• Title/Summary/Keyword: Disease intervention

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Congenital heart disease in the newborn requiring early intervention

  • Yun, Sin-Weon
    • Clinical and Experimental Pediatrics
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    • v.54 no.5
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    • pp.183-191
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    • 2011
  • Although antenatal diagnostic technique has considerably improved, precise detection and proper management of the neonate with congenital heart disease (CHD) is always a great concern to pediatricians. Congenital cardiac malformations vary from benign to serious conditions such as complete transposition of the great arteries (TGA), critical pulmonary and aortic valvular stenosis/atresia, hypoplastic left heart syndrome (HLHS), obstructed total anomalous pulmonary venous return (TAPVR), which the baby needs immediate diagnosis and management for survival. Unfortunately, these life threatening heart diseases may not have obvious evidence early after birth, most of the clinical and physical findings are nonspecific and vague, which makes the diagnosis difficult. High index of suspicion and astute acumen are essential to decision making. When patent ductus arteriosus (PDA) is opened Widely, many serious malformations may not be noticed easily in the early life, but would progress as severe acidosis/shock/cyanosis or even death as PDA constricts after few hours to days. Ductus dependent congenital cardiac lesions can be divided into the ductus dependent systemic or pulmonary disease, but physiologically quite different from each other and treatment strategy has to be tailored to the clinical status and cardiac malformations. Inevitably early presentation is often regarded as a medical emergency. Differential diagnosis with inborn error metabolic disorders, neonatal sepsis, persistent pulmonary hypertension of the newborn (PPHN) and other pulmonary conditions are necessary. Urgent identification of the newborn at such high risk requires timely referral to a pediatric cardiologist, and timely intervention is the key in reducing mortality and morbidity. This following review deals with the clinical presentations, investigative modalities and approach to management of congenital cardiac malformations presenting in the early life.

Congenital Cystic Adenomatoid Malformation of The Lung - A Case Report - (선천성 낭포성 선양기종: 1례 보고)

  • 김명인
    • Journal of Chest Surgery
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    • v.24 no.8
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    • pp.819-823
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    • 1991
  • The congenital cystic adenomatoid malformation of the lung is a rare disease, and is one of the most common congenital lung diseases which require prompt surgical intervention. The prognosis depends on its tissue type, prompt diagnosis and surgical intervention. The lesion consists of enlarged, variable sized multiple cyst with overgrowth of terminal bronchioles, like hamartoma. This disease can be associated with other vascular anomalies or other congenital defect especially in type II lesion We recently experienced one case of congenital cystic adenomatoid malformation The patient was 2 months old infant who showed respiratory distress without associated anomaly. After right upper lobe lobectomy, the patient was recovered uneventfully.

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Predicting Employment Status of Injured Workers Following a Case Management Intervention

  • Awang, Halimah;Mansor, Norma
    • Safety and Health at Work
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    • v.9 no.3
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    • pp.347-351
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    • 2018
  • Background: The success of an injury intervention program can be measured by the proportion of successful return to work (RTW). This study examined factors of successful return to employment among workers suffering from work-related injuries. Methods: Data were obtained from the Social Security Organization, Malaysia database consisting of 10,049 RTW program participants in 2010-2014. The dependent variable was the RTW outcome which consisted of RTW with same employer, RTW with new employer or unsuccessful return. Multinomial logistic regression was performed to test the likelihood of successful return with same employer and new employer against unsuccessful return. Results: Overall, 65.3% of injured workers were successfully returned to employment, 52.8% to the same employer and 12.5% to new employer. Employer interest; motivation; age 30-49 years; intervention less than 9 months; occupational disease; injuries in the lower limbs, upper limbs, and general injuries; and working in the manufacturing, services, and electrical/electronics were associated with returning to work with the same employer against unsuccessful return. Male, employer interest, motivation, age 49 years or younger, intervention less than 6 months, occupational disease, injuries in the upper limbs and services sector of employment were associated with returning to new employer against unsuccessful return. Conclusion: There is a need to strengthen employer commitment for early and intensified intervention that will lead to improvement in the RTW outcome.

