• Title/Summary/Keyword: Patients' safety

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A novel method for determining dose distribution on panoramic reconstruction computed tomography images from radiotherapy computed tomography

  • Hiroyuki Okamoto;Madoka Sakuramachi;Wakako Yatsuoka;Takao Ueno;Kouji Katsura;Naoya Murakami;Satoshi Nakamura;Kotaro Iijima;Takahito Chiba;Hiroki Nakayama;Yasunori Shuto;Yuki Takano;Yuta Kobayashi;Hironori Kishida;Yuka Urago;Masato Nishitani;Shuka Nishina;Koushin Arai;Hiroshi Igaki
    • Imaging Science in Dentistry
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    • v.54 no.2
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    • pp.129-137
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    • 2024
  • Purpose: Patients with head and neck cancer (HNC) who undergo dental procedures during radiotherapy (RT) face an increased risk of developing osteoradionecrosis (ORN). Accordingly, new tools must be developed to extract critical information regarding the dose delivered to the teeth and mandible. This article proposes a novel approach for visualizing 3-dimensional planned dose distributions on panoramic reconstruction computed tomography (pCT) images. Materials and Methods: Four patients with HNC who underwent volumetric modulated arc therapy were included. One patient experienced ORN and required the extraction of teeth after RT. In the study approach, the dental arch curve (DAC) was defined using an open-source platform. Subsequently, pCT images and dose distributions were generated based on the new coordinate system. All teeth and mandibles were delineated on both the original CT and pCT images. To evaluate the consistency of dose metrics, the Mann-Whitney U test and Student t-test were employed. Results: A total of 61 teeth and 4 mandibles were evaluated. The correlation coefficient between the 2 methods was 0.999, and no statistically significant difference was observed (P>0.05). This method facilitated a straightforward and intuitive understanding of the delivered dose. In 1 patient, ORN corresponded to the region of the root and the gum receiving a high dosage (approximately 70 Gy). Conclusion: The proposed method particularly benefits dentists involved in the management of patients with HNC. It enables the visualization of a 3-dimensional dose distribution in the teeth and mandible on pCT, enhancing the understanding of the dose delivered during RT.

Changes of Ward Modules according to the 2017 Revision of Medical Law (2017 의료법 개정에 따른 병실 모듈변화 연구)

  • Lee, Hyun-jin;Ju, Youn-Ock
    • KIEAE Journal
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    • v.17 no.1
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    • pp.55-61
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    • 2017
  • Purpose : As the necessity of reinforcement of infections management in medical facilities after MERS increased, Ministry of Health and Welfare promulgated the enforcement regulations of medical law on February 3, 2017. Its main objective is to improve patients' safety and medical-care quality through the establishment of isolation facilities from infectious diseases and the set-up of standards for In-patient and ICU facilities. The purpose of this study is necessarily to propose a standardized spatial composition model for ward modules by analyzing changing environments of in-patient facilities according to the strengthened medical law. Method: Theoretical studies will be undergone of Evidence-based Designs to improve patients' safety, medical quality, and domestic/overseas in-patient room guidelines. With reference to the status of 24 general hospitals over 500 beds, the spatial compositions of the in-patient rooms and the types of multi/single bed room modules will be analyzed. The directions of future in-patient room module changes through the study of the minimum ward module types and various ward types will be presented. Result: This paper will hopefully provide guidelines for hospitalization rooms that can be applied to the revised rules of medical law enforcement and provide a basis for a comprehensive study of patients' safety and efficient infection control as well.

Effects of Claustrophobia, Vital Signs on Psychological Anxiety of the Patients during MRI Examination(In Patient Safety Accident) (MRI 검사 시 환자의 심리적 불안감이 폐쇄공포 및 활력징후에 미치는 영향(환자안전사고에 있어서))

  • Kim, Jae-Cheon;Bae, Seok-Hwan;Kim, Yong-Kwon;Lee, Moo-Sik
    • Journal of the Korea Safety Management & Science
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    • v.17 no.4
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    • pp.231-240
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    • 2015
  • In this study, to find out the effect of psychological anxiety of the patients during MRI examination on the claustrophobia and vital signs, As for a study tool, to measure Anxiety Sensitivity Index(ASI), Kamsung Evaluation Index of Life Environmental Noise(KEI), Diagnostic and Statistical Manual of Mental Disorders(DSM-IV) was used, and for vital signs, blood pressure and pulse rate were measured pre and post MRI examination. In conclusion, it was indicated that though the effect of the general characteristics, psychological anxiety, on noise sensitivity and claustrophobia was small, the psychological anxiety of the patients during MRI examination affected claustrophobia and vital signs.

