• Title/Summary/Keyword: Early medical intervention

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Surgical Management of Infective Endocarditis Complicated by Embolic Stroke: Early versus Delayed Surgery

  • Kim, Gwan-Sic;Kim, Joon-Bum;Jung, Sung-Ho;Yun, Tae-Jin;Choo, Suk-Jung;Chung, Cheol-Hyun;Lee, Jae-Won
    • Journal of Chest Surgery
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    • v.44 no.5
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    • pp.332-337
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    • 2011
  • Background: The optimal timing of surgery for infective endocarditis complicated by embolic stroke is unclear. We compared early versus delayed surgery in these patients. Materials and Methods: Between 1992 and 2007, 56 consecutive patients underwent open cardiac surgery for the treatment of infective endocarditis complicated by acute septic embolic stroke, 34 within 2 weeks (early group) and 22 more than 2 weeks (delayed group) after the onset of stroke. Results: The mean age at time of surgery was $45.7{\pm}14.8$ years. Stroke was ischemic in 42 patients and hemorrhagic in 14. Patients in the early group were more likely to have highly mobile, large (>1 cm in diameter) vegetation and less likely to have hemorrhagic infarction than those in the delayed group. There were two (3.7%) intraoperative deaths, both in the early group and attributed to neurologic aggravation. Among the 54 survivors, 4 (7.1%), that is, 2 in each group, showed neurologic aggravation. During a median follow-up of 61.7 months (range, 0.4~170.4 months), there were 5 late deaths. Overall 5-year neurologic aggravation-free survival rates were $79.1{\pm}7.0%$ in the early group and $90.9{\pm}6.1%$ in the delayed group (p=0.113). Conclusion: Outcomes of early operation for infective endocarditis in stroke patients were similar to those of the conventional approach. Early surgical intervention may be preferable for patients at high risk of life-threatening septic embolism.

Breast Self Examination Practice and Breast Cancer Risk Perception among Female University Students in Ajman

  • Al-Sharbatti, Shatha Saed;Shaikh, Rizwana Burhanuddin;Mathew, Elsheba;Al-Biate, Mawahib Abd Salman
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4919-4923
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    • 2013
  • Breast cancer is the top cancer in women worldwide and its incidence is increasing, particularly in developing countries. In the United Arab Emirates (UAE), many cases are first diagnosed in later stages and at younger age compared to those seen in developed countries. Early detection in order to improve breast cancer outcome and survival remains the cornerstone of breast cancer control. Performance of breast self examination is one of the important steps for identifying breast disease at an early stage, by the woman herself. No information has hitherto been available about the frequency of this practice among female university students in UAE or about their breast cancer risk perception and therefore the present study was conducted in Ajman. It was found that 22.7% of the participants practiced BSE but only 3% of them practiced BSE monthly. Marital status but not age as significantly associated with age likelihood. The most frequent reported barriers for BSE were lack of knowledge, considering oneself not at risk and the absence of doctor advice. These factors need to be taken into account in intervention efforts.

High-pressure Injection Injuries in the Hand (수부의 고압 분사 손상)

  • Kim, Seong-Ki;Roh, Si-Gyun;Lee, Nae-Ho;Yang, Kyung-Moo
    • Archives of Plastic Surgery
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    • v.37 no.3
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    • pp.245-249
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    • 2010
  • Purpose: High-pressure injection injury is caused by accidental injection of the high-pressure injection devices in industry. The initial benign appearance of the wound fools patients into delays in an adequate treatment. And it can result in disastrous outcomes such as necrosis and amputation. To avoid the poor prognosis, the injuries require a prompt surgical intervention. The purpose of this article is to recognize the poor outcome of the highpressure injection injury and to introduce an adequate treatment in need. Methods: We have 4 cases of the high-pressure injection injuries in the hand from April, 2005 to March, 2009. Average age is 39 years (30 - 49 years old), 2 cases are the palm of dominant hand, 1 case is the thumb of dominant hand, and 1 case is the palm of non-dominant hand, respectively. We followed up these patients for 20 months on average. In 3 cases, the immediate, aggressive surgical intervention was carried out, but the other one was delayed in early adequate treatment. The wounds were covered by local advancement flap, anterolateral thigh free flap, conservative treatment with antibiotics and dressing. Results: No pathogens after culture were found nor any findings of fracture in imaging study. Conservative treatment, local advancement flap and anterolateral thigh free flap for the open wound resulted in a desirable aesthetic outcome. In a long-term follow up, functional capability of the patient was also satisfactory. Conclusion: Upon initial evaluation, most high-pressure injection injuries present as innocuous wounds with very few symptoms and result in delaying the proper management. And the majority of high-pressure injection injuries will produce significant morbidity to the hand, amputation. And the initial aggressive surgical debridement was needed to prevent the poor outcome. The key to success in treating high-pressure injection injuries of the hand is the prompt aggressive surgical intervention.

