• 제목/요약/키워드: long-term care center

검색결과 322건 처리시간 0.029초

Outcomes of Non-Metastatic Gestational Trophoblastic Neoplasia: Twelve Year Experience from a Northern Thailand Tertiary Care Center

  • Suprasert, Prapaporn;Manopunya, Manatsawee
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권14호
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    • pp.5913-5916
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    • 2015
  • Gestational trophoblastic neoplasia (GTN) is the malignant form of gestational trophoblastic disease. In non-metastatic GTN, the outcomes of treatment are impressive with methotrexate (MTX) or actinomycin D. We retrospectively reviewed the outcomes of non-metastatic GTN treated at our center from January, 1999 to December, 2013. One hundred and nine patients were recruited to the study. The median age was 33.1 years and over 90% were referral cases. Abnormal vaginal symptoms developed in 37.6% while 56.4% were asymptomatic. The most common antecedent pregnancy was a complete mole (92.7%) with the median interval time from antecedent pregnancy to GTN development being 2.0 months. The median pretreatment B-hCG was 5,624 mIu/ml. The most common first line treatment was methotrexate (MTX) and folinic acid (91.7%) followed by weekly MTX (4.6%), etoposide+ MTX+actinomycin D (EMA) (2.8%), and actinomycin D (0.9%), with the median number of cycles at 5.0. The positive response to first line chemotherapy was 73.8%. The patients were given subsequent chemotherapeutic regimens after resistance to the first line therapy and showed a final remission rate of 89.9%.The significant factor that was frequently found in patients who were non-responders to the first line treatment was a hysterectomy procedure. Two patients developed lung metastasis and brain metastasis at one and four years after the first treatment, respectively. In conclusion, the outcomes of non-metastatic GTN were excellent. However, the patients need long term follow up due to the possibility of developing multiple organ metastases.

Investigating Sexual Function and Affecting Factors in Women with Breast Cancer in Iran

  • Shandiz, Fatemeh Homaee;Karimi, Fatemeh Zahra;Rahimi, Nafiseh;Abdolahi, Mahboubeh;Anbaran, Zahra Khosravi;Ghasemi, Mina;Mazlom, Seyed Reza;Kheirabadi, Aghileh Nasaghchi
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권7호
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    • pp.3583-3586
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    • 2016
  • Background: Since the breast is strongly relevant to sexual desire, and physical and sexual attractiveness, the high prevalence of breast cancer (BC) in Iran and long-term survival of patients experiencing side effects means that measures to identify associated sexual problems are necessary. Therefore, this study was conducted to assess sexual function and affecting factors in women with BC. Materials and Methods: This cross-sectional study was performed on 94 women with BC, referred to Imam Reza (AS) Hospital, Mashhad, Iran, in 2014. The data were collected through demographic and clinical questionnaires and also a sexual function questionnaire and analyzed using SPSS version 16. Results: The total score of women's sexual function was about $24.3{\pm}4.41$. Of the total, 63 (71.3%) reported sexual dysfunction, for example reduced satisfaction or more pain. Age was the only significantly related factor. Conclusions: Breast cancer can adversely affect women's sexual function and decrease quality of life. Thus, taking measures to overcome women's sexual problems are necessary.

미래 보건문제 발생에 대응·대비를 위한 역학조사관제도 개선방안 (Improvement of Epidemiology Intelligence Service Officer Program for Preparedness and Response against Future Health Issues Included Communicable and Non-communicable Diseases in Korea)

  • 이무식
    • 보건행정학회지
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    • 제28권3호
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    • pp.294-300
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    • 2018
  • The development and management of epidemiology intelligence service (EIS) officer with more specialized competence to cope with and prepare for health threats, including pandemic of emerging and re-emerging infectious diseases, is a high priority policy issue in Korea. First of all, we need to establish the training goal of EIS officer. It is necessary to establish manpower training and management system with at least three tiers including quantitative and qualitative targets. Second, at least 50% of all EIS officer must secure a physician and secure expertise and competence for epidemic. Third, for the ultimate purpose of EIS officer, the establishment of a public health expert should expand the scope of epidemiologist's work to health and medical care, occupational environment, and various disasters. Fourth, it is essential to expand the epidemiologist training and education program to the level of advanced countries. Especially, the training course should be expanded at least twice of current times. Fifth, it is necessary to independently install and operate the 'EIS Officer Training Center' as a mid- and long-term goal. Stewardship and governance are secured with the organization, personnel, etc. that can fully manage the planning, management, and evaluation of the EIS system. In the future, it will be necessary to establish a systematic and phased operational base of education and training programs for EIS officer, and establish a sustainable implementation system for strategy development. In addition, it is urgent to revise the guidelines for training public health professionals and strengthening competencies, and for establishing professional educational institutions.