A Study on the Safety of Continuous Hemostasis after Arterial Puncture Intervention (동맥천자 인터벤션 시술 후 지속지혈 안전성에 대한 연구)

  • Kim, Seung-Gi
    • Journal of radiological science and technology
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    • v.42 no.3
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    • pp.195-199
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    • 2019
  • Most of the vascular procedures performed for various diagnoses and treatments of various abdominal intervention procedures performed by the Department of Radiology and Angiography are performed by puncture of the femoral artery. For this reason, patients should undergo blood-related tests such as prothrombin time (PT) and partial thromboplatin time (PTT). Therefore, many patients are instructed to take precautions such as putting a sandbag on the puncture site to prevent delayed hemorrhage after hemostasis of the femoral artery puncture site, and not to bend the leg of the treated area for about 3 hours. Because of this, many patients have complained of pain during the procedure and inconvenience during the absolute bed rest time in the ward. The purpose of this study was to compare the safety of balloon ancillary devices with sandbags placed on the hemostasis site to prevent delayed hemorrhage after arterial puncture. We compared the safety of each patient with the results of medical records in consideration of the problem that the patient could not press with the focus, the position of the patient was changed depending on the patient's body shape, and the problem of falling down according to the location of the puncture site. As a result, the use of a balloon type ancillary device improves the effect of continuous hemostasis, reduces discomfort during the patient's absolute stabilization time, increases the patient's satisfaction, and is a good alternative to the existing sandbag.

Design of a Smart Safety Enforcement System for Patients with Dementia (치매 환자를 위한 지능형 안전강화 시스템 설계)

  • Pi, Kyungjoon;Lee, Kyungmi;Min, Hong
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.20 no.6
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    • pp.59-64
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    • 2020
  • As the number of elderly people rapidly increases, needs of patient safety monitoring system also increases in indoor and outdoor medical facilities. With developing technologies related to sensors and information and communication technology, various dementia patient monitoring systems have been proposed. However, previous studies that depend on wearable devices provides limited functionalities. In this paper, we designed an integrated system that includes smart devices to monitor patient's status, user friendly UI/UX, and interaction with hospital information system. Medical teams and carers can receive satus of each patient in real-time and trace the location of dementia patients outdoor as well as indoor by using the proposed system.

General Anesthesia and Endoscopic Upper Gastrointestinal Tumor Resection (전신 마취와 내시경적 상부위장관 종양절제술)

  • Seung Hyun Kim
    • Journal of Digestive Cancer Research
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    • v.11 no.3
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    • pp.125-129
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    • 2023
  • Appropriate sedation and analgesia are crucial for successful endoscopic procedures, patient safety, and satisfaction. Endoscopic resection for upper gastrointestinal tumors requires a deep sedation level because the procedure is lengthy and induces moderate to severe pain. Continuous patient consciousness assessment and vigilant vital signs monitoring are required for deep sedation. General anesthesia may unintentionally occur even during deep sedation for endoscopic tumor resection, which may cause unexpected complications, especially in high-risk patients. Previous studies have revealed that general anesthesia increases the en bloc resection rate and decreases the procedure time. Complications, such as perforation, aspiration pneumonia, and cardiopulmonary instability, including hypoxemia, hypotension, and arrhythmia, occurred more frequently in patients with sedation compared to those with general anesthesia. Therefore, general anesthesia demonstrated potential benefits in endoscopic treatment results and patient safety. General anesthesia should be considered a useful alternative for sedation in patients undergoing endoscopic gastrointestinal tumor resection. However, more high-quality prospective studies are required to determine the safety and effectiveness of general anesthesia in endoscopic upper gastrointestinal tumor resection because most studies comparing general anesthesia and sedation in these procedures have been retrospectively conducted and the results were inconsistent.

Efficacy and Safety of Trastuzumab Added to Standard Treatments for HER2-positive Metastatic Breast Cancer Patients

  • Zhu, Zhen-Li;Zhang, Jun;Chen, Mei-Lan;Li, Ke
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7111-7116
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    • 2013
  • Introduction: Trastuzumab, an HER2-targeting agents, has shown efficacy in metastatic HER2-positive breast cancer patients. Single-agent clinical trials have evaluated therapeutic regimens using trastuzumab for metastatic breast cancer patients. The aim of our study is to evaluate the efficacy and safety of trastuzumab in combination with chemotherapy or hormone therapy in HER2-positive metastatic breast cancer patients. Methods: A literature research was conducted in PubMed and to identify appropriate studies from relevant reviews. Randomized controlled trials comparing chemotherapy or hormone therapy regimens in combination with trastuzumab were eligible. Dadta on clinical outcomes, including safety, efficacy, and patient characteristics were collected. Results: Seven articles describing five trials were included in our systematic review and meta-analysis. Partners of trastuzumab included in trials were anthracycline, paclitaxel, docetaxel, anastrozole and letrozole. The addition of trastuzumab to chemotherapy improved the overall survival (HR=0.79, 95%CI 0.65-0.96), while to hormone therapy did not (HR=0.85 95%CI 0.56-1.30). All trastuzumab-containing regimens increased cardiac toxicity (RR=3.37, 95%CI 1.26-9.02) and grade III-IV adverse events. Conclusions: Our study supports the addition of trastuzumab to chemotherapy which is effective and tolerated for metastatic breast cancer with HER2+ patients. Of note, more adverse events will occur followed the use of trastuzumab, especially cardiac toxicity, with two treatment regimens.

