained from the clinical chart of each patient, the CHILD score to assess severity of hepatic disease, endoscopic informs and phone calls. The frequency of rebleeding before 6 weeks was 32.20% (56 patients). Also, the frequency of rebleeding after that time was 22.56% (37 patients). There was a mortality rate of 5.70% (10 patients) and a mortality rate due to rebleeding of 13.33% (6 patients). Variceal hemorrhage is an important cause of mobimortality in peruvian people. The frequency of rebleeding and mortality due to rebleeding resulted slightly lower than in other countries.

  3. [Sociodemographic and clinical characteristics of patients infected with Leptospira spp. treated at four hospitals in Medellín, Colombia, 2008-2013].

    PubMed

    Echeverri-Toro, Lina María; Penagos, Sara; Castañeda, Laura; Villa, Pablo; Atehortúa, Santiago; Ramírez, Faiver; Restrepo, Carlos; Ospina, Sigifredo; Agudelo, Yuli; Hidrón, Alicia; Agudelo, Paola; Valderrama, Eliana; Agudelo, Carlos Andrés

    2017-01-24

    Leptospirosis remains a significant health problem in tropical regions including Latin America, where its presentation is 100 times higher than that observed in other regions of the world. Mortality reaches 10% in severe cases. Its diagnosis is challenging because clinical manifestations during the initial phase are non-specific and because of limited availability of diagnostic tests. To describe the demographic and clinical characteristics and the outcomes in hospitalized patients with leptospirosis. This retrospective study included patients treated at four institutions in Medellín between January, 2009, and December, 2013, with a compatible clinical picture and a positive IgM for Leptospira spp. We included 119 patients, 80% male, and 58% of rural origin. The mean duration of symptoms was 9.6 days (SD=9.6). Eighty nine per cent of patients had fever; 62%, jaundice; 74%, myalgia; 46%, diarrhea; 41%, hepatomegaly; 13%, splenomegaly, and 13%, conjunctival injection. Fifty four per cent of patients had impaired renal function; 32%, pulmonary compromise, and 13%, liver failure. Sixteen per cent required admission to the ICU; 12%, mechanical ventilation, and 11%, vasopressor therapy.Weil's syndrome occurred in 38.6% and 5% died. The average hospital stay was 11 days (SD=9.6). In this population, the clinical manifestations and complications of leptospirosis were similar to those reported in the literature. We observed a relatively low overall mortality in relation to global statistics.

  4. Comparison between children treated at home and those requiring hospital admission for rotavirus and other enteric pathogens associated with acute diarrhea in Melbourne, Australia.

    PubMed Central

    Pitson, G A; Grimwood, K; Coulson, B S; Oberklaid, F; Hewstone, A S; Jack, I; Bishop, R F; Barnes, G L

    1986-01-01

    The etiology of acute diarrhea in children less than 42 months of age attending one pediatric hospital in Melbourne, Australia, was studied during a 7-month period encompassing the winter of 1984. Pathogens identified in 157 children treated as outpatients with mild disease were compared with those in 232 children hospitalized with severe disease. The pathogens (and frequencies among outpatients and inpatients, respectively) detected were rotaviruses (32.5 and 50.9%), enteric adenoviruses (8.9 and 7.4%), Campylobacter jejuni (7.2 and 1.3%), and Salmonella sp. (4.0 and 1.7%). Electropherotypes of rotavirus strains from outpatients and inpatients were compared. Two strains predominated during the 7 months of this study and were observed with equal frequency from outpatients and inpatients. Rotaviruses of the same electropherotype caused a wide spectrum of disease, with symptoms ranging from mild to severe, life-threatening diarrhea. The similarity of etiological agents identified from children with mild and severe forms of acute diarrhea suggests that the etiology of community enteric illness can be reasonably inferred from the etiology of inpatient disease in children in the same geographic area. During the winter epidemic period, the severity of symptoms associated with rotavirus infection in young children is likely to be determined by the inherent susceptibility of the host rather than by genetic differences in the strains of infecting rotaviruses. Images PMID:3020082

  5. Korean Affairs Report No. 299

    DTIC Science & Technology

    1983-08-11

    certainly win victory. Ladies and gentlemen, the South Korean masses and the Latin American masses are close freinds fighting in the same ranks of the...DAILY ON ’WEAK-KNEED’ ROK DIPLOMACY SK151246 Seoul TONG-A ILBO in Korean 15 Jul 83 p 2 iArticle from the column "Tidbits"] IText] Yi Ki-chu, political...Korean 16 Jul 83 p 2 lEditorial: "The Dignity of the Constitution"] [Text] We are observing the 35th Constitution Day. On 17 July 1948, our

  6. Scabies Among Elderly Korean Patients with Histories of Leprosy.

    PubMed

    Park, Hyungcheol; Lee, Chaeyoung; Park, Seungkyu; Kwon, Hyeon; Kweon, Sun-Seog

    2016-07-06

    A scabies epidemic, traced by the hospital-based surveillance system, was reported in a Korean leprosarium. A total of 200 symptomatic cases were found during 2012-2014 among 570 elderly former leprosy patients. Most of cases were classic type scabies (87%) and aged 75 years and older (72%). Surveillance system for early diagnosis and prompt intervention was applied and the scabies epidemic was controlled effectively in this long-term care facility. © The American Society of Tropical Medicine and Hygiene.

  7. Neurologic outcome in comatose patients resuscitated from out-of-hospital cardiac arrest with prolonged downtime and treated with therapeutic hypothermia.

    PubMed

    Kim, Won Young; Giberson, Tyler A; Uber, Amy; Berg, Katherine; Cocchi, Michael N; Donnino, Michael W

    2014-08-01

    Previous reports have shown that prolonged duration of resuscitation efforts in out-of-hospital cardiac arrest (OHCA) is associated with poor neurologic outcome. This concept has recently been questioned with advancements in post-cardiac arrest care including the use of therapeutic hypothermia (TH). The aim of this study was to determine the rate of good neurologic outcome based on the duration of resuscitation efforts in OHCA patients treated with TH. This prospective, observational, study was conducted between January 2008 and September 2012. Inclusion criteria consisted of adult non-traumatic OHCA patients who were comatose after return of spontaneous circulation (ROSC) and received TH. The primary endpoint was good neurologic outcome defined as a cerebral performance category score of 1 or 2. Downtime was calculated as the length of time between the patient being recognized as pulseless and ROSC. 105 patients were treated with TH and 19 were excluded due to unknown downtime, leaving 86 patients for analysis. The median downtime was 18.5 (10.0-32.3)min and 33 patients (38.0%) had a good neurologic outcome. When downtime was divided into four groups (≤10min, 11-20min, 21-30min, >30min), good neurologic outcomes were 62.5%, 37%, 25%, and 21.7%, respectively (p=0.02). However, even with downtime >20min, 22.9% had a good neurologic outcome, and this percentage increased to 37.5% in patients with an initial shockable rhythm. Although longer downtime is associated with worse outcome in OHCA patients, we found that comatose patients who have been successfully resuscitated and treated with TH have neurologically intact survival rates of 23% even with downtime >20min. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  8. Neurologic outcome in comatose patients resuscitated from out-of-hospital cardiac arrest with prolonged downtime and treated with therapeutic hypothermia

    PubMed Central

    Kim, Won Young; Giberson, Tyler A.; Uber, Amy; Berg, Katherine; Cocchi, Michael N.; Donnino, Michael W.

    2014-01-01

    Background Previous reports have shown that prolonged duration of resuscitation efforts in out-of-hospital cardiac arrest (OHCA) is associated with poor neurologic outcome. This concept has recently been questioned with advancements in post-cardiac arrest care including the use of therapeutic hypothermia (TH). The aim of this study was to determine the rate of good neurologic outcome based on the duration of resuscitation efforts in OHCA patients treated with TH. Methods This prospective, observational, study was conducted between January 2008 and September 2012. Inclusion criteria consisted of adult non-traumatic OHCA patients who were comatose after return of spontaneous circulation (ROSC) and received TH. The primary endpoint was good neurologic outcome defined as a cerebral performance category score of 1 or 2. Downtime was calculated as the length of time between the patient being recognized as pulseless and ROSC. Results 105 patients were treated with TH and 19 were excluded due to unknown downtime, leaving 86 patients for analysis. The median downtime was 18.5 (10.0–32.3) minutes and 33 patients (38.0%) had a good neurologic outcome. When downtime was divided into four groups (≤10 min, 11-20 min, 21-30 min, > 30 min), good neurologic outcomes were 62.5%, 37%, 25%, and 21.7%, respectively (p=0.02). However, even with downtime >20 minutes, 22.9% had a good neurologic outcome, and this percentage increased to 37.5% in patients with an initial shockable rhythm. Conclusions Although longer downtime is associated with worse outcome in OHCA patients, we found that comatose patients who have been successfully resuscitated and treated with TH have neurologically intact survival rates of 23% even with downtime > 20 minutes. PMID:24746783

  9. Management of Sport Injuries with Korean Medicine: A Survey of Korean National Volleyball Team

    PubMed Central

    Hwang, Eui-Hyoung; Kwon, Ojin

    2016-01-01

    The purpose of this study was to report the current state of Korean medicine (KM) treatment on sports injury by implementing survey with volleyball team medical doctors participating in 2013-2014 season. Six KM doctors completed a questionnaire that includes injury parameters: type, location, situation, and pain scores. We collected 166 injury cases from 94 Korean male and female national volleyball players. Knee (25.9%), low back (13.3%), elbow, and ankle (8.4%) injuries were most common. Joint (41.6%) and muscle (30.7%) were major injured tissues. KM team medical doctors utilized acupuncture (40.4%), chuna manual therapy (16.0%), physical therapy (15.2%), taping (9.0%), and cupping (7.8%) to treat volleyball injuries. Any types of medications were used infrequently. Additional physical and exercise therapy were preferred after receiving acupuncture (both 46.9%). This study presented the preliminary injury profile of Korean elite volleyball players. Injury and treatment parameters could be useful to build advanced KM model in sport medicine. PMID:27651819

  10. Korean Affairs Report No. 282

    DTIC Science & Technology

    1983-05-17

    realised. The U.S. imperialists and the South Korean puppet clique are making the South Korean economy more dependent and driving the people into the...long people have seen that, with short- sighted political outlooks, you try to make parliamentary politics work only for the relations between the...It is true that a sense of danger generally makes people unite, but, on the other hand, sometimes it implants a sense of defeat among the people

  11. Korean Affairs Report No. 300.

    DTIC Science & Technology

    2007-11-02

    reporter said: 10 The United States has heightened with each passing day the strategic position of the Korean Peninsula, claiming that Korea is "its...people were undergoing all tribulations under the Japanese imperialists’ colonial rule, served the Japanese imperialists as their running dog ...Korea in an attempt to per- petuate the division of Korea and have the South Korean authorities recognized . CSO: 4100/188 25 N. KOREA/POLITICS AND

  12. Standardization of Korean nursing terminology.

    PubMed

    Park, Hyeoun-Ae; Kim, Ji-Hyun; Lee, Ji-Hyun; Lee, Hyang-Yeon; Kim, Jeong-Wha; Kim, Won-Ock; Kim, Ok-Soo; Lee, Young-Whee; Park, Ho-Ran; Choi-Kwon, Smi; Kim, In-Sook; Park, Young-Joo; Park, Young-Im

    2006-01-01

    Korean nursing terminology was standardized to improve sharing and exchange of nursing data and information. English nursing terms were collected from existing nursing terminology, journal articles, nursing records, text books, and nursing/medical dictionaries, translated into Korean and were tested for their validity. More than 9000 terms were standardized and published on a website for further feedback from the users. This study will contribute to communication within the nursing community and with other health care professionals.

  13. Alternative view of health behavior: the experience of older Korean women.

    PubMed

    Yang, Jin Hyang; Yang, Bok Sun

    2011-03-01

    In this study we explored the perspectives of older Korean women on the principles and meanings of health behavior. Participants were 12 women age 65 and older, with no serious illnesses requiring hospitalization, who were living independently. We used an interpretative phenomenological approach for data collection and analysis. Seven themes emerged: (a) eating well in accordance with one's physical requirements; (b) maintaining one's inherited health; (c) controlling one's illness properly; (d) maintaining good relationships with close relatives and friends; (e) being modest and free from greed; (f) staying in harmony with nature; and (g) regaining energy and vitality. These experiences were mainly based on the traditional Korean concept of health promotion, "food is medicine," rather than on Western concepts of health promotion. In providing optimal geriatric nursing care for Korean older women, the results will be significant because they are based on older women's traditional Korean perspectives of health promotion rather than existing perspectives of Western medicine.

  14. The Korean Neonatal Network: An Overview

    PubMed Central

    Chang, Yun Sil; Park, Hyun-Young

    2015-01-01

    Currently, in the Republic of Korea, despite the very-low-birth rate, the birth rate and number of preterm infants are markedly increasing. Neonatal deaths and major complications mostly occur in premature infants, especially very-low-birth-weight infants (VLBWIs). VLBWIs weigh less than 1,500 g at birth and require intensive treatment in a neonatal intensive care unit (NICU). The operation of the Korean Neonatal Network (KNN) officially started on April 15, 2013, by the Korean Society of Neonatology with support from the Korea Centers for Disease Control and Prevention. The KNN is a national multicenter neonatal network based on a prospective web-based registry for VLBWIs. About 2,000 VLBWIs from 60 participating hospital NICUs are registered annually in the KNN. The KNN has built unique systems such as a web-based real-time data display on the web site and a site-visit monitoring system for data quality surveillance. The KNN should be maintained and developed further in order to generate appropriate, population-based, data-driven, health-care policies; facilitate active multicenter neonatal research, including quality improvement of neonatal care; and ultimately lead to improvement in the prognosis of high-risk newborns and subsequent reduction in health-care costs through the development of evidence-based neonatal medicine in Korea. PMID:26566355

  15. First-time first-trimester induced abortion and risk of readmission to a psychiatric hospital in women with a history of treated mental disorder.

    PubMed

    Munk-Olsen, Trine; Laursen, Thomas Munk; Pedersen, Carsten B; Lidegaard, Ojvind; Mortensen, Preben Bo

    2012-02-01

    Mental health problems are associated with women's reproductive decisions and predict poor mental health outcomes after abortion and childbirth. To study whether having a first-trimester induced abortion influenced the risk of psychiatric readmission and compare findings with readmission risk in women with mental disorders giving birth. Survival analyses were performed in a population-based cohort study merging data from the Danish Civil Registration System, the Danish Psychiatric Central Register, and the Danish National Hospital Register from January 1,1994, to December 31, 2007. Denmark. All women born in Denmark between 1962 and 1992 with a record of 1 or more psychiatric admissions at least 9 months before a first-time first-trimester induced abortion or childbirth. Main Outcome Measure  Readmission at a psychiatric hospital with any type of mental disorder from 9 months before to 12 months after a first-time first-trimester induced abortion or childbirth. Relative risk (RR) for readmission risk 9 to 0 months before a first-trimester induced abortion was 0.95 (95% CI, 0.73-1.23) compared with the first year after the abortion. This contrasts with a reduced risk of readmission before childbirth (RR, 0.56; 95% CI, 0.42-0.75) compared with the first year post partum. Proximity to previous psychiatric admission in particular predicted rehospitalization risks in both the abortion and the childbirth group. Risk of readmission is similar before and after first-time first-trimester abortion, contrasting with a marked increased in risk of readmission post partum. We speculate that recent psychiatric episodes may influence women's decisions to have an induced abortion; however, this decision does not appear to influence the illness course in women with a history of treated mental disorders.

  16. Pattern of chemotherapy-related adverse effects among adult cancer patients treated at Gondar University Referral Hospital, Ethiopia: a cross-sectional study.

    PubMed

    Belachew, Sewunet Admasu; Erku, Daniel Asfaw; Mekuria, Abebe Basazn; Gebresillassie, Begashaw Melaku

    2016-01-01

    Adverse drug reactions (ADRs) are a global problem and constitute a major clinical problem in terms of human suffering. The high toxicity and narrow therapeutic index of chemotherapeutic agents makes oncology pharmacovigilance essential. The objective of the present study was to assess the pattern of ADRs occurring in cancer patients treated with chemotherapy in a tertiary care teaching hospital in Ethiopia. A cross-sectional study over a 2-year period from September 2013 to August 2015 was conducted on cancer patients undergoing chemotherapy at Gondar University Referral Hospital Oncology Center. Data were collected directly from patients and their medical case files. The reported ADRs were assessed for causality using the World Health Organization's causality assessment scale and Naranjo's algorithm. The severities of the reported reactions were also assessed using National Cancer Institute Common Terminology CTCAE version 4.0. The Pear-son's chi-square test was employed to examine the association between two categorical variables. A total of 815 ADRs were identified per 203 patients included in the study. The most commonly occurring ADRs were nausea and vomiting (18.9%), infections (16.7%), neutropenia (14.7%), fever and/or chills (11.3%), and anemia (9.3%). Platinum compounds (31.4%) were the most common group of drugs causing ADRs. Of the reported ADRs, 65.8% were grades 3-4 (severe level), 29.9% were grades 1-2 (mild level), and 4.3% were grade 5 (toxic level). Significant association was found between age, number of chemotherapeutic agents, as well as dose of chemotherapy with the occurrence of grades 3-5 toxicity. The high incidence of chemotherapy-related ADRs among cancer patients is of concern. Setting up an effective ADR monitoring and reporting system (onco-pharmacovigilance) and creating awareness among health care professionals regarding the importance of ADR reporting may help prevent the problem.

  17. Direct Cost for Treating Chronic Kidney Disease at an Outpatient Setting of a Tertiary Hospital: Evidence from a Cross-Sectional Study.

    PubMed

    Ahlawat, Rajiv; Tiwari, Pramil; D'Cruz, Sanjay

    2017-05-01

    Chronic kidney disease (CKD) has a high morbidity and mortality in developing countries. And this burden is also increasing rapidly in India. Unaffordability due to high cost of medication and hemodialysis remains one of the major barriers in the successful treatment of CKD. To determine the direct cost involved in treating CKD at an outpatient department of a public tertiary care hospital. This cross-sectional study was carried out at a public tertiary care hospital. Patients diagnosed with CKD by a physician were included in the study after obtaining a written informed consent. All the relevant data were collected on a predesigned case record form. The results are based on data obtained from 150 patients. The average age of the patients was 55.7 ± 10.1 years. The average number of drugs per prescription was found to be 6.5 ± 1.7. The annual average costs of treatment for patients on medication only and for patients on hemodialysis plus medication were Rs 25,836 (US $386) and Rs 2,13,144 (US $3181), respectively (Rs = Indian rupee). Treatment cost was found to be statistically significantly higher in patients on hemodialysis, treatment support by employer, patients with a smoking habit, patients with comorbidities, and patients with end-stage renal disease. Calcium tablets, vitamin D sachets, iron supplements, torsemide, and amlodipine were the top five medications prescribed. Reimbursement, patient's dialysis status, habits, and comorbidities were found to have a significant effect on the direct cost of treatment. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  18. Pattern of chemotherapy-related adverse effects among adult cancer patients treated at Gondar University Referral Hospital, Ethiopia: a cross-sectional study

    PubMed Central

    Belachew, Sewunet Admasu; Erku, Daniel Asfaw; Mekuria, Abebe Basazn; Gebresillassie, Begashaw Melaku

    2016-01-01

    Background Adverse drug reactions (ADRs) are a global problem and constitute a major clinical problem in terms of human suffering. The high toxicity and narrow therapeutic index of chemotherapeutic agents makes oncology pharmacovigilance essential. The objective of the present study was to assess the pattern of ADRs occurring in cancer patients treated with chemotherapy in a tertiary care teaching hospital in Ethiopia. Methods A cross-sectional study over a 2-year period from September 2013 to August 2015 was conducted on cancer patients undergoing chemotherapy at Gondar University Referral Hospital Oncology Center. Data were collected directly from patients and their medical case files. The reported ADRs were assessed for causality using the World Health Organization’s causality assessment scale and Naranjo’s algorithm. The severities of the reported reactions were also assessed using National Cancer Institute Common Terminology CTCAE version 4.0. The Pear-son’s chi-square test was employed to examine the association between two categorical variables. Results A total of 815 ADRs were identified per 203 patients included in the study. The most commonly occurring ADRs were nausea and vomiting (18.9%), infections (16.7%), neutropenia (14.7%), fever and/or chills (11.3%), and anemia (9.3%). Platinum compounds (31.4%) were the most common group of drugs causing ADRs. Of the reported ADRs, 65.8% were grades 3–4 (severe level), 29.9% were grades 1–2 (mild level), and 4.3% were grade 5 (toxic level). Significant association was found between age, number of chemotherapeutic agents, as well as dose of chemotherapy with the occurrence of grades 3–5 toxicity. Conclusion The high incidence of chemotherapy-related ADRs among cancer patients is of concern. Setting up an effective ADR monitoring and reporting system (onco-pharmacovigilance) and creating awareness among health care professionals regarding the importance of ADR reporting may help prevent the problem

  19. Korean and Korean American Adolescents' Responses to Literature: Impact of Narratives and Interpretive Community

    ERIC Educational Resources Information Center

    Kim, Eunhyun

    2014-01-01

    How might Korean/Korean American youth cope with everyday life as a minority or a model minority if they had early and consistent exposure to literature depicting the mirrored experiences of Korean/Korean Americans? This study employed qualitative methods and an interpretive approach which enhance understanding of the life experiences, literary…

  20. Korean and Korean American Adolescents' Responses to Literature: Impact of Narratives and Interpretive Community

    ERIC Educational Resources Information Center

    Kim, Eunhyun

    2014-01-01

    How might Korean/Korean American youth cope with everyday life as a minority or a model minority if they had early and consistent exposure to literature depicting the mirrored experiences of Korean/Korean Americans? This study employed qualitative methods and an interpretive approach which enhance understanding of the life experiences, literary…

  1. [The life of medical historian Miki Sakae, and the "history of Korean medicine and of diseases in Korea"].