Treatment of Mycobacterium avium Complex Pulmonary Disease

  • Kwon, Yong-Soo;Koh, Won-Jung;Daley, Charles L.
    • Tuberculosis and Respiratory Diseases
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    • 제82권1호
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    • pp.15-26
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    • 2019
  • The pathogen Mycobacterium avium complex (MAC) is the most common cause of nontuberculous mycobacterial pulmonary disease worldwide. The decision to initiate long-term antibiotic treatment is difficult for the physician due to inconsistent disease progression and adverse effects associated with the antibiotic treatment. The prognostic factors for the progression of MAC pulmonary disease are low body mass index, poor nutritional status, presence of cavitary lesion(s), extensive disease, and a positive acid-fast bacilli smear. A regimen consisting of macrolides (clarithromycin or azithromycin) with rifampin and ethambutol has been recommended; this regimen significantly improves the treatment of MAC pulmonary disease and should be maintained for at least 12 months after negative sputum culture conversion. However, the rates of default and disease recurrence after treatment completion are still high. Moreover, treatment failure or macrolide resistance can occur, although in some refractory cases, surgical lung resection can improve treatment outcomes. However, surgical resection should be carefully performed in a well-equipped center and be based on a rigorous risk-benefit analysis in a multidisciplinary setting. New therapies, including clofazimine, inhaled amikacin, and bedaquiline, have shown promising results for the treatment of MAC pulmonary disease, especially in patients with treatment failure or macrolide-resistant MAC pulmonary disease. However, further evidence of the efficacy and safety of these new treatment regimens is needed. Also, a new consensus is needed for treatment outcome definitions as widespread use of these definitions could increase the quality of evidence for the treatment of MAC pulmonary disease.

Physicochemical properties and physiological activity of bean sprouts extract containing Hovenia dulcis Thunb concentrates

  • Ji-An Heo;Wool-Lim Park;Hye-Ji Min;Jeong-Ho Kim;Yeong-Seon Won;Kwon-Il Seo
    • 한국식품저장유통학회지
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    • 제30권4호
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    • pp.617-629
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    • 2023
  • Reactive oxygen species are the byproducts of metabolic processes in the body, However, excessive amount may cause side effects such as cancer. Therefore, to reduce the production of these species, but their long-term administration at high doses may induce side effects. Hence, natural materials with antioxidant activities are attracting attention. Two of these natural materials are soybean sprouts and Hovenia dulcis Thunb. fruits, but few studies have evaluated the effects of their combination. Thus, we prepared a soybean sprout extract containing 1.5% H. dulcis Thunb. fruit concentrate (BHM) to develop a functional food material derived from natural products and then confirmed its physicochemical properties and physiological activity. Among the organic acids detected in BHM, malic acid exhibited the highest content of 1,451.03 ppm, and the main free sugars were glucose (645.48 ppm) and fructose (738.11 ppm). Taurine was the most abundant free amino acid at a concentration of 11.95 ppm, followed by those of arginine (10.97 ppm) and glutamic acid (10.16 ppm). Analyses of the mineral components revealed large amounts of Zn and Fe in BHM, and the respective total polyphenol and flavonoid contents in BHM were 957.16 and 601.93 ppm. The DPPH radical and H2O2 scavenging activities and reducing power indicated excellent antioxidant efficacy compared to the positive controls. Furthermore, blood alcohol and acetaldehyde concentrations were measured to confirm the hangover-relieving effects of BHM, with both significantly decreased (p<0.05). BHM displays potential for development as a functional food, and the results of this study may be used as basic data in further research.

