• 제목/요약/키워드: respiratory management

검색결과 852건 처리시간 0.03초

의증 유소아 기도이물의 임상적 고찰 (Clinical Analysis of Suspected Airway Foreign Bodies in Infants and Children)

  • 안병훈;송달원;최용식;박기철;이근양;김중강
    • 대한기관식도과학회지
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    • 제3권1호
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    • pp.84-93
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    • 1997
  • The bronchoscopy is usually performed in the patients who present symptoms of wheezing, hemoptysis, signs of airway obstruction, unexplained long-term chronic cough with or without radiologic features of pneumonia, emphysema or atelectasis. The symptoms and signs of cases of suspected airway foreign body are of often cofused with those of asthma pneumonia and other respiratory tract disease. The ventilating bronchoscopy will be helpful for removal of certain foreign bodies as well as alleviating medically-unresponsive bronchopulmonary conditions via removing abnormal secretions or merely improving ventilation. The authors have performed clinical analysis of 59 patients who were suspected of airway foreign bodies and treated by ventilating bronchoscopy from September 1985 to February 1995. The results were as follows: 1) Among the 59 cases of bronchoscopy, 51 cases(97%) were under the age of 3. The ratio of male and female was 2.69:1 2) Most common presenting symptom was coughing(84.7%) followed by dyspnea, fever, wheezing and anterior chest pain. 3) Among 39 cases of identified foreign bodies, abnormal findings in the chest X-ray films were found in 33 cases(84.6%) and most common abnormal radiologic feature was pneumonia in 10 cases(25.6%) followed by combination of pneumonia and emphysema, or emphysema alone. All the 20 cases of absent foreign body presented abnormal radiologic features and common findings were pneumonia and atelectasis. 4) Vegetable foreign bodies were the most common form of removed airway foreign bodies(69.2%) followed by metallic foreign bodies(12.8%) and plastic foreign bodies(7.7%). 5) By distribution of the location of foreign bodies, 29 cases(74.4%) were located in the main bronchus( 16 cases of right side and 13 cases of left side), 8 cases were in the trachea and 2 cases were found at the cordal level. 6) By duration of foreign body lodgement in the airway, 9 cases(23.1%) were removed within 7 to 30 days, 10 cases(5.6%) within 3 days and 5 cases(12.8%) were enlodged over 30 days. 7) In the cases of absent foreign bodies, common bronchoscopic findings were mucopurulent or thick mucoid discharge in the main bronchi, erythema or edema of bronchial mucosa and all the cases were improved after ventilating bronchoscopy with concomitant medical management.

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유기인산 화합물 중독으로 의심했던 벤타존 중독 1례 (A Case of Bentazone Poisoning Mimicking Organophosphate Intoxication)

  • 정현민;김지혜;한승백;백진휘;김지윤;김준식
    • 대한임상독성학회지
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    • 제8권2호
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    • pp.122-124
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    • 2010
  • $Basagran^{(R)}$ is a herbicide that is widely used in the field and it acts by interfering with photosynthesis in plants. It consists of bentazone, 2-methyl-4-chlorophenoxyacetic acid (MCPA) and surfactants. Bentazone is commonly used, but poisoning due to Bentazone has not been previously reported in Korea. The patients with toxic effects of bentazone show mild to severe symptoms and various complications. We report here on a case of a woman who intentionally ingested 500 ml of $Basagran^{(R)}$ and she was discharged without complication. As soon as the patient visited the emergency department, we started to treat her as if she had organophosphate intoxication because of the cholinergic symptoms. We could not detect the bentazone in her serum and urine, and we could confirm $Basagran^{(R)}$ ingestion only after getting information from her husband. Bentazone poisoning may induce harmful complications like muscle rigidity, rhabdomyolysis, respiratory failure and cardiac arrest. A detailed history taking, an accurate analysis method and early conservative management will be helpful for patients with acute bentazone poisoning.

