• 제목/요약/키워드: Concerns of Pain Management

검색결과 29건 처리시간 0.023초

Management of hyperthyroid patients in dental emergencies: a case report

  • Lee, Kyung-Jin;Park, Wonse;Pang, Nan-Sim;Cho, Jin-Hyung;Kim, Kee-Deog;Jung, Bock Young;Kwak, Eun-Jung
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제16권2호
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    • pp.147-150
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    • 2016
  • The prevalence of thyroid disease, particularly hyperthyroidism, has rapidly increased in Korea in the past 10 years. Therefore, it is important to consider the complete medical history including thyroid disease in patients under dental treatment. Both the drugs used for dental treatment and psychological symptoms associated with treatment can induce emergencies in hyperthyroid patients. This case report considers emergency situations during dental treatment for hyperthyroid patients, and discusses risk factors and related concerns.

Full mouth rehabilitation of a patient with Sturge-Weber syndrome using a mixture of general and sedative anesthesia

  • Doh, Re-Mee;Yu, Tae-min;Park, Wonse;Kim, Seungoh
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제15권3호
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    • pp.173-179
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    • 2015
  • Issues related to the control of seizures and bleeding, as well as behavioral management due to mental retardation, render dental treatment less accessible or impossible for patients with Sturge-Weber syndrome (SWS). A 41-year-old man with SWS visited a dental clinic for rehabilitation of missing dentition. A bilateral port-wine facial nevus and intraoral hemangiomatous swollen lesion of the left maxillary and mandibular gingivae, mucosa, and lips were noted. The patient exhibited extreme anxiety immediately after injection of a local anesthetic and required various dental treatments to be performed over multiple visits. Therefore, full-mouth rehabilitation over two visits with general anesthesia and two visits with target-controlled intravenous infusion of a sedative anesthesia were planned. Despite concerns regarding seizure control, bleeding control, and airway management, no specific complications occurred during the treatments, and the patient was satisfied with the results.

Clinical Prognostic Factors and Survival Outcome in Renal Cell Carcinoma Patients - A Malaysian Single Centre Perspective

  • Yap, Ning Yi;Ng, Keng Lim;Ong, Teng Aik;Pailoor, Jayalakshmi;Gobe, Glenda Carolyn;Ooi, Chong Chien;Razack, Azed Hassan;Dublin, Norman;Morais, Christudas;Rajandram, Retnagowri
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권12호
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    • pp.7497-7500
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    • 2013
  • Background: This study concerns clinical characteristics and survival of renal cell carcinoma (RCC) patients in University Malaya Medical Centre (UMMC), as well as the prognostic significance of presenting symptoms. Materials and Methods: The clinical characteristics, presenting symptoms and survival of RCC patients (n=151) treated at UMMC from 2003-2012 were analysed. Symptoms evaluated were macrohaematuria, flank pain, palpable abdominal mass, fever, lethargy, loss of weight, anaemia, elevated ALP, hypoalbuminemia and thrombocytosis. Univariate and multivariate Cox regression analyses were performed to determine the prognostic significance of these presenting symptoms. Kaplan Meier and log rank tests were employed for survival analysis. Results: The 2002 TNM staging was a prognostic factor (p<0.001) but Fuhrman grading was not significantly correlated with survival (p=0.088). At presentation, 76.8% of the patients were symptomatic. Generally, symptomatic tumours had a worse survival prognosis compared to asymptomatic cases (p=0.009; HR 4.74). All symptoms significantly affect disease specific survival except frank haematuria and loin pain on univariate Cox regression analysis. On multivariate analysis adjusted for stage, only clinically palpable abdominal mass remained statistically significant (p=0.027). The mean tumour size of palpable abdominal masses, $9.5{\pm}4.3cm$, was larger than non palpable masses, $5.3{\pm}2.7cm$ (p<0.001). Conclusions: This is the first report which includes survival information of RCC patients from Malaysia. Here the TNM stage and a palpable abdominal mass were independent predictors for survival. Further investigations using a multicentre cohort to analyse mortality and survival rates may aid in improving management of these patients.

중년여성의 갱년기 증상과 건강요구에 대한 기초조사 (A study on menopausal symptoms and health needs among middle aged women.)

