• Title/Summary/Keyword: Early Fatality

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Awareness and Practices Regarding Breast and Cervical Cancer among Turkish Women in Gazientep

  • Karadag, Gulendam;Gungormus, Zeynep;Surucu, Ramazan;Savas, Esen;Bicer, Fulya
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.3
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    • pp.1093-1098
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    • 2014
  • Background: Cancer is a major public health problem both in our country and worldwide due to its disease burden, fatality and tendency for increased incidence. In Turkey, breast cancer ranks first with an incidence of 41.6% and cervical cancer is the tenth most common cancer with an incidence of 4.4%. Objectives and Design: This descriptive, cross-sectional study was conducted with 240 women aged from 15 to 65 years admitted to a gynecology-obstetrics outpatient clinic of a private hospital in Gaziantep. Study data were collected by the investigators through a 36-item questionnaire form which was generated using information gathered from similar surveys in the literature. Results: It was determined that 34.6% of women were high-school graduates, and 64.2% had a medium income level. The majority (79.2%) stated that they never performed BSE and 49.5% of them said that they did not know how to do it. Some 79.2% did not know what a Pap smear was and 73.3% had not experienced a smear test ever. Conclusions: In this study, we found that most of the women had insufficient knowledge of breast and cervical cancer, while knowledge and practices increased with the education level. Based on these findings, we suggest that there is a need for planning, implementation and assessment of health policies and healthcare services at the national and regional level and we believe that nurses working in the field of protective health services should develop educational programmes for women with a primary focus on cancer in order to increase awareness among the female population in Turkey.

COVID-19 progression towards ARDS: a genome wide study reveals host factors underlying critical COVID-19

  • Shama Mujawar;Gayatri Patil;Srushti Suthar;Tanuja Shendkar;Vaishnavi Gangadhar
    • Genomics & Informatics
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    • v.21 no.2
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    • pp.16.1-16.14
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    • 2023
  • Coronavirus disease 2019 (COVID-19) is a viral infection produced by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus epidemic, which was declared a global pandemic in March 2020. The World Health Organization has recorded around 43.3 billion cases and 59.4 million casualties to date, posing a severe threat to global health. Severe COVID-19 indicates viral pneumonia caused by the SARS-CoV-2 infections, which can induce fatal consequences, including acute respiratory distress syndrome (ARDS). The purpose of this research is to better understand the COVID-19 and ARDS pathways, as well as to find targeted single nucleotide polymorphism. To accomplish this, we retrieved over 100 patients' samples from the Sequence Read Archive, National Center for Biotechnology Information. These sequences were processed through the Galaxy server next generation sequencing pipeline for variant analysis and then visualized in the Integrative Genomics Viewer, and performed statistical analysis using t-tests and Bonferroni correction, where six major genes were identified as DNAH7, CLUAP1, PPA2, PAPSS1, TLR4, and IFITM3. Furthermore, a complete understanding of the genomes of COVID-19-related ARDS will aid in the early identification and treatment of target proteins. Finally, the discovery of novel therapeutics based on discovered proteins can assist to slow the progression of ARDS and lower fatality rates.

Cardiac valve replacement: a 7-year long-term evaluation (심장조직판막치환: 7 년간의 술후 장기성)

