• Title/Summary/Keyword: Invasive procedures

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Safety Management for MR-Guided Interventions

  • Cherkashin, Mikhail;Berezina, Natalia;Serov, Alexey;Fedorov, Artem;Andreev, Georgy;Kuplevatsky, Vladymir
    • Investigative Magnetic Resonance Imaging
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    • v.20 no.3
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    • pp.152-157
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    • 2016
  • Purpose: Operating room management is the serious and complex task for hospital managers and the common approach is to develop relevant standard operational procedures. From patient and staff safety perspective, operating room management should be well-studied and hospital should identify and address any potential risks. Simultaneous usage of different imaging and less-invasive treatment technologies demands strong management control. Materials and Methods: We have formed the multidisciplinary expert panel (surgeons, anesthesiologists, radiologists, healthcare managers etc.) for hybrid theater management standard operational procedure development. On the first stage the general concept of hybrid room design and patient routing was developed. The second stage included the technical details discussion. For patient safety improvement we modified the Surgical Safety Check-list in accordance with potential MRI-related safety challenges and concerns. Results: WHO Surgical Safety Checklist is a simple and easy-to use tool which includes three blocks of question (grouped by the surgery process). We have developed two additional blocks of questions for the intraoperative magnetic resonance investigation. It is very important to have a special detailed routing with a strong control of ferromagnetic devices and anesthesiology care. Conclusion: High-energy MRI (1.5-3.0T) is characterized by potential influence on patient and staff safety in case of hybrid surgery. It is obvious to have a strong managerial control of ferromagnetic devices and anesthesiology care. Surgical Safety Checklist is the validated tool for improving patient safety. Modification and customization of this check-list potentially provides the opportunity for surgery processes improving.

Identification of two novel Duchenne muscular dystrophies mutations in patients with Becker muscular dystrophy

  • Kim, Dahye;Kim, Yoon-Myung;Seo, Go Hun;Kim, Gu Hwan;Yoo, Han Wook;Yum, Mi-Sun;Ko, Tae-Sung;Lee, Beom Hee
    • Journal of Genetic Medicine
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    • v.14 no.2
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    • pp.75-79
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    • 2017
  • Duchenne and Becker muscular dystrophies (DMD and BMD, respectively) are X-linked neuromuscular disorders characterized by progressive muscle weakness and severe skeletal muscle degeneration. BMD is a milder form with a later onset. Patients with BMD tend to survive much longer than those with DMD. The differentiation between DMD and BMD is important in the genetic counseling of affected patients and their families. Since muscle biopsies are invasive procedures, the differential diagnosis of BMD and DMD is often dependent on the mutation identified in the DMD gene in affected patients. However, when a novel DMD mutation is identified, the differential diagnosis should be based on muscle biopsy findings with other clinical findings. Here we describe two Korean patients with BMD confirmed by muscle biopsy and genetic testing. Two novel exonic deletions in the DMD gene were identified.

A Case of Brain Abscess due to Parvimonas micra in a Healthy Child without Dental Disease (특이 과거력이 없는 소아에서 발생한 Parvimonas micra 뇌농양 1예)

  • Lee, Shin Young;Roh, Tae Hoon;Jung, Hyun Joo
    • Pediatric Infection and Vaccine
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    • v.27 no.2
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    • pp.127-133
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    • 2020
  • Parvimonas micra is a non-spore-forming anaerobic gram-positive coccus and a known commensal of the skin, gums, vagina, and gastrointestinal tract. It is rarely associated with severe infections, which typically follow invasive procedures such as dental treatment. We describe a case of a brain abscess caused by P. micra in an immunocompetent 11-year-old boy without periodontal disease. He presented with a 7-day history of headaches and vomiting, and complained of diplopia that began on the day of presentation. He did not have any recent dental treatment or specific past medical history. A brain abscess in the left frontoparietal lobe was noted on brain magnetic resonance imaging. P. micra was cultured from brain abscess aspirate. He was successfully treated with surgical drainage and combined antibiotic therapy with ceftriaxone and metronidazole for 6 weeks.

