BACKGROUND: Clonidine, a prototype alpha2-adrenoreceptor agonist, has been shown to be effective as a preanesthetic medication in adults. Many authors have reported the effects of intravenous clonidine pretreatment on the hemodynamic responses to tracheal intubation, on the anesthetic requirements during the operation and on postoperative analgesia in adults. The current study was designed to investigate the efficacy of two doses of intravenous clonidine as a premedicants. METHODS: In a prospective, randomized, double-blind, controlled clinical trial, 60 children, aged 5 12 years, undergoing an elective adenotonsillecctomy received saline, 1 microgram/kg clonidine or 2 microgram/kg clonidine intravenously. These agents were administered 10 minutes before the estimated time of induction of anesthesia with intravenous atropine 0.01 mg/kg. A blinded observer noted the childrens'levels of sedation, the quality of separation from parent, and degree of acceptance of mask application during the inhalation of 100% oxygen just after pentothal sodium injection. Hemodynamic changes after tracheal intubation were compared among the three groups. RESULTS: Clonidine produced significant sedation, and this effect were dose related. The clonidine administered groups provided a better quality of separation than the control group. Amnesia about mask application was significantly higher in the clonidine 2 microgram/kg administered group. These doses of clonidine did not attenuate increases in blood pressure and heart rate after tracheal intubation. No consistent differences in the blood pressure or heart rate after tracheal intubation were observed in the three groups. No clinically significant perioperative hypotension or bradycardia was observed. CONCLUSIONS: These data indicate that, the combination of intravenous 1 microgram/kg clonidine or 2 microgram/kg clonidine with atropine 0.01 mg/kg is an effective form of premedication in pediatric surgery. However, the optimal dose of clonidine for both sedation and hemodynamic stability after tracheal intubation in this setting remains to be determined.
Adult ; Amnesia ; Analgesia ; Anesthesia ; Atropine ; Blood Pressure ; Bradycardia ; Child ; Clonidine* ; Heart Rate ; Hemodynamics ; Humans ; Hypotension ; Inhalation ; Intubation ; Masks ; Oxygen ; Parents ; Preanesthetic Medication ; Premedication* ; Prospective Studies ; Sodium ; Sympathetic Nervous System ; Thiopental

BACKGROUND: Adequate staffing is necessary to meet patient care needs and provide safe, quality nursing care. In November 1999, the Korean government implemented a new staffing policy that differentiates nursing fees for inpatients based on nurse-to-bed ratios. The purpose was to prevent hospitals from delegating nursing care to family members of patients or paid caregivers, and ultimately deteriorating the quality of nursing care services. PURPOSE: To examine nurse staffing levels and related factors including hospital, nursing and medical staff, and financial characteristics. METHODS: A cross-sectional design was employed using two administrative databases, Medical Care Institution Database and Medical Claims Data for May 1-31, 2002. Nurse staffing was graded from 1 to 6, based on grading criteria of nurse-to-bed ratios provided by the policy. The study sample consisted of 42 tertiary and 186 general acute care hospitals. RESULTS: None of tertiary or general hospitals gained the highest nurse staffing of Grade 1 (i.e., less than 2 beds per nurse in tertiary hospitals; less than 2.5 beds per nurse in general hospitals). Two thirds of the general hospitals had the lowest staffing of Grade 6 (i.e., 4 or more beds per nurse in tertiary hospitals; 4.5 or more beds per nurse in general hospitals). Tertiary hospitals were better staffed than general hospitals, and private hospitals had higher staffing levels compared to public hospitals. Large-sized general hospitals located in metropolitan areas had higher staffing than other general hospitals. Occupancy rate was positively related to nurse staffing. A negative relationship between nursing assistant and nurse staffing was found in general hospitals. A greater number of physician specialists were associated with better nurse staffing. CONCLUSIONS: The staffing policy needs to be evaluated and modified to make it more effective in leading hospitals to increase nurse staffing.
Workload/economics ; Program Evaluation ; Personnel Staffing and Scheduling/*economics ; Nursing Staff, Hospital/economics/*supply & distribution ; Logistic Models ; Korea ; Humans ; *Hospital Charges ; *Health Policy ; Cross-Sectional Studies ; Bed Occupancy/economics ; Analysis of Variance

