• 제목/요약/키워드: Patients' safety

검색결과 2,382건 처리시간 0.032초

Does reduction of the oncologic safety margin for facial basal cell carcinoma result in higher recurrence rates?

  • Kim, Eon Su;Yang, Chae Eun;Chung, Yoon Kyu
    • 대한두개안면성형외과학회지
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    • 제22권3호
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    • pp.135-140
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    • 2021
  • Background: Wide surgical excision is the gold standard for basal cell carcinoma (BCC) treatment. Typically, resection requires a safety margin ≥ 4 mm. We aimed to confirm BCC excisions' cancer recurrence rate and safety on the facial region with new safety margins. Methods: We included patients with primary BCC on the facial region who underwent wide excision with 2- or 3-mm safety margins at our institution between January 2010 and December 2018. Medical records were reviewed to confirm the epidemiology and surgical information. Recurrence was confirmed by physical examination through regular 6-month follow-up. Results: We included 184 out of 233 patients in this study after applying the exclusion criteria. The mean age and follow-up period were 71.2±10.2 years and 29.3±13.5 months, respectively. The predominantly affected area was the nose (95 cases); a V-Y advancement flap was the most commonly used surgical method. There were two cases of recurrence in the 2 mm margin group and one recurrence in the group resected with 3 mm margins. Conclusion: In this large cohort study, we found 2-3 mm excision margins can yield enough safety in facial BCCs. The recurrence rates were found to be comparable with those reported after wider margins.

환자안전사고에 의한 손상환자의 병원내 사망 관련 요인 : 2013-2017 퇴원손상심층조사자료 활용 (Factors Related to In-Hospital Death of Injured Patients by Patient Safety Accident : Using 2013-2017 Korean National Hospital Discharge In-depth Injury Survey)

  • 김상미;이현숙
    • 한국병원경영학회지
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    • 제26권1호
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    • pp.17-25
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    • 2021
  • This study aimed to analysis factors related to in-hospital death of injured patients by patient safety accident. A total of 1,529 inpatients were selected from Korea Centers for Disease Control and Prevention database(2013-2017). Frequency, Fisher's exact test, t-test, ANOVA, logistic regression analyses by using STATA 12.0 were performed. Analysis results show that the mortality rate was lower for female than male but the mortality rate was higher for the older age, the higher the CCI, head (or neck), multiple, systemic damage sites, internal and others, metropolitan cities based on Seoul and 300-499 based on the bed size of 100-299. Based on these findings, the possibility of using the in-depth investigation of discharge damage from the Korea Centers for Disease Control and Prevention as a data source for the patient safety survey conducted to understand the actual status of patient safety accident types, frequency, and trends should be reviewed. Also, it is necessary to prevent injury and minimize death by identifying factors that affect death after injury by patient safety accident.

Characteristics and Outcomes of Patients with Bicycle-Related Injuries at a Regional Trauma Center in Korea

  • Lee, Yoonhyun;Lee, Min Ho;Lee, Dae Sang;Kim, Maru;Jo, Dae Hyun;Park, Hyosun;Cho, Hangjoo
    • Journal of Trauma and Injury
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    • 제34권3호
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    • pp.147-154
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    • 2021
  • Purpose: We analyzed the characteristics and outcomes of patients with bicycle-related injuries at a regional trauma center in northern Gyeonggi Province as a first step toward the development of improved prevention measures and treatments. Methods: The records of 239 patients who were injured in different types of bicycle-related accidents and transported to a single regional trauma center between January 2017 and December 2018 were examined. This retrospective single-center study used data from the Korea Trauma Database. Results: In total, 239 patients experienced bicycle-related accidents, most of whom were males (204, 85.4%), and 46.9% of the accidents were on roads for automobiles. Forty patients (16.7%) had an Injury Severity Score (ISS) of 16 or more. There were 125 patients (52.3%) with head/neck/face injuries, 97 patients (40.6%) with injuries to the extremities, 59 patients (24.7%) with chest injuries, and 21 patients (8.8%) with abdominal injuries. Patients who had head/neck/face injuries and an Abbreviated Injury Score (AIS) ≥3 were more likely to experience severe trauma (ISS ≥16). In addition, only 13 of 125 patients (10.4%) with head/neck/face injuries were wearing helmets, and patients with injuries in this region who were not wearing helmets had a 3.9-fold increased odds ratio of severe injury (AIS ≥2). Conclusions: We suggest that comprehensive accident prevention measures, including safety training and expansion of safety facilities, should be implemented at the governmental level, and that helmet wearing should be more strictly enforced to prevent injuries to the head, neck, and face.