    PubMed

    Kim, Ho

    2005-12-01

    maintained during his entire life regarding the Korean medicine, was that 'One can only talk about the medicine of China and Japan when he or she is well versed in the medicine of Korea'. And his lifetime achievement, "History of Korean Medicine and of Diseases in Korea" was authored upon the basis established by such conviction and philosophy. First, in this book the perspective of Cultural Transmission, which considers the flow of cultural qualities and assets to be ordinarily flowing from highly developed regions to less developed ones, was firmly maintained. He argued that the medicine of China had to pass through the Korean peninsula to reach Japan. Second, he suggested that studies of medicine and diseases could only be fully and thoroughly understood when it is approached not only from the perspective devised by medical historical studies but also from perspectives devised for general and total historical examination of human life events. And third, he argued that all historical studies should be based upon proofs and evidences, and the 'development' factor of a particular type of studies or practices should be measured by whether that study or practice has reached or accomplished the level of Western modern science. Demonstrating such conviction, out of Korean traditional medical practices he particularly examined the medical procedures of treating tumors or regulations and procedures developed for forensic medicine, which he considered superior to or at least at the same level with Western medicine. In his final years he was forced to battle cancer, but he refused to be hospitalized. Instead, he exhibited his firm belief that medicine and medical practices which believe in the ultimate power of human body and soul are what the practitioners should pursue in order to acquire the very core of medicine. He died in 1992, at home, surrounded by his family. He is known to have always uttered that one of the most celebrated Medical books of Korea, the "Dongeui Bogam

  2. Reliability and Validity of the Korean Version of the Foot Function Index.

    PubMed

    Huh, Jung-Wook; Eun, Il-Soo; Ko, Young-Chul; Park, Man-Jun; Hwang, Keum-Min; Park, Sook-Hyun; Park, Tae-Hong; Park, Joon-Hyung

    2016-01-01

    Although translated versions of the Foot Function Index (FFI) in several languages are available, the absence of a Korean version has precluded comparing the data from Korea with the data from other countries using the FFI. We, therefore, evaluated the reliability and validity of the adapted Korean version of the FFI. We translated the English version of the FFI into Korean and back into English. We mailed the Korean version of the visual analog scale, FFI, and the previously validated Medical Outcomes Study Short-Form 36-item questionnaire (SF-36) to 121 patients with treated foot complaints. To evaluate the test-retest reliability and internal consistency, we used the intraclass correlation coefficient and Cronbach's α, respectively. We also evaluated the concurrent and construct validity of Korean version of the FFI by comparing the visual analog scale and SF-36. Cronbach's α was 0.91 and 0.95 for the pain and disability subscales, respectively. The reproducibility was good, and a strong correlation between the FFI and the SF-36 and visual analog scale with related content was observed, indicating good construct validity.The Korean version of the FFI is a reliable and valid questionnaire for the self-assessment of pain and disability in Korean patients with foot complaints. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Effects of topical application of 10,000 IU heparin on patients with perineal dermatitis and second-degree burns treated in a public pediatric hospital.

    PubMed

    Ferreira Chacon, Julieta Maria; Mello de Andrea, Maria Lydia; Blanes, Leila; Ferreira, Lydia Masako

    2010-11-01

    High-molecular-weight sodium heparin (10,000 IU) has been developed based on studies conducted on burn patients; it has anti-inflammatory, antigenic and anticoagulant properties. The aim of this paper was to evaluate the effects of topical application of sodium heparin spray on two immunosuppressed patients (a child and a young person) with perineal dermatitis and an immunosuppressed child with second-degree burns. This is a report of three clinical cases treated in a pediatric hospital. Sodium heparin spray (10,000 IU) was applied at a dose of 4200 IU per percentage of body surface area affected over the hyperemic region. Heparin spray treatment was discontinued after crust formation and wound reepithelialization; essential fatty acid was applied until spontaneous separation of the crust or total wound reepithelialization. Heparin spray had analgesic, angiogenic and anti-inflammatory effects, and did not require secondary wound closure. Pain control was of fundamental importance to the patients; in the three cases, improvement in analgesia was achieved within 24 h of treatment. The topical application of heparin spray in patients with perineal dermatitis or superficial second-degree burns demonstrated good tolerability, resulted in good aesthetic outcomes, and reduced pain. Copyright © 2010 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

  4. The Impact of HLA and KIR Ligand Mismatching on Unrelated Allogeneic Hematopoietic Stem Cell Transplantation in Korean Adult Patients

    PubMed Central

    Park, Hyewon; Rho, Eun Youn; In, Ji Won; Kim, Inho; Yoon, Sung-Soo; Park, Seonyang; Shin, Sue; Park, Kyoung Un

    2015-01-01

    Background The impact of HLA and KIR ligand mismatching on the outcome of hematopoietic stem cell transplantation (HSCT) remains unclear. Previous reports have identified considerable ethnic differences in the impact of HLA and KIR ligand mismatches, as well as KIR ligand status, on HSCT; however, to date, no data has been acquired in Korean adult patients. Methods We investigated the association of high-resolution HLA matching on five loci (HLA-A, -B, -C, -DRB1, and -DQB1), KIR ligand mismatching, and KIR ligand status on the outcome of allogeneic HSCT from unrelated donors in 154 Korean adult patients treated at Seoul National University Hospital. Results In a multivariate analysis, less than 9/10 allelic matches in five HLA loci was an independent risk factor for acute graft-versus-host disease (GVHD) (grade II to IV) (P=0.019, odds ratio [OR]=2.7). In addition, HLA-A allele mismatching was increasingly prevalent in patients with acute GVHD compared to patients without (61.9% vs. 34.5%, P=0.06). For KIR ligand status, the patient and donor combination of both C1/C1 ligands showed better event-free and overall survival than combinations with C2 ligand patients or donors (P=0.048, P=0.034, respectively) by log-rank test. Conclusions Korean adult transplant patients with less than 9 of 10 HLA allele matches in the HLA-A, -B, -C, -DRB1, and DQB1 loci have a higher likelihood of developing acute GVHD (grade II to IV). Impact of KIR ligand status on clinical outcome should be further studied in a larger patient population. PMID:25553290

  5. Safety climate practice in Korean manufacturing industry.

    PubMed

    Baek, Jong-Bae; Bae, Sejong; Ham, Byung-Ho; Singh, Karan P

    2008-11-15

    Safety climate survey was sent to 642 plants in 2003 to explore safety climate practices in the Korean manufacturing plants, especially in hazardous chemical treating plants. Out of 642 plants contacted 195 (30.4%) participated in the surveys. Data were collected by e-mail using SQL-server and mail. The main objective of this study was to explore safety climate practices (level of safety climate and the underlying problems). In addition, the variables that may influence the level of safety climate among managers and workers were explored. The questionnaires developed by health and safety executive (HSE) in the UK were modified to incorporate differences in Korean culture. Eleven important factors were summarized. Internal reliability of these factors was validated. Number of employees in the company varied from less than 30 employees (9.2%) to over 1000 employees (37.4%). Both managers and workers showed generally high level of safety climate awareness. The major underlying problems identified were inadequate health and safety procedures/rules, pressure for production, and rule breaking. The length of employment was a significant contributing factor to the level of safety climate. In this study, participants showed generally high level of safety climate, and length of employment affected the differences in the level of safety climate. Managers' commitment to comply safety rules, procedures, and effective safety education and training are recommended.

  6. Korean Culture and Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Kang-Yi, Christina D.; Grinker, Roy R.; Mandell, David S.

    2013-01-01

    This paper reviews the literature on early child development among Koreans, with a focus on autism spectrum disorders (ASD). The literature review of 951 abstracts in English, 101 abstracts in Korean and 27 full articles published from 1994 to 2011 was performed to understand the presentation of and response to ASD in Korean culture. Based on…

  7. Korean Culture and Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Kang-Yi, Christina D.; Grinker, Roy R.; Mandell, David S.

    2013-01-01

    This paper reviews the literature on early child development among Koreans, with a focus on autism spectrum disorders (ASD). The literature review of 951 abstracts in English, 101 abstracts in Korean and 27 full articles published from 1994 to 2011 was performed to understand the presentation of and response to ASD in Korean culture. Based on…

  8. Ethnic Attachment among Second Generation Korean Americans.

    ERIC Educational Resources Information Center

    Hong, Joann; Min, Pyong Gap

    1999-01-01

    Describes the levels of second-generation Korean-American adolescents' (n=approximately 237) cultural, social, and psychological dimensions of attachment and examines the major factors highly correlated with two of the dimensions of ethnic attachment: use of the Korean language and Korean friendships. Findings support the view that high levels of…

  9. Processing of the Korean Eojoel Ambiguity

    ERIC Educational Resources Information Center

    Lee, Yoonhyoung; Nam, Kichun; Gordon, Peter C.

    2009-01-01

    Korean writing is a syllabary where spaces occur between phrases rather than between words. This characteristic of Korean allows different types of information in Korean sentences to be dissociated in ways that are not possible in the languages that have been the focus of most psycholinguistic research, thereby providing new opportunities to…

  10. Koreans in America. In America Series.

    ERIC Educational Resources Information Center

    Patterson, Wayne; Kim, Hyung-chan

    The immigration of Koreans to the United States is traced from 1903, and the contributions Korean Americans have made to the United States are identified in this book which is part of a series for children. The number of Korean immigrants, small for many years, increased dramatically with the easing of government restrictions in the 1960s, until,…

  11. Select Bibliography of the Korean War.

    ERIC Educational Resources Information Center

    Sandler, Stanley

    2000-01-01

    Discusses various resources on the history of the Korean War that include, but are not limited to, works from the North Korean perspective, "standard" accounts from a western perspective that identify U.S. and South Korean shortcomings, and works on the secrecy around U.S. special operations. Provides a detailed bibliography. (CMK)

  12. Korean Folk Music in Your Curriculum

    ERIC Educational Resources Information Center

    Bowman, Barbara G.

    2008-01-01

    Koreans are a growing minority in the United States. Worldwide, it is believed that more than seventy million people speak Korean, approximately as many as who speak Italian. The music of Korea offers a delightful addition to the general music classroom. There are several reasons why Korean music is not readily accessible to most general music…

  13. Korean Geodetic VLBI Project

    NASA Astrophysics Data System (ADS)

    Kondo, T.; Kim, T.; Han, S.; Kwak, Y.; Oh, H.; Yi, S.; Bae, M.; Kim, K.; Moon, J.; Park, J.

    2009-04-01

    A permanent geodetic VLBI station with a 22-m diameter antenna will be newly constructed in Korea by the National Geographic Information Institute, Korea (NGII) for the project named Korea VLBI system for Geodesy (KVG) that aims at maintaining the Korean geodetic datum accurately. The KVG has started officially since October, 2008. The construction of all system will be completed by the end of 2011. In Korea, the Korea Astronomy and Space Science Institute (KASI) has already promoted Korean VLBI Network (KVN) project dedicated to radio astronomy since 2001, and three 21-m diameter antennas have been constructed at Seoul, Ulsan, and Jeju Island. Although their receivers have not yet been fully installed, the antenna is designed to be able to receive 22, 43, 86, and 129 GHz bands simultaneously. In parallel with the KVN project, the National Geographic Information Institute, Korea (NGII) has been planning to construct their own VLBI antenna dedicated to geodetic measurements since 2001 to maintain the Korean Geodetic Datum accurately on the International Terrestrial Reference Frame (ITRF). It also aims at a fundamental station in East Asia and will contribute to the better determination of the ITRF there. A grand design for KVG project realizing NGII's plan has been proposed by the Ajou University under the collaborations with the National Institute of Information and Communications Technology, Japan (NICT), National Astronomical Observatory, Japan (NAO), and the Geographical Survey Institute, Japan (GSI). The design of KVG antenna follows the VLBI2010 except for receiving frequencies and the diameter; VLBI2010 is the guideline for next generation's geodetic VLBI system compiled by the International VLBI Service for Geodesy and Astrometry (IVS). The antenna is designed to be able to receive 2, 8, 22, and 43 GHz bands simultaneously in order to carry out geodetic VLBI observations not only with current geodetic VLBI stations equipped with 2/8 GHz receivers but also

  14. Social and cultural construction of urinary incontinence among Korean American elderly women.

    PubMed

    Kang, Youngmi; Crogan, Neva L

    2008-01-01

    The purpose of this article is to describe the social and cultural constructions that influence help-seeking for urinary incontinence (UI) among Korean American elderly women. Many Korean American elder women do not perceive UI as a problem worthy of attention. The reason may lie in its social and cultural construction. The social construction is rooted in the collectivist nature of Korean culture, which makes UI a family, rather than an individual, problem. The cultural construction is related to Confucianism, which directs conceptions about ageism, shame, and fatalism. This article will help the gerontological nurse to better understand Korean American elderly women's sociocultural background related to UI care and could lead to appropriate family centered interventions to manage or treat UI in this population.

  15. Prevalence of Musculoskeletal Disorders Among Korean Police Personnel.

    PubMed

    Rhee, Hak Young; Cho, Jae Hwan; Seok, Jong Min; Cho, Taek Sang; Jeon, Woo Jin; Lee, Jin Gu; Kim, Sung Kyu

    2015-01-01

    This study was conducted to investigate efficient, systematic management of the Korean police and to examine the status and prevention of musculoskeletal disorders in Korean police officers. For police officers in special working environments, the importance of basic data is emphasized for human resources (HR) management and the prevention of industrial hazards from an industrial health care perspective. This study was conducted on police officers who visited the national police hospital and who underwent x-ray, computed tomography (CT), and magnetic resonance imaging (MRI) for the diagnosis of musculoskeletal disorders. The results revealed that examinations for the lower extremities and spine were most frequently conducted using x-ray, CT, and MRI. In particular, knee and lumbar examinations were most frequently conducted among all lower extremity and spine examinations, respectively.

  16. Frequency of cancer in children residing in Mexico City and treated in the hospitals of the Instituto Mexicano del Seguro Social (1996–2001)

    PubMed Central

    Juárez-Ocaña, Servando; González-Miranda, Guadalupe; Mejía-Aranguré, Juan Manuel; Rendón-Macías, Mario Enrique; Martínez-García, María del Carmen; Fajardo-Gutiérrez, Arturo

    2004-01-01

    Background The objective of this article is to present the frequency of cancer in Mexican children who were treated in the hospitals of the Instituto Mexicano del Seguro Social in Mexico City (IMSS-MC) in the period 1996–2001. Methods The Registry of Cancer in Children, started in 1996 in the IMSS-MC, is an on-going, prospective register. The data from 1996 through 2001 were analyzed and the different types of cancer were grouped according to the International Classification for Cancer in Children (ICCC). From this analysis, the general and specific frequencies by age and by sex were obtained for the different groups of neoplasms. Also, the frequency of the stage of the disease that had been diagnosed in cases of children with solid tumors was obtained. Results A total of 1,702 new cases of children with cancer were registered, with the male/female ratio at 1.1/1. Leukemias had the highest frequency with 784 cases (46.1%) and, of these, acute lymphoblastic leukemias were the most prevalent with 614 cases (78.3%). Thereafter, in descending order of frequency, were tumors of the central nervous system (CNST) with 197 cases (11.6%), lymphomas with 194 cases (11.4%), germinal cell tumors with 110 cases (6.5%), and bone tumors with 97 cases (5.7%). The highest frequency of cancer was found in the group of one to four year-olds that had 627 cases (36.8%). In all the age groups, leukemias were the most frequent. In the present work, the frequency of Hodgkin's disease (~4%) was found to be lower than that (~10%) in previous studies and the frequency of tumors of the sympathetic nervous system was low (2.3%). Of those cases of solid tumors for which the stage of the disease had been determined, 66.9% were diagnosed as being Stage III or IV. Conclusions The principal cancers in the children treated in the IMSS-MC were leukemias, CNST, and lymphomas, consistent with those reported by developed countries. A 2.5-fold reduction in the frequency of Hodgkin's disease was found

  17. Frequency of cancer in children residing in Mexico City and treated in the hospitals of the Instituto Mexicano del Seguro Social (1996-2001).

    PubMed

    Juárez-Ocaña, Servando; González-Miranda, Guadalupe; Mejía-Aranguré, Juan Manuel; Rendón-Macías, Mario Enrique; Martínez-García, María del Carmen; Fajardo-Gutiérrez, Arturo

    2004-08-13

    The objective of this article is to present the frequency of cancer in Mexican children who were treated in the hospitals of the Instituto Mexicano del Seguro Social in Mexico City (IMSS-MC) in the period 1996-2001. The Registry of Cancer in Children, started in 1996 in the IMSS-MC, is an on-going, prospective register. The data from 1996 through 2001 were analyzed and the different types of cancer were grouped according to the International Classification for Cancer in Children (ICCC). From this analysis, the general and specific frequencies by age and by sex were obtained for the different groups of neoplasms. Also, the frequency of the stage of the disease that had been diagnosed in cases of children with solid tumors was obtained. A total of 1,702 new cases of children with cancer were registered, with the male/female ratio at 1.1/1. Leukemias had the highest frequency with 784 cases (46.1%) and, of these, acute lymphoblastic leukemias were the most prevalent with 614 cases (78.3%). Thereafter, in descending order of frequency, were tumors of the central nervous system (CNST) with 197 cases (11.6%), lymphomas with 194 cases (11.4%), germinal cell tumors with 110 cases (6.5%), and bone tumors with 97 cases (5.7%). The highest frequency of cancer was found in the group of one to four year-olds that had 627 cases (36.8%). In all the age groups, leukemias were the most frequent. In the present work, the frequency of Hodgkin's disease (~4%) was found to be lower than that (~10%) in previous studies and the frequency of tumors of the sympathetic nervous system was low (2.3%). Of those cases of solid tumors for which the stage of the disease had been determined, 66.9% were diagnosed as being Stage III or IV. The principal cancers in the children treated in the IMSS-MC were leukemias, CNST, and lymphomas, consistent with those reported by developed countries. A 2.5-fold reduction in the frequency of Hodgkin's disease was found. Of the children, the stage of whose

  18. Impact of global risk assessment on the evaluation of hypertensive patients treated by primary care physicians in Korea (a Nation-Wide, Multi-Center, Observational, Cross-Sectional, Epidemiologic Study to Evaluate the Proportion of Cardiovascular Risk Factors in Korean hypertensive patients: WONDER study).

    PubMed

    Kim, Kwang-Il; Lee, Yil-Seob; Park, Chang Gyu

    2014-07-01

    Global cardiovascular risk evaluation and stratification is essential to identify high-risk hypertensive patients. However, it is uncertain how often the strategy is executed in real clinical practice. We sought to evaluate whether global risk evaluation might change the risk stratification in Korean hypertensive patients treated by primary care physicians. A total of 3109 hypertensive patients were analyzed. The mean age was 62.3±11.3 years, and 1502 (48.3%) of the participants were male. The global risk evaluation revealed that 1862 patients (59.9%) were classified as having high- or the very high-risk. High-risk patients were older and obese, and had a male predominance, a longer duration of hypertension and a low HDL-cholesterol. The systolic and diastolic blood pressures (BP) were significantly higher in the high-risk group (P<0.0001). However, combination antihypertensive therapy was more common in the low-risk group (P=0.0265). A total of 2155 patients (69.3%) were reclassified into the higher or the lower-risk group by performing additional tests. In a multivariate logistic regression analysis, age, body mass index, BP, metabolic syndrome, left ventricular hypertrophy and chronic kidney disease were independent factors associated with risk reclassification with global risk evaluation. In conclusion, although the majority of hypertensive patients treated by the primary care physicians were in the high- or very high-risk group, their risk levels were not appropriately stratified. However, simple additional tests enhanced the risk evaluation of hypertensive patients. Accordingly, comprehensive cardiovascular risk stratification should be undertaken in all hypertensive patients.

  19. Effectiveness of 23-valent pneumococcal polysaccharide vaccine against invasive disease and hospital-treated pneumonia among people aged ≥65 years: a retrospective case-control study.

    PubMed

    Leventer-Roberts, Maya; Feldman, Becca S; Brufman, Ilan; Cohen-Stavi, Chandra J; Hoshen, Moshe; Balicer, Ran D

    2015-05-15

    Streptococcus pneumoniae contributes considerably to the burden of pneumonia and invasive pneumococcal disease (IPD), with the effectiveness of the 23-valent pneumococcal polysaccharide vaccine (PPSV23) for preventing all-cause pneumonia still undetermined. The aim of this study was to control for common biases and confounders associated with previous observational studies and to assess PPSV23 vaccine effectiveness in preventing IPD and the most resource-intensive type of community-acquired pneumonia, hospital-treated pneumonia (HTP). This was a retrospective case-control study nested in a population-based cohort, with age-, sex-, and risk-matched controls as the base case. Demographic information, laboratory data, and diagnoses were extracted from the chronic disease registry and from inpatient and outpatient records in the Clalit Health Services database. Vaccine effectiveness for PPSV23 was assessed using multivariable conditional logistic regression. Subgroup, sensitivity, and secondary analyses were conducted to validate findings. A total of 470 070 individuals aged ≥65 years were members of Clalit Health Services during the study period (1 January 2007 through 31 December 2010). The case cohort consisted of 212 participants with IPD and 23 441 with HTP. The adjusted association between vaccination and IPD was protective (odds ratio [OR], 0.58; 95% confidence interval [CI], .41-.81), whereas there was no demonstrated protective effect between vaccination and HTP (OR, 1.01; 95% CI, .97-1.04). The sensitivity analysis and all but 1 subgroup analysis provided consistent results to the base case. The PPSV23 vaccine is effective against the most severe invasive forms of pneumococcal disease, but the lack of effectiveness of PPSV23 in protecting against all-cause HTP should be considered for future vaccine policies. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions

  20. [Impact of new information and communication technologies (NTIC) on hospital administration and patient management. Care Network for Diagnosing and Treating Neurologic Emergencies].

