• Title/Summary/Keyword: intervention treatment

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General Treatment Strategy for Intervention in Lower Extremity Arterial Disease (하지동맥 질환의 인터벤션: 전반적 치료 계획 수립)

  • Je Hwan Won
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.500-511
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    • 2021
  • The prevalence of lower extremity disease is increasing with age. With recent technological advancements, endovascular treatment is being performed more frequently. The treatment goal of intermittent claudication is to improve walking and reduce claudication. To achieve these goals, anatomical durability and patency are important. In patients with critical limb ischemia, the lesions are diffuse and particularly severe in below-the-knee arteries. The treatment goal of critical limb ischemia is to promote wound healing and to prevent major amputation, which is evaluated by the limb salvage rate. Primary stenting using covered or bare metal stents is a widely accepted endovascular treatment. While drug-eluting technologies with or without atherectomy are widely used in the treatment of femoropopliteal disease, balloon angioplasty is the mainstay treatment for below-the-knee intervention. CT angiography provides a road map for planning endovascular treatment in patients without absolute contraindications.

Risk Factors of Delayed Surgical Intervention after Conservatively Treated Acute Traumatic Subdural Hematoma

  • Kwon, Hyungjoo;Choi, Kyu-Sun;Yi, Hyeong-Joong;Chun, Hyoung-Joon;Lee, Young-Jun;Kim, Dong-won
    • Journal of Korean Neurosurgical Society
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    • v.60 no.6
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    • pp.723-729
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    • 2017
  • Objective : Acute subdural hematoma (ASDH) is generally considered a condition that should be managed surgically. However, some patients initially receive conservative treatment, a subset of whom require surgical intervention later. This study aimed to evaluate the predictors of delayed surgical intervention in ASDH patients who are initially managed conservatively. Methods : From January 2007 to December 2015, 842 patients diagnosed with ASDH were treated at our institution. Among them, 158 patients with convexity ASDH were initially treated conservatively. Patients were divided into a delayed surgery group and a conservative group. Demographic characteristics, past medication and medical histories, and radiological and laboratory data were collected by retrospective chart review. Independent risk factors were identified with univariate and multivariate analyses. Results : Twenty-eight patients (17.7%) underwent delayed surgical intervention. Their mean age was 69.0 years, and 82.1% were male. Hypertension, diabetes mellitus, and heart disease prevalence and use of anti-platelet agents did not significantly differ from the conservative group. However, age (p=0.024), previous cerebral infarction history (p=0.026), increased maximal hematoma thickness (p<0.001), midline shifting (p=0.001) and accompanying subarachnoid hemorrhage (p=0.022) on initial brain computed tomography (CT) scan, low hemoglobin level (p<0.001), high leukocyte count (p=0.004), and low glucose level (p=0.002) were significantly associated with delayed surgical intervention. In multivariate analysis, increased maximal hematoma thickness (odds ratio [OR]=1.279, 95% confidence interval [CI] 1.075-1.521; p=0.006), low hemoglobin level (OR=0.673, 95% CI 0.467-0.970; p=0.034), and high leukocyte count (OR=1.142, 95% CI 1.024-1.272; p=0.017) were independent risk factors for delayed surgical intervention. Conclusion : Due to the high likelihood of delayed surgical intervention among minimal ASDH patients with a thicker hematoma on initial brain CT, lower hemoglobin level, and higher leukocyte count, these patients should receive more careful observation.

Development of Comprehensive Nursing Intervention for the Client with Lymphedema (통합적 림프부종 간호중재 개발 연구)