Self-Care Education Programs Based on a Trans-Theoretical Model in Women Referring to Health Centers: Breast Self-Examination Behavior in Iran

  • Ghahremani, Leila;Mousavi, Zakiyeh;Kaveh, Mohammad Hossein;Ghaem, Haleh
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.12
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    • pp.5133-5138
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    • 2016
  • Background: Breast cancer is one of the most common cancers and a major public health problem in developing countries. However, early detection and treatment may be achieved by breast self-examination (BSE). Despite the importance of BSE in reducing the incidence of breast cancer and esultant deaths, the disease continues to be the most common cause of cancer death among women in Iran.This study aimed to determine the effects of self-care education on performance of BSE among women referring to health centers in our country. Materials and Methods: This quasi-experimental interventional study with pretest/posttest control group design was conducted on 168 women referred to health centers. The data were collected using a validated researcher-made questionnaire including demographic variables and trans-theoretical model constructs as well as a checklist assessing BSE behavior. The instruments were administered to groups with and without self-care education before, a week after, and 10 weeks after the intervention. Then, the data were entered into the SPSS statistical software (version 19) and analyzed using independent sample t-tests, paired sample t-test, repeated measures ANOVA, Chi-square, and Friedman tests (p<0.05). Results: The results showed an increase in the intervention group's mean scores of trans-theoretical model constructs (stages of change, self-efficacy, decisional balance, and processes of change) and BSE behavior compared to the control group (p<0.001). Conclusion: The study confirmed the effectiveness of aneducational intervention based ona trans-theoretical model in performing BSE. Therefore, designing educational interventions based on this model is recommended to improve women's health and reduce deaths due to breast cancer.

Surgical Treatment of the Spontaneous Spinal Epidural Abscess (자발성 척추 경막외 농양의 수술적 치료)

  • Lee, Jung-Kil;Kim, Soo-Han;Kim, Eun-Seong;Kim, Tae-Sun;Jung, Shin;Kim, Jae-Hyoo;Kang, Sam-Suk;Lee, Je-Hyuk
    • Journal of Korean Neurosurgical Society
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    • v.29 no.8
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    • pp.1037-1042
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    • 2000
  • Objective : The goal of this study was to recognize the clinical feature and associated risk factors in spinal epidural abscess(SEA), and to improve the outcome accordingly. Methods : A retrospective study was performed in 14 patients with SEA who underwent surgical intervention at our hospital between 1990 and 1999. Results : After a mean follow-up period of 10.2 months(range, 1-57 months), 8 patients had no or minimal deficits, 4 patients had severe paresis or plegia and/or bowel/bladder dysfunction, and 2 patients died due to medical complications. Staphylococcus aureus was the predominant pathogen, isolated in 9 patients(64.3%). Cervical and thoracic spinal epidural abscesses showed a tendency to develop rapidly and were associated with severe neurological deficits. Conclusion : Thoracic spinal epidural abscesses were associated with a poorer prognosis than those in other regions. Therefore, it should be treated more aggressively. Good neurological recovery can be obtained despite severe neurologic deficit when treated by early diagnosis and prompt surgical intervention.

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Effects of Group Training Based on the Health Belief Model on Knowledge and Behavior Regarding the Pap Smear Test in Iranian Women: a Quasi-Experimental Study

  • Shobeiri, Fatemeh;Javad, Masoumeh Taravati;Parsa, Parisa;Roshanaei, Ghodratollah
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2871-2876
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    • 2016
  • The Pap smear test is recommended for early diagnosis of cervical cancer. The aim of this study was to assess knowledge and behavior regarding the Pap smear test based on the Health Belief Model (HBM) in women referred to premarital counseling classes, Hamadan, Iran. This quasi-experimental study was conducted on 330 women, who were allocated randomly to two case and control groups (n=165). Two educational session classes were performed in the case group. Two stages in before and after intervention groups were evaluated. Analysis of data was performed by SPSS/16.0, using t-test, $x^2$, and McNemar's test. P-values <0.05 were regarded as significant. There was no significant difference between the mean scores of the various structures of this model in two groups before the intervention. However, after the intervention there were significant increase in mean score of knowledge and all variables of HBM in the intervention group(P<0.001). The findings of this study highlight the important role of education about cervical cancer on changing women's beliefs about cervical screening.

