• 제목/요약/키워드: bleeding events

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Acupuncture for chronic post-thoracotomy pain in a patient with major chest trauma: A case report

  • Kim, Kun Hyung;Cho, Hyun Min
    • Journal of Acupuncture Research
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    • 제34권1호
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    • pp.81-87
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    • 2017
  • Objectives : Chronic post-thoracotomy pain is a refractory condition that responds poorly to existing pain treatments. The aim of this report is to describe favorable symptom changes in a patient with chronic post-thoracotomy pain after major chest trauma who received a series of manual acupuncture treatments over 3 months. Methods : Twelve sessions of manual acupuncture were provided to the patient, once or twice a week. Results : The manual acupuncture sessions were well tolerated. Minor adverse events, including temporary minor bleeding at the needled sites, were intermittently observed. The patient's symptoms, including pain, sleep disturbance, and anxiety gradually resolved and had almost completely disappeared after 12 sessions of acupuncture treatment. Conclusion : This single case report cannot confirm whether the observed positive changes in the patient's symptoms and dysfunctions are associated with the acupuncture treatments. Randomized controlled trials are necessary to explore the role of acupuncture in chronic post-thoracotomy pain in patients with major chest trauma.

Review of cases of patient risk associated with ginseng abuse and misuse

  • Paik, Doo Jin;Lee, Chang Ho
    • Journal of Ginseng Research
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    • 제39권2호
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    • pp.89-93
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    • 2015
  • Ginseng has long been used as a functional food or therapeutic supplement and it is empirically known to be safe and nontoxic. During recent decades, a number of in vitro and in vivo experiments, as well as human studies have been conducted to prove the safety of various types of ginseng samples and their components. Clinical trials, case reports, and in vitro and in vivo research articles addressing the safety, toxicity, and other adverse events of ginseng application were selected and reviewed. Patient risks associated with ginseng abuse and misuse such as affective disorder, allergy, cardiovascular and renal toxicity, genital organ bleeding, gynecomastia, hepatotoxicity, hypertension, reproductive toxicity, and anticoagulant-ginseng interaction were reviewed and summarized. There are some cases of patient risk associated with ginseng abuse and misuse depending on patients' conditions although further investigation in more cases is required to clarify these issues.

Percutaneous endoscopic gastrostomy in children

  • Park, Jye-Hae;Rhie, Seon-Kyeong;Jeong, Su-Jin
    • Clinical and Experimental Pediatrics
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    • 제54권1호
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    • pp.17-21
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    • 2011
  • Purpose: Percutaneous endoscopic gastrostomy (PEG) can improve nutritional status and reduce the amount of time needed to feed neurologically impaired children. We evaluated the characteristics, complications, and outcomes of neurologically impaired children treated with PEG. Methods: We retrospectively reviewed the records of 32 neurologically impaired children who underwent PEG between March 2002 and August 2008 at our medical center. Forty-two PEG procedures comprising 32 PEG insertions and 10 PEG exchanges, were performed. The mean follow-up time was 12.2 (6.6) months. Results: Mean patient age was 9.4 (4.5) years. The main indications for PEG insertion were swallowing difficulty with GI bleeding due to nasogastric tube placement and/or the presence of gastroesophageal reflux disease (GERD). The overall rate of complications was 47%, with early complications evident in 25% of patients and late complications in 22%. The late complications included one gastro-colic fistula, two cases of aggravated GERD, and four instances of wound infection. Among the 15 patients with histological evidence of GERD before PEG, 13 (87%) had less severe GERD, experienced no new aspiration events, and showed increased body weight after PEG treatment. Conclusion: PEG is a safe, effective, and relatively simple technique affording long-term enteral nutritional support in neurologically impaired children. Following PEG treatment, the body weight of most patients increased and the levels of vomiting, GI bleeding, and aspiration fell. We suggest that PEG with post-procedural observation be considered for enteral nutritional support of neurologically impaired children.