    PubMed

    Moulin, T; Retel, O; Chavot, D

    2003-04-01

    The combination of specialised in-patient management, the development of diagnostic and therapeutic tools, the standardisation of procedures and organisation of the dies will allow for improving the prognosis of neurological patients seen in emergency situations. In order to achieve this objective, the Networks for Diagnosing and Treating Neurological Emergencies (RAIDS-UN) in Franche-Comté (FC) aim to better the quality of in-patient management for emergency on-set neurological pathologies such as traumatic brain injuries and strokes, the preparation and structuring of the dies for diagnosis and treatment, and assistance in neurology decision making. Based upon the needs of networks which approach the problem from two different directions--the RAIDS-UN/FC network (for neurological emergencies) and the RAIDS-UN/AVC network (for prevention and treatment of strokes)--they should both be able to benefit from new information and communication technologies (ICTs) in order to promote and support innovations in practice and contribute to the improvement in quality and health promotion effectiveness. In light of these developments, one may better understand the significance of the School of Medicine's role in training experts, advisors and supervisors as well as in providing a high level of quality and effective continuing education. Since 2001, the expansion of the RAIDS-UN networks has emphasised the need for the development of new professional specialties arising on the border between technology and medicine. The operation of these networks requires a strong partnership with health professionals and strategically relies upon a regional dynamic interaction which includes the hospitals, the city, the institutions and the university. It is in this manner that the RAIDS-UN networks will support other initiatives such as the Towards Unity for Health project.

  1. Epidemiological profile of 277 patients with facial fractures treated at the emergency room at the ENT Department of Hospital do Trabalhador in Curitiba/PR, in 2010

    PubMed Central

    Ykeda, Renier Barreto Arrais; Ballin, Carlos Roberto; Moraes, Rafael Souza; Ykeda, Ronnie Barreto Arrais; Miksza, Alana Farias

    2012-01-01

    Summary Introduction: Epidemiological studies that focus on facial injuries are of great interest for the knowledge of occurrence and severity of presentation. Aim: To study the epidemiological profile of 277 patients who suffered facial fractures at the Hospital do Trabalhador (HT), with an emphasis on variables such as sex, age, cause, and anatomical sites of fractures, comparing the clinical findings with other studies. Method: Retrospective nonrandomized chart review of 277 patients who were treated at HT by the ENT service during the full year 2010, victims of facial fractures. Results: Of 277 patients, 74.72% were male and 25.27% female (ratio 3:1). According to age, the fractures were distributed as follows: 0–9 years: 4.69%, 10–19 years: 17.32%, 20–29 years: 23.82%, 30–39 years: 20.21%, 40–49 years: 16.24%, 50–59 years: 10.83%, 60–69 years: 3.97%, and 60–79 years: 2.88%. The cause of trauma was most frequently interpersonal violence, 36.45%, followed by falls, 23.09%, and motor vehicle crashes with 17.32%. Regarding location, nasal fracture was the most common, with 44.75%, followed by the mandible, 14.32%, orbit, 12.78%, maxillary, 12.02%, zygomatic, 9.97%, 3.32% and front Le Fort 2.88%. Conclusion: The patients were mostly males, aged 21–30 years, victims of aggression with the most commonly fractured bone being the nose. The adoption of personal and public strategies and measures may prevent facial fractures. PMID:25991971

  2. [Clinical and therapeutic analysis of oncology patients treated at the pain and palliative care program of the Hospital Universitário Clementino Fraga Filho in 2003.].

    PubMed

    Salamonde, Giselane Lacerda Figueredo; Verçosa, Nubia; Barrucand, Louis; Costa, Antônio Filpi Coimbra da

    2006-12-01

    The main goal of palliative care is the control of pain and other symptoms in patients with chronic diseases without possibility of cure, especially advanced cancer. About 75% of patients with advanced cancer experience severe pain, which interferes with quality of life and, according to the WHO, it is considered a worldwide medical emergency. This study evaluated the profile of oncology patients enrolled in the Chronic Pain Treatment and Palliative Care Program of the HUCFF/FM/UFRJ, focusing on the role of the anesthesiologist, medications used, humanization of the treatment, and improvement in patient's quality of life. The 2003-oncology patients' charts were analyzed retrospectively. Several parameters were compared: age, race, gender, preexisting conditions organ the cancer originated from, type of pain and other symptoms, medications, hospital routine, and end of treatment. The types of pain included nociceptive, neuropathic, and incidental, which were evaluated using the unidimensional faces pain rating scale. In the first week, patients were treated with home-based patient controlled analgesia (PCA) with oral methadone. After this period, the patient returned to the clinic to calculate the regular dose of methadone. Other opioids used included codeine, tramadol, morphine, and oxycodone. Besides pain, patients experienced: constipation, vomiting, delirium, sleep disturbances, and dyspnea. Neuroleptics, corticosteroids, and laxatives were also used as adjuvant therapy. Patient controlled analgesia with methadone is safe and effective, since there were no significant side effects. The clinical and pharmacological knowledge of the anesthesiologist in the multidisciplinary team provided for better patient care, relief of symptoms, and humanization of the final stages of life.

  3. Updated Long-Term Outcomes and Prognostic Factors for Patients With Unresectable Locally Advanced Pancreatic Cancer Treated With Intraoperative Radiotherapy at the Massachusetts General Hospital, 1978 to 2010

    PubMed Central

    Cai, Sophie; Hong, Theodore S.; Goldberg, Saveli I.; Castillo, Carlos Fernandez-del; Thayer, Sarah P.; Ferrone, Cristina R.; Ryan, David P.; Blaszkowsky, Lawrence S.; Kwak, Eunice L.; Willett, Christopher G.; Lillemoe, Keith D.; Warshaw, Andrew L.; Wo, Jennifer Y.

    2014-01-01

    BACKGROUND In the current study, the authors evaluated long-term outcomes, intraoperative radiotherapy (IORT)-related toxicity, and prognostic factors for overall survival (OS) among patients with unresectable locally advanced pancreatic cancer (LAPC) who received IORT as part of their treatment at the Massachusetts General Hospital (MGH). METHODS Medical records were reviewed for 194 consecutive patients with unresectable LAPC who were treated with IORT at MGH between 1978 and 2010. OS was calculated using the Kaplan-Meier method. Prognostic factors were evaluated at the univariate level by the log-rank test and at the multivariate level by the Cox proportional hazards model. Rates of disease progression and treatment toxicity were calculated. RESULTS The 1-year, 2-year, and 3-year survival rates were 49%, 16%, and 6%, respectively. Six patients (3%) survived for > 5 years. The median OS was 12.0 months. Among 183 patients with known post-IORT disease status, the 2-year local progression-free survival and distant metastasis-free survival rates were 41% and 28%, respectively. On multivariate analysis, an IORT applicator diameter ≤ 8 cm (hazards ratio [HR], 0.51; 95% confidence interval [95% CI], 0.30–0.84 [P = .009]), a Charlson age-comorbidity index ≤3 (HR, 0.47; 95% CI, 0.31–0.73 [P = .001]), and receipt of chemotherapy (HR, 0.46; 95% CI, 0.33–0.66 [P < .001]) predicted improved OS. The median OS for patients with all 3 positive prognostic factors was 21.2 months. CONCLUSIONS Well-selected patients with LAPC with small tumors and low Charlson age-comorbidity indices can achieve good long-term survival outcomes with a treatment regimen that incorporates chemotherapy and IORT. PMID:24006012

  4. An analysis of the inpatient charge and length of stay for patients with joint diseases in Korea: specialty versus small general hospitals.

    PubMed

    Kim, Sun Jung; Park, Eun-Cheol; Jang, Sung In; Lee, Minjee; Kim, Tae Hyun

    2013-11-01

    In 2011, the Korean government designated hospitals with certain structural characteristics as specialty hospitals. This study compared the inpatient charges and length of stay of patients with joint diseases treated at these specialty hospitals with those of patients treated at small general hospitals. In addition, the study investigated whether the designation of certain hospitals as specialty hospitals had an effect on inpatient charges and length of stay. Multi-level models were used to perform regression analyses on inpatient claims data (N=268,809) for 2010-2012 because of the hierarchical structure of the data. The inpatient charge at specialty hospitals was 19% greater than that at small general hospitals, but the length of stay was 21% shorter. After adjusting for patient and hospital level confounders, specialty hospitals had a higher inpatient charge (34.6%) and a reduced length of stay (31.7%). However, the effect of specialty hospital designation on inpatient charge (2.7% higher) and length of stay (2.3% longer) was relatively smaller. Among the patient characteristics, female gender, age, and severity of illness were positively associated with inpatient charge and length of stay. In terms of location, hospitals in metropolitan area had higher inpatient charges (5.5%), but much shorter length of stay (-14%). Several structural factors, such as occupancy rate, bed size, number of outpatients and nurses were positively associated with both inpatient charges and length of stay. However, number of specialists was positively associated with inpatient charges, but negatively associated with length of stay. In sum, this study found that specialty hospitals treating joint diseases tend to incur higher charges but produce shorter length of stay, compared to their counterparts. Specialty hospitals' overcharging behaviors, although shorter length of stay, suggest that policy makers could introduce bundled payments for the joint procedures. To promote a successful

  5. Politics in the Korean War

    DTIC Science & Technology

    1994-01-01

    aspect o£ its uniqueness was the open debate between President Truman and General MacArthur con- cernin9 the war’s military and political objectives...NATIONAL DEFENSE UNIVERSITY NATIONAL WAR COLLEG~ POLITICS IN THE KOREAN WAR Course II Essay LTC Paul N. DunnlClass of 1994 COURSE II SEMINAR...to 00-00-1994 4. TITLE AND SUBTITLE Politics in the Korean War 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d

  6. Evaluating the Korean version of the Multidimensional Health Assessment Questionnaire in patients with rheumatoid arthritis.

    PubMed

    Lee, Shin-Seok; Park, Mi-Jeong; Yoon, Hyun-Jeong; Park, Yong-Wook; Park, In-Hyae; Park, Kyeong-Soo

    2006-05-01

    Although the Health Assessment Questionnaire (HAQ) and the Modified Health Assessment Questionnaire are useful tools for assessing and monitoring patients with rheumatic diseases, they have a "floor effect" and do not fully reflect the psychological status of patients. Recently, the Multidimensional Health Assessment Questionnaire (MDHAQ) was developed to overcome these shortcomings. We translated the MDHAQ into the Korean language and evaluated its reliability and validity for use with Korean-speaking patients with rheumatoid arthritis (RA). The questionnaire was translated into the Korean language by three translators, who were aware of its objectives, and it was translated back into the English language by three different translators. One question was modified to reflect Korean culture, and imperial measures were changed to metric measures because most Koreans use the metric system. The Korean MDHAQ was administered to 136 patients with RA who were attending the outpatient rheumatology clinic at the Chonnam National University Hospital (Gwangju, South Korea). Test-retest reliability was assessed in 101 patients after 1 week. To assess criterion validity, we compared MDHAQ scores with HAQ scores and the American College of Rheumatology (ACR) functional class. To test construct validity, the MDHAQ was compared to ACR core criteria (tender and swollen joint count, pain, patient's global assessment, physician's global assessment, erythrocyte sedimentation rate, and C-reactive protein), the Beck Depression Inventory (BDI), and the State-Trait Anxiety Inventory (STAI). The test-retest reliability was analyzed by computing kappa statistics, which ranged from 0.60 to 0.76. Cronbach's alpha coefficient ranged from 0.892 to 0.938. The MDHAQ was significantly correlated with the HAQ and ACR functional class (all p<0.001). The correlations between the MDHAQ scores and the ACR core set, BDI, and STAI were all high and statistically significant. The Korean version of the

  7. Study on improving blood flow with Korean red ginseng substances using digital infrared thermal imaging and Doppler sonography: randomized, double blind, placebo-controlled clinical trial with parallel design.

    PubMed

    Kang, Jaehui; Lee, Namhun; Ahn, Yochan; Lee, Hyun

    2013-02-01

    To examine the efficacy of Korean red ginseng for improving blood flow in healthy people. Participants were randomized and treated with 1500 mg of Korean red ginseng extract or placebo for 8 weeks. The effect of Korean red ginseng was evaluated by digital infrared thermal images, and Doppler sonography, and blood test. Forty subjects completed the protocol. Imbalance in local thermal distribution was significantly decreased in the Korean red ginseng group confirmed by digital infrared thermal images. Doppler sonography showed no significant change in maximum and average rates of blood circulation in single or complex areas. Blood analyses for coagulation and lipid metabolism factors revealed no significant changes. No abnormal reactions to the Korean red ginseng were observed. Digital infrared thermal imaging showed that the temperature deviation in the whole body decreased safely in the Korean red ginseng group, which mitigated the body-temperature imbalance. This result suggests that the Korean red ginseng improves blood circulation in the human body.

  8. Korean Interpersonal Patterns: Implications for Korean/American Intercultural Communication.

    ERIC Educational Resources Information Center

    Merchant, Jerrold J.

    A descriptive field study was conducted in Seoul, Korea, to assess Korean interpersonal communication. The data for the study were collected through observations of interpersonal communication patterns among students in university classes, between faculty and students as well as among various faculty members, among business people, and between the…

  9. Challenges of Discourses on "Model Minority" and "South Korean Wind" for Ethnic Koreans' Schooling in Northeast China

    ERIC Educational Resources Information Center

    Fang, Gao

    2009-01-01

    The educational success of ethnic Koreans in China has been achieved through Mandarin-Korean bilingual education, with the Korean language as the medium of instruction. Using the data collected as part of an ethnographic research on Korean elementary school students in a national Korean school in China, this article examines the relation between…

  10. Challenges of Discourses on "Model Minority" and "South Korean Wind" for Ethnic Koreans' Schooling in Northeast China

    ERIC Educational Resources Information Center

    Fang, Gao

    2009-01-01

    The educational success of ethnic Koreans in China has been achieved through Mandarin-Korean bilingual education, with the Korean language as the medium of instruction. Using the data collected as part of an ethnographic research on Korean elementary school students in a national Korean school in China, this article examines the relation between…

  11. [Impact of the chemotherapy protocols for metastatic breast cancer on the treatment cost and the survival time of 371 patients treated in three hospitals of the Rhone-Alpes region].

    PubMed

    Paviot, B Trombert; Bachelot, T; Clavreul, G; Jacquin, J-P; Mille, D; Rodrigues, J-M

    2009-10-01

    The chemotherapy of the metastatic breast cancer is characterized by the diversity of the treatment protocols and the utilisation of new expensive molecules posing the double problem of outcomes for the patients and financial effects for the hospitals. This survey describes the different chemotherapy treatments prescribed in the metastatic breast cancer and the direct costs supported by the hospitals according to the patient survival time. A cohort of 371 patients treated for a metastatic breast cancer was followed in three hospitals of the Rhone-Alpes region between 2001 and 2006. The detail of their different antineoplasic treatments, as well as the purchase cost of the drugs and their cost of hospital administration, the cost of the other hospital stays are presented in relation with the survival. The median survival time (35,8 months; CI 95%: [31.7-39.1]) since the first metastasis does not differ significantly according to the hospital. Ninety-three different chemotherapy protocols are observed combining from one to five molecules. Thirty-two different molecules are identified. In first line treatment, there is a significant difference in the use of the new molecules according to hospital (Chi(2) test; P < 10(-3)). The average cost of a chemotherapy treatment is 3,919 euro (+/- 8,069 euro), the higher cost is observed for trastuzumab (23,443 euro). The average time period before the beginning of a new chemotherapy line is 212 days (+/- 237 days) and the mean cost of hospital stay during this period is 3,903 euro (+/- 4,097 euro). If no impact of the chemotherapy treatment strategy is observed on the survival time of the patient, it is the opposite for the hospital treatment cost. These results are asking for a better control system of the authorization procedure of new molecules marketing and the harmonization of the practices.

  12. National Identity in Korean Curriculum

    ERIC Educational Resources Information Center

    Kim, Hyojeong

    2004-01-01

    The concept of national identity has evolved during the last half century within the Korean social studies curriculum. There have been seven curricular revisions since the first national curriculum was released in 1955. Each time the concept of national identity was changed with the biggest changes to this concept within the last two iterations of…

  13. Korean Basic Course. Volume Two.

    ERIC Educational Resources Information Center

    Park, B. Nam

    Volume Two of the Korean Basic Course contains Units 29 through 47. Most units consist of (1) a basic dialog, (2) notes on the basic dialog, (3) additional vocabulary and phrases, (4) grammar notes, (5) drills, (6) a supplementary dialog for comprehension, (7) a narrative for comprehension and reading, and (8) exercises. Two of the last units…

  14. Black raspberry: Korean vs. American

    USDA-ARS?s Scientific Manuscript database

    This fact sheet shows Korean black raspberry (Rubus coreanus) fruit, flower, and leaf features that distinguish them from their Rubus relatives, black raspberry (R. occidentalis) native to America. Common names with fruit characteristics, including berry size and pigment fingerprints, are summarized...

  15. Traditional Korean Child Rearing Practices.

    ERIC Educational Resources Information Center

    Han, Myunghee; Washington, Ernest D.

    This study describes traditional Korean child rearing and its relation to personality, social development, and their implications for education. Topics addressed include the family structure, traditional value orientation, the prenatal period, patterns of interaction in infancy, the baby as a vulnerable being, the baby as a spiritual being, the…

  16. Structural Case Assignment in Korean

    ERIC Educational Resources Information Center

    Koak, Heeshin

    2012-01-01

    In this dissertation, I aim to provide a theory on the distribution of structural Case in Korean. I propose the following Structural Case Assignment Hypothesis (SCAH) regarding the assignment of structural Case: "Structural Case is assigned by phase heads (C: nominative; v: accusative) to every argument in the c-command domain of the phase…

  17. Asian Pacific Perspectives: Korean Americans.

    ERIC Educational Resources Information Center

    Los Angeles Unified School District, CA.

    These instructional materials on Korean Americans for elementary students were developed through the K.E.Y.S. project (Knowledge of English Yields Success). Information is included about early immigrants, the second generation, student groups, war brides, recent immigrants, and third and fourth generations. A chart of traditional and modified…

  18. Asian Pacific Perspectives: Korean Americans.

    ERIC Educational Resources Information Center

    Los Angeles Unified School District, CA.

    These instructional materials on Korean Americans for elementary students were developed through the K.E.Y.S. project (Knowledge of English Yields Success). Information is included about early immigrants, the second generation, student groups, war brides, recent immigrants, and third and fourth generations. A chart of traditional and modified…

  19. A KOREAN-ENGLISH DICTIONARY.

    ERIC Educational Resources Information Center

    MARTIN, SAMUEL E.; AND OTHERS

    ALTHOUGH THE PURPOSE OF THIS DICTIONARY IS TO "GIVE A FULL AND ACCURATE PORTRAYAL OF THE BASIC NATIVE KOREAN VOCABULARY," SOME OF THE COMMON AND USEFUL CHINESE AND EUROPEAN LOANWORDS HAVE BEEN INCLUDED AS WELL. THE AUTHORS (SAMUEL E. MARTIN, YANG HA LEE, AND SUNG-UN CHANG) HAVE FOLLOWED THE HANKUL SPELLING CONVENTIONS OF THE…

  20. Korean Basic Course: Area Background.

    ERIC Educational Resources Information Center

    Defense Language Inst., Washington, DC.

