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Using Implementation Science to Advance Cancer Prevention in India

  • Krishnan, Suneeta;Sivaram, Sudha;Anderson, Benjamin O.;Basu, Partha;Belinson, Jerome L;Bhatla, Neerja;D' Cruz, Anil;Dhillon, Preet K.;Gupta, Prakash C.;Joshi, Niranjan;Jhulka, PK;Kailash, Uma;Kapambwe, Sharon;Katoch, Vishwa Mohan;Kaur, Prabhdeep;Kaur, Tanvir;Mathur, Prashant;Prakash, Anshu;Sankaranarayanan, R;Selvam, Jerard M;Seth, Tulika;Shah, Keerti V;Shastri, Surendra;Siddiqi, Maqsood;Srivastava, Anurag;Trimble, Edward;Rajaraman, Preetha;Mehrotra, Ravi
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3639-3644
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    • 2015
  • Oral, cervical and breast cancers, which are either preventable and/or amenable to early detection and treatment, are the leading causes of cancer-related morbidity and mortality in India. In this paper, we describe implementation science research priorities to catalyze the prevention and control of these cancers in India. Research priorities were organized using a framework based on the implementation science literature and the World Health Organization's definition of health systems. They addressed both community-level as well as health systems-level issues. Community-level or "pull" priorities included the need to identify effective strategies to raise public awareness and understanding of cancer prevention, monitor knowledge levels, and address fear and stigma. Health systems-level or "push" and "infrastructure" priorities included dissemination of evidence-based practices, testing of point-of-care technologies for screening and diagnosis, identification of appropriate service delivery and financing models, and assessment of strategies to enhance the health workforce. Given the extent of available evidence, it is critical that cancer prevention and treatment efforts in India are accelerated. Implementation science research can generate critical insights and evidence to inform this acceleration.

A SURVEY OF DENTAL TREATMENT UNDER GENERAL ANESTHESIA (전신마취하에 치료한 환자에 대한 실태조사)

  • Kim, Ha-Na;Baik, Byeong-Ju;Kim, Jae-Gon;Kwon, Byoung-Woo;Yang, Yeon-Mi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.33 no.2
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    • pp.317-322
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    • 2006
  • Dental caries in children has declined over the past few decades. However, Certain populations of children experience high levels of dental disease. To perform the highest quality dental care for the pediatric patient, the practitioner may need to use pharmacological means to obtain a quiescent, cooperative patient. Furthermore, complex treatment can impose high demands on the very young, making use of general anesthesia the preferred approach for some patients. General anesthesia is widely used to provide comprehensive dental treatment for children in USA and Europe and Scandinavia etc. Parental and patient satisfaction following completion of dental care under general anesthesia is reportedly high. Dental general anesthesia has disadvantage that it is expansive and carries a small but significant risk of mortality. However, It has the advantage of permitting treatment at a single visit, allowing immediate relief of pain and requiring little or no cooperation from the child. Rampant caries was the major indication for use of general anesthesia in the youngest age group or medically compromised patients. This study describe the characteristics of patient receiving comprehensive dental treatment under general anesthesia at the pediatric dentistry of Chonbuk National University Hospital in Jeonju, Korea in the 4year period between December 2001 and April 2005.

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Efficacy and Safety of Combination Treatment of Traditional Korean Medicine after Gastric Cancer Surgery: A Systematic Review and Meta-analysis Protocol (위암 수술 후 항암치료를 병행한 한의치료의 유효성 및 안전성: 체계적 문헌고찰 및 메타분석 프로토콜)

