• Title/Summary/Keyword: Patient outcome

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Development of a Tele-Rehabilitation System for Outcome Evaluation of Physical Therapy

  • Park, Hyung-Soon;Lee, Jeong-Wan
    • Journal of Biomedical Engineering Research
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    • v.29 no.3
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    • pp.179-186
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    • 2008
  • This paper presents a portable tele-assessment system designed for remote evaluation of the hypertonic elbow joint of neurologically impaired patients. A patient's upper limb was securely strapped to a portable limb-stretching device which is connected through Internet to a portable haptic device by which a clinician remotely moved the patient's elbow joint and felt the resistance from the patient. Elbow flexion angle and joint torques were measured from both master and slave devices and bilaterally fed back to their counterparts. In order to overcome problems associated with the network latency, two different tele-operation schemes were proposed depending on relative speed of tasks compared to the amount of time delay. For slow movement tasks, the bilateral tele-operation was achieved in real-time by designing control architectures after causality analysis. For fast movement tasks, we used a semi-real-time tele-operation scheme which provided the clinicians with stable and transparent feeling. The tele-assessment system was verified experimentally on patients with stroke. The devices were made portable and low cost, which makes it potentially more accessible to patients in remote areas.

Myositis Ossificans Traumatica in the Temporalis Muscle (측두근의 외상성 골화성 근염)

  • Oh, Seung Il;Lee, Yoon Ho
    • Archives of Craniofacial Surgery
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    • v.14 no.1
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    • pp.53-57
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    • 2013
  • Myositis ossificans is a condition characterized by ossification within a muscle. It is a rare and unusual pathologic entity that has defied medical efforts to establish a definite etiology, pathogenesis, and satisfactory treatment of the disease. The condition predominantly affects the flexor muscles of the upper limbs and thighs, but rarely the head and neck area. A 53-year-old male patient visited our medical institution complaining of trismus, defined as limited mouth opening. The patient had a history of trauma to the facial bones and the computed tomography scans revealed calcification in the left temporalis muscle. The patient underwent surgical removal of the calcified mass with bilateral coronoidectomy under general anesthesia. Mouth opening at the end of post-operative 2 months was 28 mm. His oral intake of food was satisfactory. Myositis ossificans of the temporalis muscle is a very rare case. Satisfactory outcome was obtained by combining surgical excision of the affected muscle, coronoidectomy, and detachment of the insertion site of the ossified muscle.

A Retrospective Study of Patients that Used Herbal Medicine During Pregnancy (임신 중 한약 복용 환자에 대한 후향적 연구)

  • Jung, Eun-Hye;Jang, Sae-Byul;Choi, Kyung-Hee;Yoo, Dong-Youl
    • The Journal of Korean Obstetrics and Gynecology
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    • v.27 no.3
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    • pp.79-93
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    • 2014
  • Objectives: This study was to establish safety and efficacy of using herbal medicine during pregnancy and to investigate patient's satisfaction. Methods: We investigated general pregnancy outcome, birth history, newborn infant's physical condition and patient's satisfaction. Survey respondents were 54 gynecological outpatients who visited Daejeon University Dunsan Oriental hospital from January 1, 2011 through February 28, 2013. Results: A total of fifty one cases maintained pregnancy and 3 cases had miscarriages. Forty seven cases delivered normally, 4 cases gave birth prematurely. There was no congenital malformation due to using herbal medicine and most of newborn babies had on the average weight and height and were healthy condition. The average score of patient's satisfaction was 3.44 point (Excellent=5). Conclusions: This study presents safety and efficacy of using herbal medicine during pregnancy.

Effect of an Ankle Strengthening Exercise that Uses PNF on the Balance and Walking Ability of Patients with Acute Disseminated Encephalomyelitis -A Single Case Study- (PNF를 이용한 발목 강화 운동이 급성파종성 뇌척수염 환자의 균형 및 보행 향상에 미치는 영향 -단일사례연구-)

  • Jung, Du-Kyo
    • PNF and Movement
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    • v.15 no.1
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    • pp.85-96
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    • 2017
  • Purpose: Peripheral neuropathy accompanied by sensory disturbance, such as limb paralysis and hemiplegia, is mainly caused by acute disseminated encephalomyelitis (ADEM). This case study aimed to determine the effect of ankle strengthening exercises that use proprioceptive neuromuscular facilitation (PNF) on the gait, balance, ankle-control ability, and sit-to-stand ability on a patient with ADEM. Methods: A 10-year-old male with quadriplegia and ankle-control impairment participated in this 4-week training intervention. The patient, diagnosed with ADEM, was treated with ankle strengthening exercises that used PNF. Results: The patient demonstrated improvements in balance, ankle-control ability, sit-to-stand ability, and gait performance. Outcome measures (manual muscle test, modified Ashworth scale, sensory assessment, coordination assessment, Berg balance scale, 5 time sit-to-stand test, and 10 m walk test) were taken before and after the training program. Conclusion: The results of this case suggest that an ankle strengthening exercise that uses PNF can improve the gait, balance, ankle-control ability, and sit-to-stand ability in patients with ADEM. In ADEM, the initial treatment is important, and the use of ankle strengthening exercises with PNF could lead to meaningful results. However, there is limited research due to an insufficient number of cases. In the future, more patients will need to be studied.