색전술에 의한 안면부 동정맥 기형의 치료 : 증례 보고 (Treatment of Facial Arteriovenous Malformations by Embolization: A Case Report)

  • 김정연;임현수;남옥형;이효설;최성철;김미선
    • 대한소아치과학회지
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    • 제49권2호
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    • pp.228-233
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    • 2022
  • 동정맥 기형(Arteriovenous malformations, AVMs)은 동맥과 정맥이 직접적으로 연결되어 모세혈관과 연결되지 않은 희귀한 선천성 기형 중 하나이다. AVM은 유아기 후반이나 소아기까지는 임상적으로 나타나지 않을 수 있다. 특히 안면 AVM은 생명을 위협하는 치과적 응급 상황을 일으킬 수 있다. 전신병력이 없는 만 5세 여아가 하악 좌측 제2유구치의 후방 치은 주위의 자발적인 잇몸 출혈로 내원하였다. 감별진단 및 치료를 위해 전신마취 하에 대퇴정맥 접근을 통한 혈관조영술이 시행되었다. 동맥색전술 만으로도 혈류량이 효과적으로 감소되었다. 5개월 동안의 경과관찰에서 재발되지 않았다. 본 연구는 성장기 환자에서 이환된 혈관의 색전술이 외과적 절제술보다 더 효과적이고 안전한 방법이 될 수 있다고 보고하는 바이다.

COVID-19 시대에 중환자실 전담의사 감독 하에 두경부 전문의에 의해 시행된 기관절개술에 대한 후향적 분석 연구 (Tracheostomy Performed by a Head and Neck Surgeon Under the Supervision of an Intensive Care Unit Specialists in the COVID-19 Era: A Retrospective Analysis)

  • 한원호;이윤임;백선화;석준걸
    • 대한후두음성언어의학회지
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    • 제33권2호
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    • pp.97-102
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    • 2022
  • Background and Objectives Tracheostomy is a relatively safe procedure, and the recent emergence of COVID-19 has raised the need to perform tracheostomy immediately in the bed of an intensive care unit (ICU) rather than an operating room. The purpose of this study was to determine the occurrence of complications related to surgical tracheotomy performed in the ICU by an ENT specialist. Materials and Method From March 2019 to January 2022, a total of 101 patients underwent tracheostomy in the ICU. Demographics and complications were classified according to postoperative period. Results Within 24 hours after the procedure, bleeding events were confirmed in 2 patients (2.0%) with mild bleeding. One case (1.0%) of ventricular fibrillation occurred shortly after the procedure. There were no complications from 24 hours to 1 week after procedure. After one week, 4 patients (4.5%) had a local infection, and 3 patients (3.4%) had a tube obstruction. During all follow-up periods, there were no serious side effects such as death, major vascular injury, pneumothroax. No complications were observed throughout the entire period in 6 COVID-19 patients. Conclusion The number of complications of surgical tracheotomy in the ICU performed by a specialist was lower than in previous studies, and there were no complications that delayed treatment or endangered life. The ENT training hospitals should provide sufficient training opportunities for residents to perform surgical tracheostomy and strive to minimize complications associated with the procedure and pre- and post-operative management under the detailed guidance and supervision of specialists.

Comparison of scissor-type knife to non-scissor-type knife for endoscopic submucosal dissection: a systematic review and meta-analysis

