• Title/Summary/Keyword: Pain Term

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Modified Zhu Ling Tang Administration for Asymptomatic Microhematuria Due to Suspicion of Kidney Trauma Following a Motor Vehicle Accident: a Case Report (교통사고 이후 신장외상 의심소견에 의한 무증상성 미세혈뇨의 저령탕 가감 투여 경과 : 증례보고)

  • Kim, Bo-min;Jo, Hee-geun
    • The Journal of Internal Korean Medicine
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    • v.40 no.3
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    • pp.551-556
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    • 2019
  • Objectives: This study aimed to introduce a clinical case of asymptomatic microhematuria due to suspicion of kidney trauma following a motor vehicle accident. Methods: A 19-year-old male was hospitalized with the chief complaint of back pain after a motor vehicle accident. He showed an elevated urine red blood cell (RBC) level in the laboratory test, although no specific traumatic lesions were present on the body. He was assessed to have asymptomatic microhematuria, and Zhu Ling Tang (polyporus decoction) was given to him to be taken three times daily. Results: After the treatment, the level of urine red blood cells returned to normal range. Adverse events were not observed. Conclusions: Zhu Ling Tang caused a short-term improvement in the urinalysis levels of a patient with asymptomatic hematuria. However, further studies are needed, as this study is only a single-case report.

Current Diagnostic Methods for Periprosthetic Joint Infection

  • Lee, Jiyoung;Park, Heechul;Bae, Jinyoung;Hyun, Hyanglan;Kim, Sunghyun
    • Biomedical Science Letters
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    • v.28 no.1
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    • pp.1-8
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    • 2022
  • Total joint arthroplasty is a successful joint replacement treatment that improves joint function and overall quality of life and provides pain relief. However, the prevalence of periprosthetic joint infection (PJI) has become prevalent with the rise in the incidence of arthroplasty surgery. PJI occurs rarely following arthroplasty however presents with serious complications, including high morbidity. The identification of causative microorganisms is essential for the treatment of PJI. Managing PJI requires complex treatment strategies, including long-term antibacterial treatment, and significant medical costs can be incurred. The American Academy of Orthopedic Surgeons, the Centers for Disease Control and Prevention, and Surgical Care Improvement Project guidelines recommend that prophylactic antibiotics such as first-generation cephalosporins be infused completely 1 hour before surgical incision. However, these preventative antibiotics are very limited, therefore risk factors must be identified to diagnosis and treat patients effectively. Moreover, determining antimicrobial susceptibility during artificial joint surgery and choosing the most appropriate treatment strategy following an accurate diagnosis of microbial infections are essential. In the present review, we describe the management, including the etiology, diagnosis, and classification of PJI, and approaches to its diagnosis using the available novel molecular diagnostic methods.

The Effect of Problem-Based Learning for Patient Safety on Self-Leadership, Patient Safety Competencies, and Reflective Thinking of Nursing Students

  • Park, Jung-Ha;Yun, Ji-Ah;Park, Kyoung-Duck
    • International journal of advanced smart convergence
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    • v.11 no.2
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    • pp.194-204
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    • 2022
  • This study is a one-group pretest-posttest design to evaluate the effect of problem-based learning (PBL) for patient safety on self-leadership, patient safety competencies, and reflective thinking of nursing students. The research was conducted from March 2 to April 15, 2022, in which 57 nursing students participated. PBL for patient safety was examined in a total of 8 sessions in the order of motivation, problem identification, task performance planning, problem-solving methods, summary and solution, presentation, and evaluation. The following topics of patient safety were selected for each team: nursing records, high-alert medication, medication error and intravenous fluid regulation, blood transfusion care, fall, bedsore, infection control, and pain management. We provided feedback on the learning process and outcomes of nursing students. According to the results, self-leadership showed a statistically significant improvement in self-expectations (t=2.60, p=0.01), goal setting (t=2.84, p<0.01), self-reward (t=3.32, p<0.01), and self-criticism (t=2.32, p=0.02). Patient safety competencies showed a statistically significant improvement in patient safety knowledge (t=13.05, p<0.001) and patient safety skills (t=4.87, p<0.001) but not in reflective thinking. The results prove that PBL for patient safety is an effective teaching-learning strategy to improve self-leadership and patient safety competencies. Future studies must develop and validate specific and long-term teaching-learning methods to improve reflective thinking.

