• Title/Summary/Keyword: Supportive therapy

검색결과 238건 처리시간 0.03초

Disseminated Cytomegalovirus Infection and Protein Losing Enteropathy as Presenting Feature of Pediatric Patient with Crohn's Disease

  • Cakir, Murat;Ersoz, Safak;Akbulut, Ulas Emre
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제18권1호
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    • pp.60-65
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    • 2015
  • We report a pediatric patient admitted with abdominal pain, diffuse lower extremity edema and watery diarrhea for two months. Laboratory findings including complete blood count, serum albumin, lipid and immunoglobulin levels were compatible with protein losing enteropathy. Colonoscopic examination revealed diffuse ulcers with smooth raised edge (like "punched out holes") in the colon and terminal ileum. Histopathological examination showed active colitis, ulcerations and inclusion bodies. Immunostaining for cytomegalovirus was positive. Despite supportive management, antiviral therapy, the clinical condition of the patient worsened and developed disseminated cytomegalovirus infection and the patient died. Protein losing enteropathy and disseminated cytomegalovirus infection a presenting of feature in steroid-naive patient with inflammatory bowel disease is very rare. Hypogammaglobulinemia associated with protein losing enteropathy in Crohn's disease may predispose the cytomegalovirus infection in previously healthy children.

Anaplastic Large Cell Lymphoma of the Duodenum in a Teenage Girl: Misdiagnosed as an Intramural Duodenal Hematoma

  • Sriphongphankul, Hansa;Tanpowpong, Pornthep;Ruangwattanapaisarn, Nichanan;Thirapattaraphan, Chollasak;Treepongkaruna, Suporn
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제22권6호
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    • pp.571-575
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    • 2019
  • We report a case of a 13-year-old girl who presented with a 2-month history of intermittent abdominal pain. Laboratory examination showed hepatitis and pancreatitis. Because of persistent vomiting, computed tomography (CT) was performed, which revealed a circumferential soft tissue density in the duodenal wall, causing partial obstruction. Supportive therapy failed. Repeat CT showed no significant change from the initial study. The patient underwent upper endoscopy, which revealed a mass in the second portion of the duodenum, which occluded most parts of the lumen. The histopathological finding was consistent with an anaplastic large cell lymphoma, a rare form of small bowel neoplasm. After the third course of chemotherapy, complete resolution of the mass was noted, and her symptoms were relieved.

위장관염으로 오인된 콜히친 중독 1례 (A Case of Colchicine Intoxication Presenting as Acute Gastroenteritis)

  • 안지윤;손유동;권혁술;안희철
    • 대한임상독성학회지
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    • 제6권2호
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    • pp.138-141
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    • 2008
  • A 47-year-old woman ingested about 12 mg of colchicine with suicidal intent. Colchicine, a highly poisonous alkaloid, is a commonly used treatment for gout, Bechet's disease, and familial Mediterranean fever. Despite the knowledge of its side effects, the risk of a significant overdose is under-appreciated. She suffered from acute multisystem toxicity, including gastrointestinal disorders, bone marrow suppression, alopecia, and probable pancreatitis, but she ultimately recovered with supportive therapy. We report a case of acute colchicine toxicity from a single overdose with a review of the literature.

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Management of Persistent Pulmonary Hypertension in Preterm Infants

  • Lee, Byong Sop
    • Neonatal Medicine
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    • 제28권1호
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    • pp.1-6
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    • 2021
  • Persistent pulmonary hypertension of the newborn (PPHN) is a consequence of the failure of a decrease in the elevated pulmonary vascular resistance after birth. Pulmonary vasodilators, including inhaled nitric oxide (iNO), have been the mainstream of targeted therapy for PPHN, but no drugs have been proven to be effective in preterm infants with PPHN. The fetus remains hemodynamically stable despite lower arterial oxygen tension and pulmonary blood flow as compared to full-term newborns. This adaptation is due to the lower oxygen requirement and high oxygen-carrying capacity of fetal circulation. The immature lungs of preterm infants are more vulnerable to reactive oxygen species, and the response of pulmonary vascular dilatation to blood oxygen tension is blunted in preterm infants. Recently, iNO has been reported to be effective in a selected group of preterm infants, such as those with prolonged preterm rupture of membrane-oligohydramnios-pulmonary hypoplasia sequence. PPHN in preterm infants, along with maximum supportive treatment based on fetal physiology and meticulous assessment of cardiovascular function, is in dire need of new treatment guidelines, including optimal dosing strategies for pulmonary vasodilators.

