• 제목/요약/키워드: Care efficacy

검색결과 1,246건 처리시간 0.041초

Ovarian Masses: Is Multi-detector Computed Tomography a Reliable Imaging Modality?

  • Khattak, Yasir Jamil;Hafeez, Saima;Alam, Tariq;Beg, Madiha;Awais, Mohammad;Masroor, Imrana
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권4호
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    • pp.2627-2630
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    • 2013
  • Background: Ovarian cancer continues to pose a major challenge to physicians and radiologists. It is the third most common gynecologic malignancy and estimated to be fifth leading cancer cause of death in women, constituting 23% of all gynecological malignancies. Multi-detector computed tomography (MDCT) appears to offer an excellent modality in diagnosing ovarian cancer based on combination of its availability, meticulous technique, efficacy and familiarity of radiologists and physicians. The aim of this study was to compute sensitivity, specificity, positive and negative predictive values and diagnostic accuracy of 64-slice MDCT in classifying ovarian masses; 95% confidence intervals were reported. Materials and Methods: We prospectively designed a cross-sectional analytical study to collect data from July 2010 to August 2011 from a tertiary care hospital in Karachi, Pakistan. A sample of 105 women aged between 15-80 years referred for 64-MDCT of abdomen and pelvis with clinical suspicion of malignant ovarian cancer, irrespective of stage of disease, were enrolled by non-probability purposive sampling. All patients who were already known cases of histologically proven ovarian carcinoma and having some contraindication to radiation or iodinated contrast media were excluded. Results: Our prospective study reports sensitivity, specificity; positive and negative predictive values with 95%CI and accuracy were computed. Kappa was calculated to report agreement among the two radiologists. For reader A, MDCT was found to have 92% (0.83, 0.97) sensitivity and 86.7% (0.68, 0.96) specificity, while PPV and NPV were 94.5% (0.86, 0.98) and 86.7% (0.63, 0.92), respectively. Accuracy reported by reader A was 90.5%. For reader B, sensitivity, specificity, PPV and NPV were 94.6% (0.86, 0.98) 90% (0.72, 0.97) 96% (0.88, 0.99) and 87.1% (0.69, 0.95) respectively. Accuracy computed by reader B was 93.3%. Excellent agreement was found between the two radiologists with a significant kappa value of 0.887. Conclusion: Based on our study results, we conclude MDCT is a reliable imaging modality in diagnosis of ovarian masses accurately with insignificant interobserver variability.

Infant Parents' Marital Satisfaction and Their Family Environment Focused on Employment Status (영아기 자녀를 둔 부모의 결혼만족도 및 가정환경 탐색 - 취업여부를 중심으로)

  • Kim, Jin Kyung
    • Korean Journal of Childcare and Education
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    • 제11권4호
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    • pp.63-79
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    • 2015
  • This study explored the effect of mother's employment status on family environment and physical environment and psychological environment, the main concern of this which factors have effects on marital satisfactions of either employed or non-employed mothers. First, the result of analysis on family environment according to mothers' employment status shows non-employed mother's parental stress is higher than employed mother's. Besides, non-employed mother's self-esteem is lower than employed mother's, and non-employed mother's depression is significantly high. Concerning fathers' factors, the level of conflict between husband and wife is higher among husbands when their wives are employed. In the light of childrens' factors, non-employed mothers consider that their children display more negative emotion and more picky. Children's development of employed mothers is included in normal development range more than that of non-employed mothers. Second, conflict between husbands and wives have an significantly negative effect on marital satisfaction regardless wife's employment status. Husbands' cooperation in child-rearing and marital satisfaction have a positive effect on wives' marital satisfaction. The significant factor which influences on employed mother's marital satisfaction is education level of wives. This study would be meaningful in that infancy home environment was compared focusing on the mothers' employment status, and some factors which factors(variables) have impacts on marital satisfaction of infancy mothers were examined.

