• Title/Summary/Keyword: early intervention

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Is Early Spinal Cord Stimulation in Patients with Complex Regional Pain Syndrome Necessary? -A case report- (복합부위통증증후군 제I형 환자에서 조기 척수자극술이 필요한가? -증례보고-)

  • Min, Hyoung Ki;Han, Kyung Ream;Lee, Sang Eun;Kim, Kyoung Tae;Kim, Chan
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.223-227
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    • 2006
  • Complex regional pain syndrome (CRPS) is clinically characterized by pain, abnormal regulation of blood flow and sweating, edema of skin and subcutaneous tissues, sensory and motor disturbances, and trophic changes of the skin. A 21-year-old man was suffering from pain and swelling in his right hand and forearm. His arm had been in splints for 3 weeks following an extension injury of the right fingers and wrist, with the pain having developed 2 weeks after the splinting. He was treated with various nerve blocks including continuous epidural infusion, thoracic sympathetic block and peripheral nerve blocks, and squeezing his edematous region under general anesthesia as well as intravenous lidocaine and ketamine infusions. However, all of the performed treatments had no effect on the patient's pain or hand swelling. As a next line therapy, spinal cord stimulation should be considered because of intractable severe pain and swelling to almost all other modalities of therapy. We therefore performed an early intervention of spinal cord stimulation for the patient with refractory CRPS type I 5 months after the onset of pain and have got an excellent result.

The Convergent Influence of the Incidence of Delirium in Patients after Arthroplasty (인공관절치환 수술 후 발생하는 섬망에 따른 융복합적 영향)

  • Kim, Young-Hee;Kwon, Young-Chae
    • Journal of Digital Convergence
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    • v.14 no.11
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    • pp.369-377
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    • 2016
  • This study examined artificial joint replacement surgery for early intervention and prevention of the occurrence of delirium surgery. Data of study were analysed using the sample through the EMR (Electronic Medical Record) and after surgery to provide basic data. The subjects were elderly aged 60 years or more and the number of the sample was 821. Data were analysed by using SPSS 20.0 with t-test, $x^2$-test and multiple logistic regression analysis. The study results showed patients with artificial joint replacement surgery incidence of delirium was 13.5%, findings of these variables insisted that the main influencing factors of delirium were caused by age, fall history, physical activity, emotional status, body mass index (BMI) before surgery. The study suggested that the above findings are required for early intervention, early detection and prevention of delirium.

Feasibility of Early and Repeated Low-dose Interscalene Brachial Plexus Block for Residual Pain in Acute Cervical Radiculopathy Treated with NSAIDS

  • Iwata, Toshio;Mitoro, Mari;Kuzumoto, Naoya
    • The Korean Journal of Pain
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    • v.27 no.2
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    • pp.125-132
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    • 2014
  • Background: To improve residual pain management in acute cervical radiculopathy treated with NSAIDs, the feasibility of early and repeated low-dose interscalene brachial plexus block (IS-BPB) needs to be assessed. Methods: This was a prospective study on patients receiving NSAIDs (loxoprofen) for cervical radiculopathy of ${\leq}2$-week onset. Pain was assessed using the visual analogue scale (VAS). A low-dose ultrasonography (USG)-guided IS-BPB (dexamethasone [1.65 mg; 0.5 ml] and mepivacaine [1%; 3.0 ml]) was performed at baseline and weekly thereafter for 4 weeks in an outpatient setting for the intervention group. All patients were evaluated using a visual satisfaction score (VSS) at week 4. Patients with baseline VAS scores < 70 (mild to moderate pain; MM group) and ${\geq}70$ (severe pain; SE group) were compared to the controls receiving NSAIDs. Results: A total of 316 IS-BPBs were performed in the intervention group. There was a significant difference in the decline in the VAS from week 0 to week 3 in the MM and SE groups (P < 0.05); however, from week 3 to week 4, the therapeutic effect exhibited no significant difference. Thirteen patients at week 2 (15.5%; MM: 27.7%; SE: 0%), 43 at week 3 (51.2%; MM: 83.0%; SE: 10.8%), and 47 at week 4 (56.0%; MM: 85.1%; SE: 18.9%) achieved a VAS score of ${\leq}20$. Patient satisfaction was high, and the decrease in VAS scores in both groups was significant (P < 0.05) compared to the controls. Conclusions: Weekly, low-dose, USG-guided IS-BPB can be implemented for early pain relief in acute cervical radiculopathy, with high patient satisfaction.