  • Lee, Sang-Ho;Seong, Sang-Hyeon;Seo, Gyeong-Pil
    • Journal of Chest Surgery
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    • v.16 no.4
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    • pp.602-614
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    • 1983
  • Six hundred fourteen consecutive cases of bioprosthetic cardiac valve replacement performed during the period from March 1976 through December 1982 were reviewed. A total of 748 tissue valves [534 Ionescu-Shiley valves, 144 Hancock valves, 46 Angell-Shiley, and 24 Carpentier-Edwards] were implanted in 610 patients. Of these, 477 had single valve replacements [403 mitral, 60 aortic, and 14 tricuspid] including three REDO MVR and one REDO AVR. The remaining 129 had double valve replacements [95 AVR and MVR and 34 MVR and TVR] and 8 had triple valve replacement.592 cases were evaluated. Overall early mortality rate [within 30 days of operation] was 7.1% [6.2% in single valve replacement, 10.2% in double valve replacement, and 16.7% in triple valve replacement]. Leading causes of mortality were low cardiac output or myocardial failure and ventricular arrhythmias. The follow-up period was from one month to 7 years with a cumulative follow-up of 906.6 patient-years [mean 1.53 years]. The late mortality was 1.6%, 3.9%, 0%, 2.6%, 6.6% and 2.0% per patient-year for MVR, AVR, TVR or triple valve replacement, AVR+MVR, MVR+TVR and total, respectively. Actuarial analysis of late results including early mortalities indicates an expected survival rate of 87.6+1.8% at 3 years and 85.92.4% at 7 years for all cases. We also analyzed actuarial survival rate between groups of each valve replacement [AVR, TVR, Double valve, and Triple valve] and the tissue valve groups in MVR. We experienced 7 cases [0.77% per patient-year] of confirmed endocarditis, two of which were fatal. Valve failure-free rates calculated according to the confirmed cases were 97.5% at 4 years, 87.5% at 7 years, and 88.3% at 6 years for Ionescu-Shiley, Hancock and Angell-Shiley valves, respectively. The occurrence rate of thromboembolism was 2.0% per patient-year in total cases, although almost all the patients were given anticoagulant therapy for one year. The occurring rate in MVR was 1.5% and 2.7% per patient-year for Ionescu-Shiley and Hancock valve groups, respectively. The difference in actuarial rate free from thromboemboli between Ionescu-Shiley and Hancock groups was statistically significant [P value less than 0.001]. Thromboembolic events beyond the period of anticoagulation therapy mainly occurred in patients with atrial fibrillation. The actuarial thromboemboli free survival was 95.71.4% at 3 years and 80.17.3% at 7 years. The incidence of hemorrhagic complications was 1.2% per patient-year [fatality 0.55% per patient-year] for anticoagulated patients. Although our clinical data favorably compares with results from other reports, our results suggest that anticoagulant therapy be given on a short-term basis or not at all to hemodynamically stable patients. Long-term therapy with antiplatelet drugs is probably inevitable with patients who have thromboembolic risk factors [such as atrial fibrillation].

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Self-poisoning as a Target Group for Prevention of Suicide (자살 예방을 위한 집중관리 대상으로서의 중독)

  • Kwak, Moon Hwan;Kang, Hyun Young;Lee, Si Jin;Han, Kap Su;Kim, Su Jin;Lee, Eu Jung;Lee, Sung Woo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.16 no.2
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    • pp.93-101
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    • 2018
  • Purpose: The Korean government has tried to decrease the suicide death rate over the last decade. Suicide attempts, particularly non-fatal attempts, are the most powerful known risk factor for a completed suicide. An analysis of suicide attempt methods will help establish the effective preventive action of suicide. Fit prevention according to the method of suicide attempt may decrease the incidence of suicide death. Self-poisoning is suggested as a major method of both suicide attempts and suicide death. The aim of this study was to determine if a self-poisoning patient is a suitable target for the prevention of the suicide. Methods: This was retrospective analysis of a prospective cohort, which included patients who presented to the emergency department (ED) after a self-harm or suicide attempt from Jan 2013 to Dec 2017. The proportion of methods in suicide attempts, psychological consultation, and fatality according to the suicide attempt method were analyzed. The types of poison were also analyzed. Results: Poisoning was the most common method of suicide attempts (52.1%). The rate of psychological consultations were 18.8% for all patients and 29.1% for poison patients (p<0.001). The rate of mortality in poisoning was 0.6%. Psychological consultation was performed more frequently in admission cases than discharged cases. The most common materials of poisons was psychological medicines and sedatives that had been prescribed at clinics or hospital. Conclusion: Self-poisoning is a major method of suicide attempt with a high rate of psychiatric consultation, low mortality rate, versus others methods. The prevention of suicide death for suicide attempts may focus on self-poisoning, which is the major method of suicide attempts. A suitable aftercare program for self-poisoning may be an effective method for preventing suicide if an early diagnosis and management of psychiatric disorders through psychiatric consultation can be made, and early connection to social prevention program for non-fatal patients are possible.