  • Harishankar Gopakumar;Ishaan Vohra;Srinivas Reddy Puli;Neil R Sharma
    • Clinical Endoscopy
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    • 제57권1호
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    • pp.36-47
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    • 2024
  • Background/Aims: Scissor-type endoscopic submucosal dissection (ST-ESD) knives can reduce the adverse events associated with ESDs. This study aimed to compare ST-ESD and non-scissor-type (NST)-ESD knives. Methods: We identified ten studies that compared the performance characteristics and safety profiles of ST-ESD and NST-ESD knives. Fixed- and random-effects models were used to calculate the pooled proportions. Heterogeneity was assessed using the I2 test. Results: On comparing ST-ESD knives to NST-ESD knives, the weighted odds of en bloc resection was 1.61 (95% confidence interval [CI], 0.90-2.90; p=0.14), R0 resection was 1.10 (95% CI, 0.71-1.71; p=0.73), delayed bleeding was 0.40 (95% CI, 0.17-0.90; p=0.03), perforation was 0.35 (95% CI, 0.18-0.70; p<0.01) and ESD self-completion by non-experts was 1.89 (95% CI, 1.20-2.95; p<0.01). There was no heterogeneity, with an I2 score of 0% (95% CI, 0%-54.40%). Conclusions: The findings of reduced odds of perforation, a trend toward reduced delayed bleeding, and an improvement in the rates of en bloc and R0 resection with ST-ESD knives compared to NST-ESD knives support the use of ST-ESD knives when non-experts perform ESDs or as an adjunct tool for challenging ESD procedures.

COVID-19 (SARS-CoV-2) mRNA vaccination does not affect basal sex hormone levels (follicle-stimulating hormone, luteinizing hormone, estradiol) in reproductive-age women

  • Haeng Jun Jeon;Woo Sik Lee;Ji Eun Park;Ji Young Hwang;Ji Won Kim
    • Clinical and Experimental Reproductive Medicine
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    • 제51권2호
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    • pp.151-157
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    • 2024
  • Objective: People vaccinated with the coronavirus disease 2019 (COVID-19) (severe acute respiratory syndrome coronavirus-2 [SARS-CoV-2]) mRNA vaccine have reported experiencing various adverse effects. For instance, reproductive-age women have presented with complaints of abnormal uterine bleeding or menstrual cycle changes. We speculated that differences in basal sex hormone levels before and after vaccination may be present in women who experienced irregular bleeding or menstrual cycle changes; thus, this study aimed to investigate the differences in basal sex hormone levels of women before and after two doses of SARS-CoV-2 mRNA vaccination. Methods: This retrospective study included patients who received SARS-CoV-2 mRNA vaccines between January 2021 and February 2022 at a single center. In an outpatient setting, patients were queried regarding their menstrual cycle, the date of SARS-CoV-2 mRNA vaccination, vaccination type, and vaccination side effects. Differences in basal hormone levels (menstrual cycle days 2-3, follicle-stimulating hormone [FSH], luteinizing hormone [LH], and estradiol) before and after vaccination were compared. Results: Among the 326 patients, patients with no laboratory records of the hormones were excluded. The median time interval between SARS-CoV-2 mRNA vaccination and the laboratory test day was 79 days (interquartile range, 44 to 127). A comparative analysis of these hormones before and after vaccination revealed no significant differences. Subgroup analyses based on age and reported adverse events also found no statistically significant differences. Conclusion: This study showed no significant differences in basal hormone levels (FSH, LH, and estradiol) before and after SARS-CoV-2 mRNA vaccination.

일 지역 대학생의 재난경험과 재난대비에 대한 조사연구 (A Study on Disaster Experience and Preparedness of University Students)

  • 강경희;엄동춘;남은숙
    • 한국간호교육학회지
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    • 제18권3호
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    • pp.424-435
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    • 2012
  • Purpose: The purpose of this study was to investigate the disaster experience (accidents, education etc) and the concern for disaster preparedness of college students. Methods: This research design was a descriptive study. Data were collected from November 1, 2011 to December 30, 2011 and analyzed by the SPSS PASW statistics 18.0 program. Results: There were statistical significances in major (p<.050), grade(p<.001), and a completed disaster class(p<.001) between general characteristics and concern for disaster preparedness. The major disaster events that occurred from 2003 to 2010 in Korea were the 2007 Taean oil spill (85.4%), the 2003 Daegu subway fire (82.7%), and the 2008 Sungnyemun fire (62.9%). The possible disaster events in Korea were hurricanes, floods, fires (including wildfire), and the shutdown of communication lines. Subjects learned about cardiopulmonary resuscitation (18.2%), first aid for bleeding and fractures (17.8%), a fire drill (14.3%), and an escape drill for an earthquake (14.0%). They wanted to learn the fire drill (11.33%), the escape drill for an earthquake (9.7%), a war drill (9.0%), a disaster confrontation drill on the subway (8.6%), and a fire and explosion evacuation drill (8.4%). Half of subjects were not prepared with emergency supplies for disasters because they thought that a disaster would not occur. Conclusion: It is necessary to develop the disaster educational programs according to subject's demands in Korea.

