• Title/Summary/Keyword: Referral

검색결과 635건 처리시간 0.027초

Fertility preservation in women with cancer

  • Lee, Sanghoon;Song, Jae Yun;Ku, Seung Yup;Kim, Sun Haeng;Kim, Tak
    • Clinical and Experimental Reproductive Medicine
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    • 제39권2호
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    • pp.46-51
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    • 2012
  • Fertility preservation (FP) is an effort to retain the fertility of cancer patients, and as an emerging discipline, it plays a central role in cancer care. Because of improvement in diagnostic and therapeutic strategies, an increasingly large number of patients are surviving with cancer. FP specialists should make an effort to spread the significance of FP among reproductive women with cancer and provide appropriate education both for associated physicians and for cancer patients who wish to preserve their fertility. Physicians who take part in the initial diagnosis and management of cancer should consider the importance of early referral of young cancer patients to FP specialists and take care of those patients by providing timely information and appropriate counseling. Individualized treatment strategies should be delivered depending on the patient's situation with appropriate team approach.

Scoring System and Management Algorithm Assessing the Role of Survivin Expression in Predicting Progressivity of HPV Infections in Precancerous Cervical Lesions

  • Indarti, Junita;Aziz, M. Farid;Suryawati, Bethy;Fernando, Darrell
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권3호
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    • pp.1643-1647
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    • 2013
  • Background: To identify the risk factors and assess the role of survivin in predicting progessivity precancerous cervical lesions. Materials and Methods: This case-control study was conducted from October 2009 until May 2010. We obtained 74 samples, classified according to the degree of cervical intraepithelial neoplasia (CIN): 19 samples for CIN 1, 18 samples for CIN 2, 18 samples for CIN 3, and 19 samples as controls. Demographic profiles and risk factors assesment, histopathologic examination, HPV DNA tests, immunocytochemistry (ICC) and immunohistochemistry (IHC) staining for survivin expression were performed on all samples. Data was analyzed with bivariate and multivariate analysis. Results: Multivariate analysis revealed significant risk factors for developing precancerous cervical lesions are age <41 years, women with ${\geq}2$ sexual partners, course of education ${\geq}13$ years, use of oral contraceptives, positive high-risk HPV DNA, and high survivin expression by ICC or IHC staining. These factors were fit to a prediction model and we obtained a scoring system to predict the progressivity of CIN lesions. Conclusions: Determination of survivin expression by immunocytochemistry staining, along with other significant risk factors, can be used in a scoring system to predict the progressivity of CIN lesions. Application of this scoring system may be beneficial in determining the action of therapy towards the patient.

Initial Diagnosis of Functional Gastrointestinal Disorders in Children Increases a Chance for Resolution of Symptoms

  • Trivic, Ivana;Hojsak, Iva
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제21권4호
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    • pp.264-270
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    • 2018
  • Purpose: The aim of this study was to describe functional gastrointestinal disorders (FGID) presented in a tertiary medical center, characteristics of patients and results of the diagnostic work-up together with an outcome during the follow up. Methods: This was a retrospective, single center, observational study including all patients who were diagnosed with FGID based on Rome III criteria from January to December 2015 in tertiary medical center. Results: Overall 294 children were included (mean age, 8.9 years [range, 1-18 years]; 165 females). Majority had functional constipation (35.4%), followed by functional abdominal pain (30.6%), irritable bowel syndrome (17.0%), functional dyspepsia (12.6%), functional nausea (3.4%) and abdominal migraine (1.0%). Regression model found that only significant factor associated with improvement of symptoms is the establishment of the functional diagnosis at the first visit (hazard ratio, 2.163; 95% confidence inverval, 1.029-4.544). There was no association between improvement of symptoms and presence of alarm signs/symptoms (weight loss, nocturnal symptoms and severe vomiting) at diagnosis. Furthermore, in pain symptoms (functional abdominal pain, irritable bowel syndrome, dyspepsia) no treatment positively correlated with pain improvement. Conclusion: Regardless of the initial diagnosis of FGID, positive diagnosis at the first visit increases a chance for resolution of symptoms.

