• Title, Summary, Keyword: treatment delays

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Analysis of Treatment and Delay Times by Disease Site and Delivery Technique at Samsung Medical Center - Proton Therapy Center

  • Jo, Kwanghyun;Ahn, Sung Hwan;Chung, Kwangzoo;Cho, Sungkoo;Shin, Eunhyuk;Hong, Chae-Seon;Park, Seyjoon;Kim, Dae-Hyun;Lee, Boram;Lee, Woo-Jin;Seo, Se-Kwang;Jang, Jun-Young;Choi, Doo Ho;Lim, Do Hoon;Han, Youngyih
    • Progress in Medical Physics
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    • v.27 no.4
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    • pp.258-266
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    • 2016
  • We have treated various disease sites using wobbling and scanning proton therapy techniques since December 2015 at the Samsung Medical Center. In this study, we analyze the treatment time for each disease site in 65 wobbling and 50 scanning patient treatments. Treatment times are longest for liver and lung patients using the respiratory gating technique in the wobbling treatment and for cranio-spinal irradiation in pediatric patients with anesthesia in the scanning treatment. Moreover, we analyze the number of incidents causing treatment delays and the corresponding treatment delay time. The X-ray panel was the main reason for delays in the wobbling treatment; this decreased continually from January to June 2016, related closely to the proficiency of the human operators involved. The main reason for delays in the scanning treatment was interlocks during scanning pattern delivery; this was resolved by proton machine engineers. Through this work, we hope to provide other institutes with useful insight for initial operation of their proton therapy machines.

Educational Levels and Delays in Start of Treatment for Head and Neck Cancers in North-East India

  • Krishnatreya, Manigreeva;Kataki, Amal Chandra;Sharma, Jagannath Dev;Nandy, Pintu;Rahman, Tashnin;Kumar, Mahesh;Gogoi, Gayatri;Hoque, Nazmul
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10867-10869
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    • 2015
  • Background: There are various patient and professional factors responsible for the delay in start of treatment (SOT) for head and neck cancers (HNC). Materials and Methods: This retrospective study was conducted on data for HNC patients registered at the hospital cancer registry in North-East India. All cases diagnosed during the period of January 2010 to December 2012 were considered for the present analysis. Educational levels of all patients were clustered into 3 groups; illiterates (unable to read or write), qualified (school or high school level education), and highly qualified (college and above). Results: In the present analysis 1066 (34.6%) patients were illiterates, 1,869 (60.6%) patients were literates and 145 (4.7%) of all patients with HNC were highly qualified. The stage at diagnosis were stage I, seen in 62 (34.6%), stage II in 393 (12.8%), stage III in 1,371 (44.5%) and stage IV in 1,254 (40.7%). The median time (MT) to the SOT from date of attending cancer hospital (DOACH) was, in illiterate group MT was 18 days, whereas in the qualified group of patients it was 15 days and in the highly qualified group was 10 days. Analysis of variance showed there was a significant difference on the mean time for the delay in SOT from DOACH for different educational levels (F=9.923, p=0.000). Conclusions: Educational level is a patient related factor in the delays for the SOT in HNCs in our population.

Epidemiology of Animal Bites and Factors Associated With Delays in Initiating Post-exposure Prophylaxis for Rabies Prevention Among Animal Bite Cases: A Population-based Study

  • Esmaeilzadeh, Firooz;Rajabi, Abdolhalim;Vahedi, Sajad;Shamsadiny, Mohammad;Ghojogh, Mousa Ghelichi;Hatam, Nahid
    • Journal of Preventive Medicine and Public Health
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    • v.50 no.3
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    • pp.210-216
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    • 2017
  • Objectives: One way to prevent deaths due to rabies is the timely utilization of post-exposure prophylaxis (PEP). Therefore, in addition to an understanding of the epidemiological distribution of animal bites, it is necessary to explore the factors leading to delays in PEP initiation. Methods: This cross-sectional study was conducted in Iran in 2011, and included 7097 cases of animal bites recorded at the Rabies Treatment Center of the Shiraz University of Medical Sciences using the census method. Logistic regression was used to identify factors associated with delays in PEP. Results: Among the patients studied, 5387 (75.9%) were males. The prevalence of animal bites in Fars province was 154.4 per 100 000 people. Dogs were the most frequent source of exposure (67.1%), and the most common bitten part of the body was the hands (45.5%). A delay in the initiation of PEP was found among 6.8% of the studied subjects. This delay was more likely in housewives (odds ratio [OR], 4.66; 95% confidence interval [CI], 2.12 to 10.23) and less likely in people with deep wounds (OR, 0.65; 95% CI, 0.43 to 0.97). Conclusions: Although all animal bite victims received complete PEP, in some cases, there were delays. Further, the type of animal involved, the depth of the bite, and the patient's occupation were the major factors associated with a delay in the initiation of PEP for rabies prevention.

The Effect of Parent Education Program Based on Sensory Integration Approach on the Parent's Understanding of Sensory Processing Ability of Children With Developmental Delays (감각통합접근 부모교육이 발달지체 아동의 감각처리능력에 대한 부모의 이해도에 미치는 효과)

  • Park, Hae-Seong;Kim, Kyeong-Mi;Chang, Moonyoung
    • The Journal of Korean Academy of Sensory Integration
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    • v.13 no.1
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    • pp.33-43
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    • 2015
  • Objective : The purpose of this study is to investigate the effect of parent education program with sensory integration approach on the parent's understanding of sensory processing ability of their own children with developmental delays. Methods : The period of this study is from March 15, 2015 to May 10, 2015. The participants of this study were thirty of parents who have children with developmental delays. The participants were randomly divided as experimental group (15 parents) and control group (15 parents) and an educational program was provided to those parents in the experimental group. The education program was developed based on sensory integration approach and 1:1 intensive individual counseling education. Short Sensory Profile (SSP) & a specially designed questionnaire were used to evaluate the parent's understanding of sensory processing ability of their children with developmental delays. The effect of between the groups was analyzed using an independent two samples t-test, and the effect of the intervention within a group was measured using the paired t-test. Results : After the intervention of parent education program, the total score of SSP was significantly decreased and the score of the parent questionnaire was significantly increased (p<.05). Conclusion : The results of this study show that parent education program with sensory integration approach is effective to improve the parent's understanding of sensory processing ability of their children with developmental delays. This study can be used as a good resource for therapists who is planning to provide sensory integration treatment for children with disabilities.