    Designed to serve as an introduction to some aspects of Korean culture and civilization, this text consists largely of lectures on various topics prepared by staff members of the Defense Language Institute. The major section on the Republic of South Korea includes information on: (1) the historical setting; (2) the politico-military complex; (3)…

  1. Korean Type Distal Radius Anatomical Volar Plate System: A Preliminary Report

    PubMed Central

    Kim, Jeong Hwan; Kim, Jihyeung; Kim, Min Bom; Rhee, Seung Hwan; Gong, Hyun Sik; Lee, Young Ho

    2014-01-01

    Background Distal radius fracture is the most common fracture of the upper extremity, and approximately 60,000 distal radius fractures occur annually in Korea. Internal fixation with an anatomical volar locking plate is widely used in the treatment of unstable distal radius fractures. However, most of the currently used distal radius anatomical plate systems were designed based on the anatomical characteristics of Western populations. Recently, the Korean-type distal radius anatomical volar plate (K-DRAVP) system was designed and developed based on the anatomical characteristics of the distal radius of Koreans. The purpose of this study was to evaluate the preliminary results of the new K-DRAVP system, and to compare its radiologic and functional results with those of the other systems. Methods From March 2012 to October 2012, 46 patients with acute distal radius fractures who were treated with the K-DRAVP system at three hospitals were enrolled in this study. Standard posteroanterior and lateral radiographs were obtained to assess fracture healing, and three radiographic parameters (volar tilt, radial inclination, and radial length) were assessed to evaluate radiographic outcomes. The range of motion and grip strength, the Gartland and Werley scoring system, and the disabilities of the arm, shoulder and hand (DASH) questionnaire were used to assess clinical and functional outcomes. Results All radiologic parameters were restored to normal values, and maintained without any loosening or collapse until the time of final follow-up. Grip strength was restored to 84% of the value for the unaffected side. The mean range of motion of the wrist at final follow-up was restored to 77%-95% of the value for the unaffected side. According to the Gartland and Werley scoring system, there were 16 excellent, 26 good, and 4 fair results. The mean DASH score was 8.4 points. There were no complications after surgery. Conclusions The newly developed K-DRAVP system could be used to

  2. Report on the Project for Establishment of the Standardized Korean Laboratory Terminology Database, 2015.

    PubMed

    Jung, Bo Kyeung; Kim, Jeeyong; Cho, Chi Hyun; Kim, Ju Yeon; Nam, Myung Hyun; Shin, Bong Kyung; Rho, Eun Youn; Kim, Sollip; Sung, Heungsup; Kim, Shinyoung; Ki, Chang Seok; Park, Min Jung; Lee, Kap No; Yoon, Soo Young

    2017-04-01

    The National Health Information Standards Committee was established in 2004 in Korea. The practical subcommittee for laboratory test terminology was placed in charge of standardizing laboratory medicine terminology in Korean. We aimed to establish a standardized Korean laboratory terminology database, Korea-Logical Observation Identifier Names and Codes (K-LOINC) based on former products sponsored by this committee. The primary product was revised based on the opinions of specialists. Next, we mapped the electronic data interchange (EDI) codes that were revised in 2014, to the corresponding K-LOINC. We established a database of synonyms, including the laboratory codes of three reference laboratories and four tertiary hospitals in Korea. Furthermore, we supplemented the clinical microbiology section of K-LOINC using an alternative mapping strategy. We investigated other systems that utilize laboratory codes in order to investigate the compatibility of K-LOINC with statistical standards for a number of tests. A total of 48,990 laboratory codes were adopted (21,539 new and 16,330 revised). All of the LOINC synonyms were translated into Korean, and 39,347 Korean synonyms were added. Moreover, 21,773 synonyms were added from reference laboratories and tertiary hospitals. Alternative strategies were established for mapping within the microbiology domain. When we applied these to a smaller hospital, the mapping rate was successfully increased. Finally, we confirmed K-LOINC compatibility with other statistical standards, including a newly proposed EDI code system. This project successfully established an up-to-date standardized Korean laboratory terminology database, as well as an updated EDI mapping to facilitate the introduction of standard terminology into institutions. © 2017 The Korean Academy of Medical Sciences.

  3. Health Information in Korean (한국어)

    MedlinePlus

    ... Electroencephalogram) - 한국어 (Korean) Bilingual PDF Health Information Translations Lumbar Puncture - 한국어 (Korean) Bilingual PDF Health Information Translations Neuromuscular Disorders EMG and Nerve Conduction Tests - 한국어 (Korean) Bilingual PDF Health Information ...

  4. Long-term outcome of infective endocarditis: A study on patients surviving over one year after the initial episode treated in a Finnish teaching hospital during 25 years

    PubMed Central

    Heiro, Maija; Helenius, Hans; Hurme, Saija; Savunen, Timo; Metsärinne, Kaj; Engblom, Erik; Nikoskelainen, Jukka; Kotilainen, Pirkko

    2008-01-01

    Background Only a few previous studies have focused on the long-term prognosis of the patients with infective endocarditis (IE). Our purpose was to delineate factors potentially associated with the long-term outcome of IE, recurrences of IE and requirement for late valve surgery. Methods A total of 326 episodes of IE in 303 patients were treated during 1980–2004 in the Turku University Hospital. We evaluated the long-term outcome and requirement for late valve surgery for 243 of these episodes in 226 patients who survived longer than 1 year after the initial admission. Factors associated with recurrences were analysed both for the 1-year survivors and for all 303 patients. Results The mean (SD) follow-up time for the 1-year survivors was 11.5 (7.3) years (range 25 days to 25.5 years). The overall survival was 95%, 82%, 66%, 51% and 45% at 2, 5, 10, 15 and 20 years. In age and sex adjusted multivariate analyses, significant predictors for long-term overall mortality were heart failure within 3 months of admission (HR 1.97, 95% CI 1.27 to 3.06; p = 0.003) and collagen disease (HR 2.54, 95% CI 1.25 to 5.19; p = 0.010) or alcohol abuse (HR 2.39, 95% CI 1.30 to 4.40; p = 0.005) as underlying conditions, while early surgery was significantly associated with lower overall mortality rates (HR 0.31, 95% CI 0.17 to 0.58; p < 0.001). Heart failure was also significantly associated with the long-term cardiac mortality (p = 0.032). Of all 303 patients, 20 had more than 1 disease episode. Chronic dialysis (p = 0.002), intravenous drug use (p = 0.002) and diabetes (p = 0.015) were significant risk factors for recurrent episodes of IE, but when analysed separately for the 1-year survivors, only chronic dialysis remained significant (p = 0.017). Recurrences and late valve surgery did not confer a poor prognosis. Conclusion Heart failure during the index episode of IE was the complication, which significantly predicted a poor long-term outcome. Patients who underwent surgery

  5. Psychiatry in Former Socialist Countries: Implications for North Korean Psychiatry

    PubMed Central

    Park, Young Su; Park, Sang Min; Jun, Jin Yong

    2014-01-01

    Very little information is available regarding psychiatry in North Korea, which is based on the legacy of Soviet psychiatry. This paper reviews the characteristics of psychiatry in former socialist countries and discusses its implications for North Korean psychiatry. Under socialism, psychiatric disorders were attributed primarily to neurophysiologic or neurobiological origins. Psychosocial or psychodynamic etiology was denied or distorted in line with the political ideology of the Communist Party. Psychiatry was primarily concerned with psychotic disorders, and this diagnostic category was sometimes applied based on political considerations. Neurotic disorders were ignored by psychiatry or were regarded as the remnants of capitalism. Several neurotic disorders characterized by high levels of somatization were considered to be neurological or physical in nature. The majority of "mental patients" were institutionalized for a long periods in large-scale psychiatric hospitals. Treatment of psychiatric disorders depended largely on a few outdated biological therapies. In former socialist countries, psychodynamic psychotherapy was not common, and psychiatric patients were likely to experience social stigma. According to North Korean doctors living in South Korea, North Korean psychiatry is heavily influenced by the aforementioned traditions of psychiatry. During the post-socialist transition, the suicide rate in many of these countries dramatically increased. Given such mental health crises in post-socialist transitional societies, the field of psychiatry may face major challenges in a future unified Korea. PMID:25395966

  6. Psychiatry in former socialist countries: implications for north korean psychiatry.

    PubMed

    Park, Young Su; Park, Sang Min; Jun, Jin Yong; Kim, Seog Ju

    2014-10-01

    Very little information is available regarding psychiatry in North Korea, which is based on the legacy of Soviet psychiatry. This paper reviews the characteristics of psychiatry in former socialist countries and discusses its implications for North Korean psychiatry. Under socialism, psychiatric disorders were attributed primarily to neurophysiologic or neurobiological origins. Psychosocial or psychodynamic etiology was denied or distorted in line with the political ideology of the Communist Party. Psychiatry was primarily concerned with psychotic disorders, and this diagnostic category was sometimes applied based on political considerations. Neurotic disorders were ignored by psychiatry or were regarded as the remnants of capitalism. Several neurotic disorders characterized by high levels of somatization were considered to be neurological or physical in nature. The majority of "mental patients" were institutionalized for a long periods in large-scale psychiatric hospitals. Treatment of psychiatric disorders depended largely on a few outdated biological therapies. In former socialist countries, psychodynamic psychotherapy was not common, and psychiatric patients were likely to experience social stigma. According to North Korean doctors living in South Korea, North Korean psychiatry is heavily influenced by the aforementioned traditions of psychiatry. During the post-socialist transition, the suicide rate in many of these countries dramatically increased. Given such mental health crises in post-socialist transitional societies, the field of psychiatry may face major challenges in a future unified Korea.

  7. Bleeding-related hospital admissions and 30-day readmissions in patients with non-valvular atrial fibrillation treated with dabigatran versus warfarin.

    PubMed

    Lau, W C Y; Li, X; Wong, I C K; Man, K K C; Lip, G Y H; Leung, W K; Siu, C W; Chan, E W

    2017-10-01

    Essentials Bleeding is a common cause of hospital admission and readmission in oral anticoagulant users. Patients with dabigatran and warfarin were included to assess hospital admission risk. Dabigatran users had a higher risk of 30-day readmission with bleeding than warfarin users. Close monitoring following hospital discharge for dabigatran-related bleeding is warranted. Background Reducing 30-day hospital readmission is a policy priority worldwide. Warfarin-related bleeding is among the most common cause of hospital admissions as a result of adverse drug events. Compared with warfarin, dabigatran achieves a full anticoagulation effect more quickly following its initiation; hence it may lead to early-onset bleeds. Objectives To compare the incidence of bleeding-related hospital admissions and 30-day readmissions with dabigatran vs. warfarin in patients with non-valvular atrial fibrillation (NVAF). Methods This was a retrospective cohort study using a population-wide database managed by the Hong Kong Hospital Authority. Patients newly diagnosed with NVAF from 2010 through to 2014 and prescribed dabigatran or warfarin were 1:1 matched by propensity score. The incidence rate of hospital admission with bleeding (a composite of gastrointestinal bleeding, intracranial hemorrhage and bleeding at other sites) was assessed. Results Among the 51 946 patients with NVAF, 8309 users of dabigatran or warfarin were identified, with 5160 patients matched by propensity score. The incidence of first hospitalized bleeding did not differ significantly between groups (incidence rate ratio, 0.92; 95% confidence interval [CI], 0.66-1.28). Among patients who were continuously prescribed their initial anticoagulants upon discharge, dabigatran use was associated with a higher risk of 30-day readmission with bleeding over warfarin (adjusted hazard ratio, 2.87; 95%CI, 1.10-7.43). Conclusion When compared with warfarin, dabigatran was associated with a comparable incidence of first hospital

  8. What Makes Koreans Happy?: Exploration on the Structure of Happy Life among Korean Adults

    ERIC Educational Resources Information Center

    Kim, Myoung So; Kim, Hye Won; Cha, Kyeong Ho; Lim, Jeeyoung

    2007-01-01

    The current study explored the perceptions of Korean people about what can make them happy and constructed a comprehensive measurement of happiness of Korean. A total of 61 Korean adults participated in Focused Group Interview (FGI), where they were asked three questions (e.g., What makes you happy? What could make you happier than now? In…

  9. What Makes Koreans Happy?: Exploration on the Structure of Happy Life among Korean Adults

    ERIC Educational Resources Information Center

    Kim, Myoung So; Kim, Hye Won; Cha, Kyeong Ho; Lim, Jeeyoung

    2007-01-01

    The current study explored the perceptions of Korean people about what can make them happy and constructed a comprehensive measurement of happiness of Korean. A total of 61 Korean adults participated in Focused Group Interview (FGI), where they were asked three questions (e.g., What makes you happy? What could make you happier than now? In…

  10. Participation motivation and competition anxiety among Korean and non-Korean wheelchair tennis players

    PubMed Central

    Jeong, Irully; Park, Sunghee

    2013-01-01

    The purpose of this study was to examine differences in participation motivation and competition anxiety between Korean and non-Korean wheelchair tennis players and to identify relations between participation motivation and competition anxiety in each group. Sixty-six wheel-chair tennis players who participated in the 2013 Korea Open Wheel-chair Tennis Tournament in Seoul completed the Participation Motivation Survey and the Competitive State Anxiety Inventory II. Data were analyzed by a frequency analysis, descriptive statistics, Pearson’s correlation analysis, and independent samples t-test to identify participants’ demographic characteristics, differences in participation motivation, competition anxiety between Korean and non-Korean players, and correlations between participation motivation and competition anxiety in each group. Korean players reported significantly higher motivation in purification compared to non-Korean players, whereas non-Korean players reported significantly higher motivation in enjoyment. In addition, non-Korean players demonstrated higher cognitive anxiety and self-confidence compared to Korean players. Moreover, the physical anxiety of Korean players was negatively correlated with learning, health-fitness, and enjoyment motivation. On the other hand, only self-confidence was significantly related to learning motivation and enjoyment motivation in non-Korean players. Thus, the results presented herein provide evidence for the development of specialized counseling programs that consider the psychological characteristics of Korean wheelchair tennis players. PMID:24409429

  11. Korean Adoptee Identity: Adoptive and Ethnic Identity Profiles of Adopted Korean Americans

    ERIC Educational Resources Information Center

    Beaupre, Adam J.; Reichwald, Reed; Zhou, Xiang; Raleigh, Elizabeth; Lee, Richard M.

    2015-01-01

    Adopted Korean adolescents face the task of grappling with their identity as Koreans and coming to terms with their adoptive status. In order to explore these dual identities, the authors conducted a person-centered study of the identity profiles of 189 adopted Korean American adolescents. Using cluster analytic procedures, the study examined…

  12. Learning Korean Language in China: Motivations and Strategies of Non-Koreans

    ERIC Educational Resources Information Center

    Gao, Fang

    2010-01-01

    The ethnographic research reported in this article documents how a group of non-Korean families, whose children are participating in a Korean bilingual school in Northeast China, construct their motivations and strategies of learning Korean language. The main motivation of expectancy of further education opportunities and success in future career…

  13. Korean Adoptee Identity: Adoptive and Ethnic Identity Profiles of Adopted Korean Americans

    ERIC Educational Resources Information Center

    Beaupre, Adam J.; Reichwald, Reed; Zhou, Xiang; Raleigh, Elizabeth; Lee, Richard M.

    2015-01-01

    Adopted Korean adolescents face the task of grappling with their identity as Koreans and coming to terms with their adoptive status. In order to explore these dual identities, the authors conducted a person-centered study of the identity profiles of 189 adopted Korean American adolescents. Using cluster analytic procedures, the study examined…

  14. Korean American College Students' Language Practices and Identity Positioning: "Not Korean, but Not American"

    ERIC Educational Resources Information Center

    Kang, Hyun-Sook

    2013-01-01

    This article explores the intersection between language practices and ethnic identity for 8 second-generation Korean American learners who were participating in a Korean-as-a-foreign-language (KFL) class at a U.S. university. This study aims to examine the fluid nature of ethnic identity by examining how Korean heritage learners negotiate,…

  15. The Korean Diaspora. Historical and Sociological Studies of Korean Immigration and Assimilation in North America.

    ERIC Educational Resources Information Center

    Kim, Hyung-chan, Ed.

    This anthology presents some results of recent research on Korean immigration to and assimilation in America. The essays address three major questions concerned with problems of immigration and assimilation: (1) What caused the immigration of Koreans to the Hawaiian Islands and the United States mainland? (2) How has the Korean experience in…

  16. Korean American College Students' Language Practices and Identity Positioning: "Not Korean, but Not American"

    ERIC Educational Resources Information Center

    Kang, Hyun-Sook

    2013-01-01

    This article explores the intersection between language practices and ethnic identity for 8 second-generation Korean American learners who were participating in a Korean-as-a-foreign-language (KFL) class at a U.S. university. This study aims to examine the fluid nature of ethnic identity by examining how Korean heritage learners negotiate,…

  17. Phonological Acquisition of Korean Consonants in Conversational Speech Produced by Young Korean Children

    ERIC Educational Resources Information Center

    Kim, Minjung; Kim, Soo-Jin; Stoel-Gammon, Carol

    2017-01-01

    This study investigates the phonological acquisition of Korean consonants using conversational speech samples collected from sixty monolingual typically developing Korean children aged two, three, and four years. Phonemic acquisition was examined for syllable-initial and syllable-final consonants. Results showed that Korean children acquired stops…

  18. The Korean Diaspora. Historical and Sociological Studies of Korean Immigration and Assimilation in North America.

    ERIC Educational Resources Information Center

    Kim, Hyung-chan, Ed.

    This anthology presents some results of recent research on Korean immigration to and assimilation in America. The essays address three major questions concerned with problems of immigration and assimilation: (1) What caused the immigration of Koreans to the Hawaiian Islands and the United States mainland? (2) How has the Korean experience in…

  19. Participation motivation and competition anxiety among Korean and non-Korean wheelchair tennis players.

    PubMed

    Jeong, Irully; Park, Sunghee

    2013-01-01

    The purpose of this study was to examine differences in participation motivation and competition anxiety between Korean and non-Korean wheelchair tennis players and to identify relations between participation motivation and competition anxiety in each group. Sixty-six wheel-chair tennis players who participated in the 2013 Korea Open Wheel-chair Tennis Tournament in Seoul completed the Participation Motivation Survey and the Competitive State Anxiety Inventory II. Data were analyzed by a frequency analysis, descriptive statistics, Pearson's correlation analysis, and independent samples t-test to identify participants' demographic characteristics, differences in participation motivation, competition anxiety between Korean and non-Korean players, and correlations between participation motivation and competition anxiety in each group. Korean players reported significantly higher motivation in purification compared to non-Korean players, whereas non-Korean players reported significantly higher motivation in enjoyment. In addition, non-Korean players demonstrated higher cognitive anxiety and self-confidence compared to Korean players. Moreover, the physical anxiety of Korean players was negatively correlated with learning, health-fitness, and enjoyment motivation. On the other hand, only self-confidence was significantly related to learning motivation and enjoyment motivation in non-Korean players. Thus, the results presented herein provide evidence for the development of specialized counseling programs that consider the psychological characteristics of Korean wheelchair tennis players.

  20. Learning Korean Language in China: Motivations and Strategies of Non-Koreans

    ERIC Educational Resources Information Center

    Gao, Fang

    2010-01-01

    The ethnographic research reported in this article documents how a group of non-Korean families, whose children are participating in a Korean bilingual school in Northeast China, construct their motivations and strategies of learning Korean language. The main motivation of expectancy of further education opportunities and success in future career…

  1. Validation of the Korean translation of obesity-related problems scale assessing the quality of life in obese Korean.

    PubMed

    Lee, Yeon Ji; Moon, Kon-Hak; Choi, Ji-Ho; Cho, Min-Jung; Shin, Seok Hwan; Heo, Yoonseok

    2013-03-01

    The objective of this study was to translate the obesity-related problems (OP) scale for Koreans and to validate it for use in Korean populations. Translation and back-translation of the OP scale was performed and a pilot test was conducted. Following this, patients who had received treatment at the Obesity Center of Inha University Hospital were selected for participation in the field test. Cronbach's alpha (α) was used for assessment of the internal consistency of the OP scale. Spearman's correlation coefficients were used to assess the concurrent validity between the OP scale, the EuroQoL-5D (EQ-5D), and the Beck depression inventory (BDI) scale. One-way analysis of variance and t-test were used to assess the factors associated with the OP scale. A total of 67 individuals participated in the field study. The standardized Cronbach's α of the OP was 0.913. A significant negative correlation was observed between the OP scale and the EQ-5D and a positive correlation was observed between the OP scale and the BDI (the correlation coefficient with EQ-5D = -0.316, and the BDI = 0.305, P < 0.05). The results of this study prove that the Korean version of the OP has been translated and adapted correctly in order to meet the standard of its use.

  2. Arms Control in the Korean Peninsula.

    DTIC Science & Technology

    1986-05-01

    defense expenditures of both sides are assessed as follows:4 The South Korean population outnumbers North Korea two to one. This presents difficulties for...99. Kim, Chum-Kon, The Korean War, Seoul, Kwang-Myong Publishing Company Ltd., 1980. The Text of Mutual Defense Treaty between Korea and the USA...AIR WAR COLLEGE RESEARCH REPORT ABSTRACT TITLE: Arms Control in the Korean Peninsula AUTHOR: Kim, Hyon, Colonel, Republic of Korea Air Force - 1

  3. The Economic Implications of Korean Reunification

    DTIC Science & Technology

    2007-11-02

    Korea (ROK) and the Democratic People’s Republic of Korea (DPRK). The eventual reunification of the Korean peninsula will offer many challenges for...in the development of two very different governments and economies. The two Koreas are technically still at war; the Korean War ended with the signing...96 Korea actually began to become industrialized during the last fifteen years of Japanese occupation. The number of Koreans employed in heavy

  4. Air Power in the Korean War

    DTIC Science & Technology

    1998-04-01

    was simply to expel the North Korean communists from the free country in the south called the Republic of Korea . The U.S. national objective was to... Korea reasoning that the forces could best be used elsewhere. During the three years prior to the Korean War, Truman’s policy toward the ROK was...increasing Chinese Communist interests in North Korea .4 On 10 March 1950, Truman was further warned that the North Koreans would “invade sometime in

  5. Operational Art Requirements in the Korean War

    DTIC Science & Technology

    2012-05-17

    Rhee, enough for defense but not enough to precipitate South Korean offensive actions to unify Korea .27 Adding to the tension in the region, the...percent of the Korean Peninsula. The United States decided to intervene in the defense of the South and proceeded to press the United Nations (U.N...the Korean War, these works primarily fall into three broad areas of scholarship: the American strategy concerning Korea and the Cold War

  6. Korean Defense Industry: Threat or Ally?

    DTIC Science & Technology

    1994-02-22

    framework for defense industrial cooperation with Korea . While Senator Dixon eventually dropped his opposition and the Korean Fighter Program is now...US defense firms to transfer technology to Korean firms, the US Government must recognize two realities: first, Korea will develop indigenous...serious Korean competition in the foreseeable future. 8 It does not appear that the Korea defense industry is poised to take away significant market

  7. Understanding employment barriers among older Korean immigrants.

    PubMed

    Rhee, Min-Kyoung; Chi, Iris; Yi, Jaehee

    2015-06-01

    This study involved an in-depth exploration of the employment barriers of older Korean immigrants in Los Angeles. This qualitative study used data obtained from 6 focus groups and 5 individual interviews. Participants were 36 older Korean immigrants living in Los Angeles, aged 50 years and older, and either unemployed or employed in part-time or full-time work. A grounded theory analytical approach and constant comparison method were used. Ten major themes emerged as employment barriers for older Korean immigrants and were categorized as stereotype, human capital, and acculturation barriers. Ageism among employers specific to Korean culture, lack of English proficiency, separation from U.S. culture, marginalization from both Korean and U.S. cultures, and lack of social networks were important themes. In addition, older Korean immigrants experienced multiple interconnected barriers. The findings highlight the importance of using a multidimensional approach to explore employment barriers among older Korean immigrants who face multiple obstacles in finding jobs. Implications for local governments and Korean communities and potential services to support employment opportunities for older Korean immigrants are discussed. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Combined Operations in the Korean War

    DTIC Science & Technology

    1989-04-24

    Research Cfice, 1952. Ministry of National Defense , Republic of Korea . The History of United Nations Forces in the Korean War. Volume VI, Seou 1: 1977. ,-,h...committed to repelling the North Korean and Chinese armies from the Republic of Korea (ROK). The Korean War was not anticipated and neither was the extent...Coaal: tior War Early on 25 June Iz)50 the North Korean People- Army =_NKPA launched an overwhelming invasion into the Repu’Tli,: cf Korea . Pres-.i,ent

  9. Development of a Web-Based Nationwide Korean Pediatric Dental Sedation Registry.

    PubMed

    Choi, Sung Chul; Yang, Yeonmi; Yoo, Seunghoon; Kim, Jiyeon; Jeong, Taesung; Shin, Teo Jeon

    2017-09-22

    Finding a balance between sedation efficacy and safety remains an ongoing challenge. In children, the risk of sedation-related complications is relatively high. It is of utmost importance to determine the factors related to improved overall sedation outcomes. However, most previous reports have been based on small samples at single institutions. The Korean Academy of Pediatric Dentistry (KAPD) developed a Korean Pediatric Dental Sedation Registry using a web-based platform. Specialists in pediatric dental sedation selected the itemized list included within the registry through an extensive literature review. The web-based registry was built into the KAPD homepage to facilitate easy access to the sedation data. All teaching and university hospitals agreed to participate in the Korean Pediatric Dental Sedation Registry. This is the first attempt to collect sedation data on a nationwide scale in the field of pediatric dentistry. The sedation database established with the registry may facilitate standardizing and improving pediatric dental sedation clinical practices.

