• 제목/요약/키워드: Patient-Controlled

검색결과 969건 처리시간 0.029초

Essential Thrombocytosis-Associated Thromboembolism in the Abdominal Aorta

  • Chong, Byung Kwon;Mun, Dana;Kang, Chae Hoon;Park, Chong-bin;Cho, Won Chul
    • Journal of Chest Surgery
    • /
    • 제49권5호
    • /
    • pp.397-400
    • /
    • 2016
  • Essential thrombocytosis (ET) is a myeloproliferative disorder characterized by an anomalous increase in platelet production. Many patients with ET are asymptomatic. Few studies have reported ET-associated thromboembolism in large vessels such as the aorta. We report a patient with ET who presented with peripheral embolism from an abdominal aortic thrombus and developed acute limb ischemia. The patient underwent aortic replacement successfully. The patient's platelet count was controlled with hydroxyurea, and no recurrence was noted over 2 years of follow-up.

Hypertensive crisis following mRNA COVID-19 vaccination in adolescents: two case reports

  • Myung Hyun Cho;Hae Il Cheong
    • Childhood Kidney Diseases
    • /
    • 제26권2호
    • /
    • pp.97-100
    • /
    • 2022
  • In response to the global coronavirus disease 2019 (COVID-19) pandemic, vaccines were developed and approved quickly. However, numerous cardiovascular adverse events have been reported. We present two adolescent cases who developed a hypertensive crisis following NT162b2 mRNA COVID-19 vaccination. Patient 1 was an 18-year-old male and his systolic blood pressure was 230 mmHg one day after the second vaccine. He was obese. No secondary cause of hypertension other than the vaccine was identified. Patient 2 was an 18-year-old male who complained with palpitation after the first vaccine. His blood pressure was 178/109 mmHg. He had autosomal dominant polycystic kidney disease. Both were treated with continuous infusion of labetalol followed by losartan, and blood pressure was controlled. Patient 2 received second vaccination and his blood pressure did not rise. It is warranted to measure blood pressure in adolescents at high risk of hypertension after NT162b2 mRNA COVID-19 vaccination.

COVID-19 백신 접종 후 발생한 다발성 농양 1예: 증례 보고 (Multiple Abscesses Following COVID-19 Vaccination: A Case Report)

  • 이효범;김갑래;김태호
    • 대한족부족관절학회지
    • /
    • 제27권2호
    • /
    • pp.67-70
    • /
    • 2023
  • Vaccines can cause adverse reactions, such as soreness, swelling, or redness at the injection site. Some reactions are associated with fever and rash, which are usually mild and transient, and serious side effects are rare. In particular, there are no reports of systemic infection following a COVID-19 vaccination. The authors present a case report of a patient who developed multiple abscesses caused by Staphylococcus aureus after a COVID-19 vaccination. The patient had no previous symptoms or signs of infection. The patient was controlled successfully after surgical and antibiotics treatment.

Azygos and right superior intercostal vein injury secondary to blunt trauma: a case report

  • Nima Yaftian;Benjamin Dunne;Phillip Antippa
    • Journal of Trauma and Injury
    • /
    • 제36권1호
    • /
    • pp.53-55
    • /
    • 2023
  • Azygos vein injuries are rare consequences of blunt trauma. When there is high drainage output from a right-sided intercostal catheter, an azygos injury must be considered in the differential diagnosis. We report the case of a 38-year-old male patient involved in a fall from a height during a motorcycle accident. Computed tomography demonstrated a large right-sided hemothorax and left-sided pneumothorax. The patient was transferred to the operating theatre and underwent a clamshell thoracotomy. A laceration in the azygos vein at the confluence of the arch of the azygos and the right superior intercostal vein was identified. Bleeding was controlled at the trifurcation. The patient survived and was discharged home on postoperative day 15.

