• Title/Summary/Keyword: Patient consultation

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Incidental occurrence of an unusually large mastoid foramen on cone-beam computed tomography and review of the literature

  • Syed, Ali Z.;Sin, Cleo;Rios, Raquel;Mupparapu, Mel
    • Imaging Science in Dentistry
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    • v.46 no.1
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    • pp.39-45
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    • 2016
  • The incidental finding of an enlarged mastoid foramen on the right posterior mastoid region of temporal bone is reported, together with a discussion of its clinical significance. A 67-year-old female underwent the pre-implant assessment of a maxillary left edentulous region. A cone-beam computed tomographic (CBCT) image was acquired and referred for consultation. Axial CBCT slices revealed a unilateral, well-defined, noncorticated, low-attenuation, transosseous defect posterior to the mastoid air cells in the right temporal bone. The borders of the osseous defect were smooth and continuous. No other radiographic signs suggestive of erosion or sclerosis were noted in the vicinity. The density within the defect was homogenous and consistent with a foramen and/or soft tissue. The patient's history and physical examination revealed no significant medical issues, and she was referred to a neuroradiologist for a second opinion. The diagnosis of an enlarged mastoid foramen was made and the patient was reassured.

Unrecognized intraorbital wooden foreign body

  • Kim, Young Ho;Kim, Hyonsurk;Yoon, Eul-Sik
    • Archives of Craniofacial Surgery
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    • v.19 no.4
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    • pp.300-303
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    • 2018
  • Intraorbital wooden foreign bodies may present difficulties in diagnosis due to their radiolucent nature. Delayed recognition and management can cause significant complications. We present a case report that demonstrates these problems and the sequela that can follow. A 56-year-old man presented with a 3-cm laceration in the right upper eyelid, sustained by a slipping accident. After computed tomography (CT) scanning and ophthalmology consultation, which revealed no fractures and suggested only pneumophthalmos, the wound was repaired by a plastic surgery resident. Ten days later, the patient's eyelid displayed signs of infection including pus discharge. Antibiotics and revisional repair failed to solve the infection. Nearly 2 months after the initial repair, a CT scan revealed a large wooden fragment in the superomedial orbit. Surgical exploration successfully removed the foreign body and inflamed pocket, and the patient healed uneventfully. However, the prolonged intraorbital infection had caused irreversible damage to the superior rectus muscle, with upgaze diplopia persisting 1 year after surgery and only minimal muscle function remaining. We report this case to warn clinicians of the difficulties in early diagnosis of intraorbital wooden foreign bodies and the grave prognosis of delayed management.

Mucosa-associated lymphoid tissue lymphoma on right lower eyelid previously diagnosed as lymphoid hyperplasia

  • Kim, Yang Seok;Na, Young Cheon;Huh, Woo Hoe;Kim, Ji Min
    • Archives of Craniofacial Surgery
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    • v.20 no.1
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    • pp.66-70
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    • 2019
  • Mucosa-associated lymphoid tissue (MALT) lymphoma is an uncommon form of non-Hodgkin lymphoma involving the mucosa-associated lymphoid tissue. Most commonly affected organ is the stomach. But, it could affect almost every organ in the whole body. If they have suspicious lesion, excision biopsy could be made. For staging, blood test including blood smear, abdomen and chest tomography or scan will be checked. Also, bone marrow test can be done if it is needed. The patient had visited the clinic for palpable mass on right lower eyelid. With excisional biopsy, it was diagnosed as lymphoid hyperplasia on pathologic test. But 2 years later, the patient came with recurrent symptom for our department with worry. At that time, we recommended excisional soft tissue biopsy under general anesthesia. Unfortunately, it was revealed MALT lymphoma on pathologic finding. It turned out to be stage 3 in Ann Arbor staging system without B symptoms. Hematologic consultation was made and she was treated with adjuvant chemotherapy for eight cycles to complete remission. We report a case of MALT lymphoma on subcutaneous tissue at right lower eyelid previously diagnosed as lymphoid hyperplasia.

