• 제목/요약/키워드: Feeding therapy

검색결과 147건 처리시간 0.029초

Comparison of minimally invasive surfactant therapy with intubation surfactant administration and extubation for treating preterm infants with respiratory distress syndrome: a randomized clinical trial

  • Sabzehei, Mohammad Kazem;Basiri, Behnaz;Shokouhi, Maryam;Ghahremani, Sajad;Moradi, Ali
    • Clinical and Experimental Pediatrics
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    • 제65권4호
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    • pp.188-193
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    • 2022
  • Background: Respiratory distress syndrome (RDS) is a common cause of hospitalization and death in preterm infants who require surfactant treatment and respiratory support. Purpose: This study aimed to compare the clinical outcomes of minimally invasive surfactant therapy (MIST) and the INtubation, SURfactant administration, and Extubation (INSURE) technique in preterm infants with RDS. Methods: In this clinical trial, 112 preterm infants born at 28-36 weeks of gestation and diagnosed with RDS randomly received 200-mg/kg surfactant by MIST or the INSURE method. In the MIST group, surfactant was administered using a thin catheter (5F feeding tube); in the INSURE group, surfactant was administered after intubation using a feeding tube and the tracheal tube was removed after positive pressure ventilation was started. Nasal continuous positive airway pressure was applied in both groups for respiratory support and the postprocedure clinical outcomes were compared. Results: The mean hospitalization time was shorter for infants in the MIST group than for those in the INSURE group (9.19±1.72 days vs. 10.21±2.15 days, P=0.006). Patent ductus arteriosus was less frequent in the MIST group (14.3% vs. 30.4%, P=0.041). Desaturation during surfactant administration occurred less commonly in the MIST group (19.6% vs. 39.3%, P=0.023). There were no significant intergroup differences in other early or late complications. Conclusion: These results suggest that surfactant administration using MIST could be a good replacement for INSURE in preterm infants with RDS since its use reduced the hospitalization time and the number of side effects.

소화기 종양에 대한 내시경적 완화치료 (The Role of Endoscopic Interventions in Palliative Care for the Gastrointestinal Tumors)

  • 김혜강;정대영
    • Journal of Digestive Cancer Research
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    • 제2권1호
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    • pp.1-4
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    • 2014
  • Palliative care for cancer aims to relieve the discomfort and pain from the cancer itself and associated conditions. Gastrointestinal cancers originate from the tube like structure of gastrointestinal tract and cause complications such as obstruction, bleeding, adhesion, invasion, and perforation to adjacent organ. Recent advances in interventional endoscopy enables endoscopy physicians to do safe and effective care for gastrointestinal cancer patients. Endoscopic palliation includes stent, hemostasis, nutritional support and targeted drug delivery. Self expandable metallic stent is one of the most important modalities in gastrointestinal palliation. Through the endoscopy or over the wire pre-placed by endoscopy, stents restore the gastrointestinal luminal patency and relieve the obstructive condition. Endoscopic hemostasis is another important palliation in gastrointestinal cancer patients. Epinephrine injection, argon plasma coagulation and thermal cauterization are usual modalities for hemostasis. Histoacryl glue and fibrin glue are also available. Hemostatic nanopowder spray is newly reported effective in benign disease and is supposed to be effective also in cancer bleeding. Enteral feeding tubes including gastro- or jejunostomy and nosoduodenal tubes are placed by using endoscopic guidance. Enteral feeding tubes role as the route of easily absorbable or semi-digested nutrients and effectively maintain both patients calorie requirements and gut microenvironment. Photodynamic therapy is the one of the outstanding medical employments of photo-physics. Especially for superficial cancers in esophagus, photodynamic therapy is very useful in cancer removal and maintaining organ structure. In biliary neoplasm, photodynamic therapy is well known to be effective in cancer ablation and biliary ductal patency restoration. Targeted drug delivery is the lastest issue in palliative endoscopy. Debates and questions are still on the table. In this article, the role of endoscopic interventions in palliative care for the gastrointestinal tumors will be thoroughly reviewed.

