• Title/Summary/Keyword: disease outcome

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Outcome and Prognosis in Critically III Children Receiving Continuous Renal Replacement Therapy (소아 중환자에서 지속적 신대체요법의 치료 결과와 예후)

  • Park, Kwang-Sik;Son, Ki-Young;Hwang, You-Sik;Kim, Joung-A;Cheung, Il-Chun;Shin, Jae-Il;Park, Ji-Min;Ahn, Sun-Young;Lyu, Chuhl-Joo;Lee, Jae-Seung
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.247-254
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    • 2007
  • Purpose : Continuous renal replacement therapy(CRRT) has been the first choice for the treatment of acute renal failure in critically ill children not only in western countries but also in Korea. However, there are very few studies that have analyzed the outcome and prognosis of this modality in Korean children. We performed this study to evaluate the factors associated with the outcome and prognosis of patients treated with CRRT. Methods : We retrospectively reviewed the medical records of 32 children who had received CRRT at Severance hospital from 2003 to 2006. The mean age was 7.5 years(range 4 days-16 years) and the mean body weight was 25.8 kg (range 3.2-63 kg). Results : Eleven(34.4%) of the 32 patients survived. Bone marrow transplantation and malignancy were the most common causes of death and underlying disease leading to the need for CRRT Mean patient weight, age, duration of CRRT, number of organ failures, urine output, estimated glomerular filtration rate(eGFR), C-reactive protein, and blood urea level did not differ significantly between survivors and nonsurvivors. (1) Pediatric risk of mortality(PRISM) III score at CRRT initiation($9.8{\pm}5.3$ vs. $26.7{\pm}7.6$, P<0.0001), (2) maximum pressor number ($2.1{\pm}1.2$ vs. $3.0{\pm}1.0$, P=0.038), and (3) the degree of fluid overload($5.2{\pm}6.0$ vs. $15.0{\pm}8.9$, P=0.002) were significantly lower in survivers than in nonsurvivors. Multivariate analysis revealed that fluid overload was the only independent factor reducing survival rate. Conclusion : CRRT was successfully applied to the treatment of acute renal failure in a wide range of critically ill children. To improve survival, we suggest the early initiation of CRRT to prevent the systemic worsening and progression of fluid overload in critically ill children with acute renal failure. (J Korean Soc Pediatr Nephrol 2007;11:247-254)

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Current status of pediatric kidney transplantation (소아 신이식의 최신 지견)

  • Kim, Sung-Do;Cho, Byoung-Soo
    • Clinical and Experimental Pediatrics
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    • v.52 no.10
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    • pp.1075-1081
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    • 2009
  • Renal transplantation is the treatment of choice for children with end-stage renal disease. The outcome of pediatric kidney transplantation has improved dramatically in recent years, with lower acute rejection rates, superior graft survival, and low mortality. These improvements have allowed increased attention to other aspects of care for long-term survivors. Taking this into consideration, this review article will focus on the key issues related to pediatric kidney transplantation such as growth, neurocognitive function, nonadherence, and posttransplantation infectious complications, including lymphoproliferative disease, to broaden the understanding of pediatricians who provide pre-and postoperative care to children with end-stage renal disease.

The Surgical Outcome of Congenital Cardivascular Disease in Adult (성인의 선천성 심혈관 기형에 대한 수술 성적)

  • 김영대
    • Journal of Chest Surgery
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    • v.28 no.4
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    • pp.340-345
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    • 1995
  • Between 1983 and 1993, 250 patients over 16 years of age who had undergone a surgical correction of a congenital cardiovascular disease were reviewed. 222 patients were divided into acyanotic group and 28 patients were cyanotic group. The most common defects were atrial septal defect [96 patients and ventricular septal defect [95 patients . There were 128 patients in the third decade, 71 patients under 20 years of age, 40 patients in the fourth decade and 11 patients over 40 years of age. The male to female ratio was 1.05:1. Operative mortality was 6.8% [4.1% in the acyanotic group and 26.8% in the cyanotic group and the most common cause of death was low cardiac output syndrome.

