• Title/Summary/Keyword: Patient blood management

Search Result 284, Processing Time 0.022 seconds

Identification of Germline BRCA1 Mutations among Breast Cancer Families in Northeastern Iran

  • Kooshyar, Mohammad Mahdi;Nassiri, Mohammadreza;Mahdavi, Morteza;Doosti, Mohammad;Parizadeh, Amirreza
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.14 no.7
    • /
    • pp.4339-4345
    • /
    • 2013
  • Background: The purpose of this study was to evaluate the prevalence of BRCA1 (MIM: 113705) founder mutations in familial breast cancer (BC) patients with high risks in Iran. BRCA1 is among the cancer susceptibility genes best known for high penetrance mutations. BRCA1 genotyping is now used to determine patient counseling, management decisions, and prognosis of this syndrome. Materials and Method: Thirty nine patients with clinical BC and 29 high risk healthy women, related to the patients, participated in the study. DNA from blood samples was extracted and analyzed by PCR and SSCP methods in order to find 185delAG and 5382insC founder mutations. In addition, a 251bp fragment of BRCA1's exon 11 was amplified and analyzed for determination of new mutations. Results: The data indicated the presence of 185delAG and 5382insC founder mutations in both groups studied. Two out of 39 BC patients (5.1%) and one out of 29 relatives (3.4%) were suspected to be carriers of 185delAG mutations. However, we found only one patient (2.6%) to be a carrier of a 5382insC mutation. Also, 2 women (5.1%) of the patient group and 3 n (10.3%) of relatives group were identified as carriers of unclarified mutations in the 251bp fragment of the BRCA1 gene. The carriers of BRCA1 founder mutations have a high lifetime risk of breast cancer. Conclusions: Therefore, these data are useful in counseling of individuals with a significant family history of breast cancer.

Dental Treatment of an AIDS Patient with Cerebral Infarction History and Hepatitis Type B Under General Anesthesia (뇌경색 및 B형 간염을 동반한 후천성 면역 결핍증 환자의 전신 마취 하 치과치료)

  • Ji, Sang-Eun;Kim, Jong-Soo;Kim, Chul-Hwan;Kim, Seung-Oh
    • Journal of The Korean Dental Society of Anesthesiology
    • /
    • v.14 no.4
    • /
    • pp.237-241
    • /
    • 2014
  • Acquired Immune Deficiency Syndrome is the state which develops after complications with the infection from HIV. Irrespective of their state, all HIV infections have infectivity. According to a 2013 U.N. AIDS global report, the number of reported newly infected with HIV is constantly falling, while that of Korea has been increasing over recent years and it surpassed 10,000 in 2013. This phenomenon might be attributed to the unusualness of the blood test for early detection of HIV infection. From this fact, we can assume that we have strong possibilities for encounters with infections in the office. But many misconceptions about the disease makes patients try to hide their medical history, which can lead to a nationwide spread of the infection without proper management. Even though it may be difficult to take care of HIV patients in smaller dental offices, large scale hospitals have the means to arrange protocols to treat them. We present a case about dental treatment of a patient with AIDS that has a history of cerebral infarction and hepatitis type B under general anesthesia. The purpose of this case report was to discuss the special considerations of dental care for patients with HIV.

Successful Management of Post-Traumatic Hydrocephalus and Pseudomeningocele Following Traumatic Brain Injury in a Cat

  • Hyoung-Won Seo;Jeong-Min Lee;Hae-Boem Lee;Yoon-Ho Roh;Tae-Sung Hwang;Kun-Ho Song;Joong-Hyun Song
    • Journal of Veterinary Clinics
    • /
    • v.40 no.1
    • /
    • pp.56-61
    • /
    • 2023
  • A 5-month-old female domestic short-haired cat presented with a history of seizure episodes for two months following an animal bite injury to the head. There were no remarkable findings on physical and neurological examination or blood analysis. Computed tomography revealed a fracture of the left parietal bone with an inward displacement of the bone fragment while magnetic resonance imaging revealed an enlarged temporal horn of the left lateral ventricle and a pseudomeningocele compressing the adjacent cerebral parenchyma. Subsequently, cerebrospinal fluid analysis results were normal. The patient was diagnosed with traumatic brain injury (TBI), with subsequent post-traumatic hydrocephalus (PTH) and pseudomeningocele. Despite treatment with phenobarbital and levetiracetam, seizures were not sufficiently controlled. Craniectomy for bone fragment removal and duraplasty were performed after a week. The patient then returned to normal condition with no further seizure activity. On repeated MRI two months after discharge, the hydrocephalus of the lateral ventricle and pseudomeningocele were enlarged; however, the patient maintained a good clinical status without any neurological signs. To the best of our knowledge, PTH and intracranial pseudomeningoceles have not yet been reported in cats. PTH and pseudomeningocele are among the complications of TBI and may not have any significant relevance with the clinical signs in this case. Thus, to broaden our knowledge about PTH and pseudomeningocele in cats, we describe serial changes in the clinical findings of this cat over the treatment period.