암환자의 불안관리를 위한 이압요법 적용 효과 (The Effect of Auricular Acupressure Therapy on Anxiety of Cancer Pateint)

  • 김귀분
    • 대한간호학회지
    • /
    • 제32권6호
    • /
    • pp.888-896
    • /
    • 2002
  • The purpose of this study wsa to necessitate auricular acupressure therapy as an independent nursing intervention on cancer paitents by confirming its effectiveness. Method: The experimental study was unequivalently controlled pre-post measure study. The subjects were 40 cancer patients who were hospitalized in K medical center in Seoul. The experimental group (20) and the control group (20) were randomly assigned. As measured tools, Spielberger's State-trait Anxiety (1976) measured tool by Kim's transplation (1978). The auricular acupressure therapy was applied to experimental group, and the pre-post measure was performed to both group. The data was analyzed by using SPSS computer program that included descriptive statistics, 2-test, and t-test. Result: 1) The experimental group with the auricular acupressure therapy showed lower trait anxiety scores in comparison with the control group (t= 8.036, p=.000). 2) The experimental group which applied the auricular acupressure therapy showed lower state anxiety scores in comparison with the control group (t= 19.616, p=.000). This result showed that cancer patients with the auricular acupressure therapy applied cancer patients decreased state anxiety and trait anxiety. Therefore , effectiveness of the auricular acupressure therapy was confirmed through this study. Conclusion: According to the result, anxiety of cancer pateint should be decreased and controlled by the auricular acupressure therapy as independent nursung intervension. In addition, the auricular acupressure therapy will provide effective independent nursing intervention that will decrease anxiety on patient with other disease and will improve quality of their lives.

대동맥 축착증 수술 1례 (A Case of Coarctation of the Aorta)

  • 노중기
    • Journal of Chest Surgery
    • /
    • 제11권3호
    • /
    • pp.321-325
    • /
    • 1978
  • Coarctation of the aorta was rare condition among the congenital cardiovascular defects in Korea. We experienced a case of coarctatlon of the aorta [postductal type], which was successfully corrected by resection and end to end anastomosis. This patient, 21 years male patient, was admitted to the medical department for evaluation of hypertension, headache and exertional dyspnea during 4 years, and transferred to the department of chest surgery for operation. On physical examination, blood pressures were measured on both extremity, measuring 190/100mmHg on the arm and 100/80mmHg on the leg. Systolic murmur was heard on 2nd to 3rd left intercostal space and left sternal border. On simple chest x-ray, rib notching was seer/on low border of right 3rd and left 4th rib. Final preoperative diagnosis was made by the retrograde aortic catheterization and aortography, which showed the typical configuration of postductal type of coarctation with poststenotic dilatation of the aorta. On 20th, July, 1978, under the general anesthesia with endotracheal intubation, resection of coarctation of the aorta and end to end anastomosis was performed. During clamp for resection, blood pressure of upper extremity was elevated to 200/140mmHg, and controlled by Arfornad. During recovery, blood pressure over 160ramrig in systole was controlled by Reserpine for 8days postoperatively. At discharge, postoperative 8th day, brachial and femoral artery pressure was 145/85 mmHg and 135/80mmHg. After discharge, there was no evidence of specific symptoms and hypertension without antihypertensive drug.

  • PDF

Selective Neurotomy of Sacral Lateral Branches for Pain of Sacroiliac Joint Dysfunction

  • Kim, Hyo-Joon;Shin, Dong-Gyu;Kim, Hyoung-Ihl;Shin, Dong-A
    • Journal of Korean Neurosurgical Society
    • /
    • 제38권5호
    • /
    • pp.338-343
    • /
    • 2005
  • Objective : The sacroiliac joint complex is often related with functionally incapacitating pain in old aged people. The purpose of this study is to delineate the investigation strategies and to determine the long-term effect of radiofrequency [RF] neurotomies for pain arising from sacroiliac Joint dysfunction[SIJD]. Methods : Sixteen patients were diagnosed as having chronic pain from SIJD by comparative controlled blocks on L5 dorsal rami, sacroiliac Joints and deep interosseous ligaments. After confirming the positive response [more than 50% of pain relief], sensory stimulation was applied to detect the 'pathological' branches. Subsequently, RF neurotomies were performed on the selected nerve branches. Surgical outcome was graded as successful, moderate improvement, and failure after a 6month follow-up period. Results : Stimulation intensity was 0.45V to elicit pain response in the L5 dorsal rami and lateral sacral branches. The number of RF-lesioned nerve branches was 6per patient. The average number of lesions for each branch was 1.3. Most commonly selected branches were L5 dorsal ramus [88%] and S2-upper division [88%]. Ten patients [63%] reported a successful outcome according to the outcome criteria after 6months of follow-up, and five patients [31%] reported complete relief [100%]. Five patients [31%] showed moderate improvements. One patient reported failure. Conclusion : RF neurotomy of lateral sacral branches is an excellent treatment modality for the pain due to SIJD, provided that comparative controlled block shows a positive response.

