• Title/Summary/Keyword: Retrospective approach

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Linking Clinical Events in Elderly to In-home Monitoring Sensor Data: A Brief Review and a Pilot Study on Predicting Pulse Pressure

  • Popescu, Mihail;Florea, Elena
    • Journal of Computing Science and Engineering
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    • v.2 no.2
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    • pp.180-199
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    • 2008
  • Technology has had a tremendous impact on our daily lives. Recently, technology and its impact on aging has become an expanding field of inquiry. A major reason for this interest is that the use of technology can help older people who experience deteriorating health to live independently. In this paper we give a brief review of the in-home monitoring technologies for the elderly. In the pilot study, we analyze the possibility of employing the data generated by a continuous, unobtrusive nursing home monitoring system for predicting elevated(abnormal)pulse pressure(PP) in elderly(PP=systolic blood pressure-diastolic blood pressure). Our sensor data capture external information(behavioral) about the resident that is subsequently reflected in the predicted PP. By continuously predicting the possibility of elevated pulse pressure we may alert the nursing staff when some predefined threshold is exceeded. This approach may provide additional blood pressure monitoring for the elderly persons susceptible to blood pressure variations during the time between two nursing visits. We conducted a retrospective pilot study on two residents of the TigerPlace aging in place facility with age over 70, that had blood pressure measured between 100 and 300 times during a period of two years. The pilot study suggested that abnormal pulse pressure can be reasonably well estimated (an area under ROC curve of about 0.75) using apartment bed and motion sensors.

Effects of Two Chemotherapy Regimens, Anthracycline-based and CMF, on Breast Cancer Disease Free Survival in the Eastern Mediterranean Region and Asia: A Meta-Analysis Approach for Survival Curves

  • Zare, Najaf;Ghanbari, Saeed;Salehi, Alireza
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.2013-2017
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    • 2013
  • Background: To compare the effects of two adjuvant chemotherapy regimens, anthracycline-based and cyclophosphamide, methotrexate, fluorourical (CMF) on disease free survival for breast cancer patients in the Eastern Mediterranean region and Asia. Methods: In a systematic review with a multivariate mixed model meta-analysis, the reported survival proportion at multiple time points in different studies were combined. Our data sources were studies linking the two chemotherapy regimens on an adjuvant basis with disease free survival published in English and Persian in the Eastern Mediterranean region and Asia. All survival curves were generated with Graphdigitizer software. Results: 14 retrospective cohort studies were located from electronic databases. We analyzed data for 1,086 patients who received anthracycline-based treatment and 1,109 given CMF treatment. For determination of survival proportions and time we usesb the transformation Ln (-Ln(S)) and Ln (time) to make precise estimations and then fit the model. All analyses were carried out with STATA software. Conclusions: Our findings showed a significant efficacy of anthracycline-based adjuvant therapy regarding disease free survival of breast cancer. As a limitation in this meta-analysis we used studies with different types of anthracycline-based regimens.

Early Experiences of Single Incision Laparoscopic Surgery in Pediatrics in a Single Center (단일기관 소아환자에서 단일절개복강경하수술의 초기경험)

  • Song, Ra-Yeong;Jung, Kyuwhan
    • Advances in pediatric surgery
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    • v.19 no.2
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    • pp.90-97
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    • 2013
  • Laparoscopic surgery has become popular in the past few decades, owing to less postoperative pain, fast recovery, and better cosmetic outcomes. The laparoscopic approach has been employed in pediatric surgery for the same reasons. After the first attempts of single incision laparoscopic appendectomy in pediatrics in 1998, single incision laparoscopic surgery (SILS) has recently been proven to be safe and feasible for the pediatric population. However, limitations have been reported for SILS, such as the wide learning curve, compared to standard laparoscopic surgery, and the restricted number of hospitals with surgical training programs including SILS. In this study, we intend to present our initial experiences with SILS in children, and to describe the technique, instruments used, and outcomes. This is a retrospective study of 71 pediatric patients who underwent SILS, at a tertiary medical center, between September, 2012 and August, 2013. Electronic medical records were reviewed for demographics, type of procedure, operation time, use of additional ports, conversion to open surgery, complications and hospital stay. Additional ports were inserted in 4 cases, for the purpose of traction. Postoperative complications were noted in 13 cases, which were mostly related to wound inflammation or formation of granulation tissue. According to our analyses, patients with complications had significantly longer use and more frequent use of pain killers. Notwithstanding the small sample size, many of the procedures performed in pediatric patients seem to be possible with SILS.