  10. Beliefs, practices, and experiences of Korean women in relation to childbirth.

    PubMed

    Park, K J; Peterson, L M

    1991-01-01

    Korean women's health beliefs and childbirth experiences in the United States were examined. A convenience sampling procedure was used, and face-to-face interviews were conducted in Korean. Interviews were audiotaped, typed, and translated from Korean to English. These women had a holistic concept of health. Some practices were influence by ancient Chinese medicine. Childbirth experiences indicated that language is a barrier requiring specific interventions. Recommendations include (a) development of an assessment tool with which health-care professionals can identify individual health beliefs early in pregnancy; (b) development of a bilingual pamphlet about medical terms and the U.S. health-care system; (c) development of a short bilingual dictionary of common foods for use in menu selection during hospitalization; and (d) provision of English practice periods based on anticipatory guidance principles to prepare women to ask for specific assistance.

  11. Validation Study for the Korean Version of Fear of Cancer Recurrence Inventory.

    PubMed

    Shin, Jinyoung; Goo, Aejin; Ko, Hyeonyoung; Kim, Ji Hae; Lim, Seung U; Lee, Han Kyeong; Simard, Sébastien; Song, Yun Mi

    2017-11-01

    Fear of cancer recurrence (FCR) is one of the most prevalent unmet psychosocial needs. This study aimed to confirm the cultural equivalence, reliability, and validity of the Korean version of Fear of Cancer Recurrence Inventory (K-FCRI). We conducted a forward-backward translation of the English version FCRI to Korean version through meticulous process including transcultural equivalence test. The psychometric property of the K-FCRI was then validated in 444 survivors from cancers at various sites. The Korean translation was accepted well by participants. There was a good cultural equivalence between the Korean version and the English version of FCRI. Confirmatory factor analysis supported the original seven-factor structure with slightly insufficient level of goodness-of-fit indices (comparative fit index = 0.900, non-normed fit index = 0.893, root mean square error of approximation = 0.060). The K-FCRI had high internal consistency (α = 0.85 for total scale and α = 0.77-0.87 for subscales) and test-retest reliability (r = 0.90 for total scale and r = 0.54-0.84 for subscales). The K-FCRI had significant correlations with the Korean version of Fear of Progression Questionnaire, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Version 3.0, Hospital Anxiety and Depression Scale, and Fatigue Severity Score, supporting the good construct validity and psychometric properties of K-FCRI. The K-FCRI was confirmed as a valid and reliable psychometric test for measuring FCR of Korean survivors from cancers at various sites. © 2017 The Korean Academy of Medical Sciences.

  12. The Korean Question--Revisited.

    DTIC Science & Technology

    1987-03-01

    PAGE D/02Q P REPORT DOCUMENTATION PAGE I&. REPORT SECURITY CLASSIFICATION lb RESTRICTIVE MARKINGS Unclassified 2a. SECURITY CLASSIFICATION AUTHORITY 3 ...CLASSIFICATION OF THIS PAGE All other editions are obsolete *U.S. 02-0rnf6nt PUtncla s fi 0102-LF-014-6602 Unclass’ife * ’ 3 5 33%1C EXECUTIVE SUMMARY THE KOREAN...0. 1 Purpose *............. .........*0*60 3 Approach ....................... .** 3 Scope and Limitations .............. 3 Assumptions

  13. Surprise: The Korean Case Study

    DTIC Science & Technology

    1992-05-18

    theory through education ; a mre rigid approach toward decision making in foriegn policy; appropriate military doctrine; mobile and flexible forces. 20...TJUR 19 ARSTRAC7 (Contrwe on ,vvere of necesury end iderltIfy by block fnumber) Clearly m.ilitary surorise is arnng the greatest dangers a country ...SURPRISE: THE KOREAN CASE STUDY Clearly military surprise is among the greatest dangers a country can face. Despite a knowledge of this danger, responsible

  14. Korean speech sound development in children from bilingual Japanese-Korean environments.

    PubMed

    Kim, Jeoung Suk; Lee, Jun Ho; Choi, Yoon Mi; Kim, Hyun Gi; Kim, Sung Hwan; Lee, Min Kyung; Kim, Sun Jun

    2010-09-01

    This study investigates Korean speech sound development, including articulatory error patterns, among the Japanese-Korean children whose mothers are Japanese immigrants to Korea. The subjects were 28 Japanese-Korean children with normal development born to Japanese women immigrants who lived in Jeonbuk province, Korea. They were assessed through Computerized Speech Lab 4500. The control group consisted of 15 Korean children who lived in the same area. The values of the voice onset time of consonants /p(h)/, /t/, /t(h)/, and /k(*)/ among the children were prolonged. The children replaced the lenis sounds with aspirated or fortis sounds rather than replacing the fortis sounds with lenis or aspirated sounds, which are typical among Japanese immigrants. The children showed numerous articulatory errors for /c/ and /l/ sounds (similar to Koreans) rather than errors on /p/ sounds, which are more frequent among Japanese immigrants. The vowel formants of the children showed a significantly prolonged vowel /o/ as compared to that of Korean children (P<0.05). The Japanese immigrants and their children showed a similar substitution /n/ for /ɧ/ [Japanese immigrants (62.5%) vs Japanese-Korean children (14.3%)], which is rarely seen among Koreans. The findings suggest that Korean speech sound development among Japanese-Korean children is influenced not only by the Korean language environment but also by their maternal language. Therefore, appropriate language education programs may be warranted not only or immigrant women but also for their children.

  15. Too Korean to be White and Too White to Be Korean: Ethnic Identity Development among Transracial Korean American Adoptees

    ERIC Educational Resources Information Center

    Hoffman, Joy; Pena, Edlyn Vallejo

    2013-01-01

    The purpose of this grounded theory study was to explore how lived experiences affect ethnic identity development of transracial Korean American adoptees raised by White parents with the intent of informing higher education practice. Participants included 12 recently college-graduated transracial Korean American adoptees who were raised in the…

  16. Too Korean to be White and Too White to Be Korean: Ethnic Identity Development among Transracial Korean American Adoptees

    ERIC Educational Resources Information Center

    Hoffman, Joy; Pena, Edlyn Vallejo

    2013-01-01

    The purpose of this grounded theory study was to explore how lived experiences affect ethnic identity development of transracial Korean American adoptees raised by White parents with the intent of informing higher education practice. Participants included 12 recently college-graduated transracial Korean American adoptees who were raised in the…

  17. Prevalence of the ST239 Clone of Methicillin-Resistant Staphylococcus aureus and Differences in Antimicrobial Susceptibilities of ST239 and ST5 Clones Identified in a Korean Hospital

    PubMed Central

    Cha, Hwa Yun; Moon, Dong Chan; Choi, Chul Hee; Oh, Jae Young; Jeong, Young Sook; Lee, Yoo Chul; Seol, Sung Yong; Cho, Dong Taek; Chang, Hyun-Ha; Kim, Shin-Woo; Lee, Je Chul

    2005-01-01

    A total of 188 nonduplicate methicillin-resistant Staphylococcus aureus (MRSA) isolates obtained between 2001 and 2004 in a university hospital in Daegu, Korea, were analyzed for their clonal types by molecular typing techniques, including multilocus sequence typing, spaA typing, staphylococcal chromosomal cassette mec (SCCmec) typing, and pulsed-field gel electrophoresis (PFGE). They were examined for their antimicrobial susceptibilities. The majority (87%) of MRSA isolates belonged to sequence type 239 (ST239; n = 100; 53%) and ST5 (n = 63, 34%) on the basis of sequence typing. MRSA isolates belonging to ST239 were genotypically homogeneous, while those belonging to ST5 showed variations in spaA type, SCCmec type, and PFGE patterns. The rates of resistance of the MRSA isolates belonging to ST239 to trimethoprim, sulfamethoxazole, tobramycin, gentamicin, erythromycin, and tetracycline were significantly higher than those of the isolates belonging to ST5 (P < 0.05). This study demonstrated that the ST239 clone, while rarely detected in Korea, was prevalent and that the antimicrobial susceptibility of the ST239 clone was significantly different from that of the ST5 clone. PMID:16081886

  18. Rheumatoid arthritis patients fulfilling Korean National Health Insurance reimbursement guidelines for anti-tumor necrosis factor-α treatment and comparison to other guidelines.

    PubMed

    Hur, Jin-Wuk; Choe, Jung-Yoon; Kim, Dong-Wook; Kim, Hyun Ah; Kim, Sang-Hyon; Kim, Wan-Uk; Kim, Yun Sung; Lee, Hye-Soon; Lee, Sang-Heon; Park, Sung-Hwan; Park, Won; Park, Yong-Beom; Suh, Chang-Hee; Shim, Seung-Cheol; Song, Yeong-Wook; Yoon, Bo Young; Yu, Dae Young; Yoo, Dae Hyun

    2015-11-01

    The aim of this study was to compare anti-tumor necrosis factor-α (TNFα) treatment status in rheumatoid arthritis (RA) patients with the Korean National Health Insurance (KNHI) reimbursement eligibility criteria and with American College of Rheumatology (ACR) recommendations, Japan College of Rheumatology (JCR) guidelines and British Society for Rheumatology (BSR) guidelines. Between December 2011 and August 2012, outpatients from 17 South Korean general hospitals diagnosed with RA according to the 1987 ACR criteria were enrolled into a noninterventional, cross-sectional, observational study. Of 1700 patients (1414 female (83.2 %), mean age of 56.6 ± 12.0, mean disease duration 97.9 ± 91.8 months), 306 (18.0 %) had used anti-TNFα agents, and 224 (13.2 %) were currently using an anti-TNFα agent. Of 1394 anti-TNFα-naive patients, 32 (2.3 %) met KNHI reimbursement guidelines, 148 (10.6 %) met ACR recommendations, and 127 (9.1 %) and 126 (9.0 %) were considered eligible for anti-TNFα agents according to JCR and BSR guidelines, respectively. The main discrepancy was the higher active joint count required by the KNHI eligibility criteria. In the opinion of treating rheumatologists, the KNHI reimbursement criteria ineligibility accounted for 15.3 % (n = 213) of the reasons for not initiating anti-TNFα agents in anti-TNFα-naive group. The anti-TNFα user group showed significantly higher disease activity than the anti-TNFα-naive group based on DAS28 score. In comparison with the ACR recommendations and JCR and BSR guidelines, fewer patients met KNHI reimbursement eligibility criteria for anti-TNFα agents. The current amendment of the KNHI criteria based on DAS28 score will improve an access to biologic agents including anti-TNFα treatment for South Korean patients with active RA.

  19. Beyond volume: hospital-based healthcare technology as a predictor of mortality for cardiovascular patients in Korea.

    PubMed

    Kim, Jae-Hyun; Lee, Yunhwan; Park, Eun-Cheol

    2016-06-01

    To examine whether hospital-based healthcare technology is related to 30-day postoperative mortality rates after adjusting for hospital volume of cardiovascular surgical procedures.This study used the National Health Insurance Service-Cohort Sample Database from 2002 to 2013, which was released by the Korean National Health Insurance Service. A total of 11,109 cardiovascular surgical procedure patients were analyzed. The primary analysis was based on logistic regression models to examine our hypothesis.After adjusting for hospital volume of cardiovascular surgical procedures as well as for all other confounders, the odds ratio (OR) of 30-day mortality in low healthcare technology hospitals was 1.567-times higher (95% confidence interval [CI] = 1.069-2.297) than in those with high healthcare technology. We also found that, overall, cardiovascular surgical patients treated in low healthcare technology hospitals, regardless of the extent of cardiovascular surgical procedures, had the highest 30-day mortality rate.Although the results of our study provide scientific evidence for a hospital volume-mortality relationship in cardiovascular surgical patients, the independent effect of hospital-based healthcare technology is strong, resulting in a lower mortality rate. As hospital characteristics such as clinical pathways and protocols are likely to also play an important role in mortality, further research is required to explore their respective contributions.

  20. Factors Associated with the Sexual Assault of Students: An Exploratory Study of Victims Treated at Hospital-Based Sexual Assault Treatment Centers

    ERIC Educational Resources Information Center

    Du Mont, Janice; Chertkow, Laura; Macdonald, Sheila; Asllani, Eriola; Bainbridge, Deidre; Rotbard, Nomi; Cohen, Marsha M.

    2012-01-01

    Research suggests that students experience high levels of sexual assault, but studies addressing how they differ in their experiences from other sexual assault victims are virtually nonexistent. To address this gap, information was collected from consecutive individuals, aged 16 years or older, presenting to one of 7 hospital-based sexual assault…

  1. Factors Associated with the Sexual Assault of Students: An Exploratory Study of Victims Treated at Hospital-Based Sexual Assault Treatment Centers

    ERIC Educational Resources Information Center

    Du Mont, Janice; Chertkow, Laura; Macdonald, Sheila; Asllani, Eriola; Bainbridge, Deidre; Rotbard, Nomi; Cohen, Marsha M.

    2012-01-01

    Research suggests that students experience high levels of sexual assault, but studies addressing how they differ in their experiences from other sexual assault victims are virtually nonexistent. To address this gap, information was collected from consecutive individuals, aged 16 years or older, presenting to one of 7 hospital-based sexual assault…

  2. 11 March 2004: The terrorist bomb explosions in Madrid, Spain--an analysis of the logistics, injuries sustained and clinical management of casualties treated at the closest hospital.

    PubMed

    de Ceballos, J Peral Gutierrez; Turégano-Fuentes, F; Perez-Diaz, D; Sanz-Sanchez, M; Martin-Llorente, C; Guerrero-Sanz, J E

    2005-02-01

    At 07:39 on 11 March 2004, 10 terrorist bomb explosions occurred almost simultaneously in four commuter trains in Madrid, Spain, killing 177 people instantly and injuring more than 2000. There were 14 subsequent in-hospital deaths, bringing the ultimate death toll to 191. This report describes the organization of clinical management and patterns of injuries in casualties who were taken to the closest hospital, with an emphasis on the critically ill. A total of 312 patients were taken to the hospital and 91 patients were hospitalized, of whom 89 (28.5%) remained in hospital for longer than 24 hours. Sixty-two patients had only superficial bruises or emotional shock, but the remaining 250 patients had more severe injuries. Data on 243 of these 250 patients form the basis of this report. Tympanic perforation occurred in 41% of 243 victims with moderate-to-severe trauma, chest injuries in 40%, shrapnel wounds in 36%, fractures in 18%, first-degree or second-degree burns in 18%, eye lesions in 18%, head trauma in 12% and abdominal injuries in 5%. Between 08:00 and 17:00, 34 surgical interventions were performed in 32 patients. Twenty-nine casualties (12% of the total, or 32.5% of those hospitalized) were deemed to be in a critical condition, and two of these died within minutes of arrival. The other 27 survived to admission to intensive care units, and three of them died, bringing the critical mortality rate to 17.2% (5/29). The mean Injury Severity Score and Acute Physiology and Chronic Health Evaluation II scores for critically ill patients were 34 and 23, respectively. Among these critically ill patients, soft tissue and musculoskeletal injuries predominated in 85% of cases, ear blast injury was identified in 67% and blast lung injury was present in 63%. Fifty-two per cent suffered head trauma. Over-triage to the closest hospital probably occurred, and the time of the blasts proved to be crucial to the the adequacy of the medical and surgical response. The number of

  3. 11 March 2004: The terrorist bomb explosions in Madrid, Spain – an analysis of the logistics, injuries sustained and clinical management of casualties treated at the closest hospital

    PubMed Central

    de Ceballos, J Peral Gutierrez; Turégano-Fuentes, F; Perez-Diaz, D; Sanz-Sanchez, M; Martin-Llorente, C; Guerrero-Sanz, JE

    2005-01-01

    At 07:39 on 11 March 2004, 10 terrorist bomb explosions occurred almost simultaneously in four commuter trains in Madrid, Spain, killing 177 people instantly and injuring more than 2000. There were 14 subsequent in-hospital deaths, bringing the ultimate death toll to 191. This report describes the organization of clinical management and patterns of injuries in casualties who were taken to the closest hospital, with an emphasis on the critically ill. A total of 312 patients were taken to the hospital and 91 patients were hospitalized, of whom 89 (28.5%) remained in hospital for longer than 24 hours. Sixty-two patients had only superficial bruises or emotional shock, but the remaining 250 patients had more severe injuries. Data on 243 of these 250 patients form the basis of this report. Tympanic perforation occurred in 41% of 243 victims with moderate-to-severe trauma, chest injuries in 40%, shrapnel wounds in 36%, fractures in 18%, first-degree or second-degree burns in 18%, eye lesions in 18%, head trauma in 12% and abdominal injuries in 5%. Between 08:00 and 17:00, 34 surgical interventions were performed in 32 patients. Twenty-nine casualties (12% of the total, or 32.5% of those hospitalized) were deemed to be in a critical condition, and two of these died within minutes of arrival. The other 27 survived to admission to intensive care units, and three of them died, bringing the critical mortality rate to 17.2% (5/29). The mean Injury Severity Score and Acute Physiology and Chronic Health Evaluation II scores for critically ill patients were 34 and 23, respectively. Among these critically ill patients, soft tissue and musculoskeletal injuries predominated in 85% of cases, ear blast injury was identified in 67% and blast lung injury was present in 63%. Fifty-two per cent suffered head trauma. Over-triage to the closest hospital probably occurred, and the time of the blasts proved to be crucial to the the adequacy of the medical and surgical response. The number of

  4. The Cultural Negotiations of Korean Immigrant Youth

    ERIC Educational Resources Information Center

    Yeh, Christine J.; Ma, Pei-Wen; Madan-Bahel, Anvita; Hunter, Carla D.; Jung, Sunna; Kim, Angela B.; Akitaya, Kyoko; Sasaki, Kiyoko

    2005-01-01

    The authors investigated the process of cultural adjustment among 13 Korean immigrant youths using consensual qualitative research (C. E. Hill, B. J. Thompson, & E. N. Williams, 1997). Results indicate that Korean youth are expected to negotiate and shift their identities to meet differing expectations across various interpersonal contexts.…

  5. Group Psychodrama for Korean College Students

    ERIC Educational Resources Information Center

    Chae, Soo Eun; Kim, Soo Jin

    2017-01-01

    Psychodrama was first introduced in the Korean literature in 1972, but its generalization to college students did not occur until the 1990s. Despite findings from psychodrama studies with Korean college students supporting psychodrama as effective for developing and maintaining good interpersonal relationships, as well as decreasing anxiety and…

  6. College Psychotherapy at a Korean University

    ERIC Educational Resources Information Center

    Chae, Soo Eun; Choi, Mi Hwa

    2016-01-01

    In the online interview presented in this article, two Korean counselors offer comments to questions regarding issues faced at a Korean University. They reflected on their roles and some of the many topics faced that included: (1) student misunderstanding about counseling needs, and how counseling questionnaires and the counselor helps them; (2)…

  7. Russian Nonproliferation Policy and the Korean Peninsula

    DTIC Science & Technology

    2006-12-01

    the Committee for Foreign Relation of the Korean Association of Slavic Studies . Dr. Shin received his Ph.D. in political science from the Moscow...President Vladimir Putin and Its Significance for the Republic of Korea), Korean Slavic Studies , Vol. 19, No. 2, 2004, pp. 675-710. 28. Daehan

  8. Group Psychodrama for Korean College Students

    ERIC Educational Resources Information Center

    Chae, Soo Eun; Kim, Soo Jin

    2017-01-01

    Psychodrama was first introduced in the Korean literature in 1972, but its generalization to college students did not occur until the 1990s. Despite findings from psychodrama studies with Korean college students supporting psychodrama as effective for developing and maintaining good interpersonal relationships, as well as decreasing anxiety and…

  9. Rock Music and Korean Adolescent's Antisocial Behavior.

    ERIC Educational Resources Information Center

    Kim, Inkyung; Kwak, Keumjoo; Chang, Geunyoung; Yang, Jinyoung

    The relationship between rock music preference and antisocial behavior among Korean adolescents was examined. The Korean versions of the Sensation Seeking Scale and the Antisocial Behavior Checklist were used to measure sensation seeking motivation and delinquency. Adolescents (N=1,079) were categorized as "rock/metal,""dance,"…

  10. Development of the Korean Career Indecision Inventory.

    ERIC Educational Resources Information Center

    Tak, Jinkook; Lee, Ki-Hak

    2003-01-01

    Five analyses using Korean college students (n=283, 700, 844, 306, 315) were conducted to develop the Korean Career Indecision Inventory. Five factors emerged consistently and were confirmed by factor analysis: lack of career information, lack of necessity recognition, lack of self-identity, indecisiveness, and external barriers. Reliability and…

  11. Culture and the Korean Kindergarten Curriculum.

    ERIC Educational Resources Information Center

    Lee, Ki Sook

    This paper examines the relationship between Korean culture and the historical development of its kindergarten (preschool) curriculum. After reviewing the values that were emphasized in traditional Korean society, focusing on ethics, loyalty and filial piety, propriety, and gender roles, the paper provides examples of how these values influences…

  12. Birth outcomes of Korean women in Hawaii.

    PubMed Central

    Mor, J M; Alexander, G R; Kieffer, E C; Baruffi, G

    1993-01-01

    Since the end of the Korean War, immigration of Koreans to the United States has increased rapidly. In 1990, 11.6 percent of all Asians in the United States were of Korean ethnicity, and it is projected that Koreans will outnumber all other Asian groups, except Filipinos, in the United States by the year 2030. Despite the growing size of this population, very little is known about their health status. This study, using 1979-89 Hawaii vital record data, investigates the relationship between maternal sociodemographic characteristics, prenatal care utilization factors, and birth outcomes among Koreans as compared with Caucasians. The ethnic term "Caucasian" is used in Hawaii's vital records and is synonymous with non-Hispanic whites. Korean mothers were more likely to be older and have lower educational attainment, and less likely to be adolescent, single, or to have received adequate prenatal care than Caucasian mothers. More than 80 percent of the Korean mothers were foreign born. Significantly higher risks for very preterm delivery (less than 33 weeks) and very low birth weight births were observed for Koreans as compared with Caucasians. Nativity had no effect on birth outcome in this population. The results of this study suggest that prevention of preterm birth is an important focus for improving pregnancy outcomes in this growing ethnic group. PMID:8341786

  13. Korean Education: Focusing on the Future.

    ERIC Educational Resources Information Center

    Diem, Richard A.; And Others

    1997-01-01

    Recounts a group of western educators' three-week tour of Korea, sponsored by the Korean Studies Workshop. The educators interviewed administrators, attended lectures, and visited elementary and secondary schools. Provides an excellent overview of the state of Korean K-12 education, including proposed curricular reforms. (MJP)

  14. Korean Education and Foreign Assistance Programs.

    ERIC Educational Resources Information Center

    Korean Central Education Research Inst., Seoul.