이침과 한약치료를 병행한 임신오조(姙娠惡阻) 환자 4례의 증상호전 및 안전성 보고 (4 Cases of Hyperemesis Gravidarum Patients Treated by Herbal Medicine and Auricular Acupuncture, and Safety of These Medical Interventions)

  • 박승혁;채민수;김남훈;황덕상;이진무;이창훈;이경섭;장준복
    • 대한한방부인과학회지
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    • 제26권3호
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    • pp.133-142
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    • 2013
  • Objectives: To identify effects and safety of Korean traditional herbal medicine and auricular acupuncture for hyperemesis gravidarum patients. Methods: Korean traditional herbal medicine and auricular acupuncture were applied to 4 hyperemesis gravidarum patients, and we investigated changes of symptoms, continuance of pregnancy, and whether they delivered or not. Results: Hyperemesis gravidarum symptom was improved in 3 patients, and 1 patient showed complete recovery. Among them, 2 patients had children by natural childbirth, 1 patient had a repeat cesarean due to previous cesarean section, and 1 patient has been maintaining pregnancy well for 25weeks. Conclusions: It is confirmed that symptoms of hyperemesis gravidarum patients were improved by Korean traditional herbal medicine and auricular acupuncture, and these medical interventions are safe.

침치료가 폐암 환자의 피로도에 미치는 영향: Pilot Study (The Effectiveness of Acupuncture for Fatigue Severity in Lung Cancer Patients: Pilot Study)

  • 현대성;김종대;권효정;정현정
    • Korean Journal of Acupuncture
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    • 제29권4호
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    • pp.623-633
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    • 2012
  • Objectives : Fatigue is a common and distressing symptom that is a concern for cancer patients. It has a decisive effect on quality of life. The purpose of this study was to examine the feasibility of clinical trial to evaluate of efficacy and safety of acupuncture on cancer related fatigue of lung cancer patients. Methods : Total lung cancer 9 patients complained of fatigue were treated by acupuncture twice a week for four weeks(8 times in total). Evaluation of the severity of fatigue was measured by FSS(Fatigue Severity Score). In visit 1, 10, we checked FSS. For check safety of acupuncture treatment, we did blood test. Results : After 4 weeks of acupuncture treatment, the FSS was significantly decreased from $4.92{\pm}1.06$ to $3.74{\pm}1.37$(p=0.008). And the level of hemoglobin was significantly increased from 10.87 g/dl to 12.01 g/dl(p=0.014). No other lab measures indicated any significant differences between before and after acupuncture treatment. Conclusions : This study suggests that acupuncture treatment will be beneficial for lung cancer patients to improve the fatigue severity. And acupuncture treatment is safe method for lung cancer patients. A large-scale study to confirm efficacy and safety of acupuncture is needed.

Phase II Study on Safety and Efficacy of Yadanzi® (Javanica oil emulsion injection) Combined with Chemotherapy for Patients with Gastric Cancer

