• 제목/요약/키워드: Regional Medical Center

검색결과 548건 처리시간 0.027초

Soft-tissue Sarcomas in the Asia-Pacific Region: A Systematic Review

  • Ngan, Roger;Wang, Edward;Porter, David;Desai, Jayesh;Prayogo, Nugroho;Devi, Beena;Quek, Richard
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권11호
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    • pp.6821-6832
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    • 2013
  • Background: Soft-tissue sarcomas require tailored and multidisciplinary treatment and management. However, little is known about how sarcomas are treated and managed throughout the Asia-Pacific region. Materials and Methods: MEDLINE was systematically searched using prespecified criteria. Publications (previous 10 years) that reported tumour characteristics, treatment patterns, survival outcomes, and/or safety outcomes of patients with soft-tissue sarcoma were selected. Exclusion criteria were studies of patients <18 years of age; ${\leq}10$ patients; countries other than Australia, Hong Kong, Indonesia, Korea, Malaysia, New Zealand, Philippines, Singapore, Taiwan, or Thailand; >20% benign tumours; sarcomas located in bones or joints; gastrointestinal stromal tumour; Kaposi's sarcoma; or not reporting relevant outcomes. Results: Of the 1,822 publications retrieved, 35 (32 studies) were included. Nearly all patients (98%, 1,992/2,024; 31 studies) were treated with surgery, and more studies used adjuvant radiotherapy than chemotherapy (24 vs 17 studies). Survival outcomes and recurrence rates varied among the studies because of the different histotypes, sites, and disease stages assessed. Only 5 studies reported safety findings. Conclusions: These findings highlight the lack of specific data available about soft-tissue sarcomas in the Asia-Pacific region. Better efforts to understand how the sarcoma is managed and treated will help improve patient outcomes in the region.

Management of the Most Common Functional Gastrointestinal Disorders in Infancy: The Middle East Expert Consensus

  • Indrio, Flavia;Enninger, Axel;Aldekhail, Wajeeh;Al-Ghanem, Ghanem;Al-Hussaini, Abdulrahman;Al-Hussaini, Bakr;Al-Refaee, Fawaz;Al-Said, Khoula;Eid, Bassam;Faysal, Wafaa;Hijazeen, Ruwaida;Isa, Hasan M.A.;Onkarappa, Dinesh;Rawashdeh, Mohammad;Rohani, Pejman;Sokhn, Maroun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제24권4호
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    • pp.325-336
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    • 2021
  • The occurrence of functional gastrointestinal disorders (FGIDs) is a formidable challenge for infants, parents, and healthcare professionals. Although data from the Middle East are scarce, experts consider FGIDs a prevalent condition in everyday clinical practice. The new Rome IV criteria revisited the definitions from a clinical perspective to provide a practical and consistent diagnostic protocol for FGIDs. However, the treatment practices for functional disorders vary considerably among Middle Eastern countries, often resulting in mismanagement with unnecessary investigations and treatments. In addition, the role of various treatment modalities, including probiotics such as Lactobacillus reuteri DSM 17938, in FGIDs requires further discussion and evaluation. During a consensus meeting, a locally relevant approach for treating common FGIDs such as infant regurgitation, infant colic, and functional constipation was discussed and approved by regional experts. The participants suggested a simplified treatment plan and protocol for general pediatricians and other primary care physicians managing FGIDs. This easy-to-follow standardized protocol will help streamline the initial management of this complex disorder in the Middle East region and even globally.

부산도시보건소의 기능별 공간구성 및 면적배분에 관한 연구 (AA Study of Spatial Composition and Area Distribution by Function in Public Health Centers of Busan)