암성 통증 조절을 위한 자가통증조절장치를 이용한 몰핀의 지속적 피하투여 -증례 보고- (Continuous Subcutaneous Administration of Morphine Using Patient Controlled Analgesia Device for Control of Cancer Pain)

  • 이경호;이철;김원태
    • The Korean Journal of Pain
    • /
    • 제11권2호
    • /
    • pp.321-325
    • /
    • 1998
  • Most of the patients with pain resulting from advanced cancer need opioid for adequate analgesia. Various Methods of drug administration to control the pain have been developed. One of them, continuous administration of intravenous morphine is used for more effective pain control in the patient with severe pain that cannot be satisfactorily controlled by other Methods of morphine administration. But this is not a suitable method at home because of the possibility of serious infectious complications and the difficulty in managing intravenous access by untrained personnel. Continuous subcutaneous adminstration of drugs can not only overcome such disadvantages of continuous intravenous infusion but also get almost the same effect of pain control as continuous intravenous infusion, and allows opportunity to move freely and return home, improving quality of life. We used continuous subcutaneous morphine and metoclopramide in the patients with cancer pain via a portable PCA device, and accomplished satisfactory pain relief without significant side effect.

  • PDF

A comparison of 0.075% and 0.15% of ropivacaine with fentanyl for postoperative patient controlled epidural analgesia after laparoscopic gynecologic surgery

  • Jung, Hyun Chul;Seo, Hyo Jung;Lee, Deok Hee;Park, Sang-Jin
    • Journal of Yeungnam Medical Science
    • /
    • 제34권1호
    • /
    • pp.37-42
    • /
    • 2017
  • Background: A motor blockade of lower limbs interferes with early ambulation and limits the usefulness of patient-controlled epidural analgesia (PCEA). The concentration of local anesthetic solution is a major determinant for motor block with PCEA. We compared the effects of epidural infusion of 0.075% ropivacaine with 0.15% epidural ropivacaine on postoperative analgesia, motor block of lower limbs, and other side effects. Methods: A total of 70 patients undergoing laparoscopic gynecologic surgery received epidural infusions (group R1, 0.15% ropivacaine with fentanyl; group R2, 0.075% ropivacaine with fentanyl). Pain score, motor block, and side effects (hypotension, nausea, vomiting, pruritus, urinary retention, dizziness, and numbness) were measured. Results: There were no significant differences in the demographic profiles between the groups. Pain scores of the group R1 and the group R2 were not significantly different. Motor block was more frequent in the group R1 (0.15% ropivacaine with fentanyl) than in the group R2 (0.075% ropivacaine with fentanyl). Conclusion: Lower concentration of ropivacaine (0.075%), when compared with higher concentration of ropivacaine (0.15%), seemed to provide similar analgesia with less motor blockade of the lower limbs for the purpose of PCEA.

Orthostatic Intolerance Ambulation in Patients Using Patient Controlled Analgesia

  • Park, Kwang Ok;Lee, Yoon Young
    • The Korean Journal of Pain
    • /
    • 제26권3호
    • /
    • pp.277-285
    • /
    • 2013
  • Background: Opioid analgesics are widely used to reduce postoperative pain and to enhance post-operative recovery. However, orthostatic intolerance (OI) induced by opioid containing intravenous patient controlled analgesia (IPCA) may hinder postoperative recovery. This study investigated factors that affect OI in patients receiving IPCA for postoperative pain control. Methods: OI was instantly evaluated at the time of first ambulation in 175 patients taking opioid containing IPCA after open and laparoscopic subtotal gastrectomies. Patients were classified as having OI if they experienced dizziness, nausea/vomiting, blurred vision, headache, somnolence and syncope. Factors contributing to OI were assessed with logistic regression analysis. Results: Out of 175 patients, 61 (52.6%) male and 44 (74.6%) female patients experienced OI at the time of first ambulation. The frequency of OI related symptoms were dizziness (97, 55.4%), nausea (46, 26.3%), headache (9, 5.1%), blurred vision (3, 1.7%) and vomiting (2, 1.1%). Significant risk factors for OI were gender (P=0.002) and total amount of opioids administered (P=0.033). Conclusions: The incidence of OI is significantly higher in male than in female patients and is influenced by the opioid dose.