  • Liu, Jin;Huang, Xin-En;Tian, Guang-Yu;Cao, Jie;Lu, Yan-Yan;Wu, Xue-Yan;Xiang, Jin
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권3호
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    • pp.2009-2012
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    • 2013
  • Objective: To investigate the efficacy and safety of Yadanzi$^{(R)}$ (Javanica oil emulsion injection) combined with chemotherapy for treatment of patients with advanced gastric cancer. Methods: From January 2011 to December 2012, we recruited 75 patients with advanced gastric cancer, who received javanica oil emulsion injection together with chemotherapy. After two cycles of treatment, efficacy and safety of the combined therapies were evaluated. Results: Overall response rate of 75 patients after treatment was 85.3% (CR+PR+SD). Treatment related side effects were recorded. No treatment related death occurred. Conclusions: Javanica oil emulsion injection combined with chemotherapy could be considered as a safe and effective regimen in treating patients with advanced gastric cancer. Further randomized clinical trials should be conducted to confirm whether the addition of Yadanzi$^{(R)}$ to chemotheraphy could be associated with reduced toxicity, enhanced tolerability and improved quality of life for patients with advanced gastric cancer.

Safety and tolerability of elubaquine (bulaquine, CDRI 80/53) for treatment of Plasmodium vivax malaria in Thailand

  • Krudsood Srivicha;Wilairatana Polrat;Tangpukdee Noppadon;Chalermrut Kobsiri;Srivilairit Siripun;Thanachartwet Vipa;Muangnoicharoen Sant;Luplertlop Natthanej;Brittenham Gary M.;Looareesuwan Sornchai
    • Parasites, Hosts and Diseases
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    • 제44권3호
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    • pp.221-228
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    • 2006
  • We conducted a study to compare the safety and tolerability of anti-relapse drugs elubaquine and primaquine against Plasmodium vivax malaria. After standard therapy with chloroquine, 30 mg/kg given over 3 days, 141 patients with P. vivax infection were randomized to receive primaquine or elubaquine. The 2 treatment regimens were primaquine 30 mg once daily for 7 days (group A, n = 71), and elubaquine 25 mg once daily for 7 days (group B, n = 70). All patients cleared parasitemia within 7 days after chloroquine treatment. Among patients treated with primaquine, one patient relapsed on day 26; no relapse occurred with elubaquine treatement. Both drugs were well tolerated. Adverse effects occurred only in patients with G6PD deficiency who were treated with primaquine (group A, n = 4), whose mean hematocrit fell significantly on days 7,8 and 9 (P= 0.015, 0.027, and 0.048, respectively). No significant change in hematocrit was observed in patients with G6PD deficiency who were treated with elubaquine (group B, n = 3) or in patients with normal G6PD. In conclusion, elubaquine, as anti-relapse therapy for P. vivax malaria, was as safe and well tolerated as primaquine and did not cause clinically significant hemolysis.

Safety Assessment of Intravenous Administration of Trastuzumab in 100ml Saline for the Treatment of HER2-Positive Breast Cancer Patients

  • Abe, Hajime;Mori, Tsuyoshi;Kawai, Yuki;Tomida, Kaori;Yamazaki, Keiichi;Kubota, Yoshihiro;Umeda, Tomoko;Tani, Tohru
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권8호
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    • pp.4843-4846
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    • 2013
  • Background: The infusion rate is considered to affect incidence and severity of infusion reactions (IRs) caused by protein formulations. Trastuzumab (TRS) is approved for 90-minute infusion as the initial dose followed by 30-minute infusion with 250 ml saline. In the study, we evaluated the safety of TRS intravenously administered over 30 minutes with 100 ml saline to reduce burden of patients, safety of infusion with 250 ml saline already being established. Materials and Methods: Women with HER2 positive breast cancer, ${\geq}18$ years and ${\geq}55%$ left ventricular ejection fraction (LVEF), were registered in the study. Patients received 8mg/kg of TRS 250 ml over 90 minutes followed by 6mg/kg of TRS 100ml over 30 minutes in a three-week cycle. Results: A total of 31 patients were recruited, 24 for adjuvant therapy and seven with metastases. The median age was 59 years (range 39 to 82). The total number of TRS doses ranged from 5 to 17 with the median of 15. Mild IR occurred in two patients at the first dose. However, no IR was observed after reducing to 100 ml saline. No decrease of LVEF, increase of serum brain natriuretic peptide or any other adverse events were reported. Conclusions: Intravenous infusion of TRS with 100 ml saline over 30 minutes in breast cancer patients can be considered safe based on results from the study. It can be given on an outpatient basis as with the currently recommended dilution in 250 ml saline.