A Case of Mucous Membrane Pemphigoid: From Diagnosis to Therapeutic Strategy

  • Kang, Kun-Hwa;Byun, Jin-Seok;Jung, Jae-Kwang;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • 제46권2호
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    • pp.63-68
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    • 2021
  • Mucous membrane pemphigoid (MMP) is a heterogeneous group of chronic, autoimmune subepithelial blistering diseases, predominantly involving oral mucosal membrane. Because of its pathophysiology of autoimmune reaction, MMP-related gingivitis would not respond to conventional periodontal treatments. We present a case of a 65-year-old female with a chief complaint of chronic generalized buccal gingivitis, unimproved after periodontal treatment for four months. Based on the clinical findings, histological examination, and direct immunofluorescence microscopy, it was diagnosed as MMP. The symptoms were relieved with immunomodulatory therapy using corticosteroids and the supportive management of professional plaque control. MMP can cause pathological involvement throughout the oral and other mucosae of the body, thus leading to functional impairment through repeated inflammatory cascades. Therefore, accurate diagnosis is essential to properly manage local and possible systemic complications of MMP.

Uroperitoneum Secondary to the Rupture of the Urinary Bladder in a Thoroughbred Foal

  • Jeong, Hyohoon;Park, Kyung-won;Lee, Eun-bee;Kang, Tae-Young;Seo, Jong-pil
    • 한국임상수의학회지
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    • 제38권6호
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    • pp.305-309
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    • 2021
  • A 13-day-old Thoroughbred female foal weighing 59 kg was referred to the Jeju National University Equine Hospital with clinical signs including depression, labored breathing, tachycardia, anorexia, and marked distended abdomen. Uroperitoneum secondary to a rupture of the urinary bladder was diagnosed based on the history, clinical signs, and ultrasound imaging. An emergency laparotomy for cystorrhaphy under inhalation anesthesia was performed, and the patient recovered uneventfully. A course of extensive supportive therapy with systemic antibiotics after surgery was carried out. The foal fully recovered and was discharged after 14 days of hospitalization. The follow-up after seven months revealed the patient to be clinically healthy. This report describes a case of uroperitoneum secondary to the rupture of the urinary bladder in a Thoroughbred foal, along with the clinical outcomes of surgical repair and intensive treatment in detail.

Disease Progression-Associated Diagnostic and Treatment Procedure for a Dog with Hepatic Abscesses: A Case Report

  • Hyunji Lee;Sungwon Ann;Youngsam Kwon;Min Jang;Sangkwon Lee;Taeho Oh;Seulgi Bae
    • 한국임상수의학회지
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    • 제39권6호
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    • pp.360-365
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    • 2022
  • A 15-year-old spayed female Yorkshire Terrier was presented to our hospital with a history of anorexia, depression and abdominal pain. Diagnostic procedures including blood test, radiography and ultrasonography were performed. Abdominal ultrasonography revealed multiple hypoechoic cysts in the left lobe of the liver. Over time, the cysts increased in size and became more echogenic. Four days later, the rupture of the largest cyst was suspected, and hepatic abscesses with bacteria were confirmed by aspiration of the cyst. Despite surgical resection of the abscessed liver lobe, antibiotic administration, and supportive therapy, the dog died 9 days after presentation to the hospital and 4 days after the surgical procedure. The present case report described the overall diagnostic and therapeutic approaches for liver abscesses in a dog.

