• Title/Summary/Keyword: Hospital unit

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Contralateral Breast Symmetrisation in Immediate Prosthetic Breast Reconstruction after Unilateral Nipple-Sparing Mastectomy: The Tailored Reduction/Augmentation Mammaplasty

  • Salgarello, Marzia;Visconti, Giuseppe;Barone-Adesi, Liliana;Franceschini, Gianluca;Masetti, Riccardo
    • Archives of Plastic Surgery
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    • v.42 no.3
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    • pp.302-308
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    • 2015
  • Background In the literature on nipple-sparing mastectomy (NSM) with one-stage immediate implant reconstruction, contralateral symmetrisation has drawn little attention, with many surgeons still performing standard cosmetic mammaplasty procedures. However, standard implant-based mammaplasty usually does not result in proper symmetry with the mastectomy side, especially regarding breast projection, overall shape, and volume distribution. Methods We retrospectively reviewed 19 consecutive patients undergoing unilateral NSM with immediate prosthetic reconstruction and contralateral simultaneous symmetrisation by using the tailored reduction/augmentation mammaplasty technique between June 2012 and August 2013. Results The average follow-up time was 13 months (range, 10-24 months). No major complications, such as infection, haematoma, and nipple-areola complex necrosis, were experienced. Conclusions Our experience suggests that simultaneous contralateral symmetrisation with tailored reduction/augmentation mammaplasty after unilateral immediate implant reconstruction after NSM facilitates durable and pleasant symmetric outcomes.

Risk Factors for Falls in Tertiary Hospital Inpatients: A Survival Analysis (상급종합병원 입원환자의 낙상 위험요인: 생존분석으로)

  • Cho, Young Shin;Lee, Young Ock;Youn, Young Sun
    • Journal of Korean Critical Care Nursing
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    • v.12 no.1
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    • pp.57-70
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    • 2019
  • Purpose : The purpose of this study was to identify the risk factors for falls in tertiary hospital inpatients and to suggest data for developing a nursing intervention program for preventing falls. Methods: Data were collected between January 1, 2017, to December 31, 2017. Kaplan-Meier estimation was used to measure the survival rate, and the log-rank test was used for the differences between the fall group and the non-fall group. The Cox proportional hazards model was used to identify the risk factors for falls. Results: The incidence rate of falls for the inpatients was 1.2 cases per 1,000 days of hospitalization. The risk factors for falls were more likely to be found among those who were aged ${\geq}81$, had not undergone surgery, had poor joint motion, had unsteady gait, needed help or supervision, used assistive devices, had comorbidity, and took at least two drugs. Conclusion: For the inpatients, the risk factors for falls included age, surgery, comorbidity, medication that could change mobility, joint motion, and use of patient care equipment. It is necessary to give special attention to inpatients who have any of these risk factors and to develop a falls risk assessment tool.

Quarantine and Appendicitis: A Macro-Area Experience

  • Nicola, Zampieri;Virginia, Murri;Mauro, Cinquetti;Amedeo, Elio;Saverio, Camoglio Francesco
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.1
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    • pp.75-80
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    • 2021
  • Purpose: Appendicitis is the most frequent urgency in pediatric age; the aim of this study was to investigate the association of quarantine for severe acute respiratory syndrome coronavirus 2 pandemic and the incidence of pediatric appendicitis in a specific macro area. Methods: We retrospectively analyzed the medical records of consecutive patients who underwent surgical exploration for acute appendicitis in the period March-April since 2014. This specific quarantine period was divided into two phases as indicated by National government. Patient data, demographics, characteristics and outcomes were studied and evaluated comparing patients treated during quarantine especially phase 1 vs. phase 2 (March-April 2020). Results: After reviewing medical charts following the inclusion and exclusion criteria, 155 patients were studied; focusing on the final outcome, it is possible to show a decreased amount of appendicitis during phase 1 and a progressive increase during phase 2; respect to previous years, there was a statistical increase in severity of appendicitis during quarantine (gangrenous vs. phlegmonous appendicitis). Conclusion: During this specific quarantine there was a reduction in appendicitis and a progressive increase during phase 2. These results offer new perspective among disease incidences during lockdown.

Prevalence and Genotype Distribution of HPV among Women Attending a Cervical Cancer Screening Mobile Unit in Lampang, Thailand

  • Paengchit, Kannika;Kietpeerakool, Chumnan;Lalitwongsa, Somkiet
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6151-6154
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    • 2014
  • A growing body of literature is evidence that identifying subtypes of high-risk human papillomavirus (HR-HPV) has impacted on various steps of cervical cancer prevention.Thus, it is mandatory to determine the background prevalence and distribution of HPV subtypes for designing and implementing area-specific management. The present study was conducted to evaluate prevalence and distribution of HPV subtypes among women aged 30-70 years living in Lampang, an area with a high incidence of cervical cancer, through use of a mobile screening unit. Of 2,000 women recruited in this study, 108 (5.40%, 95%CI: 4.45-6.48) were found to have HR-HPV infection. Risk was significantly correlated with age and number of partners. Singly or in combination, the most common genotype was HPV 52 (17.6%), followed by HPV 16 (14.81%), HPV 58 (13.89%), HPV 33 (11.11%), HPV 51 (11.11%), and HPV 56 (9.26%). HPV 18 was found in only 5.6% of cases. Together, HPV 16/18 were noted in approximately 20.4% of cases. Eighteen(16.67%) women were positive with multiple subtypes of HR-HPV. Co-infection most frequently involved HPV 16 or HPV 58. These findings have obvious implications for vaccine policy.