Efficacy and safety of dienogest in patients with endometriosis: A single-center observational study over 12 months

  • Park, So Yun;Kim, Sung Hoon;Chae, Hee Dong;Kim, Chung-Hoon;Kang, Byung Moon
    • Clinical and Experimental Reproductive Medicine
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    • 제43권4호
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    • pp.215-220
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    • 2016
  • Objective: To evaluate the efficacy and safety of dienogest treatment in patients who had received dienogest for 12 months or more to treat endometriosis. Methods: We analyzed the clinical data of 188 women with endometriosis who had been treated with 2 mg of dienogest once a day for 12 months or more at a single institute. We evaluated changes in endometriosis-associated pain and endometrioma size, recurrence rate, and adverse events following dienogest administration. Bone mineral density (BMD) was measured in patients who were prescribed dienogest for more than 18 months. Results: Pain was significantly reduced at 12 months after dienogest medication. In those treated with dienogest due to recurrent endometrioma, the size of the endometrioma was significantly decreased at the 12-month and 18-month follow-ups. We found only one case of sonographic recurrence during dienogest administration among those who were treated postoperatively to prevent recurrence (1 of 114, 0.9%). The most common adverse drug reaction was uterine bleeding (3.2%), and other adverse events were generally tolerable and associated with low discontinuation rates (5.2%). Among the 50 patients in whom BMD was measured, 10 patients (20%) had a Z-score below the expected range for age. Conclusion: The administration of dienogest for a year or more seems to be highly effective in preventing recurrence after surgery, reducing endometriosis-associated pain, and decreasing the size of recurrent endometrioma, with a favorable safety and tolerability profile. However, BMD should be checked in patients on long-term medication due to possible bone loss in some women.

한약재 약욕요법이 소아 발열기간에 미치는 영향 : 체계적 문헌고찰 및 메타분석 (Effect of Herbal Bath for Duration of Pediatric Fever : a Systematic Review and Meta-analysis)

  • 김예지;박소현;서혜선;박슬기;이선행;이진용
    • 대한한방소아과학회지
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    • 제35권3호
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    • pp.53-66
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    • 2021
  • Objective The purpose of this study is to evaluate whether herbal bath shortens the duration of pediatric fever. Methods Databases, such as Medline, EMBASE, Cochrane library, OASIS, KISS, KMBASE, CNKI, Wanfang Med Online were used to search randomized controlled trials. Those trials that included children younger than 18-year-old were evaluated for the clinical efficacy of herbal bath in fever by analyzing 'body temperature (BT) drop start time' and 'time to return to normal BT'. Results 12 studies or 1306 participants were analyzed in the study. When applying herbal bath in combination with the controlled treatment, 'BT drop start time' was decreased by 0.11 hours, and 'time to return to normal BT' was decreased by 10.94 hours compared to the controlled group. When comparing herbal bath with tepid bath, 'time to return to normal BT' was reduced by 8.19 hours in herbal bath group. In regards to safety, 3 studies out of 12 studies mentioned about its adverse events: 2 studies did not have any adverse events, and a minor needle-shaped bleeding had occurred in one of the studies. Conclusion Use of herbal bath as a treatment of fever in children was associated with shortened duration of fever. However, cautious interpretation is necessary due to its limited safety data.