Clustering for Home Healthcare Service Satisfaction using Parameter Selection

  • Lee, Jae Hong;Kim, Hyo Sun;Jung, Yong Gyu;Cha, Byung Heon
    • International Journal of Advanced Culture Technology
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    • v.7 no.2
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    • pp.238-243
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    • 2019
  • Recently, the importance of big data continues to be emphasized, and it is applied in various fields based on data mining techniques, which has a great influence on the health care industry. There are many healthcare industries, but only home health care is considered here. However, applying this to real problems does not always give perfect results, which is a problem. Therefore, data mining techniques are used to solve these problems, and the algorithms that affect performance are evaluated. This paper focuses on the effects of healthcare services on patient satisfaction and satisfaction. In order to use the CVParameterSelectin algorithm and the SMOreg algorithm of the classify method of data mining, it was evaluated based on the experiment and the verification of the results. In this paper, we analyzed the services of home health care institutions and the patient satisfaction analysis based on the name, address, service provided by the institution, mood of the patients, etc. In particular, we evaluated the results based on the results of cross validation using these two algorithms. However, the existence of variables that affect the outcome does not give a perfect result. We used the cluster analysis method of weka system to conduct the research of this paper.

Successful engraftment after infusion of multiple low doses of CD34+ cells from a poorly matched sibling donor in a patient with severe aplastic anemia

  • Kum, Chang Dae;Lee, Mi Jin;Park, Jun Eun
    • Journal of Yeungnam Medical Science
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    • v.36 no.2
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    • pp.148-151
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    • 2019
  • The dose of CD34+ cells is known to influence the outcome of allogeneic peripheral blood stem cell (PBSC) and/or T-cell-depleted transplantation. A previous study proposed that $2{\times}10^6\;CD34+\;cells/kg$ is the ideal minimum dose for allogeneic transplantation, although lower doses did not preclude successful therapy. In the case we present here, CD34+ cells were collected from a matched sibling donor on the day of allogeneic hematopoietic stem cell transplantation; however, the number of cells was not sufficient for transplantation. Consequently, PBSCs were collected three additional times and were infused along with cord blood cells from the donor that were cryopreserved at birth. The cumulative dose of total nuclear cells and CD34+ cells was $15.9{\times}10^8\;cells/kg$ and $0.95{\times}10^6\;cells/kg$, respectively. White blood cells from this patient were engrafted on day 12. In summary, we report successful engraftment after infusion of multiple low doses of CD34+ cells in a patient with severe aplastic anemia.

The three-point crossover technique for immediate reconstruction of the umbilicus

  • Lee, Cho Long;Yang, Ho Jik
    • Archives of Plastic Surgery
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    • v.48 no.2
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    • pp.175-178
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    • 2021
  • The umbilicus is an important aesthetic component of the abdomen; therefore, its absence is both cosmetically and psychologically distressing to the patient. However, loss of the umbilicus during abdominal surgical procedures is often unavoidable. Umbilical reconstruction is aimed at obtaining a natural, three-dimensional appearance. We propose a simple method for immediate umbilical reconstruction with good long-term results. This technique was used successfully on a patient who underwent tumor excision. A 49-year-old woman presented with a large mass, measuring 5.8×4.0 cm, on her umbilicus. The mass, an epidermal cyst, developed after laparoscopic uterine myomectomy 5 years earlier. Complete excision of the mass resulted in a large defect, and immediate umbilical reconstruction was planned. Our procedure involved apposing and anchoring two opposing flaps onto the abdominal wall, so that the umbilicus would retain its depth over a long period of time. Negative-pressure wound therapy was applied for 72 hours as a mild compressive dressing. No complications were encountered. The healing process was uneventful and the aesthetic outcome was pleasing; a natural-appearing navel was created. The patient was satisfied with the end result. This technique provides a permanent and sufficient depression for the umbilicus.

Eclectic rehabilitation for bell's palsy: A case report

  • Jha, Jyoti;Khan, Huma;Zaidi, Sahar
    • CELLMED
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    • v.12 no.3
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    • pp.11.1-11.5
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    • 2022
  • Bell's Palsy is one of the most common mononeuropathies or disorders affecting a single nerve and is associated with facial nerve weakness and paralysis. Though self-limiting the disorder may leave its long-lasting residual manifestations in the form of abnormal facial symmetry, inability to close the eyes, and other poor outcomes leading to disability and impairment in societal functioning among patients. Treatment strategies include pharmacological, surgical, and therapeutic options and to limit the long-term devastating effects therapeutic options play a vital role. Physiotherapeutic techniques have been widely used among patients with Bell's Palsy but not all techniques are performed in combination. One is compared with the other and also for short durations. We planned this study to see the outcome of combined techniques available in Physiotherapy on a patient with long-term follow-up. This is a case of 38 years old male patient diagnosed with right-sided bell palsy who received 7 weeks of rehabilitation in the form of electrotherapy, facial exercises, facial PNF, massage, and education on eye care. The implementation of 7 weeks of physiotherapeutic rehabilitation led to improved facial functions and a reduction in the level of disability in the patient.

