• Asian Pacific Journal of Cancer Prevention
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• 제13권8호
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• pp.3723-3730
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• 2012

Delay in help-seeking behaviour which is potentially preventable has a major effect on the prognosis and survival of patients with breast cancer. The objective of this study was to explore reasons for delay in seeking help among patients with breast cancer from the East Coast of peninsular Malaysia. A qualitative study using face-to-face in-depth interview was carried out involving 12 breast cancer patients who had been histo-pathologically confirmed and were symptomatic on presentation. Respondents were selected purposely based on their history of delayed consultation, diagnosis or treatment. All were of Malay ethnicity and the age range was 26-67 years. Three were in stage ll, seven in stage lll and two in stage lV. At the time of interview, all except one respondent had accepted treatment. The range of consultation time was 0.2-72.2 months with a median of 1.7 months, diagnosis time was 1.4-95.8 months( median 5.4 months )and treatment time was 0-33.3 months (median 1.2 months). The themes derived from the study were poor knowledge or awareness of breast cancer, fear of cancer consequences, beliefs in complementary alternative medicine, sanction by others, other priorities, denial of disease, attitude of wait and see and health care system weakness. Help-seeking behaviour was influenced by a complex interaction of cognitive, environmental, beliefs, culture and psycho-social factors. Breast cancer awareness and psychological counselling are recommended for all patients with breast symptoms to prevent delay in seeking clinical help.

• 대한소아치과학회지
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• 제45권3호
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• pp.393-399
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• 2018

치과치료 중에 통증을 유발할 수 있는 요소를 차단함으로써 환자의 공포와 두려움을 줄여줄 수 있다. 이를 위해 벤조케인을 함유한 도포마취제가 광범위하게 사용되고 있다. 그러나, 2018년 5월 28일 식품의약품안전처는 의약품 안전 서한을 통해 24개월 미만의 소아 및 영아에서 벤조케인 함유 제제의 사용을 금지하고 그 이상의 경우라 하더라도 메트헤모글로빈혈증(Methemoglobinemia, MHb)의 발생가능성이 있으므로 신중한 사용을 권고하였다. 이는 지난 5월 23일 미국 식품의약국(Food and Drug Administration, FDA)의 권고의 후속 조치로 시행된 것이다. 벤조케인을 함유한 제제를 사용하는 경우, 치과의사는 MHb의 발생가능성을 반드시 고려해야 하며 MHb의 조기 진단과 적절한 조치가 시행될 수 있도록 준비하고 있어야한다. MHb의 치료제는 메틸렌블루가 1930년대부터 이용되고 있다. 치과의사는 메틸렌블루의 적절한 사용법과 용량을 숙지하고, MHb의 조기 진단을 위한 방법과 진단 장비에 익숙해야 한다. 무엇보다도 환자의 안전에 대한 적절한 대비와 훈련이 필요할 것이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제45권4호
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• pp.207-214
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• 2019

Objectives: Medically compromised patients often fear required dental surgical procedures that can increase the risk of medical emergency when combined with reduced tolerance for stress. A stress reduction protocol (SRP) helps doctors minimize treatment-related stress and improves patient management with minimum complications. Diabetes and co-morbid hypertension carry 4-fold risk of aggravation of cardiovascular emergencies and 7.2-fold risk of mortality. Diabetic neuropathy can result in difficult diagnosis of myocardial infarction and reduces chances of surviving a myocardial infarction compared with a non-diabetic person. The aim of the study was to assess the feasibility of a protocol for management of patients having both diabetes and hypertension who required minor oral surgery to minimize the rate of cardiovascular emergencies. Materials and Methods: A prospective study was conducted in 140 patients having both diabetes and hypertension who required minor oral surgical procedures. A systematic approachable protocol was designed for management of such patients. Results: Among 140 patients, 6 patients (4.3%) had cardiovascular complications, while 3 patients (1 with syncope and 2 with hypertension) did not require any intervention other than observation. Two patients were managed with aspirin and nitroglycerin, and 1 patient had possible myocardial infarction (overall incidence 0.7%) with chest pain, S-T segment elevation on electrocardiogram, and troponin level of 0.60 ng/mL. Conclusion: The proposed protocol helps to improve management of patients having both diabetes and hypertension. We recommend that patients with uncontrolled diabetes and uncontrolled hypertension and/or patients having history of cardiovascular complication should be treated in a medical facility with a readily available cardiology unit. This facilitates prompt response to emergency and instant implementation of treatment, helping to reduce morbidity and mortality.