일개 중소 도시의 종합병원에서 검사자에 따른 신생아청각선별검사의 비교 (Comparison of Newborn Hearing Screening Tests Depending on the Examiners in a General Hospital in a City)

  • 정유선
    • 농촌의학ㆍ지역보건
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    • 제43권3호
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    • pp.172-179
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    • 2018
  • Objectives: To review the status of newborn hearing screening (NHS) and to investigate the effect of the examiners on NHS tests to help the quality control of NHS at a general hospital in a city. Methods: The charts of newborns from January 2015 to March 2016 and from August 2016 to October 2017 were retrospectively reviewed. We compared the results of tests performed by several examiners(group 1) with those performed by one audiologist (group 2) using the same automated auditory brainstem response test. Results: The screening rate and referral rate were not significantly different between group 1 and group 2. The confirmatory test rate was higher in the group 2, but it was not significant. In group 1, the number of tests performed 3 or more times in one ear at one time was significantly higher. The number of tests performed in only one ear at one time was higher in group 2. The screening rate within one month after birth was 64.21%, referral rate was 7.32%, confirmatory test rate within 3 months after birth was 21.74%, and the prevalence of hearing loss was 1.46%. Conclusions: There was no significant difference of results depending on the examiners. In order to make proper screening test, it is necessary to periodically educate the examiner and to instruct the examiner by the supervisor doctors.

개에서 발생한 소화기계 이물에 대한 회고분석 - 143 증례 (Retrospective Study of 143 Dogs with Alimentary Foreign Bodies)

  • 최지혜;계서연;김현욱
    • 한국임상수의학회지
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    • 제32권1호
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    • pp.49-55
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    • 2015
  • This study was retrospectively investigated the clinical features, diagnostic imaging, treatment, and prognosis of foreign bodies according to alimentary site and type of foreign body, in 143 dogs. Among 28 breeds, Maltese, Shih Tzu, and terriers including the Yorkshire terrier were presented with high prevalence. Bone was the most commonly identified (33%) foreign body regardless of alimentary site. Approximately 76% of foreign bodies were in the stomach and small intestine. All esophageal foreign bodies were diagnosed on survey radiography, with the most common location being the caudal thoracic esophageal segment. Further diagnostic examinations including ultrasonography or contrast studies were additionally performed to detect radiolucent foreign bodies and perforation or leakage in the stomach and intestine. However, most seeds could be identified based on the characteristic features such as hyperdense thin double lines and inner gas on survey radiography. In conclusion, complications such as peritonitis and intestinal perforation were mainly observed in cases with seeds and linear foreign bodies. Especially, fabric foreign bodies could be induce peritonitis and re-perforation with high prevalence after surgical correction.

고령자를 위한 공공도서관 지역정보서비스에 관한 연구 (A Study on Community Information Services for Elderly People in Public Libraries)

  • 김다은;차미경
    • 한국비블리아학회지
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    • 제27권2호
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    • pp.213-233
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    • 2016
  • 고령화 사회가 진행됨에 따라 공공도서관의 고령 이용자도 증가하고 있어 이들을 위한 서비스의 개발이 요구된다. 고령자에게 필요한 정보는 건강, 의료, 복지 등 지역과 밀접한 일상생활 관련한 정보가 많으며, 이는 공공도서관에서 제공하는 지역정보서비스의 주요 영역이기도 하다. 본 연구에서는 고령자에게 필요한 지역정보의 유형 및 내용, 제공 방법 등을 문헌연구, 해외사례조사 및 국내 현황조사를 통하여 정리하고 공공도서관의 지역정보서비스를 통한 고령자 서비스 강화 방안을 제안하였다.

의료기관 에이즈 상담간호사 직무의 타당성 (Validation of Job Analysis for Hospital HIV/AIDS Nurse Counselor)

  • 백희정;조희;한종숙
    • 가정∙방문간호학회지
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    • 제19권2호
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    • pp.173-182
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    • 2012
  • The purpose of this study is to identify the appropriateness and validity of the HIV/AIDS nurse counselor's job, and to propose the job description. Mixed method was used: nominal group interview was used as a qualitative research and a survey was used as a quantitative research. Three of the nominal group members evaluated the appropriateness of the duties and tasks. To identify the validity of the evaluated duties and tasks, importance, difficulty and frequency were surveyed by 14 nurses who were working at the hospital as a HIV/AIDS nurse counselors. For the HIV/AIDS nurse counselor, 7 duties and 35 tasks - infection control of the HIV/AIDS, counseling, client advocacy, development of the educational material, referral to the resources, referral services at the hospital, and self-improvement - were identified. Proposed job description will be used as a reference for the role position and the training curriculum of the HIV/AIDS nurse counselors who are working at the hospital.