Bevacizumab Concomitant with Chemotherapy is Effective in Treating Chinese Patients with Advanced Non-Squamous Non-Small Cell Lung Cancer

  • Sun, Jing;Hu, Yi;Wu, Bai-Shou;Wang, Jin-Liang;Tao, Hai-Tao;Zhang, Su-Jie
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권14호
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    • pp.5945-5950
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    • 2014
  • Objectives: To retrospectively review the safety and clinical efficacy of bevacizumab concomitant with chemotherapy in Chinese patients with advanced non-squamous non-small cell lung cancer (NSNSCLC). Methods: Clinical data for 79 patients with NSNSCLC who received bevacizumab concomitant with chemotherapy in Chinese PLA General Hospital from April 28th 2009 to May 5th 2013 were retrospectively reviewed to analyze the clinical efficacy including disease control rate (DCR), overall response rate (ORR), progression-free survival (PFS), overall survival (OS), the Eastern Cooperative Oncology Group (ECOG) score and the safety. Results: The Eastern Cooperative Oncology Group (ECOG) score was 0-2. By the final cutoff date (June 9, 2013), 54 (68.4%) patients had disease progression and 37 (46.8%) died. The ORR was 32.9% and the DCR was 83.5%. The ORR of the first-, second-, and third- or later-line treatments were 51.4%, 25.0% and 12.5%, while the DCR were 94.3%, 80.0% and 70.8%, respectively. The median OS (mOS) and PFS (mPFS) were 13.5 and 5.83 months, respectively. The mOS of patients with the first-, second-, and third- or later- line treatments were 16.2, 10.9 and 8.30 months, while the mPFS were 7.27, 5.90 and 5.17 months, respectively. Chemotherapy-related adverse events included myelosuppression, vomiting, hepatic dysfunction and renal dysfunction, while the common serious bevacizumab-related adverse events were thromboembolic problems, gastrointestinal perforation and reversible posterior leukoencephalopathy syndrome, which could be well managed. Conclusions: Bevacizumab concomitant with chemotherapy is effective and the related toxicity can be well tolerated in Chinese patients with NSNSCLC.

Efficacy and safety of dienogest in patients with endometriosis: A single-center observational study over 12 months

  • Park, So Yun;Kim, Sung Hoon;Chae, Hee Dong;Kim, Chung-Hoon;Kang, Byung Moon
    • Clinical and Experimental Reproductive Medicine
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    • 제43권4호
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    • pp.215-220
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    • 2016
  • Objective: To evaluate the efficacy and safety of dienogest treatment in patients who had received dienogest for 12 months or more to treat endometriosis. Methods: We analyzed the clinical data of 188 women with endometriosis who had been treated with 2 mg of dienogest once a day for 12 months or more at a single institute. We evaluated changes in endometriosis-associated pain and endometrioma size, recurrence rate, and adverse events following dienogest administration. Bone mineral density (BMD) was measured in patients who were prescribed dienogest for more than 18 months. Results: Pain was significantly reduced at 12 months after dienogest medication. In those treated with dienogest due to recurrent endometrioma, the size of the endometrioma was significantly decreased at the 12-month and 18-month follow-ups. We found only one case of sonographic recurrence during dienogest administration among those who were treated postoperatively to prevent recurrence (1 of 114, 0.9%). The most common adverse drug reaction was uterine bleeding (3.2%), and other adverse events were generally tolerable and associated with low discontinuation rates (5.2%). Among the 50 patients in whom BMD was measured, 10 patients (20%) had a Z-score below the expected range for age. Conclusion: The administration of dienogest for a year or more seems to be highly effective in preventing recurrence after surgery, reducing endometriosis-associated pain, and decreasing the size of recurrent endometrioma, with a favorable safety and tolerability profile. However, BMD should be checked in patients on long-term medication due to possible bone loss in some women.