• 제목/요약/키워드: Patient Related Management

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Radiation Induced Lung Injury: Prediction, Assessment and Management

  • Giridhar, Prashanth;Mallick, Supriya;Rath, Goura Kishore;Julka, Pramod Kumar
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권7호
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    • pp.2613-2617
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    • 2015
  • Radiation induced lung injury has long been considered a treatment limiting factor for patients requiring thoracic radiation. This radiation induced lung injury happens early as well as late. Radiation induced lung injury can occur in two phases viz. early (< 6 months) when it is called radiation pneumonitis and late (>6 months) when it is called radiation induced lung fibrosis. There are multiple factors that can be patient, disease or treatment related that predict the incidence and severity of radiation pneumonitis. Radiation induced damage to the type I pneumocytes is the triggering factor to initiate such reactions. Over the years, radiation therapy has witnessed a paradigm shift in radiation planning and delivery and successfully reduced the incidence of lung injury. Radiation pneumonitis is usually a diagnosis of exclusion. Steroids, ACE inhibitors and pentoxyphylline constitute the cornerstone of therapy. Radiation induced lung fibrosis is another challenging aspect. The pathophysiology of radiation fibrosis includes continuing inflammation and microvascular changes due to pro-angiogenic and profibrogenic stimuli resembling those in adult bronchiectasis. General supportive management, mobilization of airway secretions, anti-inflammatory therapy and management of acute exacerbations remains the treatment option. Radiation induced lung injury is an inevitable accompaniment of thoracic radiation.

도농 지역에서 만성 요통 환자의 우울증 평가 (Assessment of Depression in Chronic Back Pain Patients in Urban-rural areas)

  • 이정모;김종문;김종훈;정진상
    • 한국지역사회생활과학회지
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    • 제15권2호
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    • pp.159-166
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    • 2004
  • This study was undertaken to investigate the severity of depression and to analyze various factors related to depression in chronic back pain patients in urban-rural areas. In this study, 30 patients who suffered from back pain more than 6 months, and 30 normal subjects who had similar demographic characteristics as the patient group were evaluated using the Back Depression Inventory(BDI). Various factors such as age, sex, causes of back pain, vocational history, pain continuity, visual analogue scale(VAS), duration of pain, type of management, and urban or rural residence were recorded for the study group. The results are 1) The study group revealed higher BDI scores than the control group(p<0.05). 2) The patients who were older and had higher VAS, longer duration of pain, or previous history of surgical management for back pain, and an urban 033residence revealed higher BDI scores(p<0.05). 3) The BDI scores were not significantly influenced by the subjects' sex, causes of back pain, pain continuity, and vocational history in the study group(p>0.05). From this study, we concluded that a Psychosocial approach is required for the management of chronic back pain patients. Also, it is necessary to assess the factors, which are making depression worse in other chronic diseases for comprehensive rehabilitation.

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Online Social Networks - Opportunities for Empowering Cancer Patients

  • Mohammadzadeh, Zeinab;Davoodi, Somayeh;Ghazisaeidi, Marjan
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권3호
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    • pp.933-936
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    • 2016
  • Online social network technologies have become important to health and apply in most health care areas. Particularly in cancer care, because it is a disease which involves many social aspects, online social networks can be very useful. Use of online social networks provides a suitable platform for cancer patients and families to present and share information about their medical conditions, address their educational needs, support decision making, and help to coping with their disease and improve their own outcomes. Like any other new technologies, online social networks, along with many benefits, have some negative effects such as violation of privacy and publication of incorrect information. However, if these effects are managed properly, they can empower patients to manage cancer through changing behavioral patterns and enhancing the quality of cancer patients lives This paper explains some application of online social networks in the cancer patient care process. It also covers advantages and disadvantages of related technologies.

