• 제목/요약/키워드: Referral center

검색결과 217건 처리시간 0.023초

Clinical presentations of critical cardiac defects in the newborn: Decision making and initial management

  • Lee, Jae-Young
    • Clinical and Experimental Pediatrics
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    • 제53권6호
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    • pp.669-679
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    • 2010
  • The risk of mortality and morbidity of patients with congenital heart defects (CHDs) is highest during neonatal period and increases when diagnosis and proper management are delayed. Neonates with critical CHDs may present with severe cyanosis, respiratory distress, shock, or collapse, all of which are also frequent clinical presentations of various respiratory problems or sepsis in the newborn. Early diagnosis and stabilization and timely referral to a tertiary cardiac center are crucial to improve the outcomes in neonates with CHDs. In this review, the clinical presentation of critical and potentially life-threatening CHDs is discussed along with brief case reviews to help understand the hemodynamics of these defects and ensure proper decision-making in critically ill patients.

Treatment of steroid-resistant pediatric nephrotic syndrome

  • Kang, Hee-Gyung
    • Clinical and Experimental Pediatrics
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    • 제54권8호
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    • pp.317-321
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    • 2011
  • Children who suffer from steroid-resistant nephrotic syndrome (SRNS) require aggressive treatment to achieve remission. When intravenous high-dose methylprednisolone fails, calcineurin inhibitors, such as cyclosporine and tacrolimus, are used as the first line of treatment. A significant number of patients with SRNS progress to end-stage renal disease if remission is not achieved. For these children, renal replacement therapy can also be problematic; peritoneal dialysis may be accompanied by significant protein loss through the peritoneal membrane, and kidney allograft transplantation may be complicated by recurrence of SRNS. Plasmapheresis and rituximab were initially used for treatment of recurrent SRNS after transplantation; these are now under consideration as rescue therapies for refractory SRNS. Although the prognosis of SRNS is complicated and unfavorable, intensive treatment in the early stages of the disease may achieve remission in more than half of the patients. Therefore, timely referral of pediatric SRNS patients to pediatric nephrology specialists for histological and genetic diagnosis and treatment is highly recommended.

Characteristics of Hodgkin Lymphoma in a Defined Group of Iranian Pediatric Patients

  • Baharvand, Maryam;Mortazavi, Hamed
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권13호
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    • pp.5167-5169
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    • 2014
  • This study was conducted to describe the characteristics of Hodgkin lymphoma in Iranian children. In a referral center for pediatric oncology (Mofid Hospital) in Tehran, patient data over a 10-year period were retrieved and recorded accordingly. Among 82 cases, 73.2% were male, 26.8% were female, and 70.7% were 5-9 years old. About 40% of patients were in stage III and 42.7% had systemic signs. Cervical nodes were commonly involved (91.5%). The most frequent histological subtype was mixed cellularity. The main hematological features were anemia (47.6%), lymphopenia (20.7%), and eosinophilia (8.7%). Survival rate was 72%, and 8.4% of patients were deceased. A 3% recurrence rate was observed in our patients. A significant relationship was found between the stage of disease and systemic signs (P<0.0005, ${\chi}^2$). Despite diagnosis of Hodgkin lymphoma in many children in Iran being made in higher stages, the mortality rate is relatively low.

개의 파보바이러스에 대한 난황 항체 생산 (Production of chicken egg yolk antibody to Canine parvovirus)

  • 오태호;한홍율
    • 대한수의학회지
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    • 제36권4호
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    • pp.895-902
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    • 1996
  • 산란계에 불활화 개 파보바이러스 백신을 근육내로 1주 간격으로 4회 접종하여 면역화시키고 최종 접종 2주후에 채란하여 $4^{\circ}C$에 보관하며 사용하였다. 난황항체는 5% HPMCP를 이용하여 분리하였고 0.5% HPMCP 용액은 lipid 침전에 매우 효과적이었으며 희석배수 10배에서 투명한 상층액을 나타내었다. 1차분리한 상층액의 단백질 농도는 2.5mg/ml이었고 최종 단백질 용액의 경우는 26.53mg/ml이었다. SDS-PAGE 전기영동상에서 분자량 60~70 KD 및 30~40 KD의 2 band가 나타났으며 non-reducing 전기영동에서는 닭 혈청 IgG와 같은 120~160 KD의 분자량을 보인 band가 각각의 분리용액에서 나타났다. 난황 항체의 개 파보바이러스에 대한 혈구응집억제반응 항체역가는 혈청의 역가에 비해 1주의 차이를 주며 증가했으며 난황 항체는 1:640에서 1:2560, 혈청은 1:640에서 1:5120을 나타내었다.

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초유결핍 신생자견에서 난황 항체의 방어효과 (Protective effect of chicken egg yolk antibody in colostrum-deprived neonatal puppies)

  • 오태호;한홍율
    • 대한수의학회지
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    • 제36권4호
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    • pp.903-913
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    • 1996
  • 총 15두의 초유를 섭취하지 않은 신생자견을 대상으로 난황항체를 경구투여한 후 개 파보바이러스를 경구 접종하여 실험감염을 유발시켜 난황항체의 수동 면역에 의한 예방효과를 알아보고자 한다. 항체역가는 면역화된 산란계로부터 분리한 난황항체를 투여한 자견이 비면역 난황항체를 투여한 자견에 비해 높았다. 개 파보바이러스 접종 직전의 항체역가는 대조군의 경우 1:40에서 1:80, 실험군의 경우는 1:320에서 1:1280이었다. 모든 대조군의 자견들은 바이러스 접종후 4일에 임상증상을 나타내었고 총 7두중 6두가 폐사된 반면 실험군 자견은 2두만이 증상을 나타내었고 폐사 자견은 없었다(p<0.01). 개 파보바이러스를 경구 접종한 후 전체 자견의 혈구응집억제반응역가는 접종후 6일까지 감소하는 경향을 보였다. 접종후 5일의 분변내 혈구 응집반응역가는 실험군 자견의 경우 < 2에서 64였으며 대조자견은 216에서 2048로 높았다.

