• 제목/요약/키워드: Referral

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하악관절 동통, 기능장애 및 이갈이의 치 - 정신과적 분석연구 (A Case Study on Temporomandibular Dysfuncton, Pain and Bruxism)

  • Chung-Shik Lee
    • Journal of Oral Medicine and Pain
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    • 제15권1호
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    • pp.69-78
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    • 1991
  • This study was intended to review comprehensively the articles related to temporomandibular joint disorder patients and to analyze psychoanalytically the case with temporomandibular dysfunction and bruxism as a symptom of hysterical conversion disorder. As a result, the author found that , in the aspect of psychoanalysis, the temporomandibular problem and bruxism was a kind of symptom of emotional conflict being converted to the face. I would like to emphasize that the referral process and the ability to work as a therapeutic team including dentist and psychiatrist can enhance the probability of successful treatment for several types of patients.

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XML에 의한 디지털라이브러리 구현에 관한 연구 (A Study on Implementation of XML-based Digital Library)

  • 박재용
    • 경영과정보연구
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    • 제7권
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    • pp.1-20
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    • 2001
  • KORMARC used in library bibliographic information, had been pointed several weaknesses such as inflexibility lack of link information and compatibility. In addition, a sudden increase in digital information associated with development of internet is demanding an integration of web resources metadata as the resource of library information. This study mentioned XML/KORMARC system or adaption of XML standard format turned out to be the most efficient way to use KORMARC formats and to expand the range of those information service such as bibliographic information, factual information, referral information and full-text.

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Free flap thrombosis in patients with hypercoagulability: A systematic review

  • Biben, Johannes Albert;Atmodiwirjo, Parintosa
    • Archives of Plastic Surgery
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    • 제46권6호
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    • pp.572-579
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    • 2019
  • Background Even with satisfactory anastomosis technique and adequate experience of the surgeon, flap loss due to thrombosis can still occur due to the patient's underlying condition. Patients with hypercoagulability due to etiologies such as malignancy, hereditary conditions, and acquired thrombophilia are among those who could benefit from free flap procedures. This review aimed to evaluate the risk of free flap thrombosis in patients with hypercoagulability and to identify the most effective thromboprophylaxis regimen. Methods This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. The PubMed, Embase, and Cochrane Library databases were explored. Types of free flaps, types of hypercoagulable states, thrombosis prevention protocols, thrombosis complication rates, and flap vitality outcomes were reviewed. Samples from the included studies were pooled to calculate the relative risk of free flap thrombosis complications in patients with hypercoagulability compared to those without hypercoagulability. Results In total, 885 articles underwent title, abstract, and full-text screening. Six articles met the inclusion criteria. The etiologies of hypercoagulability varied. The overall incidence of thrombosis and flap loss in hypercoagulable patients was 13% and 10.3%, respectively. The thrombosis risk was two times higher in hypercoagulable patients (P=0.074) than in controls. Thromboprophylaxis regimens were variable. Heparin was the most commonly used regimen. Conclusions Hypercoagulability did not significantly increase the risk of free flap thrombosis. The most effective thromboprophylaxis regimen could not be determined due to variation in the regimens. Further well-designed studies should be conducted to confirm this finding.

Patients' Profile, Clinical Presentations and Histopathological Features of Colo-rectal Cancer in Al Hassa Region, Saudi Arabia

  • Amin, Tarek Tawfik;Suleman, Waseem;Al Taissan, Abdul Aziz;Al Joher, Abdul Latif;Al Mulhim, Othman;Al Yousef, Abdul Hameed
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권1호
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    • pp.211-216
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    • 2012
  • Background: Patients' demographics, presenting clinical and histopathological features for colo-rectal cancer (CRC) are important factors for patients' outcome and disease prognosis. This study aimed to describe the pattern of CRC in terms of patients' demographics, main presenting symptoms and histopathological features in Al Hassa region of Saudi Arabia. Subjects and Methods: A retrospective hospital records-based study which included reviewing of patients' records diagnosed with CRC at three general hospitals in Al Hassa region, Saudi Arabia. A compilation form was designed to collect information regarding socio-demographics, age at diagnosis; referral sites and the main presentations at CRC diagnosis. sites and the main presentations at CRC diagnosis. Histopathological reports were reviewed to delineate the main cytopathologic features, prominent cytological characteristics, the presence of predisposing pathology, and disease stage. Results: Of the 142 cases with CRC, 15.5% and 33.1% were affected before 40 and 50 years of age respectively. Emergency rooms were main referral sites for CRC cases (31.0%). Right colon was affected in 16.9% while left colonic lesions accounted for 62.7%. Intestinal obstruction was the main presentations (41.5%), and 26.1% presented with symptoms indicating distant metastastic lesions. Adenocarcinoma was the predominant pathological lesions (86.6%). Metastastic CRC was diagnosed in 62.7%. Duke's staging showed that 22.5% and 40.1% of lesions were classified into C and D categories respectively. Conclusion: Saudi patients with CRC present late with distant metastasis, and advanced disease stage. A sizeable proportion of patients developed the lesions at relatively young age. Screening recommendations should be enacted and revised in response to current change with younger age of affection.

