• Title/Summary/Keyword: Prospectively

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Clinician Experience with Using Hypoallergenic Formulas to Treat Infants with Suspected Cow's Milk Protein Allergy: A Secondary Analysis of a Prospective Survey Cohort

  • Jesse Beacker;Jerry M. Brown;Jared Florio;Jessica V. Baran;Luke Lamos;Lea Oliveros;Jon A. Vanderhoof;Panida Sriaroon;Michael J. Wilsey
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.26 no.5
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    • pp.277-283
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    • 2023
  • Purpose: Cow's milk protein allergy (CMPA) is a common condition in infants, but little is known about healthcare providers' clinical experience treating infants with CMPA. To address this gap, we analyzed prospectively collected data from healthcare providers (HCPs) who treated infants under six months old with suspected CMPA using hypoallergenic formulas. The study focused on a commercial extensively hydrolyzed formula containing Lactobacillus rhamnosus GG (ATCC53103) (eHF-LGG) or a commercial amino acid formula (AAF). Methods: In this secondary analysis of prospectively collected survey data, 52 HCPs treated 329 infants under six months old with suspected CMPA using hypoallergenic formulas. A series of two de-identified surveys per patient were collected by HCPs to assess short-term symptom relief in the patients and HCP's satisfaction with the management strategies. The initial survey was completed at the initiation of treatment of CMPA, and the second survey was completed at a follow-up visit. Results: The majority of HCPs (87%) in the study were general pediatricians, and most saw 2 to 10 CMPA patients weekly. Results showed that clinicians reported satisfaction with treatment in 95% of patients in the EHF cohort and 97% of patients in the AAF cohort and achieved expected clinical results in 93% and 97% of patients using eHF and AAF, respectively. Furthermore, few patients were switched from the hypoallergenic formula once initiated. Conclusion: The study provides new insights into HCP perspectives on treating infants with CMPA and supports using hypoallergenic formulas to manage this condition. However, additional prospective controlled studies are needed to confirm these initial findings.

Doses of Coronary Study in 64 Channel Multi-Detector Computed Tomography : Reduced Radiation Dose According to Varity of Examnination Protocols (64 채널 Multi-Detector Computed Tomography를 이용한 관상동맥검사의 선량 : 검사 프로토콜 다변화에 따른 환자선량 감소)

  • Kim, Moon-Chan
    • Journal of radiological science and technology
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    • v.32 no.3
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    • pp.299-306
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    • 2009
  • Purpose : To compare radiation dose for coronary CT angiography (CTA) obtained with 6 examination protocols such as a retrospectively ECG gated helical scan, a prospectively ECG gated sequential scan, low kVp technique, and cardiac dose modulation technique. Materials and Methods : Coronary CTA was performed by using 6 current clinical protocols to evaluate effective dose and organ dose in primary beam area with anthropomorphic female phantom and glass dosimetric system in 64 channel multi-detector CT. After acquiring topograms of frontal and lateral projection with 80 kVp and 10 mA, main coronary scan was done with 0.35 sec tube rotation time, 40 mm collimation ($0.625\;mm{\times}64\;ea$), small scan field of view (32 cm diameter), 105 mm scan length. Heart beat rate of phantom was maintained 60 bpm in ECG gating. In constant mAs technique 120 kVp, 600 mA was used, and 100 kVp for low kVp technique. In a retrospectively ECG gated helical CT technique 0.22 pitch was used, peak mA (600 mA) was adopted in range of $40{\sim}80%$ of R-R interval and 120mA(80% reduction) in others with cardiac dose modulation. And 210 mAs was used without cardiac dose modulation. In a prospectively ECG gated sequential CT technique data were acquired at 75% R-R interval (middle diastolic phase in cardiac cycle), and 120 msec additional padding of the tube-on time was used. For effective dose calculation region specific conversion factor of dose length product in thorax was used, which was recommended by EUR 16262. Results : The mean effective dose for conventional coronary CTA without cardiac dose modulation in a retrospectively ECG gated helical scan was 17.8 mSv, and mean organ dose of heart was 103.8 mGy. With low kVp and cardiac dose modulation the mean effective dose showed 54.5% reduction, and heart dose showed 52.3% reduction, compared with that of conventional coronary CTA. And at the sequential scan(SnapShot pulse mode) under prospective ECG gating the mean effective dose was 4.9 mSv, this represents an 72.5% reduction compared with that of conventional coronary CTA. And heart dose was 33.8 mGy, this represents 67.4% reduction. In the sequential scan technique under prospective ECG gating with low kVp the mean effective dose was 3.0 mSv, this represents an 83.2% reduction compared with that of conventional coronary CTA. And heart dose was 17.7 mGy, this represents an 82.9% reduction. Conclusion : In coronary CTA at retrospectively ECG gated helical scan, cardiac dose modulation technique using low kVp reduced dose to 50% above compared with the conventional helical scan. And the prospectively ECG gated sequential scan offers substantially reduced dose compared with the traditional retrospectively ECG gated helical scan.