Profile of Lymphadenopathy in Kashmir Valley: a Cytological Study

  • Qadri, Sumyra Khurshid;Hamdani, Nissar Hussain;Shah, Parveen;Lone, Mohammad Iqbal;Baba, Khalil Mohammad
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3621-3625
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    • 2012
  • Lymphadenopathy is one of the commonest and significant manifestations of local as well as systemic ailments, especially malignancies. Fine needle aspiration cytology (FNAC) helps in diagnosing the disease itself, in general, but more importantly ruling out malignancy, in particular. Hence it saves much of the cost and use of resources incurred with excision biopsy of such lymph nodes. This prompted us to study the cytologic patterns of lymphadenopathy in our setting and the diagnostic utility of FNAC in the evaluation of lymphadenopathy. In this retrospective observational study, 1,579 patients (953 males and 626 females) with lymphadenopathy who were subjected to FNAC over a period of three years (January 2009 to December 2011) were studied. The cervical region was involved in most of the cases (76%) followed by the axillary region (17.5%). Metastatic malignancy (38.2%) was the commonest cause of lymphadenopathy followed by reactive lymphoid hyperplasia (36.9%), tuberculosis (9.1%) and lymphomas (8.6%). Squamous cell carcinoma (32.2%) followed by adenocarcinoma (21.9%) were the most frequent metastatic tumors. FNAC is a useful diagnostic tool in the management of patients presenting with lymphadenopathy and should be considered before more invasive and costly procedures are performed, particularly in developing countries.

Distinct Postsurgical Management in Young and Elderly Breast Cancer Patients Results in Equal Survival Rates

  • Oran, Ebru Sen;Yankol, Yucel;Soybir, Gursel Remzi;Karsidag, Tamer;Sakalli, Onur;Gecgel, Umit;Soybir, Onur Can;Soran, Atilla
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7843-7847
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    • 2014
  • Background: Although breast cancer (BC) is one of the most common malignant diseases in women, the majority of the studies describing the characteristics of BC in elderly patients have been limited to survival assessments or tumor features, without using younger BC patients as a reference group. The aim of our study was to describe and compare tumor characteristics and management patterns in elderly versus younger breast cancer patients in Turkey. Materials and Methods: We retrospectively analyzed 152 patients with invasive breast cancer who underwent surgery in our institution between 2002 and 2012. Patients were divided into 2 groups according to age at the time of diagnosis. Results: There were 62 patients in the elderly group (${\geq}65$ years) and 90 patients in the younger group (<65 years). Compared to the younger group, tumors in the elderly group were more likely to be larger (p=0.018), of lower grade (p=0.005), and hormone receptor-positive (p>0.001). There were no significant differences regarding histology, localization, lymph node involvement, or types of surgical procedures between the 2 groups. Comorbidities were more common in elderly patients (p<0.001). In addition, elderly patients were more likely to receive hormonal therapy (p<0.001) and less likely to receive radiotherapy (p=0.08) and chemotherapy (p=0.003). There was no difference in survival and locoregional recurrence rates between the groups. Conclusions: The results of this study demonstrate that breast cancer in elderly patients has more favorable tumor features, warranting less aggressive treatment regimens after surgery.

Infective Endocarditis Caused by Methicillin-Resistant Staphylococcus aureus Combined with Meningitis (수막염과 동반된 메티실린내성 황색포도알균에 의한 감염성 심내막염 1예)

  • Na, Kyung Won;Kim, Jon Soo;Kim, Hyun Jung
    • Pediatric Infection and Vaccine
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    • v.23 no.3
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    • pp.229-235
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    • 2016
  • Infective endocarditis (IE) caused by methicillin-resistant Staphylococcus aureus (MRSA) has become a worldwide concern. We present a case of a 12-year-old child with IE of the native mitral valve due to MRSA infection after an invasive dental procedure. Based on the clinical symptoms and the presence of cerebrospinal fluid pleocytosis, the patient was initially diagnosed with presumed bacterial meningitis and treated with empiric antibiotics. On the third day of hospitalization, MRSA was cultured from the initial blood samples and vegetation was observed on the mitral valve during an echocardiogram, findings which are compatible with a diagnosis of IE. The revised guidelines for antibiotic prophylaxis for the prevention of IE advise that IE prophylaxis for dental procedures is reasonable only for patients with underlying cardiac conditions, who are at the highest risk of adverse outcomes from IE. However, in this case, the patient had no high risk factors indicative of IE prophylaxis, except for mitral valve prolapse. She had no recurrence of IE over a follow-up period of 12 months.

Hybrid Method for Stent-graft Insertion in a Patient with a Thoracic Aortic Aneurysm Involving the Aortic Arch - A case report - (대동맥궁을 침범한 흉부대동맥류 환자에게 시행한 Hybrid 스텐트-그라프트 삽입술 1예 - 1예 보고 -)

  • Kim, Dong-Hyun;Won, Yong-soon;Her, Keun;Shin, Hwa-Hyun
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.292-295
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    • 2010
  • The surgical treatments for aortic arch aneurysm are thought to be very invasive procedures, and high morbidity and mortality rates have been reported after aortic arch aneurysm operations. Many surgeons currently prefer the insertion of a stent-graft rather than an operation for treating an aortic arch aneurysm and if needed, with bypass of the subclavian or carotid arteries, which is called the 'hybrid method'. We managed one patient with an aortic arch aneurysm by using the hybrid method, and so we report on this case with a review of the relevant literature.

