• Title/Summary/Keyword: Intensive treatment

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Medical treatment of dissecting aortic aneurysm: report of a case (박리성 대동맥류의 보존적 치료 1례 보)

  • 김병열
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.687-690
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    • 1984
  • Aortic dissection, a condition characterized by hemorrhage into the media and variable extension along the length of the aorta, has long been recognized as a catastrophic Cardiovascular event. Recent developments in diagnostic and therapeutic skills have improved the prognosis considerably, but there is still controversy as to how cases should be managed. We experienced a case of dissecting aortic aneurysm [DeBakey Type III ], which were managed using intensive medical treatment. The period of follow up was about 11 years. At last, patient was died by progression of dissection into proximal aorta and resulted in aortic insufficiency and congestive heart failure.

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Fatal Rhabdomyolysis in a Patient with Head Injury

  • Park, Yong Jin;Kim, Seok Won
    • Journal of Korean Neurosurgical Society
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    • v.53 no.5
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    • pp.303-304
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    • 2013
  • Rhabdomyolysis is a rare but potentially life-threatening disorder caused by the release of injured skeletal muscle components into the circulation. The authors report a case of severe head injury, in which a hyperosmolar state and continuous seizure complicated by severe rhabdomyolysis and acute renal failure evolved during the course of treatment resulted in a fatal outcome despite intensive supportive treatment. Our bitter experience suggests that rhabdomyolysis should be born in mind in patients with severe head injury who may develop hyperosmolar state and continuous seizure.

Fibrinolytic (Thrombolytic) Therapy for Post Intraventricular Hemorrhagic Hydrocephalus in Preterm Infants

  • Young Soo Park
    • Journal of Korean Neurosurgical Society
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    • v.66 no.3
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    • pp.263-273
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    • 2023
  • While the survival rate of preterm infants has increased dramatically over the last few decades, intraventricular hemorrhage and subsequent hydrocephalus remain major unsolved problems in neonatal intensive care. Once intraventricular hemorrhage occurs, severe neurological sequelae are inevitable. Treatment of this complicated pathology and achievement of favorable neurofunctional outcomes in fragile infants are crucial challenges for pediatric neurosurgeons. Fibrinolytic therapy, which chemically dissolves hematoma, is a promising and useful treatment method. In this paper, the historical background of fibrinolytic therapy for post-intraventricular hemorrhagic hydrocephalus in preterm infants is reviewed and a recent method of fibrinolytic therapy using urokinase is introduced.

A Study on the Remodeling Strategy for the Equipment Intensive Areas of General Hospitals - Focused on the Diagnosis/Treatment Areas, the Supply Areas - (종합병원 설비집약적인 부문의 리모델링 방안에 관한 연구 - 중앙진료부와 공급부를 중심으로 -)

  • Kim Ha-Jin
    • Korean Institute of Interior Design Journal
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    • v.14 no.1
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    • pp.100-108
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    • 2005
  • If remodeling is defined as activities that restore the overall function of a building up to the standards currently demanded rather than as a simple replacement or repair of old facilities and equipment, the main task of remodeling should be the reduction in differences between areas, establishment of a functional linkage between departments and setup of a smooth circulation system. Therefore, this study is an analysis of remodeling strategies and construction processes to resolve major tasks of remodeling. Through this research we acquire concluding remarks. 1) The remodeling strategies of equipment-intensive areas can be divided into two measures: utilizing the existing buildings (the main buildings) the most, and of concentrated relocation in the new buildings. The former method is advantageous in that the main building serves as a center in hospital layouts because concentrated placement of the diagnosis/ treatment area and the supply area benefit the overall operation in terms of functions. However, the measure has limits in that it is difficult to install the facilities and equipment of the new demands due to the low ceilings, which serve as a potential challenge in future growth and changes. 2) The latter measure is the one in which equipment-intensive areas and the areas that are absolutely short of space are first placed in the new buildings while other areas (the outpatient area, the administration area and the miscellaneous areas) are in the existing building (main building). Given the possibility of development In the future, concentrated placement in the new buildings can be said to be more effective order to actively address future growth and changes.