  • Jong-hee Kim;Eunbin Kwag;So-jung Park;Donghyun Kim;Soodam Kim;Jihye Park;Hwa-seung Yoo
    • Herbal Formula Science
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    • v.31 no.4
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    • pp.361-371
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    • 2023
  • Objectives : Gastric cancer is a malignant tumor of the digestive tract that not only has a high mortality rate, but also affects quality of life. In Traditional Korean Medicine, acupuncture and herbal medicines can increase the survival rate for Gastric cancer and improve the quality of life. Traditional Korean Medicine treatment played an important role when used alone or in combination with chemotherapy. However, there is still insufficient evidence to support the efficacy and safety of Traditional Korean Medicine in patients undergoing chemotherapy after surgery. Therefore, the purpose of this study is to systematically evaluate the effect of oriental medicine treatment on patients as a complementary therapy for Gastric cancer. Methods : 2 researchers will search using EMBASE, Pubmed, CNKI, Cochrane Library, CiNii, KMBASE, KISS, OASIS, RISS, ScienceON. The search period of the database is from inception until June 2022. This study will include a randomized controlled trial of GC for acupuncture and herbal treatment. Primary outcomes include anti-cancer effects. Secondary outcomes evaluate survival rates and improvements in quality of life. The data uses Review Manager Software 5.4. Results : This study will provide a systematic evaluation by synthesizing the anti-cancer effect, survival rate and quality of life of Gastric cancer when Traditional Korean Medicine is combined with chemotherapy. Conclusion : The conclusion of this study will provide a basis for determining whether Traditional Korean Medicine treatment for Gastric cancer treatment is an effective and safe treatment method in clinical practice.

Using Artificial Intelligence Software for Diagnosing Emphysema and Interstitial Lung Disease (폐기종 및 간질성 폐질환: 인공지능 소프트웨어 사용 경험)

  • Sang Hyun Paik;Gong Yong Jin
    • Journal of the Korean Society of Radiology
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    • v.85 no.4
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    • pp.714-726
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    • 2024
  • Researchers have developed various algorithms utilizing artificial intelligence (AI) to automatically and objectively diagnose patterns and extent of pulmonary emphysema or interstitial lung diseases on chest CT scans. Studies show that AI-based quantification of emphysema on chest CT scans reveals a connection between an increase in the relative percentage of emphysema and a decline in lung function. Notably, quantifying centrilobular emphysema has proven helpful in predicting clinical symptoms or mortality rates of chronic obstructive pulmonary disease. In the context of interstitial lung diseases, AI can classify the usual interstitial pneumonia pattern on CT scans into categories like normal, ground-glass opacity, reticular opacity, honeycombing, emphysema, and consolidation. This classification accuracy is comparable to chest radiologists (70%-80%). However, the results generated by AI are influenced by factors such as scan parameters, reconstruction algorithms, radiation doses, and the training data used to develop the AI. These limitations currently restrict the widespread adoption of AI for quantifying pulmonary emphysema and interstitial lung diseases in daily clinical practice. This paper will showcase the authors' experience using AI for diagnosing and quantifying emphysema and interstitial lung diseases through case studies. We will primarily focus on the advantages and limitations of AI for these two diseases.

Sevoflurane Insufflation Sedation for the Dental Treatment of a Patient with Pulmonary Arterial Hypertension : A Case Report (폐동맥 고혈압 환자의 치과치료에서 세보플루란 흡입 진정의 사용 : 증례보고)

  • Chi, Seongin;Kim, Seungoh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.1
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    • pp.75-79
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    • 2015
  • Pulmonary arterial hypertension (PAH) is a common complication of Congenital heart defects (CHD) with left-to-right shunts, and PAH with increased pulmonary vascular resistance (PVR) is associated with considerable morbidity and mortality. General anesthesia (GA) can be life-threatening in patients with PAH, because the positive pressure ventilation during GA increases pulmonary arterial pressure and decreases pulmonary blood flow. This may also lead to hypoxia. Therefore, spontaneous ventilation may be safer than positive pressure ventilation in patients with PAH. A five-year-old male child, weighing 11 kg, with medical history showing a total correction of Tetralogy of Fallot (TOF) in 2009 and ongoing treatment with hypertension (HTN) medicine since 2007, visited the Dankook University Dental Hospital. He had multiple dental caries, and the treatment was completed under sevoflurane insufflation sedation via nasal cannula. The patient remained sedated throughout the operation while maintaining normal vital signs and spontaneous respiration. In conclusion, sevoflurane insufflation sedation may be a safer alternative to GA for the dental treatment of patients with PAH.