Health Behaviors in Hypertensive Patients (고혈압 환자들의 건강형태)

  • 황정희;강복수;윤성호;김석범;이경수
    • Korean Journal of Health Education and Promotion
    • /
    • v.17 no.1
    • /
    • pp.115-130
    • /
    • 2000
  • This study was conducted to examine health behaviors in hypertensive patients and the factors that would affect these healthy life-styles. and to provide basic data for effective and continuous hypertension control in private medical facilities. Among those patients diagnosed as hypertension who had visited the Department of Internal Medicine of Yeungnam University Hospital during the two month period from August 2 to September 30, 1999, the present study included 222 patients who were in more than one month after the initial diagnosis of hypertension and those who had hypertension for less than 10 years. Using a structured questionnaire, the present study was conducted by a self-administered survey method, and the obtained data were analyzed with t-test, $x^2$-test and one-way analysis of variance using the SPSS statistical program. The scores on knowledge related to hypertension were higher as the education level of a patient was higher(p〈0.05). As for occupation, those who performed office or management jobs showed higher scores than those who were into manufacturing jobs, and as for economic status, although those patients who were in middle class showed highest scores, however, no statistical significance was observed. The scores of knowledge on hypertension was higher when the family history of hypertension was present(p〈0.05). The scores of health-related behaviors were higher with higher education level and higher economic status, higher in those with family history of hypertension, and higher in those with office or management jobs than those who had manufacturing jobs(p〈0.05). Blood pressure measurement on regular basis was performed most frequently in those who were between 50-59 years old with 83.3% and was least frequent in those who were older than 70 years old with 50%(p〈0.05). The frequency of regular blood pressure measurement was higher with higher education level, higher economic status, higher in those with family history of hypertension, and the highest in those with management position with 93.5%, however, on statistical significance was observed. Changes in health-related behaviors after hypertension diagnosis were higher with higher education level, higher economic status, and in those patients performed office or management work. In particular, diet change was observed in female and higher economic status and smoking cessation was observed in 60-69 years old. Housewives and office workers or managers have taken exercise more regularly and those who had management jobs and had high scores on knowledge related to hypertension would participate health education program more actively. Thus, for improving health-related behaviors for continuous management of hypertension, changes in health-related behaviors can be followed through conduction health education to improve understanding of knowledge related to hypertension as the method of helping to improve changes in health life-styles in those with little education and those in low economic status.

  • PDF

Streptococcal Toxic Shock Syndrome Occurred during Postoperative Radiotherapy in a Cancer Patient with Preexisting Lymphedema and Chronic Illness -Case Report- (수술 후 림프부종과 만성질환을 동반한 종양 환자에서 방사선치료 기간 동안 발생한 연쇄구균독소충격증후군 예)

  • Jang, Ji-Young;Oh, Yoon-Kyeong;Kim, Dong-Min
    • Radiation Oncology Journal
    • /
    • v.24 no.4
    • /
    • pp.317-321
    • /
    • 2006
  • A case is reported of a man with malignant fibrous histiocytoma (MFH) in right thigh who developed streptococcal toxic shock syndrome (STSS) during postoperative radiotherapy. Before radiotherapy, a patient complained wax and wane lymphedema following wide excision of tumor mass which was confirmed as MFH. He took some nonsteroidal antiinflammatory drug (NSAID) for about one month. He suffered preexisting hepatitis C virus (HCV) infection, diabetes and well-controlled hypertension. The patient received conventional radiotherapy to right thigh with a total dose of 32.4 Gy at 1.8 Gy per day. At last radiotherapy fraction, cutaneous erythematous inflammation was suddenly developed at his affected thigh. At that time, he also complained of oliguria, fever and chills. The patient was consulted to internal medicine for adequate evaluation and management. The patient was diagnosed as suggested septic shock and admitted without delay. At admission, he showed hypotension, oliguria, constipation, abnormal renal and liver function. As a result of blood culture, Streptococcus pyogenes was detected. The patient was diagnosed to STSS. He was treated with adequate intravenous antibiotics and fluid support. STSS is one of oncologic emergencies and requires immediate medical intervention to prevent loss of life. In this patient, underlying HCV infection, postoperative lymphedema, prolonged NSAID medication, and radiotherapy may have been multiple precipitating factors of STSS.