  • Cho, Myoung-Ok;Jung, Hyang-Mi;Jun, Jum-Yee;Sohn, Sue-Kyung;Yoo, Young-Ja;No, Mi-Young;Park, Soon-Ok
    • Korean Journal of Adult Nursing
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    • v.15 no.2
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    • pp.316-326
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    • 2003
  • Purpose: The purpose of this study was the development of a comprehensive nursing intervention program for the client with acute lymph stasis and stage I lymphedema. Method: The Quasi-experimental design using a non-equivalent control group was used. The subjects were 22 stroke patients with lymph stasis in the control group and 23 patients in the experimental group. The complex physical therapy of Casley-Smith was carried out to the control group for 10 hours, and comprehensive nursing intervention for the experimental group was carried out for 60 minutes. The data for this study was gathered from Feb. 2002 until June 2002 and pertains knowledge about lymphedema, self-care for managing lymphedema, and circumferences of affected limbs. Data was analyzed by mean, standard deviation, ${\chi}^2-test$, and t-test. Result: The changes in knowledge about lymphedema, self-care practices, and circumference of affected limbs after nursing intervention did not show significant differences between control group and experiment group. Conclusion: It can be concluded that comprehensive nursing intervention had more efficiency than complex physical therapy in the treatment of edema for stroke patients because of it's simplicity and time saving. Thereby, the comprehensive nursing intervention program developed in this study would be a useful therapy for the clients with lymph stasis and early stage lymphedema.

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Effect of practice guideline reminder and flow-sheet for improvement of quality in management of hypercholesterolemia (고콜레스테롤혈증 환자 진료의 질 향상을 위한 임상 지침 리마인더(Reminder)와 추적 관리지의 효과)

  • Cho, Han Kyu;Park, Hye Soon;Cho, Hong-Jun
    • Quality Improvement in Health Care
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    • v.4 no.2
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    • pp.230-240
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    • 1997
  • Background : Hypercholesterolemia is a major independent risk factor of coronary heart disease. Practice guidelines for management of hypercholesterolemia had been made in several developed countries. This study was undertaken to assess the effect of practice guideline reminders and flow-sheets to improve the quality of management of hypercholesterolemia. Methods: Practice guideline reminders and flow-sheets based on National Cholesterol Education Program Adult Treatment Panel II guidelines, were placed on the office desks of outpatient department of family medicine at the Asan Medical Center. Before this intervention, we educated the doctors to use these reminders and flow-sheets. The charts of all patients who had cholesterol levels greater than or equal to 240 mg/dl during 4 months before and after introduction of reminders and flow-sheets, were reviewed retrospectively. We compared the performances of physicians about management of hypercholesterolemia between pre-intervention period and post-intervention period. Results: The detection rate of hypercholesterolemia in post-intervention period was increased to 83.2% compared by 71.5% in pre-intervention period. Risk factor analysis for coronary heart disease increased significantly from 16.9% to 68.7%. Adequacy of management was 19.2% in pre-intervention period and 78.0% in post-intervention period. It showed statistically significant improvement in management of hypercholesterolemia. Conclusion : This study suggested that practice guideline reminders and flow-sheets were the effective methods in improving the quality in management of hypercholesterolemia.

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The Effects of Integrated Provision Action Observation and Synchronized Electrical Sensory Stimulation for Sit-to-stand in Stroke Patients Function (일어서기 동작에 대한 동작관찰과 동기화된 전기적 감각자극의 통합적 제공이 뇌졸중 환자의 기능에 미치는 효과)

  • Moon, Young;Choi, Jong-duk
    • Physical Therapy Korea
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    • v.27 no.3
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    • pp.191-198
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    • 2020
  • Background: Stroke patients experience multiple dysfunctions that include motor and sensory impairments. Therefore, new intervention methods require a gradational approach depending on functional levels of a stroke patient's activity and should include cognition treatment to allow for a patient's active participation in rehabilitation. Objects: This study investigates the effect of integrated revision of electrical sensory stimulation, which stimulates somatosensory and action observation training, which is synchronized cognition intervention method on stroke patients' functions. Methods: Twenty-one stroke patients were randomized into two groups. The two groups underwent twenty minutes of intervention five times a week for three weeks. This study used an electromyogram to evaluate symmetric muscle activation of lower extremities and muscle onset time when performing sit to stand before and after intervention. A weight-bearing ratio was used to evaluate the weight-bearing of the affected side in a sit to standing. To evaluate sit to stand performance ability, this study performed five timed sit to stand tests. Results: The two groups both showed statistically significant improvement in muscle onset time of lower extremity, static balance ability in a standing position, and sit to stand performance after the intervention (p < 0.05). In addition, the action observation and synchronized electrical sensory stimulation group showed significant improvement in symmetric muscle activation of lower extremities and weight-bearing ratio of the affected side (p < 0.05). Conclusion: action observation and synchronized electrical sensory stimulation (AOT with ESS) can have positive effects on a stroke patient's sit to stand performance, and the intervention method that provides integrated AOT with ESS can be used as new nervous system intervention program.