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일부 초등학교 학생들의 응급처치 교육효과 -기도 폐쇄 시 응급처치 교육을 중심으로- (Effects of a First-aid Skills Training for Elementary Students - Focus on Management of Foreign Body Airway Obstruction -)

  • 김유선;김현숙;김윤신
    • 한국학교보건학회지
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    • 제24권1호
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    • pp.50-60
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    • 2011
  • Purpose: This paper compares practical first aid training and theoretical first aid training in elementary schools. Methods: Research subjects were randomly selected and sorted into experimental and control groups. The former is one class (28 students) of the fifth grade students, and the latter is another class (30 students). In order to verify the effect of first aid training, we conducted theoretical as well as practical first-aid instruction about foreign body airway obstruction to the experimental group, but conducted only theoretical instruction with the control group. Data were analyzed by the ${\chi}^2$-test and t-test, one-way using the SPSS / win 12.0 program. The results were as follows (p=.05). Results: The first hypothesis was that the knowledge of an experimental group would be better than that of a control group. The analysis showed a significant difference (p=.000) between the two groups, supporting this hypothesis. The second hypothesis was that the experimental group would be more accurate than the control group. There was no because of (p=.000) between the two groups on this measure. The third hypothesis, that the two groups would vary over time on the measure of accuracy, was supported by the following observations: the experimental results were accumulated before, two days after and two weeks after the training (experimental group, p=.000, and control group, p=.000). This supports the third hypothesis that the technical performance accuracy levels of complete respiratory obstruction first aid vary over time. Conclusion: First aid training has to include practical education as well as theoretical education in the future, as part of a school's health education for elementary students. Health education classrooms should be prepared to teach first-aid theory and be supplied with equipment for practical exercises. Schools, communities, and private organizations need to carry out the practical education component periodically.

Investigation of chlamydophilosis from naturally infected cats

  • Wasissa, Madarina;Lestari, Fajar Budi;Nururrozi, Alfarisa;Tjahajati, Ida;Indarjulianto, Soedarmanto;Salasia, Siti Isrina Oktavia
    • Journal of Veterinary Science
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    • 제22권6호
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    • pp.67.1-67.7
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    • 2021
  • Background: Chlamydophila felis, formerly known as Chlamydia psittaci var. felis, is frequently associated with ocular, respiratory, and occasionally reproduction tract infections. Even though the infection is sometimes asymptomatic, it potentially results in a latent immunosuppressive infection. Objective: This study aimed to identify occurrences of feline chlamydophilosis, rarely reported in cats in Indonesia. Methods: The observation was conducted in three cats with clinical signs of Cp. felis infection, particularly relapsing conjunctivitis. The cats' histories were recorded based on owners' information. Conjunctival swabs were sampled for cytology examination and molecular assay detection. A phylogenetic tree was generated using MEGA-X software to reveal group clustering. A post-mortem examination was performed on the cat that died during an examination. Results: Cp. felis was detected in both cytological examination and polymerase chain reaction assay. The phylogenetic tree demonstrated that the Cp. felis isolated in this study clustered with several other isolates from the other countries. Cp. felis can be isolated from cats with different clinical manifestations and levels of severity. The chronic fatal infection demonstrated interstitial broncho-pneumonia under histopathological examination. Conclusions: Molecular assay of Cp. felis is always recommended to obtain a definitive diagnosis of feline chlamydophilosis since the disease can have various clinical manifestations. Even though it may be subclinical and is often not fatal, an infected cat may be a carrier that could spread the pathogen in the surrounding environment. Serious disease management is suggested to avoid high costs associated with regularly relapsing disease.

COVID-19 확산방지를 위한 보육시설, 집단급식소 및 식품접객업소 생활방역 매뉴얼 개발 (Development of Guidelines for Preventing COVID-19 in Childcare Centers, Institutional Foodservices and Restaurants)

  • 이승완;장혜자;한아름;이선영;김성일;반경녀
    • 급식외식위생학회지
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    • 제1권1호
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    • pp.37-44
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    • 2020
  • The virus isolated from patients with severe pneumonia of unknown etiology in Wuhan City, Hubei province in China was termed SARS-CoV-2 and the World Health Organization (WHO) named the disease caused by this virus as coronavirus disease 2019 (COVID-19). The COVID-19 infection has spread rapidly and become a pandemic. In July 2020, there were 13.25 million infected patients and over 570,000 deaths worldwide, and 13,711 infected patients and 294 deaths were reported in South Korea. Since the primary mode of transmission of COVID-19 is through respiratory droplets, the importance of preventive measures, including social distancing, has become important in daily life. In response to the continuous spread of COVID-19, this study developed three guidelines for preventing COVID-19 for the food service industry including childcare centers, institutional foodservices and restaurants by the integration of the manual of controlling foodborne illness. These are included the COVID-19 prevention action methods for food deliverers, for food service administrator, for foodservice works and for customers. All guidelines were designed for easy understanding using illustrations and have been systematically explained subject wise. Thus, these COVID-19 prevention guidelines can be appropriately applied depending on the specific situation and workplace. In addition, they are worthy as educational materials that contribute to the food safety.

