• 제목/요약/키워드: Referral center

검색결과 220건 처리시간 0.025초

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.

Normal ossification of the glenoid mimicking a glenoid fracture in an adolescent patient: a case report

  • Maria Galan-Olleros;Rosa M. Egea-Gamez;Angel Palazon-Quevedo;Sergio Martinez-Alvarez;Olga M. Suarez Traba;Marta Escribano Perez
    • Clinics in Shoulder and Elbow
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    • 제26권3호
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    • pp.306-311
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    • 2023
  • A 13-year-old male was diagnosed with a glenoid fracture following direct shoulder trauma, for which surgical treatment was considered. After referral to a center for pediatric orthopedic care, physical examination, contralateral shoulder X-ray, and detailed computed tomography examination ruled out the presence of fracture; these findings were later confirmed by magnetic resonance imaging. Normal ossification patterns in the adolescent shoulder may simulate a fracture in traumatic settings. To accurately diagnose and manage pediatric shoulder pathology, orthopedic surgeons must be aware of the normal anatomy of the growing shoulder, its secondary ossification centers, and growth plates.

Viewpoints of Family Caregivers about Posttraumatic Growth in Cancer Patients

  • Tahory, Hale;Mohammadian, Robab;Rahmani, Azad;Seyedrasooli, Alehe;Lackdezajy, Sima;Heidarzadeh, Mehdi
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권2호
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    • pp.755-758
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    • 2016
  • Background: There is little information about the objectivity of posttraumatic growth experienced by cancer patients. So, the aim of present study was to investigate the viewpoints of family caregivers regarding posttraumatic growth in cancer patients. Materials and Methods: This descriptive study was conducted in one referral medical center in East Azerbaijan Province in northwest of Iran. 120 primary family caregivers of cancer patients participated with a convenience sampling method. The Posttraumatic Growth Inventory (PTGI) and Perception about Prognosis Scale (PPS) were applied for data collection with analysis performed using SPSS statistical software. Results: Family caregivers believed that their patients had a good prognosis (score 3.95 from 5). The total score of PTGI was 60.7 (SD=18.8) that indicates a moderate level of growth as reported by family caregivers. Conclusions: Family caregivers of cancer patients have incorrect viewpoints about the prognosis of their patients and reported moderate levels of growth. These findings showed that posttraumatic growth among cancer patients is an objective phenomenon.

도시 저소득층 만성질환노인을 위한 보건소 방문간호서비스의 경제성 분석 (Economic Evaluation of Visitng Nurse Services for the Low.;.income Elderly with Long-term Care Needs)

  • 이태화
    • 대한간호학회지
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    • 제34권1호
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    • pp.191-201
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    • 2004
  • Purpose: This study aimed to evaluate economic viability of public health center visiting nurse services for the low-income elderly with long-term care needs. Method: The sample consisted of 252 community dwelling elderly who enrolled in public health center visiting nurse services for three months or more. Data was collected on physical (ADL and IADL) and cognitive impairments of the elderly, contents and frequency of visiting nurse services, cost per visit, and costs of alternative services for long-term care. Result: The mean score of ADL and IADL levels of the elderly was 2.80.4904, which indicated these patients were mostly independent. Eighty four percent of the elderly subjects were cognitively intact. Among visiting nurse services supplied, providing assessment was 34%, followed by education and counseling 26%, medication 22%, and referral. The mean cost per visit was 17,824.1 won, which transformed into a total cost per person per year of 161,130.2 won. Comparing the cost of a visiting nurse service with those of other long-term care alternatives, the visiting nurse service was the least costly alternative, followed by an outpatient clinic, hospital based home care, and nursing home. Conclusion: Overall, the results of the study provide evidence of the economic viability of visiting nurse services for the low-income elderly among long-term care alternatives.

Evaluation of Thromboelastography Analysis for Treatment of Heartworm Disease in Dogs over Time: a Pilot Study

  • Han, Donghyun;Yoon, Won-Kyoung;Lee, Hyekyung;Yu, Do-Hyeon;Jung, Dong-In
    • 한국임상수의학회지
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    • 제36권1호
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    • pp.42-45
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    • 2019
  • Thromboelastography (TEG) analysis consists of ${\alpha}$, G, K, MA, and R types of values and tests the effectiveness of blood clotting, which can be assessed for platelet function, clotting strength, and fibrinolysis. Canine heartworm diseases caused by Dirofilaria immitis, a vascular nematode, can lead to hyperfibrinolysis and hypercoagulation. In this study, G and MA values showed a statistically significant decrease over time after treatment of heartworm disease. Additionally, the ${\alpha}-value$ showed a high correlation with G, K, MA, and R values. The G value showed a high correlation with K and MA values, while The K value showed a high correlation with MA and R values. This study clearly found a gradual decrease in G and MA values in dogs with heartworm disease over time, both before and after treatment. This suggests that the clot formation time is longer and that the intensity of clot formation is lowered and may improve the risk of thromboembolism in dogs with heartworm disease.