영적간호중재가 말기암환자의 삶의 의미와 영적고통에 미치는 효과

  • Yun, Mae-Ok
    • Korean Journal of Hospice Care
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    • v.5 no.2
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    • pp.64-74
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    • 2005
  • Purpose : This study is non-equivalent control group pre-post design attempted to see 'The effect of spiritual nursing intervention on the meaning of life and spiritual distress of the terminal cancer patients.' Method : The data collection was performed from June to October, 2004. The subjects were 41 terminal cancer patients of one general hospital in Jeon Ju city. They are formed two groups, 20 experimental group and 21 control group. Experimental treatment provided spiritual nursing intervention 3 times per a week, the mean 45 minutes each, for 4 weeks for experimental group with the contents of therapeutical use of oneself, use of bible, use of hymn, use of prayer, depend on the priest in the spiritual need assessment of 6 kinds. Study tools was used the thing which Kim(1990) developed about purpose inspection of life which Crumbaugh(1968) developed to measure the meaning of life. The measure of spiritual distress was used the tool which Kim(1990) developed, spiritual nursing intervention was developed by researcher of this thesis. Data was analyzed by descriptive statistics of real number, percentage, the mean etc. and x2-test, t-test, ANCOVA. Result: The 1st hypothesis, 'spiritual the meaning of life score in the experimental group, who received the spiritual nursing intervention, will be higher than the control group who did not receive it' was supported(F=157.09, P=0.000) The 2nd hypothesis, 'spiritual distress score in the experimental group, who received the spiritual nursing intervention, will be lower than the control group who did not receive it' was supported(F=36.48, P=0.000) Conclusion: Spiritual nursing intervention was verified as an effective program to improve the meaning of life and decrease spiritual distress for the terminal cancer patients. Thus, it was confirmed with an effective nursing intervention which helps them in order to spend the rest time of life meaningfully and meet the peaceful death.

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The Effect of Combination Intervention of Occupation - Based Intervention and Computerized Cognitive Rehabilitation on Depression in Stroke Patients for Wellness (작업기반 중재와 전산화인지재활치료의 결합 중재가 뇌졸중 환자의 웰니스를 위한 우울감에 미치는 영향)

  • Kim, Sun-Ho
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.1
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    • pp.229-236
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    • 2021
  • The purpose of this study is to investigate how the combined intervention of occupation-based intervention and computerized cognitive rehabilitation treatment affects the psychosocial function, cognitive function, and depression of stroke patients. 23 stroke patients were divided into experimental group(n=11) and a control group(n=12), and the experimental group and the control group received CoTras for 4 weeks and 30 minutes each, and additionally the experimental group received task-based intervention for 30 minutes before the start of CoTras. It was conducted 20 times for a total of 4 weeks. Self-efficacy scale, stress scale, depression scale, neurobehavioral cognitive status examination were used. As a result of the study, the experimental group showed significant improvement in improvement of self-efficacy, stress, and depression than the control group, and the experimental group showed a small effect difference in magnitude of effect from the control group in cognitive function. Based on this study, it is possible to utilize the simultaneous task-based intervention with CoTras to improve psychosocial function, depression and cognitive function in stroke patients.

Analysis and Evaluation of Pathogen Contamination Status in Interventional Angiography Room (인터벤션실의 오염실태 분석 및 평가)