2013 학생 정신건강 지역협력모델 구축·지원 사업 : 정신건강 고위험군 관리와 학교 내 정신건강 인식의 변화 (2013 Students' Mental Health School-Community Cooperative Model : Management of High Risk Students and Change in Awareness of Mental Health in School)

  • 김진아;하경희;홍현주;김희영
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제26권2호
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    • pp.94-103
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    • 2015
  • Objectives : The purpose of this study was to examine the results of the 2013 students' mental health school-community cooperative model. This study investigated teachers' awareness of change in school environment and analyzed the follow-up conditions of students. Methods : The sample consisted of 55 schools which participated in the 2013 students' mental health school-community cooperative model. Two questionnaires were used : one was composed of items about mental health resources, school policy and practice, school climate and community referral, and the other was on management of follow-up conditions for high risk students. Results : First, teachers' awareness regarding school mental health resources, school policy and practice, school climate, and community referral showed positive change. That is, the 2013 students' mental health school-community cooperative model works for improving teachers' interest, awareness and effort regarding mental health. Second, students, who were found by screening test and observation, were managed continually. Most students received follow-up interventions at school, and half of the students were referred to a specialized institution such as a mental health clinic, Wee center, personal counseling center, community welfare center, and so on. Conclusion : This study was a preliminary research, therefore follow-up studies are required in order to accomplish the 2013 students' mental health school-community cooperative model.

Fertility preservation for patients with breast cancer: The Korean Society for Fertility Preservation clinical guidelines

  • Kim, Hoon;Kim, Seul Ki;Lee, Jung Ryeol;Hwang, Kyung Joo;Suh, Chang Suk;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
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    • 제44권4호
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    • pp.181-186
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    • 2017
  • With advances in the methods of cancer treatment used in modern medicine, the number of breast cancer survivors has been consistently rising. As the number of women who wish to become pregnant after being diagnosed with breast cancer increases, it is necessary to consider fertility preservation in these patients. However, medical doctors may be unaware of the importance of fertility preservation among cancer patients because most patients do not share their concerns about fertility with their doctors. Considering the time spent choosing and undergoing treatment, an early referral to a reproductive specialist is the best way to prevent a delay in cancer treatment. Since it is not easy to make decisions on matters related to cancer diagnosis and fertility, patients should be provided with enough time for decision-making, and to allow for this, an early referral will provide patients with sufficient time to choose an appropriate method of fertility preservation. The currently available options of fertility preservation for patients with breast cancer include cryopreservation of embryos, oocytes, and ovarian tissue and gonadotropin-releasing hormone agonist treatment before and during chemotherapy. An appropriate method of fertility preservation must be selected through consultations between individual patients and health professionals and analyses of the pros and cons of different options.

지역사회 아동의 Korean-Age and Stage Questionnaire 타당도와 효용성 연구 (A Study on the Validity and Utility of Korean-Age and Stage Questionnaire for Children in Community)

  • 이성아;황상희
    • 한국산학기술학회논문지
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    • 제11권9호
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    • pp.3390-3397
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    • 2010
  • 본 연구의 목적은 지역사회 아동을 대상으로 발달지연 선별검사 중 부모-보고형 검사인 Korean-Ages and Stages Questionnaires(K-ASQ)의 타당도와 효용성을 알아보고자 하였다. 연구방법에서 연구대상은 선별검사에 동의한 229명 아동의 부모들과 유전적 질환 혹은 선천적 발달 지연이 보고되지 않은 3~5세 아동들이었다. 연구결과 K-ASQ는 민감도 0.41%, 특이도 0.76%, 과다의뢰율 0.14%, 과소의뢰율 0.21%이였으며, 지연발달과 정상발달 예측율은 지연 발달에서는 K-ASQ 0.70%, 정상발달 예측율은 K-ASQ 0.77%로 나타났다. K-ASQ의 타당도는 정상아동을 정상으로 선별하는 특이도가 민감도보다 높았으며, 지연발달과 정상발달 예측율에서도 K-ASQ는 70% 이상으로 임상에서 아동발달 선별에 유용하게 사용될 수 있을 것이다.