Hunt-Hess and Fisher Grades as Predicting Factors for Chronic Hydrocephalus in Surgically Treated Ruptured Aneurysm (수술적 치료를 받은 파열성 뇌동맥류환자에서의 예후와 뇌실-복강 단락술의 예측인자로써의 Hunt-Hess Grade와 Fisher Grade)

  • Hong, Chang Ki;Park, Chong Oon;Hyun, Dong Keun;Ha, Young Soo
    • Journal of Korean Neurosurgical Society
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    • v.30 no.1
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    • pp.60-65
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    • 2001
  • Objective : The popular grading systems in use, such as Hunt-Hess grade and Fisher scale score, are based primarily on the patient's clinical conditions or computerized tomography score after aneurysmal subarachnoid hemorrhage(SAH). The author investigated whether the need for ventriculoperitoneal(VP) shunt for chronic hydrocephalus and outcome can be predicted by Hunt-Hess grade and Fisher scale. Methods : A series of 146 patients admitted to our hospital from August 1991 to July 1999, who presented with SAH and underwent craniotomy for aneurysm clipping were studied retrospectively. Chronic hydrocephalus was defined as clinically and radiographically demonstrated hydrocephalus that lasted 2 weeks or longer after initial hemorrhage which required shunting. Patients were evaluated based on following factors : Hunt-Hess grade, Fisher scale, age, sex, hypertension, aneurysm location, and intervals from aneurysm rupture to operation. Results : The overall mortality rate of the study group was 8.2%. Hunt-Hess grade(p=0.001) or Fisher scale (p=0.001) at all pretreatment times was significantly correlated with outcome. In addition, there was an increased risk of poor outcome in older age(65<). However, there were statistically no significant relationship between outcome and sex, location of aneurysm, hypertension, and interval from aneurysmal rupture to operation(p>0.05). Of 134 surviving patients, 16 patients(12%) underwent VP shunt placement secondary to chronic hydrocephalus. Hunt-Hess grade(p=0.001) is more predictive of chronic hydrocephalus than Fisher scale(p=0.146). Aneurysm location was significantly correlated with development of chronic hydrocephalus (p<0.05), without significant correlations in sex, age, hypertension. IVH, and ICH. Conclusion : This study suggests that there is a high clinical correlation between outcome and Hunt-Hess grades and Fisher scales on admission, but Hunt-Hess grade is more predictive for chronic hydrocephalus than Fisher scale. In addition, age(<65 yrs) is the significant factor for prediction of outcome. There was a trend of increasing risk for chronic hydrocephalus according to aneurymal location.

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Evolution of Process and Outcome Measures during an Enhanced Recovery after Thoracic Surgery Program

  • Lee, Alex;Seyednejad, Nazgol;Lawati, Yaseen Al;Mattice, Amanda;Anstee, Caitlin;Legacy, Mark;Gilbert, Sebastien;Maziak, Donna E.;Sundaresan, Ramanadhan S.;Villeneuve, Patrick J.;Thompson, Calvin;Seely, Andrew J.E.
    • Journal of Chest Surgery
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    • v.55 no.2
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    • pp.118-125
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    • 2022
  • Background: A time course analysis was undertaken to evaluate how perioperative process-of-care and outcome measures evolved after implementation of an enhanced recovery after thoracic surgery (ERATS) program. Methods: Outcome and process-of-care measures were compared between patients undergoing major elective thoracic surgery during a 9-month pre-ERATS implementation period to those at 1-3, 4-6, and 7-9 months post-ERATS implementation. Outcome measures included length of stay, the 30-day readmission rate, 30-day emergency department visits, and minor and major adverse events. Process measures included first time to activity, out-of-bed, ambulation, fluid diet, diet as tolerated, as well as removal of the first and last chest tube, epidural, patient-controlled analgesia, and Foley and intravenous catheters. Results: In total, 704 patients (352 pre-ERATS, 352 post-ERATS) were included. Mobilization-related process measures, including time to first activity (16.5 vs. 6.8 hours, p<0.001), out-of-bed (17.6 vs. 8.9 hours, p<0.001), and ambulation (32.4 vs. 25.4 hours, p=0.04) saw statistically significant improvements by 1-3 months post-ERATS implementation compared to pre-ERATS. Time to Foley removal improved by 4-6 months post-ERATS (19.5 vs. 18.2 hours, p=0.003). Outcome measures, including the 30-day readmission rate and emergency department visits, steadily decreased post-ERATS. By 7-9 months post-ERATS, both minor (18.2% vs. 7.9%, p=0.009) and major (13.6% vs. 4.4%, p=0.007) adverse events demonstrated statistically significant improvements. Length of stay trended towards improvement from 6.2 days pre-ERATS to 4.8 days by 7-9 months post-ERATS (p=0.06). Conclusion: The adoption of ERATS led to improvements in multiple process-of-care measures, which may collectively and gradually achieve optimization of clinical outcomes.