• Title/Summary/Keyword: Treatment need

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The Clinical Features and Prognostic Factors in Adults with Acute Etrodotoxin Poisoning Caused by Ingesting Puffer Fish (복어 섭취 후 발생한 급성 테트로도톡신 중독 환자의 임상적 특징과 예후 인자 분석)

  • Jo, Yong Soo;Chun, Byeong Jo;Moon, Jeong Mi;Ryu, Hyun Ho;Jung, Yong Hun;Lee, Sung Min;Song, Kyung Hwan;Ryu, Jin Ho
    • Journal of The Korean Society of Clinical Toxicology
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    • v.12 no.2
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    • pp.46-53
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    • 2014
  • Purpose: We conducted this study in order to determine clinical features and prognostic factors in adults with acute tetrodotoxin (TTX) poisoning caused by ingestion of puffer fish. Methods: In this retrospective study, 107 patients were diagnosed with TTX poisoning. The subjects were divided into two groups according to duration of treatment; Group I, patients were discharged within 48 hours (n=76, 71.0%), Group II patients were discharged after more than 48 hours (n=31, 29.0%). Group II was subsequently divided into two subgroups [IIa (n=12, 11.2%), IIb (n=19, 17.8%)] according to the need for mechanical ventilation support. Results: In multivariable logistic regression analysis, the predictors of the need for treatment over 48 hours were dizziness (odds ratio [OR], 4.72; 95% confidence intervals [CI], 1.59-12.83), time interval between onset of symptom and ingestion (OR, 0.56; 95% CI, 0.16-0.97), $PaCO_2$<35 mmHg (OR, 8.37; 95% CI, 2.37-23.59). In addition, predictors of the need for mechanical ventilation were a time interval between onset of symptoms and ingestion (OR, 0.54; 95% CI, 0.11-0.96) and $PaCO_2$<35 mmHg (OR, 5.65; 95% CI, 1.96-18.66). Conclusion: Overall, dizziness, time interval between onset of symptoms and ingestion, ${\Delta}DBP$ and $PaCO_2$<35 mmHg predict the need for treatment over 48 hours, time interval between onset of symptoms and ingestion and $PaCO_2$<35 mmHg predict the need for mechanical ventilation support after acute TTX poisoning.

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Causes of Delay in Seeking Treatment in Patients with Breast Cancer in Iran: a Qualitative Content Analysis Study

  • Rastad, Hadis;Khanjani, Narges;Khandani, Behjat Kalantari
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4511-4515
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    • 2012
  • Background: In the Middle East, including Iran, breast cancer is the most frequent malignancy among women. Without treatment, a malignant breast tumor advances in stage, diminishing a woman's chances of survival. In this study we aimed to gain insight into the causes of delay in seeking treatment in patients with breast cancer. Methods: The participants in this qualitative, content analysis study were 10 women in whom a diagnosis of breast cancer in the stages of II b, III or IIV had been made. They were selected from patients of a major oncology clinic in Kerman, Iran. Data were collected by means of semi-structured interviews that lasted between 20 to 30 minutes. Sampling was discontinued when data saturation was achieved. Content analysis was conducted by classifying the data into themes and sub-themes. Results: The results of our study revealed several factors that interfered with patients' professional consultation seeking and prompt treatment. These factors included; lack of knowledge, fear of being diagnosed with cancer, not seeing oneself at risk, mental preoccupation and wrong diagnosis by physicians. Conclusions: This study suggests that women and even physicians need further information about breast cancer symptoms. Women need encouragement to seek medical advice when they encounter suspicious symptoms. Additionally, women may benefit from awareness of the pros of early detection and reassurance about the improvements in the success of breast cancer treatment.

The Dosimetric evaluation of the standard electron cone for the extended cone for the extended SSD and The Dosimetric characteristics of the custom-made electron cone (표준 전자선 cone의 확장된 SSD에서의 선량평가 및 자체제작한 전자선 cone의 특성)

  • Chung Se Young;Chung Hui Young;Kim Young Bum;Kwon Young Ho
    • The Journal of Korean Society for Radiation Therapy
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    • v.11 no.1
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    • pp.73-78
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    • 1999
  • In general, the patients of the head and neck cancer are treated with 4MV photon beam up to prescribed dose, but spinal cord should be excluded in the treatment field. When its absorbed dose is limited at the tolerance dose. In case of the patients who has the positive posterior neck nodes need a boost electron beam treatment to the prescribed dose. In that case, the anatomical structure of the neck and the physical structure of the standard electron cone interrupt to allow proper access to the disease site. Therefore, we extended treatment SSD for the remove of the those hindrances. In this study, we evaluated the dosimetric variation of the standard electron cone for the extended SSD, from 100cm to 120cm, 5 cm increment, and compare to the custom-made electron cone. As a result, the $\%$ depth dose, the point of maximum dose and the range of maximum were changed within the $2\%$. The penumbra width was increased from 1.0cm to 2.0cm. However, the dosimetric characteristics of the custom-made electron cone was very similar to that of the 100cm SSD standard electron cone and due to its characteristic of physical structure, patients didn't need re-positioning after photon beam treatment, therefore accurate treatment was possible, we conclude that the custom-made electron cone was very useful for the clinical practice.

