• 제목/요약/키워드: early intervention

검색결과 946건 처리시간 0.025초

Early versus Delayed Surgery for Spinal Epidural Abscess : Clinical Outcome and Health-Related Quality of Life

  • Behmanesh, Bedjan;Gessler, Florian;Quick-Weller, Johanna;Dubinski, Daniel;Konczalla, Juergen;Seifert, Volker;Setzer, Matthias;Weise, Lutz
    • Journal of Korean Neurosurgical Society
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    • 제63권6호
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    • pp.757-766
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    • 2020
  • Objective : Spinal epidural abscess (SEA) is a severe and life-threatening disease. Although commonly performed, the effect of timing in surgical treatment on patient outcome is still unclear. With this study, we aim to provide evidence for early surgical treatment in patients with SEA. Methods : Patients treated for SEA in the authors' department between 2007 and 2016 were included for analysis and retrospectively analyzed for basic clinical parameters and outcome. Pre- and postoperative neurological status were assessed using the American Spinal Injury Association Impairment Scale (AIS). The self-reported quality of life (QOL) based on the Short-Form Health Survey 36 (SF-36) was assessed prospectively. Surgery was defined as "early", when performed within 12 hours after admission and "late" when performed thereafter. Conservative therapy was preferred and recommend in patients without neurological deficits and in patients denying surgical intervention. Results : One hundred and twenty-three patients were included in this study. Forty-nine patients (39.8%) underwent early, 47 patients (38.2%) delayed surgery and 27 (21.9%) conservative therapy. No significant differences were observed regarding mean age, sex, diabetes, prior history of spinal infection, and bony destruction. Patients undergoing early surgery revealed a significant better clinical outcome before discharge than patients undergoing late surgery (p=0.001) and conservative therapy. QOL based on SF-36 were significantly better in the early surgery cohort in two of four physical items (physical functioning and bodily pain) and in one of four psychological items (role limitation) after a mean follow-up period of 58 months. Readmission to the hospital and failure of conservative therapy were observed more often in patients undergoing conservative therapy. Conclusion : Our data on both clinical outcome and QOL provide evidence for early surgery within 12 hours after admission in patients with SEA.

Associations Between Parental Depression and Early Childhood Development in Indonesia: A Cross-sectional Study

  • Saptarini, Ika;Rizkianti, Anissa;Arfines, Prisca Petty;Suparmi, Suparmi;Maisya, Iram Barida
    • Journal of Preventive Medicine and Public Health
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    • 제54권6호
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    • pp.451-460
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    • 2021
  • Objectives: This study aimed to determine the associations between parental depression and early childhood development among children aged 36 months to 59 months in Indonesia. Methods: From Indonesia's Basic Health Survey (RISKESDAS) 2018, this study included 6433 children aged 36 months to 59 months and their parents. Maternal and paternal depression was examined using the Mini International Neuropsychiatric Interview survey instrument, which was previously translated into Indonesian. The study also used the Early Child Development Index to measure child development and its 4 domains (cognitive, physical, socio-emotional, and learning). Multivariate logistic regression analysis was performed to determine the association between parental depression and early childhood development. Results: Overall, 10.3% of children aged 36 months to 59 months were off-track for development. After adjusting for biological, parental, and social characteristics, children born to parents with depression were found to be 4.72 times more likely to be off-track for development (95% confidence interval, 1.83 to 12.15). Conclusions: Children of depressed parents were more likely to be off-track for development. The findings highlight the need for early diagnosis and timely intervention for parental depression to promote early childhood development.

The Outcomes of Open Ankle Fractures in Patients Managed by Early or Delayed Definitive Fixation: A Comparative Analysis of 73 Patients

  • Raghavendra Kaganur;Bhaskar Sarkar;Pragadeeshwaran Jaisankar;Nirvin Paul;Md Quamar Azam;Anurag Bhakhar
    • 대한족부족관절학회지
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    • 제28권1호
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    • pp.8-14
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    • 2024
  • Purpose: Ankle fracture fixation is the gold standard of treatment but it does have its own complications. There is inadequate data regarding the comparative effectiveness of early vs. delayed fixation for open ankle fracture outcomes. This study compares the clinical and functional outcomes of open ankle fractures treated by early or delayed definitive fixation and identifies the limitations of both methods. Materials and Methods: All 73 patients enrolled in the study underwent surgical intervention within 24 hours of injury. The early fixation group (group A) consisting of 39 patients underwent definitive fixation as an index procedure, while the delayed fixation group (group B) consisted of 34 patients who underwent debridement and external fixator application as an index procedure and definitive fixation when soft tissue condition was conducive. All patients were evaluated at 2, 6, and 12 weeks postoperatively and then three monthly for a year. Results: Enneking and American Orthopaedic Foot and Ankle Society scores were markedly higher in the early fixation group at 6 months postoperatively (p-values <0.001 and 0.011, respectively). However, no discernible intergroup difference was evident at 12 months postoperatively. Between 6 and 12 months, group functional outcome scores were significantly different. At 6 months, there was a substantial difference in dorsiflexion between the two groups (p-values 0.001 and <0.001, respectively), but no difference was observed at 12 months postoperatively. At 6 and 12 months, group average plantar flexions were non-significantly different. Conclusion: Early definitive fixation of complex ankle fractures using a targeted approach produced promising results for lower grade open fractures (grades 1 and 2), and delayed definitive fixation, after initial external fixation to allow for soft tissue stabilization, produced promising results for higher grade open fractures (grades 3A and 3B). At 12-month follow-ups, clinical and functional outcomes achieved using these strategies were equivalent.