방문간호센터 경영효율성 개선 사례 분석: 경영 컨설팅 적용을 중심으로 (Case Analysis of Visiting Nursing Center for Improving Efficiencies: Based on Business Management Consulting)

  • 임지영;김주행;김선희
    • 가정∙방문간호학회지
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    • 제28권2호
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    • pp.111-123
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    • 2021
  • Purpose: This study aimed to present the management strategies necessary to improve the operational efficiency of visiting nurse centers and evaluate their effectiveness. Methods: The subjects of this study were visiting nurse centers registered as long-term care centers. Based on value chain analysis, cost information analysis, and data envelope analysis, the study was carried out according to the Magerison's management consulting procedure, for six months. This procedure comprised eight sub-steps of approach and application. Results: The following management strategies were agreed upon: establishment of a cooperative network with other visiting care centers, creation of high satisfaction of external customers by providing practical training to care workers, and making rehabilitation and exercise services as the core nursing activities to be focused on. Conclusion: The management consulting process and analysis method applied in this study can referred to as a useful methodological framework for revitalizing visiting nursing centers in the future.

Epidemioclinical Feature of Early-Onset Colorectal Cancer at-Risk for Lynch Syndrome in Central Iran

  • Zeinalian, Mehrdad;Hashemzadeh-Chaleshtori, Morteza;Akbarpour, Mohammad Javad;Emami, Mohammad Hassan
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권11호
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    • pp.4647-4652
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    • 2015
  • Background: Colorectal cancer (CRC) is becoming one of the most complicated challenges of human health, particularly in developing countries like Iran. In this paper, we try to characterize CRC cases diagnosed < age 50 at-risk for Lynch syndrome within central Iran. Materials and Methods: We designed a descriptive retrospective study to screen all registered CRC patients within 2000-2013 in Poursina Hakim Research Center (PHRC), a referral gastroenterology clinic in central Iran, based on being early-onset (age at diagnosis ${\leq}50years$) and Amsterdam II criteria. We calculated frequencies and percentages by SPSS 19 software to describe clinical and family history characteristics of patients with early-onset CRC. Results: Overall 1,659 CRC patients were included in our study of which 413 (24.9%) were ${\leq}50years$ at diagnosis. Of 219/413 successful calls 67 persons (30.6%) were reported deceased. Family history was positive for 72/219 probands (32.9%) and 53 families (24.2%) were identified as familial colorectal cancer (FCC), with a history of at-least three affected members with any type of cancer in the family, of which 85% fulfilled the Amsterdam II Criteria as hereditary non-polyposis colorectal cancer (HNPCC) families (45/219 or 20.5%). Finally, 14 families were excluded due to proband tumor tissues being unavailable or unwillingness for incorporation. The most common HNPCC-associated extracolonic-cancer among both males and females of the families was stomach, at respectively 31.8 and 32.7 percent. The most common tumor locations among the 31 probands were rectum (32.3%), sigmoid (29.0%), and ascending colon (12.9%). Conclusions: Given the high prevalence of FCC (~1/4 of early-onset Iranian CRC patients), it is necessary to establish a comprehensive cancer genetic counseling and systematic screening program for early detection and to improve cancer prognosis among high risk families.