Nursing Process of Abdominal Surgery Patients (복부수술환자의 간호과정)

  • Yoo, Hyung-Sook
    • Journal of Korean Academy of Nursing Administration
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    • v.8 no.3
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    • pp.411-430
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    • 2002
  • Purpose : This study was to develop Nursing Process Model of abdominal surgery patient using nursing diagnoses of NANDA, Nursing Interventions Classification(NIC), and Nursing Outcomes Classification(NOC). Method : The data in database were collected from nursing records in sixty patients with abdominal surgery admitted in a university hospital and open questionnaires of thirteen nurses. Systematic nursing process resulting from each nursing diagnoses, most common, was developed by the statistical analysis through database query from clinical database of abdominal surgery patients. Result : 51 nursing diagnoses were identified in abdominal surgery patients. The most commonly occurred nursing diagnoses were Pain, Risk for Infection, Sleep Pattern Disturbance, Hyperthermia, Altered Nutrition: Less Than Body Requirements in order. The linkage lists of NANDA to NIC and NANDA to NOC, and the nursing activities according to nursing diagnoses of abdominal surgery patients were identified in unit. Conclusion : Nursing Process of abdominal surgery patients was comprised of core nursing diagnoses, core nursing interventions, core nursing outcomes which provides the most reliable data in unit and could make nurses facilitate nursing process easily without full consideration of knowledge about nursing language classification system. Therefore, it could support nurses' decision making and recording of nursing process especially in the computerized patient record system if unit nursing process model using standardized nursing language system which contains of their own core nursing process data was developed.

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Evaluation of Clinical Alarms and Alarm Management in Intensive Care Units (중환자실에서 사용되는 의료장비의 경보음 발생과 관리 현황)

  • Jeong, Yu Jin;Kim, Hyunjung
    • Journal of Korean Biological Nursing Science
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    • v.20 no.4
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    • pp.228-235
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    • 2018
  • Purpose: This study aimed to investigate the clinical alarm occurrence and management of nurses toward clinical alarms in the intensive care unit (ICU). Methods: This observational study was conducted with 40 patients and nurses cases in two ICUs of a university hospital. This study divided 24 hours into the unit of an hour and conducted two times of direct observation per unit hour for 48 hours targeting the medical devices applied to 40 patients. Data were analyzed using IBM SPSS Statistics 23. Results: On average, 3.8 units of medical devices were applied for each patient and the ranges of alarm settings were wide. During 48 hours, 184 cases of clinical alarm were occurred by four types of medical devices including physiological monitors, mechanical ventilators, infusion pumps, and continuous renal replacement therapy. Among them, false alarm was 110 cases (59.8%). As for the alarm management by ICU nurses, two-minute alarm mute took up most at 38.0% (70 cases), and no response was second most at 32.6% (60 cases). When valid alarm sounded, nurses showed no response at 43.2%. Conclusion: The findings suggest that a standard protocol for alarm management should be developed for Korean ICU settings. Based on the protocol, continuous training and education should be provided to nurses for appropriate alarm management.

Prognostic Factors in Patients with Non-small Cell Lung Carcinoma and Brain Metastases: a Malaysian Perspective

