• Title/Summary/Keyword: Patient blood management

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Risk factors associated with repeated epidural blood patches using autologous blood

  • Oh, Ah Ran;Park, Jungchan;Jeong, Ji Seon;Lee, Jin Young;Choi, Ji Won;Kim, Hara;Sim, Woo Seog
    • The Korean Journal of Pain
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    • v.35 no.2
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    • pp.224-230
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    • 2022
  • Background: An epidural blood patch (EBP) is a procedure to treat intracranial hypotension that does not respond to conservative treatment. EBPs are commonly repeated when the symptoms persist. In this study, we used a large single-center retrospective cohort and evaluated the factors associated with repeated EBPs. Methods: From January 2010 to December 2020, a total of 596 patients were treated with EBPs for intracranial hypotension. We evaluated the factors associated with repeated EBPs in the entire population, in patients with spontaneous intracranial hypotension (SIH), and in those with available myelographies. Results: In a total of 596 patients, 125 (21.1%) patients required repeated EBPs, and 96/278 (34.5%) in SIH and 29/314 (9.2%) in iatrogenic population. In patients with SIH, international normalized ratio (INR) and cerebrospinal fluid (CSF) leakage on myelographies consistently exhibited significant associations (odds ratio [OR], 1.38; 95% confidence interval [CI], 1.02-1.87; P = 0.043 and OR, 2.18; 95% CI, 1.28-3.69; P = 0.004). In patients with iatrogenic injury, INR and CSF leakage on myelogram did not show difference in repeated EBPs. Conclusions: Repeated EBPs may be more frequently required in patients with SIH. Prolonged INR and CSF leakage were associated with repeated EBPs in patient with SIH. Further studies are needed to determine factors associated with repeated EBP requirements.

Antihypertensive effect of Meridian Tai Ji exercise treatment in hypertension patients (고혈압 환자에서 경락도인태극권의 혈압강하 효과)

  • Shin, Mi-Suk;Han, Chang-Hyun;Kang, Kyung-Won;Choi, Sun-Mi
    • Korean Journal of Oriental Medicine
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    • v.14 no.1
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    • pp.67-72
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    • 2008
  • Objectives : The purpose of the study was to determine the effects of a 4 weeks Meridian Tai Ji exercise treatment on blood pressure reducing in hypertensive patients. Methods : We measured the blood pressure of 3 patients who were visited in the Gwacheon Health center from 21th November 2007 to 17th December 2007. Eligible participants had systolic blood pressure ${\geq}$ 120 mmHg or diastolic blood pressure ${\geq}$ 80 mmHg with antihypertensive drug. Blood pressure measurements were after the patient had been in rest for at least 10 minute. Twelve sessions of Meridian Tai Ji exercise treatment over 4 weeks were performed in the patients. Blood pressure were measured twice before and after each session. Results : After 4 weeks, blood pressure reduction was observed in the treatment patients, with an average decline of systolic blood pressure up to 5.67 mmHg and diastolic blood pressure up to 0.17 mmHg. But, it was not statistically significant. Blood pressure increased between measurements taken before and after an Meridian Tai Ji exercise treatment session, although individual responses were quite variable. No significant difference was found in the immediate effect. Conclusion : Twelve sessions of Meridian Tai Ji exercise treatment do not seem to control hypertension. Further research is required to determine whether Meridian Tai Ji exercise treatment can enhance clinical management of hypertension if it is used in combination with more enrolled participants, over longer periods, or randomized controlled trial.

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Sequential patient recruitment monitoring in multi-center clinical trials

  • Kim, Dong-Yun;Han, Sung-Min;Youngblood, Marston Jr.
    • Communications for Statistical Applications and Methods
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    • v.25 no.5
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    • pp.501-512
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    • 2018
  • We propose Sequential Patient Recruitment Monitoring (SPRM), a new monitoring procedure for patient recruitment in a clinical trial. Based on the sequential probability ratio test using improved stopping boundaries by Woodroofe, the method allows for continuous monitoring of the rate of enrollment. It gives an early warning when the recruitment is unlikely to achieve the target enrollment. The packet data approach combined with the Central Limit Theorem makes the method robust to the distribution of the recruitment entry pattern. A straightforward application of the counting process framework can be used to estimate the probability to achieve the target enrollment under the assumption that the current trend continues. The required extension of the recruitment period can also be derived for a given confidence level. SPRM is a new, continuous patient recruitment monitoring tool that provides an opportunity for corrective action in a timely manner. It is suitable for the modern, centralized data management environment and requires minimal effort to maintain. We illustrate this method using real data from two well-known, multicenter, phase III clinical trials.

