• Title/Summary/Keyword: Clinical morbidity

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An interesting case of survival to multiple ruptures of aneurysms, with persistent trigeminal artery, cranial nerve deficit, and evolutionary exposure of neurovascular treatment

  • Hector Lezcano;Maria Fernanda Solorzano
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.2
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    • pp.189-195
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    • 2023
  • Subarachnoid hemorrhage secondary to rupture of an aneurysm is a severe condition, associated with a high rate of morbidity and mortality. There are few cases in the literature of rupture of an aneurysm of the persistent trigeminal artery. This is the case of a 62-year-old female who has suffered multiple ruptures of aneurysms, in different decades of her life, with the development of de novo aneurysm, been this the presented case, a rupture of aneurysm of the persistent trigeminal artery. This patient has survival to these conditions and remain without important morbidity. The case manifested with a clinical picture of third and seventh cranial nerve deficit, which this last one, there are not previous publications of cases with this deficit. This aneurysm was embolized with coils, and the postoperative condition was satisfactory, been discharged at 4 postoperative days.

Causal Attributions, Social Support and Psychological Morbidity in Patients Undergoing Thyroid Surgery

  • Yildirim, Nazmiye Kocaman;Ozcinar, Beyza;Dogan, Selim;Aksakal, Nihat;Sahbaz, Nuri Alper;Tutal, Firat;Torun, Bahar Canday;Ozkan, Mine;Erbil, Yesim
    • Journal of Endocrine Surgery
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    • v.18 no.4
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    • pp.219-227
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    • 2018
  • Purpose: The primary objective of the present study was to investigate the course of anxiety and depression in thyroidectomy. The second objective was to investigate the association between somatic symptoms and psychological symptoms, and the final objective was to identify the sociodemographic, clinical, and psychosocial factors that affect psychiatric morbidity. Methods: This prospective study, 101 patients who were admitted to the Endocrine Surgery Clinic of the Department of General Surgery, Istanbul Faculty of Medicine, University of Istanbul, with thyroid pathology were included in the study. Data were collected before surgery, and in the early, and late periods after surgery. Data were collected using a semi-structured interview form, a visual analogue scale, and the Hospital Anxiety and Depression Scale. Results: The average scores of anxiety and depression before surgery were statistically significantly higher compared with the early and late periods after surgery (P<0.001). Psychological morbidity was identified about 10% of patients before surgery and remained after thyroidectomy. A poor positive correlation founded between somatic symptoms and psychological condition in period surgery (P<0.05). Various sociodemographic features and psychosocial parameters affected anxiety and depression level (P<0.05). Conclusion: Anxiety and depression level in thyroid diseases decreased after thyroidectomy. These patients may express psychologic distress through somatic symptoms. Screening of psychological morbidity is suggested in patients planned thyroid surgery, especially in women, low-educated, inadequate social support, attributed to psychological causes.

Association between vitamin D level at birth and respiratory morbidities in very-low-birth-weight infants

  • Kim, Ian;Kim, Sung Shin;Song, Jee In;Yoon, Seock Hwa;Park, Ga Young;Lee, Yong-Wha
    • Clinical and Experimental Pediatrics
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    • v.62 no.5
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    • pp.166-172
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    • 2019
  • Purpose: This study aimed to evaluate vitamin D status at birth in very-low-birth-weight infants (VLBWIs: <1,500 g) and to determine the association between vitamin D level and respiratory morbidity. Methods: A retrospective study was conducted at Soonchunhyang University Bucheon Hospital between November 2013 and November 2017. We collected blood samples and data on respiratory morbidity from 230 VLBWIs on the first day of life. Patients who were transferred to other hospitals (n=19), died before 36 weeks of gestational age (n=18), or whose blood samples were not collected immediately after birth (n=5) were excluded. Finally, 188 patients were enrolled. VLBWIs with different vitamin D levels were compared with respect to demographic features, maternal diseases, respiratory morbidities, and other neonatal diseases. Results: The mean serum vitamin D level, as measured by 25-hydroxyvitamin D (25(OH)D), was $13.4{\pm}9.3ng/mL$. The incidence of vitamin D deficiency (<20 ng/mL) was 79.8%, and 44.1% of preterm infants had severe vitamin D deficiency (<10 ng/mL). Logistic analysis shows that a low serum 25(OH)D level (<20 ng/mL) was a risk factor for respiratory distress syndrome (odds ratio [OR], 4.32; P=0.010) and bronchopulmonary dysplasia (OR, 4.11; P=0.035). Conclusion: The results showed that 79.8% of preterm infants in this study had vitamin D deficiency at birth. Low vitamin D status was associated with respiratory morbidity, but the exact mechanism was unknown. Additional studies on the association between vitamin D level and neonatal morbidity are required.

