• Title/Summary/Keyword: observational clinical study

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Risk Awareness on Uterine Cancer among Australian Women

  • George, Mathew;Asab, Nihad Abu;Varughese, Elizabeth;Irwin, Matthew;Oldmeadow, Christopher;Hollebone, Keith;Apen, Kenneth;Renner, Stefan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10251-10254
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    • 2015
  • Uterine cancer is the most common invasive gynaecological cancer in Australia. Early detection is a key predictive factor achieved by increasing public awareness and participation in screening. This observational study measures awareness of gynaecological malignancies, particularly uterine, among women in two rural areas of New South Wales, Australia. Patients presenting to gynaecology clinics in January to March 2014 were invited to complete a structured questionnaire. Women with a history of cancer and incomplete questionnaires were excluded. Of the 382 patients invited to participate, 329 (86%) responded with complete feedback. Most respondents were younger than than 50 years (66%) and married with at least 2 children (74%). The majority (94%) of participants had no awareness of uterine cancer and many (46%) were unable to identify common risk factors including obesity, diabetes and hypertension. The ability to identify risk factors was correlated to age, marital status and obesity. The study identifies poor awareness on uterine malignancies in two typical areas of rural Australia. Although external validity is limited by sociological factors, poor awareness of uterine cancer among rural patients in this study represents a valid public health concern. It is imperative to improve awareness of uterine cancer and available screening programs to facilitate early detection and cure.

Outcomes of Home Monitoring after Palliative Cardiac Surgery in Infants with Congenital Heart Disease (선천성 심질환으로 고식적 수술을 시행 받은 영아의 홈모니터링의 성과)

  • Kim, Sang Wha;Uhm, Ju-Yeon;Im, Yu Mi;Yun, Tae-Jin;Park, Jeong-Jun;Park, Chun Soo
    • Journal of Korean Academy of Nursing
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    • v.44 no.2
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    • pp.228-236
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    • 2014
  • Purpose: Common conditions, such as dehydration or respiratory infection can aggravate hypoxia and are associated with interstage mortality in infants who have undergone palliative surgery for congenital heart diseases. This study was done to evaluate the efficacy of a home monitoring program (HMP) in decreasing infant mortality. Methods: Since its inception in May 2010, all infants who have undergone palliative surgery have been enrolled in HMP. This study was a prospective observational study and infant outcomes during HMP were compared with those of previous comparison groups. Parents were trained to measure oxygen saturation, body weight and feeding volume and to contact the hospital through the hotline for emergency situations. Telephone counseling was conducted by clinical nurse specialists every week post discharge. Results: Forty-one infants were enrolled in HMP. Nine hundred telephone counseling sessions were conducted. Seventy-three infants required telephone triage with the most common conditions being gastrointestinal (50.7%) and respiratory symptoms (32.9%). With HMP intervention, interstage mortality decreased from 18.6% (8/43) to 9.8% (4/41) (${\chi}^2$=1.15, p=.283). Conclusion: Results indicate that active measures and treatments using the HMP decrease mortality rates, however further investigation is required to identify various factors that contribute to hemodynamic complications during the interstage period.

Outcome of complete acellular dermal matrix wrap with polyurethane implant in immediate prepectoral breast reconstruction

  • Naemonitou, Foteini;Mylvaganam, Senthurun;Salem, Fathi;Vidya, Raghavan
    • Archives of Plastic Surgery
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    • v.47 no.6
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    • pp.567-573
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    • 2020
  • Background Polyurethane implants have been used on and off in breast reconstruction since 1991 while prepectoral breast reconstruction has gained popularity in recent times. In this study, we present our outcomes from the use of acellular dermal matrix (ADM) complete wrap with polyurethane implants in prepectoral breast reconstruction. Methods This is a retrospective review of prospectively maintained database from 41 patients receiving complete ADM wrap with prepectoral polyurethane implants over a 3-year period. Selection criteria were adapted from a previous study (4135 Trust Clinical Audit Database) evaluating prepectoral reconstruction with Braxon matrices. Patient demographics, operative data, surgical complications, and outcomes were collected and analyzed. Results A total of 52 implant reconstructions were performed in 41 patients with a mean follow-up of 14.3 months (range, 6-36 months). The overall reported complication rates including early (less than 6 weeks) and late complications. Early complications included two patients (4.9%) with wound dehiscence. One of which had an implant loss that was salvageable. Another patient (2%) developed red-breast syndrome and two women (4.9%) developed with seroma treated conservatively. Late complications included one patient (2%) with grade II capsular contraction, 12 patients with grade I-II rippling and two patients (4.9%) with grade III rippling. Conclusions We present our experience of prepectoral polyurethane implant using complete ADM wrap. This is one of the few papers to report on the outcome of the prepectoral use of polyurethane in immediate implant-based breast reconstruction. Our early observational series show satisfactory outcome and long-term results are warranted by a large multicenter study.