Effect of a 12-week weight management program on the clinical characteristics and dietary intake of the young obese and the contributing factors to the successful weight loss

  • Lee, AeJin;Jeon, Kyeong Jin;Kim, Hye-Kyeong;Han, Sung Nim
    • Nutrition Research and Practice
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    • v.8 no.5
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    • pp.571-579
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    • 2014
  • BACKGROUND/OBJECTIVES: The objectives were to investigate the effect of a 12-wk intervention with behavioral modification on clinical characteristics and dietary intakes of young and otherwise healthy obese and to identify factors for successful weight loss. The goal was to lose 0.5 kg per week by reducing 300-500 kcal/day and by increasing physical activities. SUBJECTS AND METHODS: Forty four obese subjects (BMI > 25) and 19 normal weight subjects (BMI 18.5-23) finished the 12-week intervention. Obese subjects participated in 5 group educations and 6 individual counseling sessions. Normal weight subjects attended 6 individual counseling sessions for evaluations of dietary intake and exercise pattern. Anthropometric and clinical characteristics and 3-day dietary records were evaluated at baseline and week12. RESULTS: Weight and serum triglyceride and free fatty acid concentrations in obese group decreased significantly with intervention. Intakes of energy, fat, and cholesterol decreased significantly in the obese. Active participation, realistic weight loss goal setting, and weight gain after high school graduation not during childhood were identified as key factors for successful weight loss. CONCLUSIONS: The 12-week intervention with behavioral modification resulted in reduced energy and fat intakes and led to significant weight loss and improvements of clinical characteristics in the obese. The finding that those who became obese during childhood lost less weight indicates the importance of 'early' intervention.

Parent's Gestalt Speech Intervention for Fluency Development of Fluency Disorder he Subject of Essay (부모의 게슈탈트적 언어 중재가 유창성장애인의 유창성 개선에 미치는 영향)

  • Ko, Young-Ok
    • The Journal of the Korea Contents Association
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    • v.13 no.11
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    • pp.269-276
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    • 2013
  • This study was aimed of the effects of the Parent's Gestalt Speech Intervention for stuttering development of Fluency disorder Child. The Parent's Gestalt Speech Intervention was made up of a program understand phase, an awareness phase, a change phase and, finally, an arrangement and termination phase. The subjects 6 (female 2, male 4) of this research were developed a stuttering behavior without any apparent neurological damage or other speech or developmental impediments. To access their stuttering behaviors, I used methods for observing levels of behavioral in each phase. The results of the study are as follows: In regard to stuttering behavior, word repetition frequency decreased in the interim assessments, showing that the learning of fluent speech was acquired early in the therapy process. In conclusion, the results of the study show that Parent's Gestalt Speech Intervention for stuttering development of Fluency disorder Child.

Study on the Development of Home Care Nursing Intervention Protocol for Stroke Patients (뇌졸중 환자의 가정간호중재 프로토콜 개발)

  • Yoo Ji-Soo
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.1
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    • pp.122-136
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    • 2000
  • Stroke patient needs rehabilitation after receiving an acute treatment in a hospital. When stroke patient gets involved in an early discharge program, home care nurse plays a pivotal role to make them to gain a full strength and to come back to his/her prior life before he/she is sick. In spite of the importance of home care nursing intervention protocol for home care nurses to perform home care nursing autonomously, home care nursing intervention protocol for stroke patient is rarely developed. Therefore this study was conducted to develop home care nursing protocol that is applicable for stroke patients in home care nursing area. 41 home care nursing charts for stroke patients registered in home care nursing agencies from December 1st 1994 to August 31st 1999 at Y hospitals in Seoul and Won-Ju city were analyzed. 44 home care nurses who were having over three years' experience on stroke patients were participated in this study as a user validity validation group. The results of this study are as follows. 1. 28 nursing diagnoses were selected on the basis of evaluation of nursing diagnoses of stroke patients presented in a previous literature and case studies on home care nursing. 2. 17 nursing diagnoses were classified through the frequency analysis of home care nursing charts for 41 stroke patients who had received home care nursing. The order of sequence was like these: impaired skin integrity, risk for infection, nutritional deficit, impaired physical mobility, constipation, knowledge deficit, ineffective airway clearance, anxiety in family members, risk for aspiration, self care deficit, altered urinary elimination, ineffective individual coping, social isolation, risk for injury, self-esteem disturbance, impaired verbal communication, fatigue of family caregiver. 3. Based on validation on expert and user validities, 44 nursing interventions which were above ICV=.80 were chosen. 4. Nursing intervention protocols which showed above ICV=.90 were developed and were like these; pressure ulcer care, position change, preventive care for circulatory dysfunction, tube care : catheter, vital sign monitor, constipation/impaction management, artificial airway management, suction of airway secretion, environmental management : safety, and fall prevention.