Management of Reproduction on Small, Medium and Large Rabbit Farms: A Review

  • Szendro, Zs.;Szendro, K.;Zotte, A. Dalle
    • Asian-Australasian Journal of Animal Sciences
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    • v.25 no.5
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    • pp.738-748
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    • 2012
  • One of the main goals of small, medium and large farms is to improve the reproductive performance of rabbit does. Stocks of lower productivity can be improved by crossing with intensive breeds. A better nutritional status of both foetuses and suckling kits has a positive effect on their later productivity. Overfeeding young females before first mating can lead to conditions of fattiness. Using restricted feeding or higher fibre content in the feed and changing it for a higher level ad libitum feeding about one week prior to first mating leads to longer lifespan and higher productive level. Intensive reproductive rhythm creates a negative energy balance in does : they are unable to consume enough feed (energy) for the nutritional requirements of foetus and lactation, and therefore lose most of their fat reserves. Furthermore, primiparous does also expend energy because they are still growing. Under intensive conditions, the 42-d reproductive rhythm (re-mating 11 days after parturition) is recommended. Under extensive conditions, the 18 or 25-d mating interval with 35 to 42-d weaning could be suitable. On small farms, natural mating is favoured; on large farms AI is commonly employed. The main advantage of AI is the all-in, all-out system. Hormonal (PMSG) treatment is used with AI to increase receptivity on d 11. Frequent and high level PMSG use can lead to higher anti-PMSG antibody rates. Lower level (max. 20 IU) and less frequent PMSG injection or non-hormonal alternative methods (short dam-litter separation, changing nursing method or lighting programs) are recommended for this reason.

Clinical Study about Patients in Intensive Care Unit at an Oriental Medical Hospital - Focused on Main Disease and Complications - (한방병원 중증치료실 입원 환자의 임상적 분석 - 주 질환 및 합병증 위주로 -)

  • Noh, Hyun-In;Lee, Jee-Sook;Yoon, Da-Rae;Yi, Seo-Ra;Ryu, Jae-Hwan
    • The Journal of Internal Korean Medicine
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    • v.33 no.2
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    • pp.172-179
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    • 2012
  • Objectives : This study was designed to quantify the characteristics, main diagnosis and complications in the intensive care unit (ICU) at an Oriental Medical Hospital. Methods : The medical records of 44 patients admitted to the ICU at Kyunghee Oriental Medical Hospital between January 1, 2011 and December 31, 2011 were reviewed. Basic characteristics of patients, admission channel, main diagnosis, east-western medical therapy, mortality, and complications were investigated retrospectively based on medical notes. Results : 1. The total number of patients was 44. Males were 63.6%, females 36.3%. Average admission days was 15.9. 2. The most frequent age group is eighties, 38.6%. 3. The most frequent disease is cerebrovascular disease, 61.3%. 4. The medical therapy done after admission to ICU was intubation. Central vein insertion was performed next, followed by Foley's catheter insertion, ventilator, tracheostomy, nasogastric intubation, and thoracentesis in order. The proportion of Oriental medical treatment provided to the patients of ICU was as follows: herbal medication only 6.8%; herbal medication plus acupuncture 31.8%; herbal medication, acupuncture electro-acupuncture, plus subcutaneous acupuncture 2.3%; and none 27.3%. 5. The number of cases of complications occurred since ICU admission was 18. The most frequently observed complication was infection, including 6 cases of pneumonia and 4 cases of urinary tract infection. Conclusions : We suggest that ICUs of Oriental medical hospitals need to be managed effectively to treat diseases including cerebrovascular disease and prevent complications.

Effects of a Personalized Nurse-Led Educational Program for New Patients Receiving Oral Anticoagulant Therapy after Mechanical Heart Valve Prosthesis Implantation on Adherence to Treatment

  • Eltheni, Rokeia;Schizas, Nikolaos;Michopanou, Nektaria;Fildissis, Georgios
    • Journal of Chest Surgery
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    • v.54 no.1
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    • pp.25-30
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    • 2021
  • Background: Life-long anticoagulant therapy is mandatory for patients who undergo heart valve replacement with implantation of a mechanical prosthesis. The aim of this study was to investigate the effects of a nurse-led patient educational program concerning oral anticoagulant therapy intake after heart valve replacement surgery on patients' knowledge of important parameters of anticoagulant administration. Methods: In this single-center study, 200 patients who underwent surgical implantation of a mechanical prosthesis were divided into 2 groups. The control group received the basic education concerning oral anticoagulants, while the intervention group received a personalized educational program. Results: Personalized education was correlated with a better regulation of therapeutic international normalized ratio (INR) levels and adequate knowledge among patients. Therapeutic levels of INR were achieved in 45% of the patients during the first month, 71% in the third month, and 89% in the sixth month after discharge in the intervention group, compared to 25%, 47%, and 76% in the control group, respectively. Patients' satisfaction with the information was higher in the intervention group than in the control group. The percentage of satisfaction reached 80% for the intervention group versus 37% for the patients of the control group. Conclusion: The implementation of the nurse-led educational programs was associated with improved clinical results and increased adherence to oral anticoagulant treatment.