    Since the problems facing Korean education arise from very complicated factors, it was felt that the objective views of foreign observers would undoubtedly be of great help in efforts to solve them. In this connection, the Central Education Research Institute held a Seminar on Korean Education with the participation of foreign agencies in Korea…

  15. College Psychotherapy at a Korean University

    ERIC Educational Resources Information Center

    Chae, Soo Eun; Choi, Mi Hwa

    2016-01-01

    In the online interview presented in this article, two Korean counselors offer comments to questions regarding issues faced at a Korean University. They reflected on their roles and some of the many topics faced that included: (1) student misunderstanding about counseling needs, and how counseling questionnaires and the counselor helps them; (2)…

  16. Korean Intermediate Course. Selected Newspaper Articles.

    ERIC Educational Resources Information Center

    Defense Language Inst., Washington, DC.

    The purpose of this material is to provide reading matter for the last phase of the Defense Language Institute's extended and intermediate courses in Korean. (See ED 024 943 for the Korean Basic Course, Lesson Units 1-112.) The content of this volume is current, introduces important vocabulary not encountered elsewhere in the courses, and calls…

  17. Small Business Among Koreans in Los Angeles.

    ERIC Educational Resources Information Center

    Bonacich, Edna; And Others

    The purpose of this paper is to describe the character of small business among Koreans in Los Angeles, to examine the means by which Koreans are able to enter small business in an economy which clearly is moving in the opposite direction, and to consider why it is that immigrant small business should flourish within monopoly capitalism. Korean…

  18. Association Between Psychotropic and Cardiovascular Iatrogenic Alerts and Risk of Hospitalizations in Elderly People Treated for Dementia: A Self-Controlled Case Series Study Based on the Matching of 2 French Health Insurance Databases.

    PubMed

    Zerah, Lorene; Boddaert, Jacques; Leperre-Desplanques, Armelle; Bonnet-Zamponi, Dominique; Verny, Marc; Deligne, Jean; Boelle, Pierre-Yves

    2017-06-01

    Elderly people are at risk of repeated hospitalizations, some of which may be drug related and preventable. In 2011, a group of French healthcare experts selected 5 iatrogenic alerts (IAs), based on criteria identified in a literature search and from their professional experience, to assess the appropriateness of medication in elderly patients. Our objective was to examine the association between hospitalizations and IAs in elderly patients treated for Alzheimer disease who are particularly sensitive to adverse drug events. A 2-year (January 1, 2011, to December 31, 2012) longitudinal national database study, with a study design similar to self-controlled case series, was performed to analyze data on drug prescriptions and hospitalization. IAs were defined as (1) long half-life benzodiazepine; (2) antipsychotic drugs in patients with Alzheimer disease; (3) co-prescription of 3 or more psychotropic drugs; (4) co-prescription of 2 or more diuretics; and (5) co-prescription of 4 or more antihypertensive drugs. Data were obtained by matching of 2 French National Health Insurance Databases. France. All affiliates, aged ≥75 years, receiving treatment for Alzheimer disease, alive on January 1, 2011 were included. We calculated the relative increase in the number of hospitalizations in patients with IAs. The analysis was performed over four 6-month periods. A total of 10,754 patients were included. During the periods with IAs, hospitalization rates increased by 0.36/year compared with 0.23/year in the periods without for the same patient, and the number of hospitalizations doubled [proportional fold change = 1.9, 95% confidence interval (1.8, 2.1)]. We estimated that 22% [95% confidence interval (20%, 23%)] of all hospitalizations were associated with IAs, 80% of which were due to psychotropic IAs. The IAs could be used as a simple and clinically relevant tool by prescribing physicians to assess the appropriateness of the prescription in elderly patients treated for

  19. Processing of Compound Words by Adult Korean-English Bilinguals

    ERIC Educational Resources Information Center

    Ko, In Yeong

    2011-01-01

    The purpose of this dissertation study is to investigate how Korean-English bilinguals process compound words in both English and Korean. The major research question is: when Korean-English bilinguals process Korean or English compound words, what information is used to segment compound words into their constituents and, in particular, does…

  20. Children Negotiating Korean American Ethnic Identity through Their Heritage Language

    ERIC Educational Resources Information Center

    You, Byeong-keun

    2005-01-01

    This preliminary study provides an interpretive reading of focus group interviews of four Korean American children in the Phoenix metropolitan area. It examines how these Korean American children are negotiating their ethnic identity as Korean Americans while learning Korean as a heritage language. It shows that maintaining heritage language is…

  1. Bullying Involvement of Korean Children in Germany and in Korea

    ERIC Educational Resources Information Center

    Bae, Hwa-ok

    2016-01-01

    This study compared bullying involvement of Korean or Korean-German children living in Germany with children in Korea, and examined children's perceptions of school environment associated with bullying involvement of the children. This study included 105 Korean or Korean-German children living in the Bayern State of Germany as the study sample and…

  2. Bullying Involvement of Korean Children in Germany and in Korea

    ERIC Educational Resources Information Center

    Bae, Hwa-ok

    2016-01-01

    This study compared bullying involvement of Korean or Korean-German children living in Germany with children in Korea, and examined children's perceptions of school environment associated with bullying involvement of the children. This study included 105 Korean or Korean-German children living in the Bayern State of Germany as the study sample and…

  3. Processing of Compound Words by Adult Korean-English Bilinguals

    ERIC Educational Resources Information Center

    Ko, In Yeong

    2011-01-01

    The purpose of this dissertation study is to investigate how Korean-English bilinguals process compound words in both English and Korean. The major research question is: when Korean-English bilinguals process Korean or English compound words, what information is used to segment compound words into their constituents and, in particular, does…

  4. Research on Korean Pharmacopuncture in South Korea since 2007.

    PubMed

    Lim, ChungSan; Park, SangKyun; Sun, SeungHo; Lee, KwangHo

    2014-12-01

    The purpose of this study was to investigate the current trends in research on pharmacopuncture in Korea since 2007. A literature review was performed by using the search engines 'Science and Technology Society Village', 'Korean Studies Information Service System', 'National Discovery for Science Leaders', and 'Oriental Medicine Advanced Searching Integrated System' in Korea from January 2007 to December 2013. Searched key words were 'pharmacopuncture', 'herbal acupuncture', 'aqua-acupuncture', and 'bee venom'. Finally, we selected 457 papers, including Korean experimental studies and clinical studies. Selected papers were classified according to year of publication, type of pharmacopuncture, disease & topic, research type and the publishing journal. One hundred fifty pharmacopunctures were studied in 457 papers. Single compound pharmacopuncture was the most studied pharmacopuncture in experimental studies while animal-based pharmacopuncture was the most studied pharmacopuncture in clinical studies. Bee venom placed first among the various pharmacopunctures, followed by placenta, sweet bee venom, mountain-ginseng, and anti-inflammatory pharmacopunctures. Experimental research on pharmacopuncture has fallen since 2007 when 55 papers were published. However, clinical research has been increasing steadily. In clinical studies, case reports were numerous than randomized clinical trials (RCTs). Musculoskeletal diseases were the most frequently-treated diseases in studies on pharmacopuncture; among the musculoskeletal diseases, rheumatoid arthritis was the most frequently-treated disease in experimental studies and low back pain was the most frequently-treated condition in clinical studies. Since 2007, 45 different journals have published studies on pharmacopuncture, with the Journal of the Korean Acupuncture and Moxibustion Medicine Society having the largest number of papers on pharmacopuncture and the Journal of Pharmacopuncture the second largest number. The trends

  5. Treatment-seeking behaviors and related epidemiological features in Korean acne patients.

    PubMed

    Suh, Dae Hun; Shin, Jung Won; Min, Seong Uk; Lee, Dong Hun; Yoon, Mi Young; Kim, Nack In; Kye, Young Chul; Lee, Eil Soo; Ro, Young Suck; Kim, Kwang Joong

    2008-12-01

    Little is known about the treatment-seeking behaviors of acne patients, especially Asian acne patients. This study was performed to obtain detailed information about the treatment-seeking behaviors in Korean acne patients. Patients who visited the dermatology departments at 17 university hospitals completed a self-administered questionnaire. Most patients obtained information about acne from doctors or the Internet. The most important criteria for selecting a treatment method or choosing a particular clinic were effectiveness and accessibility. Patients used traditional medicine, visited beauty clinics, drank more water, and used over-the-counter topical agents more frequently than they sought doctors during the worsening period. The degree of satisfaction in treatment was found to depend on the total cost of treatment, number of places visited, site affected by acne, and emotional stress. Those who had experienced a side effect tended to have been treated for longer, to have paid more for treatment, and to have an associated skin disease. Treatments prescribed by dermatology clinics had the lowest aggravating rate, although improvement rates for family medicine clinics were also fairly high. This is the first study to investigate in detail the demographic features and characteristics of the treatment-seeking behaviors of acne patients in Asia.

  6. Hospitalization Costs for Patients Undergoing Orthopedic Surgery Treated With Intravenous Acetaminophen (IV-APAP) Plus Other IV Analgesics or IV Opioid Monotherapy for Postoperative Pain.

    PubMed

    Maiese, Brett A; Pham, An T; Shah, Manasee V; Eaddy, Michael T; Lunacsek, Orsolya E; Wan, George J

    2017-02-01

    To assess the impact on hospitalization costs of multimodal analgesia (MMA), including intravenous acetaminophen (IV-APAP), versus IV opioid monotherapy for postoperative pain management in patients undergoing orthopedic surgery. Utilizing the Truven Health MarketScan(®) Hospital Drug Database (HDD), patients undergoing total knee arthroplasty (TKA), total hip arthroplasty (THA), or surgical repair of hip fracture between 1/1/2011 and 8/31/2014 were separated into postoperative pain management groups: MMA with IV-APAP plus other IV analgesics (IV-APAP group) or an IV opioid monotherapy group. All patients could have received oral analgesics. Baseline characteristics and total hospitalization costs were compared. Additionally, an inverse probability treatment weighting [IPTW] with propensity scores analysis further assessed hospitalization cost differences. The IV-APAP group (n = 33,954) and IV opioid monotherapy group (n = 110,300) differed significantly (P < 0.0001) across baseline characteristics, though the differences may not have been clinically meaningful. Total hospitalization costs (mean ± standard deviation) were significantly lower for the IV-APAP group than the IV opioid monotherapy group (US$12,540 ± $9564 vs. $13,242 ± $35,825; P < 0.0001). Medical costs accounted for $701 of the $702 between-group difference. Pharmacy costs were similar between groups. Results of the IPTW-adjusted analysis further supported the statistically significant cost difference. Patients undergoing orthopedic surgery who received MMA for postoperative pain management, including IV-APAP, had significantly lower total costs than patients who received IV opioid monotherapy. This difference was driven by medical costs; importantly, there was no difference in pharmacy costs. Generalizability of the results may be limited to patients admitted to hospitals similar to those included in HDD. Dosing could not be determined, so it was not possible to quantify

  7. Effective population size of korean populations.

    PubMed

    Park, Leeyoung

    2014-12-01

    Recently, new methods have been developed for estimating the current and recent changes in effective population sizes. Based on the methods, the effective population sizes of Korean populations were estimated using data from the Korean Association Resource (KARE) project. The overall changes in the population sizes of the total populations were similar to CHB (Han Chinese in Beijing, China) and JPT (Japanese in Tokyo, Japan) of the HapMap project. There were no differences in past changes in population sizes with a comparison between an urban area and a rural area. Age-dependent current and recent effective population sizes represent the modern history of Korean populations, including the effects of World War II, the Korean War, and urbanization. The oldest age group showed that the population growth of Koreans had already been substantial at least since the end of the 19th century.

  8. Clinicopathologic Review of Ovarian Masses in Korean Premenarchal Girls

    PubMed Central

    Ki, Eun Young; Byun, Seung Won; Choi, Yoon Jin; Lee, Keun Ho; Park, Jong Sup; Lee, Sung Jong; Hur, Soo Young

    2013-01-01

    Objective: To review the clinicopathological characteristics of ovarian masses in Korean premenarchal girls. Design: The data collected from hospital medical records were reviewed retrospectively regarding age, presentation, diagnosis, treatment, and outcome. Participants: There were 65 premenarcheal girls who underwent surgery at Seoul St. Mary's Hospital between January 1990 and March 2012. Results: The most common presenting symptom was abdominal pain (n=31, 47.7%), followed by palpable abdominal masses 16 (n=16, 24.6%), abdominal distension (n=8, 12.3%), vaginal bleeding (n=4, 6.2%), incidental finding (n=3, 4.6%), difficulty in urination or defecation (n=2, 3.1%), and prenatal sonographic findings (n=1, 1.5%). Of the patients with benign tumors, including non-neoplastic lesions and benign cysts, 26 (51%) underwent cystectomy, 6 (11.8%) underwent oophorectomy, 17 (33.3%) underwent unilateral salpingo-oophorectomy and none underwent bilateral salpingo-oophorectomy. Of the patients with malignant tumors, 2 (14.3%) underwent bilateral salpingo-oophorectomy, 7 (50%) underwent unilateral salpingo-oophorectomy, 2 (14.3%) underwent oophorectomy, and 2 (14.3%) underwent cystectomy. Conclusion: Abdominal pain was the most common symptom. However, the incidence of abdominal distension was higher in patients with malignant tumors than in those with benign tumors. We assessed clinical features, operative outcomes, and histological classifications of Korean prememarchal girls with ovarian masses. Further studies with a larger number of subjects are needed to confirm our results. PMID:23801894

  9. [Lee Jungsook, a Korean independence activist and a nurse during the Japanese colonial period].

    PubMed

    Kim, Sook Young

    2015-04-01

    This article examines the life of Lee Jungsook, a Korean nurse, as a independence activist during the Japanese colonial period. Lee Jungsook(1896-1950) was born in Bukchung in Hamnam province. She studied at Chungshin girl's high school and worked at Severance hospital. The characteristics and culture of her educational background and work place were very important factors which influenced greatly the life of Lee Jungsook. She learned independent spirit and nationalism from Chungshin girls' high school and worked as nurse at the Severance hospital which were full of intense aspiration for Korea's independence. Many of doctors, professors and medical students were participated in the 3.1 Independence Movement. Lee Jungsook was a founding member of Hyulsungdan who tried to help the independence activists in prison and their families and worked as a main member of Korean Women's Association for Korean Independece and Kyungsung branch of the Korean Red Cross. She was sent to jail by the Japanese government for her independence activism. After being released after serving two years confinement, she worked for the Union for Women's Liberation as a founding member. Lee Joungsook was a great independence activist who had a nursing care spirit as a nurse.

  10. Professionalism: the major factor influencing job satisfaction among Korean and Chinese nurses.

    PubMed

    Hwang, J-I; Lou, F; Han, S S; Cao, F; Kim, W O; Li, P

    2009-09-01

    The nursing shortage has become an internationally important issue. Nurses' professionalism and job satisfaction have been recognized as strong factors influencing their turnover. As international interchanges in nursing education are growing between Korea and China, understanding the commonalities and differences in factors associated with job satisfaction is critical to improving nurses' job retention. To compare the factors influencing job satisfaction among Korean and Chinese nurses. A cross-sectional survey was conducted. The participants were comprised of 693 nurses at three general hospitals in Jinan, People's Republic of China and 593 nurses at two general hospitals in Seoul, Korea. A questionnaire was designed to measure the nurses' professionalism and job satisfaction. Stepwise multiple regression analysis was performed to identify factors related to job satisfaction. Professionalism was the common factor influencing job satisfaction in Korean and Chinese nurses. Professionalism was positively related to job satisfaction in both groups. Additional factors associated with job satisfaction were demographics and job characteristics such as age, job position and department of work, which were significant only in Korean nurses. Professionalism was the most important factor influencing job satisfaction in both Korean and Chinese nurses. Enhancing nursing professionalism is recommended as a common strategy to improve nurses' job retention across different healthcare systems.

  11. Validation of Edmonton Symptom Assessment System in Korean Cancer Patients

    PubMed Central

    Kwon, Jung Hye; Nam, Seung-Hyun; Koh, Sujin; Hong, Young Seon; Lee, Kyung Hee; Shin, Sang-Won; Hui, David; Park, Kyun Woo; Yoon, So Young; Won, Ji Yun; Chisholm, Gary; Bruera, Eduardo

    2013-01-01

    Context The Edmonton Symptom Assessment System (ESAS) is a brief, widely adopted multidimensional questionnaire to evaluate patient-reported symptoms. Objectives To develop a Korean version of the ESAS (K-ESAS) and to perform a psychometric analysis in Korean patients with advanced cancer. Methods We tested the K-ESAS in two pilot studies with 15 patients each. We assessed internal consistency, test-retest reliability, and concurrent validity in 163 Korean patients, who completed the K-ESAS along with the Korean versions of the M. D. Anderson Symptom Inventory (K-MDASI) and the Hospital Anxiety and Depression Scale (K-HADS) twice. Thirty-eight patients completed the questionnaires again seven days later to assess responsiveness. Results K-ESAS scores had good internal consistency, with a Cronbach’s alpha coefficient of 0.88, indicating that no questions had undue influence on the score. Pearson correlation coefficients for K-ESAS symptom scores between baseline and after 2–4 hours ranged from 0.72 (95% confidence interval [CI] 0.64, 0.79) to 0.87 (95% CI 0.82, 0.90), indicating strong test-retest reliability. For concurrent validity, Pearson correlation coefficients between K-ESAS symptom scores and corresponding K-MDASI symptom scores ranged from 0.70 (95% CI 0.62, 0.77) to 0.83 (95% CI 0.77, 0.87), indicating good concurrent validity. For the K-HADS, concurrent validity was good for anxiety (r = 0.73, 95% CI 0.65, 0.79) but moderate for depression (r = 0.4, 95% CI 0.26, 0.52). For responsiveness, changes in K-ESAS scores after seven days were moderately correlated with changes in K-MDASI scores but weakly correlated with changes in K-HADS scores. Conclusion The K-ESAS is a valid and reliable tool for measuring multidimensional symptoms in Korean cancer patients. PMID:23628516

  12. Report on the Project for Establishment of the Standardized Korean Laboratory Terminology Database, 2015

    PubMed Central

    Lee, Kap-No

    2017-01-01

    The National Health Information Standards Committee was established in 2004 in Korea. The practical subcommittee for laboratory test terminology was placed in charge of standardizing laboratory medicine terminology in Korean. We aimed to establish a standardized Korean laboratory terminology database, Korea-Logical Observation Identifier Names and Codes (K-LOINC) based on former products sponsored by this committee. The primary product was revised based on the opinions of specialists. Next, we mapped the electronic data interchange (EDI) codes that were revised in 2014, to the corresponding K-LOINC. We established a database of synonyms, including the laboratory codes of three reference laboratories and four tertiary hospitals in Korea. Furthermore, we supplemented the clinical microbiology section of K-LOINC using an alternative mapping strategy. We investigated other systems that utilize laboratory codes in order to investigate the compatibility of K-LOINC with statistical standards for a number of tests. A total of 48,990 laboratory codes were adopted (21,539 new and 16,330 revised). All of the LOINC synonyms were translated into Korean, and 39,347 Korean synonyms were added. Moreover, 21,773 synonyms were added from reference laboratories and tertiary hospitals. Alternative strategies were established for mapping within the microbiology domain. When we applied these to a smaller hospital, the mapping rate was successfully increased. Finally, we confirmed K-LOINC compatibility with other statistical standards, including a newly proposed EDI code system. This project successfully established an up-to-date standardized Korean laboratory terminology database, as well as an updated EDI mapping to facilitate the introduction of standard terminology into institutions. PMID:28244299

  13. Efficacy of closantel against Fasciola hepatica in Korean native goats.

    PubMed

    Lee, C G; Cho, S H; Kim, J T; Lee, C Y

    1996-10-25

    Closantel (Flukiver), a salicylanilide antiparasitic compound, was tested in Korean native goats infected with Fasciola hepatica. The goats were administered closantel once orally at a dose of 10 mg/kg body weight. Efficacy was monitored weekly by fecal examination of all infected animals starting the second week post-treatment and continuing for 3 weeks. Closantel elicited 80.3, 97.8 and 92.7% efficacy in goats with naturally-acquired fasciolosis at the second, third and fourth week post-treatment, respectively. It elicited a 100% efficacy in goats experimentally infected with F. hepatica metacercariae and treated at 18 weeks post-infection.