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Evaluation of facial appearance in patients with repaired cleft lip and palate: comparing the assessment of laypeople and healthcare professionals

  • Alhayek, Samar;Alsalem, Mohammed;Alotaibi, Yazeed;Omair, Aamir
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.5.1-5.5
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    • 2019
  • Background: The present study aimed to determine whether laypeople and professionals rate the facial appearance of individuals with repaired complete unilateral or bilateral cleft lip and palate (UCLP, BCLP) similarly based on viewing full facial images. Methods: The study followed a cross-sectional analytical design where five young patients aged 10 to 14 years, who had completed all stages of their unilateral or bilateral cleft lip and palate treatment (bilateral: three, unilateral: two), were evaluated by two groups. The assessment was done by laypeople and 97 qualified professionals (33 orthodontists, 32 plastic surgeons, and 32 oral and maxillofacial surgeons). Professionals were not involved in any stage of the patients' treatment. Results: The facial appearance assessment of the professional groups on different facial aesthetics was significantly lower than that of laypeople, and they had higher perceived need for further treatment. On the other hand, laypeople had higher aesthetic ratings and lower perceived need for further treatment. Differences were also observed between the assessments of the professional groups. Participants who had lower aesthetic assessments of the repair tended to report a higher influence of cleft lip and palate on social activities and professional life. Conclusion: Differences in perception exist between healthcare professionals and laypeople. The discrepancies between the professional groups could be attributed to different treatment modalities and protocols.

The Knowledge, Attitude and Practice of Blood Pressure Management from the Patient's Viewpoint: A Qualitative Study (고혈압 환자들의 관점에서 본 혈압관리에 대한 지식, 태도, 실천: 질적연구)

  • Lee, Sok-Goo;Jeon, So-Youn
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.4
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    • pp.255-264
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    • 2008
  • Objectives: This study adopted a qualitative method to explore the layman's beliefs and experience concerning high blood pressure and its management in order to develop a strategy to increase adherence to proper medical treatment. Methods: Semi-structured interviews that focused on personal experiences with hypertension and its management were conducted with 26 hypertensive patients. The participants were selected according to a BP above 140/90 mmHg (hypertension stage 1), based on the seventh report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure (JNC-VII). The interviews lasted for approximately 30 minutes (range: 20-60 minutes). The resulting questions were formulated into open-ended questions. The interview questionnaire was composed 17 items to examine non-adherence to treatment and 19 items to examine adherence to treatment. Results: Most participants recognized that the direct cause of high blood pressure was unhealthy behavior rather than inheritance. Thus, the hypertensive patient believed they could recover their blood pressure to a normal level through removing the direct cause of hypertension (weight reduction, diet, exercise) instead of taking drugs. The reasons for these statements were that the drugs for controlling hypertension are not natural or they are artificial, and they may have side effects, and drugs are not treatment for the root cause of hypertension. Most of the hypertensive patients chose to manage their behaviors as soon as they knew their blood pressure was high. Therefore, we should not divide the subjects into two groups according to their taking drugs or not, but they should be divided into two groups according to their willingness or not to manage their condition. Conclusions: For developing a strategy for an individual approach to hypertension management, we need to develop a client-centered attitude and strategy. That is, we need to tailor our approach to individual cases to avoid generalizations and stereotyping when developing an adherence increasing strategy.

Inhalation Sedation with Nitrous Oxide in Dental Treatment (Nitrous Oxide를 이용한 흡입진정)

  • Yoon, Byung-Bae
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.2 no.1 s.2
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    • pp.1-6
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    • 2002
  • The usage of nitrous oxide is increased for the anxious patient to dental treatment. There are two methods to induce the sedation during dental treatment. One is sedation with drugs the other no need of drugs. We discussed here about sedation with drugs. The methods of drug administration are oral, intramuscular, intravenous, inhalation. The method of oral administration of drugs are convenient to patient and doctor but poor controllability. Intramuscular method is a parenteral technique that maintains several advantages over the enteral technique. However its pales in comparison to other parenteral technique. Intravenous method represents most effective method of ensuring predictable and adequate sedation in all patients. But it has inability to reverse the action of drugs after they have been injected except some drugs (e.g., narcotics and benzodiazepine). A variety of gaseous agents may be administered by inhalation to produce sedation. In dental practice, the inhalation administration of gas means use of nitrous oxide. There are many advantages of nitrous oxide administration. First, very short latent period and rapid onset of drug action which lead to possible titration of drug concentration. With nitrous oxide, clinical effects may become noticeable as quickly as 15 to 30 seconds after inhalation. Recovery from inhalation sedation is also quite rapid. In out patient dental practice rapid recovery is very important because it permit to discharge the patient without escort and the patient return to their ordinary life without limit. To success the conscious sedation with nitrous oxide, the administrator should be keep the mind that always titration of nitrous oxide concentration during induction and treatment. Careful observation need during treatment to prevent oversedation because the adequate nitrous oxide concentration to patients changed by environmental stress. Always begins with 100% oxygen and ends with 100% oxygen to prevent diffusion hypoxia which rare in clinical practice.