Autonomic Neurocardiac Function in Patients with Major Depressive Disorder - Using a Heart Rate Variability Test Battery - (주요우울장애 환자에서의 자율신경심장기능 - Heart Rate Variability 검사를 사용하여 -)

  • Park, Young-Su;Lee, Kang-Joon;Kim, Hyun;Chung, Young-Cho
    • Sleep Medicine and Psychophysiology
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    • v.11 no.2
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    • pp.100-105
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    • 2004
  • Objectives: Major depression is associated with an increased risk of cardiovascular mortality. One possible explanation for this association is that major depression influences autonomic neurocardiac regulation. However, previous studies on the relationship between heart rate variability (HRV) and major depression have revealed conflicting results. The purpose of this study is to clarify that major depressive patients compared to healthy controls show a reduction in HRV as an expression of reduced modulation of vagal activity to the heart. Methods: According to DSM-IV, the time and frequency domain HRV indices (5-min resting study) of 30 patients with major depressive disorder were compared with those of 30 healthy controls. Standardized HRV tests enable quantitative estimation of autonomic nervous system function. Results: After controlling for age and gender, subjects with major depression showed a higher heart rate and significantly lower modulation of cardiovagal activity compared to controls. The total power (TP) band, very low frequency (VLF: 0.003-0.04 Hz) band, low frequency (LF: 0.04-0.15 Hz) band, and high frequency (HF: 0.15-0.4 Hz) band were significantly reduced in subjects with major depression compared to control subjects. Conclusion: Patients with major depression may suffer from functional disturbances in the interaction between the sympathetic and parasympathetic autonomic systems.

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Clinical Study of 80 Cases of Mitral Valve Operations Via Extended Transseptal Approach (확장시킨 경중격 절개방식을 통한 승모판 수술의 80례 임상 분석)

  • 김학제;황재준;최영호;손영상;김욱진;김태식;김현구
    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1037-1042
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    • 1998
  • Background: Among the various techniques for the adequate exposure of the mitral valve, the extended transseptal approach is the essential prerequisite for accurate repair or replacement of the mitral apparatus. But the efficacy and safty of the extended transseptal approach has not determined in Korea yet. Materials and methods: Retrospective data of 80 consecutive patients, operated from September 1992 to July 1997 were reviewed. Seventy- eight patients underwent mitral valve replacement and 2 patients underwent excision of left atrial myxoma. Thirty-eight of 78 patients had other concomitant procedures such as aortic valve replacement(n=22), tricuspid annulopasty(n=14), coronary artery bypass graft(n=1) and closure of ventricular septal defect(n=1). Mean follow up was 23.3±15.0 months and total follow up was 1792 patient-months. Results: The hospital mortality rate was 3.8%(3 patients). Two deaths were due to low cardiac output and one due to postoperative bleeding of coagulopathy. Among the 46 patients who had atrial fibrillation preoperatively, 45 had atrial fibrillation postoperatively and 1 converted to sinus rhythm. All 34 patients who were in normal sinus rhythm preoperatively remained in sinus rhythm after the operation. Mean aortic cross clamping time was 62 minutes for isolated mitral procedure and 90 minutes for concomitant procedures. There were no specific complications related to this approach. Conclusions: We suggest that the extended transseptal approach is an easy and good method for mitral valve surgery, especially in patients with small sized left atrium.

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Clinical Analysis of the Chest Trauma (흉부 손상의 임상적 고찰)