  14. Historical series of patients with visceral leishmaniasis treated with meglumine antimoniate in a hospital for tropical diseases, Maceió-AL, Brazil.

    PubMed

    Silveira, Lindon Johoson Diniz; Rocha, Thiago José Matos; Ribeiro, Sandra Aparecida; Pedrosa, Célia Maria Silva

    2015-01-01

    Visceral leishmaniasis is an endemic protozoan found in Brazil. It is characterized by fever, pallor, hepatosplenomegaly, lymphadenopathy, and progressive weakness in the patient. It may lead to death if untreated. The drug of choice for treatment is meglumine antimoniate (Glucantime). The aim of this study was to evaluate patients with visceral leishmaniasis according to criteria used for diagnosis, possible reactions to Glucantime and blood pressure measured before and after treatment. 89 patients admitted to the Teaching Hospital Dr. Hélvio Auto (HEHA) in Maceió-AL, in the period from May 2006 to December 2009 were evaluated. Data were collected on age, sex, origin, method of diagnosis, adverse effects of drugs, duration of hospitalization, duration of treatment and dosage up to the onset of adverse effects. There was a predominance of child male patients, aged between one and five years old, from the interior of the State of Alagoas. Parasitological diagnosis was made by bone marrow aspirate; three (3.37%) patients died, 12 (13.48%) had adverse reactions and treatment was changed to amphotericin B, and 74 (83.14%) were cured. Changes that led to replacing Glucantime were persistent fever, jaundice, rash, bleeding and cyanosis. During the study, 89 patients hospitalized for VL were analyzed: 74 were healed, 12 were replaced by amphotericin B treatment and three died. Most of them were under five years old, male and came from the interior. The dosage and duration of treatment with Glucantime were consistent with that advocated by the Ministry of Health. Persistence of fever, jaundice, rash, cyanosis and bleeding were the reactions that led the physician to modify treatment. No change was observed in blood pressure before and after treatment. This study demonstrated the work of a hospital, a reference in the treatment of leishmaniasis, which has many patients demanding its services in this area. It demonstrates that this disease is still important today, and

  15. Comparison of the clinical characteristics and treatment outcomes of patients requiring hospital admission to treat eosinophilic and neutrophilic exacerbations of COPD

    PubMed Central

    Kang, Hye Seon; Rhee, Chin Kook; Kim, Sung Kyoung; Kim, Jin Woo; Lee, Sang Haak; Yoon, Hyung Kyu; Ahn, Joong Hyun; Kim, Yong Hyun

    2016-01-01

    Purpose We compared the clinical characteristics and treatment outcomes of patients with eosinophilic and neutrophilic COPD exacerbations requiring hospital admission. Patients and methods This was a retrospective multicenter study performed between January 2010 and December 2014. In all, 1,688 COPD patients admitted via the outpatient clinics or emergency departments of six university hospitals were enrolled. The patients were grouped by complete blood counts: eosinophilic group, >2% peripheral blood eosinophils, and neutrophilic group, >65% peripheral blood neutrophils or >11,000 leukocytes/mL. The patients with radiographic evidence of pneumonia at the time of admission, those with lung cancer, those admitted for treatment of other medical problems, and those who chronically used steroids were excluded. Results A total of 605 patients hospitalized with COPD exacerbations (177 eosinophilic and 380 neutrophilic) were included. Pulmonary functions, including the forced expiratory volume in 1 second and forced vital capacity, were better in patients with eosinophilic exacerbations. Treatment outcomes, including the rate of admission to the intensive care unit and mortality, were poorer in patients with neutrophilic exacerbations (4.5% vs 12.4%, P=0.004; 1.1% vs 4.5%, P=0.043, respectively). Congestive heart failure (odds ratio [OR] =3.40, 95% confidence interval [CI]: 1.28–9.01) and neutrophilic exacerbation (OR = 2.81, 95% CI: 1.21–6.52) were independent risk factors for intensive care unit admission. Conclusion COPD patients with neutrophilic exacerbations experienced worse clinical outcomes than did those with eosinophilic exacerbations. The peripheral blood eosinophil count may be a useful predictor of clinical progress during hospitalization of COPD patients with acute exacerbations. PMID:27757029

  16. Is Health Literacy Associated With Depressive Symptoms Among Korean Adults? Implications for Mental Health Nursing.

    PubMed

    Rhee, Taeho Greg; Lee, Hee Yun; Kim, Nam Keol; Han, Gyounghae; Lee, Jeonghwa; Kim, Kyoungwoo

    2017-10-01

    This study investigated whether health literacy is associated with depressive symptoms among Korean adults, when adjusting for relevant risk factors for depression. Data were collected from a sample of 585 community-dwelling Korean adults living in Seoul and Kwangju, South Korea, using a quota sampling strategy. A cross-sectional, multivariate regression analysis was used to investigate the association between health literacy and depressive symptoms. When controlled for covariates, a lower level of health literacy was significantly associated with a higher level of depressive symptoms. Health literacy may play an important role in preventing and treating depression. Future research is needed to determine if improving health literacy, through health promotion interventions, can enhance community-dwelling Korean adults' understanding of depressive symptoms and relevant treatment options. © 2016 Wiley Periodicals, Inc.

  17. Time to death in a prospective cohort of 252 patients treated for fracture of the proximal femur in a major hospital in Portugal.

    PubMed

    Campos, Sónia; Alves, Sandra Maria Ferreira; Carvalho, Marilia Sá; Neves, Nuno; Trigo-Cabral, Abel; Pina, Maria Fátima

    2015-07-01

    The objectives were to analyze one-year survival and mortality predictors in patients with fracture of the proximal femur (low/moderate trauma). A prospective cohort was formed by inviting all patients hospitalized in the Orthopedic Ward of the second largest hospital in Portugal (May 2008-April 2009). Survival was assessed at 3, 6, 9, and 12 months after fracture and related to demographic factors, lifestyle, and clinical history, as well as to data from medical records (fracture type, surgery date, surgical treatment, and preoperative risk). Of the 340 patients hospitalized, 252 were included (78.9% women). Mortality at 3, 6, 9, and 12 months was 21.2%, 25%, 28.8%, and 34.6% for men and 7.8%, 13.5%, 19.2%, and 21.4% for women, respectively. Predictors of death were male gender (HR = 2.54; 95%CI: 1.40-4.58), ASA score III/IV vs. I/II (HR = 1.95; 95%CI: 1.10-3.47), age (HR = 1.06; 95%CI: 1.03-1.10), and delay in days to surgery (HR = 1.07; 95%CI: 1.03-1.12). Factors related to death were mainly related to patients' characteristics at admission.

  18. Korean Immigrant Mothers' Perspectives: The Meanings of a Korean Heritage Language School for Their Children's American Early Schooling Experiences

    ERIC Educational Resources Information Center

    Kim, Jinhee

    2011-01-01

    This study examines what a Korean heritage language school means to Korean immigrant families and their children, considering Korean immigrant mothers' perspectives on American early schooling. As part of an ethnographic research project on Korean-American children's peer culture in a heritage school, seven mothers, two guardians (grandmothers),…

  19. A Situated Perspective on Bilingual Development: Preschool Korean-English Bilinguals' Utilization of Two Languages and Korean Honorifics

    ERIC Educational Resources Information Center

    Kim, So Jung

    2017-01-01

    In spite of the increasing Korean population, there is still a paucity of studies examining emergent Korean bilingual children's dual-language development within their social contexts. In particular, no existing study has paid attention to the honorific system of Korean, which is one of the most important features in learning the Korean language.…

  20. A Situated Perspective on Bilingual Development: Preschool Korean-English Bilinguals' Utilization of Two Languages and Korean Honorifics

    ERIC Educational Resources Information Center

    Kim, So Jung

    2017-01-01

    In spite of the increasing Korean population, there is still a paucity of studies examining emergent Korean bilingual children's dual-language development within their social contexts. In particular, no existing study has paid attention to the honorific system of Korean, which is one of the most important features in learning the Korean language.…

  1. Korean Immigrant Mothers' Perspectives: The Meanings of a Korean Heritage Language School for Their Children's American Early Schooling Experiences

    ERIC Educational Resources Information Center

    Kim, Jinhee

    2011-01-01

    This study examines what a Korean heritage language school means to Korean immigrant families and their children, considering Korean immigrant mothers' perspectives on American early schooling. As part of an ethnographic research project on Korean-American children's peer culture in a heritage school, seven mothers, two guardians (grandmothers),…

  2. Korean Affairs Report, No. 315.

    DTIC Science & Technology

    1983-10-24

    infection and parasitic insects dropped to 49.7 people out of 1,000 from the 128 figure in the 1960’s. Tuberculosis, however, took 34.2 out of 1,000 lives...accidents and infections caused the most deaths among children two to five. People in their thirties dies most frequently of accidents, tuberculosis and...Korean companies in oil exploration projects in East Madura and in a coal development project in Pasir area, an Energy-Resources Ministry spokesman

  3. Korean Affairs Report. No. 297

    DTIC Science & Technology

    2007-11-02

    Korean to South Korea 0300 GMT 4 Jul 83 [Roundtable talk among Madam Yun, announcer Kim Chol-min and moderator Min Hye-kyong, from "Today’s Feature...questions of two disturbs our country’s reunification and of who on earth opposes and wants division? Will you talk about these questions first, Madam Yun... Madam Yun] To note a conclusion first, it is the United States that opposes our country’s reunification and seeks the perpetuation of division. As

  4. The role of surgery in treating pleuropulmonary suppurative disease--review of 77 cases managed at Queens Hospital Center between 1986 and 1989.

    PubMed Central

    Cordice, J. W.; Chitkara, R. K.

    1992-01-01

    Despite the generally salutary experience in recent years of managing suppurative pleuropulmonary disease, empyemas and lung abscesses have persisted and increased in incidence in hospitals such as Queens Hospital Center that serve large numbers of the socioeconomically disadvantaged. This study documents the etiology, clinical presentation, treatment, and treatment results of suppurative pleuropulmonary disease at Queens Hospital Center, which serves a large segment of the urban poor, many of whom are black. Results indicate that contributory or antecedent etiologic factors include a history of prior disease (specifically pneumonia, lung abscess, obstructive lung disease, pulmonary neoplasia, and tuberculosis); a predisposition to constitutional or immunologic deficiencies (specifically, alcoholism, anemia/malnutrition, drug abuse, and acquired immunodeficiency syndrome [AIDS]); conditions contributing to tracheobronchial aspiration (specifically, alcoholism and seizure disorders); and a miscellaneous group such as prior surgery, cardiovascular disease, and sepsis syndrome. The patients in this study were young with maximal incidence occurring in the third to fifth decades of life. Patients were predominantly male (75%) and black (66%). There were 18 deaths (23%), with sepsis being the cause in 10 (56%). Most surgical interventions were conservative, ie, bronchoscopies (48), thoracenteses (43), and tube thoracotomies (39). Thirty-one open thoracotomies were performed for drainage, decortication, or pulmonary resection. The surgical mortality was three cases or 5% of the patients who underwent surgery. The designated incidence of proven AIDS in this series (29%) was low, undoubtedly because many patients refused testing, and the multiple gram-positive and gram-negative infections that were seen did not conform to the Centers for Disease Control criteria for diagnosis and case reporting for AIDS.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1602513

  5. Treatment-seeking Paths in the Management of Severe Malaria in Children under 15 Years of Age Treated in Reference Hospitals of Kinshasa, Democratic Republic of Congo

    PubMed Central

    Ilunga-Ilunga, Félicien; Levêque, Alain; Ngongo, Léon Okenge; Laokri, Samia; Dramaix, Michèle

    2015-01-01

    Background: In the Democratic Republic of Congo (DRC), few studies have focused on treatment-seeking paths selected by caretakers for the management of severe childhood malaria in an urban environment. The present study aims at describing the treatment-seeking paths according to the characteristics of households, as well as the subsequent impact on pre-hospitalisation delay and malarial fatality and on the main syndromes associated with severe childhood malaria. Methods: This descriptive study included data collected at nine hospitals in Kinshasa between January and November 2011. A total of 1,350 children, under 15 years of age and hospitalised for severe malaria, were included in the study. Results: Regarding the management of malaria, 31.5% of households went directly to the health centre or hospital while 68.5% opted for self-medication, church and/or traditional healing therapy. The most frequent first-line option was self-medication, adopted by more than 61.5% of households. Nevertheless, rational self-medication using antimalarial drugs recommended by the WHO (artemisinin-based combinations) was reported for only 5.5% of children. Only 12.5% of households combined 2 or 3 traditional options. The following criteria influenced the choice of a modern vs. traditional path: household socioeconomic level, residential environment, maternal education level and religious beliefs. When caretakers opted for traditional healing therapy, the pre-hospitalisation delay was longer and the occurrence of respiratory distress, severe anaemia and mortality was higher. Conclusion: The implementation of a malaria action plan in the Democratic Republic of Congo should take into account the diversity and pluralistic character of treatment-seeking behaviours in order to promote the most appropriate options (hospital and rational self-medication) and to avoid detrimental outcomes. PMID:25729313

  6. HISTORICAL SERIES OF PATIENTS WITH VISCERAL LEISHMANIASIS TREATED WITH MEGLUMINE ANTIMONIATE IN A HOSPITAL FOR TROPICAL DISEASES, MACEIÓ-AL, BRAZIL

    PubMed Central

    Silveira, Lindon Johoson Diniz; Rocha, Thiago José Matos; Ribeiro, Sandra Aparecida; Pedrosa, Célia Maria Silva

    2015-01-01

    Introduction: Visceral leishmaniasis is an endemic protozoan found in Brazil. It is characterized by fever, pallor, hepatosplenomegaly, lymphadenopathy, and progressive weakness in the patient. It may lead to death if untreated. The drug of choice for treatment is meglumine antimoniate (Glucantime®). The aim of this study was to evaluate patients with visceral leishmaniasis according to criteria used for diagnosis, possible reactions to Glucantime® and blood pressure measured before and after treatment. Methods: 89 patients admitted to the Teaching Hospital Dr. Hélvio Auto (HEHA) in Maceió-AL, in the period from May 2006 to December 2009 were evaluated. Data were collected on age, sex, origin, method of diagnosis, adverse effects of drugs, duration of hospitalization, duration of treatment and dosage up to the onset of adverse effects. Results: There was a predominance of child male patients, aged between one and five years old, from the interior of the State of Alagoas. Parasitological diagnosis was made by bone marrow aspirate; three (3.37%) patients died, 12 (13.48%) had adverse reactions and treatment was changed to amphotericin B, and 74 (83.14%) were cured. Changes that led to replacing Glucantime® were persistent fever, jaundice, rash, bleeding and cyanosis. Conclusion: During the study, 89 patients hospitalized for VL were analyzed: 74 were healed, 12 were replaced by amphotericin B treatment and three died. Most of them were under five years old, male and came from the interior. The dosage and duration of treatment with Glucantime® were consistent with that advocated by the Ministry of Health. Persistence of fever, jaundice, rash, cyanosis and bleeding were the reactions that led the physician to modify treatment. No change was observed in blood pressure before and after treatment. This study demonstrated the work of a hospital, a reference in the treatment of leishmaniasis, which has many patients demanding its services in this area. It demonstrates

  7. Perceived health, life satisfaction, and cardiovascular risk factors among elderly Korean immigrants and elderly Koreans.

    PubMed

    Sin, Mo-Kyung; Chae, Young-Ran; Choe, Myoung-Ae; Murphy, Patrick; Kim, Jeungim; Jeon, Mi-Yang

    2011-03-01

    Acknowledging that changes in sociocultural environment influence health status, the purpose of this study was to compare perceived health, life satisfaction, and cardiovascular health in elderly Korean immigrants and elderly Koreans. In this cross-sectional study, a convenience sample of 88 elderly Korean immigrants and 295 elderly Koreans 65 and older were recruited from Korean communities in the United States and Korea. Respondents' perceived health was measured by self-assessment; life satisfaction was self-assessed using a dichotomous scale of general satisfaction with life; and cardiovascular health status was surveyed by self-report of major diagnosed cardiovascular risk factors (i.e., hypertension, hyperlipidemia, diabetes mellitus) and body mass index measurement for obesity. Despite having better perceived health and life satisfaction, elderly Korean immigrants also had higher prevalence of cardiovascular risk factors. The findings provide health care providers with useful information for effective health assessment of minority immigrants.

  8. [Skateboard accidents. 168 skateboard accidents treated at the Odense Hospital Emergency Department during the period 1 January 1980 to 12 December 1988].

    PubMed

    Hejnsten, H; Ovesen, O C

    1990-08-06

    During recent years, an increasing number of skateboard accidents have been registered in Odense Hospital. Typically, boys aged 10-14 years are involved and these had fallen on outstretched arms. No injuries endangering life were registered but 36% had fractures and half of these were localized to the wrist. Approximately 8% of the injuries resulted in hospitalization. Despite prohibition in the traffic legislation, 65% of the injuries occurred in trafficated regions and only 15% occurred in specially made skateboard rinks. The real risk involved in board skating are unknown but, in this selected group of board skaters, no significant connection could be demonstrated between routine experience in board skating, employment of protective equipment and frequency of fractures. Employment of protective equipment was commonest among persons who were members of a club and among those injured on skateboard ramps. The frequency of fractures was significantly higher among persons injured on ramps than among the remainder. Possible prophylactic measures are discussed and simple rules are recommended.

  9. Characteristics of Korean phonology: review, tutorial, and case studies of Korean children speaking English.

    PubMed

    Ha, Seunghee; Johnson, Cynthia J; Kuehn, David P

    2009-01-01

    A significant number of bilinguals in English-speaking countries speak Korean as their first language. One such country is the United States (U.S.). As the U.S. becomes increasingly diverse, providing more effective services for culturally and linguistically diverse children is a critical issue and growing challenge for speech-language pathologists. The U.S. Census Bureau reports that the number of Korean immigrants in the U.S. has steadily increased over the past decade. As a result, a greater number of children who speak Korean as a first or second language may need speech, language, and hearing services. This paper provides a review of the literature on (1) phonological characteristics of the Korean language and (2) speech sound acquisition and developmental patterns for phonological processes in Korean children. We illustrate how language knowledge of Korean might impact the learning of English based on case studies of three Korean children speaking English in the U.S. We describe considerations for more appropriate evaluation and treatment of speech sound disorders in Korean-English-speaking children. Readers will be able to: (1) understand phonological characteristics of the Korean language and speech sound acquisition and developmental patterns for phonological process in Korean children, (2) describe characteristics of English speech sound acquisition in successive bilingual English-Korean learners and interference patterns that result from the influence of two independent phonological and phonetic systems, and (3) describe considerations and clinical implications for the more appropriate evaluation and treatment of speech sound disorders in Korean-English speaking children.

  10. [Ethyl alcohol and psychoactive drugs in patients with head and trunk injuries treated at the Department of General Surgery, Provincial Hospital in Siedlce].