Urinary Biomarkers for the Noninvasive Detection of Gastric Cancer

  • Li, Dehong;Yan, Li;Lin, Fugui;Yuan, Xiumei;Yang, Xingwen;Yang, Xiaoyan;Wei, Lianhua;Yang, Yang;Lu, Yan
    • Journal of Gastric Cancer
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    • v.22 no.4
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    • pp.306-318
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    • 2022
  • Gastric cancer (GC) is associated with high morbidity and mortality rates. Thus, early diagnosis is important to improve disease prognosis. Endoscopic assessment represents the most reliable imaging method for GC diagnosis; however, it is semi-invasive and costly and heavily depends on the skills of the endoscopist, which limit its clinical applicability. Therefore, the search for new sensitive biomarkers for the early detection of GC using noninvasive sampling collection methods has attracted much attention among scientists. Urine is considered an ideal biofluid, as it is readily accessible, less complex, and relatively stable than plasma and serum. Over the years, substantial progress has been made in screening for potential urinary biomarkers for GC. This review explores the possible applications and limitations of urinary biomarkers in GC detection and diagnosis.

Development of a Pharmaceutical Care Service Model for Patients with Diabetes in Ambulatory Care Settings (외래환자 대상 당뇨병 약료서비스 모델 개발)

  • Yoon, Jeong-Hyun
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.1
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    • pp.1-8
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    • 2017
  • The prevalence of diabetes and its related morbidity and mortality are being increased. Despite the advancement of evidence-based pharmacotherapy in the management of diabetes, many patients in our country do not achieve satisfied therapeutic outcomes. Pharmaceutical care service can be defined as a patient-centered clinical service provided by pharmacists to improve therapeutic outcomes and quality of life of patients, by identifying, and preventing or resolving drug-related problems (DRPs). Pharmaceutical care service is interdisciplinary team-based practice, and is provided through collaborative practice agreement (CPA) between one or more physicians and pharmacists. This article describes a model of pharmaceutical care service which can be adopted in our country for patients with diabetes in the ambulatory care settings. With the successful implementation of this service, clinical, economic, and humanistic outcomes of patients will be improved. Therefore, by actively implementing pharmaceutical care service, pharmacist should contribute to the promotion of patients' health and to the advancement of health care delivery system.

Clinical presentations of critical cardiac defects in the newborn: Decision making and initial management

  • Lee, Jae-Young
    • Clinical and Experimental Pediatrics
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    • v.53 no.6
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    • pp.669-679
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    • 2010
  • The risk of mortality and morbidity of patients with congenital heart defects (CHDs) is highest during neonatal period and increases when diagnosis and proper management are delayed. Neonates with critical CHDs may present with severe cyanosis, respiratory distress, shock, or collapse, all of which are also frequent clinical presentations of various respiratory problems or sepsis in the newborn. Early diagnosis and stabilization and timely referral to a tertiary cardiac center are crucial to improve the outcomes in neonates with CHDs. In this review, the clinical presentation of critical and potentially life-threatening CHDs is discussed along with brief case reviews to help understand the hemodynamics of these defects and ensure proper decision-making in critically ill patients.