Nutrition care is important for patients’ well-being. With legislation for reimbursement for nutrition support team activities from the Korea Ministry of Health and Welfare, this has increased the importance of nurses’ role in nutrition. Nutrition support nurses (NSNs) focus on the optimization of nutritional health and prevention of nutrition-related illness and injury. NSN performs as an advanced practice nurse, a core member of a nutrition support team, an educator or consultant, a policy maker in nutrition care, and a researcher or a member of quality improvement. NSNs should develop their core competency to fulfill their roles in nutrition care and the need to participate in qualified nutrition support education programs. Further, the tasks and duties of NSNs should be specifically identified so that NSNs can fulfill their roles.

No abstract available.
Craniocerebral Trauma* ; Follow-Up Studies* ; Head* ; Humans

The overall purpose of this study was to investigate the effects of level of isoflavones supplementation on bone metabolism in growing female rats. The effects of level of isoflavones supplementation on bone mineral density (BMD) and bone mineral content (BMC) were inspected in this study. Forty-five rats divided into three groups: Casein, 1/2IF, IF. The serum and urine concentrations of calcium and phosphorus were determined. BMD and BMC were estimated by using PIXImus (GE Lunar Co, Wisconsin.) in spine and femur on 3, 6, 9 weeks after feeding. This study of results were as follows: The isoflavones supplementation level did not affect weight gain, mean food intake and food efficiency ratio. The serum concentration of calcium, phosphorus were not significantly different by different level of isoflavones supplementation. The urinary calcium and phosphorus excretion were not significantly different, too. Spine and femur BMD, BMC were not significantly increased by different level of isoflavones supplementation on 3 and 6 weeks after feeding. Spine BMD and spine BMC per weight, femur BMC per weight were significantly increased in the groups 1/2IF and IF at the ninth week after feeding, but there was no significant difference by different level of isoflavones supplementation. Spine BMD per weight and femur BMD per weight were significantly higher in the group of IF than in the group of Casein and 1/2IF at the ninth week after feeding. These results suggest that the group of IF with rich isoflavones supplementation was effective to the increase of BMD spine and femur in growing female rats, respectively.
Animals ; Bone Density* ; Calcium ; Caseins ; Eating ; Female* ; Femur ; Humans ; Isoflavones* ; Metabolism ; Phosphorus ; Rats* ; Spine ; Weight Gain

Elastofibroma is a rare benign tumor-like condition manifesting as firm and spherical mass with poorly circumscribed margins of fibroelastic tissue, occuring in the subscapular region or the chest wall of elderly persons. It is not a true neoplasm but rather a reactive or degenerative process causing abnormal elastogenesis. It is unilateral in the majority of cases and the right side is affected more commonly than the left. We report a case of bilateral elastofibromas removed from both subscapular regions of a 73-year-old female farmer. She was presented with tender masses on the bilateral subscapular areas for seven years. Microscopically, it consisted of a mixture of intertwining broad eosinophilic collagen bundles and elastic fibers associated with a few fibroblasts and mature fat cells. The elastic fibers had a degenerated beaded appearance or were fragmented into serrated globules in a linear arrangement.
Adipocytes ; Aged ; Collagen ; Elastic Tissue ; Eosinophils ; Female ; Fibroblasts ; Humans ; Thoracic Wall

Interscalene bracheal plexus block has became a popular method of anesthesia for surgical operation on the upper extremities. Possible complications are subarachnoid block, epidural block, phrenic nerve block, vagus or recurrent laryngeal nerve block, sympathetic nerve block, intravascular injection. But reported complications has been few and generally without prolonged effects. The following describes a patient who developed signs and symptoms suggestive of inadvertent phrenic nerve block and epidural anesthesia as complications of interscalene bracheal plexus block The complications were attributed to using of inferomedially directed 5 cm needle and then additional blind block of the brachial plexus with 5 or 6 times. We emphasize that if the appropriate length of needle and technique are not used, phrenic nerve paralysis and serious complications including total spinal or epidural block can occur as a result of a medially misdirected needle.
Anesthesia ; Anesthesia, Epidural ; Autonomic Nerve Block ; Brachial Plexus ; Humans ; Needles ; Paralysis* ; Phrenic Nerve* ; Recurrent Laryngeal Nerve ; Upper Extremity