    PubMed

    Sienkiewicz, Piotr

    2011-01-01

    Drug abuse is a social, moral, and penal problem in Poland since many years. Ethyl alcohol remains the prime cause of concern. The effect of narcotics (including alcohol) on trauma has been the object of investigations for years. 1) To determine the reliability of subjective assessment of sobriety of the patient by the physician. 2) To determine correlations between inebriety, duration of hospital stay, type and extent of surgical intervention, and death. 3) To compare blood alcohol content measured with an immunoenzyme assay and the reference gas chromatographic method (GC-headspace). 4) To assess correlations between GCS score, type of trauma, and blood alcohol content. The study was done in 207 patients referred between 1.07.2008 and 30.06.2009 to the hospital's emergency department due to trauma of the head and/or trunk. The significant role of ethyl alcohol in trauma of the head and trunk has been corroborated, in particular in young males admitted from Friday to Monday between 8:00 pm and 8:00 am. Ethyl alcohol in serum was detected in 34% of patients (40.1% of males and 12.5% of females) qualified to the test. The presence of alcohol in blood correlated with pedestrian or cyclist road accidents or violence (assault). Fractures of the skull and surgical treatment of wounds were significantly more frequent in inebriated patients. Inebriated patients were more inclined to leave the hospital on demand. According to the GCS score, 55.8% of patients with less than 15 points were inebriated. Disorders of speech were observed by the physician in only 47.9% of inebriated patients. The smell of alcohol on the breath was noted in 81.69% of inebriated patients and 60.42% of them admitted drinking alcohol. Subjective assessment of sobriety/inebriety by the physician was correct in 81.7% of patients. The involvement of drugs acting like alcohol in trauma is marginal in Siedlce and its region. Xenobiotics were found in just three of 207 patients qualified to the test. The

  11. Prevalence and Epidemiological Factors Involved in Cellulitis in Korean Patients With Lymphedema

    PubMed Central

    Park, Sae In; Yang, Eun Joo; Kim, Dong Kyu; Jeong, Ho Joong; Kim, Ghi Chan

    2016-01-01

    Objective To evaluate the prevalence and associated factors involved in cellulitis with lymphangitis among a group of Korean patients who were being treated for lymphedema. We present our epidemiologic research and we also report a systematic review of these types of cases. Methods This was a retrospective medical record study among 1,246 patients diagnosed with lymphedema. The study was carried out between January 2006 and December 2012 at the Kosin University Gospel Hospital and Seoul National University Bundang Hospital. Cases were examined for onset time, affected site, seasonal trend, and recurrence pattern of lymphedema, lymphangitis, and cellulitis. We also evaluated the history of blood-cell culture and antibiotic use. Results Ninety-nine lymphedema patients experienced complications such as cellulitis with accompanying lymphangitis. Forty-nine patients had more than two recurrences of cellulitis with lymphangitis. The incidence and recurrence of cellulitis with lymphangitis were significantly higher in the patients with lower-extremity lymphedema. There was a significant trend toward higher cellulitis prevalence in the lower-extremity lymphedema group according to the time of lymphedema onset. Among the cellulitis with lymphangitis cases, 62 cases were diagnosed through blood-cell culture; 8 of these 62 cultures were positive for β-hemolytic streptococci. Conclusion The prevalence rate of cellulitis with lymphangitis in patients with lymphedema was 7.95%, and the prevalence of recurrent episodes was 3.93%. Especially, there was high risk of cellulitis with lymphangitis after occurrence of lower-extremity lymphedema with passage of time. Lymphedema patients should be fully briefed about the associated risks of cellulitis before treatment, and physicians should be prepared to provide appropriate preventive education. PMID:27152284

  12. Multifractal analysis of the Korean agricultural market

    NASA Astrophysics Data System (ADS)

    Kim, Hongseok; Oh, Gabjin; Kim, Seunghwan

    2011-11-01

    We have studied the long-term memory effects of the Korean agricultural market using the detrended fluctuation analysis (DFA) method. In general, the return time series of various financial data, including stock indices, foreign exchange rates, and commodity prices, are uncorrelated in time, while the volatility time series are strongly correlated. However, we found that the return time series of Korean agricultural commodity prices are anti-correlated in time, while the volatility time series are correlated. The n-point correlations of time series were also examined, and it was found that a multifractal structure exists in Korean agricultural market prices.

  13. Evaluation of the Effectiveness of Two Morphine Protocols to Treat Neonatal Abstinence Syndrome in a Level II Nursery in a Community Hospital.

    PubMed

    DeAtley, Heather N; Burton, Amanda; Fraley, Michelle DeLuca; Haltom, Joan

    2017-07-01

    The authors sought to evaluate the impact on length of hospital stay and treatment duration of morphine after implementation of a change in the institutional protocol for managing neonatal abstinence syndrome (NAS) in an effort to improve patient outcomes. A single-center, retrospective chart review was conducted at a Level II nursery in a community hospital in Kentucky. Fifty-nine neonates born between January 1, 2014, and December 31, 2015, who were diagnosed with NAS and received morphine for treatment were included. The protocol 1 group consisted of 33 neonates who received an initial dose of morphine 0.04 mg/kg/dose administered orally every 4 hours (January 1-December 31, 2014), and the protocol 2 group consisted of 26 neonates who received an initial dose of morphine 0.06 mg/kg/dose administered orally every 3 hours (January 1-November 30, 2015), after a change in the protocol for managing NAS was implemented on January 1, 2015. Data were reviewed and compared between the two protocol groups to determine the impact that the dosage change had on length of hospital stay and morphine treatment duration. The average length of stay decreased by 7 days in the protocol 2 group compared with the protocol 1 group (21 vs 28.65 days). The average duration of treatment decreased by 7 days in the protocol 2 group compared with the protocol 1 group (18.3 vs 25.4 days). These differences between groups were not statistically significant, however, because the population size was not large enough to achieve adequate power. These results indicate that protocol 2 displayed the potential to decrease length of stay and duration of treatment compared with protocol 1 at this facility; however, balancing higher starting doses with the risk of oversedation will continue to challenge the health care team. Concern for oversedation when using the higher starting dose in protocol 2 has prompted further research (e.g., protocol 3, initial morphine 0.05 mg/kg/dose every 3 hrs). Continued

  14. Differences in knowledge, attitudes, beliefs, and perceived risks regarding colorectal cancer screening among Chinese, Korean, and Vietnamese sub-groups.

    PubMed

    Le, T Domi; Carney, Patricia A; Lee-Lin, Frances; Mori, Motomi; Chen, Zunqiu; Leung, Holden; Lau, Christine; Lieberman, David A

    2014-04-01

    Asian ethnic subgroups are often treated as a single demographic group in studies looking at cancer screening and health disparities. To evaluate knowledge and health beliefs associated with colorectal cancer (CRC) and CRC screening among Chinese, Korean, and Vietnamese subgroups, a survey assessed participants' demographic characteristics, healthcare utilization, knowledge, beliefs, attitudes associated with CRC and CRC screening. Exploratory factor analysis identified six factors accounting >60 % of the total variance in beliefs and attitudes. Cronbach's alpha coefficients assessed internal consistency. Differences among Asian subgroups were assessed using a Chi square, Fisher's exact, or Kruskal-Wallis test. Pearson's correlation coefficient assessed an association among factors. 654 participants enrolled: 238 Chinese, 217 Korean, and 199 Vietnamese. Statistically significant differences existed in demographic and health care provider characteristics, knowledge, and attitude/belief variables regarding CRC. These included knowledge of CRC screening modalities, reluctance to discuss cancer, belief that cancer is preventable by diet and lifestyle, and intention to undergo CRC screening. Chinese subjects were more likely to use Eastern medicine (52 % Chinese, 25 % Korean, 27 % Vietnamese; p < 0.001); Korean subjects were less likely to see herbs as a form of cancer prevention (34 % Chinese, 20 % Korean, 35 % Vietnamese; p < 0.001). Vietnamese subjects were less likely to consider CRC screening (95 % Chinese, 95 % Korean, 80 % Vietnamese; p < 0.0001). Important differences exist in knowledge, attitudes, and health beliefs among Asian subgroups. Understanding these differences will enable clinicians to deliver tailored, effective health messages to improve CRC screening and other health behaviors.

  15. Quality of Life Assessment in Korean Patients with Pemphigus

    PubMed Central

    Sung, Jae Yong; Roh, Mi Ryung

    2015-01-01

    Background Measuring the quality of life (QOL) is important in the evaluation of nonclinical aspects of diseases, for the discovery of functional and psychological limitations, and in choosing treatment in the initial phase of the disease. Pemphigus is a potentially fatal autoimmune bullous disease caused by autoantibodies against desmogleins (cadherin family proteins in desmosomes). Thus far, there has been no published study on QOL in Korean patients with pemphigus. Objective To study the impact of pemphigus on the QOL in a large number of Korean patients. Methods Sixty-six patients enrolled at the Gangnam Severance Hospital from March 2012 to March 2013 were assessed for QOL by using the Dermatology Life Quality Index (DLQI), and for anxiety and depression by using the General Health Questionnaire (GHQ). Spearman's rank-order correlation, t-test, and ANOVA were used to identify the relations between the DLQI score and other clinical variables. Results Pemphigus vulgaris and pemphigus foliaceus significantly reduced the QOL of patients. The average DLQI score for all patients was 10.18. The mean DLQI score was 13.45 in patients in the active state and 5.15 in the patients in the remission state. The DLQI score highly correlated with disease severity, titer of anti-desmoglein 1 in enzyme-linked immunosorbent assay, and the corticosteroid dose. However, the QOL was not affected by sex, age, subtype of pemphigus, duration of disease, or comorbidities. Forty-two percent of the patients showed a positive result in the GHQ, reflecting probable minor psychiatric nonpsychotic conditions, and the GHQ score positively correlated to the DLQI score. Conclusion Pemphigus significantly impairs the QOL of patients. The QOL of Korean pemphigus patients significantly correlates with clinical severity. Therefore, considerable attention should be paid to the patients' QOL and psychological states as well as clinical status. PMID:26512162

  16. Associations between Dietary Pattern and Depression in Korean Adolescent Girls.

    PubMed

    Kim, Tae-Hee; Choi, Ji-young; Lee, Hae-Hyeog; Park, Yongsoon

    2015-12-01

    Dietary patterns are important for the physical and psychological development of adolescent girls. The purpose of the present study was to evaluate the relationship between dietary patterns and depression in this population. We conducted a case-control study in a tertiary university hospital of 849 girls aged 12 to 18 years. The study was conducted from April 2011 to December 2012. Participants were identified as having depression if they had scores greater than 16 on the Korean version of the Beck Depression Inventory. Data were obtained using validated Korean-language questionnaires. The subjects' usual dietary patterns during the past 12 months were assessed using the Food Frequency Questionnaire published by the Korean Health and Nutrition Examination Survey. Among the 849 enrolled volunteers, 116 were identified as having depressive symptoms. The mean age of the participants was 15.0 ± 1.5 years. The prevalence of girls diagnosed with depression was 13.6%. Multivariate adjusted regression analysis demonstrated that the risk of depression was significantly positively associated with the consumption of instant and processed foods and negatively associated with the intake of green vegetables and 1 to 3 servings/day of fruits, after adjusting for energy intake and menstrual regularity. Additionally, depression was negatively associated with intake of fiber, β-carotene, vitamin B6, vitamin E, vitamin C, potassium, zinc, folate, iron, and copper after adjusting for confounding variables. Consumption of fast foods including ramen noodles, hamburger, pizza, fried food, and other processed foods was associated with increased risk of depression in adolescent girls. Thus, caution is required regarding dietary choices in this population. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  17. The "Jolly Fat" Effect in Middle-Aged Korean Women.

    PubMed

    Yim, Gyeyoon; Ahn, Younjhin; Cho, Juhee; Chang, Yoosoo; Ryu, Seungho; Lim, Joong-Yeon; Park, Hyun-Young

    2017-09-18

    It has been hypothesized that depression and obesity are bi-directionally associated, and when overweight people appear to show a lower risk of depression, this supports the "Jolly Fat" hypothesis. The aim of this study was to examine the "Jolly Fat" hypothesis in middle-aged women in Korea, by different perceived stress levels. We performed a cross-sectional study of 44 to 56 aged Korean women (n = 2201) who underwent a health check-up program at the healthcare centers of Kangbuk Samsung Hospital (Seoul and Suwon centers) in Korea. General and abdominal obesity were defined as body mass index ≥25 kg/m(2) and waist circumference ≥85 cm, respectively. Depressive symptoms were measured by a Korean version of the Center for Epidemiologic Studies-Depression scale. The association between obesity and depressive symptoms was investigated by using multiple logistic regression analyses by different levels of perceived stress, with adjustment for potential confounding factors. The prevalence of general and abdominal obesity and depressive symptoms were 23.7%, 21.4%, and 16.5%, respectively. Women with general obesity were less likely to have depressive symptoms (odds ratio [OR]: 0.50; 95% confidence interval [CI]: 0.25-1.00; p-value: 0.049) in the low-stress group. We also found that women with abdominal obesity had a 60% decrease in the odds of having depressive symptoms (OR: 0.40; 95% CI: 0.18-0.87; p-value: 0.02) in the low-stress group. No significant association was found in the high-stress group. These findings indicate that the relationship between obesity and depressive symptoms in the Korean middle-aged women supports the "Jolly Fat" hypothesis. Further, our results underscore the role of stress as an important potential mediator exerting effects on the association between obesity and depressive symptoms.

  18. Injury epidemiology after the 2001 Gujarat earthquake in India: a retrospective analysis of injuries treated at a rural hospital in the Kutch district immediately after the disaster

    PubMed Central

    Phalkey, Revati; Reinhardt, Jan D.; Marx, Michael

    2011-01-01

    Background The number of injured far exceeds those dead and the average injury to mortality ratio in earthquakes stands at 3:1. Immediate effective medical response significantly influences injury outcomes and thus the overall health impact of earthquakes. Inadequate or mismanagement of injuries may lead to disabilities. The lack of precise data from immediate aftermath is seen as a remarkable weak point in disaster epidemiology and warrants evidence generation. Objective To analyze the epidemiology of injuries and the treatment imparted at a secondary rural hospital in the Kutch district, Gujarat, India following the January 26, 2001 earthquake. Design/Methods Discharge reports of patients admitted to the hospital over 10 weeks were analyzed retrospectively for earthquake-related injuries. Results Orthopedic injuries, (particularly fractures of the lower limbs) were predominant and serious injuries like head, chest, abdominal, and crush syndrome were minimal. Wound infections were reported in almost 20% of the admitted cases. Surgical procedures were more common than conservative treatment. The most frequently performed surgical procedures were open reduction with internal fixation and cleaning and debridement of contaminated wounds. Four secondary deaths and 102 transfers to tertiary care due to complications were reported. Conclusion The injury epidemiology reported in this study is in general agreement with most other studies reporting injury epidemiology except higher incidence of distal orthopedic injuries particularly to the lower extremities. We also found that young males were more prone to sustaining injuries. These results warrant further research. Inconsistent data reporting procedures against the backdrop of inherent disaster data incompleteness calls for urgent standardization of reporting earthquake injuries for evidence-based response policy planning. PMID:21799668

  19. Comparison of long-term mortality after acute myocardial infarction treated by percutaneous coronary intervention in patients living alone versus not living alone at the time of hospitalization.

    PubMed

    Nakatsuma, Kenji; Shiomi, Hiroki; Watanabe, Hiroki; Morimoto, Takeshi; Taniguchi, Tomohiko; Toyota, Toshiaki; Furukawa, Yutaka; Nakagawa, Yoshihisa; Horie, Minoru; Kimura, Takeshi

    2014-08-15

    Living alone was reported to be associated with increased risk of cardiovascular disease. There are, however, limited data on the relation between living alone and all-cause mortality in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). The Coronary REvascularization Demonstrating Outcome Study in Kyoto (CREDO-Kyoto) AMI registry was a cohort study of patients with AMI enrolled in 26 hospitals in Japan from 2005 through 2007. For the current analysis, we included those patients who underwent PCI within 24 hours of symptom onset, and we assessed their living status to determine if living alone would be an independent prognostic risk factor. Among 4,109 patients eligible for the current analysis of 5,429 patients enrolled in the CREDO-Kyoto AMI registry, 515 patients (12.5%) were living alone at the time of hospital admission. The cumulative 5-year incidence of all-cause death was 18.3% in the living alone group and 20.1% in the not living alone group (log-rank p = 0.77). After adjusting for potential confounders, risk of the living alone group relative to the not living alone group for all-cause death was not significantly different (adjusted hazard ratio 0.82, 95% confidence interval 0.65 to 1.02, p = 0.08). In a subgroup analysis stratified by age, the adjusted risk for all-cause death was also not different between the living alone group and the not living alone group both in the older population (aged ≥75 years) and the younger population (aged <75 years). In conclusion, living alone was not associated with higher long-term mortality in patients with AMI who underwent PCI.

  20. Prospective, consecutive case series of 158 snakebite patients treated at Savannakhet provincial hospital, Lao People's Democratic Republic with high incidence of anaphylactic shock to horse derived F(ab')2 antivenom.

    PubMed

    Vongphoumy, Inthanomchanh; Chanthilat, Phankham; Vilayvong, Phongmany; Blessmann, Joerg

    2016-07-01

    Snakebites are a seriously neglected public health problem in Lao PDR. Community-based cross-sectional surveys in two districts of Savannakhet province in Southern Laos revealed an incidence of up to 1105 snakebites per 100,000 persons per year. In contrast the number of snakebite patients treated in district and provincial hospitals are low. In order to improve health care for snakebite victims, antivenom was introduced to Savannakhet provincial hospital in July 2013 and medical staff has been trained in management of venomous snakebites at the same time. After the intervention the number of snakebite patients treated at the provincial hospital increased significantly from 4 patients in 2012 to 158 snakebite patients between July 2013 and November 2015. They were included into a prospective, consecutive case series. Median age was 32 years (range 1.5-70 years) and male-to-female ratio 2.2:1. Forty patients were bitten by Malayan pit vipers, 26 by green pit vipers, 24 by cobras, including 3 cases of venom ophthalmia, 5 by kraits, 8 by non-venomous species and in 55 cases the snake could not be identified. Forty-three out of 158 patients received horse derived F(ab')2 antivenom from Queen Saovabha Memorial Institute (QSMI) in Bangkok. Twenty-three patients (53%) developed early adverse reactions (EARs) within one hour after antivenom administration, including 13 patients (30%) with severe anaphylaxis. This extremely high rate of severe EARs turns the use of antivenom into a risky intervention. In contrast a retrospective chart review from Chulalongkorn University in Bangkok found only 3.5% early reactions including 1.2% severe anaphylactic reactions using the same antivenom from QSMI between 1997 and 2006. The reason for this enormous difference remains unclear. A better understanding of the aetiology and pathophysiology behind antivenom induced anaphylaxis is crucial in order to identify patients at risk and to improve safety of antivenom administration. Copyright

  1. Dominant Language Influence in Acquisition and Attrition of Binding: Interpretation of the Korean Reflexive "Caki"

    ERIC Educational Resources Information Center

    Kim, Ji-Hye; Montrul, Silvina; Yoon, James

    2010-01-01

    This study investigates how the dominant language of Korean heritage speakers (English) influences Korean (minority language) in the domain of binding interpretations by comparing the performance of Korean immigrants in English dominant context with that of incomplete learners of Korean and L2 learners of Korean. Four groups (10 Korean immigrants,…

  2. Dominant Language Influence in Acquisition and Attrition of Binding: Interpretation of the Korean Reflexive "Caki"

    ERIC Educational Resources Information Center

    Kim, Ji-Hye; Montrul, Silvina; Yoon, James

    2010-01-01

    This study investigates how the dominant language of Korean heritage speakers (English) influences Korean (minority language) in the domain of binding interpretations by comparing the performance of Korean immigrants in English dominant context with that of incomplete learners of Korean and L2 learners of Korean. Four groups (10 Korean immigrants,…

  3. A three-year follow-up on injuries sustained by cruise ship passengers and crew treated at the Orthopaedic and Traumatology Department at Dubrovnik County Hospital.

    PubMed

    Bekic, Marijo; Mikolaucic, Michele; Golubovic, Marko; Kojic, Niksa; Lenz, Rikard; Lojpur, Jakisa; Bekic, Marijana

    2015-11-01

    Dubrovnik is one of the most popular destinations in the world for cruise ships. Several cruise ship passengers and crew members who have suffered different injuries have been treated at our department. This was a retrospective study to analyse injuries that occurred to crew members and passengers on cruise ships that docked in Dubrovnik over a three-year period from December 2010 to December 2013. During this period, a total of 370 patients suffered trauma that needed medical treatment. A total of 119 of these patients required hospitalisation and received medical help based on the nature of the trauma they suffered. The remaining 251 patients were treated at our outpatient clinic. Female patients in this study were exposed to osteoporotic trauma. Male patients presented mostly with injuries sustained during physical activities or because of the nature of their job on board. The leading cause of trauma accidents in the present study was falls on the same level. Copyright © 2015. Published by Elsevier Ltd.

  4. Palonosetron versus other 5-HT₃ receptor antagonists for prevention of chemotherapy-induced nausea and vomiting in patients with hematologic malignancies treated with emetogenic chemotherapy in a hospital outpatient setting in the United States.

    PubMed

    Craver, Chris; Gayle, Julie; Balu, Sanjeev; Buchner, Deborah

    2011-01-01

    confounders including alcohol consumption and prior history of motion sickness, potential underestimation of incidence of uncontrolled CINV, and inability to draw conclusions pertaining to cause and effect relationship. In this retrospective hospital study, patients with hematologic malignancies treated with HEC or MEC and initiated on antiemetic prophylaxis with palonosetron in the hospital outpatient setting were more likely to experience significantly lower CINV event rates (in the hospital outpatient, inpatient, and emergency room settings) versus patients initiated on other 5-HT₃ RAs.

  5. Current Developments in Sino-Korean Studies

    ERIC Educational Resources Information Center

    Hashimoto, Mantaro J.

    1977-01-01

    This article examines and evaluates studies in the field of Sino-Korean linguistics appearing primarily since 1955. Discussions focus on how studies were developed, the current state, and what problems exise. A bibliography is included. (CHK)

  6. The immigration experience among elderly Korean immigrants.

    PubMed

    Lee, Y-M

    2007-06-01

    The purpose of this preliminary, qualitative study was to describe elderly Korean immigrants' perception of stressors they experienced through immigration and the acculturation process. The methodology used was naturalistic inquiry, a descriptive approach used to elicit the elderly immigrants' own perception of their immigration and acculturation experiences. The six elderly Korean immigrants were interviewed via a semi-structured, open-ended interview guide. The main stressors identified by the subjects as a result of adjusting to life in th