Comparision of cardiovascular and analgesic effects of epidural administration of medetomidine, medetomidine-buprenorphine and medetomidine-fentanyl in dogs anesthetized with isoflurane (Isofourane으로 마취된 개에 medetomidine, medetomidine-buprenorphine, medetomidine-fentanyl의 경막외 투여 시 심혈관계 반응과 진통효과의 비교)

  • Chang, Hwa-Seok;Kim, Hye-Jin;Choi, Chi-Bong;Lee, Jung-Sun;Kim, Hwi-Yool
    • Korean Journal of Veterinary Research
    • /
    • v.47 no.1
    • /
    • pp.103-115
    • /
    • 2007
  • The aim of this study was to compare the reaction of the cardiovascular system, and the anesthetic effect among 3 experimental groups, epidural administration of medetomidine as a single agent, the combination of buprenorphine and medetomidine, and the combination of fentanyl and medetomidine. Twenty one dogs were anesthetized with isoflurane and allowed to breathe spontaneously. Epidural, arterial, and venous catheters were inserted. The tip of epidural catheter was positioned at the level of the space between the sixth and seventh lumbar vertebra. After a stable plane of anesthesia was achieved, these dogs were each administered one of the following treatments epidurally : medetomidine $10{\mu}g/kg$ (Group M), a combination of medetomidine $5{\mu}g/kg$ and buprenorphine $10{\mu}g/kg$ (Group M/B), and a combination of medetomidine $5{\mu}g/kg$ and fentanyl $10{\mu}g/kg$ (Group M/F). Heart rate (HR), Respiratory rate (RR), End-tidal carbon dioxide (EtCO2), and arterial blood pressure were measured before drug administration (base line) and 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, and 60 min postinjection. Blood gas analysis was performed before injection and 5, 15, 25, 35, 45, 60 min postinjection. Isoflurane was discontinued 80 min postinjection and pain/motor function were evaluated up to 260 min postinjection every 15 min. At the early stage of drug introduction (until 5 min), the HR was decreased significantly in all 3 groups compared with base line. In Group M, HR was significantly decreased compared with the other 2 groups. With time (starting 20 min after drug introduction), the HR was decreased significantly in Group M/B in respect to base line. However, no significant difference was seen number-wise in all 3 groups. During 60 min after drug introduction, the systolic, diastolic and mean arterial pressures were highest in Group M and lowest in Group M/F. Among 3 groups, drug action and motor loss duration were longest in Group M/F. Analgesic effect observed in the M/F group was the most prominent and long-lasting, compared to those seen in the other 2 groups. Given the fact that the recovery of motor function takes place in a short period of time after analgesic effects disappeared, additional use of M/F depending on the patient's condition would be a good way to achieve effective pain management. However, proper care should be taken to ensure the function of cardiovascular system in the patient because the administration of M/F under isoflurane anesthesia results in a significant decline in arterial blood pressure ($65{\pm}10mmHg$).

Dental Management in a Patient with Glanzmann's Thrombasthenia : A Case Report (글란즈만 혈소판무력증 환자의 치과적 관리)

  • Han, Miran;Kim, Jongsoo
    • Journal of the korean academy of Pediatric Dentistry
    • /
    • v.47 no.3
    • /
    • pp.352-358
    • /
    • 2020
  • Glanzmann's thrombasthenia (GT) is a rare, autosomal recessive inherited congenital disorder, characterized by impaired blood coagulation due to platelet dysfunction. It was first reported by the pediatrician Glanzmann in 1918. GT affects both males and females, and it is more common in regions of the Middle East, India, and France, where intermarriage is common. It has an incidence of about 1 in 1,000,000 people. In South Korea, according to the Division of Rare Diseases, Korea Centers for Disease Control and Prevention, around 200 cases have been reported in 2018. Clinical symptoms include petechia, ecchymosis, epistaxis, and gingival bleeding. The spontaneous loss of deciduous teeth can result in excessive bleeding with that blood transfusion should be considered. Preventing hemorrhages and hemostasis are most important factors in dental treatment. Local bleeding can be controlled by compression, but platelet transfusion can be required by prolonged bleeding. Pediatric dentists can minimize the gingival bleeding by control of the oral hygiene to prevent gingivitis and dental caries. The importance of oral hygiene and periodic recall check-up should be emphasized. During dental treatment, the examination and the treatment plan of patient should be modified to prevention of hemorrhages carefully. A 6-year-old girl with GT was referred for the treatment of dental caries, and resin restoration was performed under nitrous oxide inhalation sedation. After treatment, compression was required for the bleeding control.

