• Title/Summary/Keyword: interventional studies

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Pulmonary stenosis and pulmonary regurgitation: both ends of the spectrum in residual hemodynamic impairment after tetralogy of Fallot repair

  • Yoo, Byung Won;Park, Han Ki
    • Clinical and Experimental Pediatrics
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    • v.56 no.6
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    • pp.235-241
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    • 2013
  • Repair of tetralogy of Fallot (TOF) has shown excellent outcomes. However it leaves varying degrees of residual hemodynamic impairment, with severe pulmonary stenosis (PS) and free pulmonary regurgitation (PR) at both ends of the spectrum. Since the 1980s, studies evaluating late outcomes after TOF repair revealed the adverse impacts of residual chronic PR on RV volume and function; thus, a turnaround of operational strategies has occurred from aggressive RV outflow tract (RVOT) reconstruction for complete relief of RVOT obstruction to conservative RVOT reconstruction for limiting PR. This transformation has raised the question of how much residual PS after conservative RVOT reconstruction is acceptable. Besides, as pulmonary valve replacement (PVR) increases in patients with RV deterioration from residual PR, there is concern regarding when it should be performed. Regarding residual PS, several studies revealed that PS in addition to PR was associated with less PR and a small RV volume. This suggests that PS combined with PR makes RV diastolic property to protect against dilatation through RV hypertrophy and supports conservative RVOT enlargement despite residual PS. Also, several studies have revealed the pre-PVR threshold of RV parameters for the normalization of RV volume and function after PVR, and based on these results, the indications for PVR have been revised. Although there is no established strategy, better understanding of RV mechanics, development of new surgical and interventional techniques, and evidence for the effect of PVR on RV reverse remodeling and its late outcome will aid us to optimize the management of TOF.

Somatostatin Analogues Do Not Prevent Carcinoid Crisis

  • Guo, Lin-Jie;Tang, Cheng-Wei
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6679-6683
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    • 2014
  • Background: Carcinoid crisis is a life-threating syndrome of neuroendocrine tumors (NETs) characterized by dramatic blood pressure fluctuation, arrhythmias, and bronchospasm. In the era of booming anti-tumor therapeutics, this has become more important since associated stresses can trigger carcinoid crisis. Somatostatin analogues (SSTA) have been recommended for prophylactic administration before intervention procedures for functioning NETs. However, the efficacy is still controversial. The aim of this article is to review efficacy of SSTA for preventing carcinoid crisis. Materials and Methods: PubMed, Cochrane Controlled trials Register, and EMBASE were searched using 'carcinoid crisis' as a search term combining terms with 'somatostatin'; 'octreotide'; 'lanreotide' and 'pasireotide' until December 2013. Results: Twenty-eight articles were retrieved with a total of fifty-three unique patients identified for carcinoid crisis. The most common primary sites of NETs were the small intestine and respiratory tract. The triggering factors for carcinoid crisis included anesthesia/surgery (63.5%), interventional therapy (11.5%), radionuclide therapy (9.6%), examination (7.7%), medication (3.8%), biopsy (2%) and spontaneous (2%). No randomized controlled trials (RCTs) were identified and two case-control studies were included to assess the efficacy of SSTA for preventing carcinoid crisis by meta-analysis. The overall pooled risk of perioperative carcinoid crisis was similar despite the prophylactic administration of SSTA (OR 0.44, 95% CI: 0.14 to 1.35, p=0.15). Conclusions: SSTA wasnot helpful for preventing carcinoid crisis based on a meta-analysis of retrospective studies. Attentive monitoring and careful intervention are essential. Future studies with better quality are needed to clarify any effect of SSTA for preventing carcinoid crisis.

How Does Advance Provision of Emergency Contraceptives Affect Contraceptive Use and Sexual Activity Among Adolescents? Systematic Review and Meta-Analysis (응급피임약 사전 제공이 청소년의 성과 피임 행위에 어떤 영향을 미치는가?: 체계적 문헌고찰과 메타분석)

  • Ryu, Kyungsoon;Lee, Misoon;Kim, Younghae;Ban, Seonhwa;Choi, Mihyang
    • Journal of Korean Academy of Nursing
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    • v.48 no.3
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    • pp.255-265
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    • 2018
  • Purpose: The purpose of this study was to analyze the effect of emergency contraceptive pill on adolescent sexuality and contraceptive behaviors through a meta - analysis of intervention studies on advance provision of emergency contraceptives. This study aimed to provide objective data on the transition of general medicines to be discussed in relation to the reclassification of emergency contraceptive pills. Methods: Using electronic database, 1,820 studies written in Korean or English without limitation of the year were reviewed and for analysis, 5 studies were selected, in which emergency contraceptives were provided to adolescents. Results: The advance provision of emergency contraceptives has increased their use and shortened the time it takes to take contraceptive pills after unprotected sex. There was no change in the frequency of engaging in sexual intercourse and unprotected sex or in existing contraceptive behavior, pregnancy rates decreased, but there was no increase in sexually transmitted infection. Conclusion: The results of this study provide objective grounds for the reclassification of emergency contraceptive pills and propose effective interventional programs on contraceptive education, such as on efficacy and side effects of the contraceptive drug and its proper use among the youth who engage in sexual activity, to improve their reproductive health.