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Effects of Winter Heating on the Treatment Characteristics and Performance of Absorbent Biofilter System (흡수성 Biofilter System에서 동절기 가온이 처리 특성과 성능에 미치는 영향)

  • Kwun, Soon-Kuk;Cheon, Gi-Seol;Kim, Song-Bae
    • Journal of The Korean Society of Agricultural Engineers
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    • v.47 no.6
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    • pp.73-82
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    • 2005
  • This study was performed to evaluate the need for heating wastewater to enhance treatment efficiency of organic matter (BOD, SS) during cold winter in newly developed Absorbent Biofilter System (ABS) which was established in the Suwon Campus of the Seoul National University. Treatments consisted of non-heating (2000 year) and heating(2001, 2002 year), and sampled data were analyzed during cold winter period as well as post winter period to investigate the influence of heating after winter season. Even the average air temperature showed only $0.4^{\circ}C$ difference between two experimental years, the difference in the average effluent temperature during cold winter period between heating and non-heating experiment was approximately $11^{\circ}C$. The average effluent concentration of organic matter in non-heating treatment exceeded the Korean standards for water quality of discharged effluent in riparian area (BOD and SS 10 mg/L); however, the standards were met in case of heating treatment during both winter and post winter period. Therefore, the need fur heating wastewater during cold winter season in ABS was justified. On the other hand, there was no improvement of treatment efficiency in T-N and T-p, but we observed the more activated nitrification as increasing the wastewater temperature. Because the average underground temperature was $5^{\circ}C$ higher than the average air temperature during cold winter period, we recommend that the ABS can be established in the underground rather than on-ground for saving the heating cost.

Case Reports of Elderly Patients in Aging Society (성이 교정환장의 치험 예)

  • Park, Yang-Ho;Cheon, Se-Hwan;Lee, Kyu-Hong;Hwang, Yong-In;Kim, Yoon-Ji;Kim, Seon-Ah
    • The Journal of the Korean dental association
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    • v.45 no.12 s.463
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    • pp.753-760
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    • 2007
  • Recently orthodontics in elderly people is continually increasing due to aging of the society arising from decrease of birth rate as well as death rate. As the elderly population grows, needs for oral health care increases, and elderly patients with poor teeth alignment need more attention with orthodontic treatment. Our study analyzes various treatment protocols for different cases of aged orthodontic patients, and following are considerations in orthodontic treatment of elderly patients. 1. Periodontal treatment should be preceded before orthodontic treatment. 2. Periodontal condition should be considered when selecting teeth for extraction 3. In dealing with the residual prosthesis, condition of prosthesis, anchorage availability, and need for size reduction, patient seconomic status should be taken into consideration. 4. Fixed retainers are recommended for retention.

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An Analysis of Domestic and International VR Technology in Phobia Treatment (가상현실 기술을 이용한 공포증 치료의 국내외 동향 분석)

  • Kim, Seul-ki;Suk, Hae-jung
    • Cartoon and Animation Studies
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    • s.41
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    • pp.307-336
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    • 2015
  • Virtual reality technology is one of the important technologies that will affect our life in many ways. This novel technology will draw new paradigm into the medical field due to its advantages in physical safety and environment that are fully controlled. Phobia treatment using VR technology has been implemented and its feasibility has been proved through a number of researches in many institutions. This study has observed the current progress of its technology environment and the trend of research. Also, This study has analyzed the results from domestic and international data. Analysis shows that other countries are ahead of korea in all aspects of the phobia treatment using virtual reality method. Although the authors limited the kinds of journals, the amount of quantity in international researches are two times more than domestics. Also, The researchers in other countries concentrate on the multi-modal studies. To use virtual reality in the phobia treatment, we need to understand the needs of the society members and the government has responsibility to support what the researchers need.

Analysis of Water Quality caused by Improvement of Sewage Treatment Plant in Masan Bay (하수처리장 개선이 마산만 수질에 미치는 영향분석)

  • Oh Hyun-Taik;Goo Jun-Ho;Park Sung-Eun;Choi Yun-Sun;Jung Rae-Hong;Choi Woo-Jeung;Lee Won-Chan;Park Jong-Soo
    • Journal of Environmental Science International
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    • v.14 no.8
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    • pp.777-783
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    • 2005
  • For the sustainable management of marine ecosystem in Masan Bay, we have to assess the carrying capacity and standard of target water quality. In this research, we assume that all pollutants loads are treated in Dukdong sewage treatment plant, then we simulate the physical-biological model for prediction water quality for the achievement of standard water quality. In 2001 year, for the achievement of COD 2.5 mg/L, we need to reduce COD $90\%$, nitrogen $30\%$, phosphate $90\%$ than that of the present value, According to these results, the water quality of sewage treatment plant is required to treat COD 13.5 mg/L, nitrogen 33.3 mg/L, phosphate 6,0 mg/L. If the sewage treatment plant will be expanded much larger in 2011, it will need to be treated in COD 6.6 mg/L, nitrogen 2.5 mg/L, phosphate 5 mg/L for the achievement of water quality standard in COD 2.5 mg/L.