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Effects of Dysphagia Treatment Applied to Infants with Pierre Robin Syndrome - Single Subject Research Design

  • Kim, Mikyung;Kim, Deokju
    • International Journal of Advanced Culture Technology
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    • 제8권1호
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    • pp.1-12
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    • 2020
  • Pierre Robin syndrome is characterized by micrognathia, glossoptosis, and cleft palate. Infants with Pierre Robin syndrome causes feeding difficulty, upper airway obstruction, and other symptoms. This study aims to examine the effects of applying dysphagia treatment to infants with Pierre Robin syndrome. The study participant was an infant who was born four weeks premature and referred for dysphagia treatment approximately 100 days after birth. At the initial assessment, the infant showed oral sensory sensitivity, a high level of facial and masticatory muscle tension, and a low stability of the chin and cheeks with almost no normal "sucking-swallowing-breathing" pattern. We set the baseline period and intervention period using the AB design. During the baseline period, non-nutritive sucking training using a rubber nipple was conducted without implementing an oral stimulation intervention. During the intervention period, non-nutritive sucking training and an oral stimulation intervention were performed. After the intervention period, the infant's daily oral intake and oral intake per time significantly increased compared to that during the baseline period. We observed that the oral intake time of the infant decreased during the intervention period compared to that in the baseline period, which indicated an improvement in control over the chin, tongue, and lip movements, a change in muscular tension, and stabilization of the "sucking-swallowing-breathing" pattern. We provided dysphagia treatment before breastfeeding, it was positive effects such as normal development of the infant, transition from tube feeding to bottle feeding, and enhancement of overall oral motor function.

신경성 식욕부진증에 대한 한약치료, 인지행동치료 및 인간중심상담치료 병행 1예 보고 (A Case Report of Concurrent Korean Herbal Medicine Treatment, Cognitive Behavior Therapy, and Person-centered Counseling Therapy for Anorexia Nervosa)

  • 허미숙;김환;서영경;양창섭;이미영;장익순;정인철
    • 동의신경정신과학회지
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    • 제28권3호
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    • pp.195-206
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    • 2017
  • Objectives: To evaluate the effects of concurrent therapy with cognitive behavior therapy and person-centered counseling in addition to general Korean herbal medicine treatment for a patient with anorexia nervosa. Methods: A patient diagnosed with anorexia nervosa was treated with Korean herbal medicine treatment, cognitive behavior therapy, and person-centered treatment. The results were evaluated through a feeding interview, self-checklist, beck depression inventory (BDI) and InBody test. Results: After the treatment period, the treatment effects such as improvement of dietary restriction and elimination behavior, weight gain, and reduced depression were confirmed. Conclusions: This study suggests that concurrent therapy together with cognitive behavior therapy, person-centered counseling, and general Korean herbal medicine treatment is effective on patients with anorexia nervosa.

뇌졸중환자에서 재원기간과 퇴원장소 예측을 위한 K-MBI의 유용성 (Utility of Korean Modified Barthel Index (K-MBI) to Predict the Length of Hospital Stay and the Discharge Destinations in People With Stroke)

  • 노동국;김경호;강대희;이지선;남경완;신형익
    • 한국전문물리치료학회지
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    • 제14권3호
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    • pp.81-89
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    • 2007
  • The purpose of this study was to utilize the K-MBI (Korean Modified Barthel Index) and subscales of K-MBI in predicting the length of hospital stay (LOS) and the discharge destinations for stroke patients. The study population consisted of 97 stroke patients (57 men and 40 women) admitted to the Seoul National University at the Bundang Hospital. All participants were assessed by K-MBI at admission and discharge after rehabilitation therapy and the information available was investigated at admission. The data were analyzed by using the Mann-Whitney U test, the stepwise multiple regression and the logistic regression. The median LOS was 30 days (mean, 32.8 days; range, 22 to 43 days). The K-MBI score at initiation of rehabilitation therapy (p<.001), the type of stroke and living habits before a stroke were the main explanatory indicators for LOS (p<.05). Within the parameters of K-MBI measured at initiation for rehabilitation, feeding and chair/bed transfer were the explanatory factors for LOS prediction (p<.01). Confidence in the prediction of LOS was 20%. Significant predictors of discharge destination in a logistic regression model were the discharge K-MBI score, sex and hemiplegic side. Dressing in items of discharge K-MBI was the significant predictor of discharge destination. The K-MBI score was the most important factor to predict LOS and discharge destination. Knowledge of these predictors can contribute to more appropriate treatment and discharge planning.