The Current Status of Complementary-Alternative Medicine for Asthmatics in Korea : Experience in One Tertiary Care Hospital (한 대학병원에서의 천식환자의 대체-보완의료의 실태와 경향)

  • Hwang, Bo Young;Park, Mi Na;Choi, Hye Sook;Choi, Cheon Woong;Yoo, Ji Hong;Kang, Hong Mo;Park, Myung Jae
    • Tuberculosis and Respiratory Diseases
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    • 제61권4호
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    • pp.339-346
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    • 2006
  • Background: There has no known epidemiologic survey on the frequency of complementary-alternative medicine (CAM) use in the treatment of adult asthma in Korea. This study examined the current use of CAM by asthma patients in Korea. Methods: One hundred adults with asthma, who had been admitted to Kyunghee university hospital between January 2000 and December 2003, were enrolled in this survey. They received a structured questionnaire interview and a clinical assessment of prevalence and pattern of CAM use. Results: 53% patients had an experience of at least one type of CAM during their asthma management. Users of CAM had more hospital visits than those who had never used CAM($1.46{\pm}0.68$ vs. $2.11{\pm}1.20$, p=0.001). Those in their $50^{th}$ decades had more experience of CAM (80%) than the other age groups. The methods of CAM used by our patients are as follows: Diet/nutritional therapy in 35 patients(69%), herbal therapy in 28 patients(53%), acupuncture in 9 patients(17%), moxa treatment in 6 patients(11%), breathing exercises in 1 patient(2%). Conclusions: More than 50% of patients with bronchial asthma have used CAM. A more detailed and large scaled study will be needed to define the actual status of the use of CAM in the treatment for asthma. Inaddition, further research on the scientific validation of the clinical efficacy of CAM in asthma management should be followed.

A Phenomenological Approach to Experiences of Young Children's Mothers on Respected Parents & Respected Children Parent Education Program (유아기 자녀를 둔 어머니들의 부모존경-자녀존중 부모교육 참가 경험에 대한 현상학적 접근)

  • Song, Seung Min;Doh, Hyun-Sim;Kim, Min Jung;Kim, Soo Jee;Yun, Ki Bong;Kim, Jung Eun
    • Korean Journal of Childcare and Education
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    • 제10권4호
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    • pp.133-158
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    • 2014
  • The purpose of this study was to understand the experiences of the young children's mothers who participated in Respected Parents & Respected Children(RPRC) through a phenomenological approach. Data were collected from 9 mothers of preschool children using weekly journals, self-reported worksheets, observer's descriptive notes and reflective notes, and semi-structured pre-interviews and post-interviews to share their experiences regarding their participation in the program. From a phenomenological study, that is one of the qualitative analysis methods, 7 theme categories and 16 lower categories emerged. Theme categories were (1) the intrinsic motivation for participation in parent education program, (2) the beginning of change: mother, (3) the beginning of change: children, (4) the lasting conflicts, (5) the absence of positive parent's role model and intergenerational transmission of parenting, (6) the raising parenting efficacy, (7) the emotional supporting experience from parent education program and expectations of the continuous education course. Discussions and the implications for support practices and interventions were provided.

High Flow Nasal Cannula versus Nasal CPAP in Preterm Infants (미숙아에서 경비지속기도양압과 가습고유량비강캐뉼라의 사용에 대한 비교 연구)

  • Yoon, Seong-Ho;Kwon,Young-Hee;Park, Hyun-Kyung;Kim, Chang-Ryul;Seol, In-Jun;Lee, Hyun-Ju
    • Neonatal Medicine
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    • 제18권2호
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    • pp.293-300
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    • 2011
  • Purpose: The aim of the study was to investigate the change in usage and clinical outcomes of using a humidified high flow nasal cannula (HHFNC) in preterm infants. Methods: A retrospective review of patients with gestational age <32 weeks born at our neonatal intensive care unit from January 2008 to March 2011 was performed. First, data were compared between Era 1 (January 2008 to February 2009) and Era 2 (March 2009 to March 2011) to describe the increased usage of HHFNC. Second, the patients (gestational age 25-30 weeks) were divided into two groups to compare clinical outcomes. nasal continuous positive airway pressure (NCPAP) and HHFNC groups who received either NCPAP or HHFNC as a respiratory support within 14 days of birth. Results: Compared to Era 1, HHFNC usage increased from 10 to 55% in Era 2, whereas NCPAP usage decreased from 40 to 5%. No difference in pulmonary or adverse outcomes including the incidence of reintubation and bronchopulmonary dysplasia (BPD), days on oxygen and a ventilator, and other outcomes was observed between the HHFNC and NCPAP groups. Days to reach full feed (32.2${\pm}$16.7 vs. 24.7${\pm}$10.2, P=0.05) and regain birth weight (20.9${\pm}$16.9 vs. 17.2${\pm}$4.3, P=0.04) decreased in the HHFNC group. Conclusion: HHFNC was feasible and did not differ in respiratory and other outcomes, but days to reach full feed and regain birth weight decreased in the HHFNC, when compared with the NCPAP. An additional prospective multicenter designed study is needed to better define safety and efficacy of HHFNC.

