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Resumen La Clínica de Odontopediatría desarrolla un modelo de atención con énfasis en promoción, educación y rehabilitación destacándose su control y mantenimiento. No hay información sobre el impacto de los controles periódicos. Objetivo: Evaluar la asociación del número de controles y la salud bucal de niños entre 5 y 10 años. Estudio transversal, descriptivo (2017-18) y retrospectivo (hasta 2014) en dos subpoblaciones: G1=controles y G2=primera vez, evaluando diferencias de piezas afectadas Resultados: 115 niños, 44 en G1 y 71 en G2. El 100% presentaron biopelícula. G1 presentó un valor significativamente menor del IPV>20% (p<0.001), de lesiones cavitadas (p<0.001). G1 con 2 o más controles el promedio de lesiones iniciales fue de 2,6 y G2 de 4,5 (p<0.001). Conclusiones: Los niños con dos o más controles presentaron mejor situación de salud bucal que quienes consultaron por primera vez. Se confirma la importancia del control programado para el mantenimiento de la salud bucal.
Resumo A Clínica de Odontologia Pediátrica desenvolve um modelo de cuidado com ênfase na promoção, educação em saúde e reabilitação destacando seu controle e manutenção. Não há informações que sustentem o impacto que os controles regulares. Objetivo: Avaliar a associação do número de controles anuais e da saúde bucal de crianças entre 5 e 10 anos. Estudo transversal e descritivo (2017-18) e retrospectiva (até 2014) em duas subpopulações: G1-controle e G2-primeira vez. Resultados: 115 crianzas: G1-44 e G2-71. 100% do de crianças apresentaram biofilme. G1 apresentou valor de IPV>20% e lesões cavitadas significativamente menor (p<0,001). G1 com 2 ou mais controles a média de lesões iniciais foi de 2,6 e no G2 4,5 (p <0,001). Conclusões: Crianças que assistem a 2 ou mais controles têm uma melhor situação de saúde bucal em comparação com aquelas que consultam pela primeira vez. Confirma-se a importância do controle programado para manutenção da saúde bucal.
Abstract The Pediatric Dentistry Clinic at the School of Dentistry, Universidad de la República, has a care model that focuses on promotion, health education and rehabilitation, and aims to support health control and maintenance. There is no information on the impact of periodic checkups. Objective: To evaluate the association between the number of checkups and oral health in children aged between 5 and 10. Cross-sectional, descriptive (2017-18) and retrospective (up to 2014) study in two subpopulations: G1 = checkups, and G2 = first visit. We evaluated the differences in the number of teeth affected. Results: The sample included 115 children: 44 in G1 and 71 in G2. All of them had biofilm. G1 presented significantly lower values regarding visible plaque index (VPI) (>20%) (p < 0.001) and cavitated lesions (p < 0.001). G1 members, who had attended two or more checkups, had 2.6 initial lesions on average, and G2 members, 4.5 (p < 0.001). Conclusions Children who had attended two or more checkups had better oral health than those seeking care for the first time. This confirms the importance of scheduled checkups for maintaining oral health.
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Health technology assessment (HTA) is defined as multidisciplinary policy analysis to look into the medical, economic, social, and ethical implications of the development, distribution, and use of health technology. Following the recent changes in the social environment, there are increasing needs to improve Korea's healthcare environment by, inter alia, assessing health technologies in an organized, timely manner in accordance with the government's strategies to ensure that citizens' medical expenses are kept at a stable level. Dedicated to HTA and research, the National Evidence-based Healthcare Collaborating Agency (NECA) analyzes and provides grounds on the clinical safety, efficacy, and economic feasibility of health technologies. HTA offers the most suitable grounds for decision making not only by healthcare professionals but also by policy makers and citizens as seen in a case in 2009 where research revealed that glucosamine lacked preventive and treatment effects for osteoarthritis and glucosamine was subsequently excluded from the National Health Insurance's benefit list to stop the insurance scheme from suffering financial losses and citizens from paying unnecessary medical expenses. For the development of HTA in Korea, the NECA will continue exerting itself to accomplish its mission of providing policy support by health technology reassessment, promoting the establishment and use of big data and HTA platforms for public interest, and developing a new value-based HTA system.