Epidemiology of trigeminal neuralgia: an electronic population health data study in Korea

  • Lee, Cheol-Hyeong;Jang, Ho-Yeon;Won, Hyung-Sun;Kim, Ja-Sook;Kim, Yeon-Dong
    • The Korean Journal of Pain
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    • 제34권3호
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    • pp.332-338
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    • 2021
  • Background: Trigeminal neuralgia (TN) is one of the most painful disorder in the orofacial region, and many patients have suffered from this disease. For the effective management of TN, fundamental epidemiologic data related to the target population group are essential. Thus, this study was performed to clarify the epidemiological characteristics of TN in the Korean population. This is the first national study to investigate the prevalence of TN in Korean patients. Methods: From 2014 to 2018, population-based medical data for 51,276,314 subscribers to the National Health Insurance Service of Korea were used for this study. Results: The incidence of TN was 100.21 per 100,000 person-years in the year of 2018 in Korea, and the male to female ratio was 1:2.14. The age group of 51-59 years had the highest prevalence of TN. Constant increases in medical cost, regional imbalance, and differences in prescription patterns by the medical specialties were showed in the management of TN. Conclusions: The results in this study will not only help to study the characteristics of TN, but also serve as an important basis for the effective management of TN in Korea.

외상성 기도 손상의 임상적 고찰 (Clinical Aanalysis of Airway Trauma)

  • 조현민;김영진;류한영;황정주
    • Journal of Trauma and Injury
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    • 제24권1호
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    • pp.7-11
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    • 2011
  • Purpose: Traumatic airway injuries have high rates of mortality and morbidity. Thus, we evaluated the clinical results of trauma-related airway-injury patients. Methods: A clinical analysis was performed for patients with airway trauma who were admitted and treated at the Department of Thoracic and Cardiovascular Surgery, Konyang University Hospital from Dec. 2002 to Dec. 2009. Results: Sixteen patients were admitted and treated. Fourteen patients were male, and the ages of the patients ranged from 16 to 75 years. Six cases were penetrating injuries, 4 were traffic-accident injuries. 3 were fall injuries, and. 3 were other blunt trauma injuries. Anato- mic injuries included 14 trachea cases (87.5%), 1 Rt. main bronchus (6.25%), and 1 Lt. main bronchus cases (6.25%). Diagnosis was made by using computed tomography and bronchoscopy. Five patients were treated with an explothoracotomy, and 7 underwent neck exploration with primary repair. Three patients simply needed conservative management, and 1 patient was treated with a closed thoracostomy. The post-operative mortality rate was 6.25 % (1 patient). Conclusion: Airway trauma is dangerous and should be treated as an emergency, so a high index of suspicion is essential for rapid diagnosis and successful surgical intervention in patients with airway injuries.

Non-Value-added Activity 개선을 통한 간호업무 효율성 향상 (Case study on improvements in non-value-added nursing activities to increase the efficiency of nursing care)

  • 박양희;권인각;박계숙;장혜정;송미라;김희진
    • 한국의료질향상학회지
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    • 제19권2호
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    • pp.68-80
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    • 2013
  • Background: This study investigates improvements in non-value-added nursing activities in clinical work, in order to improve the efficiency and quality of nursing activities. Methods: The study was performed as a quality improvement project at a tertiary general hospital. The nursing activities that needed improvements were categories into admission care, discharge care, supply management, diagnostic work-up related activities, and others. The nursing time and frequency of non-value-added activities were compared across nine nursing units before and after implementation of the quality improvement program. Post-implementation patient and nurse satisfaction were subsequently analyzed. Result: Post-implementation, the time spent on non-value-added nursing activities was reduced and patients and nurses were satisfied with the improvements. Discussion: Reducing non-value-added activities in nursing can increase the work efficiency and ensure time for patient care, thus improving the quality of nursing care. For further study, accurate surveys on nursing activities based on nursing time are required.