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Ovarian Malignancy Probability Score (OMPS) for Appropriate Referral of Adnexal Masses

  • Arab, Maliheh;Honarvar, Zahra;Hosseini-Zijoud, Seyed-Mostafa
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권20호
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    • pp.8647-8650
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    • 2014
  • Background: Ovarian cancer is the most common cancer cause of gynecologic cancer deaths. In order to increase the likelihood of patient survival through primary operation by gyneco-oncologists, an appropriate algorithm for referral is considered here. Materials and Methods: Suspicious adnexal mass cases including ovarian malignancy probability score-1 (OMPS1) scores between 2.3-3.65 are re-evaluated by OMPS2. Sensitivity and specificity of each score were determined. Results: Sensitivity and specificity with a 3.82 score of OMPS2 in the studied subgroup (OMPS1 scores between 2.3-3.65) were 64% and 76.9% respectively. Conclusions: Management of OMPS1 scores of below 2.3 with sensitivity of 100% and above 3.65 with specificity of 72.9% is clear. In the subgroup of cases with OMPS1 score between 2.3-3.65, OMPS2 is helpful for triage with a cutoff score of 3.82.

Comparison of p16INK4a Immunocytochemistry with the HPV Polymerase Chain Reaction in Predicting High Grade Cervical Squamous Intraepithelial Lesions

  • Indarti, Junita;Fernando, Darrell
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권9호
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    • pp.4989-4992
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    • 2013
  • Aim: To compare p16INK4a immunocytochemistry with the HPV polymerase chain reaction in predicting high grade cervical squamous intraepithelial lesions. Materials and Methods: This diagnostic case-control study was conducted from January 2010 until December 2010. We obtained 30 samples, classified according to the degree of cervical intraepithelial neoplasia (CIN): 11 samples for CIN 1, 9 samples for CIN 2, and 10 samples for CIN 3. HPV PCR, p16INK4a immunocytochemistry, and histopathological examination were performed on all samples. Statistical analysis was conducted using SPSS 20.0. Results: In predicting CIN 2-3, we found p16INK4a to have similar specificity and positive predictive value as HPV PCR (95%, 97.2% vs 96.7%), but better sensitivity (87.5% vs 72.5%) and negative predictive value (82.1% vs 67.6%). The most prevalent types of high-risk HPV in our study were HPV 33, 35, 58, 52, and 16. Conclusions: p16INK4a has better diagnostic values than HPV PCR and may be incorporated in the triage of ASCUS and LSIL to replace HPV PCR. Genotype distribution of HPV differs in each region, providing a challenge to develop HPV vaccines based on the epidemiology of HPV in that particular region.

다발성 골 융해를 동반한 림프종 증례 (A Case of B Cell Lymphoma Presenting with Multiple Osteolysis in a Juvenile Golden Retriever)

  • 최지혜;이진수;김현욱;최을수
    • 한국임상수의학회지
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    • 제29권1호
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    • pp.98-102
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    • 2012
  • A 1.5-year-old male Golden Retriever was presented with worsening lameness of two month duration. Abnomral findings of blood works and serum chemistry included anemia, thrombocytopenia, hypercalcemia and hyperglobulinemia. Radiography revealed osteolysis of polyostotic regions including right femur and tibia, bilateral ilium, and spinous processes from the 13th thoracic vertebra to 5th lumbar vertebra. Enlarged multiple lymph nodes and mixed echo pattern of muscular region ventral to vertebra were observed with ultrasonography. Because concentrations of both parathyroid hormone and parathyroid hormone related peptide were all within reference ranges, humoral hypercalcemia by tumor was ruled out and extensive osteolysis was considered as the cause of hypercalcemia. Based on radiographic and ultrasonographic study, lymphoma, multiple myeloma and osteomyelitis were included in differential diagnosis. Fungal serologic test was negative. Monoclonal gammopathy was not found on serum protein electrophoresis. Cytological and histopathological examinations of the lytic lesions revealed neoplastic lymphoid proliferation, and B cell type clonal expansion was detected by polymerase chain reaction for the antigen receptor gene rearrangement. The case was diagnosed as B cell lymphoma involving polyostotic regions.