Medical Treatment of Breast Cancer Bone Metastasis: From Bisphosphonates to Targeted Drugs

  • Erdogan, Bulent;Cicin, Irfan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1503-1510
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    • 2014
  • Breast cancer bone metastasis causing severe morbidity is commonly encountered in daily clinical practice. It causes pain, pathologic fractures, spinal cord and other nerve compression syndromes and life threatening hypercalcemia. Breast cancer metastasizes to bone through complicated steps in which numerous molecules play roles. Metastatic cells disrupt normal bone turnover and create a vicious cycle to which treatment efforts should be directed. Bisphosphonates have been used safely for more than two decades. As a group they delay time to first skeletal related event and reduce pain, but do not prevent development of bone metastasis in patients with no bone metastasis, and also do not prolong survival. The receptor activator for nuclear factor ${\kappa}B$ ligand inhibitor denosumab delays time to first skeletal related event and reduces the skeletal morbidity rate. Radionuclides are another treatment option for bone pain. New targeted therapies and radionuclides are still under investigation. In this review we will focus on mechanisms of bone metastasis and its medical treatment in breast cancer patients.

Cost Optimization in SIS Model of Worm Infection

  • Kim, Jong-Hyun;Radhakrishnan, Sridhar;Jang, Jong-Soo
    • ETRI Journal
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    • v.28 no.5
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    • pp.692-695
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    • 2006
  • Recently, there has been a constant barrage of worms over the Internet. Besides threatening network security, these worms create an enormous economic burden in terms of loss of productivity not only for the victim hosts, but also for other hosts, as these worms create unnecessary network traffic. Further, measures taken to filter these worms at the router level incur additional network delays because of the extra burden placed on the routers. To develop appropriate tools for thwarting the quick spread of worms, researchers are trying to understand the behavior of worm propagation with the aid of epidemiological models. In this study, we present an optimization model that takes into account infection and treatment costs. Using this model we can determine the level of treatment to be applied for a given rate of infection spread.

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Evaluation of Upper-Limb Motor Recovery after Brain Injury: The Clinical Assessment and Electromyographic Analysis (뇌손상 후 상지 운동기능 회복 평가: 임상적 평가 및 운동반응 근전도 분석)

  • Kim, Young-Ho;Tae, Ki-Sik;Song, Sung-Jae
    • Physical Therapy Korea
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    • v.12 no.1
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    • pp.91-99
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    • 2005
  • We assessed whether the use of a symmetrical upper limb motion trainer in daily repetitive training for a 6-week period reduced spasticity and improved motor function in three chronic hemiparetic patients. Upper limb motor impairment and disability were measured by the Fugl-Meyer Assessment (FMA), Modified Ashworth Scale (MAS) and Manual Muscle Test (MMT), respectively. The electromyography (EMG) of the affected hand was recorded during isometric wrist flexion and extension. In all patients, FMA and MMT scores were significantly improved after the 6-week training. However, MAS scores of the affected wrist spasticity did not change considerably. Onset and Offset delays in muscle contraction significantly decreased in the affected wrist. The co-contraction ratio of flexor and extensor muscles significantly increased after the 6-week training. Onset and offset delays of the muscle contraction and co-contraction ratio correlated significantly with the patients' FMA. This study showed that repetitive, symmetric movement training can improve upper limb motor functions and abilities in chronic hemiparetic patients. Also, the EMG assessment of motor response is likely to provide insights into mechanisms and treatment strategies for motor recovery in chronic hemiparetic patients.

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An analysis of the causes of prehospital delays in patients with suspected acute stroke (급성 뇌졸중 의심 환자의 병원 전 지연 원인 분석)

  • Lee, Nam-Jin;Moon, Jun-Dong
    • The Korean Journal of Emergency Medical Services
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    • v.24 no.2
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    • pp.27-38
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    • 2020
  • Purpose: Stroke is a time-sensitive disease that could have reduced complications and mortality with timely diagnosis and treatment. This study aimed to analyze the causes of delay in detecting the clinical signs and symptoms of stroke. Methods: This retrospective observational study analyzed the emergency medical services reports of suspected stroke patients with positive predictive values on the Cincinnati Prehospital Stroke Scale. The study was conducted in Daejeon, Republic of Korea from January 1, 2016 through December 31, 2017. Results: Prolonged prehospital time was associated with high blood pressure, history of cerebrovascular disease, and incidences during daily activities, and sleep. High blood pressure and complications from a previous stroke strongly associated with the prolonged stroke-detection phase (p<.05). Total prehospital time was shortened when patients had evident stroke symptoms, such as decreased level of consciousness, dysarthria, and hemiplegia (p<.05). There was no significant difference in gender or age as a factor that delayed the total prehospital time of the suspected stroke patients. Conclusion: Many patients did not recognize the early clinical symptoms and signs of a stroke. Furthermore, risk factors, such as high blood pressure and history of stroke, prolonged the total prehospital time. Therefore, we need targeted interventions that educate about warning symptoms of stroke, along with emphasis on the importance of emergency calls to substantially reduce the prehospital delays.

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.