Patients on Anticoagulants after a Head Trauma : Is a Negative Initial CT Scan Enough? Report of a Case of Delayed Subdural Haematoma and Review of the Literature

  • Hadjigeorgiou, Georgios F.;Anagnostopoulos, Christos;Chamilos, Christos;Petsanas, Adamantios
    • Journal of Korean Neurosurgical Society
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    • 제55권1호
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    • pp.51-53
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    • 2014
  • Mild traumatic brain injury is common in elderly patients, many of whom are on anticoagulant. The common practice is to discharge these patients from the emergency room if the computed tomography (CT) of the brain is normal. However, a very small proportion of these patients may develop a life threatening intracranial haematoma in the following days. We present here a case of a 66-year-old male on anticoagulant therapy that developed a subdural haematoma 48 hours after a mild head injury, with a normal initial CT scan of the brain. The patient underwent a craniotomy with evacuation of a large subdural clot. Postoperatively he had progressively improved and six months later has a Glasgow Outcome Score of three. This case is characterized by the delayed onset of a subdural haematoma in a patient on anticoagulation and we discuss here the possible pathogenesis related to this phenomenon. We also briefly review the pertinent literature and the current guidelines for the management of this type of head injuries.

Fourth Recurrence of Cardiac Myxoma in a Patient with the Carney Complex

  • Kwon, O Young;Kim, Gun Jik;Jang, Woo Sung;Lee, Young Ok;Cho, Jun Yong;Lee, Jong Tae
    • Journal of Chest Surgery
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    • 제49권2호
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    • pp.119-121
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    • 2016
  • Although cardiac myxoma is the most commonly encountered benign cardiac tumor in cardiac surgery practice, recurrent cardiac myxoma is very rare, is most commonly related to the Carney complex, and usually requires multiple cardiac operations with specific requirements in terms of perioperative management. In this report, we describe a patient who experienced the fourth recurrence of cardiac myxoma and review the diagnostic criteria of the Carney complex. This is the first report of such a case in Korea.

A method to prevent cerebrospinal fluid leakage: Reinforcing acellular dermal matrix

  • Lee, Hojune;Eom, Ye Seul;Pyon, Jai-Kyong
    • 대한두개안면성형외과학회지
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    • 제21권1호
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    • pp.45-48
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    • 2020
  • In neurosurgical cases, problems related to wound healing can vary from simple wound dehiscence to multilayer defects. This study demonstrates an effective method to prevent persistent cerebrospinal fluid (CSF) leakage using reinforcing acellular dermal matrix in neurosurgical patients with wound dehiscence. A 52-year-old woman was admitted for management of recurrent glioblastoma. After tumor removal surgery, the patient experienced sustained CSF leakage from the wound despite reparative attempts. The plastic surgery team performed wound repair procedure after remnant tumor removal by the neurosurgery team. Acellular dermal matrix was applied over the mesh plate to prevent CSF leakage and the postoperative status of the patient was evaluated. No sign of CSF leakage was found in the immediate postoperative period. After 3 years, there were no complications including CSF leakage, wound dehiscence, and infection. We hereby propose this method as a feasible therapeutic alternative for preventing CSF leakage in patients experiencing wound problem after neurosurgical procedures.

Pelizaeus-Merzbacher 병 환자의 외래전신마취 하 치과치료 -증례보고- (Dental Treatment of a Patient with Pelizaeus-Merzbacher Disease under Outpatient General Anesthesia -A Case Report-)

  • 김태경;신차욱;김현정;염광원;서광석
    • 대한치과마취과학회지
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    • 제7권1호
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    • pp.18-21
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    • 2007
  • Pelizaeus-Merzbacher disease (PMD) can be defined as an X-linked recessive leukodystrophy that is caused by a mutation in the proteolipid protein gene on chromosome Xq22. PMD is one of a group of progressive, degenerative disorders of the cerebral white matter known as the leukodystrophies. Due to the progressive nature of the disorders and their devastating effects on the central nervous system, these children frequently require anesthesia during imaging procedures such as MRI or during various surgical procedures. Anesthetic concerns in theses cases include high prevalence of seizure disorders, gastroesophageal reflux with the risk of aspiration, airway complications related to poor pharyngeal muscle control and copious oral secretions, and mental retardation. We report a successful anesthetic management in a patient with PMD for dental procedures.

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