  • Tang, Weng Heng;Alip, Adlinda;Saad, Marniza;Phua, Vincent Chee Ee;Chandran, Hari;Tan, Yi Hang;Tan, Yan Yin;Kua, Voon Fong;Wahid, Mohamed Ibrahim;Tho, Lye Mun
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.1901-1906
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    • 2015
  • Background: Brain metastases occur in about 20-40% of patients with non-small-cell lung carcinoma (NSCLC), and are usually associated with a poor outcome. Whole brain radiotherapy (WBRT) is widely used but increasingly, more aggressive local treatments such as surgery or stereotactic radiosurgery (SRS) or stereotactic radiotherapy (SRT) are being employed. In our study we aimed to describe the various factors affecting outcomes in NSCLC patients receiving local therapy for brain metastases. Materials and Methods: The case records of 125 patients with NSCLC and brain metastases consecutively treated with radiotherapy at two tertiary centres from January 2006 to June 2012 were analysed for patient, tumour and treatment-related prognostic factors. Patients receiving SRS/SRT were treated using Cyberknife. Variables were examined in univariate and multivariate testing. Results: Overall median survival was 3.4 months (95%CI: 1.7-5.1). Median survival for patients with multiple metastases receiving WBRT was 1.5 months, 1-3 metastases receiving WBRT was 3.6 months and 1-3 metastases receiving surgery or SRS/SRT was 8.9 months. ECOG score (${\leq}2$ vs >2, p=0.001), presence of seizure (yes versus no, p=0.031), treatment modality according to number of brain metastases (1-3 metastases+surgery or $SRS/SRT{\pm}WBRT$ vs 1-3 metastases+WBRT only vs multiple metastases+WBRT only, p=0.007) and the use of post-therapy systemic treatment (yes versus no, p=0.001) emerged as significant on univariate analysis. All four factors remained statistically significant on multivariate analysis. Conclusions: ECOG ${\leq}2$, presence of seizures, oligometastatic disease treated with aggressive local therapy (surgery or SRS/SRT) and the use of post-therapy systemic treatment are favourable prognostic factors in NSCLC patients with brain metastases.

Pharmacokinetics of Procainamide and N-acetylprocainamide (Procainamide와 그 대사산물(N-acetylprocainamide)의 약동학적 분석에 관한 연구)

  • Chang, In-Jin;Shin, Jae-Gook;Shin, Sang-Goo;Park, Chan-Woong;Lim, Jung-Kyoo
    • The Korean Journal of Pharmacology
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    • v.25 no.1
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    • pp.101-107
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    • 1989
  • To evaluate disposition characteristics of procainamide and its active metabolite, N-acetylprocainamide (NAPA), cross-over study for procainamide and NAPA was performed in 5 male adult dogs. After single administration of 10 mg/kg procainamide over 15 minutes, the range of measured plasma NAPA concentrations during experimental period were 0.03 to 0.124 ug/ml and early 'dip' phenomenon was distinct on NAPA concentration to time curve in all 5 dogs. Volume of distribution (Vss) and central compartment volume (Vc) of procainamide were $1.20{\pm}0.27\;L/kg$ of body weight and $0.36{\pm}0.08\;L/kg$, respectively. Vss and Vc of NAPA were $1.21{\pm}0.21\;L/kg$ and $0.26{\pm}0.07\;L/kg$, respectively. Intercompartmental clearance (Clint) of procainamide was 3.44 L/kg/hr and that of NAPA was 1.62 L/kg/hr. Total body clearance (Cl) of procainamide and NAPA were $0.47{\pm}0.08$ and $0.35{\pm}0.08\;L/kg/hr$. The half-life $(t_{1/2{\beta}})$ of procainamide and NAPA were 2.85 hrs and 2.77 hrs, respectively. Metabolic clearance (Clm)of procainamide by N-acetylation was $18.24{\pm}6.22\;ml/kg/hr$, which corresponded to 3.9% of total procainamide clearance.

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Effects of Core Exercise Using Pressure Biofeedback Unit on Muscle Strength of Lower Extremity (생체자기 측정 기구를 이용한 코어 운동이 하지 근력에 미치는 영향)

  • An, Jung-Ae;Kim, Kyong-Hun
    • Journal of Korean Physical Therapy Science
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    • v.24 no.2
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    • pp.17-26
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    • 2017
  • Purpose: The importance of core exercise on muscle activation of the lower extremity has been studied. This study investigated the effects of core exercise using pressure biofeedback unit on muscle strength of lower extremity. Method: Fourteen healthy young adults (7 males and 7 females) were recruited. They were randomly separated two groups and performed core exercise using pressure biofeedback unit of one set for three minutes, 10sets per day for three weeks. Result: The mean of muscle strength of lower extremity, maximum power of muscle and peak TQ/BW in core exercise group significantly increased after core exercise using bio feedback unit (p<.05). Conclusion: These findings suggest that core exercise using pressure biofeed-back unit may help improving of muscle strength of lower extremity in young adults.

STUDY FOR HOUNSFIELD UNITS IN COMPUTED TOMOGRAM WITH JAW LESION (악골 병소의 켬퓨터 촬영상에서 Hounsfield Unit에 관한 연구)

  • Kim, Chul-Hwan;Jung, Jong-Il
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.4
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    • pp.391-396
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    • 2006
  • The CT number is called Hounsfield unit(HU). Generally HU has a score between +1000 from -1000, and it is standardized usingthe air(-1000), water(0), and compact bone(+1000). Hounsfield Unit to standardize the density in computed tomography using the air and water has been used to analysis of lesion in other medical field. Computed tomography is popular method to analysis of lesion in oral & maxillofacial field but the analysis about density of lesion by Hounsfield unit is still obscure. For this study, computed tomography taken in Dankook University Dental Hospital and Hounsfield unit was measured to compare the difference of jaw bone lesion as cystic lesion, benign tumor, malignant tumor.