• Title/Summary/Keyword: Treatment delays

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Analysis of Treatment and Delay Times by Disease Site and Delivery Technique at Samsung Medical Center - Proton Therapy Center

  • Jo, Kwanghyun;Ahn, Sung Hwan;Chung, Kwangzoo;Cho, Sungkoo;Shin, Eunhyuk;Hong, Chae-Seon;Park, Seyjoon;Kim, Dae-Hyun;Lee, Boram;Lee, Woo-Jin;Seo, Se-Kwang;Jang, Jun-Young;Choi, Doo Ho;Lim, Do Hoon;Han, Youngyih
    • Progress in Medical Physics
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    • v.27 no.4
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    • pp.258-266
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    • 2016
  • We have treated various disease sites using wobbling and scanning proton therapy techniques since December 2015 at the Samsung Medical Center. In this study, we analyze the treatment time for each disease site in 65 wobbling and 50 scanning patient treatments. Treatment times are longest for liver and lung patients using the respiratory gating technique in the wobbling treatment and for cranio-spinal irradiation in pediatric patients with anesthesia in the scanning treatment. Moreover, we analyze the number of incidents causing treatment delays and the corresponding treatment delay time. The X-ray panel was the main reason for delays in the wobbling treatment; this decreased continually from January to June 2016, related closely to the proficiency of the human operators involved. The main reason for delays in the scanning treatment was interlocks during scanning pattern delivery; this was resolved by proton machine engineers. Through this work, we hope to provide other institutes with useful insight for initial operation of their proton therapy machines.

Educational Levels and Delays in Start of Treatment for Head and Neck Cancers in North-East India

  • Krishnatreya, Manigreeva;Kataki, Amal Chandra;Sharma, Jagannath Dev;Nandy, Pintu;Rahman, Tashnin;Kumar, Mahesh;Gogoi, Gayatri;Hoque, Nazmul
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10867-10869
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    • 2015
  • Background: There are various patient and professional factors responsible for the delay in start of treatment (SOT) for head and neck cancers (HNC). Materials and Methods: This retrospective study was conducted on data for HNC patients registered at the hospital cancer registry in North-East India. All cases diagnosed during the period of January 2010 to December 2012 were considered for the present analysis. Educational levels of all patients were clustered into 3 groups; illiterates (unable to read or write), qualified (school or high school level education), and highly qualified (college and above). Results: In the present analysis 1066 (34.6%) patients were illiterates, 1,869 (60.6%) patients were literates and 145 (4.7%) of all patients with HNC were highly qualified. The stage at diagnosis were stage I, seen in 62 (34.6%), stage II in 393 (12.8%), stage III in 1,371 (44.5%) and stage IV in 1,254 (40.7%). The median time (MT) to the SOT from date of attending cancer hospital (DOACH) was, in illiterate group MT was 18 days, whereas in the qualified group of patients it was 15 days and in the highly qualified group was 10 days. Analysis of variance showed there was a significant difference on the mean time for the delay in SOT from DOACH for different educational levels (F=9.923, p=0.000). Conclusions: Educational level is a patient related factor in the delays for the SOT in HNCs in our population.

EXPONENTIALLY FITTED NUMERICAL SCHEME FOR SINGULARLY PERTURBED DIFFERENTIAL EQUATIONS INVOLVING SMALL DELAYS

  • ANGASU, MERGA AMARA;DURESSA, GEMECHIS FILE;WOLDAREGAY, MESFIN MEKURIA
    • Journal of applied mathematics & informatics
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    • v.39 no.3_4
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    • pp.419-435
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    • 2021
  • This paper deals with numerical treatment of singularly perturbed differential equations involving small delays. The highest order derivative in the equation is multiplied by a perturbation parameter 𝜀 taking arbitrary values in the interval (0, 1]. For small 𝜀, the problem involves a boundary layer of width O(𝜀), where the solution changes by a finite value, while its derivative grows unboundedly as 𝜀 tends to zero. The considered problem contains delay on the convection and reaction terms. The terms with the delays are approximated using Taylor series approximations resulting to asymptotically equivalent singularly perturbed BVPs. Inducing exponential fitting factor for the term containing the singular perturbation parameter and using central finite difference for the derivative terms, numerical scheme is developed. The stability and uniform convergence of difference schemes are studied. Using a priori estimates we show the convergence of the scheme in maximum norm. The scheme converges with second order of convergence for the case 𝜀 = O(N-1) and for the case 𝜀 ≪ N-1, the scheme converge uniformly with first order of convergence, where N is number of mesh intervals in the domain discretization. We compare the accuracy of the developed scheme with the results in the literature. It is found that the proposed scheme gives accurate result than the one in the literatures.