Significance of Serum Ferritin in Multiple Trauma Patients with Acute Respiratory Distress Syndrome (다발성 외상 환자에서 발생되는 급성 호흡 곤란 증후군의 예측 인자로서 혈청 페리틴의 의의)

  • Ji, Yae-Sub;Kim, Nak-Hee;Jung, Ho-Geun;Ha, Dong-Yeup;Jung, Ki-Hoon
    • Journal of Trauma and Injury
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    • v.20 no.2
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    • pp.57-64
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    • 2007
  • Purpose: Clinically, acute respiratory distress syndrome (ARDS) occurs within 72 hours after acute exposure of risk factors. Because of its high fatality rate once ARDS progresses, early detection and management are essential to reduce the mortality rate. Accordingly, studies on early changes of ARDS were started, and serum ferritin, as well the as injury severity score (ISS), which has been addressed in previous studies, thought to be an early predictive indicator for ARDSMethods: From March 2003 to March 2005, we investigated 50 trauma patients who were admitted to the intensive care unit in Dongguk University Medical Center, Gyeongju. The patients were characterized according to age, sex, ISS, onset of ARDS, time onset of ARDS, serum ferritin level (posttraumatic $1^{st}\;&\;2^{nd}$ day), amount of transfused blood, and death. Abdominal computed topography was performed as an early diagnostic tool to evaluate the onset of ARDS according to its diagnostic criteria. The serum ferritin was measured by using a $VIDAS^{(R)}$ Ferritin (bioMeriux, Marcy-1' Etoile, France) kit with an enzyme-linked fluorescent assay method. For statistical analysis, Windows SPSS 13.0 and MedCalc were used to confirm the probability of obtaining a predictive measure from the receiver operating characteristics (ROC) curve. Results: The ISS varied from 14 to 66 (mean: 33.8) whereas the onset of ARDS could be predicted with the score above 30 (sensitivity: 90.0%, specificity: 60.0%, p<0.05). On the posttraumatic $1^{st}$ day, the serum ferritin levels were measured to be from 31 mg/dL to 1,200 mg/dL (mean: 456 mg/dL), and the onset of ARDS could be predicted when the value was over 340 mg/dL (sensitivity: 80.0%, specificity: 65.0%, p<0.05). On the posttraumatic $2^{nd}$ day, the serum ferritin levels were measured to be from 73 mg/dL to 1,200 mg/dL (mean: 404 mg/dL), and the onset of ARDS could be predicted when the value was over 627 mg/dL (sensitivity: 60.0%, specificity: 92.5%, p<0.05). The serum ferritin levels and the ISS were significantly higher on the posttraumatic $1^{st}$ and $2^{nd}$ day in the ARDS group, suggesting that they are suitable indices predicting the onset of ARDS, however relationship between the serum ferritin levels and the ISS was not statistically significant. Conclusion: In this study, we discovered increasing serum ferritin levels in multiple- trauma patients on the posttraumatic $1^{st}$ & $2^{nd}$ day and concluded that both the serum ferritin level and the ISS were good predictors of ARDS. Although they do not show statistically significant relationship to each other, they can be used as independent predictive measures for ARDS. Since ARDS causes high mortality, further studies, including the types of surgery and the methods of anesthesia on a large number of patients are essential to predict the chance of ARDS earlier and to reduce the incidence of death.

Brain abscess in Korean children: A 15-year single center study

  • Lee, Cha-Gon;Kang, Seong-Hun;Kim, Yae-Jean;Shin, Hyung-Jin;Choi, Hyun-Shin;Lee, Jee-Hun;Lee, Mun-Hyang
    • Clinical and Experimental Pediatrics
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    • v.53 no.5
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    • pp.648-652
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    • 2010
  • Purpose: A brain abscess is a serious disease of the central nerve system. We conducted this study to summarize the clinical manifestations and outcomes of brain abscesses. Methods: A retrospective chart review of pediatric patients diagnosed with brain abscesses from November 1994 to June 2009 was performed at Samsung Medical Center, Seoul, Korea. Results: Twenty-five patients were included in this study. On average, 1.67 cases per year were identified and the median age was 4.3 years. The common presenting clinical manifestations were fever (18/25, 72%), seizure (12/25, 48%), altered mental status (11/25, 44%), and signs of increased intracranial pressure (9/25, 36%). A total of 14 (56%) patients had underlying illnesses, with congenital heart disease (8/25, 32%) as the most common cause. Predisposing factors were identified in 15 patients (60%). The common predisposing factors were otogenic infection (3/25, 12%) and penetrating head trauma (3/25, 12%). Causative organisms were identified in 64% of patients (16/25). The causative agents were $S$ $intermedius$ (n=3), $S$ $aureus$ (n=3), $S$ $pneumoniae$ (n=1), Group B streptococcus (n=2), $E.$ $coli$ (n=1), $P.$ $aeruginosa$ (n=1), and suspected fungal infection (n=5). Seven patients received medical treatment only while the other 18 patients also required surgical intervention. The overall fatality rate was 16% and 20% of patients had neurologic sequelae. There was no statistical association between outcomes and the factors studied. Conclusion: Although uncommon, a brain abscess is a serious disease. A high level of suspicion is very important for early diagnosis and to prevent serious consequences.