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지역사회 정신보건센터의 상대적 효율성에 영향을 미치는 조직관련 특성 (Organizational Determinants related with Relative Efficiency of the Community Mental Health Centers)

  • 김성옥
    • 보건행정학회지
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    • 제11권2호
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    • pp.58-84
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    • 2001
  • This study was conducted to explore the relationship between the efficiency and its organizational determinants of tile Community Mental Health Centers(CMHCs). Data are obtained from 81 personnel of 27 CMHCs from Sept. to Oct. in 1999(19 in Kyunggi province, 7 in Seoul City and 1 in Chunchon, Kangwon province). Major findings of this study are as follows. 1. DEA is a mathematical programming technique that optimizes the relative efficiency ratio of inputs over outputs for each decision-making unit(DMU). It produces a summary scalar efficiency ratio for each DMU of CMHCs. It assessed multiple inputs and multiple outputs simultaneously, and compared to specific peer group of CMHCs. 2. Organizational determinants of DEA efficiency of CMHCs we proved as advertisement(+), location of CMHCs(in public facility)(+), area of facility(+), period of operation(+), job satisfaction(+), clarity of work-role(vague), cohesion(-), rate of certified personnel(+), number of referral(+), and voluntary service time(-).

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Rhinolith: An incidental radiographic finding

  • Maheshwari, Nisha;Etikaala, Badirinath;Syed, Ali Z.
    • Imaging Science in Dentistry
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    • 제51권3호
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    • pp.333-336
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    • 2021
  • Rhinoliths are foreign bodies composed of mineralised deposits in the nasal cavity that are rarely encountered in routine dental practice. The current report presents a case of a 77-year-old female patient who visited a dental treatment centre for a routine dental check-up and prophylaxis. On the clinical examination, the patient did not report any breathing difficulty, nasal obstruction, or any form of discharge. Panoramic radiography showed a horizontally magnified radiopaque structure in the right nasal fossa region. Cone-beam computed tomography (CBCT) revealed a hyperdense entity with a laminated presentation in the right nasal fossa. The hyperdense entity was diagnosed as a rhinolith based on the radiographic findings. Although the patient was asymptomatic, a referral was made to an ear, nose, and throat surgeon for a further evaluation. This report highlights the importance of CBCT imaging in the diagnosis of soft-tissue calcifications.

보건진료소의 고혈압 환자 간호사례 (Case Report of Hypertension Patient by Community Health Practitioner)

  • 박도순
    • 한국농촌간호학회지
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    • 제14권1호
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    • pp.17-22
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    • 2019
  • Purpose: This study was done to describe a community health practitioner's nursing case study for a hypertension patient. Methods: For this purpose, data were collected through interviews and nursing records. The nursing process was carried out from January to March in 2019. Results: For this patient, blood pressure was checked 5 times and total cholesterol test was performed 5 times over 41 consultations. Even though the patient was 84 years old, he was very interested in health. When the blood pressure and cholesterol level measured by community health practitioner were high, he was embarrassed by the recommendation to get a hospital checkup. After referral to a medical clinic and hospital, he was satisfied with the results of the tests and medical treatment, and constantly practiced daily walking exercise. Conclusion: It is very important for community health practitioners to assess patient symptoms correctly and refer the patient timely to manage complications.

소화기암 환자의 디스트레스 관리 (Distress Management in Patients with Digestive Cancer)

  • 나의현
    • Journal of Digestive Cancer Research
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    • 제11권1호
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    • pp.35-40
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    • 2023
  • Distress in patients with digestive cancers can considerably impact not only their treatment adherence but also their health-related quality of life. Early distress recognition in patients, appropriate interventions by the oncology team, or referral to mental health professionals, can enhance the treatment efficiency. This review aims to provide an overview of distress evaluation and its management in patients with cancer, specifically digestive cancers, and to address the psychological responses and distress that occur in those patients during treatment. Furthermore, the review will introduce possible psychological interventions for patients with digestive cancers who experience significant distress, depending on the duration and planning of the treatment.

Penile neoplasm associated with Equus caballus papillomavirus type 2 infection in a miniature Appaloosa: a case report

  • Sang-Kyu Lee;Jungho Yoon;Youngjong Kim;Inhyung Lee
    • 대한수의학회지
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    • 제64권1호
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    • pp.8.1-8.5
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    • 2024
  • An 18-year-old miniature Appaloosa stallion presented with 6 months of history of sanguineous crusts on medial hind limbs and discomfort of micturition. Cauliflower-like and small masses were treated with cryotherapy for 6 months, but the regrowth of masses occurred. Subsequently, local excision via laser and topical treatment with 5% 5-fluorouracil for 5 months were followed. However, the horse was euthanized 4 months later due to regrowth of the masses. The mass was diagnosed as penile papilloma with cellular atypia and Equus caballus papillomavirus type 2 (EcPV-2) DNA was detected. This is the first report of equine penile neoplasm with EcPV-2 infection in Asia.