Prolongation of the effect of a single dose of rocuronium in a patient with postpolio syndrome under desflurane anesthesia: a case report

  • Kimura, Yukifumi;Nitta, Yukie;Shibuya, Makiko;Fujisawa, Toshiaki
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.3
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    • pp.233-237
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    • 2022
  • Postpolio syndrome (PPS) is widely known to manifest as muscle weakness in patients affected by poliomyelitis in early childhood. This is caused by the long-term overwork of motor nerves regenerated from surviving nerve cells. We report a characteristic delay in recovery from muscle relaxation after administering rocuronium to a patient with PPS under general anesthesia with desflurane. A 59-year-old woman was scheduled to undergo surgical debridement for jaw osteonecrosis. She had a history of poliomyelitis at the age of 2 years, and was diagnosed with PPS at the age of 51 years. General anesthesia was induced with 80 mg propofol, 50 ㎍ fentanyl, and 30 mg (0.69 mg/kg) rocuronium, and maintained with desflurane and remifentanil. The durations of train-of-four (TOF) count 0 and 1 were 96 and 37 min, respectively. Five minutes after discontinuing desflurane, the TOF count was 4. Three minutes after administering 200 mg sugammadex, the TOF ratio was 0.83, and the tracheal tube was subsequently removed. In summary, the effect of a single dose of rocuronium on twitch in TOF monitoring was significantly prolonged in a patient with PPS, which may have been exacerbated by desflurane.

Thoracic Fetiform Teratoma: A Case Report of a Very Rare Entity in a Peruvian Hospital

  • Ludwig Caceres-Farfan;Wildor Samir Cubas;Franco Alban;Jorge Mantilla-Vasquez;Johny Mayta-Rodriguez;Karen Mendoza-Guerra
    • Journal of Chest Surgery
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    • v.56 no.4
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    • pp.282-285
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    • 2023
  • Mature fetiform teratoma, or homunculus, is a term coined for a rare variant of teratoma with a prevalence of 0.01% of teratomas. There have been very few cases reported in the world, and its thoracic presentation is extremely unusual. We present the case of a 31-year-old female patient with a history of progressive chest pain in the left hemithorax, associated with dyspnea on moderate exertion and cough. Imaging studies revealed a large intrathoracic tumor visually compatible with a teratoma. Surgical resection by a clamshell approach was successful, and subsequent anatomopathological studies of the operative specimen concluded that the mass was a mature fetiform thoracic teratoma. The treatment of this entity is generally surgical and includes wide resection due to its large adhesive component to surrounding tissues. Thus, the cardiothoracic surgeon must know approaches that allow wide resection, making these cases true surgical challenges.

Outcomes of the GentleWave system on root canal treatment: a narrative review

  • Hernan Coaguila-Llerena;Eduarda Gaeta;Gisele Faria
    • Restorative Dentistry and Endodontics
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    • v.47 no.1
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    • pp.11.1-11.11
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    • 2022
  • This study aimed to describe the outcomes of the GentleWave system (GW) (Sonendo) on root canal treatment. Published articles were collected from scientific databases (MEDLINE/PubMed platform, Web of Science, Scopus, Science Direct and Embase). A total of 24 studies were collected from August/2014 to July/2021, 20 in vitro and 4 clinical. GW System was not associated with extrusion of the irrigant, promoted faster organic dissolution than conventional syringe irrigation (CSI), passive ultrasonic irrigation (PUI) continuous ultrasonic irrigation (CUI) and EndoVac, reduced more bacterial DNA and biofilm than PUI and CUI, promoted higher penetration of sodium hypochlorite into dentinal tubules than PUI and CUI in vitro, and removed more intracanal medication than CSI and PUI. GW was able to remove pulp tissue and calcifications. Moreover, its ability to remove hard-tissue debris and smear layer was better than that of CSI, and its ability to remove root canal obturation residues was lower or similar to that of PUI, and similar to that of CSI and EndoVac. Regarding root canal obturation of minimally instrumented molar canals, GW was associated with high-quality obturation. Clinically, the success rate of endodontic treatment using GW was 97.3%, and the short-term postoperative pain in the GW group was not different from CSI. Further research, mainly clinical, is needed to establish whether GW has any advantages over other available irrigation methods.

De Novo Vertebral Artery Dissecting Aneurysm after Parent Artery Occlusion of the Contralateral Vertebral Artery

  • Yuichiro Tsuji; Sho Murase; Yuzo Kuroda; Masahiko Wanibuchi
    • Journal of Korean Neurosurgical Society
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    • v.67 no.1
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    • pp.115-121
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    • 2024
  • After treatment of unilateral vertebral artery dissecting aneurysm (VADA), de novo VADA rarely occurs on the contralateral side. In this article, we report a case of subarachnoid hemorrhage (SAH) due to de novo VADA in the contralateral vertebral artery (VA) 3 years after parent artery occlusion of unilateral VADA, with a review of the literature. A 47-year-old woman was admitted to our hospital complaining of headache and impaired consciousness. Head computed tomography showed SAH, and three-dimensional computed tomography angiography showed a fusiform aneurysm in the left VA. We performed an emergency parent artery occlusion. Three years and 3 months after the initial treatment, the patient presented to our hospital with complaints of headache and neck pain. Magnetic resonance imaging revealed SAH, and magnetic resonance angiography revealed de novo VADA in the right VA. We performed a stent-assisted coil embolization. The patient had a good postoperative course and was discharged with a modified Rankin scale score of 0. Long-term follow-up is necessary in patients with VADA because contralateral de novo VADA can develop even several years after the initial treatment.