  • 차영남;장효순;김금자;한혜실;임혜경;정영해
    • 대한간호
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    • 제34권4호
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    • pp.70-82
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    • 1995
  • During the middle age of a woman's life cycle. several health changes and problems occur. Therefore. middle aged women must manage their health and maintain quality life by coping with bodily changes. However. today there is not enough research and health programs for middle aged women. Data from the study will be used for health promotion program development of middle aged women. Data was collected from January 21 to 24. 1995 by telephone interview. Four hundred middle aged women between 40 and 59 years old and living in Chon Ju City were interviewed. The results of this study were as follow: 1. Frequency rate of menopausal symptoms was 38.4%. The most serious menopausal symptom was psychosomatic symptom. Mean score orders of experienced symptoms were back pain, joint pain(1.80). nervousness(1.80). general weakness(1.67). 2. The most important problems as perceived by the clients were children(45.8%), health (24.0%) and economics(7.8%). The most serious health problems were concerning the muscle-skeletal system(45%) such as arthritis. spinal disk problems and osteoporosis. Adult diseases04.S%) such .as hypertension and diabetes were also health concerns. Health management activities reported were exercise(22.5%), social activity02%) and inactivity(53%)' 33% of clients were interested in health groups and they wanted a program of health education, exercise and social activity to be provided. 3. General characteristic variables were significantly related to the level of menopausal symptoms as follows: age(t=-2.06, p=0.040), status of marriage(t=-3.56, p=0.000), educational level (F=4.35. p=0.05) and menopausal status(t=4.37, p=0.000).

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경북 북부지역에서 물리치료를 받는 만성 근골격계 질환을 가진 외래 환자의 만족도 조사 (Survey on Satisfaction of Outpatients with Chronic Musculoskeletal Pain Using Physical Therapy in North Gyeong-buk)

  • 김진섭
    • 디지털융복합연구
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    • 제11권6호
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    • pp.205-212
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    • 2013
  • 본 연구의 목적은 경북 북부 지역의 만성 근골격계 환자의 의료서비스 만족도에 영향을 미치는 요인을 분석하기 위해 시행되었다. 경북 북부 지역의 병원을 방문한 107명의 만성 근골격계 환자가 본 연구대상이다. 2012년 5월 7일부터 6월 6일 설문 조사로 자료를 수집했다. 수집 된 자료는 다중회귀분석을 통해 분석했다. 본 연구의 주된 연구결과는 다음과 같다. 만성 근골격계 환자의 만족도를 결정하는 요인은 "물리치료사의 설명", "접수 절차", "가정운동프로그램", "직원들의 정중성", "환자의 의견에 귀 기울임" 이었다. 만성 근골격계 환자의 재이용과 강하게 관련된 요인은 "물리치료사의 설명", "접수 절차", "최신 장비"였다. 따라서 "물리치료사의 설명", "접수 절차", "직원들의 정중성", "환자의 의견에 귀 기울임", "최신장비", "가정운동프로그램"의 질적 향상은 병원에서 매우 중요한 요인임을 시사한다. 또한, 본 연구의 결과는 병원에서 만성 근골격계 환자에 대한 만족도를 향상시키는데 기여 할 것이다.

암환자의 신약개발 임상시험 참여 경험 (Experience of Patients with Cancer Participating in a Clinical Trial for the Development of a New Drug)

  • 김현영
    • 종양간호연구
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    • 제6권2호
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    • pp.121-132
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    • 2006
  • Purpose: The purpose of this study was to describe the lived experience of the patients with cancer participating in a clinical trial for the development of a new drug. Method: This study was based on a phenomenological approach. The eight patients participating in a clinical trial were selected as the participations of this study. The data were obtained through in-depth interviews from the participants and were analyzed using the Giorgi method. Results: Essential experiences of the patients with cancer under a clinical trial consisted of anticipating recovery of physical health and a social role, passing the strict criteria of a clinical trial, diminishing economic burden, satisfaction with special treatment receiving, social contribution, concerns about side effects and withdrawal from the clinical trial, conflicts as a participant, pain, limited administration of other treatments, regret for giving up other treatments, strict compliance with instructions, prevention of side effects and maintaining desirable life-style. Integrated units of meaning of these components were hope, good luck, a sense of satisfaction, fear, distress, and the will of self-control. Conclusion: The most essential meaning of the cancer patients participating in a clinical trial was hope. Hope was found to be a primary factor reinforcing the will of self-management. The results of this study can be of great help to the research nurses to understand the lived experience of the patients with cancer and to plan an effective nursing intervention for the patients.