Epidemiology of Animal Bites and Factors Associated With Delays in Initiating Post-exposure Prophylaxis for Rabies Prevention Among Animal Bite Cases: A Population-based Study

  • Esmaeilzadeh, Firooz;Rajabi, Abdolhalim;Vahedi, Sajad;Shamsadiny, Mohammad;Ghojogh, Mousa Ghelichi;Hatam, Nahid
    • Journal of Preventive Medicine and Public Health
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    • v.50 no.3
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    • pp.210-216
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    • 2017
  • Objectives: One way to prevent deaths due to rabies is the timely utilization of post-exposure prophylaxis (PEP). Therefore, in addition to an understanding of the epidemiological distribution of animal bites, it is necessary to explore the factors leading to delays in PEP initiation. Methods: This cross-sectional study was conducted in Iran in 2011, and included 7097 cases of animal bites recorded at the Rabies Treatment Center of the Shiraz University of Medical Sciences using the census method. Logistic regression was used to identify factors associated with delays in PEP. Results: Among the patients studied, 5387 (75.9%) were males. The prevalence of animal bites in Fars province was 154.4 per 100 000 people. Dogs were the most frequent source of exposure (67.1%), and the most common bitten part of the body was the hands (45.5%). A delay in the initiation of PEP was found among 6.8% of the studied subjects. This delay was more likely in housewives (odds ratio [OR], 4.66; 95% confidence interval [CI], 2.12 to 10.23) and less likely in people with deep wounds (OR, 0.65; 95% CI, 0.43 to 0.97). Conclusions: Although all animal bite victims received complete PEP, in some cases, there were delays. Further, the type of animal involved, the depth of the bite, and the patient's occupation were the major factors associated with a delay in the initiation of PEP for rabies prevention.

The Effect of Parent Education Program Based on Sensory Integration Approach on the Parent's Understanding of Sensory Processing Ability of Children With Developmental Delays (감각통합접근 부모교육이 발달지체 아동의 감각처리능력에 대한 부모의 이해도에 미치는 효과)

  • Park, Hae-Seong;Kim, Kyeong-Mi;Chang, Moonyoung
    • The Journal of Korean Academy of Sensory Integration
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    • v.13 no.1
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    • pp.33-43
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    • 2015
  • Objective : The purpose of this study is to investigate the effect of parent education program with sensory integration approach on the parent's understanding of sensory processing ability of their own children with developmental delays. Methods : The period of this study is from March 15, 2015 to May 10, 2015. The participants of this study were thirty of parents who have children with developmental delays. The participants were randomly divided as experimental group (15 parents) and control group (15 parents) and an educational program was provided to those parents in the experimental group. The education program was developed based on sensory integration approach and 1:1 intensive individual counseling education. Short Sensory Profile (SSP) & a specially designed questionnaire were used to evaluate the parent's understanding of sensory processing ability of their children with developmental delays. The effect of between the groups was analyzed using an independent two samples t-test, and the effect of the intervention within a group was measured using the paired t-test. Results : After the intervention of parent education program, the total score of SSP was significantly decreased and the score of the parent questionnaire was significantly increased (p<.05). Conclusion : The results of this study show that parent education program with sensory integration approach is effective to improve the parent's understanding of sensory processing ability of their children with developmental delays. This study can be used as a good resource for therapists who is planning to provide sensory integration treatment for children with disabilities.

Medical Treatment of Breast Cancer Bone Metastasis: From Bisphosphonates to Targeted Drugs

  • Erdogan, Bulent;Cicin, Irfan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1503-1510
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    • 2014
  • Breast cancer bone metastasis causing severe morbidity is commonly encountered in daily clinical practice. It causes pain, pathologic fractures, spinal cord and other nerve compression syndromes and life threatening hypercalcemia. Breast cancer metastasizes to bone through complicated steps in which numerous molecules play roles. Metastatic cells disrupt normal bone turnover and create a vicious cycle to which treatment efforts should be directed. Bisphosphonates have been used safely for more than two decades. As a group they delay time to first skeletal related event and reduce pain, but do not prevent development of bone metastasis in patients with no bone metastasis, and also do not prolong survival. The receptor activator for nuclear factor ${\kappa}B$ ligand inhibitor denosumab delays time to first skeletal related event and reduces the skeletal morbidity rate. Radionuclides are another treatment option for bone pain. New targeted therapies and radionuclides are still under investigation. In this review we will focus on mechanisms of bone metastasis and its medical treatment in breast cancer patients.

