• Title/Summary/Keyword: treatment delays

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Perceptions regarding the multidisciplinary treatment of patients with severe trauma in Korea: a survey of trauma specialists

  • Shin Ae Lee;Yeon Jin Joo;Ye Rim Chang
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.322-328
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    • 2023
  • Purpose: Patients with multiple trauma necessitate assistance from a wide range of departments and professions for their successful reintegration into society. Historically, the primary focus of trauma treatment in Korea has been on reducing mortality rates. This study was conducted with the objective of evaluating the current state of multidisciplinary treatment for patients with severe trauma in Korea. Based on the insights of trauma specialists (i.e., medical professionals), we aim to suggest potential improvements. Methods: An online questionnaire was conducted among 871 surgical specialists who were members of the Korean Society of Traumatology. The questionnaire covered participant demographics, current multidisciplinary practices, perceived challenges in collaboration with rehabilitation, psychiatry, and anesthesiology departments, and the perceived necessity for multidisciplinary treatment. Results: Out of the 41 hospitals with which participants were affiliated, only nine conducted multidisciplinary meetings or rounds with nonsurgical departments. The process of transferring patients to rehabilitation facilities was not widespread, and delays in these transfers were frequently observed. Financial constraints were identified by the respondents as a significant barrier to multidisciplinary collaboration. Despite these hurdles, the majority of respondents acknowledged the importance of multidisciplinary treatment, especially in relation to rehabilitation, psychiatry, and anesthesiology involvement. Conclusions: This survey showed that medical staff specializing in trauma care perceive several issues stemming from the absence of a multidisciplinary system for patient-centered care in Korea. There is a need to develop an effective multidisciplinary treatment system to facilitate the recovery of trauma patients.

Pharmacotherapy for dementia (치매의 약물요법)

  • Youn, HyunChul;Jeong, Hyun-Ghang
    • Journal of the Korean Medical Association
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    • v.61 no.12
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    • pp.758-764
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    • 2018
  • Dementia is a clinical syndrome characterized by a cluster of symptoms and signs that manifest as difficulties in cognitive functions such as memory, psychological and psychiatric changes, and impairments in activities of daily living. As a result of worldwide trends of population aging, dementia has had a huge impact on public health in almost all countries. Disease modification therapies for dementia have not yet been developed. However, pharmacotherapy is essential in patients with dementia to combat delays in their cognitive and functional decline. In this article, we review the current pharmacotherapy for dementia. Three acetylcholinesterase inhibitors-donepezil, rivastigmine, galantamine-and memantine are the only medications that have been approved for the treatment of dementia. We present the indications, dose recommendations, side effects, and criteria for National Health Insurance coverage in Korea of these medications for dementia treatment. Although the Ministry of Food and Drug Safety in Korea has not approved any medications for managing the behavioral and psychological symptoms of dementia, some antipsychotics and antidepressants have been studied and used clinically for those purposes. Clinicians may consider vitamin E, Ginkgo biloba extract, choline alfoscerate, or omega-3 fatty acids as additional treatment options. Non-steroid anti-inflammatory drugs, estrogen hormone therapy, and statins are not generally recommended for dementia treatment. We believe that our findings will aid clinicians in the treatment of patients with cognitive decline.

Femoral Neuropathy due to Iliacus Muscle Hematoma in a Patient on Warfarin Therapy

  • Kong, Woo-Keun;Cho, Keun-Tae;Lee, Ho-Jun;Choi, Jae-Sung
    • Journal of Korean Neurosurgical Society
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    • v.51 no.1
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    • pp.51-53
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    • 2012
  • Spontaneous hematomas of the iliacus muscle are rare lesions and these are seen in individuals receiving anticoagulation therapy or patients with blood dyscrasias such as hemophilia. It can cause femoral neuropathy and resultant pain and paralysis. Although there is no clear consensus for the treatment of femoral neuropathy from iliacus muscle hematomas, delays in the surgical evacuation of hematoma for decompression of the femoral nerve can lead to a prolonged or permanent disability. We report here on a rare case of a spontaneous iliacus muscle hematoma that caused femoral neuropathy in a patient who was taking warfarin for occlusive vascular disease and we discuss the treatment.