The usability of Infraorbital Approach on the patients with Orbito-Zygomatic Fracture (안와-관골골절 환자에서 안와하 접근법의 유용성)

  • Yun, Chi Sun;Kim, Jong Hwan;Yang, Ho Jik
    • Archives of Craniofacial Surgery
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    • v.10 no.1
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    • pp.19-22
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    • 2009
  • Purpose: There are various approaches for open reduction surgery for orbitozygomatic fractures. After the incisions are performed, patients might have various complications. In this point of view, we conducted a retrospective study of the usability of infraorbital incision on elderly patients, generally more vulnerable to scleral show and ectropion. Methods: In this study, 20 patients who are relatively more vulnerable to scleral show and ectropion through snap-back test having infraorbital incision were reviewed. We monitored the duration of the surgery, and complications resulted from the incision. We evaluated the scars with the researcher's observations and with the patient's level of satisfaction on a scale of 1 to 5. Results: On average, 5 minutes was spent between the skin incision and the fracture exposure. No case of scleral show and ectropion occurred. One year follow-up observation revealed 4 cases of visible scars, 9 cases of barely visible scars, and 7 cases of invisible scars. The subjective satisfaction level of the patients' scar is an average of 4.0. Conclusion: Infraorbital incision has many advantages. First, it can reduce the complications such as scleral show and ectropion. Second, it can shorten the operation time. Third, it can diminish incision-related scars.

Comparison Study of Open Reduction and Closed Reduction in Treatment of Mandibular Subcondylar Fractures (하악골 과두하부골절 정복술에서 관혈적 정복술과 비관혈적 정복술의 비교 연구)

  • Jang, Ju Yun;Kang, Dong Hee
    • Archives of Craniofacial Surgery
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    • v.9 no.2
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    • pp.51-54
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    • 2008
  • Purpose: The choice of open versus closed reduction for mandibular subcondylar fracture is a debatable issue. To evaluate the advantage of open approach to closed method with IMF(intermaxillary fixation), we conducted a retrospective study to compare the outcomes of each method. Methods: From 2002 to 2006, 29 patients with mandibular subcondylar fractures were treated by open or closed reduction. 17 patients were treated by open reduction and 12 patients by closed reduction and IMF. Each group was assessed for duration of mandibular immobilization, incidences of buccal palsy, malocclusion, TMJ(temporomandibular joint) pain, and deviation of the mandible on mouth opening. Results: All cases showed accurate reduction in anatomical position, no significant displacement and no deviation on mouth opening during the follow-up period. IMF period is statistically shorter in open reduction (p<0.05). Differences in incidence of other complications were not significant statistically. Conclusion: As there are significant independent morbidities associated with IMF which requires postoperative rehabilitation, prolonged temporomandibular immobilization should not be overlooked. Some patients with poor compliances will not tolerate IMF in nonsurgical treatment. In the aspect of patient's convenience and early recovery by short IMF period, open reduction would be recommended as a better treatment method.

Urinary Cytologic Findings of Transitional Cell Carcinoma - Analysis of 83 Cases- (이행세포암종의 요 세포학적 소견 - 83예 분석 -)

  • Kim, Yeon-Mee;Cho, Hye-Je
    • The Korean Journal of Cytopathology
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    • v.6 no.2
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    • pp.148-155
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    • 1995
  • Urinary cytology has become an essential element in the diagnosis and management of transitional ceil carcinoma(TCC) of the urinary tract. It has the advantage of being noninvasive, inexpensive, and easily accessible. Besides that it can even detect malignancy when unsuspected at cystoscopy. We report a retrospective review of urine cytology un the diagnosis of 83 TCC cases that underwent 295 cytologic evaluation. All patients had biopsy-proven TCC of the bladder, ureter and renal pelvis, The overall incidence of the positive cytology cases was 66.2%. To define the cytologic features of tumor cells, we tried to use three cytologic gradings such as "grade 1", "grade 2", and "grade 3" according to the cytologic degree of anaplastic neoplastic cells. These cytologic gades of TCC were relatively well correlated with the histologic grade and tumor invasiveness. This result suggests that the recognition of characteristic cellular features of TCC can suspect the histologic grade and tumor stage. The false negative TCC cases were 78.9%. They showed severe inflammatory or bloody background and a few neoplastic cells. Therefore, a cautious approach for accurate interpretation, personal experience, and proper fixation and processing could expand the role of urinary cytology.