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The Multiethnic Cohort Study of Diet and Cancer: Design and Early Findings

  • Kolonel, Laurence N.
    • Nutritional Sciences
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    • v.7 no.1
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    • pp.53-58
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    • 2004
  • The Multiethnic Cohort Study was designed to study prospectively the relationship of diet and other lifestyle factors to the risk of cancer. The cohort was established in 1993-1996 in Hawaii and California (primarily Los Angeles) and included a representative sample of more than 215,000 men and women primarily from five different ethnic groups: Japanese, whites, Native Hawaiians, Latinos, and African- Americans. Because of the emphasis on diet, great attention was paid to developing and pre-testing a self-administered quantitative food frequency questionnaire that would adequately assess food and nutrient intakes in these groups. An extensive food composition database was also created for the study. In addition, during data collection, a calibration study was conducted that makes possible adjustment for measurement error in nutrient intakes and valid comparison of intakes across the several ethnic groups. At the present time, blood and urine specimens are being collected from cohort participants and should yield a biorepository of more than 80,000 subjects. Baseline data indicate that the cohort is well representative of the general population of Hawaii and California, so that results can be generalized. These data also show a wide range in dietary intakes and in other lifestyle variables that should facilitate the testing of etiologic hypotheses.

The Change of Derum and Urine Amylase Level Following Cardiopulmonary Bypass in the Patients with Congenital heart disease (선천성 심기형 환아에서 체외순환후 혈청 및 소변 Amylase치의 변화)

  • Baek, Hui-Jong;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.28 no.10
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    • pp.892-899
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    • 1995
  • Pancreatitis is a known complication of cardiac surgery with cardiopulmonary bypass. Although ischemia is believed to be a factor, the exact cause of pancreatitis after cardiopulmonary bypass remains unknown.We prospectively studied 67 consecutive patients undergoing cardiac surgery with cardiopulmonary bypass for evaluation of the pancreatic injury after cardiopulmonary bypas. Serial measurement of amylase level in serum and urine was done postoperatively. Hyperamylasemia was detected in 15 patients[22.4% , of whom no patient had pancreatitis. There was no significant difference between serum amylase level and parameters such as cardiopulmonay bypass time, aortic cross clamp time, mean blood pressure, rectal temperature, flow rate, and use of circulatory arrest during cardiopulmonary bypass. Hyperamylasuria was detected in 8 patients[11.9% , and urine amylase level was elevated significantly in the groups with prolonged cardiopulmonary bypass, mean blood pressure more than 40mmHg, and rectal temperature more than 20 $^{\circ}$C. We recommend that serum amylase level and/or amylase-creatinine clearance ratio is measured for ealy detection and management of pancreatitis after cardiopulmonary bypass.