DYNAMIC ANALYSIS FOR DELAYED HCV INFECTION IN VIVO WITH ANTI-RETRO VIRAL TREATMENT

  • Krishnapriya, P.;Hyun, Ho Geun
    • Nonlinear Functional Analysis and Applications
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    • v.26 no.3
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    • pp.629-648
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    • 2021
  • In this paper, we study a within-host mathematical model of HCV infection and carry out mathematical analysis of the global dynamics and bifurcations of the model in different parameter regimes. We explore the effect of reverse transcriptase inhibitors (RTI) on spontaneous HCV clearance. The model can produce all clinically observed patient profiles for realistic parameter values; it can also be used to estimate the efficacy and/or duration of treatment that will ensure permanent cure for a particular patient. From the results of the model, we infer possible measures that could be implemented in order to reduce the number of infected individuals.

Koebner Phenomenon Delays Therapeutic Effect of Pulsed Dye Laser on Refractory Psoriasis

  • Park, Jae Wan;Shin, Sun Hye;Han, Hye Sung;Yoo, Kwang Ho
    • Medical Lasers
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    • v.9 no.1
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    • pp.62-64
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    • 2020
  • Psoriasis is a common chronic inflammatory skin disease that is histopathologically characterized by abnormal differentiation and hyperproliferation of keratinocytes, infiltration of T lymphocytes, and alternations of the dermal vasculature. Pulsed dye laser (PDL) is commonly used to treat cutaneous vascular lesions, and it has been studied for the treatment of localized psoriatic lesions. A 30-year-old female patient with refractory psoriasis on her forehead was treated using PDL. After two sessions, the size of the psoriatic lesion increased, which might have occurred due to koebnerization. As the patient continued to receive PDL treatment, the lesion showed significant improvement with no recurrence on the one-year follow-up. We present here a case of refractory psoriasis treated with PDL and demonstrates an association between a delayed therapeutic effect and the Koebner phenomenon.

A surge in neglected shoulder dislocations and delayed surgical management due to the coronavirus disease 2019 lockdown in India

  • Sahu, Dipit;Gupta, Arun;Bansal, Samarjit S.
    • Clinics in Shoulder and Elbow
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    • v.24 no.4
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    • pp.265-271
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    • 2021
  • Four patients with shoulder problems that were traumatic in etiology presented to us with delays in seeking care ranging from 6 to 12 weeks due to the coronavirus disease 2019 (COVID-19) lockdown. The care of three cases (a 3-month-old neglected anterior shoulder dislocation with a greater tuberosity fracture in a 30-year old man, a 3-month-old neglected anterior shoulder dislocation in a 17-year old boy, and a 2-month-old neglected greater tuberosity fracture in a 31-year old man) was delayed due to the lockdown and the ensuing travel restrictions, while that of one case (a 6-week-old fracture-dislocation of the proximal humerus in a 55-year-old woman) was delayed because the patient was undergoing treatment for COVID-19 at the time of injury. This report intends to present the exceptional circumstances around these cases. The unique treatment challenges and their outcomes are also described to advise the surgeons of the nuances and difficulties in treating these injuries.

Lysophosphatidylethanolamine Treatment Delays Leaf Senescence and Improve Fruit Storability in Melon (Cucumis melo L.)

  • Hong, Ji-Heun
    • Horticultural Science & Technology
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    • v.30 no.2
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    • pp.158-161
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    • 2012
  • The influence of lysophosphatidylethanolamine (LPE) on anti-senescence of melon leaves and the change in fruit quality during the storage at low temperature were studied. In most of the crops, freshness of leaves is important factor for characteristics of fruits, such as sugar contents, color, and firmness. Melon ($Cucumis$ $melo$ L. cv. Prince) plants were sprayed with LPE at 5 and 3 weeks before commercial harvest. In upper part, LPE treatment showed slight high number of fresh leaf compared to no treatment (None). However, in lower part, LPE resulted in apparent inhibition effect on senescence, showing that lower side of melon plant kept fresh upon LPE application up to about 30%. The SSC of melon treated with LPE was similar to that of fruit from None at harvest. There was no change in soluble solids content (SSC) for all treatment during the storage at $7^{\circ}C$. There were no significant differences in firmness of mesocarp from melons given different treatments at harvest. The firmness of mesocarp from melon treated with LPE was higher than none after 2 weeks storage. The electrolyte leakage means for melon treated with LPE did not differ significantly from the means at initial storage after 2 weeks storage among the treatments. None increased 57% from its initial electrolyte leakage during storage. These results suggest that the application of LPE may have potential to inhibit senescence of leaves and maintain fruit quality during the storage in melon.