  • 조희영;윤소희;김석태
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제21권2호
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    • pp.55-65
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    • 2015
  • Purpose: Korea is increasing in the demand for medical services due to rapid economic growth and population aging in modern society. Thus, the importance has been emphasized for the health promotion in the community and the publicity and substantiality of public health centers. However, the environment is insufficient, compared to required functions and developed services as a urban public health center. The purpose of this study is to analysis the plane type and area composition of public health centers in Busan and to identify the property of their spatial configuration Methods: Eight public health centers in Busan, were classified, which had been selected as a medical tourism city. Subsequently, space requirements were analyzed, facilities were typed, vertical, horizontal spaces were reviewed, and area ratios by business function were calculated. Results: A review of the property of spatial configuration and an analysis of the area ratio revealed the three findings. 1)The horizontal analysis found various types: a single type, a multi-type, a radial type, and a circular type, 2)The vertical analysis showed that since a care function (general practice), and a task function (maternal and child health) were concentrated in lower level spaces, the lobby and core were closed located for providing quick medical services. 3)The analysis of the area ratio in public health centers in terms of their function indicated that each public health center' programs had the greatest influence on the area. Implications: This study attempted to present spatial structural problems and improvements for city public health center by identifying their state and classify their functions and types and by calculating the ratio of their area configuration according to the spatial composition. It was thus aimed to presenting implications in establish public functions and roles by activating business through in connection with the number of municipalities in many ways, such as regional health. medical welfare, etc. to improve the health of local residents, and by providing differentiated programs in accordance with local characteristics.

소아 피부 및 연조직 감염 환자에서의 황색포도알균의 항생제 감수성의 변화: 2010년부터 2018년까지 단일기관에서의 경험 (Changing Susceptibility of Staphylococcus aureus in Children with Skin and Soft Tissue Infections: a Single Center Experience from 2010 to 2018)

  • 조용선;이신혜;이택진
    • Pediatric Infection and Vaccine
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    • 제26권3호
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    • pp.140-147
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    • 2019
  • 목적: 피부 및 연조직 감염(skin and soft tissue infections [SSTIs])의 가장 흔한 원인은 황색포도알균(Staphylococcus aureus)이다. 본 연구는 19세 미만의 SSTI 환자에서 분리된 황색포도알균의 항생제 감수성의 변화추이를 알아보고자 하였다. 방법: 황색포도알균이 분리된 소아청소년 지역사회관련 SSTI 환자에서 후향적 관찰연구를 시행하였다. 미생물학 및 인구학적 자료를 수집하고, 항생제 감수성의 변화추이를 관찰하였다. 결과: 2010년 1월부터 2018년 12월까지 총 807개의 지역사회관련 황색포도알균이 연구에 포함되었다. Oxacillin에 대한 감수성은 전반적으로 증가하여(P<0.001) 2018년에는 75.0%였다. Trimethoprim/sulfamethoxazole과 tetracycline에 대한 감수성은 매우 높게 유지되어 2018년 각각 97.6%와 95.2%였다. 만 1-5세 연령군에서 만 6-18세 연령군에 비해 oxacillin 감수성이 유의하게 낮았다(53.4% vs. 75.0%, P<0.001). 결론: 소아청소년의 지역사회관련 SSTI의 원인이 된 황색포도알균 중 메티실린내성 황색포도알균의 비율이 감소하고 있는 것으로 보인다. 임상의는 경험적 항생제를 선택할 때 지역적 항생제 감수성 양상을 확인해야 한다.

Predictive Factors for Supraclavicular Lymph Node Recurrence in N1 Breast Cancer Patients

  • Kong, Moonkyoo;Hong, Seong Eon
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권4호
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    • pp.2509-2514
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    • 2013
  • Background: The purpose of this study was to identify predictive factors for supraclavicular lymph node recurrence (SCLR) in N1 breast cancer patients and define a high-risk subgroup who might benefit from supraclavicular nodal radiotherapy (RT). Materials and Methods: From January 1995 to December 2009, 113 breast cancer patients with 1 to 3 positive axillary lymph nodes were enrolled in this study. All patients underwent breast-conserving surgery (BCS) or modified radical mastectomy (MRM). RT was given to all patients who received BCS. Among the patients given MRM, those with breast tumors >5 cm in size received RT. Regional nodal irradiation was not applied. Systemic chemotherapy was given to 105 patients (92.9%). Patient data were retrospectively reviewed and analyzed to identify predictive factors for SCLR. Results: The median follow-up duration was 6.5 years, with 5- and 10-year actuarial SCLR rates of 9.3% and 11.2%, respectively. Factors associated with SCLR on univariate analysis included histologic grade, number of dissected axillary lymph nodes, lymphovascular invasion, extracapsular extension (ECE), and adjuvant chemotherapy. On multivariate analysis, histologic grade and ECE remained significant. The patient group with grade 3 and ECE had a significantly higher rate of SCLR compared with the remainder (5-year SCLR rate; 71.4% vs. 4.0%, p<0.001). Conclusions: Histologic grade and ECE status are significant predictive factors for SCLR. Supraclavicular nodal RT is necessary in N1 breast cancer patients featuring histologic grade 3 and ECE.