The Effect of Systematic Approach to Tracheostomy Care in Patients Transferred from the Surgical Intensive Care Unit to General Ward

  • Jung, Yooun-joong;Kim, Younghwan;Kyoung, Kyuhyouck;Keum, Minae;Kim, Taehyun;Ma, Dae seong;Hong, Suk-Kyung
    • Acute and Critical Care
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    • 제33권4호
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    • pp.252-259
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    • 2018
  • Background: The aim of this study was to investigate the effects of using a systematic approach to tracheostomy care by a clinical nurse specialist and surgical intensivists for patients with a tracheostomy who were transferred from the surgical intensive care unit (SICU) to the general ward. Methods: In this retrospective study, subjects were limited to SICU patients with a tracheostomy who were transferred to the general ward. The study period was divided into a preintervention period (January 1, 2007 to December 31, 2010) and a postintervention period (January 1, 2011 to December 31, 2014), and electronic medical records were used to analyze and compare patient characteristics, clinical outcomes, and readmission to the SICU. Results: The analysis included 44 patients in the preintervention group and 96 patients in the postintervention group. Decannulation time ($26.7{\pm}25.1$ vs. $12.1{\pm}16.0days$, P=0.003), length of stay in the general ward ($70.6{\pm}89.1$ vs. $40.5{\pm}42.2days$, P=0.008), length of total hospital stay ($107.5{\pm}95.6$ vs. $74.7{\pm}51.2days$, P=0.009), and readmission rate of SICU decreased due to T-cannula occlusion (58.8% vs. 5.9%, P=0.010). Conclusions: Using a systematic approach to tracheostomy care in the general ward led to reduction in decannulation time through professional management, which resulted in a shorter hospital stay. It also lowered SICU readmission by solving problems related to direct T-cannula.

Genotype-phenotype correlations in pediatric patients with myotonic dystrophy type 1

  • Kim, Hyeong Jung;Na, Ji-Hoon;Lee, Young-Mock
    • Clinical and Experimental Pediatrics
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    • 제62권2호
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    • pp.55-61
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    • 2019
  • Purpose: Myotonic dystrophy, also known as dystrophia myotonica (DM), is an autosomal dominant disorder with 2 genetically distinct forms. DM type 1 (DM1) is the more common form and is caused by abnormal expansion of cytosine/thymine/guanine (CTG) repeats in the DM protein kinase (DMPK ) gene. Our study aimed to determine whether the age of onset is correlated with CTG repeat length in a population of pediatric patients with DM1. Methods: We retrospectively identified 30 pediatric patients with DM1 that underwent DMPK testing, of which the clinical data of 17 was sufficient. The cohort was divided into 2 subgroups based on the clinical phenotype (congenital-onset vs. late-onset) and number of CTG repeats (<1,000 vs. ${\geq}1,000$). Results: We found no significant difference between the age of onset and CTG repeat length in our pediatric patient population. Based on clinical subgrouping, we found that the congenital-onset subgroup was statistically different with respect to several variables, including prematurity, rate of admission to neonatal intensive care unit, need for respiratory support at birth, hypotonia, dysphagia, ventilator dependence, and functional status on last visit, compared to the late-onset subgroup. Based on genetic subgrouping, we found a single variable (poor feeding in neonate) that was significantly different in the large CTG subgroup than that in the small CTG subgroup. Conclusion: Clinical variables exhibiting statistically significant differences between the subgroups should be focused on prognosis and designing tailored management approaches for the patients; our findings will contribute to achieve this important goal for treating patients with DM1.