Body Mass Index at Presentation of Inflammatory Bowel Disease in Children

  • Carbonell, Fernando R Medina;Chandan, Ojasvini Choyudhry
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제23권5호
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    • pp.439-446
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    • 2020
  • Purpose: The evidence for an association between inflammatory bowel disease (IBD) and obesity is conflicting. Therefore, we set out to review the body mass index (BMI) at presentation of IBD to understand if the rise of the obesity rate in the general population, lead to an increase of obesity in patients with IBD at the time of diagnosis. Methods: Retrospective review of all patients with IBD seen at Children's Hospital and Medical Center from January 1st 2010 to December 31st 2014. From the initial visit and endoscopy, we obtained: age; sex; BMI; disease phenotype; disease severity. Results: We had a total of 95 patients, 35 patients were excluded due to incomplete data or referral being made after diagnosis was made. 28 were males and 32 were females, Age range was 2-17 years. A 37 had Crohn's disease, 19 ulcerative colitis, and 4 indeterminate colitis. Disease severity in 19 cases was mild, 29 moderate and 12 severe. BMI distribution was as follows-obese (5.0%), overweight (6.7%), normal weight (65.0%), mild malnutrition (8.3%), moderate malnutrition (15.0%), severe malnutrition (1.7%). Conclusion: Our data is consistent with other series. Showing most children had a normal BMI, regardless of disease severity or phenotypes. One confounding factor is the possibility of delay in referral to GI. This could mean some obese children may fall in the normal BMI range at the time of diagnosis due to ongoing weight loss. Future studies should include prospective cohort studies, comparing incidence of IBD in obese and non-obese patients, severity at presentation, duration of symptoms, and clinical outcomes.

Predictors of Mortality after Surgery for Empyema Thoracis in Chronic Kidney Disease Patients

  • Pulle, Mohan Venkatesh;Puri, Harsh Vardhan;Asaf, Belal Bin;Bishnoi, Sukhram;Malik, Manish;Kumar, Arvind
    • Journal of Chest Surgery
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    • 제53권6호
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    • pp.392-399
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    • 2020
  • Background: Surgical treatment of empyema thoracis in patients with chronic kidney disease is challenging, and few studies in the literature have evaluated this issue. In this study, we aim to report the surgical outcomes of empyema and to analyze factors predicting perioperative mortality in patients with chronic kidney disease. Methods: This retrospective study included data from 34 patients with chronic kidney disease (estimated glomerular filtration rate <60 mL/min/1.73 ㎡ for 3 or more months) who underwent surgery for empyema between 2012 and 2020. An analysis of demographic characteristics and perioperative variables, including complications, was carried out. Postoperative mortality was the primary outcome measure. Results: Patients' age ranged from 20 to 74 years with a 29-to-5 male-female ratio. The majority (n=19, 55.9%) of patients were in end-stage renal disease (ESRD) requiring maintenance hemodialysis. The mean operative time was 304 minutes and the mean intraoperative blood loss was 562 mL. Postoperative morbidity was observed in 70.5% of patients (n=24). In the subgroup analysis, higher values for operative time, blood loss, intensive care unit stay, and complications were found in ESRD patients. The mortality rate was 38.2% (n=13). In the univariate and multivariate analyses, poor performance status (Eastern Cooperative Oncology Group >2) (p=0.03), ESRD (p=0.02), and late referral (>8 weeks) (p<0.001) significantly affected mortality. Conclusion: ESRD, late referral, and poor functional status were poor prognostic factors predicting postoperative mortality. The decision of surgery should be cautiously assessed given the very high risk of perioperative morbidity and mortality in these patients.

Epidemiologic Survey of Infantile Cancer in Iran based on the Data of the Largest Pediatric Cancer Referral Center (Ali-Asghar Children Hospital), 1996-2005

  • Bahoush-Mehdiabadi, Gholamreza;Habibi, Roshanak;Shariftabrizi, Ahmad;Vossough, Parvaneh
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권3호
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    • pp.1211-1217
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    • 2014
  • Background: Cancer in infants younger than one year of age represents a unique problem with distinct epidemiological, clinical and genetic characteristics compared with older age groups. No report is yet available from Iran regarding epidemiological and survival rate of cancers diagnosed in this age group. Materials and Methods: The population under study comprised of patients which were diagnosed and admitted to Ali-Asghar hospital between years 1996-2005. In total, 287 infants were included in the retrospective descriptive survey. Patient files were evaluated for age of patient at the time of diagnosis, sex, geographical residence, consanguinity of parents, histological diagnosis, site of cancer involvement, type of therapy, date of last follow-up and cause of death (if applicable). Results: The average age at the time of diagnosis was 7.2 months old. The most frequent malignancy was retinoblastoma (44%), followed by leukemia (19%) and neuroblastoma (10%), with five-year overall survival rates of 77.7%, 41% and 90%, respectively Parents of 40 infants (13.9%) had consanguinity relationships. Conclusions: Although we cannot make any conclusions regarding the incidence of infant cancer subtypes based on this study, survival rates for major types were similar to the developed countries, which signifies strict adherence to standards of care in Ali-Asghar hospital, the main infant cancer care centre in Iran. A Childhood Cancer Registry with high-resolution data collection and also advanced genetic testing is advocated for in-depth analysis of variation in incidence and survival.