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기능적 전기 자극을 병행한 과제 지향적 훈련이 경수 손상 환자의 손 기능에 미치는 영향: 개별사례 연구 (Effects of Task-Oriented Training With Functional Electrical Stimulation on Cervical Spinal Cord Injury Patients' Hand Function: A Single-Subject Experimental Design)

  • 고석범;박혜연;김종배;김정란
    • 재활치료과학
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    • 제7권1호
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    • pp.63-77
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    • 2018
  • 목적 : 본 연구는 기능적 전기 자극을 병행한 과제 지향적 훈련이 불완전 경수 손상 환자의 손 기능에 미치는 영향을 알아보고자 하였다. 연구방법 : 대상자는 불완전 경수 손상 진단을 받은 성인 3명으로, ABA 설계를 사용하였으며, 연구기간 동안 기초선(A1) 5회기, 중재기(B) 20회기, 재기초선(A2) 5회기로 총 30회기 실시하였다. 중재기(B) 동안 기능적 전기 자극을 병행한 과제 지향적 훈련이 제공되었고, 모든 회기에는 손 기능을 평가하기 위해 상자와 나무토막 검사(Box and Block Test), 떨어지는 막대 잡기(Grip the falling bar)와 먹기 흉내 내기(Simulated feeding)를 측정하였으며, 기초선(A1) 전, 재기초선(A2) 후로 Canadian Occupational Performance Measure(COPM), Jebsen-Taylor Hand Function Test(JTHFT)와 Wolf Motor Function Test(WMFT)를 실시하여 중재 효과를 살펴보았다. 결과 : 모든 대상자는 상자와 나무토막 검사(Box and Block Test), 떨어지는 막대 잡기(Grip the falling bar)와 먹기 흉내 내기(Simulated feeding)를 통해 기초선(A1)보다 중재기(B)에서 우세 손 기능이 향상되었고, 재기초선(A2)에서 그 효과가 유지되었다. 재기초선(A2) 후 COPM, JTHFT와 WMFT의 결과, 우세 손 기능의 향상과 과제 수행도와 만족도의 향상을 보였다. 결론 : 기능적 전기 자극을 병행한 과제 지향적 훈련은 경수 손상 환자의 손 기능뿐만 아니라, 대상자가 선택한 훈련 과제의 과제 수행도와 만족도 향상에 효과적이다.

젖소 17두의 주목나무 독성 중독 (Yew Poisoning in 17 Dairy Cattle)

  • 이수한;배춘식;정병현
    • 한국임상수의학회지
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    • 제20권3호
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    • pp.406-409
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    • 2003
  • We found seventeen dairy cattle with the abnormal signs in cardiovascular and gastrointestinal systems after feeding of the yew foilage. Among them three cattle were dead due to yew poisoning. Among the remaining fourteen dairy cattle, four cattle showed similar symptoms as did dead cattle. Although the remaining ten dairy cattle did not show any abnormal signs, we conducted a therapy of forced magnesium sulfate infusion because the yew consumption might have been occurred in all cattle. As a result of the therapy, we could not found further signs of yew poisoning. The performance of the therapy and the treatment procedures adapted by the therapy could be concluded as follows: The cardioselective toxicity and inhibition of peristaltic activity by the taxine in yew foilage might be involved in the symptoms of acute poisoning as anorexia, dullness, muscle tremor, dyspnea, and sudden death. We also performed the dose response relationship of taxine to the range of clinical symptoms and examined recovery performances. Through the autopsy of the cattle, we could confirm the presence of yew foilages that might have caused the poisoning in the gastrointestinal tract. However, we could not identify further abnormalities in other organs. In this case report, we demonstrated that practice of the forced magnesium sulfate infusion in yew poisoning was helpful for the attenuating the taxine poisoning by blocking the further proceeding of the toxic effect.