Experience of Patients' Having Hypertension and Diabetes Participation in Health Care (고혈압 및 당뇨병 환자의 건강관련 의사결정 참여경험)

  • Lee, Jihae
    • The Journal of the Korea Contents Association
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    • v.21 no.3
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    • pp.552-560
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    • 2021
  • This study attempted to explore the experience of patients' having hypertension and diabetes participation in health care. 11 chronic patients who regularly visited community health centers for more than a year participated in this study. The data was collected through individual interviews and analyzed by thematic analysis method. As a result, 6 sub-themes and 3 themes derived from the data. The themes were 'Trying to utilize short consultation time efficiently', 'Answering within narrow limits to healthcare provider', 'Being lack of continuous motivation for health care'. The result showed the need for nurses to provide accurate and sufficient health information and motivate patients in supportive manner to encourage chronic patients' participation in health care.

Evolving the Cybersecurity of Clinical Photography in Plastic Surgery

  • Daisy L. Spoer;Alexandra Junn;John D. Bovill;Zoe K. Haffner;Andrew I. Abadeer;Stephen B. Baker
    • Archives of Plastic Surgery
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    • v.50 no.4
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    • pp.443-444
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    • 2023
  • Point-of-care photography and photo sharing optimize patient outcomes and facilitate remote consultation imperative for resident surgeons. This literature review and external pilot survey study highlight the risks associated with current practices concerning patient privacy and biometric security. In a survey of 30 plastic surgeon residents and attendings, we found that the majority took photos of patients with their iPhones and shared them with colleagues via Apple iMessage. These findings corroborate previous reports and highlight a lack of physician user acceptance of secure photo-sharing platforms. Finally, we frame a successful example from the literature in the context of a postulated framework for institutional change. Prioritizing the privacy and safety of patients requires a strategic approach that preserves the ease and frequency of use of current practices.

Development of Physician Coaching Model for Improvement of Patient-Doctor Communication (환자-의사 커뮤니케이션 개선을 위한 의사코칭 모델 개발)

  • Na, Hyun Sook;Kwon, Young Dae;Noh, Jin-Won
    • The Journal of the Korea Contents Association
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    • v.13 no.2
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    • pp.331-340
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    • 2013
  • Recently there is a heated debate going on regarding the patient-doctor communication in the medical schools and medical service sector. Patient-doctor communication is an interactive communication made during the consultation session which is known to bring positive effect to both the patient and the doctor. Through this research, a doctor coaching model was developed by combining a method that would help the patient and doctor communicate better by increasing the doctor's communication skill and a coaching mechanism. Through the research, the doctor coaching model consists of 5 levels. First is the 'relationship creation' which would cause the doctor's interest and expectations toward coaching mechanism. Second is 'recognition of change' and this would cause to understand the problem and pros of the doctor's communication with the patient and set a direction regarding the coaching. Third is 'understanding the perspective' and this would lead the doctor to think from the patient's perspective. Fourth is 'increasing problem solving and communication skills' and this would set specific terms as to how the doctor can improve his communication skills. Fifth is 'goal setting and support' where goal regarding the improvements can be set and agreement regarding the ways to maintain and strengthen the advantage can be made. The developed doctor coaching model is most meaningful in a way that it has first adapted a coaching mechanism to improve patient-doctor communication. Also in cases where such will be utilized in the future medical service sector, it is expected to affect greatly the doctor's communication skill and patient sympathizing skills. Hereby it will contribute in increasing the patient's treatment satisfaction.

Intelligence Type Electronic Medical Examination Chart and Data Treatment of Cyber Doctor to Interconnect ASP and SQL (ASP와 SQL을 연동한 사이버닥터의 지능형 전자진료차트와 데이터처리)

  • Kim Seok-Soo
    • Journal of Digital Contents Society
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    • v.4 no.1
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    • pp.57-66
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    • 2003
  • This paper presents the content regarding electronic medical examination chart and data treatment for efficient medical examination and prompt treatment by realizing mutual conversation type remote medical examination system among 3 parties(patient, doctor, pharmacist) on internet base. This is an intelligence type remote medical examination system for both on-line and off-line mode to transcend time and space on the web being participated by anybody, which is cheap type to solve problems in existing remote medical examination system such as high price based on hardware, incompatibility, and so on. By interconnecting ASP and SQL on IIS 4.0 web server, database enables system integration for efficient data processing, on-line consultation between patient and doctor, medical examination on off-line, transmission of medical prescription to pharmacist designated by patient and preparation of medicine, semi-eternal storage of medical examination data owing to storage and search of medical examination data, exact medical examination and prescription using this medical examination data by patient and doctor, and so on.