응급실 내원 자살시도자의 정신과 진료 연계 관련 특성 (The Psychiatric Treatment Link Characteristics of Suicide Attempters Visiting Emergency Room)

  • 박한나;전성숙;변은경
    • 동서간호학연구지
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    • 제20권2호
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    • pp.93-102
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    • 2014
  • Purpose: This study aimed to investigate the characteristics of patients attempting suicide and to analyze treatment determination factors for patients with mental illness who go to an emergency center for treatment. Methods: Data collected from 117 suicide attempters who visited Busan Regional Emergency Medical Center were analyzed using frequency, percentage, ${\chi}^2$-test with SPSS/WIN 15.0. Results: Only 31 cases consulted with the psychiatric department; the other attempters' refused to consult (26.5%). Among the 31 attempters who consulted, 23 cases (74.2%) were suffering from depression. The most common reason (38.6%) suicidal attempters gave to refuse psychiatric treatment was "I'm not mad. I don't need the psychiatric treatment". Treatment determination factors for mental illness were religion (p<.001), past history (p=.017), financial satisfaction (p=.048), previous history of suicidal attempts (p=.006), sleep disturbance (p<.001), expression of suicide (p=.010), and type of leaving the emergency room (p=.020, p<.001). Conclusion: Results suggest that people frequently misunderstand psychiatric treatment which leads to their refusal to accept psychiatric treatment. Therefore hospitals need to develop standard guidelines and procedures for suicidal attempters with the collaboration of emergency and psychiatry departments. In addition, medical teams need to provide attempters appropriate information and encourage them to actively seek psychiatric treatment.

일부 산업보건관련 기관의 분석실험실 안전보건에 관한 실태와 대책 (A Survey and Recommendation on Safety and Health for Occupational Health Laboratories)

  • 유계묵;노영만;한진구;원정일
    • 한국산업보건학회지
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    • 제10권2호
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    • pp.150-164
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    • 2000
  • This study was conducted at occupational health laboratories in Seoul and Gyunggi district area from December, 1999 to January, 2000. The main purpose of this study was to survey the actual condition of safety and health by questionnaire and checklist and to assess the performance of fume hoods and the airborne exposures to chemicals in the laboratories. The chemicals in the cabinet were not classified by hazardous properties and the compressed gases were not stored safely. The prevalences of laboratories having first aid kits, fire extinguishers, and safety showers were found to be 18%, 55%, and 9%, respectively. Most laboratory workers were not educated for safety and health. Also, there was no performance evaluation for hazards and risks. The fume hoods in laboratories had not been annually inspected by checklist and the face velocity had been checked more than one time in the previous year for only 18% of them. Five percent of fume hoods had the face velocity more than 4.0 m/sec and 17% had no capture performance. Detected organic solvents were methylenechloride, acetone, ethylbenzene, isopropanol, xylene, methylisobutylketone, trichloroethylene, and toluene. The concentrations of organic solvents were much less than the occupational exposure limits proposed by the Ministry of Labor in Korea. This study showed that the actual condition of safety and health was not appropriate for laboratory workers. It is recommended that laboratory workers should be educated for the treatment and storage of hazardous chemicals and compressed gases to improve the working environment of the occupational safety and health laboratories.

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불안을 동반한 주요우울장애 환자에 대한 뇌파 알파 비대칭의 특성 연구 (Electroencephalographic Alpha Asymmetry in Major Depressive Disorder Patients With Anxiety Symptoms)