Time to presentation and mortality outcomes among patients with diabetes and acute myocardial infarction

  • Min-A Shin;Seok Oh;Min Chul Kim;Doo Sun Sim;Young Joon Hong;Ju Han Kim;Youngkeun Ahn;Myung Ho Jeong
    • The Korean journal of internal medicine
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    • v.39 no.1
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    • pp.110-122
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    • 2024
  • Background/Aims: Due to limited real-world evidence on the association between time to presentation (T2P) and outcomes following acute myocardial infarction and diabetes (AMI-DM), we investigated the characteristics of patients with AMI-DM and their outcomes based on their T2P. Methods: 4,455 patients with AMI-DM from a Korean nationwide observational cohort (2011-2015) were divided into early and late presenters according to symptom-to-door time. The effects of T2P on three-year all-cause mortality were estimated using inverse probability of treatment weighting (IPTW) and survival analysis. Results: The incidence of all-cause mortality was consistently higher in late presenters than in early presenters (11.4 vs. 17.2%; p < 0.001). In the IPTW-adjusted dataset, the incidence of all-cause mortality was numerically higher in late presenters than in early presenters (9.1 vs. 12.4%; p = 0.072). In the survival analysis, the cumulative incidence of all-cause mortality was significantly higher in late presenters than in early presenters before and after IPTW. In the subgroup with ST-elevation myocardial infarction, late presenters had a higher incidence of cardiac death than early presenters before (4.8 vs. 10.5%; p < 0.001) and after IPTW (4.2 vs. 9.7%; p = 0.034). In the initial glycated hemoglobin (HbA1c)-stratified analysis, these effects were attenuated in patients with HbA1c ≥ 9.0% before (adjusted hazard ratio [HR]: 1.45, 95% confidence interval [CI]: 0.80-2.64) and after IPTW (adjusted HR: 0.82, 95% CI: 0.40-1.67). Conclusions: Late presentation was associated with higher mortality in patients with AMI-DM; therefore, multifaceted and systematic interventions are needed to decrease pre-hospital delays.

A Study on Diesel Spray Combustion Modeling by Eulerian and Lagrangian Conditional Moment Closure Models (Eulerian 및 Lagrangian CMC 모델을 사용한 디젤분무연소 모델링에 관한 연구)

  • Kim, Woo Tae;Cho, Hyun Su;Huh, Kang Y.
    • 한국연소학회:학술대회논문집
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    • 2012.11a
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    • pp.195-198
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    • 2012
  • Numerical simulation is performed to evaluate the conditional moment closure (CMC) models for spray development, ignition, and turbulent combustion for the Engine Combustion Network (ECN) test cases. The CMC model is implemented in the open source code, OpenFOAM, to provide conditional flame structures through the solution of Eulerian as well as Lagrangian conditional transport equations. In spite of more accurate treatment of the convective term, Eulerian CMC provides similar ignition delays and lift-off lengths with Lagrangian CMC.

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Cost Optimization in SIS Model of Worm Infection

  • Kim, Jong-Hyun;Radhakrishnan, Sridhar;Jang, Jong-Soo
    • ETRI Journal
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    • v.28 no.5
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    • pp.692-695
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    • 2006
  • Recently, there has been a constant barrage of worms over the Internet. Besides threatening network security, these worms create an enormous economic burden in terms of loss of productivity not only for the victim hosts, but also for other hosts, as these worms create unnecessary network traffic. Further, measures taken to filter these worms at the router level incur additional network delays because of the extra burden placed on the routers. To develop appropriate tools for thwarting the quick spread of worms, researchers are trying to understand the behavior of worm propagation with the aid of epidemiological models. In this study, we present an optimization model that takes into account infection and treatment costs. Using this model we can determine the level of treatment to be applied for a given rate of infection spread.

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Evaluation of Upper-Limb Motor Recovery after Brain Injury: The Clinical Assessment and Electromyographic Analysis (뇌손상 후 상지 운동기능 회복 평가: 임상적 평가 및 운동반응 근전도 분석)

  • Kim, Young-Ho;Tae, Ki-Sik;Song, Sung-Jae
    • Physical Therapy Korea
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    • v.12 no.1
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    • pp.91-99
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    • 2005
  • We assessed whether the use of a symmetrical upper limb motion trainer in daily repetitive training for a 6-week period reduced spasticity and improved motor function in three chronic hemiparetic patients. Upper limb motor impairment and disability were measured by the Fugl-Meyer Assessment (FMA), Modified Ashworth Scale (MAS) and Manual Muscle Test (MMT), respectively. The electromyography (EMG) of the affected hand was recorded during isometric wrist flexion and extension. In all patients, FMA and MMT scores were significantly improved after the 6-week training. However, MAS scores of the affected wrist spasticity did not change considerably. Onset and Offset delays in muscle contraction significantly decreased in the affected wrist. The co-contraction ratio of flexor and extensor muscles significantly increased after the 6-week training. Onset and offset delays of the muscle contraction and co-contraction ratio correlated significantly with the patients' FMA. This study showed that repetitive, symmetric movement training can improve upper limb motor functions and abilities in chronic hemiparetic patients. Also, the EMG assessment of motor response is likely to provide insights into mechanisms and treatment strategies for motor recovery in chronic hemiparetic patients.

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