The Effectiveness of Non-pharmacological Interventions on Anxiety in Children Undergoing Surgery: A Systematic Review and Meta-analysis (수술 환아의 불안에 적용한 비약물적 중재의 효과: 체계적 문헌고찰 및 메타분석)

  • Kim, Hyeon-Young;Shin, Sun Hwa
    • Journal of East-West Nursing Research
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    • v.27 no.1
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    • pp.1-13
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    • 2021
  • Purpose: The purpose of this study was to examine the effectiveness of non-pharmacological interventions for reducing perioperative anxiety in children undergoing surgery. Methods: A systematic review of randomized controlled trials (RCTs) with the primary outcome of children's perioperative anxiety was conducted. The literature search was performed using various databases, including Cochrane Library, CINAHL, EMBASE, PubMed, and Korean electronic databases with confined to RCTs between 2000 and 2020. A total of sixteen studies were suitable the inclusion criteria and were systematically reviewed. The bias risk of randomized studies was evaluated using Cochrane's risk of bias tool. For the meta-analysis, RevMan 5.4 was used to analyze effect sizes of interventional factors. Results: Finally, twelve RCTs studies were used for meta-analysis. The non-pharmacological interventions implemented to reduce perioperative anxiety in children were therapeutic play, clown therapy and information provision. First, therapeutic play had a significant effect on reducing preoperative anxiety, with an effect size of -1.46 (95% CI=-1.78~-1.14). Second, clown therapy had a significant effect on reducing preoperative anxiety, with an effect size of -0.97 (95% CI=-1.45~-0.49). Finally, the provision of information had a significant effect on reducing preoperative anxiety, with an effect size of -0.75 (95% CI=-0.99~-0.51). Conclusion: This meta-analysis suggests that non-pharmaceutical interventions provide effective methods of reducing perioperative anxiety in children. Therefore, the findings verify evidence that various non-pharmacological interventions are effective means for reducing children's preoperative anxiety.

Research Trends and Instrument for Assessment in Sleep Quality (국내 수면 질 관련 양적 연구동향 및 측정도구 분석)

  • Son, Youn-Jung;Park, Jin-Hee;Youn, Heun-Keung;Kim, Sun-Hee
    • Korean Journal of Adult Nursing
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    • v.21 no.6
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    • pp.691-704
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    • 2009
  • Purpose: The purpose of this study was to identify the research trends and instruments for assessment of sleep quality in Korea. Methods: 66 quantitative research reports published from 2000 to March 2009 in Korea were selected from 5 databases: RISS4U, KISS, KISTI, DBpia, and the National Assembly Library and were analyzed according to criteria such as publication years, type of journal, participants, study fields, research design, participants, key words and instruments for assessment. Results: Research in sleep quality has been rapidly increasing in recent years. More than half of the research analyzed was conducted in nursing. The majority of research methods were survey and correlational research. Patients with chronic illness and the elderly were the major subjects in those researches. Most research was performed based on hospitals and communities. The types of variables tested for their relation and influence on sleep quality were quite limited. With respect to the instrument used for assessing sleep quality, most studies did not consider whether or not the validity of their instrument had been established. Conclusion: It is recommended to conduct clinically applicable interventional research with an experimental design and to develop a reliability and validity established sleep quality instrument for Koreans.

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Noise Level and Frequency Experienced by Premature Infants Receiving Incubator Care in the Neonatal Intensive Care Unit (신생아집중치료실 내 인큐베이터 간호를 받는 미숙아가 경험하는 소음 수준 및 빈도)

  • Joo, So Hyun;Kim, Tae Im
    • Child Health Nursing Research
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    • v.26 no.2
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    • pp.296-308
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    • 2020
  • Purpose: The purpose of this study was to identify the noise level and frequency experienced by premature infants receiving incubator care in the neonatal intensive care unit (NICU). Methods: The participants were 20 premature infants receiving incubator care in the NICU of a university hospital in Daejeon Metropolitan city. The noise level was measured using a professional sound-level meter (ET-958, FLUS, Shenzhen, China) based on a noise classification table developed by the author. The data were analyzed with descriptive statistics, the t-test, analysis of variance, and Pearson correlation coefficients using SPSS for Windows version 22.0. Results: The average noise level experienced by premature infants receiving incubator care in the NICU was 51.25 dB (range: 45.0~81.7 dB). The frequency of noises was highest for factors related to nursing activities (40.3%), followed by human factors (29.1%), machine alarm sounds (20.1%), incubator operation (6.6%), and internal environmental factors (3.9%). Conclusion: According to the above results, the noise level experienced by premature infants receiving incubator care in the NICU exceeded the recommendations of the American Academy of Pediatrics. Therefore, it is necessary to develop an interventional program to reduce noise in the NICU, and to conduct follow-up studies to verify its effectiveness.