Brachytherapy in Coronary Artery Disease (관상동맥질환의 방사성동위원소 치료)

  • Song, Ho-Chun
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.2
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    • pp.113-119
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    • 2006
  • Coronary artery disease is a loading cause of morbidity and mortality across the world. Percutaneous coronary intervention has become the major technique of revascularization. However, restenosis remains a major limitation of this procedure. Recently the need for repeat intervention due to restenosis, the most vexing long-term failure of percutaneous coronary intervention, has been significantly reduced owing to the introduction of two major advances, intracoronary brachytherapy and the drug-eluting stents. Intracoronary brachytherapy has been employed in recent years to prevent restenosis lesions with effective results, principally in in-stent restenosis. Restenosis is generally considered as au excessive form of normal wound healing divided up in precesses: elastic recoil, neointimal hyperplasia, and negative vascular remodeling. Restenosis has previously been regarded as a proliferative process in which neointimal thickening, mediated by a cascade of inflammatory mediators and other factors, is the key factor. Ionizing radiation has been shown to decrease the proliferative response to injury in animal models of restenosis. Subsequently, several randomized, double blind trials have demonstrated that intracoronary brachytherapy can reduce the rates of both angiographic restenosis and clinical event rates in patients undergoing percutaneous coronary intervention for in stent restenosis. Some problems, such as late thrombosis and edge restenosis, have been identified as limiting factors of this technique. Brachytherapy is a promising method of preventing and treating coronary artery restenosis.

Congenital web of the common bile duct combined with multiple intrahepatic duct stricture: a case report of successful radiological intervention

  • Lim, Hanseul;Hwang, Shin;Ko, Gi-Young;Han, Hyejin
    • Journal of Yeungnam Medical Science
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    • v.39 no.2
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    • pp.161-167
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    • 2022
  • Congenital web formations are extremely rare anomalies of the extrahepatic biliary tree. We herein report a case of common bile duct septum combined with multiple intrahepatic bile duct strictures in a 74-year-old female patient who was successfully treated with radiological intervention. The patient initially visited the hospital because of upper abdominal pain. Imaging studies revealed multifocal strictures with dilatation in both intra- and extrahepatic ducts; the final clinical diagnosis was congenital common bile duct web combined with multiple intrahepatic duct strictures. Surgical treatment was not indicated because multiple biliary strictures were untreatable, and the disease was clinically diagnosed as benign. The multiple strictures were extensively dilated twice through bilateral percutaneous transhepatic biliary drainage (PTBD) for 2 months. After 1 month of observation, PTBD catheters were successfully removed. The patient is doing well at 6 months after completion of the radiological intervention, with the maintenance of normal liver function. Congenital web of the bile duct is very rare, and its treatment may vary depending on the patterns of biliary stenosis. In cases where surgical intervention is not indicated for congenital web and its associated disease, radiological intervention with balloon dilatation can be a viable therapeutic option.

Effects of a Nurse Presence Program on Suicide Prevention for Elders with a Chronic Disease (간호사의 함께있음 프로그램이 만성질환 노인의 자살예방에 미치는 효과)

  • Jo, Kae-Hwa
    • Journal of Korean Academy of Nursing
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    • v.37 no.7
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    • pp.1027-1038
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    • 2007
  • Purpose: The purpose of this study was to identify the effects of a nurse presence program on suicide prevention for elders with chronic disease. Method: The subjects were recruited from two different elderly institutions located in D city and K province, Korea. Twenty subjects in the control group received no intervention and nineteen subjects in the experimental group received a nurse presence program. Result: There were more significant decreases in suicide ideation, and the cortisol level and increases in life satisfaction in the experimental group compared to the control group. Conclusion: According to the above results, a nurse presence program for elders with a chronic disease decreased stressful events like suicide ideation and increased self esteem through therapeutic interaction. These findings suggest that this program can be used as an efficient independent nursing intervention for elders in a critical situation.

Clinical Feasibility of Mental Practice for Gait Ability Improvement of Parkinson Disease Patients: ABA Single Subject Design

  • Song, Hyun Seung;Kim, Jin Young
    • The Journal of Korean Physical Therapy
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    • v.26 no.6
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    • pp.398-402
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    • 2014
  • Purpose: This study was carried out in order to verify actual applicability of mental practice in the clinical field by applying it to Parkinson disease patients. Methods: : The number of subjects was three and they were aged between 65 and 69. One year or longer period has passed since they were diagnosed with Parkinson disease. The baseline A consisted of three sessions. After the baseline period, the researcher applied mental practice to the subjects once per day, for 20 minutes per each time, for 10 sessions. The no-intervention withdrawal phase was composed of three sessions. Outcome measures 10 meter walking test(10MWT), timed up and go (TUG) test, 8-figure walk test (8FWT). Results: All results indicated that 10 MWT, TUG, F8WT was improved when compared mental practice(B) to pre base line(A). base line(A) after mental practice intervention(B) was also sustained. Conclusion: As a result of the mental practice, we can know that it helps straight gait, dynamic balance, curved gait to improve.