Evaluation of Therapeutic Effect of the Extract from Rhubarb (Rheum officinalis) in Dogs with Chronic Renal Failure (개의 만성 신부전에서 대황 추출물의 치료학적 효과의 평가)

  • Kim, Ye-Won;Hyun, Changbaig
    • Journal of Veterinary Clinics
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    • 제29권6호
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    • pp.435-440
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    • 2012
  • This study was designed to evaluate the clinical efficacy and safety of Rhubarb extracts ($Rubenal^{(R)}$) in dogs with chronic renal failure (CRF). Client-owned 40 dogs with CRF graded International renal interest Society (IRIS) II-III were enrolled in this study. The dogs were equally allocated and blindly administered with $Rubenal^{(R)}$ or placebo. The following items were evaluated at day 0, 30, 90 and 180: body condition score (BCS), clinical score (appetite, polydipsia/polyuria, quality of life score), hemogram (WBC, RBC, PCV), serum biochemistry (ALT/AST, ALP, Creatinine/BUN, total protein, albumin), serum electrolyte (Na, K, Cl, Ca, P), systolic blood pressure, urinalysis (UPC, USG) and IRIS stage. In this study, we found that the $Rubenal^{(R)}$ preparation was well tolerated by dogs and induced no adverse effects. Statistically significant improvements were observed in clinical score (quality of life score by vet and clients), serum BUN and creatinine levels, serum phosphorus concentration, level of proteinuria, and the IRIS score of CRF in dogs after 6 month of treatment of $Rubenal^{(R)}$. Those findings suggested that the Rhubarb extracts can improve the clinical signs of CRF (i.e. azotemia, hypertension, proteinuria, hyperphosphoremia) and the quality of life (i.e. BCS, clinical score) and can retard the progression of CRF in dogs. Therefore the Rhubarb extracts can be a good supplementary drug for treating dogs with subclinical and clinical renal diseases. However, care should be taken for interpreting our result, because this study is not double-blinded controlled study but pilot study.

Effects of Maternity Nursing Simulation using High-fidelity Patient Simulator for Undergraduate Nursing Students (고충실도 시뮬레이터를 활용한 모성간호 시뮬레이션 교육의 효과)

  • Kim, Ahrin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • 제17권3호
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    • pp.177-189
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    • 2016
  • This study examined the effectiveness of maternity nursing simulations using a high-fidelity simulator for undergraduate nursing students. One-group pretest-posttest design was used. The simulation-based education program consisted of three sessions, including the clinical scenarios about prenatal, childbearing and postpartum care. The program provided for 3 weeks in November 2014. Data was collected before and after the simulation education using self-reported questionnaires, which included simulation effectiveness, problem solving ability, communication skills and self-confidence in maternity nursing. The data of 83 participants were analyzed using the IBM SPSS 20.0 program. After simulation education, the overall score of the simulation effectiveness was 17.4 out of 26.0. Communication skill (t=4.58, p=<.001) and self-confidence in maternity nursing (t=9.70, p=<.001) increased significantly in the posttest. On the other hand, there was no significant change in the problem solving ability. The simulation effectiveness correlated significantly with the problem solving ability (r=.494, p<.001), communication skill (r=.361, p<.001), and self-confidence in maternity nursing (r=.497, p<.001) after simulation-based education. These findings suggest that the high-fidelity simulation in maternity nursing education could be used not only to enhance the nursing competency, but also to deal with the limitations of the clinical practicum in the current situation.

Anti-inflammatory and antimicrobial effects of Jeju rosemary essential oil against skin flora (제주산 로즈마리 에센셜 오일의 항염 및 피부 상재균에 대한 항균 활성)

  • Kim, So-Hee;Yi, Mi-Ran;Kim, Chang-Soo;Kim, Jung-Mi;Bu, Hee-Jung
    • Journal of the Korean Applied Science and Technology
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    • 제35권3호
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    • pp.744-756
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    • 2018
  • The purpose of this study was to investigate the anti-inflammatory effect and the antimicrobial activity to skin flora of essential oil from rosemary that naturally grown in Jeju. rosemary essential oil was extracted by water distillation essential oil extraction method. In order to confirm the anti-inflammatory activity of rosemary essential oil, it was confirmed that the production of NO and $PGE_2$ induced by LPS in RAW 264.7 cells was inhibited in a concentration-dependent manner. Western blot analysis showed that the expression of iNOS and COX-2, which are biosynthetic enzymes, decreased in a concentration-dependent manner. In addition, production of $TNF-{\alpha}$ and IL-6 the pro-inflammatory cytokines were inhibited. Antimicrobial activities of three S. epidermidis and three P. acnes strains including two antibiotic resistant strains were observed in paper disc method and MIC and MBC tests showed inhibition of bacterial growth and death. From the results of the experiment, we confirmed that rosemary essential oil has the anti-inflammatory and antimicrobial efficacy and it could be used as a cosmetic and skin care material in the future.