A Case Report of a Patient with Myelodysplastic Syndrome Who Has Lower Back Pain (요통을 동반한 MDS 환자에 대한 관리 1례)

  • Joo, Seong-hee;Bae, Jung-han;An, So-yeon;Jang, Eun-gyeong;Lee, Jang-hoon;Kim, Young-chul
    • The Journal of Internal Korean Medicine
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    • v.39 no.2
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    • pp.230-236
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    • 2018
  • Objectives: This case aims to describe management of a patient with myelodysplasitc syndrome who has lower back pain. Methods: A 75-year-old female patient with myelodysplasitc syndrome was hospitalized from February 28, 2018 to March 14, 2018. The patient was treated with Azacitidine at Bundangjyesaeng Hospital, and lower back pain worsened without any reason. The patient was willing to undergo traditional Korean medical treatment, and Wonyuksayuk-tang was chosen considering both hematopoiesis dysfunction and lower back pain. Results: The patient was diagnosed with myelodysplatic syndrome after bone marrow aspiration and biopsy at Bundangjyesaeng Hospital. After the Wonyuksayuk-tang treatment, platelet levels increased about 50% compared with initial blood test results. In addition, lower back pain and general weakness were slightly improved. Conclusion: It is important to manage the quality of life of patients with myelodysplastic syndrome. This case suggests that traditional Korean medicine has a beneficial effect on the management of myelodysplastic syndrome.

A Design of Prescription management System using Network Analysis Technique (네트워크 분석 기법을 이용한 운동처방 관리시스템 설계 및 구현)

  • Kim, Kyoung-Hun;Song, Young-Jae
    • The Journal of the Korea Contents Association
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    • v.11 no.12
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    • pp.112-121
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    • 2011
  • It has become general common sense through numerous researches that exercise provides positive impacts on physical and mental health. And it has been reported that regular exercise adjusts obesity by reducing body fat and lipid levels found in the blood and ultimately, it improves human quality of life. In this study, indices for managing swimming exercise therapy were induced through prior researches and weighted value was measured by modelling correlations between indices by using fuzzy ANP (Analytic Network Process) technique. With the determined results, users can be provided with real-time individualized exercise prescription without space constraint. And patient management system was intended to be realized so that tailor-made management per patient can be established on real-time through mobile equipments such as portable phone, smart phone, notebook and etc.

Pulmonary Atresia with Intact Ventricular Septum (둔형 폐동맥 폐쇄증 1)

  • 손영상
    • Journal of Chest Surgery
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    • v.20 no.2
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    • pp.432-437
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    • 1987
  • Pulmonary atresia with intact ventricular septum is a extremely rare congenital cardiac anomaly. With the history of cyanosis and failure to thrive, this anomaly should not be excluded and emergency management is necessary. Our patient was 69 day-old male with pulmonary atresia which was confirmed by cardiac angiography. Prostaglandin E1 was used for maintenance of pulmonary blood flow preoperatively. Right ventricular outflow reconstruction with pericardial patch and concomitant pulmonary valvotomy were done on beating heart for palliation. With this method, growing of right ventricle and tricuspid annulus are highly expected.

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The Change of Derum and Urine Amylase Level Following Cardiopulmonary Bypass in the Patients with Congenital heart disease (선천성 심기형 환아에서 체외순환후 혈청 및 소변 Amylase치의 변화)

  • Baek, Hui-Jong;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.28 no.10
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    • pp.892-899
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    • 1995
  • Pancreatitis is a known complication of cardiac surgery with cardiopulmonary bypass. Although ischemia is believed to be a factor, the exact cause of pancreatitis after cardiopulmonary bypass remains unknown.We prospectively studied 67 consecutive patients undergoing cardiac surgery with cardiopulmonary bypass for evaluation of the pancreatic injury after cardiopulmonary bypas. Serial measurement of amylase level in serum and urine was done postoperatively. Hyperamylasemia was detected in 15 patients[22.4% , of whom no patient had pancreatitis. There was no significant difference between serum amylase level and parameters such as cardiopulmonay bypass time, aortic cross clamp time, mean blood pressure, rectal temperature, flow rate, and use of circulatory arrest during cardiopulmonary bypass. Hyperamylasuria was detected in 8 patients[11.9% , and urine amylase level was elevated significantly in the groups with prolonged cardiopulmonary bypass, mean blood pressure more than 40mmHg, and rectal temperature more than 20 $^{\circ}$C. We recommend that serum amylase level and/or amylase-creatinine clearance ratio is measured for ealy detection and management of pancreatitis after cardiopulmonary bypass.