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Humans , Adenosine-5'-(N-ethylcarboxamide) , Administrative Personnel , Biomedical Technology , Decision Making , Delivery of Health Care , Evidence-Based Practice , Glucosamine , Insurance , Korea , Osteoarthritis , Policy Making , Social Environment , Technology Assessment, BiomedicalABSTRACT
BACKGROUND AND OBJECTIVES: The early assessment of treatment is not done for benign paroxysmal positional vertigo (BPPV) since the well-known phenomenon of fatigability after a repeated positional test can mimic successful treatment. The aim of this study is to evaluate the clinical implication of ‘fatigability’ after Epley maneuver and to identify the therapeutic efficacy of Epley maneuver in posterior canal BPPV (PC-BPPV). SUBJECTS AND METHOD: This study was prospectively conducted by two dizziness clinics on 51 consecutive patients diagnosed with PC-BPPV. All patients included in the study received Epley maneuver treatment. The therapeutic results were reassessed immediately after a single trial of Epley maneuver. After 30 minutes, results were reassessed repeatedly to confirm the fatigability of diagnostic procedure immediately after treatment. If the treatment was not successful after 30 minutes, Epley maneuver was repeatedly performed until complete resolution. RESULTS: Immediately after the first maneuver, 45 of 51 (88.2%) patients had neither vertigo nor nystagmus during the positional test. All patients demonstrated complete resolution after receiving one to three Epley maneuvers on the day of diagnosis. ‘Fatigability (false negative result)’ was confirmed for only one case (1 of 6 patients, 16.7%), in which nystagmus was observed after 30 minutes but not identified immediately after the first Epley maneuver. CONCLUSION: The therapeutic efficacy of Epley maneuver is very high in PC-BPPV. Considering the possibility of fatigability when reassessment is performed immediately after therapeutic maneuver, clinicians should avoid assessing the outcome immediately after treatment in patients with PC-BPPV.
Subject(s)
Humans , Benign Paroxysmal Positional Vertigo , Diagnosis , Dizziness , Fatigue , Methods , Prospective Studies , VertigoABSTRACT
Andrographolide total ester sulfonate (ATES) injection is one of the products of traditional Chinese medicine (TCM) currently used against viral infection in China.ATES injection was approved for manufacturing and marketing in January 2002.It is indicated for acute respiratory infections,tonsillitis,chronic obstructive pulmonary disease,influenza,foot and mouth disease,bronchiolitis,herpangina,mumps,infectious mononucleosis and psychosis.However,its usage also carries risk.We investigated the use of ATES at the Wuhan Union Hospital from January 2014 to December 2014 and evaluated its real-word clinical application using the hospital centralized monitoring method.A total of 848 cases were enrolled in this study.In these cases,it was mainly used for postoperative anti-inflammation and treating upper respiratory infection,pneumonia and bronchitis.Among them,39.86％ were contraindicated.Irregular medication of adults and children accounted for 1.91％ and 23.38％,respectively.Improper choice of solvent accounted for 3.18％.The choice of intravenous drip versus aerosol inhalation was reasonable.A case of adverse events (AEs) was observed in the monitoring period,and the incidence of adverse drug reaction (ADR) of ATES injection was 0.12％.ATES injection in our hospital is relatively safe with a low incidence of adverse reactions.The study assesses the clinical usage and adverse reactions of ATES injection,and provides suggestions for rational use in clinical practice.
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BACKGROUND: The use of therapeutic materials based on new health technology has increased in recent years in the field of medicine, raising concerns for medical practitioners regarding increased spending on the new therapeutic materials amid the rapid population ageing and increase of chronic diseases in Korea. While therapeutic materials have significant importance in the health care system, they have not been given appropriate attention in the academic world of Korea. The purpose of this study is to identify factors that affect the growth of expenditure on therapeutic materials and to derive implications for an effective management considering the diversity of therapeutic materials. METHODS: Using the claims data of the National Health Insurance Services, specific utilization patterns of groups of therapeutic materials in the middle classification level of Health Insurance Review and Assessment Service from 2007 to 2014 were analyzed. Four categories (J5083: drug eluting coronary stent, D0302: nonmetallic anchor, K6014: gauze, K6023: gauze) that exhibit unique patterns with respect to price and volume were selected. Then, decomposition analysis was performed to identify the largest contributor to the spending growth by dividing the products into existing, new, and abandoned products for the period between 2010 and 2013. RESULTS: The effect of new products had larger impact on spending growth than the effect of core items in drug eluting coronary stent (J5083) and nonmetallic anchor (D0302). In addition, existing products in general included items priced relatively lower when compared with another item manufactured by the same company. In the gauze category, however, existing products had the largest impact on expenditure and the effect of volume was greater than that in other categories. CONCLUSION: This study provides evidence that appropriate management measures classified by the characteristics of therapeutic materials are required for therapeutic materials pricing and reassessment in Korea.
Subject(s)
Biomedical Technology , Chronic Disease , Classification , Delivery of Health Care , Health Expenditures , Health Status , Insurance , Korea , National Health Programs , StentsABSTRACT
To assess the clinical use and occurrence of adverse reactions of Xiyanping injection, and to provide reference for rational drug use in the clinic. Based on hospital central monitoring method, the clinical data of Xiyanping injection in our hospital in 2014 was tracked and analyzed. A total of 848 inpatients were enrolled in this study. Among them, 39.9% were not in accordance with the medication purpose. In practice, the dose more than the limits prescribed by the instructions of child and adult were accounted for 1.72% and 6.62%, respectively; improper choice of solvent, accounting for 3.18%; both the choice of versus intravenous drip and aerosol inhalati administration route were reasonable; mixed with other drug, accounting for 2.24%. The incidence of ADR of Xiyanping injection was 0.12%, which showed good safety. Irrational use of Xiyanping injection existed in clinics, and the use should be strengthened and regulated. The manufacturer should improve the drug instruction of usage and dosage.