Success of a Cervical Cancer Screening Program: Trends in Incidence in Songkhla, Southern Thailand, 1989-2010, and Prediction of Future Incidences to 2030

  • Sriplung, Hutcha;Singkham, Phathai;Iamsirithaworn, Sopon;Jiraphongsa, Chuleeporn;Bilheem, Surichai
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권22호
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    • pp.10003-10008
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    • 2014
  • Background: Cervical cancer has been a leading female cancer in Thailand for decades, and has been second to breast cancer after 2007. The Ministry of Public Health (MoPH) has provided opportunistic screening with Pap smears for more than 30 years. In 2002, the MoPH and the National Health Security Office provided countrywide systematic screening of cervical cancer to all Thai women aged 35-60 years under universal health care coverage insurance scheme at 5-year intervals. Objectives: This study characterized the cervical cancer incidence trends in Songkhla in southern Thailand using joinpoint and age period cohort (APC) analysis to observe the effect of cervical cancer screening activities in the past decades, and to project cervical cancer rates in the province, to 2030. Materials and Methods: Invasive and in situ cervical cancer cases were extracted from the Songkhla Cancer Registry from 1990 through 2010. Age standardized incidence rates were estimated. Trends in incidences were evaluated by joinpoint and APC regression models. The Norpred package was modified for R and was used to project the future trends to 2030 using the power of 5 function and cut trend method. Results: Cervical cancer incidence in Songkhla peaked around 1998-2000 and then dropped by -4.7% per year. APC analysis demonstrated that in situ tumors caused an increase in incidence in early ages, younger cohorts, and in later years of diagnosis. Conclusions: Both joinpoint and APC analysis give the same conclusion in continuation of a declining trend of cervical cancer to 2030 but with different rates and the predicted goal of ASR below 10 or even 5 per 100,000 women by 2030 would be achieved. Thus, maintenance and improvement of the screening program should be continued. Other population based cancer registries in Thailand should analyze their data to confirm the success of cervical cancer screening policy of Thailand.

Surgical Ligation on Significant Patent Ductus Arteriosus in Very Low Birth Weight Infants: Comparison between Early and Late Ligations

  • Lee, Jun Ho;Ro, Sun Kyun;Lee, Hyun Ju;Park, Hyun Kyung;Chung, Won-Sang;Kim, Young Hak;Kang, Jeong Ho;Kim, Hyuck
    • Journal of Chest Surgery
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    • 제47권5호
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    • pp.444-450
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    • 2014
  • Background: We aimed to evaluate the efficacy and safety of early surgical ligation (within 15 days of age) over late surgical ligation (after 15 days of age) by a comparative analysis of very low birth weight (VLBW) infants undergoing surgical correction for symptomatic patent ductus arteriosus (PDA) over the course of 6 years in our hospital. Methods: We retrospectively reviewed all the medical records in the neonatal intensive care unit at Hanyang University Seoul Hospital, from March 2007 to May 2013, to identify VLBW infants (<1,500 g) who underwent surgical PDA ligation. Results: The gestational age (GA) in the late ligation (LL) group was significantly younger than in the early ligation (EL) group (p=0.010). The other baseline characteristics and preoperative conditions did not differ significantly between the two groups. The intubation period before surgery (p<0.001) and the age at surgery (p<0.001) were significantly different. The postoperative clinical outcomes of the study patients, including major morbidity and mortality, are summarized. There were no significant differences in bronchopulmonary dysplasia, sepsis, or mortality between the EL and the LL groups. However, the LL group was significantly associated with an increased risk of necrotizing enterocolitis (p=0.037) and with a prolonged duration of the total parenteral nutrition (p=0.046) after adjusting for GA. Conclusion: Early surgical ligation for the treatment of PDA that failed to close after medical treatment or in cases contraindicated for medical treatment might be desirable to reduce the incidence of necrotizing enterocolitis and to alleviate feeding intolerance in preterm infants.