The study of Health Care Utilization and Direct Medical Cost in the Diabetes Mellitus Client (당뇨병 질환자의 의료이용 및 직접의료비 연구)

  • Yoo, In Sook
    • The Journal of the Convergence on Culture Technology
    • /
    • v.1 no.4
    • /
    • pp.87-101
    • /
    • 2015
  • This study was aimed to make data how much spent money of medical utilization and direct medical cost. In order to research we were using Korea Health panel 2012 Statistics which data contained Diabetes mellitus client 812 people in age 19. The method of this study was emergency cost, admission medical cost, out patient department cost(client own due, National Health insurance service due, not insurance fee). The result of this study, Diabete Mellitus client were using 198 times during 1 year per 100, total medical direct cost were 859,942 won, 447,359 won, 363,255,508. And admission times were 5.6 times per year, total direct cost was 772,240 won, 4,061,982 won, and 3,298,329,384 won, and out patient clinic using number was 10 times, medical cost total direct cost containing total direct cost was 11,978 won, 26,020 won, and 21,129,240 won. From this research we conclusion that the occurrence of diabetes mellitus can be increased medical cost and direct medical cost and it can be huge burden to client including their family and quality of life in the future. We suggest that in order to prevention and management of diabetes mellitus healthy diet, activity, blood sugar, and blood management should be encouragement.

Design and Implementation of a Cardiac Arrest Supporting System Using Wearable Device (웨어러블 기기를 사용한 심정지 환자 지원 시스템의 설계 및 구현)

  • Jang, Jin-Soo;Lee, Seo-Joon;Lee, Kwang-In;Lee, Tae-Ro
    • Journal of Digital Convergence
    • /
    • v.15 no.1
    • /
    • pp.227-238
    • /
    • 2017
  • Cardiac arrest is a serious intensive emergency disease that causes death within less than several minutes by depriving the body and brain of blood supply. Survival rate of cardiac arrest patients outside of hospitals is especially low. This is because pedestrians usually do not perceive the patient as a sick person, also, even if they do so, they have no medical knowledge to properly react to such emergency. The purpose of this study is to propose a solution that uses widely spread smart phones to alert pedestrians of the cardiac arrest patient, prevents cardiac arrest, and provides first-aid measures. By applying the proposed solution, cardiac arrest can be prevented in advance, pedestrians can be alerted to keep the golden time(4 minutes), and first witness can quickly proceed with CPR, ultimately enhancing the survival rate of the cardiac arrest patient.

Development of a Prototype Patient Monitoring System with Module-Based Bedside Units and Central Stations: Overall Architecture and Specifications (모듈형 환자감시기와 중앙 환자감시기로 구성되는 환자감시시스템 시제품의 개발: 전체구조 및 사양)

  • Woo, E.J.;Park, S.H.;Jun, B.M.;Moon, C.W.;Lee, H.C.;Kim, S.T.;Kim, H.J.;Seo, J.J.;Chae, K.M.;Park, J.C.;Choi, K.H.;Lee, W.J.;Kim, K.S.
    • Proceedings of the KOSOMBE Conference
    • /
    • v.1996 no.05
    • /
    • pp.315-319
    • /
    • 1996
  • We have developed a prototype patient monitoring system including module-based bedside units, interbed network, and central stations. A bedside unit consists of a color monitor and a main CPU unit with peripherals including a module controller. It can also include up to 3 module cases and 21 different modules. In addition to the 3-channel recorder module, six different physiological parameters of ECG, respiration, invasive blood pressure, noninvasive blood pressure, body temperature, and arterial pulse oximetry with plethysmogaph are provided as parameter modules. Modules and a module controller communicate with up to 1Mbps data rate through an intrabed network based on RS-485 and HDLC protocol. Bedside units can display up to 12 channels of waveforms with any related numeric informations simultaneously. At the same time, it communicates with other bedside units and central stations through interbed network based on 10Mbps Ethernet and TCP/IP protocol. Software far bedside units and central stations fully utilizes gaphical user interface techniques and all functions are controlled by a rotate/push button on bedside unit and a mouse on central station. The entire system satisfies the requirements of AAMI and ANSI standards in terms of electrical safety and performances. In order to accommodate more advanced data management capabilities such as 24-hour full disclosure, we are developing a relational database server dedicated to the patient monitoring system. We are also developing a clinical workstation with which physicians can review and examine the data from patients through various kinds of computer networks far diagnosis and report generation. Portable bedside units with LCD display and wired or wireless data communication capability will be developed in the near future. New parameter modules including cardiac output, capnograph, and other gas analysis functions will be added.

  • PDF