Pediatric Stroke

  • Jeong, Goun;Lim, Byung Chan;Chae, Jong-Hee
    • Journal of Korean Neurosurgical Society
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    • v.57 no.6
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    • pp.396-400
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    • 2015
  • Pediatric stroke is relatively rare but may lead to significant morbidity and mortality. Along with the advance of brain imaging technology and clinical awareness, diagnosis of pediatric stroke is increasing wordwide. Pediatric stroke differs from adults in variable risk factor/etiologies, diverse and nonspecific clinical presentation depending on ages. This review will be discussed pediatric stroke focusing on their clinical presentations, diagnosis and etiologies/risk factors.

Neonatal arrhythmias: diagnosis, treatment, and clinical outcome

  • Ban, Ji-Eun
    • Clinical and Experimental Pediatrics
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    • v.60 no.11
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    • pp.344-352
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    • 2017
  • Arrhythmias in the neonatal period are not uncommon, and may occur in neonates with a normal heart or in those with structural heart disease. Neonatal arrhythmias are classified as either benign or nonbenign. Benign arrhythmias include sinus arrhythmia, premature atrial contraction, premature ventricular contraction, and junctional rhythm; these arrhythmias have no clinical significance and do not need therapy. Supraventricular tachycardia, ventricular tachycardia, atrioventricular conduction abnormalities, and genetic arrhythmia such as congenital long-QT syndrome are classified as nonbenign arrhythmias. Although most neonatal arrhythmias are asymptomatic and rarely life-threatening, the prognosis depends on the early recognition and proper management of the condition in some serious cases. Precise diagnosis with risk stratification of patients with nonbenign neonatal arrhythmia is needed to reduce morbidity and mortality. In this article, I review the current understanding of the common clinical presentation, etiology, natural history, and management of neonatal arrhythmias in the absence of an underlying congenital heart disease.

Conservative surgical approach to aggressive benign odontogenic neoplasm: a report of three cases

  • Kumar, Vijay
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.1
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    • pp.37-42
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    • 2015
  • Aggressive benign odontogenic neoplasms have substantial potential to grow to an enormous size with resulting bone deformities, and they often invade adjacent tissues and spread beyond their normal clinical and radiographic margins; as such, they have a high rate of recurrence. Historically, management (conservative versus aggressive) on the basis of clinical, radiographic and/or histopathologic characteristics has been controversial. However, recent advances in the understanding of the biological features of these lesions may provide greater evidence of the benefits of conservative management. Three patients with different complaints and final histopathologic diagnoses were enrolled in the study. All three cases were treated by a single operator with similar conservative surgical procedures. During follow-up, the patients had uneventful secondary healing and bone regeneration, less packing time than previously reported, no clinical or radiographic evidence of recurrence and no apparent deformity. The aggressive behavior of these lesions requires long clinical and radiographic follow-up. Conservative surgical management may be an option to reduce recurrence and morbidity and increase the probability of uneventful secondary healing and bone regeneration.

Clinical Manifestation Patterns and Trends in Poststreptococcal Glomerulonephritis

  • Kim, Kee Hyuck
    • Childhood Kidney Diseases
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    • v.20 no.1
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    • pp.6-10
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    • 2016
  • Poststreptococcal glomerulonephritis (PSGN) is one of the most recognized diseases in pediatric nephrology. Typical clinical features include rapid onset of gross hematuria, edema, and hypertension, and cases are typically preceded by an episode of group A ${\beta}$-hemolytic streptococcus pharyngitis or pyoderma. The most common presenting symptoms of PSGN are the classic triad of glomerulonephritis: gross hematuria, edema, and hypertension. However, patients with PSGN sometimes present with unusual or atypical clinical symptoms that often lead to delayed diagnosis or misdiagnosis of the disease and increased morbidity. Additionally, the epidemiology of postinfectious glomerulonephritis (PIGN), including PSGN, has changed over the past few decades. This paper reviews atypical clinical manifestations of PSGN and discusses the changing demographics of PIGN with a focus on PSGN.