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Pelizaeus-Merzbacher 병 환자의 외래전신마취 하 치과치료 -증례보고- (Dental Treatment of a Patient with Pelizaeus-Merzbacher Disease under Outpatient General Anesthesia -A Case Report-)

  • 김태경;신차욱;김현정;염광원;서광석
    • 대한치과마취과학회지
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    • 제7권1호
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    • pp.18-21
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    • 2007
  • Pelizaeus-Merzbacher disease (PMD) can be defined as an X-linked recessive leukodystrophy that is caused by a mutation in the proteolipid protein gene on chromosome Xq22. PMD is one of a group of progressive, degenerative disorders of the cerebral white matter known as the leukodystrophies. Due to the progressive nature of the disorders and their devastating effects on the central nervous system, these children frequently require anesthesia during imaging procedures such as MRI or during various surgical procedures. Anesthetic concerns in theses cases include high prevalence of seizure disorders, gastroesophageal reflux with the risk of aspiration, airway complications related to poor pharyngeal muscle control and copious oral secretions, and mental retardation. We report a successful anesthetic management in a patient with PMD for dental procedures.

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수혈 감소 전략을 위한 점탄성 응고 검사법의 유용성 (Viscoelastic Coagulation Test Guided Therapy for a Strategy to Reduce Transfusions)

  • 박선영
    • 대한수혈학회지
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    • 제29권3호
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    • pp.240-252
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    • 2018
  • 점탄성 응고 검사법은 전혈 검사법으로 혈장성분뿐 아니라 응고 과정의 세포 기반 측면까지 동시에 볼 수 있는 방법이다. 프로트롬빈시간이나 활성화부분트롬보플라스틴시간과 같은 기존의 응고 검사법과 달리 이 검사는 현장 현시 검사로 즉시 시행할 수 있다. 점탄성 응고 검사법은 사망률 등의 예후 예측 인자이고, 응고 장애를 좀 더 예민하게 감지하여 결과적으로 출혈을 줄여주는 효과를 줄 수 있다. 점탄성 응고 검사 결과를 이용한 수혈 전략이 수혈 요구량을 줄여주었다고 보고되기도 하였다. 아직 이 방법의 정확성과 신뢰도에 대한 우려가 있기도 하지만, ROTEM 등의 점탄성 응고 검사법은 환자혈액관리에 응용하는 것은 유용할 것이다.

중·고령 초기 유방암 생존자를 돌보는 가족의 경험 (Family Members' Caregiving Experience for Middle-aged and Elderly Breast Cancer Survivors at Early Stages)

  • 박소영;박향경;구향나;백정연;노은정
    • 한국노년학
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    • 제40권1호
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    • pp.111-130
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    • 2020
  • 본 연구는 중·고령 초기 유방암 생존자를 위한 가족들의 돌봄 경험에 대해 이해하고자 한 질적 연구이다. 총 4명의 유방암 생존자 가족들을 대상으로 초점집단면접(FGI)을 실시하였고 추가로 1명의 가족에 대해 개별심층면접을 실시하였다. 초점집단면접과 개별심층면접 내용을 주제 분석한 결과, 다음 4가지 주제가 나타났다: 첫째, 살얼음 위를 걷는 듯한 일상의 감정들 (치료시기마다 서로 뒤얽히는 감정들, 생존자의 고통을 지켜볼 수밖에 없는 안타까움, 암 재발과 죽음에 대한 두려움, 관계 변화에 대한 걱정, 딸로서 겪는 다양한 감정), 둘째, 생활의 중심이 된 돌봄 (낯설고 서툴렀던 돌봄, 내 생활을 잃어감), 셋째, 회복의 시작, 생존자와 가족이 느끼는 온도 차이 (생존자가 느끼는 심연의 고통을 헤아리지 못함, 생존자가 아직 환자라는 사실을 잊고 소홀히 대함), 넷째, 앞으로 나아가기 (나아질 것이라는 희망, 지치지 않기 위한 나를 위한 돌봄). 본 연구 결과를 토대로 유방암 생존자 가족의 심리사회적 욕구를 반영하고 돌봄 과정에서 가족 지지를 지원하기 위한 사회복지서비스 및 정책 방안에 대해 제언하였다.