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Overview of RCT for Non-Alcoholic Fatty Liver Disease and Non-Alcoholic Steatohepatitis

  • Son, Chang-Gue
    • The Journal of Korean Medicine
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    • v.32 no.3
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    • pp.44-49
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    • 2011
  • Objective: This study aimed to get information on the current status of therapies to date for non-alcoholic fatty liver disease (NAFLD), including non-alcoholic steatohepatitis (NASH). Methods: All randomized clinical controlled trial (RCT)-derived papers for NAFLD or NASH were reviewed via PubMed Database. Results: 39 RCTs met the review criteria, of which 15 and 24 papers were for NAFLD and NASH, respectively. 83% of the papers were released since 2006, and 30 studies were conducted for western medicines, antioxidants and lifestyle intervention whereas nine trials were done using herbal medicine or acupuncture which showed positive outcome. Conclusions: NAFLD and NASH are new epidemic disorders which can be a target of traditional Oriental medicine. This study will be helpful for the Oriental medicine-based strategies or therapeutic development for them.

Exploring Study Designs for Evaluation of Interventions Aimed to Reduce Occupational Diseases and Injuries

  • van der Molen, Henk F.;Stocks, Susan J.;Frings-Dresen, Monique H.W.
    • Safety and Health at Work
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    • v.7 no.1
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    • pp.83-85
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    • 2016
  • Effective interventions to reduce work-related exposures are available for many types of work-related diseases or injuries. However, knowledge of the impact of these interventions on injury or disease outcomes is scarce due to practical and methodological reasons. Study designs are considered for the evaluation of occupational health interventions on occupational disease or injury. Latency and frequency of occurrence of the health outcomes are two important features when designing an evaluation study with occupational disease or occupational injury as an outcome measure. Controlled evaluation studies-giving strong indications for an intervention effect-seem more suitable for more frequently occurring injuries or diseases. Uncontrolled evaluation time or case series studies are an option for evaluating less frequently occurring injuries or diseases. Interrupted time series offer alternatives to experimental randomized controlled trials to give an insight into the effectiveness of preventive actions in the work setting to decision and policy makers.

Interstitial Lung Disease and Diffuse Alveolar Hemorrhage, the Two Key Pulmonary Manifestations in Microscopic Polyangiitis

  • Kim, Min Jung;Shin, Kichul
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.4
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    • pp.255-262
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    • 2021
  • Microscopic polyangiitis (MPA) is an antineutrophil cytoplasmic antibody (ANCA)-associated necrotizing vasculitis, which mainly affects small vessels in various organs, especially the lungs. The two key pulmonary manifestations, interstitial lung disease (ILD) and diffuse alveolar hemorrhage (DAH), increase the morbidity and death rate of patients with MPA. ILD is more common in MPA than in other ANCA-associated vasculitis subsets and is primarily associated with myeloperoxidase-ANCA. Unlike alveolar hemorrhage due to pulmonary capillaritis, ILD can initially manifest as isolated pulmonary fibrosis. Of note, its most frequent radiographic pattern is the usual interstitial pneumonia pattern, similar to the characteristic pattern seen in idiopathic pulmonary fibrosis. In this review we present the pathogenesis, clinical manifestations, and radiographic and histopathologic features of ILD and DAH in MPA. We also briefly summarize the outcome and therapeutic options for the two conditions.

Under-use of Radiotherapy in Stage III Bronchioaveolar Lung Cancer and Socio-economic Disparities in Cause Specific Survival: a Population Study

  • Cheung, Min Rex
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.9
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    • pp.4091-4094
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    • 2014
  • Background: This study used the receiver operating characteristic curve (ROC) to analyze Surveillance, Epidemiology and End Results (SEER) bronchioaveolar carcinoma data to identify predictive models and potential disparity in outcomes. Materials and Methods: Socio-economic, staging and treatment factors were assessed. For the risk modeling, each factor was fitted by a Generalized Linear Model to predict cause specific survival. The area under the ROC was computed. Similar strata were combined to construct the most parsimonious models. A random sampling algorithm was used to estimate modeling errors. Risk of cause specific death was computed for the predictors for comparison. Results: There were 7,309 patients included in this study. The mean follow up time (S.D.) was 24.2 (20) months. Female patients outnumbered male ones 3:2. The mean (S.D.) age was 70.1 (10.6) years. Stage was the most predictive factor of outcome (ROC area of 0.76). After optimization, several strata were fused, with a comparable ROC area of 0.75. There was a 4% additional risk of death associated with lower county family income, African American race, rural residency and lower than 25% county college graduate. Radiotherapy had not been used in 2/3 of patients with stage III disease. Conclusions: There are socio-economic disparities in cause specific survival. Under-use of radiotherapy may have contributed to poor outcome. Improving education, access and rates of radiotherapy use may improve outcome.