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Full mouth rehabilitation for a disabled patient: a case report (장애인 환자에서의 전악 수복 증례)

  • Kim, Ae-Ra;Vang, Mong-Sook;Park, Sang-Won;Lim, Hyun-Pil;Yun, Kwi-Dug;Yang, Hong-So
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.3
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    • pp.208-213
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    • 2013
  • The spectrum of physically challenged patients who visit to a dental clinic for treatments are diverse: from ones of mild disabilities, who lead their lives in a similar way of ordinary people, to others who suffer from diseases that are difficult to be diagnosed, and need medical expertise due to systemic care or special techniques and instruments because of behavior management and difficulty of treatments. The patient in this case was 25-year-old autistic male patient who visited the clinic on account of overall treatment for multiple carious lesions. He could perform normal daily life to some degree under the care of a guardian. This case report describes predicaments of making a treatment plan resulted from lack of information about disabled patients, and difficulties of proceeding treatment procedures under general anesthesia. It is considered that sufficient consultation and history taking are needed before treatment for disabled patients.

Radiotherapy for Brain Metastases in Southern Thailand: Workload, Treatment Pattern and Survival

  • Phungrassami, Temsak;Sriplung, Hutcha
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1435-1442
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    • 2015
  • Purpose: To study the patient load, treatment pattern, survival outcome and its predictors in patients with brain metastases treated by radiotherapy. Materials and Methods: Data for patients with brain metastases treated by radiotherapy between 2003 and 2007 were collected from medical records, the hospital information system database, and a population-based tumor registry database until death or at least 5 years after treatment and retrospectively reviewed. Results: The number of treatments for brain metastases gradually increased from 48 in 2003 to 107 in 2007, with more than 70% from lung and breast cancers. The majority were treated with whole brain radiation of 30 Gy (3 Gy X 10 fractions) by cobalt-60 machine, using radiation alone. The overall median survival of the 418 patients was 3.9 months. Cohort analysis of relative survival after radiotherapy was as follows: 52% at 3 months, 18% at 1 year and 3% at 5 years in males; and 66% at 3 months, 26% at 1 year and 7% at 5 years in females. Multivariate analysis demonstrated that the patients treated with combined modalities had a better prognosis. Poor prognostic factors included primary cancer from the lung or gastrointestinal tract, emergency or urgent consultation, poor performance status (ECOG 3-4), and a hemoglobin level before treatment of less than 10 g/dl. Conclusions: This study identified an increasing trend of patient load with brain metastases. Possible over-treatment and under-treatment were demonstrated with a wide range of survival results. Practical prognostic scoring systems to assist in decision-making for optimal treatment of different patient groups is absolutely necessary; it is a key strategy for balancing good quality of care and patient load.

Web Based Tele-Medicine System including Security Scheme (웹기반 원격진료시스템에서 암호화인증방식이 적용된 회원관리기법)

  • Kim, Seok-Soo
    • Convergence Security Journal
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    • v.5 no.1
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    • pp.19-27
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    • 2005
  • This paper presents the content regarding electronic medical examination chart and data processing for efficient medical examination and fast treatment by realizing remote medical examination system of mutual conversation type among 3 parties(patient, doctor, pharmacist) on internet base, and establishment of database enabled system integration for efficient data processing in both on-line and off-line mode by interconnecting ASP and SQL on IIS 4.0 web server, consultation between patient and doctor, medical examination on off-line mode, transmission of prescription sheet to the pharmacist designated by patient, preparation of medicine, semieternal storage of medical examination data owing to storage and check of medical examination data, more accurate medical examination and prescription using this medical examination data by patient and doctor, and so on. And, data processing between doctor and pharmacist is differently performed based on class such as general member and charge member, and service access right pursuant to this is endowed, so that certification of each member must follow by all means.

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