Screening and Optimal Culture Conditions of Antibiotic-Producing Actinomycetes B-51 for Multidrug Resistant Acinetobacter baumannii (다제내성 Acinetobacter baumannii에 유효한 방선균 B-51의 탐색 및 이 균주가 생산하는 항생물질 발효 최적 배양 조건)

  • Rhee, Moon-Soo;Kim, Gwan-Pil;Bang, Byung-Ho
    • The Korean Journal of Food And Nutrition
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    • v.23 no.1
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    • pp.63-69
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    • 2010
  • With the increase of the use of antibiotics and invasive procedures, infections caused by multidrug-resistant Acinetobacter baumannii(MRAB) are increasing. We screened the antibiotic producing strain B-51 for antibacterial activity against MRAB from the soils and studied the effects of culture medium on the antibiotic production of B-51. The medium conditions for maximum antibiotic productivity of B-51 was 2% glycerol, 0.5% soybean meal, 0.01% $CaCl_2$, 0.01% $MgSO_4{\cdot}7H_2O$ and 0.01% $KH_2PO_4$ at an initial pH of 6.0, at $30^{\circ}C$ for 76 h.

A Study on the Inpatients‘ Perception of Comfort (입원환자가 지각하는 안위에 관한 연구)

  • Kim Keum-Soon;Kang Ji-Yeon;Seo Hyun-Mi;Sohng Kyeong-Yae;Won Jong-Soon;Jeong Ihn -Sook;Chung Hae-Kyung;Kim Kyung-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.8 no.3
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    • pp.346-356
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    • 2001
  • This paper describes a Q-methodological study on the Perception of comfort in hospital in-patients. The participants completed a 37-item Q sort made up of statements which could be ranked in terms of their relevance to the subjective meaning of comfort. Three interpretable types of comfort were identified through this Q study : Type I, positive medical action style, feel secure and satisfied when medical staff show a positive attitude towards them as patients. They put a high value on prompt responses from medical staff and physical aspects of care like non-invasive procedures or comfortable position. Type II, social relation style, experience a state of comfort when they perceive support or concern from medical staff, relatives or other patients suffering from similar diseases. They feel safe and secure when medical staff are kind and have a good reputation or when the size of the hospital is big enough, Type III, emotional wellbeing style, feel that hope for a healthy life or maintaining self-care activities are highly valuable. They feel safe and comfortable when their privacy is protected. They put worth on independent thinking, strong will, and emotional or psychological comfort. The results of this study can be used as a basis to develop nursing measures for comfort. Further studies on factors which influence perception of comfort and intervention strategies according to the above types of comfort need to be done.

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Development of evidence-based protocol to maintain high humidity of incubator in Extremely Low Birth Weight Infant (초극소 저출생체중아의 고농도 가습환경 유지를 위한 근거중심 프로토콜 개발)

  • Yu, Mi;Choi, Yun-Jin;Han, Li-La;Yun, Young-Mi;Bae, Geun-Ha;Lee, Ji-Eun;Park, Ji-Seon;Park, Ui
    • Journal of Korean Critical Care Nursing
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    • v.2 no.2
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    • pp.5-17
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    • 2009
  • Purpose: The purpose of this study was to investigate the current humidification state of incubator, the factors disturbing high humidification and to establish the evidence-based nursing protocol to maintain it. Methods: The subjects were 15 infants who were born with extremely low birth weight (ELBW) from May to October, 2007, and data were collected during the first 3 days and analyzed with SPSS WIN program. Results: The goal of humidity level in incubator was 95%, but mean humidity levels were 89.7%(1st day), 91.9%(2nd day), and 91.8%(3rd day)(p<0.001). The disturbing factors were opening frequency and duration of incubator door and window by caregivers. The handling of infants by nurses and doctors happened more frequently during the first day. Especially, nurses handled them more often than others, but the duration of opening during the invasive procedures by doctors was longer than others. The opening frequency had negative correlation with duration(r=-.779, p<.01). Conclusion: So the evidence-based protocol for maintaining high humidity in incubator for ELBW infants during the first 3 days and next 2 days was made. Furthermore we need to educate NICU nurses and doctors about minimal handling.

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