  • 이준석;양병환;이소희;이승민
    • 생물정신의학
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    • 제14권1호
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    • pp.42-47
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    • 2007
  • Objectives : Studies have reported differences between depressed adults and controls in quantitative measures of EEG alpha asymmetry, but, there are few using Korean subjects. So, the present study compared EEG regional alpha asymmetries of patients having major depressive disorder(MDD) and normal controls. Methods : The subjects in this study were 11 unmedicated unipolar depressed patients and 11 non-depressed, age matched controls. Resting EEG(eyes closed and eyes open) was recorded from each participant using 8 scalp electrodes. Beck Depression Inventory(BDI), 17-item Hamilton Depression Rating Scale(HDRS), Zung's Self-Rating Depression Scale(SDS) and Spielberger's State-Trait Anxiety Inventory(STAI) were used to evaluate depression and anxiety symptoms. Results : The severities of depression measured by self-report questionnaires were positively associated with those of anxiety(state and trait) ; The subjects were both anxious and depressed. Anxious-depressed patients differed from controls in alpha asymmetry at T4 channels. They showed evidence of greater activation over right than left temporal site. Conclusion : These findings are consistent with the previousely reported alpha asymmetry of depressed patients with an anxiety disorder. The failure to find the evidence of reduced right parietal activity in depression is presumed to be due to opposing effects of comorbid anxiety on parietotemporal activity.

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병원기반 금연중재가 뇌경색 환자의 퇴원 후 12개월 지속 금연율에 미치는 효과 (The effect of a hospital-based smoking cessation intervention on the continuous abstinence rate from smoking over 12 months in patients with cerebral infarction)

  • 이영훈;오경재;한미희;김규진;박현영;김희숙;이건세
    • 보건교육건강증진학회지
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    • 제33권3호
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    • pp.61-70
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    • 2016
  • Objectives: The aim of this study was to investigate the effectiveness of a hospital-based smoking cessation intervention for increasing continuous abstinence rate from smoking in patients with cerebral infarction. Methods: One-hundred and two smokers with cerebral infarction who decided to quit smoking were enrolled in the smoking cessation intervention from December 2012 to February 2015. The smokers underwent six consecutive times of individual intervention with nurse specialist on smoking cessation including education on behavioral modification, counseling for withdrawal symptoms, and anti-smoking advice over a 12-month period. Results: Among the total participants, the continuous abstinence rate from smoking changed from 79.4% at 1 month to 60.8% at 12 months after discharge. The continuous abstinence rate from smoking after 12 months was 88.5% in participants who completed the entire program (6 times), while 51.3% in participants who did not complete the entire program (${\leq}5$ times) (P=0.001). After adjustment for general and smoking-related characteristics, complete implementation of hospital-based smoking cessation intervention was significantly associated with continuous abstinence from smoking after 12 months (odds ratio: 5.93; 95% confidence interval: 1.45-24.22). Conclusions: The hospital-based smoking cessation intervention might be effective for smoking cessation in patients with cerebral infarction, especially when the intervention was implemented thoroughly.

고압산소 치료에 대한 일개 권역 응급센터의 최근 10년 경험 및 제언 (Recent 10-Year Experience of One Regional Emergency Center and Recommendation for Hyperbaric Oxygen Therapy (HBOT))

  • 윤정훈;김기운;정윤석;한철수;민영기;조준필;최상천
    • 대한임상독성학회지
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    • 제11권2호
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    • pp.81-88
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    • 2013
  • Purpose: The aim of this study is to investigate current status, indications, and complications of hyperbaric oxygen therapy. Methods: A retrospective investigation of patients who underwent hyperbaric oxygen therapy at a university medical center from September 2004 to August 2013 was conducted based on patients' medical records and results of an email survey for 99 emergency centers. Results: During the study period, a total of 233 patients underwent hyperbaric oxygen therapy. Indications for hyperbaric oxygen treatment of illness or injury were as follows: 1) 151 cases of acute carbon monoxide poisoning(65.4%), 2) flap wound management, including 42 cases(18.2%), 3) skin care transplanted, including 23 cases(10.4%), 4) Burger's disease, including 5 five cases(2.1%), respectively. Total application time$^*$ frequency was 1,088 and total time was 1,239 hours. Among 233 patients who underwent hyperbaric oxygen therapy, 32 patients(13.7%) had complications: 1) otalgia in 21 cases(9.0%), 2) mastoiditis?in six cases(2.6%), 3) hemotympanum in five cases(2.1%), respectively. There were only 8 emergency centers that currently had an operational hyperbaric oxygen chamber in 77 emergency centers(10.4%). Conclusion: Indications identified through this study showed difference from current indications worldwide. It seems necessary that physicians' perception regarding application of hyperbaric oxygen therapy for more indications be changed and improved. A hyperbaric chamber capable of providing respiratory assistance and intensive care is also needed. A good network for sharing treatment experiences and a specialized team for administration of hyperbaric oxygen therapy is also required.

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