심근 경색후 심실중격결손: 1례 보고 (Surgical Management of Postinfarction VSD - Report of 1 case -)

  • 윤태진
    • Journal of Chest Surgery
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    • 제24권9호
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    • pp.913-917
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    • 1991
  • Ventricular septal defect complicating myocardial infarction is rare but fatal condition which requires early surgical intervention before end-organ failure ensues from cardiogenic shock. Since the first successful repair by Cooley et al in 1956, surgical skills and strategies were developed and modified to a great extent, and we adopted the new repair technique in our case which stresses that minimal or no part of the infarcted septum and left ventricular wall be resected. This technique obviates the need to resect the infarcted part of the septum and prevents recurrence of an even larger VSD, and provides adequate size and shape of the left ventricle after of transinfarction left ventriculotomy.

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Clinical Experience and Management of Cervico-Thoracic Epidural Hematoma

  • Ahn, Sang-Soak;Song, Young-Jin
    • Journal of Korean Neurosurgical Society
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    • 제47권5호
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    • pp.381-384
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    • 2010
  • Spinal epidural hematoma (SEH) causing acute myelopathy is rare. The usual clinical presentation of a SEH is sudden severe neck or back pain that progresses toward paraparesis or quadriparesis, depending on the level of the lesion. Recent studies have shown that early decompressive surgery is very important for patient's recovery. We experienced five patients of cervico-thoracic epidural hematomas associated with neurologic deficits that were treated successfully with surgical intervention.

인공심장판막치환 환자에 대한 임상적 고찰 (Clinical Evaluation of Prosthetic Valve Replacement in Valvular Heart Disease)

  • 곽문섭
    • Journal of Chest Surgery
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    • 제21권6호
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    • pp.1003-1019
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    • 1988
  • From 1982 to 1987, six patients underwent left ventricular aneurysmectomy with concomitant myocardial revascularization. Simultaneous repair of postinfarction ventricular septal defect was performed in 3 patients and left ventricular thrombectomy in two. There was no hospital mortality and late mortality during 220 months* follow up period-.[Mean 36.7 months, range 13 to 72 months] Their condition was improved in all. They live in physical condition of NYHA class I-II. We believe early surgical intervention can be life-saving, and can be done without undue surgical risk, even in cases of postinfarction VSD and LV aneurysm with failing heart.

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근골격계 장애 분석을 위한 설문지 조사에 관한 연구 (An Improved Musculoskeletal Discomfort Assessment Questionnaire)

  • 장성록
    • 한국안전학회지
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    • 제14권2호
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    • pp.148-154
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    • 1999
  • A self-report musculoskeletal assessment tool was adapted following field use by ergonomic analysis teams and was administrated to 100 employees of ChangWon techno-complex. Results were analyzed to determine of the self-report could adequately predict whether or not an employee reportedly sought medical treatment for a work-related discomfort. It is anticipated this tool can be utilized as an easily administrated, proactive surveillance instrument to assist in early identification of ergonomic concerns and to help prioritize jobs for intervention.

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Optimizing Nutrition Support in Cancer Care

  • Menon, Kavitha Chandrasekhara
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권6호
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    • pp.2933-2934
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    • 2014
  • Involvement of a multidisciplinary team in cancer care may have added benefits over the existing system of patient management. A paradigm shift in the current patient management would allow more focus on nutritional support, in addition to clinical care. Malnutrition, a common problem in cancer patients, needs special attention from the early days of cancer care to improve quality of life and treatment outcomes. Patient management teams with trained oncology dietitians may provide quality personalized nutritional care to cancer patients.

전폐절제후 늑막강으로부터 체액의 소실 -1례 보고- (Disappearance of Fluid From the Pneumonectomy Space (1 case report))

  • 최순호
    • Journal of Chest Surgery
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    • 제12권2호
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    • pp.93-96
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    • 1979
  • One case is presented in which there was radiographic evidence that pleural space fluid disappeared at the 15th day after pneumonectomy. Clinical course was uneventful and the space was refilled at the postoperative fifth month. This complication was probably due to the presence of small a bronchopleural fistula, in spite of the difficulty experienced in its demonstration. Conservative management is recommended with frequent clinical and radiographic observations, so that early surgical intervention may be undertaken if an overt bronchopleural fistula results.

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가족중심 물리치료 조기 중재에 관한 연구 (Review of Family-Center Physical Therapy Early Intervention)

  • 김중선
    • The Journal of Korean Physical Therapy
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    • 제12권3호
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    • pp.387-394
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    • 2000
  • Family-center service(FCS) is a popular phrase widely used to encompass a set of ideas about service delivery to children and their families. The purpose of this anicle is to review the history behind FCS. the dennition of FCS, the theory and conceptual framework for FCS, and the implications of FCS for physical therapists. This article provides some informations about FCS.

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