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Analysis of Medical Records and Development of Chest Pain Care Record in the Emergency Department (의무 기록 분석을 통한 응급실 흉통 간호 기록지 개발)

  • Choi, Gui Yun;Moon, Young Sook;Hong, Eun Seog
    • Korean Journal of Adult Nursing
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    • v.18 no.4
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    • pp.533-542
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    • 2006
  • Purpose: The purposes of this study were to investigate medical records and to develop care records for management of patients with chest pain in the emergency department. Method: Retrospective review of the 42 medical chart of patients presented to the emergency department with chest pain were used. The collected data were analyzed with a frequency of items in the medical records. Results: In a frequency analysis of recorded items for doctors' chest pain assessment during history taking, the history/risk factors was the highest rank. The following ranks were 'commenced with when/timing, extra symptoms, place, nature, stay/radiate, alleviate/aggravate, intensity' in sequence. In a frequency of recorded items in nurse's progress notes according to nursing actions, the 'checking/monitoring' was the highest rank. The following ranks were 'performing, administering/injecting, referring/arranging, testing, preparing/catheterizing, teaching/informing' in sequence. Chest pain care records for the emergency department was designed, based upon data analysis and literature review. Conclusion: The designed records can be a rapid and effective approach tool for assessment and recording of patients with chest pain. Further research is necessary for evaluating the designed chest pain care records.

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Post-stroke Spasticity Treated by Miniscalpel-Acupuncture: Three Case Report (뇌졸중 후 강직에 대한 도침치료: 3 증례보고)

  • Yoon, Sang-Hoon;Jo, Hee-Guen;Song, Min-Yeong
    • Journal of Korean Medicine Rehabilitation
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    • v.28 no.1
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    • pp.145-152
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    • 2018
  • Post-stroke spasticity is a common complication that can be deleterious to the daily living function and quality of life of stroke survivor. This case report was conducted to introduce the use of miniscalpel-acupuncture as a novel method for the treatment of post-stroke spasticiy in three patients with chronic stroke. Patients received miniscalpel-acpuncuture treatment for 4~7 session. The flexor digitorum brevis, pronator teres, pronator quadratus, brachioradialis, tibialis posterior, gastrocnemius on the affected side were needled. The main outcome were the Modified Ashworth Scale (MAS) muscle spasticity score and the range of motion. The evaluation indices were measured after the initiation of treatment and after treatment. After miniscalpel-acupuncture session, three patients improved as indicated in the MAS grade and range of motion. This retrospective case report presents miniscalpel-acupuncture as a potentially effective approach in Korean medicine rehabilitation treatment of post-stroke spasticity. Further research is needed to confirm these findings.

Inferior Capsular Shift for Multidirectional Shoulder Instability in Contact Sports Athletes (접촉성 운동 선수에서 견관절 다방향 불안정성에 대한 하방 관절막 이동술)

  • Choi Chong-Hyuk;Yun Kyung-Hwan;DJ Ogilvie-Hanis
    • Clinics in Shoulder and Elbow
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    • v.3 no.1
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    • pp.10-19
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    • 2000
  • The aims of this retrospective study were to evaluate the results of inferior capsular shift operation which were approached anteriorly or posteriorly according to a main instability direction in contact sports population who had multidirectional shoulder instability. Fifty-three shoulders in 47 athletes who engaged in contact sports underwent an anterior or posterior inferior capsular shift procedure for the correction of multidirectional instability of the shoulder joint. The surgical approach was selected according to the predominant direction of the instability. Follow up was average of 42 months(24∼73 months). After anterior inferior capsular shift, anterior dislocation was recurred in three shoulders, posterior dislocation in one, and inferior dislocation in two shoulders. After posterior inferior capsular shift, one dislocation occurred anteriorly, one inferiorly and one posteriorly. The excessive tightening of capsule or improper diagnosis could be causative factors for the development of dislocation in the opposite direction to the preoperative major instability. Of six patients who could not return to their sports, five had bilateral repairs. Successful repair based on the criteria of the American shoulder and elbow association was achieved in 92% of anterior repairs, and 81 % of posterior repairs.

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Surgical treatment of esophageal submucosal tumor (식도의 양성 점막하 종양의 수술적 치료)

  • Noh, Dong-Sub;Park, Chang-Kwon;Keum, Dong-Yoon;Kim, Jae-Bum
    • Korean Journal of Bronchoesophagology
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    • v.15 no.1
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    • pp.24-27
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    • 2009
  • Background: Benign tumors of the esophagus are rare. They include leiomyomas, gastrointestinal stromal tumors, neurofibromas and lipomas. In this study we present our experience with enucleation of these 13 tumors for 10 years. Material and Method: A retrospective review of patients who underwent enucleation of benign esophageal tumors between 1995 and 2005 was conducted. Symptom, tumor location and size, operative approach and outcomes after surgery were recorded. Result Thirteen patients were identified(leiomyoma: n=12; GIST n=l). Eight patients were men, five patients were women. Most of them were 4rd and 5th decade. The tumors arose in the lower(7 patients) and middle(6 patients) thirds of the esophagus. Eleven patients underwent a thoracotomy; the remainder were resected using VATS. All of patients underwent simple enucleation. There were no complications and recurrences after surgery. Conclusion: We present our experience with enucleation of these 12 leiomyomas and one GIST for 10 years.

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