  • Kim, Kyung-Wan;Im, In-Chul
    • Journal of radiological science and technology
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    • v.45 no.3
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    • pp.233-239
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    • 2022
  • In the radiology department, where radiation is used in medical institutions to perform examinations with various equipment, the field of surgical treatment is the intervention angiography room. Accordingly, strict infection control is required. The purpose of this study was to determine the contamination status by detecting pathogens before and after disinfection in the intervention angiography room, and to determine the degree of death by using a disinfectant, sodium dichloride isocyanurate, which is mainly used in the intervention angiography room. The subjects were 10 medical institutions of general hospital level or higher with an intervention angiography room in the P city, and 12 places with high contact frequency during examinations and procedures were sampled and requested to an analysis institution. As for the sample collection method, up/down, left/right directions were used to increase precision. Before disinfection, all procedures were completed, and after disinfection, exposure was performed using a disinfectant for at least 10 minutes, and detection was performed using a transport medium. As a result, in the pathogen analysis, most pathogens were detected in a humid environment or in a place with high contact frequency for microorganisms to thrive. The detected pathogens were found in the general environment or were human flora. It is a pathogen that does not cause disease under normal healthy host conditions. However, it was found to be an opportunistic infection that causes opportunistic infection depending on the case or situation in which the body's resistance is weakened. In addition, as a result of using the disinfectant mainly used in the intervention angiography room, it was found that more than 93.3% of them died. Therefore, the data of this study will be used as good basic data for the evaluation of pathogens in the intervention angiography room and will be of great help in infection control.

Effects of Sensory Integration Therapy and Home-Based Sensory Integration on Visual Attention in Children with Down Syndrome (감각통합치료와 가정프로그램 중재병행이 다운증후군 아동의 시각적 주의력에 미치는 효과: 단일사례연구)

  • Son, Ji-Won;Lee, Hye-Rim
    • The Journal of Korean Academy of Sensory Integration
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    • v.21 no.2
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    • pp.12-23
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    • 2023
  • Objective : The purpose of this study was to investigate the effect of sensory integration therapy and home program intervention on the visual attention of children with Down syndrome. Methods : This study used a single subject design for one child with Down syndrome, Sensory integrated treatment intervention was conducted once a week for 16 weeks, and home programs were conducted four times a week for 16 weeks. Changes in visual attention were measured after intervention in the target child. Results : After the intervention, the average values of object gaze, object horizontal pursuit, and object vertical pursuit time increased compared with the baseline period. In object gaze, object horizontal pursuit, and object vertical pursuit, a section higher than the ±2 standard deviation of the baseline period was observed during the intervention period. Conclusion : This study confirmed that the combination of sensory integrated therapy and home program intervention improved visual attention and visual perception in children with Down syndrome, and it is meaningful that it presented an effective intervention method.

Comparison of the Effects of Spinal Manipulation Combined with Painkiller and Muscle Relaxant to Painkiller and Muscle Relaxant Alone on Pain, Lumbar Range of Motion, and Disability Index in Patients with Chronic Low Back Pain (진통제-근육이완제 복용 병행 척추교정과 진통제-근육이완제 복용이 만성허리통증 환자의 통증, 허리 관절가동범위, 장애 지수에 미치는 효과 비교)

  • Dong-Hwan Oh;Suk-Chan Hahm
    • Journal of The Korean Society of Integrative Medicine
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    • v.12 no.2
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    • pp.33-45
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    • 2024
  • Purpose : This study aimed to compare the effects of spinal manipulation combined with medication on low back pain (LBP), range of motion, and disability in patients with chronic LBP. Methods : Twenty patients with chronic LBP were included in this study. The participants were randomly assigned to the spinal manipulation with medication group (n=10) or the medication only group (n=10). The intervention group received spinal manipulation for 15 minutes, twice a week, and took medication twice a day for eight weeks. The control group received the medication twice daily for eight weeks. Pain intensity assessed using the visual analog scale (VAS), range of motion, and disability due to LBP assessed using the Oswestry disability index were measured before and after the intervention. Results : The intervention group showed a significant improvement in pain intensity compared to the control group (p<.05), and the intervention and control groups significantly improved low back pain after the intervention (p<.05). The intervention group showed a significant improvement in the range of motion in flexion, extension, right lateral flexion, left lateral flexion, and right rotation (p<.05). The intervention group also showed a significant improvement in the change of disability in total score, pain intensity, personal care, lifting and standing compared to the control group (p<.05). Conclusion : This study showed that the combination of spinal manipulation and medication can benefit patients with chronic LBP, as evidenced by significant improvements in pain intensity, ROM, and disability. These findings suggest that utilizing both spinal manipulation and medication can positively affect individuals with chronic LBP. The results of this study should be applied in clinical settings to optimize treatment outcomes in patients with chronic LBP.