과당식이 고혈압 흰쥐에서 혈관 Endothelin-1과 산화질소합성효소의 발현 (Expression of Vascular Endothelin-1 and Nitric Oxide Synthase in Fructose-fed Hypertensive Rats)

  • 백윤웅;김명훈
    • 대한물리치료과학회지
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    • 제9권4호
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    • pp.45-52
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    • 2002
  • Rats that are fed a fructose-rich diet develop hypertension, insulin resistance, and hypertriglyceridemia. To elucidate whether altered expression levels of endothelin-1 and nitric oxide synthase are related to the development of insulin-resistant hypertension, we examined the present study. Male Sprague-Dawley rats were fed a fructose-rich diet for 5 weeks. Systolic blood pressure significantly increased in fructose-fed rats. While serum free fatty acid and plasma nitrite/nitrate levels did not significantly differ between the fructose-fed and control groups, plasma insulin and serum triglyceride concentrations significantly increased in the former. Endothelin-1 mRNA expression in the aorta increased in fructose-fed rats. Neither the protein expression of constitutive nitric oxide synthase nor that of inducible nitric oxide synthase were significantly affected by fructose feeding. However, nitrite/nitrate levels in the aorta were significantly increased. These results suggest that an increase in vascular endothelin-1 is an important contributing factor to the development of hypertension in fructose-fed rats. However, the vascular nitric oxide pathway may not be causally related to the development of fructose-induced hypertension.

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유선염(乳腺炎) 의 한방(韓方) 외치법(外治法)에 대한 문헌적고찰(文獻的考察) (A bibliographic study on the external therapy of Acute Mastitis(乳癰Yu-ong))

  • 장성환
    • 대한한방피부미용학회지
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    • 제1권1호
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    • pp.177-197
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    • 2005
  • Acute Mastitis(急性乳腺炎=乳癰) is an acute suppurative disease appearing in the breast. It is mostly caused by galactostasis, the stagnation of liver-qi(肝鬱) and stomach-heat(胃熱). It is mostly found in breast feeding women, mostly in primiparae. It usually appears in the third and the fourth weeks of postpartum. At the beginning in the chest there appear induration, distending pain, galactostasis, inversion to cold with fever followed by the enlargement of the masses, burning red, megalgia, not subduing of chills and fever, the accumulation of it to form pus. In the early phase it is advisable to follow the therapeutic principles of soothing the liver and clearing away heat, promoting lactation and subduing swelling. After the formation of pus it is advisable to cut radially and drain the pus. External Therapy(外治法) generally refers to all the methods to treat various diseases and symptoms with application of drugs and manipulation or together with proper instruments on the body surface except the method of taking medicine orally Acute Mastitis has been regarded as surgery or the method of taking medicine orally But, based on many bibliographies, acute mastitis was treated by external therapy. Thus through the historical bibliographic studies of external therapy about acute mastitis, this study was made to help the expanding of the methods of treating acute mastitis.

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미숙아의 일반적인 특성과 수유방법에 관한 조사 (A Survey on General Characteristics and Feeding Methods of the Premature Infants)

  • 이승림
    • 대한영양사협회학술지
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    • 제14권4호
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    • pp.361-370
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    • 2008
  • The purpose of this study is to provide basic data for the medical nutrition therapy of premature infants. The general characteristics, presence of metabolic disorders, hematological profile and feeding methods were compared between the premature infant group (<37 weeks, n=61) and the full-term infant group (37$\sim$42 weeks, n=165). Birth weight (p<0.0001), birth length (p<0.005), head circumference (p<0.0001), chest circumference (p<0.0001), and Apgar scores (p<0.0001) of the neonates were all statistically lower in the premature infant group. Jaundice cases (p<0.0001) were statistically higher in the premature infant group. White blood cell counts (WBC: p<0.005), mean corpuscular volume (MCV: p<0001), mean corpuscular hemoglobin (MCH: p<0.005), mean corpuscular hemoglobin concentration (MCHC: p<0.005), and mean platelet volume (MPV: p<0.05) were statistically lower in the premature infant group. The premature infant group were fed a higher rate of premature formula than breast milk and the full-term infant group were fed a high rate of human milk at a higher rate, showing differences in kinds of feeding methods (p<0.0001) between the two groups. An infant's birth weight showed a significantly positive correlation with the infant's birth length (p<0.0001), head circumference (p<0.0001), chest circumference (p<0.0001), and Apgar scores(p<0.0001). The birth length also showed a significantly positive correlation with both head circumference (p<0.05) and chest circumference (p<0.05). Head circumference showed a significantly positive correlation with chest circumference (p<0.0001) and Apgar scores (p<0.0001). Chest circumference showed a significantly positive correlation with Apgar scores (p<0.0001). In addition, the Apgar Score at of 1 minute after birth showed a significantly positive correlation with the Apgar score at of 5 minute after birth (p<0.0001).

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