PURPOSE: We compared the prophylactic effects of intravenously administered azasetron (10 mg) and ondansetron (8 mg) on postoperative nausea and vomiting (PONV) in patients undergoing gynecological laparoscopic surgery under general anesthesia. MATERIALS AND METHODS: We studied 98 ASA physical status I or II 20-65 years old, female patients, in this prospective, randomized, double blind study. Patients were randomly divided into two groups and received ondansetron 8 mg (group O) or azasetron 10 mg (group A) 5 min before the end of surgery. The incidence of PONV, Visual Analogue Scale (VAS) for pain, need for rescue antiemetic and analgesics, and adverse effects were checked at 1, 6, 12, 24, and 48 h postoperatively. RESULTS: The overall incidence of PONV was 65% in group O and 49% in group A. The incidence of PONV was significantly higher in group O than in group A at 12-24 h postoperatively (nausea; 24% vs. 45%, p = 0.035, vomiting; 2% vs. 18%, p = 0.008), but there were no significant differences at 0-1, 1-6, 6-12 or 24-48 h. CONCLUSION: In conclusion, azasetron (10 mg) produced same incidence of PONV as ondansetron (8 mg) in patients undergoing general anesthesia for gynecological laparoscopic surgery. Azasetron was more effective, in the intermediate post-operative period, between 12 and 24 h.
Adult ; Aged ; Bicyclo Compounds, Heterocyclic/*therapeutic use ; Female ; Gynecologic Surgical Procedures/*adverse effects ; Humans ; Middle Aged ; Ondansetron/*therapeutic use ; Oxazines/*therapeutic use ; Postoperative Nausea and Vomiting/*prevention & control ; Serotonin Antagonists/*therapeutic use ; Treatment Outcome ; Young Adult

PURPOSE: The aim of this study was to evaluate the efficiency of community visiting health service units using DEA and to compare the results with those of traditional evaluation methods. METHODS: Data were collected using 2008 annual reports of 10 districts in one city. Input variables were number of staff and operational budget per year and output variables were number of managed household per nurse, rate of controlled hypertension, and diabetes mellitus. EMS Window version 3.1 was used to measure efficiency score and bootstrapping Chi-square test was applied to identify differences between efficient and non-efficient unit by organizational factors. RESULTS: The average efficiency score of 10 community visiting health services was about 66%. Only two of the units operated program efficiently. The career of the staff was one among other factors associated with efficiency. The evaluation results from the traditional method and DEA were totally different. CONCLUSION: These results indicate that, evaluation methods have very important and significant effects on the evaluation results of community visiting health service units. The DEA method is recommend as an alterative method for evaluating community visiting health service.
Budgets ; Community Health Nursing ; Diabetes Mellitus ; Family Characteristics ; Health Services ; Hypertension

PURPOSE: The purpose of this study was to identify the effect of Psychosocial health and Self-nurturance on the experience of new graduate nurses. METHODS: A cross-sectional survey design was used. The participants in this study were 149 nurses who had less than 12 months of nursing experience and were working at one of 4 general hospitals. The data were collected by a self-administered questionnaire from Nov. 2012 to Oct. 2014. RESULTS: The total mean score for Psychosocial health was 3.07+/-0.60, Self-nurturance, 3.38+/-0.44, and graduate nurse experience, 2.59+/-0.27. The effect of Psychosocial health and Self-nurturance predicted 23% of variance in graduate nurse experience. CONCLUSION: These results indicate that Psychosocial health and Self-nurturance have a positive relationship to graduate nurse experience. Therefore, further studies including approaches that support Psychosocial health and Self-nurturance are recommended to help in the adaptation of newly graduated nurses to clinical settings.
Cross-Sectional Studies ; Hospitals, General ; Nursing ; Self Care