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Comparison Between HRCT abd Bronchography for Bronchiectasis (기관지 확장증에서 고해상도 전산화 단층 촬영술과 기관지 조영술의 비교)

  • 김승규
    • Journal of Chest Surgery
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    • v.26 no.11
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    • pp.871-873
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    • 1993
  • Bronchiectasis is an irreversible dilatation that may require surgery for successful treatment. We compared High Resolutional Computed Tomography[HRCT]with Bronchography to access the utility of HRCT in diagnosis and determining the extent of Bronchiectasis. We performed a comparative study of HRCT and Bronchography in 10 consecutive patients who were clinically suspected Bronchiectasis were investigated prospectively during last year.A segment-by-segment analysis of the presence, extent, type of bronchiectasis by Amashita classification was done. In 26 segments, Results of HRCT and Bronchogram were both positve, and 119 segments were both negative.But 15 segments were discorded, in 11 segments in positive bronchogram were negative in HRCT and 4 segments in positive HRCT were negative in bronchogram. The diagnostic concordance rate between 2 modalities was 90.6%[145/160]. So, we will be tried to elevate of concordance rate between 2 modalties and applied HRCT in diagnotic tool for bronchiectasis.

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Open Standard Based 3D Urban Visualization and Video Fusion

  • Enkhbaatar, Lkhagva;Kim, Seong-Sam;Sohn, Hong-Gyoo
    • Journal of the Korean Society of Surveying, Geodesy, Photogrammetry and Cartography
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    • v.28 no.4
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    • pp.403-411
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    • 2010
  • This research demonstrates a 3D virtual visualization of urban environment and video fusion for effective damage prevention and surveillance system using open standard. We present the visualization and interaction simulation method to increase the situational awareness and optimize the realization of environmental monitoring through the CCTV video and 3D virtual environment. New camera prototype was designed based on the camera frustum view model to project recorded video prospectively onto the virtual 3D environment. The demonstration was developed by the X3D, which is royalty-free open standard and run-time architecture, and it offers abilities to represent, control and share 3D spatial information via the internet browsers.

Two cases of Meniere's disease (메니에르 환자 치험 2례)

  • Lee, Kyu-Jin;Kim, Yoon-Bum;Nam, Hae-Jeong
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.18 no.3
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    • pp.158-164
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    • 2005
  • Meniere's disease is not a life-threatening but lift-altering inner ear disease characterized by episodic vertigo, fluctuating hearing loss, tinnitus and ear fullness. The etiology and pathophysiology symptoms is still disputed. Thereby the treatment of Meniere's disease is empirical. As yet no treatment has prospectively modified the clinical course of condition and thereby prevented the progressive hearing loss. We experienced two cases of Meniere's disease treated with oriental medical treatment, acupuncture and herbal medication. 15 year-old and 23 year old male patients had diagnosed Meniere's disease by western medical doctor. After treatment their vertigo is decreased and the level of hearing loss was rise up. Therefore, oriental medical treatments could be safe and effective methods.

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A Clinical Investigation of Community-Acquired Pneumonia in Mokpo Area (목포지역에서의 지역사회 획득 폐렴의 임상적 연구)

  • Yoon, Ji-Ho;Lee, Dong-Chea;Lee, Han-Sle;Lee, Chong-Hyo;Kim, Byung-Hun;Kim, Ji-Woon
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.1
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    • pp.17-24
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    • 2001
  • Background : Community-acquired pneumonia(CAP) remains a leading cause of morbidity and mortality worldwide. Recently, the evolution of drug-resistant microorganisms has become a serious problem in CAP management. Specific antimicrobial therapy is the cornerstone of CAP management. However, obtaining an accurate etiologic diagnosis clinically is not easy and empirical antimicrobial treatment is usually administered prior to the correct microbiologic diagnosis. In this study, the clinical usefulness of empirical CAP treatment was investigated. Methods : A total 35 cases were studied prospectively over a 16-month period in Mokpo Catholic Hospital from Dec. 1995 to Mar. 1997. The microbiologic diagnosis was made by sputum, blood culture, a specific serum antibody test and an immunologic study. Results : The causative organisms were isolated in 10 (30%) out of 33 cases: 8 cases and 1 case on the sputum culture and blood culture respectively, and 1 case by an indirect hemagglutinin test. 12 cases had underlying diseases: pulmonary tuberculosis 4, alcoholism 4, diabetes mellitus 3, and liver cirrhosis 1. Antimicrobial treatment was given empirically and all cases recovered. Conclusion : A definite microbiologic diagnosis before commencing the appropriate treatment in CAP is not straightforward. Empirical therapy according to a clinical assessment is important and helpful. However, every effort to make the correct etiologic diagnosis should be taken.