농촌보건의료서비스 향상을 위한 제도 개선방안 (Policy Measures for Improving Health Care Services in Rural Areas)

  • 문옥륜;이규식;박재용;고대하;이기효
    • 농촌의학ㆍ지역보건
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    • 제16권2호
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    • pp.97-119
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    • 1991
  • 본 연구는 농촌지역의 보건의료수준이 의료자원의 양적, 질적 격차와 의료이용과 의료접근도 및 건강수준의 면 등에서 도시지역보다 낙후되어 있다는 사실을 각종 통계지표를 이용하여 논증하였다. 다음으로 이러한 격차를 빚은 농촌보건사업의 문제점을 파악하여 이에 대한 대처방안을 농촌보건사업의 조직, 인력, 시설 및 장비, 재원 및 그리고 관리라는 5가지 부문으로 나누어서 모색해 보았는데 구체적으로는 첫째, 농촌보건 인력의 자질향상과 적정배치방안의 수립, 둘째, 농촌보건인력의 생산성 증대, 셋째, 보건소 및 지소의 운영개선, 넷째, 취약지 민간병원의 운영 개선, 다섯째, 사회, 경제여건의 변화에 따른 새로운 보건사업의 개발, 여섯째, 통합적인 보건의료인력관리 전담기관의 설립 등의 정책대안을 제시하고 있다.

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초등학생 저학년 돌봄교실의 건강식생활 교육프로그램 개발 및 적용 (Development and Application of an Education Program for Healthy Dietary Life for Elementary School Aftercare Class Children)

  • 김정현;경민숙;박인영;박영심
    • 대한지역사회영양학회지
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    • 제24권6호
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    • pp.497-511
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    • 2019
  • Objectives: This study aimed to develop a school-centered healthy eating environment for children in elementary care classrooms and prevent incorrect eating habits and obesity through the development and application of standardized healthy eating habit-forming educational materials. Methods: Ten schools in eight districts of Gyeonggi-do and 400 students from 19 care classes were selected. Based on the developed educational materials, the program was applied to students once in two weeks. 'Notices for Parents' forms were also sent to the students' home to educate their parents. Pre and post-surveys were conducted to evaluate the effectiveness of the education. The pre-education, education, and aftercare were conducted from September 28 to September 31, 2016, from October 3 to November 30, 2016, and from December 5 to December 9, 2016, respectively. Results: The healthy eating program for elementary care classes was designed to develop a school-centered healthy eating environment and provide standardized educational material for healthy eating habits. Twelve educational topics were developed: , , , , , , , , , , , and . Moreover, the materials were produced in four forms: for students, for after school caring teachers, for external specialists, and for parents. The effectiveness evaluation was conducted to confirm the application of the program. The average eating habits score was 3.3 ± 0.6, with no significant difference between before and after application. The score of overall satisfaction of the education was 3.9 ± 0.9. The most satisfying content was 'Did you get to know how to eat evenly?'. Significant increases were observed in two contents for parents regarding their children's knowledge changes after the education: 'Five nutrients needed for growing children' and 'Knowing sugar foods and sugar-containing foods'. On the other hand, their educational satisfaction was 3.6 ± 0.6, which was lower than the children's satisfaction. This might be because their education was conducted only through the 'Notices for Parents' form. Conclusions: In the long term, the healthy eating habit-formation education for lower elementary school children is expected to be beneficial. To prevent obesity and establish healthy eating habits of children, it is important to develop healthy eating education programs centered on elementary school aftercare classes, including the development of educational materials and an application system through connection with the home and community.

일본의 재난관리체계 및 재난심리지원체계 고찰과 시사점 (The Current Status and Implications of Disaster Management System and Psychological Support System in Disaster Response in Japan)

  • 이동훈;김지윤;강현숙;이혜림
    • 한국콘텐츠학회논문지
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    • 제16권7호
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    • pp.73-90
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    • 2016
  • 본 연구에서는 일본 재난관리 및 재난심리지원 체계를 살펴보고, 국내 재난심리지원체계의 구축 및 개선에 대한 시사점을 얻고자 한다. 이를 위해 일본과 한국의 재난심리지원 체계에 대한 국 내외 문헌을 중심으로 문헌연구가 이루어졌다. 일본에서는 대규모 재난 초동기에는 중앙에서 파견된 재난심리지원 인력인 재해파견정신의료팀(DPAT)에 의한 정신의료적 지원과 함께 적십자사에 의한 심리사회적 지원이 이루어지고, 재난 이후 중장기개입에 있어서는 마음케어센터에 의한 지원이 이루어지고 있다. 재난심리지원의 중앙 컨트롤타워 역할을 하는 재해시마음의정보지원센터는 재난정신건강정보지원시스템을 통해 전국적인 재난관련 데이터를 수집 분석 관리하여 전국적 수준에서 재난상황을 파악하고, 정보의 취합을 통해 중앙에서의 재난심리지원 활동을 관리한다. 일본 재난심리지원체계는 대규모 재난 시 마다 이를 계기로 하여 문제점들을 보완하고 수정하여 현재의 모습을 갖추어 왔다는 점에서 우리나라에 시사점을 준다. 연구결과에 기초하여 논의 및 시사점이 제시되었다.