Simple, Rapid and Sensitive Portable Molecular Diagnosis of SFTS Virus Using Reverse Transcriptional Loop-Mediated Isothermal Amplification (RT-LAMP)

  • Baek, Yun Hee;Cheon, Hyo-Soon;Park, Su-Jin;Lloren, Khristine Kaith S.;Ahn, Su Jeong;Jeong, Ju Hwan;Choi, Won-Suk;Yu, Min-Ah;Kwon, Hyeok-il;Kwon, Jin-Jung;Kim, Eun-Ha;Kim, Young-il;Antigua, Khristine Joy C.;Kim, Seok-Yong;Jeong, Hye Won;Choi, Young Ki;Song, Min-Suk
    • Journal of Microbiology and Biotechnology
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    • v.28 no.11
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    • pp.1928-1936
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    • 2018
  • Recently, human infections caused by severe fever with thrombocytopenia syndrome virus (SFTSV), which can lead to fatality, have dramatically increased in East Asia. With the unavailability of vaccines or antiviral drugs to prevent and/or treat SFTSV infection, early rapid diagnosis is critical for prevention and control of the disease. Here, we report the development of a simple, rapid and sensitive portable detection method for SFTSV infection applying reverse transcription-loop mediated isothermal amplification (RT-LAMP) combined with one-pot colorimetric visualization and electro-free reaction platform. This method utilizes a pocket warmer to facilitate diagnosis in a resource-limited setting. Specific primers were designed to target the highly-conserved region of L gene of SFTSV. The detection limit of the RT-LAMP assay was approximately $10^0$ viral genome copies from three different SFTSV strains. This assay exhibited comparable sensitivity to qRT-PCR and 10-fold more sensitivity than conventional RT-PCR, with a rapid detection time of 30 to 60 minutes. The RT-LAMP assay using SFTSV clinical specimens has demonstrated a similar detection rate to qRT-PCR and a higher detection rate compared to conventional RT-PCR. Moreover, there was no observed cross-reactive amplification of other human infectious viruses including Japanese Encephalitis Virus (JEV), Dengue, Enterovirus, Zika, Influenza and Middle East Respiratory Syndrome Coronavirus (MERS-CoV). This highly sensitive, electro- and equipment-free rapid colorimetric visualization method is feasible for resource-limited SFTSV field diagnosis.

Numerical Simulation of Crash Impact Test for Fuel Tank of Rotorcraft (회전익항공기용 연료탱크 충돌충격시험 수치모사 연구)

  • Kim, Hyun-Gi;Kim, Sung-Chan;Lee, Jong-Won;Hwang, In-Hee;Kim, Kyung-Soo
    • Journal of the Computational Structural Engineering Institute of Korea
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    • v.24 no.5
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    • pp.521-530
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    • 2011
  • Since aircraft fuel tanks have many interfaces connected to the airframe as well as the fuel system, they have been considered as one of the system-dependent critical components. Crashworthy fuel tanks have been widely implemented to rotorcraft and rendered a great contribution for improving the survivability of crews and passengers. Since the embryonic stage of military rotorcraft history began, the US army has developed and practised a detailed military specification documenting the unique crashworthiness requirements for rotorcraft fuel tanks to prevent most, hopefully all, fatality due to post-crash fire. The mandatory crash impact test required by the relevant specification, MIL-DTL-27422D, has been recognized as a non-trivial mission and caused inevitable delay of a number of noticeable rotorcraft development programs such as that of V-22. The crash impact test itself takes a long-term preparation efforts together with costly fuel tank specimens. Thus a series of numerical simulations of the crash impact test with digital mock-ups is necessary even at the early design stage to minimize the possibility of trial-and-error with full-scale fuel tanks. In the present study the crash impact simulation of a few fuel tank configurations is conducted with the commercial package, Autodyn, and the resulting equivalent stresses and internal pressures are evaluated in detail to suggest a design improvement for the fuel tank configuration.