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OBJECTIVE: To investigate the clinical use of ornidazole injection in a wide patient population by the post-marketing hospital centralized monitoring method in order to regulate and guide its rational use, improve the drug specification, and provide a basis for the drug therapy. METHODS: A prospective, multi-center, large sample hospital centralized monitoring method was adopted. Five sentinel hospitals in Hubei Province were selected, and hospitalized patients who received ornidazole injection treatment from July 1, 2015 to October 31, 2015 were observed. The basic information of the patients was recorded, as well as the drug use and adverse events, and then statistical analysis was made. RESULTS: A total of 4396 cases were enrolled in this study, most of them were middle-aged female patients. Ornidazole injection was mainly used before surgeries to prevent infections and after surgeries for treatment of anaerobic infections, abdominal infections and pelvic infections. Irrational drug use existed in clinic, mainly concentrating at unreasonable dosing frequency, excessive dripping speed, and long duration of use. Eleven cases of adverse reactions were collected during the monitoring, indicating an incidence of adverse drug reactions of 2.5‰, and most of the adverse drug reactions occurred within 30 min post drug administration. CONCLUSION: The manufacturers should make further investigation on the dripping speed and quality standard of ornidazole injection to further improve the information in the package insert and regulate the clinical use.
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Objective To investigate the effect of early rehabilitation treatment in the patients with small cerebral hemorrhage and its possible mechanisms .Methods 133 patients with cerebral hemorrhage were randomly divided into the routine treatment , non-early rehabilitation and early rehabilitation groups and given the routine drug treatment .The early rehabilitation group and the non-early rehabilitation group were additionally given the rehabilitative training after 2 d and 14 d respectively .The scores of Fugl-Meyer reassessment and the Barthel index were assessed before training and after 4-week training ,and the serum levels of circulat-ing endotheial progenitor cells(EPCs) and vascular endotheial cell growth factors(VEGF) were detected .Results Compared with the routine treatment group and the non-early rehabilitation group ,the scores of Fugl-Meyer reassessment and the Barthel index af-ter treatment in the early rehabilitation group were significantly increased (P< 0 .01) .The serum levels of circulating EPCs and VEGF in the early rehabilitation group were also significantly increased compared with the routine treatment group control (P<0 .01) .Conclusion Early rehabilitation treatment can obviously improve the limb movement function and the daily living ability in the patients with small cerebral hemorrhage ,its mechanisms may be involved with the increase of circulating EPCs and VEGF .
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Este artigo é um desenvolvimento escrito mais detalhado da minha apresentação oral durante o colóquio Homenagem a André Green, onde participei como mediador e debatedor entre o linguista pós-saussuriano Simon Bouquet e o psicanalista pós-lacaniano Patrick Guyomard, ambos interlocutores de peso, principalmente junto a André Green. O artigo pretende mostrar ou, em todo caso, tentar mostrar, o quanto André Green esteve profundamente envolvido, desde há muito tempo, com as relações entre psicanálise e linguística. Ele era exigente, mas ao mesmo tempo não desistia, atravessando períodos entre renúncia e esperança de uma criatividade recíproca.
This article is a more detailed written piece of my oral presentation during the colloque Tribute to André Green, where I participated as mediator and debator between the post-Saussurian linguist Simon Bouquet and the post-Lacanian psychoanalyst Patrick Guyomard, both renowned interlocutors, specially in relation to André Green. The article intends to demonstrate or at least attempts to demonstrate how much André Green was profoundly involved, for a very long time, with the relation between psychoanalysis and linguistic. He was very demanding yet at the same time relentless, going through periods between hope and renouncement of a reciprocal creativity.
Este artículo es un desarrollo escrito más detallado de mi presentación oral durante el coloquio Homenaje a André Green, del que he participado como mediador y conductor del debate entre el lingüista post saussuriano Simon Bouquet y el psicoanalista post lacaniano Patrick Guyomard, ambos interlocutores de peso, principalmente junto a André Green. El artículo pretende mostrar o, en todo caso, intenta mostrar, cuánto estuvo André Green profundamente involucrado, desde hace mucho tiempo, con las relaciones entre psicoanálisis y lingüística. Era exigente, pero a la vez, no desistía, atravesando períodos entre renuncia y esperanza de una creatividad recíproca.
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Humans , Male , Female , Countertransference , Language , PsycholinguisticsABSTRACT
OBJECTIVE: To reassess the impact of China's entry into WTO on Chinese pharmaceutical industry.METHODS: The relevant viewpoints before the entry into WTO were reviewed and the development of the pharmaceutical industry after China's entry into WTO was analyzed,and the impact of China's entry into WTO on Chinese pharmaceutical industry was reassessed.RESULTS & CONCLUSIONS: China's entry into WTO enhanced the export of pharmaceutical products and the impact of TRIPS on pharmaceutical industry is as great as what people have predicated.To the opposite of some scholars' view,the steadily increased import of drugs after entering WTO had little impact on domestic pharmaceutical industry and the export of traditional Chinese medicine products still faces many difficulties.