국민건강보험청구 자료를 이용한 진료에피소드 자료 구축 (Construction of Medical Episode Data using National Health Insurance Service Data)

  • 박해용;박윤숙
    • 융합정보논문지
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    • 제9권9호
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    • pp.195-200
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    • 2019
  • 국민건강보험 청구자료는 급여 지급을 위한 자료로 질환에 대한 유병 및 발생자료는 아니므로 보건학적 연구 자료로 활용하기 위해서는 진료에피소드개념을 적용하여 재가공이 필요하다. 따라서 건강보험 청구자료의 보건학적 연구 자료로 활용하기 위한 시범적 진료에피소드 자료를 구축하는 것이 목적이다. 본 연구에서는 무진료기간을 퇴원한 당일 입원한 경우 월 단위 분리청구를 보정하기 위해 0으로 정의하였다. 서울지역에 한하여 호흡기계 질환(ICD10: J00-J99)및 심혈관계 질환(ICD10: I00-I99) 발생의 진료개시일부터 입원 이후 재입원까지 경향을 확인하였다. 무진료기간이 0일 일 때 자료 감소율은 건강보험청구자료의 월 단위 분리청구건으로 인한 것으로 판단된다. 또한 의료기간 종별에 따라 월 단위 분리청구 경향 차이가 있는 것으로 확인 하였다. 본 연구를 통해 구축된 시범적 진료에피소드자료는 기초적 역학정보를 산출하는 자료처리 기법으로 이용될 수 있을 것이다.

심한 임신성 비염 환자에서 미세분쇄기를 이용한 하비갑개 수술: 증례보고 (Treatment of Severe Pregnancy Rhinitis Using Microdebrider-Assisted Inferior Turbinoplasty: A Case Report)

  • 신단비;이정온;천태욱;이태훈
    • Journal of Rhinology
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    • 제25권2호
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    • pp.103-107
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    • 2018
  • Pregnancy rhinitis is a relatively common condition. It is characterized by the presence of nasal symptoms, especially nasal congestion, not present prior to pregnancy, but typically present during the last 6 or more weeks of pregnancy, without other signs of respiratory tract infection or any known allergic causes, and disappearing completely within 2 weeks after delivery. Nasal saline irrigation, intranasal steroid spray, and oral antihistamines are usually recommended as the first line of treatment for rhinitis. However, most pregnant women refuse medical treatment for pregnancy rhinitis because of the fear of teratogenicity. Severe pregnancy rhinitis increases the risk of snoring, which has been suggested as having adverse effects on the fetus. In cases where the patients are unable to control their symptoms, pregnancy rhinitis can negatively affect the quality of life (QOL) as well as the pregnancy outcome. Therefore, special caution is required for determining the appropriate diagnosis and treatment modalities for pregnancy rhinitis. Here, we report for the first time, the successful treatment of pregnancy rhinitis that was unresponsive to conservative management and medical therapy by using microdebrider-assisted inferior turbinoplasty at the final stages of pregnancy, along with a review of the relevant literature.

Knowledge and perceptions of kangaroo mother care among health providers: a qualitative study

  • Pratomo, Hadi;Amelia, Tiara;Nurlin, Fatmawati;Adisasmita, Asri C.
    • Clinical and Experimental Pediatrics
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    • 제63권11호
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    • pp.433-437
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    • 2020
  • Background: Indonesia is one of the countries with the highest preterm birth rate. Preterm infants are more likely than term and normal weight infants to experience neonatal mortality and morbidity due to acute respiratory, gastrointestinal, immunologic, central nervous system, hearing, and vision problems. Kangaroo mother care (KMC) is a proven cost-effective intervention to help reduce mortality rates among preterm infants; however, it has not been fully implemented in hospitals. Purpose: Assess KMC knowledge and perceptions among health providers. Methods: This qualitative study was conducted from December 2015 to April 2016 and consisted of 21 in-depth interviews and 3 focus group discussions (FGDs). The 3 categories of health personnel in the study were clinical providers, hospital management representatives, and Indonesian Midwife Association members. Results: Most health providers know about the benefits of KMC including stabilizing temperatures, weight gain, and maternal-infant bonding and reducing human resources and labor costs. They were also aware of which newborns were eligible for KMC treatment. Their knowledge was mostly gained from observation or obtained from pediatricians and personal experience. They believed that a low birth weight infant in an incubator could not be treated with KMC and that it could only be practiced if a special gown was used when holding the baby. This perception could be caused by a lack of formal KMC training, leading to misunderstanding of its aspects. Conclusion: In conclusion, KMC knowledge of clinical providers in the 2 hospitals was sufficient, primarily due to their health-related educational background. Some perceptions could be potential barriers to or facilitate the implementation of KMC practice. These perceptions should be considered in future KMC training designs.