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Risk Factors, Symptoms, and Intervention Analysis of Delirium Subtypes in Hospitalized Patients (입원환자에게 나타나는 섬망 아형별 위험요인과 증상 및 중재 분석)

  • Ryu, Ahyun;Kang, Young-Ok;Song, Rhayun
    • Journal of the Korea Convergence Society
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    • v.12 no.10
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    • pp.353-363
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    • 2021
  • This study aimed to investigate subtypes, risk factors, symptoms and the interventions to inpatients with delirium. The data of 108 inpatients who had the diagnosis of delirium during their hospital stay were collected from Electronic Medical Record at a university hospital and were analyzed by SPSS for Windows V. 26.0 program. As a results, Patients had a high proportion of elderly, male, orthopedic, and with fractures or amputations. The subtypes of delirium were hyperactive (51.9%), hypoactive (6.5%), and mixed (41.7%). Among the risk factors, depression and use of psychotropic agent were more common in those with hypoactive delirium. Among delirium interventions, behavioral symptom management and aggressive behavioral intervention were mainly implemented for those with hyperactive or mixed types, and emotional support was mainly implemented for those with hypoactive or mixed types. The delirium related intervention was more likely given immediately when the patients showed aggressive behaviors. Therefore, intervention strategies and protocol development are required for early detection of delirium in inpatients.

Comparison of Two Different Educational Methods for Teachers' Mammography Based on the Health Belief Model

  • Heydari, Esmat;Noroozi, Azita
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.6981-6986
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    • 2015
  • Background: Breast cancer is the most common cancer in women. One way to decrease the burden of this cancer is early detection through mammography. This study compared the effectiveness of two different educational methods for teachers' uptake of mammography based on the Health Belief Model. Materials and Methods: The current study was a randomised trial of 120 teachers over 40 years old in two groups receiving multimedia or group education, both based on the Health Belief Model. Participants completed questionnaires before, immediately and three months after educational intervention. Mammography was evaluated before and after educational intervention. Results: The participants in the two groups were demographically similar. Comparison showed no difference noted in the scores of knowledge, perceived barriers, susceptibility, and severity constructs between two groups (p > 0.05). Health motivation and benefit were perceived to be higher in the group education compared to the multimedia group. There was a significant difference in mammography between two groups after the intervention (p= 0.003). Conclusions: Planning and implementation of educational program based on the Health Belief Model can raise knowledge and increase participation in mammography especially with group education.

Evaluation of a Community-Based Program for Breast Self-Examination Offered by the Community Health Nurse Practitioners in Korea

  • Lee, Chung-Yul;Kim, Hee-Soon;Ko, Il-Sun;Ham, Ok-Kyung
    • Journal of Korean Academy of Nursing
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    • v.33 no.8
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    • pp.1119-1126
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    • 2003
  • Background. Breast cancer is the most common form of cancer among Korean women. Only 14 % of urban women and 10% of rural women in Korea, however, participated in breast cancer screening behavior in 1998 (Korean Ministry of Health & Welfare, 1999). Purpose. The aim of this study was to evaluate the effect of community-based breast self-examination (BSE) education programs in Korea. Methods. First, breast cancer risk appraisals were done with 1,977 rural women. Of the 1,977 women, nearly 30% (n=494) had a higher or equal to borderline risk of developing breast cancer. This quasi-experimental study was conducted to target these women with a high or equal to borderline risk of breast cancer. The risk appraisal feedback and breast self-examination education were used as an intervention for breast cancer prevention and early detection. Results. After a 3-month follow-up, 30.5% of the women in the intervention group performed regular BSE compared to 10.2 % of women in the control group. The mean knowledge score related to breast cancer and BSE was significantly higher for the women in the intervention group than that in the control group.

Aortopulmonary Fistula after Surgical Intervention of Acute Aortic Dissection (급성 대동맥류 수술후 원위부에 발생한 Aortopulmonary Fistula 치험 1례)

  • Cho, Gwang-Jo;No, Jae-Ook;Woo, Jong-Soo
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.178-181
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    • 1998
  • Among the late postoperative complications of the acute dissection of aorta, the fistula between dilated distal aorta and pulmonary parenchym is so rare that only few case have been reported sporadically. Although the aortopulmonary fistula is one of a fatal condition that needs prompt surgical intervention, with an appropriate management it is well controllable condition. Early diagnosis and urgent surgical intervention is the only way to prevent catastrophic hemorrhage. We experienced a surgical management of aortoplumonary fistula which occurred between upper lobe of the left lung and distal aortic dilatation of previous aortic bypass graft which was performed for Debakey type I acute aortic dissection.

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