스마트올인원 심폐순환보조장치의 안전성 및 성능평가에 관한 연구 (A Study on Safety and Performance Evaluation of Smart All-in-one Cardiopulmonary Assist Device)

  • 박준현;호예지;이예림;이덕희;최재순
    • 대한의용생체공학회:의공학회지
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    • 제40권5호
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    • pp.197-205
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    • 2019
  • The existing Extracorporeal membrane oxygenation(ECMO) and Cardiopulmonary bypass system(CPB) have been developed and applied to various devices according to their respective indications. However, due to the complicated configuration and difficult usage method, it causes inconvenience to users and there is a risk of an accident. Therefore, smart all-in-one cardiopulmonary circulation device is being developed recently. The smart all-in-one cardiopulmonary assist device consists of a blood pump for cardiopulmonary bypass, a blood oxidizer for cardiopulmonary bypass, a blood circuit for cardiopulmonary bypass, and an artificial cardiopulmonary device. It is an integrated cardiopulmonary bypass device that can be used for a variety of purposes such as emergency, intraoperative, post-operative intensive care, and long-term cardiopulmonary assist, combined with CPB used in open heart surgery and ECMO used when patient's cardiopulmonary function does not work normally. The smart all-in-one cardiopulmonary assist device does not exist as a standard and international standard applicable to advanced medical devices. Therefore, in this study, we will refer to the International Standard for Blood Components, the International Standard for Blood, the Guideline for Blood Products, and prepare applicable performance and safety guidelines to help quality control of medical devices, and contribute to the improvement of the health of people. The guideline, which is the result of conducted a survey of the method of safety and performance test, is based on the principle of all-in-one cardiopulmonary aiding device, related domestic foreign standards, the status of domestic and foreign patents, related literature, blood pump(ISO 18242), blood oxygenator (ISO 7199), and blood circuit (ISO 15676) for cardiopulmonary bypass.The items on blood safety are as follows: American Society for Testing and Materials ASTM F1841-97R17), and in the 2010 Food and Drug Administration's Safety Assessment Guidelines for Medical Assisted Circulatory Devices. In addition, after reviewing the guidelines drawn up through expert consultation bodies including manufacturers / importers, testing inspectors, academia, etc. the final guideline was established through revision and supplementation process. Therefore, we propose guidelines for evaluating the safety and performance of smart all-in-one cardiopulmonary assist devices in line with growing technology.

진행성 위암 환자 증례를 통한 한양방 병용치료의 효용성 연구 (Study of Efficiency of the East-west Medical Combined Treatment of Advanced Gastric Cancer in Patients Case)

  • 이남헌;심재철;채은영;유화승;조정효;이연월;손창규;조종관;윤담희
    • 동의생리병리학회지
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    • 제19권6호
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    • pp.1681-1684
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    • 2005
  • Gastric cancer is the most common disease which is the highest genetic rate, chemotherapy is the only known way to treat, especially advanced gastric cancer. Although, it is the remedy, the harmful side-effects are an obstacle of the sustaining treatment and negative effect on immunologic ability of patients prologed. Consequently, it is surely necessary that effective control for sequele of anti-cancer treatment, and remedy which can improve the quality of patients life. 1, the writer, medicate patients, diagnose as gastric cancer in 4th stage, with Sohap-hyangwon and Chungwoolhyadamjen who complained of pain in sequele of anti-cancer treatment. The size of the metastastic liver tumor is decreasing in patients and the immunologic abilities are maintaining stable. This clinical cases are shown that the oriental medical care in long-term can improve the quality of life of the patients who has sequele of anti-cancer treatment.