Spinal Cord Stimulation for Intractable Visceral Pain due to Chronic Pancreatitis

  • Kim, Jin-Kyung;Hong, Seok-Ho;Kim, Myung-Hwan;Lee, Jung-Kyo
    • Journal of Korean Neurosurgical Society
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    • v.46 no.2
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    • pp.165-167
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    • 2009
  • Pain caused by chronic pancreatitis is medically intractable and resistant to conventional interventional or surgical treatment. We report a case of spinal cord stimulation (SCS) for intractable pain due to chronic pancreatitis. The patient had a history of nonalcoholic chronic pancreatitis and multiple emergency room visits as well as repeated hospitalization including multiple nerve block and morphine injection for 3 years. We implanted surgical lead at T6-8 level on this patient after successful trial of percutaneous electrode. The patient experienced a decreased visual analog scale (VAS) scores for pain intensity and amount of opioid intake. The patient was followed for more than 14 months with good outcome and no further hospitalization. From our clinical case, spinal cord stimulation on intractable pain due to chronic pancreatitis revealed moderate pain control outcome. We suggest that SCS is an effective, noninvasive treatment option for abdominal visceral pain. Further studies and long term follow-up are needed to fully understand the effect of SCS on abdominal visceral pain.

Study on the Performance Evaluation and Supplementations of Extracorporeal Shockwave Therapy (체외충격파 치료기(Extracorporeal Shockwave Therapy)의 성능평가 및 보완사항에 관한 연구)

  • Oh, Chan-Woo;Park, Sang-Geon;Park, Hong-Gyu
    • The Transactions of the Korean Institute of Electrical Engineers P
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    • v.67 no.1
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    • pp.52-56
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    • 2018
  • Extracorporeal shockwave therapy has been widely spread out showing an excellent efficacy compared to traditional medicinal treatments, interventional procedures or surgeries for diseases of tendons and musculoskeletal system. Major performance tests of extracorporeal shockwave therapy consist of pressure, energy flux, concentration, and effective amount of energy on the focus area of shockwave according to IEC 61846. Shockwave should be irradiated accurately to the lesion area to improve the performance of extracorporeal shockwave therapy, which makes it necessary to add the relevant section, IEC 60601-2-36 (12.1.101. Precision of Target Markers and Target Locations). International standards of extracorporeal shockwave therapy have been prepared based on European and western people. Thus, we need to conduct many studies on Korean patients to improve the quality of extracorporeal shockwave therapy and to develop the medical industry. In addition, the performance evaluation of extracorporeal shockwave therapy which has been prepared according to international standards should be additionally modified and supplemented corresponding to the Korean circumstances.

Congenital web of the common bile duct combined with multiple intrahepatic duct stricture: a case report of successful radiological intervention

  • Lim, Hanseul;Hwang, Shin;Ko, Gi-Young;Han, Hyejin
    • Journal of Yeungnam Medical Science
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    • v.39 no.2
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    • pp.161-167
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    • 2022
  • Congenital web formations are extremely rare anomalies of the extrahepatic biliary tree. We herein report a case of common bile duct septum combined with multiple intrahepatic bile duct strictures in a 74-year-old female patient who was successfully treated with radiological intervention. The patient initially visited the hospital because of upper abdominal pain. Imaging studies revealed multifocal strictures with dilatation in both intra- and extrahepatic ducts; the final clinical diagnosis was congenital common bile duct web combined with multiple intrahepatic duct strictures. Surgical treatment was not indicated because multiple biliary strictures were untreatable, and the disease was clinically diagnosed as benign. The multiple strictures were extensively dilated twice through bilateral percutaneous transhepatic biliary drainage (PTBD) for 2 months. After 1 month of observation, PTBD catheters were successfully removed. The patient is doing well at 6 months after completion of the radiological intervention, with the maintenance of normal liver function. Congenital web of the bile duct is very rare, and its treatment may vary depending on the patterns of biliary stenosis. In cases where surgical intervention is not indicated for congenital web and its associated disease, radiological intervention with balloon dilatation can be a viable therapeutic option.

A Structural Equation Model of Terminal Care Performance for Long-term Care Hospital Nurses (요양병원 간호사의 임종간호수행 구조모형)

  • Lim, Gui Yeon;Choi, So Young
    • Journal of Korean Public Health Nursing
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    • v.37 no.2
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    • pp.275-289
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    • 2023
  • Purpose: This study developed a structural model for explaining and predicting terminal care performance in long-term care hospital nurses. The model was based on the stress integration model of Ivancevich and Matteson(1980) and the results of previous studies. Method: Data was obtained from August to September 2022 from 267 nurses in 13 long-term care hospitals in G-do. Results: Results of model verification for this study, revealed that factors directly affecting the terminal care performance of long-term care hospital nurses were nursing work environment(β=0.43, p<0.001), death anxiety(β=-0.29, p<0.001), and terminal care stress(β=0.22, p=0.003). However, the attitude toward nursing care of dying(β=0.07, p=0.287) had no effect on the terminal care performance. Conclusion: The results of this study, confirmed the necessity of improving an individual's perceived nursing work environment, continuous education related to terminal care to reduce death anxiety, and an interventional approach for enhancing terminal care performance.