Intractable Coronary Spasm Requiring Percutaneous Coronary Intervention after Coronary Artery Bypass Grafting in a Patient with Moyamoya Disease

  • Kim, Hyeon A;Kim, Young Su;Kim, Wook Sung
    • Journal of Chest Surgery
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    • v.54 no.2
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    • pp.150-153
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    • 2021
  • Moyamoya disease (MMD) is characterized by progressive steno-occlusive lesions of the distal or proximal branch of the internal carotid arteries, and cerebrovascular symptoms are its major complications. Extracranial vascular involvement including the coronary artery has been reported, and some case reports have described variant angina or myocardial infarction. However, no report has yet described a case of myocardial infarction after coronary artery bypass grafting (CABG). Here, we present a patient with MMD who suffered cardiac arrest caused by myocardial infarction due to a coronary spasm after offpump CABG and who was discharged successfully after treatment with a veno-arterial extracorporeal membrane oxygenator and percutaneous coronary intervention.

Effectiveness of Nutrition Intervention : Systematic Review & Meta-Analysis (임상영양서비스의 효과성 평가 : 체계적 검토와 메타분석을 통하여)

  • 이해영;김현아;양일선;남정모;박은철
    • Korean Journal of Community Nutrition
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    • v.9 no.1
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    • pp.81-89
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    • 2004
  • A systematic review and meta-analysis of the literatures was conducted to evaluate the effectiveness of nutrition intervention by dietitian. The 31 studies that were all randomized controlled trials, were identified from computerized search of published researches on MEDLINE, Embase database until January, 2003 and review of reference lists. The main search terms were the combination “dietitian”, “dietary intervention”, “nutrition intervention” or “nutritional intervention” and “effectiveness”. The subgroup analysis was performed by the publication year, quality score, type of disease, content of intervention, intervention provider, type of intervention (nutritional counseling and education/nutrilion counseling and education + diet modification), method of intervention (individual/group/individual + group) and follow-up period. Two reviewers independently selected trials for inclusion, assessed the quality and extracted the data. The meta-analysis of 31 studies based on the random effect model showed that the medical nutrition therapy was significantly effective in treating the diseases (effect size 0.1715 : 95% confidence interval 0.0938-0.2491). This study showed the clear evidence of the effectiveness of nutrition intervention through the meta-analysis. So the nutrition intervention by dietitian should be recommended and recognized as the effective therapy of treating the diseases. Also the nutrition intervention should be conducted regularly to maintain the effectiveness of the nutrition intervention. The nutrition intervention was significantly effective in treating the diseases on the random effect model (effect size 0.1715 : 95% confidence interval 0.0938-0.2491).

A Comparison of the Voice Differences of Patients with Idiopathic Parkinson's Disease and a Normal-Aging Group (파킨슨병 환자와 정상 노인의 음성비교)

  • Kang, Young-Ae;Kim, Yong-Duk;Ban, Jae-Chun;Seong, Cheol-Jae
    • Phonetics and Speech Sciences
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    • v.1 no.1
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    • pp.99-107
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    • 2009
  • In view of the hypothesis that the effects of Parkinson disease on voice production can be detected before pharmacological intervention, the voice differences of patients with Idiopathic Parkinson's disease and a healthy aging group were diagnostically analyzed with the long term object of establishing, for clinical purposes, early disease-progression biomarkers. Fifteen patients with Idopathic Parkinson's disease (prior to pharmacological intervention) and a healthy control group of 15 were selected and every voice was recorded three times using praat (ver. 5022) with a headset mic. Relevant parameters - acoustic measure of /a/ phonation, F0 related parameters, MPT related parameters, articulatory ratio, VOT - were then analyzed by MANOVA. Significant differences were found in the F0 related (low F0, high F0, F0 range) and MPT related parameters. There were also significant differences in acoustic measurements (intensity, shimmer, HNR, jitter), AMR (/$t{\Lambda}$/,/$k{\Lambda}$/) and VOT (/ta/), The findings indicated that the voice production of patients with Idiopathic Parkinson's disease have normal pitch but bad quality. In particular, with slow articulatory ratios and VOT values, the tongue tip functioning of patients was lower than for the healthy group.

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