Effect of Neonatal Developmental Intervention Program (NDT) on Motor Development and Growth in Premature Infants

  • Park, Geun-Hwa;Choi, Sang-Youn;Kim, Sung-Mi;Kim, Mi-Ae;Lee, Eun-Ju
    • Neonatal Medicine
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    • v.17 no.2
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    • pp.207-216
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    • 2010
  • Purpose: The aim of this study was to identify the effects of neonatal developmental intervention program (NDT) in promoting motor development and growth and to determine the usefulness of Hammersmith Neonatal Neurological Examination (HNNE) and Neonatal Behavioral Assessment Scale (NBAS) in premature infants. Methods: We performed NDT on selected premature infants (PI, n=42) and compared them with the full term control group (FC, n=20). NDT protocol and development assessment (HNNE, NBAS) were manipulated by the physical therapist in the neonatal intensive care unit. The data of this study were collected prospectively. Results: The PI with GA <34 weeks (VPI) subgroup showed a more use of mechanical ventilator and surfactant, severe bronchopulmonary dysplasia and intraventricular hemorrhage, and patent ductus arteriosus treated surgically than the PI with GA $\geq$34 weeks but less than 37 weeks (LPI) subgroup. The average scores improved significantly in the PI group between the 1st, 2nd, and 3rd assessment by repeated measure (P=0.000). Also, the PI group showed significantly higher total scores and average score at 40 weeks postmenstrual age, P=0.000, respectively than in the FC group. The LPI subgroup showed more weight gain and change in the head circumference between the 1st and 3rd assessment by repeated measure, respectively, P<0.05. The PI group showed no apnea, bradycardia and late sepsis associated with intervention and assessment. Conclusion: The NDT might be a safe and useful intervention to promote motor and growth outcomes in premature infants. Also, the HNNE and NBAS might be safe and useful tools for assessing neurodevelopment in premature infants.

An Improved Musculoskeletal Discomfort Assessment Questionnaire (근골격계 장애 분석을 위한 설문지 조사에 관한 연구)

  • 장성록
    • Journal of the Korean Society of Safety
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    • v.14 no.2
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    • pp.148-154
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    • 1999
  • A self-report musculoskeletal assessment tool was adapted following field use by ergonomic analysis teams and was administrated to 100 employees of ChangWon techno-complex. Results were analyzed to determine of the self-report could adequately predict whether or not an employee reportedly sought medical treatment for a work-related discomfort. It is anticipated this tool can be utilized as an easily administrated, proactive surveillance instrument to assist in early identification of ergonomic concerns and to help prioritize jobs for intervention.

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Optimizing Nutrition Support in Cancer Care

  • Menon, Kavitha Chandrasekhara
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2933-2934
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    • 2014
  • Involvement of a multidisciplinary team in cancer care may have added benefits over the existing system of patient management. A paradigm shift in the current patient management would allow more focus on nutritional support, in addition to clinical care. Malnutrition, a common problem in cancer patients, needs special attention from the early days of cancer care to improve quality of life and treatment outcomes. Patient management teams with trained oncology dietitians may provide quality personalized nutritional care to cancer patients.

Serum Copeptin Levels Predict Clinical Outcomes After Successful Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction

  • Choi, Hyun-Jung;Kim, Min Chul;Sim, Doo Sun;Hong, Young Joon;Kim, Ju Han;Jeong, Myung Ho;Kim, Soo-Hyun;Shin, Myung-Geun;Ahn, Youngkeun
    • Annals of Laboratory Medicine
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    • v.38 no.6
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    • pp.538-544
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    • 2018
  • Background: Serum copeptin has been demonstrated to be useful in early risk stratification and prognostication of patients with acute myocardial infarction (AMI). However, the prognostic value of copeptin after percutaneous coronary intervention (PCI) for clinical outcomes remains uncertain. We investigated the prognostic role of serum copeptin levels immediately after successful PCI as a prognostic marker for major adverse cardiac events (MACE; comprising death, repeat PCI, recurrent MI, or coronary artery bypass grafting) in patients with AMI. Methods: A retrospective study was performed in 149 patients with AMI who successfully received PCI. Serum copeptin levels were analyzed in blood samples collected immediately after PCI. The association between copeptin levels and MACE during the follow-up period was evaluated. Results: MACE occurred in 34 (22.8%) patients during a median follow-up of 30.1 months. MACE patients had higher copeptin levels than non-MACE patients did. Multiple logistic regression analysis showed that the increase in serum copeptin levels was associated with increased MACE incidence (odds ratio=1.6, P =0.005). Conclusions: A high level of serum copeptin measured immediately after PCI was associated with MACE in patients with AMI during long-term follow-up. Serum copeptin levels can serve as a prognostic marker in patients with AMI after successful PCI.