The Dual Burden of Frailty and Heart Failure

  • Cristiana Vitale;Ilaria Spoletini;Giuseppe M.C. Rosano
    • International Journal of Heart Failure
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    • 제6권3호
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    • pp.107-116
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    • 2024
  • Frailty is highly prevalent among patients with heart failure (HF) and independently predicts adverse outcomes. However, optimal frailty definitions, assessments, and management in HF remain unclear. Frailty is common in HF, affecting up to 80% of patients depending on population characteristics. Even pre-frailty doubles mortality risk versus robust patients. Frailty worsens HF prognosis through systemic inflammation, neurohormonal changes, sarcopenia, and micronutrient deficiency. Simple screening tools like gait speed and grip strength predict outcomes but lack HF-specificity. Comprehensive geriatric assessment is ideal but not always feasible. Exercise, nutrition, poly-pharmacy management, and multidisciplinary care models can help stablize frailty components and improve patient-centred outcomes. Frailty frequently coexists with and exacerbates HF. Routine frailty screening should guide supportive interventions to optimize physical, cognitive, and psychosocial health. Further research on HF-specific frailty assessment tools and interventions is warranted to reduce this dual burden.

Palliative Treatment of Advanced Cervical Cancer with Radiotherapy and Thai Herbal Medicine as Supportive Remedy - Analysis of Survival

  • Pesee, Montien;Kirdpon, Wichit;Puapairoj, Anucha;Kirdpon, Sukachart;Prathnadi, Pongsiri
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권3호
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    • pp.1593-1596
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    • 2013
  • Background: To evaluate outcomes using a Thai herbal medicine, Vilac Plus (G716/45) with standard radiotherapy in comparison with historic controls from literature reports of the results of treatment in stage IIIB cervical cancer. Materials and Methods: Between March 2003 and June 2005, thirty patients with advanced cervical cancer stage IIIB-IV who had a poor performance status were treated by palliative radiotherapy along with an adjuvant daily dose of 15-30 ml of Thai herbal tonic solution (Vilac Plus G716/45) administered orally three times after meals as an additional supportive therapy. The results were analyzed from the aspect of the overall survival rates with curves estimated by the Kaplan-Meier method. Results:.The median follow -up time for stage IIIB was 4.2 years with a range of 7.9 months - 6.1 years. The overall 1, 3, and 5 year survival rates for stage IIIB were 88%, 60% and 52%. Conclusions: The overall 5 year survival rate for stage IIIB with a poor performance status was 52% when compared with 34-54.8% for historic controls. The combined complementary palliative radiotherapy (CCPR) had low rates of radiation morbidity. It was a simple technique and feasible for developing countries. The pilot study was limited by the small number of patients and further research will be necessary to assess interrelated and confounding factors in treatment of cervical cancer patients.

미숙아의 머리 및 발 보온이 출생초기 체중에 미치는 영향 (The Influence of Thermal Head and Feet Support on Early Stage Weight Gain in Premature Neonates)

  • 백승남;홍혜성;성미혜;조결자;위현주
    • Child Health Nursing Research
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    • 제6권3호
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    • pp.397-410
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    • 2000
  • This is a nonequivalent control group pretest- posttest design in quasi experimental basis to assess how the thermal head and feet support influences on early stage weight gain in premature neonates. The clients were selected among the premature infants with the weight under 2000gms and with the gestational period under 37 weeks, admitted over 15 days in K university hospital, Seoul. The control group of 29 were selected from January 1998 to August 1998, who were without head and feet thermal support, and the experimental group of 30 were selected from September 1998 to May 1999, who were with the two thermal interventions. The results of the study follow, 1.The experimental group with thermal interventions showed more weight gain than the control group without thermal interven- tions, which was statistically significant between the two groups. 2.The physiological weight loss after birth showed less in the experimental group than in the control group. 3.The recovery of the birth weight after the physiologic weight loss showed no statistical difference between the experimental group and the control group. Consequently, the thermal head and feet supportive nursing intervention could be applied as a nursing intervention program to help the premature neonates' development. With the results above we should like to suggest the following: 1) A continuous application in the practice of our thermal supportive intervention for the premature neonates, a development of the content through evaluation, and a comparision of the results through a long time study. 2) A neccessity of deveopment of various study and cross comparision. 3) A neccessity of multi-angular study on the premature infants' characteristics influencing the thermal therapy and the study of the individual differences of the clients.

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