Successful First Round Results of a Turkish Breast Cancer Screening Program with Mammography in Bahcesehir, Istanbul

  • Kayhan, Arda;Gurdal, Sibel Ozkan;Ozaydin, Nilufer;Cabioglu, Neslihan;Ozturk, Enis;Ozcinar, Beyza;Aribal, Erkin;Ozmen, Vahit
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1693-1697
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    • 2014
  • Background: The Bahcesehir Breast Cancer Screening Project is the first organized population based breast cancer mammographic screening project in Turkey. The objective of this prospective observational study was to demonstrate the feasibility of a screening program in a developing country and to determine the appropriate age (40 or 50 years old) to start with screening in Turkish women. Materials and Methods: Between January 2009 to December 2010, a total of 3,758 women aged 40-69 years were recruited in this prospective study. Screening was conducted biannually, and five rounds were planned. After clinical breast examination (CBE), two-view mammograms were obtained. True positivity, false positivity, positive predictive values (PPV) according to ACR, cancer detection rate, minimal cancer detection rate, axillary node positivity and recall rate were calculated. Breast ultrasound and biopsy were performed in suspicious cases. Results: Breast biopsy was performed in 55 patients, and 18 cancers were detected in the first round. The overall cancer detection rate was 4.8 per 1,000 women. Most of the screened women (54%) and detected cancers (56%) were in women aged 40-49. Ductal carcinoma in situ (DCIS) and stage I cancer and axillary node positivity rates were 22%, 61%, and 16.6%, respectively. The positive predictivity for biopsy was 32.7%, whereas the overall recall rate was 18.4 %. Conclusions: Preliminary results of the study suggest that population based organized screening are feasible and age of onset of mammographic screening should be 40 years in Turkey.

Current Pharmacogenetic Approach for Oxaliplatin-induced Peripheral Neuropathy among Patients with Colorectal Cancer: A Systematic Review (대장암 환자의 옥살리플라틴(oxaliplatin) 유도 말초신경병증에 대한 약물유전학적 접근: 체계적 문헌고찰)

  • Ahn, Soojung;Choi, Soyoung;Jung, Hye Jeong;Chu, Sang Hui
    • Journal of Korean Biological Nursing Science
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    • v.20 no.2
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    • pp.55-66
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    • 2018
  • Purpose: Peripheral neuropathy is common among colorectal cancer (CRC) patients who undergo oxaliplatin-based (OXL) chemotherapy. A pharmacogenetic approach can be used to identify patients at high-risk of developing severe neuropathy. This type of approach can also help clinicians determine the best treatment option and prevent severe neurotoxicity. The purpose of this study is to investigate the evidence of pharmacogenetic markers for OXL-induced peripheral neuropathy (OXIPN) in patients with CRC. Methods: A systematic literature search was conducted using the following databases up to December 2017: Pubmed, EMBASE, and CINAHL. We reviewed the genetic risk factors for OXIPN in observational studies and randomized controlled clinical trials (RCTs). All processes were performed independently by two reviewers. Results: Sixteen studies published in English between 2006 and 2017 were included in this review. A genome-wide association approach was used in one study and various candidate genes were tested, based on their functions (e.g., DNA damage or repair, ion channels, anti-oxidants, and nerve growth etc.). The genes associated with incidence or severity of OXIPN were ABCG2, GSTP1, XRCC1, TAC1, and ERCC1. Conclusion: This study highlighted the need and the importance of conducting pharmacogenetic studies to generate evidence of personalized OXIPN symptoms management. Additional studies are warranted to accelerate the tailored interventions used for OXIPN in patients with CRC (NRF-2014R1A1A3054386).