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Differentiation of Malignant and Benign Cervical Lymph Nodes with Color and Pulsed Doppler Ultrasonography (색채 및 펄스 도플러 초음파를 이용한 경부 림프절의 양성과 악성의 감별)

  • Lee Kang-Dae;Lee Bong-Hee;Lee Yun-Woo;Lee Hwan-Ho;Ahn Kyong-Mo;Lee Young-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.17 no.1
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    • pp.19-25
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    • 2001
  • Objectives: The clinical efficacy of the color and pulsed Doppler ultrasound with spectral waveform analysis for differentiation of malignant from benign cervical lymphadenopathy was prospectively evaluated in cervical lymphadenopathy. Materials and Methods: Color and pulsed Doppler ultrasound examination was prospectively performed in 32 cervical lymph nodes in 28 patients. These 10 nodes from 10 patients were malignant and 22 nodes from 18 patients were benign, proved by operation, biopsy, and follow-up examination. Another 12 lymph nodes from 12 normal volunteers were evaluated as control group. The peak systolic velocity (PSV), minimal diastolic velocity (MDV) , and resistive indexes (RI) of arterial flows within the 32 lymph nodes were assessed to differentiate the malignant from benign nodes with pulsed Doppler ultrasonography. The results were qualitified with one-way ANOVA and Bonferroni method of multiple comparison. Results: The mean values of PSV of malignant, benign, and control nodes were 38.2(10.1-134)cm/sec, 23.3(9-38.5) cm/sec and 11.8(6.7-18.1) cm/sec, respectively. The mean values of MDV of them were 0.9(-7.5-10.7)cm/sec, 9.7(2.9-18.6)cm/sec and 6.5(3.7-9.3)cm/sec, respectively. However, there was no statistical significance in differentiation of malignant from benign nodes with PSV and MDV. The mean values of RI of malignant, benign, and control nodes were 0.99(0.80-1.30), 0.59(0.46-0.77) and 0.45(0.38-0.50), respectively. RI value of 0.8 is suggestive value for discrimination of malignant from benign lymphadenopathy during examination of color Doppler ultrasound of cervical lymphadenopathy. Conclusion: Color and pulsed Doppler ultrasound examination with spectral waveform analysis may be quite helpful in the differentiation between benign and malignant alterations of cervical lymph nodes.

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Treatment Outcomes of Septoplasty with Turbinate Surgery in Septal Deviation with Chronic Hypertrophic Rhinitis (비중격 만곡증 및 만성 비후성 비염 환자에서 비중격 성형술고 하비갑개 수술의 치료효과)

  • Kim, Yong-Dae;Suh, Bo-Su;Cho, Gil-Sung;Song, Si-Youn;Yoon, Seok-Keun;Song, Kei-Won
    • Journal of Yeungnam Medical Science
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    • v.18 no.2
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    • pp.199-207
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    • 2001
  • Background: Septoplasty with turbinate surgery is common surgical treatment in patients with septal deviation and chronic hypertrophic rhinitis. The aim of this study was to evaluation objective outcomes of septoplasty with turbinate surgery by analysis of subjective symptom score with objective acoustic rhinometric test before and after surgery, prospectively. Materials and Methods: We reviewed 45 adult patients which were done septoplasty with bilateral turbinectomy or turbinoplasty and followed up at least 3 months by one rhinologist from November 1999 to April 2000, prospectively. We analyzed subjective symptom score, minimal cross-sectional area (MCA), C-notch cross-sectional area, and total volume of both nasal cavity before and after surgery. Correlation test was studied between symptom improvement and acoustic rhinometric results. Results: Twenty nine cases were male and sixteen cases female. The average age was 26.9 year-old (range: 17 to 57 years). There was significantly improvement of symptom score in postoperative 3 months (p<0.05). There was significantly increased C-notch cross-sectional area and total volume in postoperative 3 months. Symptoms improvement were associated with acoustic rhinometric profiles, but, there was not significantly correlation. Conclusion: Septoplasty with turbinate surgery is considered to be effective for nasal obstruction in patients with septal deviation and turbinate hypertrophy. Acoustic rhinometric test is favorable objective test for evaluation of symptom improvement after septal surgery.

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