The Analysis of Neuro-Physiological Outcome of Patients with Status Epilepticus in an Intensive Care Unit (집중치료실에서 치료한 중첩성 경련 환자의 신경생리학적 결과 분석)

  • Kim, Dae-Sik;Kim, Cheon-Sik
    • Korean Journal of Clinical Laboratory Science
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    • v.37 no.2
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    • pp.96-101
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    • 2005
  • Status epilepticus is a medical emergency, so that rapid and vigorous treatment is required to prevent neuronal damage and systemic complication. Status epilepticus is generally defined as a continuous or intermittent seizure or an unconscious condition after the onset of seizure, lasting for 30 minutes or more. We report here the outcome of status epilepticus. We retrospectively reviewed medical record of 15 patients who were diagnosed with status epilepticus at the Asan Medical Center from January 2003 to February 2004. This outcome was evaluated considering various factors such as age of patients, history of seizures, neurologic impairment, etiology, mortality, return to baseline and initial electroencephalogram (EEG) findings. The range of age was between 1 to 79 years old and the longest duration of treatment was 118 days. Most patients were treated by using pentobarbital, midazolam, phenobarbital and other antiepileptic drugs. The overall mortality was 5 (33%) out of 15 patients. The mortality was related to etiology, underlying other medical conditions and initial EEG findings. 5 (55%) out of the 9 patients with acute etiology, 5 (71%) out of the 7 patients with a multifocal or burst-suppression EEG activity, and 3 (60%) out of the 5 patients with other medical disease were related to mortality. This data demonstrate high mortality due to status epilepticus. Mortality is related to etiology, other medical conditions and abnormalities on the initial EEG.

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Validation of Nursing Care Sensitive Outcomes related to Knowledge (지식에 관한 간호결과도구의 타당성 조사)

  • 이은주
    • Journal of Korean Academy of Nursing
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    • v.33 no.5
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    • pp.625-632
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    • 2003
  • Purpose: The purpose of this study was to assess the importance and sensitivity to nursing interventions of four nursing sensitive nursing outcomes selected from the Nursing Outcomes Classification (NOC). Outcomes for this study were 'Knowledge: Diet', 'Knowledge: Disease Process', 'Knowledge: Energy Conservation', and 'Knowledge: Health Behaviors'. Method: Data were collected from 183 nurses working in 2 university hospitals. Fehring method was used to estimate outcome and indicators' content and sensitivity validity. Multiple and stepwise regression were used to evaluate relationships between each outcome and its indicators. Result: Results confirmed the importance and nursing sensitivity of outcomes and their indicators. Key indicators of each outcomes were found by multiple regression. 'Knowledge: Diet' was suggested for adding new indicators because the variance explained by indicators was relatively low. Not all of the indicators selected for stepwise regression model were rated for highly in Fehring method. The R² statistics of the stepwise regression models were between 18 and 63% in importance by selected indicators and between 34 and 68% in contribution by selected indicators. Conclusion: This study refined what outcomes and indicators will be useful in clinical practice. Further research will be required for the revision of outcome and indicators of NOC. However, this study refined what outcomes and indicators will be useful in clinical practice.

Outcomes with Single Agent LIPO-DOX in Platinum-Resistant Ovarian and Fallopian Tube Cancers and Primary Peritoneal Adenocarcinoma - Chiang Mai University Hospital Experience

  • Suprasert, Prapaporn;Manopunya, Manatsawee;Cheewakriangkrai, Chalong
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.3
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    • pp.1145-1148
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    • 2014
  • Background: Single pegylated liposomal doxorubicin (PLD) is commonly used as a salvage treatment in platinum-resistant ovarian cancer, fallopian tube cancer and primary peritoneal adenocarcinoma (PPA) with a satisfactory outcome. However, the data for second generation PLD administered in this setting are still limited. We conducted a retrospective study to evaluate the outcome of patients who received single-agent second generation PLD (LIPO-DOX) after the development of clinical platinum resistance. The study period was between March 2008 and March 2013. LIPO-DOX was administered intravenously 40 $mg/m^2$ every 28 days until disease progression, but for not more than six cycles. The response rate was evaluated using the Gynecologic Cancer Intergroup (GCIG) criteria while the toxicity was evaluated according to WHO criteria. Twenty-nine patients met the inclusion criteria in the study period with an overall response rate of 13.8%. The median progression free survival and overall survival were three and eleven months, respectively. With the total of 96 cycles of chemotherapy, the patients developed grades 3 and 4 hematologic toxicity as follows: anemia, 0%, leukopenia, 9.6%, neutropenia, 32.3% and thrombocytopenia, 0%. In conclusion, the single agent second generation PLD demonstrated modest efficacy in patients with platinum-resistant ovarian cancer, fallopian tube cancer and PPA without serious toxicity.