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Effect of the Dietary Protein Level on Plasma Glucose, Lipids and Hormones in Streptozotocin-Diabetic Rats

  • Han Yung Joo
    • Journal of Nutrition and Health
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    • v.26 no.7
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    • pp.851-857
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    • 1993
  • Atherosclerotic vascular disease is a major cause of the increased morbidity and mortality assciated with diabetes mellitus. The prominent role of nutrition in hypercholesteolemia and atherosclerosis is generally accepted. Diet is a key element in the management of diabetes (type I-IDDM), yet the appropriate diet for patient with diabetes mellitus is not well known. Dietary protein has been shown to have a significant effect on plasma cholesterol levels in both experimental animals and humans. The present experiment was designed to determine the effect of the dietary protein level(20% vs 60%) on plasma glucose concentration, lipids profile, insulin and glucagon levels from non-diabetic and streptozotocin-induced diabetic rats. Results showed that a high protein diet decreased triglyceride concentration in diabetic rats. Also diabetic rats fed a high protein diet were hypocholesterolemic than rats fed a control diet. There were no effects by level of protein on fasting blood glucose concentration and insulin/glucagon ratio. Results from the present study suggest that a high protein diet may be beneficial to control pasma lipids in chemically-induced diabetic rats.

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Nursing Interventions of the Lupus Patient (루푸스(Lupus) 환자의 간호중재)

  • Kim, Myung-Ja;Sohng, Kyeong-Yae
    • Journal of muscle and joint health
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    • v.2 no.2
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    • pp.197-208
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    • 1995
  • The purpose of this study is to describe specific system manifestations and suggested nursing interventions in patients with lupus. Lupus is a chronic, inflammatory, multisystemic disorder of the immune system. Antibodies are formed which react against the person's own normal tissue. This abnormal response can be very damaging and leads to the many manifestations of the lupus. Lupus can affect any part of the body, and patients experience symptoms in organs involved. So lupus patients have integumentary, blood, central nervous system, eye, gastrointestinal, musculoskeletal, kidney, heart and lining membranes, reproductive system involvement. The courses are unpredictable and very individualized. Lupus varies greatly in severity from mild cases requiring minimal interventions to those in which significant damage occurs to vital organs such as the lungs, heart, kidney and brain which ultimately can be fatal. In addition to direct physical care, the nursing professional has an excellent position from which to support the lupus patient. Patients need assistance with receiving current, accurate information about the disease process and also to be helped in developing realistic expectations and goals. Nursing interventions for the patient with lupus is challenge drawing on at the resources, knowledge and strengths the nursing teams have to offer. Because of the unpredictable, highly individualized and frequently changing the nature of the disease itself as well as the intricacy of the patient's needs. The nurse has a key role in its management. The patient and nurse, working together, have much to offer each other. These are of inestimable value to the patient. As the nurse listens to the patient and learns what problems the patient perceives, can guide the patient in a self-help program that allows to adapt to living with a chronic illness.

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The Effect of Individual Education for Hypertensives at Home on Knowledge of Hypertension, Attitude about Chronic Disease, Self-care Management And Blood Pressue. (개별접촉 교육이 고혈압 환자의 지식$\cdot$태도와 자기건강관리 이행 및 혈압 변화에 미치는 영향)

  • Kim Myung Soon;Yang Young Hee
    • Journal of Korean Public Health Nursing
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    • v.9 no.2
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    • pp.52-68
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    • 1995
  • This is the quasi experimental study to evaluate the effect of individual health education for hypertensive patients at home on knowledge of hypertesnion, attitude about chronic disease, self-care management. The individual health education program was performed at each patient's home every one month through, 1 years. The first data collection was carried out in May 1991. and the last was done in July 1992 through questionaires. The study results were as follows; 1) The subjects were 22 hypertensive patients who agreed the participation of study among registered patients at a public health center in Incheon. They were consisted of thirteen males and nine females. And their duration of illness were average 5 years, their mean age were 65 years. The over all living conditions were poor and the average monthly income was 50 thousdand won. 2) The effect of individual health education through home visit was statistically significant. The Knowledge of hypertension (t= -4.40, p<.001), attitude about chronic disease (t=­2.65, p<.05), self-care management of the subjects were significantly improved. (t=-3.76, p<.001), and their blood pressure were decreased. 3) Between the knowledge of hypertesnion and the attitude about chronic disease showed significant positive relationship. But the self-care management had not relationship with these two factors. unexpectedly. 4) The knowledge of hypertension, attitude about chronic disease, and self-care management had not evenly influenced the control of hypertension. These results suggested that the effort needed to find out the other factors influencing self-care management and develop the self-care management measuring tool. And the health education programs for chronic patients were developed, systematically. And the standardized health education model was developed for home health care nursing intervention in community based.

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