2020 Imaging Guidelines for Thyroid Nodules and Differentiated Thyroid Cancer: Korean Society of Thyroid Radiology

  • Ji Ye Lee;Jung Hwan Baek;Eun Ju Ha;Jin Yong Sung;Jung Hee Shin;Ji-hoon Kim;Min Kyoung Lee;So Lyung Jung;Young Hen Lee;Hye Shin Ahn;Jung Hyun Yoon;Yoon Jung Choi;Jeong Seon Park;Yoo Jin Lee;Miyoung Choi;Dong Gyu Na;Korean Society of Thyroid Radiology (KSThR) and Korean Society of Radiology
    • Korean Journal of Radiology
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    • 제22권5호
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    • pp.840-860
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    • 2021
  • Imaging plays a key role in the diagnosis and characterization of thyroid diseases, and the information provided by imaging studies is essential for management planning. A referral guideline for imaging studies may help physicians make reasonable decisions and minimize the number of unnecessary examinations. The Korean Society of Thyroid Radiology (KSThR) developed imaging guidelines for thyroid nodules and differentiated thyroid cancer using an adaptation process through a collaboration between the National Evidence-based Healthcare Collaborating Agency and the working group of KSThR, which is composed of radiologists specializing in thyroid imaging. When evidence is either insufficient or equivocal, expert opinion may supplement the available evidence for recommending imaging. Therefore, we suggest rating the appropriateness of imaging for specific clinical situations in this guideline.

Burkholderia Cepacia Causing Nosocomial Urinary Tract Infection in Children

  • Lee, Ki Wuk;Lee, Sang Taek;Cho, Heeyeon
    • Childhood Kidney Diseases
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    • 제19권2호
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    • pp.143-147
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    • 2015
  • Purpose: Burkholderia cepacia is an aerobic, glucose-non-fermenting, gram-negative bacillus that mainly affects immunocompromised and hospitalized patients. Burkholderia cepacia has high levels of resistance to many antimicrobial agents, and therapeutic options are limited. The authors sought to analyze the incidence, clinical manifestation, risk factors, antimicrobial sensitivity and outcomes of B. cepacia urinary tract infection (UTI) in pediatric patients. Methods: Pediatric patients with urine culture-proven B. cepacia UTI between January 2000 and December 2014 at Samsung Medical Center, a tertiary referral hospital in Seoul, Republic of Korea, were included in a retrospective analysis of medical records. Results: Over 14 years, 14 patients (male-to-female ratio of 1:1) were diagnosed with B. cepacia UTI. Of 14 patients with UTI, 11 patients were admitted to the intensive care unit, and a bladder catheter was present in 9 patients when urine culture was positive for B. cepacia. Patients had multiple predisposing factors for UTI, including double-J catheter insertion (14.2%), vesico-ureteral reflux (28.6%), congenital heart disease (28.6%), or malignancy (21.4%). Burkholderia cepacia isolates were sensitive to piperacillin-tazobactam and sulfamethoxazole-trimethoprim, and resistant to amikacin and colistin. Treatment with parenteral or oral antimicrobial agents including piperacillin-tazobactam, ceftazidime, meropenem, and sulfamethoxazole-trimethoprim resulted in complete recovery from UTI. Conclusion: Burkholderia cepacia may be a causative pathogen for nosocomial UTI in pediatric patients with predisposing factors, and appropriate selection of antimicrobial therapy is necessary because of high levels of resistance to empirical therapy, including aminoglycosides.

Low Lung Cancer Resection Rates in a Tertiary Level Thoracic Center in Nepal - Where Lies Our Problem?

  • Thapa, Bibhusal;Sayami, Prakash
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권1호
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    • pp.175-178
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    • 2014
  • Background: Resection rates of lung cancer are low in general and especially in countries like Nepal. Advanced stage at presentation and poor general condition of the patient are the usual causes. Materials and Methods: In this prospective observational study, one hundred cases of lung cancer who presented at the Thoracic Surgery Unit between October 2011 and October 2012 were included. Results: Those aged in the $6^{th}$ and $7^{th}$ decades together accounted for 72/100 patients. The male to female ratio was 2:1. There was a mean-$29.2{\pm}14.2$ pack yrs smoking history with only five non-smokers. Seventy-six patients presented with locally advanced disease while 21 had metastases. Only three had local disease. The average time between onset of symptoms to first contact with a doctor was $2.3{\pm}5.3$ months (range: 0-35.6 months). Average time between first contact to referral was $50.4{\pm}65.7$ days (range-0-365). Only three patients were resected, one after neo-adjuvant chemotherapy. Advanced disease was the cause of unresectability in 95 cases. One of three patients with local disease had pulmonary functions allowing the warranted resection. $N_2$ disease with $T_{1-3}$ on CT scan was found in 47. Three of these patients underwent mediastinoscopy and all confirmed uninvolved $N_2$. Conclusions: Lung resection rates in our center remain low. Late presentation leading to advanced disease and poor pulmonary reserves preclude resection in most cases. More liberal use of mediastinal staging and better assessment of pulmonary functions may allow us to improve resection rates.