Needle Stick Injuries and their Related Safety Measures among Nurses in a University Hospital, Shiraz, Iran

  • Jahangiri, Mehdi;Rostamabadi, Akbar;Hoboubi, Naser;Tadayon, Neda;Soleimani, Ali
    • Safety and Health at Work
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    • v.7 no.1
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    • pp.72-77
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    • 2016
  • Background: This study aimed to determine the prevalence and factors related to needle stick injuries (NSIs) and to assess related safety measures among a sample of Iranian nurses. Methods: In this cross-sectional study, a random sample of 168 registered active nurses was selected from different wards of one of the hospitals of Shiraz University of Medical Sciences (SUMS). Data were collected by an anonymous questionnaire and a checklist based observational method among the 168 registered active nurses. Results: The prevalence of NSIs in the total of work experience and the last year was 76% and 54%, respectively. Hollow-bore needles were the most common devices involved in the injuries (85.5%). The majority of NSIs occurred in the morning shift (57.8%) and the most common activity leading to NSIs was recapping needles (41.4%). The rate of underreporting NSIs was 60.2% and the major reasons for not reporting the NSIs were heavy clinical schedule (46.7%) and perception of low risk of infection (37.7%). A statistically significant relationship was found between the occurrence of NSIs and sex, hours worked/week, and frequency of shifts/month. Conclusion: The study showed a high prevalence of NSIs among nurses. Supportive measures such as improving injection practices, modification of working schedule, planning training programs targeted at using personal protective equipment, and providing an adequate number of safety facilities such as puncture resistant disposal containers and engineered safe devices are essential for the effective prevention of NSI incidents among the studied nurses.

Validation of the Korean criteria for trauma team activation

  • Bang, Minhyuk;Kim, Yong Won;Kim, Oh Hyun;Lee, Kang Hyun;Jung, Woo Jin;Cha, Yong Sung;Kim, Hyun;Hwang, Sung Oh;Cha, Kyoung-Chul
    • Clinical and Experimental Emergency Medicine
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    • v.5 no.4
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    • pp.256-263
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    • 2018
  • Objective We conducted a study to validate the effectiveness of the Korean criteria for trauma team activation (TTA) and compared its results with a two-tiered system. Methods This observational study was based on data from the Korean Trauma Data Bank. Within the study period, 1,628 trauma patients visited our emergency department, and 739 satisfied the criteria for TTA. The rates of overtriage and undertriage in the Korean one-tiered system were compared with the two-tiered system recommended by the American College of Surgery-Committee on Trauma. Results Most of the patient's physiologic factors reflected trauma severity levels, but anatomical factors and mechanism of injury did not show consistent results. In addition, while the rate of overtriage (64.4%) was above the recommended range according to the Korean criteria, the rate of undertriage (4.0%) was within the recommended range. In the simulated two-tiered system, the rate of overtriage was reduced by 5.5%, while undertriage was increased by 1.8% compared to the Korean activation system. Conclusion The Korean criteria for TTA showed higher rates of overtriage and similar undertriage rates compared to the simulated two-tier system. Modification of the current criteria to a twotier system with special considerations would be more effective for providing optimum patient care and medical resource utilization.

Effectiveness of herbal ointment Biyeom-go according to cold-heat pattern identification: a subgroup analysis on patients with rhinitis (한열(寒熱) 변증에 따른 한의 외용 치료제 비염고의 치료 효과 : 하위 그룹 분석)

  • Son, Mi-Ju;Lee, Dong-Hyo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.32 no.4
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    • pp.29-40
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    • 2019
  • Objectives : Hwanglyeonhaedok-tang(黃連解毒湯) is a representative herbal formula with "clear heat(淸熱)" effects. The aim of this study was to evaluate the effects of Hwanglyeonhaedok-tang-based intranasal herbal ointment Biyeom-go based on the cold and heat pattern identification questionnaire(CHPIQ). Methods : We performed a subgroup analysis of the previously published prospective observational study. A total of 58 patients with rhinitis were administered Biyeom-go for 4 weeks, and its effects on the Total Nasal Symptom Score(TNSS), Mini Rhinoconjunctivitis Quality of Life Questionnaire(Mini-RQLQ) score, and nasal endoscopy index score were analyzed based on CHPIQ. Results : Among the 58 patients, the heat and non-heat patterns were shown by 39 and 19 patients, respectively, while the cold and non-cold patterns were shown by 46 and 12 patients, respectively. The change in TNSS from baseline negatively correlated with the heat pattern score(p=0.011). Improvement in TNSS was greater in the heat pattern group than in the non-heat pattern group, with a borderline significant difference(p=0.07). Mini-RQLQ and nasal endoscopy index scores tended to be lower in the heat pattern group than in the non-heat pattern group, but without a statistically significant difference. Conclusion : The findings indicate that CHPIQ is a useful tool for the diagnostic and prognostic evaluation of patients with rhinitis. This study provides fundamental evidence of the close association between the cold-heat pattern in patients with rhinitis and the treatment effects of Biyeom-go.