The impact of waiting time and delayed treatment on the outcomes of patients with hepatocellular carcinoma: A systematic review and meta-analysis

  • Feng Yi Cheo;Celeste Hong Fei Lim;Kai Siang Chan;Vishal Girishchandra Shelat
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.1
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    • pp.1-13
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    • 2024
  • Hepatocellular carcinoma (HCC) is the sixth most diagnosed cancer worldwide. Healthcare resource constraints may predispose treatment delays. We aim to review existing literature on whether delayed treatment results in worse outcomes in HCC. PubMed, Embase, The Cochrane Library, and Scopus were systematically searched from inception till December 2022. Primary outcomes were overall survival (OS) and disease-free survival (DFS). Secondary outcomes included post-treatment mortality, readmission rates, and complications. Fourteen studies with a total of 135,389 patients (delayed n = 25,516, no delay n = 109,873) were included. Age, incidence of male patients, Child-Pugh B cirrhosis, and Barcelona Clinic Liver Cancer Stage 0/A HCC were comparable between delayed and no delay groups. Tumor size was significantly smaller in delayed versus no delay group (mean difference, -0.70 cm; 95% confidence interval [CI]: -1.14, 0.26; p = 0.002). More patients received radiofrequency ablation in delayed versus no delay group (OR, 1.22; 95% CI: 1.16, 1.27; p < 0.0001). OS was comparable between delayed and no delay in HCC treatment (hazard ratio [HR], 1.13; 95% CI: 0.99, 1.29; p = 0.07). Comparable DFS between delayed and no delay groups (HR, 0.99; 95% CI: 0.75, 1.30; p = 0.95) was observed. Subgroup analysis of studies that defined treatment delay as > 90 days showed comparable OS in the delayed group (HR, 1.04; 95% CI: 0.93, 1.16; p = 0.51). OS and DFS for delayed treatment were non-inferior compared to no delay, but might be due to better tumor biology/smaller tumor size in the delayed group.

Electrochemical Properties of FeS2 Thin Film Electrodes for Thermal Batteries (열전지용 FeS2 박막전극의 전기화학적 특성)

  • Im, Chae-Nam
    • Journal of the Korean Institute of Electrical and Electronic Material Engineers
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    • v.30 no.5
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    • pp.318-324
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    • 2017
  • Powder compaction technology is widely used to prepare thermal battery components. This method, however, is limited by the size, thickness, and geometry of the battery components. This limitation leads to excessive cell capacity, overweight, and higher cost of the pellets, which decreases the specific capacities and delays the activation time of thermal batteries. $FeS_2$ thin-film cathodes were fabricated by tape-casting technology and analyzed by SEM and EDS in this paper. The residual organic binder of the $FeS_2$ thin-film cathodes decreased with the temperature of the heat treatment, which improved the specific capacity because of the lower resistance. Specific capacities of the $FeS_2$ thin-film cathodes decreased because of the higher residual binder and the restrictive reaction of active materials with molten salts as the thickness increased. $FeS_2$ thin-film cathodes showed much higher specific capacity (1,212.2 As/g) than pellet cathodes (860.7 As/g) at the optimal heat-treatment temperature ($230^{\circ}C$).

Analysis of external environmental factors affecting patient transport time

  • LEE, Hyeryeong;PARK, Sang Woong;YUN, Eunjeong;KIM, Dakyeong;CHOI, Hea Kyung
    • The Korean Journal of Food & Health Convergence
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    • v.8 no.6
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    • pp.11-17
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    • 2022
  • Emergency transport is directly related to the life of the patient, and rapid transport to the hospital is crucial. However, external environmental factors such as traffic or weather, interfere with hospital transport. In this study, we investigated the external environment affecting hospital transport time. We examined the transfer time and patient treatment time of emergency patients in an area of northern Gyeonggi-do from 2018 to 2020. Diagnosis after arrival at the hospital was used, and on-site treatment time was measured from paramedic arrival time at the scene to departure. Furthermore, we examined whether there was a correlation between the time paramedics left the scene and hospital arrival time through the reason for the delay as recorded in the emergency log. Traffic jams had the greatest impact on patient transport, while transport delays occurred due to heavy rain, but not snow. Among injured patients, electrical accidents were the most problematic in terms of on-site treatment time. This was because a lot of first aid is needed in electrical accidents. It must be necessary to mobilize two ambulances in an emergency through the expansion of infrastructure, prepare a plan for rapid transport in heavy rain, and implement strong laws against transport obstruction.