Comparative Analysis of decreased Mental state Patients after Overdose with Sedative-hypnotics (진정수면제 음독 후 의식저하로 내원한 환자의 급성중독 비교)

  • Oh, Seung Jae;Cho, Soo Hyung;Ryu, So Yeon
    • Journal of The Korean Society of Clinical Toxicology
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    • v.20 no.1
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    • pp.8-14
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    • 2022
  • Purpose: This study was undertaken to investigate how sedative-hypnotics affect the occurrence and severity of the patient's symptoms. In addition, we conducted a study to determine the type of patients who reacted severely and required hospitalization; patients were accordingly classified as hospitalized patients and patients discharged from the emergency room. Methods: From January 2017 to December 2019, we investigated the demographics, drug information, history, laboratory tests, and severity of patients who visited our emergency department and were diagnosed with benzodiazepine, zolpidem, and doxylamine succinate overdose. We further compared details of hospitalized patients and discharged patients. Results: Subjects who had overdosed and visited the ED included 120 for benzodiazepine, 147 for zolpidem, and 27 for doxylamine succinate. Comparisons between the three groups revealed differences in their early diagnosis, psychiatric history, and sleep disturbance. Differences between groups were also determined for mental state, poisoning history, treatment received in the intensive care unit, and intubation and ventilator support. In cases of benzodiazepine overdose, we obtained a high hospitalization rate (40.0%), admission to the intensive care unit (24.2%), and intubation rate (18.3%). Comparisons between hospitalized patients and discharged groups showed differences in transferred patients, early diagnosis, and mental state. Conclusion: Patients poisoned by sedative-hypnotics are increasing every year. In cases of benzodiazepine and zolpidem, the hospitalization rates were high, and benzodiazepine overdose resulted in hospitalization, intensive care unit admission, and pneumonia in a majority of cases. Therefore, active treatment and quick decisions in the emergency room are greatly required.

Job Analysis of the Staff Nurse in Cardiac Surgery Intensive Care Unit (심장외과 중환자실 일반간호사의 업무분석)

  • Ko, Yu-Kyung
    • Journal of Korean Academy of Nursing Administration
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    • v.9 no.2
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    • pp.265-282
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    • 2003
  • Purpose : This study was conducted to provide for a basic resource, which can be used to set up a efficient management system in Cardiac Surgery Intensive Care Units(CSICU). Method: 1) Questionnaires were administered and observation methods were used, to examine the nursing activities performed in the CSICU after having reviewed related literatures and a review by the experts. Thus, the nursing activities were designating 254 activities and classified into 28 categories. 2)The 22 nurses in the 2 CSICUs filled out questionnaires about nursing activities from 12 April, 2002 to 17 April, 2002. The frequency of the nursing activities in the 28 categories counted and new nursing activities added by directly observing 12 nurses by two trained research staffs for 4 day. 3)In terms of validity, the 264 nursing activities were analysed by the 25 experts. As a result, 231 nursing activities were found valid and remained as appropriate nursing activities to be used for the careful analysis of the nursing activities in CSICUs. Result: The 22 categories are as below: assessment, monitoring, respiration management, nutrition management, elimination/drainage management, mobility management, sanitation management, safety management, temperature management, specimens collection, preparation and assistance of treatment, skin/wound management, infection management, medication management, education/support, dying patient care, recording/keeping, supplies management, environment management, communications, evaluations, professional development Conclusion : The manifest job description of the staff nurse will contribute to improving the efficiency of the nursing activities and to reducing the role conflicts among the medical staffs.

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Analysis of Risk Factors to Predict Intensive Care Unit Transfer in Medical in-Patients (내과 환자의 중환자실 전동에 대한 위험요인 분석)

  • Lee, Ju Ry;Choi, Hye Ran
    • Journal of Korean Biological Nursing Science
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    • v.16 no.4
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    • pp.259-266
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    • 2014
  • Purpose: The purpose of this study was to analyze risk factors in predicting medical patients transferred to Intensive Care Unit (ICU) on the general ward. Methods: We reviewed retrospectively clinical data of 120 medical patients on the general ward and a Modified Early Warning Score (MEWS) between ICU group and general ward group. Data were analyzed with multivariate logistic regression and the area under the receiver operating characteristic curves using SPSS/WIN 18.0 program. Results: Fifty-two ICU patients and 68 general ward patients were included. In multivariate logistic regression, the MEWSs (Odds Ratio [OR], 1.91; 95% confidence interval [CI], 1.32-2.76), sequential organ failure assessment score (OR, 1.28; 95% CI, 1.10-1.72), $PaO_2/FiO_2$ ratio (OR, 0.98; 95% CI, 0.98-0.99), and saturation (OR, 0.93; 95% CI, 0.88-0.99) were predictive of ICU transfer. The sensitivity and the specificity of the MEWSs used with a cut-off value of six were 80.8% and 70.6% respectively for ICU transfer. Conclusion: These findings suggest that early prediction and treatment of patients with high risk of ICU transfer may improve the prognosis of patients.