Epidemiological and Serological Investigation on Epidemic Encephalitis in Korea (우리나라 유행성뇌염(流行性腦炎)의 역학적(疫學的) 및 혈청학적(血淸學的) 조사연구(調査硏究))

  • Lee, Chu-Won;Kim, Kyung-Ho;Kim, In-Dal
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.2
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    • pp.403-415
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    • 1974
  • The author has investigated epidemiological features of human cases of epidemic encephalitis (E. E.) in the Republic of Korea and the status of antibody requisition in pre-and post-epidemic time. And virological and serological studies with regarding the relationship of E. E. infection between human and piglet, and field survey against its vector by means of virus isolation from mosquitoes were carried out. Finally, vaccine field trial against human population has also been evaluated in order to confirm its effectiveness. The results of the studies are summarized as follows : 1. The annual incidence of reported cases during the past 25 years (1949-1973) in the Republic of Korea has shown two patterns, one was typical cyclic incidence and the other one was irregular. Annual average morbidity and mortality rate per 100,000 population were 5.7 and 2.1 and fatality rate was 34.6% in typical cyclic years. 2. With regard to the geographical distribution of E. E., the province of Jeolla-Bug-Do illustrated the highest incidence regardless of the epidemic size. 3. The main epidemic period was between mid-August and mid-September (above 90% of the total number of cases). The first case was reported in middle of July and the epidemic ceased in late of October. 4. An analysis of the age distribution of cases of E. E., has shown that above 90% of the total cases occurred in the age groups under 14 years and it was noted that about its 54% were occurred in the age groups between 5-9 years group. 5. Through the Haemagglutination Inhibition (H-I) test for the laboratory diagnosis of E. E., it was found that higher H-I antibody titer was usually detected in the convalescent phase, 15 days after onset. 6. The H-I antibody survey against 563 healthy population by age groups during the pre-epidemic season showed that 422(75%) were less than H-I titer, 1:20 and 122(21.7%) were positive H-I titer, 1:20. Among the 94 American in Seoul who had not been in E. E. endemic area previously only one person had appeared sero-conversion as a H-I titer of 1:80 after post-epidemic season. 7. The E. E. virus could be isolated from the mosquitos pools-C, tritaeniorhyncus which were caught between late July and middle August. 8. E.E. Virus was also isolated from piglet blood on early August and H-I antibody conversion was occurred mostly on middle of August. 9. H-I antibody sero-conversion rate reached to high level when vaccine purified by mouse brain tissue inoculated, showing 98.9%. Higher antibody titer was acquired when booster inoculation was performed, Four fold rise of H-I add N-T antibodies was confirmed with 93.2% and 82.1% respectively.

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A Study on Configuration Optimization for Rotorcraft Fuel Cells based on Neural Network (인공신경망을 이용한 연료셀 형상 최적화 연구)

  • Kim, Hyun-Gi;Kim, Sung-Chan;Lee, Jong-Won;Hwang, In-Hee
    • Journal of the Computational Structural Engineering Institute of Korea
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    • v.25 no.1
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    • pp.51-56
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    • 2012
  • Crashworthy fuel cells have been widely implemented to rotorcraft and rendered a great contribution for improving the survivability of crews and passengers. Since the embryonic stage of military rotorcraft history began, the US army has developed and practised a detailed military specification documenting the unique crashworthiness requirements for rotorcraft fuel cells to prevent most fatality due to post-crash fire. Foreign manufacturers have followed their long term experience to develop their fuel cells, and have reflected the results of crash impact tests on the trial-and-error based design and manufacturing procedures. Since the crash impact test itself takes a long-term preparation efforts together with costly fuel cell specimens, a series of numerical simulations of the crash impact test with digital mock-ups is necessary even at the early design stage to minimize the possibility of trial-and-error with full-scale fuel cells. In the present study a number of numerical simulations on fuel cell crash impact tests are performed with a crash simulation software, Autodyn. The resulting equivalent stresses are further analysed to evaluate a number of appropriate design parameters and the artificial neural network and simulated annealing method are simultaneously implemented to optimize the crashworthy performance of fuel cells.