EVALUATION OF EFFICACY AND SAFETY OF MINOCLINE STRIP ON CHRONIC MARGINAL PERIODONTITIS (미노클린 첨부제의 만성 변연성 치주염의 치료효과에 대한 유효성과 안전성의 평가)

  • Shin, Hyung-Shik;Han, Kyung-Yoon;Chung, Jong-Pyung
    • Journal of Periodontal and Implant Science
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    • v.24 no.3
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    • pp.493-502
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    • 1994
  • The benefits in using controlled delivery approaches include improved pharmacokinetic response, greater ability to localize the drung adjacent to the disease, and more control of local concentration at a lower total dosage. The purpose of this study was to evaluate the efficacy and safety of Minocline strip on chronic marginal periodontitis. Minocline Strip was applied in the periodontal pocket of 94 patients with a clinically diagnosed as a chronic marginal periodontitis, 4 sites for each patients with a 5mm probing pocket depth were selected in split mouth design and were divided into two group, ie., placebo group ($C_1$, $C_2$) and experimental group ($E_1$, $E_2$). Supragingival scaling and oral hygiene instruction were performed 1 week before experiment. Minocline Strip was applied on day 0 and 7, weekly, Clinical and microbiological tests were performed on day 0, 7, 14, 28 and 42. The results were as follows ; 1. Minocline Strip showed significant improvement on Chronic Marginal Periodontitis in 77 patients (82.0%) and improvement rate was more than 66.7% of all investigational items. 2. Only 6 patients complained mild pruritis during the early therapy but not needed discontinuence of the therapy. 3. The availability of Minocline Strip was 72 patients (76.6%) synthetically evaluating efficacy and safety. In conclusion, Minocline Strip appears to be effective and safe for the treatment of Chronic Marginal Periodontitis.

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Causes of Burn and Emergency Care on the Spot for the Patients Admitted to Three Hospitals in Taegu (대구시내 종합병원에 입원한 화상환자의 화상원인과 현장에서 취한 응급처치)

  • Chu, Min;Park, Jung-Han
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.2 s.24
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    • pp.238-244
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    • 1988
  • This study was conducted to investigate the causes of burn and emergency cares taken on the spot for the burn patient. Study population included 161 burn patients admitted to 2 university hospitals and 1 general hospital in Taegu from November 1, 1987 to April 30, 1988. Patients or guardians were interviewed with a structured questionnare. Out of 161 burn patients 111(68.9%)were males and 50(31.1%) females. Preschool children of 1-4 years old accounted for 29.8% of the total patients. Burns of children under 15 years of age took place at home in 91.0%, while 48.3% of burns of adult (15 years and over)males occurred at the working place, and 68.0% of adult females occurred at the home. Out of total burns occurred at home 39.8% took place at kitchen/dining room and 24.1% in the room. The most common cause of burns in children was the boiling water or hot food (74.3%). In adults the common causes were electrical burn(22.4%), hot water or food(19.0%) and explosion(12.1%) for males, and hot water or food(32.0%) and explosion (20.0%) for females. Common emergency cares for the burn taken on the spot were undressing(64.6%), pouring Soju(liquor)(13.7%), and pouring cold water(5.0%). There were a few cases who applied ash, soy or salt. To prevent burn, it is recommended to remodel the traditional kitchen and coal-briquet hole, to strengthen the safety control of LP Gas and LN Gas supply, to educate the public for the handling method for such gases, to strengthen the occupational safety control, to improve the safety device for the electric wire and socket, and to limit the temperature of hot water at home and public baths.

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Safety of Brucea javanica and Cantharidin Combined with Chemotherapy for Treatment of NSCLC Patients

  • Ji, Zhu-Qing;Huang, Xin-En;Wu, Xue-Yan;Liu, Jin;Wang, Lin;Tang, Jin-Hai
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8603-8605
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    • 2014
  • Objective: To assess the safety of Brucea javanica and Cantharidin combined with chemotherapy in treating patients with non-small-cell lung carcinoma. Method: A consecutive cohort of patients with NSCLC were divided into four groups: experimental group A treated with Brucea javanica injection combined with chemotherapy; experimental group B with Cantharidin injection combined with chemotherapy; experimental group C treated with Brucea javanica and Cantharidin injection combined with chemotherapy; and the control group receiving only chemotherapy. After more than two courses of treatment, safety, quality of life and side effects were evaluated. Results: The incidences of myelosuppression in groups A, B and C were lower than that in Control group (p<0.05), but without significant differences among A, B and C. Adverse effects on the gastrointestinal tract also were lower than in controls (p<0.05) without variation amnog the combined treatment groups. Conclusions: Brucea javanica or Cantharidin combined with chemotherapy could in both cases improve quality of life in our cohort of NSCLC patients without any increase in toxicity. However, further clinical experiments should be conducted to evaluate the efficacy of Brucea javanica and Cantharidin combined with chemotherapy for patients with NSCLC.