Short-Term Results of Osteochondral Autologous Transfer and Femoral Neck Osteochondroplasty for the Treatment of Osteochondral Lesions of the Femoral Head and Concomitant Femoroacetabular Impingement Syndrome: A Case Series

  • Fernando Diaz-Dilernia;Franco Astore;Martin Buttaro;Gerardo Zanotti
    • Hip & pelvis
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    • v.34 no.3
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    • pp.177-184
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    • 2022
  • This study aimed to analyse the initial results of five patients with symptomatic osteochondral lesions (OCL) and femoroacetabular impingement (FAI) who were treated successfully with osteochondral autologous transfer (OAT) and femoral neck osteochondroplasty (OCP) through surgical dislocation of the hip. Five patients with FAI and OCL of the femoral head who underwent surgery between 2015-2018 were studied retrospectively. All patients had a grade IV OCL, and the median defect size was 2 cm2 (interquartile range [IQR], 2-2). At the final follow-up, the modified Harris hip score showed a median value of 94 (IQR, 91-95) (P=0.04). Pain evaluation using the visual analogue scale showed a median value of 1 (IQR, 1-2) (P=0.04). Adequate graft union and healthy formation of the chondral surface were observed by magnetic resonance imaging. Although the procedure is demanding, the combination of OAT and femoral neck OCP appears to be an effective alternative in young patients.

Knowledge, Attitude, and Behavior Status on Oral Health Care of Geriatric Care Workers in Long-Term Care Facilities (장기요양시설 요양보호사의 구강건강관리에 대한 지식, 태도, 행동)

  • Jeon, Hyun-Sun;Han, Sun-Young;Chung, Won-Gyun;Choi, Jong-Hoon
    • Journal of dental hygiene science
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    • v.15 no.5
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    • pp.569-576
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    • 2015
  • The aim of this study was to assess the oral health knowledge, attitude and behavior among geriatric care workers in long-term care facilities. A self-administered questionnaire was obtained from 212 geriatric care workers attending a professional education program of 2014 dementia pilot project. The questionnaire consisted of 4 parts of the training experience (2 items), knowledge (16 items), attitude (13 items), and behavior (4 items) on oral health care. Collected data were analyzed by frequency analysis, independent t-test, and one-way ANOVA using SPSS Statistics ver. 20.0. The percentage of educational experience on oral care was 27.9% and most respondents answered that they have received the education about denture cleaning (98.3%) and brushing method (91.4%). The average knowledge score was $10.88{\pm}1.70$, and respondents showed high-level agreement in 8 of the 10 items in attitude questions. They revealed difficulties in providing oral care to the elderly people because of their lack of knowledge. The deficiencies of knowledge about oral care would have a decisive effect on not only oral and general health, but also quality of life of the elderly people. Therefore, it is required to develop professional oral care training programs for geriatric care workers and support systems should be legalized.

Long-Term Results of Surgical Treatment for Sacral Chordoma (천추 척색종의 수술적 치료 후 장기 추시 결과)

  • Chung, Jae-Yoon;Lee, Jae-Joon;Seo, Hyoung-Yeon;Jung, Sung-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.148-154
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    • 2005
  • Purpose: To evaluate the long term results of surgical treatment for sacral chordoma. Material and Method: We reviewed the records of 4 patients with sacral tumor treated surgical resection. Mean follow-up duration was 8.3 year(3~11). All cases were performed complete resection of tumor mass through posterior approach in 3 cases and anterior-posterior approach in one. The most caudad nerve-roots spared were the second sacral roots in one and the third sacral roots in 3 cases. Functions of voiding and defecation including neurological symptoms of lower extremities, other complications of surgical treatment, and local recurrence or distant metastasis of tumor were evaluated. Result: There was no motor deficit in all cases, but radiating pain was developed in one and wound infection in one. Bladder function was preserved in 2 cases, intermittent incontinence in one, and doing intermittent catheterization in one. Bowel function was preserved in one and 2 cases were suffered from constipation. At the last follow-up, disease-free was in one, local recurrence in one, and local recurrence with distant metastasis in one. Conclusion: The result of surgical resection for sacral chordoma is satisfactory showing average 8 years survival. Early detection and aggressive surgical treatment is the best to prolong survival and to minimize functional deficit with preservation of upper sacral nerves.

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