Usefulness of Predictors for Hepatotoxicity in Acetaminophen Poisoning Patient (아세트아미노펜 중독 환자에서 간독성 발생 예측인자들의 유용성)

  • Kim, Eun Young;Chung, Sung Phil;Ko, Dong Ryul;Kong, Tae Young;You, Je Sung;Choa, Min Hong;Kim, Min Joung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.16 no.2
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    • pp.149-156
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    • 2018
  • Purpose: The purpose of this study was to determine whether hepatotoxicity could be predicted early using biochemical markers in patients with acetaminophen (AAP) poisoning and to assess the usefulness of predictive factors for acute liver injury or hepatotoxicity. Methods: This study was a retrospective observational study involving a medical records review. The participants were patients who were admitted to the emergency department (ED) with AAP overdose at two hospitals over a 10-year period. Demographic data, age, time from ingestion to visit, initial AAP level, initial hepatic aminotransferases, and initial prothrombin time were recorded. Acute liver injury was defined as a peak serum ALT >50 U/L or double the admission value, and hepatotoxicity was defined as a peak ALT >1,000 U/L. Receiver operating characteristic curve analyses were performed to compare the prognostic performance among variables. Results: A total of 97 patients were admitted to the ED with AAP overdose, of whom 26 had acute liver injury and 6 had hepatotoxicity. Acute liver injury was associated with the time interval after taking the drug, and hepatotoxicity was associated with the initial PT and the ALT level. The scoring system proposed by the authors has a significant ability to predict both acute liver injury and hepatotoxicity. Conclusion: To predict the prognosis of AAP poisoning patients, the time interval after taking AAP was important, and initial prothrombin time and ALT level were useful tests. Also a scoring system combining variables may be useful.

Impact of Inter-professional Attitude and Educational Burden on Clinical Nurses' Cardiopulmonary Resuscitation-related Self-efficacy Following Team-based Cardiopulmonary Resuscitation Simulation Training (팀 기반 심폐소생술 시뮬레이션 교육을 받은 임상간호사들의 전문직 간 태도 및 교육부담감이 심폐소생 관련 자기효능감에 미치는 영향)

  • Ok, Jong Sun;An, Soo Young;Kwon, Jeong Hwa
    • Journal of muscle and joint health
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    • v.31 no.1
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    • pp.22-30
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    • 2024
  • Purpose: In-hospital cardiac arrest is rare, but often results in high mortality rates. Early and effective cardiopulmonary resuscitation (CPR) is crucial for survival and nurses are often the first responders. This study aimed to investigate how inter-professional attitudes and educational burdens affect self-efficacy related to CPR performance following team-based CPR simulation training. Methods: This retrospective observational study analyzed data from a satisfaction survey conducted after team-based CPR training sessions between January and November 2022. Of the 454 nurses surveyed, 238 were included in the study after excluding those with ambiguous responses. Multiple regression analysis was performed to assess factors influencing CPR self-efficacy. The factors examined included inter-professional attitudes and educational burden. Results: Higher levels of inter-professional attitudes, particularly regarding teamwork roles and responsibilities, lower educational burden, and a positive perception of CPR competence were all associated with improved CPR-related self-efficacy. Participants who reported higher engagement in teamwork, lower task load, and greater confidence in their CPR abilities demonstrated higher self-efficacy in performing CPR. Conclusion: Enhancing the competencies of nurses who may act as initial responders in CPR situations within or outside hospital settings can help save lives and support public health.