  • 이재덕;이계선
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.79-85
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    • 1996
  • A clinical evaluation was performed on 305 cases of chest trauma experienced at the department of the Thoracic and Cardiovascular Surgery, Dae Jeon Eul Ji Hospital, during the period from March 1991 to November 1994. Age distribution was from 4 to 85 years, the mosts common age groups were 4-th, 5th and 6th decades. The ratio of male to female was 229:76(3:1), the ratio showed male predominance, the most common cause of trauma was traffic accidents in nonpenetrating trauma and stab wounds in penetrating trauma. Hemothorax, pneumothorax, and hemopneumothorax were observed in 159 cases (52.1 %) of total cases, Rib fracture was observed in 236 cases (77.4%) of total cases, location distribution was right : left : Both (102 : 142 : 45), with left predominant, rib fracture commonly involved from the 3th to 8th rib. Lag period from accident to admission was 155 cases (50.8%) under 6hr The principles of therapy for early complications of chest trauma were rapid r expansion of the lungs by thoracentesis 5 cases(1.6%) and closed thoracostomy 1-42 cases(46.6%), but open thoracotomy had to be done on 17 cases (5.6%) because of massive bleeding 13 cases or ruptured diaphragm, foreign body. Conservative nonoperative treatment was 140 cases (45.9%). Overall mortality rate was Bcases (2.6%) and common causes of the death were respiratory insufficiency and shock.

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Clinical Analysis of Coronary Artery Bypass Surgery for Ischemic Heart Disease (허혈성 심질환의 치료에서 관동맥우회술의 임상적 고찰)

  • Jung, Tae-Eun
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.225-233
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    • 1996
  • From August 1992 to July 1996, 63 consecutive patients underwent coronary artery bypass surgery. The mean age of these patient was 57 years(range form 30 to 71years). There were 44 men and 19 women. Preoperative 12 patients had stable angina pectoris and 23 patients were unstable angina pectoris. 8 patients had previous myocardial infarctation history and emergency or urgent myocardial revascularization were performed in 9 cases. In the risk factors of coronary atherosclerosis, 25 patients(40%) were hypercholesterolemia, 38 patients(60%) have smoking history and 19 patients(30%) have hypertension history. In the patterns of disease, 9 patients were single vessel disease, 18 patients were two vessele disease and 33 patients were three vessel disease. We performed total 284 distal anastomosis(mean 3.5 anastomosis per patient) and performed one case of ascending aorta graft interposition, two cases of mitral valve replacement, one case of aortic valve replacement, one case of ventricular septal defect repair and one case of atrial septal defect repair and the mean aortic cross clamp time was 115.3 minutes. The common complications were arrhythmia(7cases), wound infection(5cases), perioperative myocardial infarction(4cases), reoperation for bleeding control(4cases) and stroke(4cases). There were six hospital deaths due to low cardiac output syndrome, ventricular arrhythmia and respiratory failure. In the evaluation of operative risk factors, preoperative intravenous nitroglycerin requirement and prolonged aortic cross clamp tirne(>2hours) were found to be predective factor of morbidity and old age(>65years) was found to be predective factor of mortality.

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Arterial Switch Operation for Transposition of G rest Arteries (대혈관전위증에 대한 동맥전환술)

  • 이호철;류한영
    • Journal of Chest Surgery
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    • v.29 no.3
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    • pp.278-284
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    • 1996
  • Nine infants with transposition of great arteries have undergone arterial switch operation from May 1989 to May 1994 in the Department of Thoracic and Cardiovascular Surgery, Yeungnam University Hospital. Patients' age ranged from 3 days to 90 days, averaging 30$\pm$21 days. Diagnosis was made by two-dimensional echocardiography in all patients. Eight patients were diagnosed as transposition of great arteries with ventricular septal defect and one patient was a simple transposition of great arteries. Associated anomalies were patent ductus arteriosus (8), atrial septal defect (7) and coarctation of aorta(1). The anatomy of the coronary arteries were 7 (77 %) type A and 2 (23 %) type D according to the Yacoub classification. Pulmonary artery reconstruction was done according to Lecompte maneuver with tautologous pericardial patch in 8 patients. Overall operative mortality rate was 55% Left heart failure and pulmonary hypertensive crisis were the cause of death on postoperative 1~2 days in three patients, and two succumbed to death due to sepsis on postoperative 2~ 3 weeks. The mean follow-up period was mean 17 months. No patient had clinically significant postoperative aortic regurgitation and supravalvular pulmonary stenosis. The excessive use of inotropic support postoperatively was identified as a stastically significant risk factor following the arterial switch operation. But other variables such as low body weight, long cardiopulmonary bypass time, excessive hemodilution during cardiopulmonary bypass, hypothermia and volume loading were not significant risk factors.

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