• Title/Summary/Keyword: patient-reported outcomes

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Management of endometrial polyps in infertile women: A mini-review

  • Jee, Byung Chul;Jeong, Hye Gyeong
    • Clinical and Experimental Reproductive Medicine
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    • v.48 no.3
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    • pp.198-202
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    • 2021
  • Considerable disagreement exists regarding whether endometrial polyps should be removed before attempting natural pregnancy and before pregnancy via intrauterine insemination (IUI) or in vitro fertilization (IVF). Through a literature review, we obtained information on the impact of endometrial polyps and polypectomy on fertility outcomes. Several observational studies have suggested that women with unexplained infertility may benefit from endometrial polypectomy for a future natural pregnancy. A few studies reported benefits from endometrial polypectomy in infertile women who plan to undergo IUI. However, no strong evidence supports polypectomy as a way to improve the pregnancy rate in infertile women who plan to undergo IVF or polypectomy during controlled ovarian stimulation for IVF. Although no studies have defined criteria for the polyp size that should be removed in infertile women, clinicians should be aware that small endometrial polyps (<10 mm) sometimes regress spontaneously. Endometrial polypectomy is currently justified in patients with repeated IVF failure, but more studies are needed to verify that endometrial polypectomy itself will eventually increase the pregnancy rate. Although several mechanisms by which endometrial polyps exert a negative effect on fertility have emerged, there is no consensus about the proper management of endometrial polyps in infertile women. Therefore, the management of endometrial polyps should be individualized depending on the patient's situation and clinician's preference.

The Development and Effect of a Video Education Program on Uncertainty and Educational Satisfaction among Spinal Surgery Patients (척추수술 환자를 위한 동영상 교육 프로그램 개발 및 효과)

  • Kim, Sun Mi;Lee, Soo Jin
    • Journal of muscle and joint health
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    • v.25 no.3
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    • pp.187-195
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    • 2018
  • Purpose: This study was conducted to develop a video education program for spinal surgery patients and to investigate the effect of the program on patients' uncertainty and educational satisfaction. Methods: This study employed a nonequivalent control group pretest-posttest design. The participants were 54 patients who had undergone spinal surgery in Busan from February to May 2017. The video education program was provided to the experimental group (n=28). The program consisted of providing existing leaflets to patients and repeatedly showing patients educational videos during their hospitalization. Leaflets were also provided to the control group (n=26) as part of traditional care. Patients' reported levels of uncertainty and educational satisfaction were measured. Data were analyzed using the chi-squared test, independent t-test, Mann-Whitney U test, and covariance analysis. Results: A significant difference was observed between the groups in uncertainty pre-post changes (U=239.50, p=.030). With the education variable controlled, there were significant differences between the groups in the educational satisfaction posttest (F=19.79, p<.001). Conclusion: The program was effective in reducing uncertainty and in enhancing educational satisfaction. Therefore, the video education program may be helpful for improving patient satisfaction and outcomes in various clinical fields.

Treatment Outcomes of Venlafaxine and Duloxetine in Refractory Burning Mouth Syndrome Patients

  • Kim, Moon-Jong;Kho, Hong-Seop
    • Journal of Oral Medicine and Pain
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    • v.44 no.3
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    • pp.83-91
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    • 2019
  • Purpose: Venlafaxine and duloxetine have been shown to be effective in the treatment of neuropathic pain disorders. However, knowledge about the efficacy of venlafaxine and duloxetine on burning mouth syndrome (BMS) is still insufficient. The purpose of this study was to investigate the efficacy of venlafaxine and duloxetine on refractory BMS patients. Methods: Twelve refractory BMS patients who were prescribed venlafaxine or duloxetine were included in this study. These patients did not respond to previous administration of clonazepam, alpha-lipoic acid, gabapentin, and nortriptyline. All participants were the primary type of BMS patients who had no local and systemic factors related to the oral burning sensation. The intensities of oral symptoms following venlafaxine or duloxetine administration were compared with those before administration and at baseline. Results: Venlafaxine and duloxetine were prescribed to four and nine patients, respectively. One patient was prescribed both medications in turn. Among them, only two patients showed improvement of oral symptoms without side effects. In the other ten patients, symptoms failed to improve. Six of them reported that the drug was ineffective, and four of them stopped taking the medications on their own due to intolerable side effects, such as insomnia, constipation, drowsiness, dizziness, and xerostomia. Conclusions: Venlafaxine and duloxetine may only relieve oral symptoms in a minority of refractory BMS patients. Further large-scale studies are needed to determine the potential clinical factors that could predict the efficacy of venlafaxine and duloxetine.

Intradural Transpetrosectomy for Petrous Apex Meningiomas

  • Han, Shuo;Zhang, Xiao-Hua;Han, Dong-Hua;Jin, Yi-Chao
    • Journal of Korean Neurosurgical Society
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    • v.62 no.5
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    • pp.610-617
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    • 2019
  • Objective : This study aimed to assess the surgical results of the intradural transpetrosectomy for petrous apex meningiomas (PAMs). In addition, we describe the methods and techniques used to expose and manage superior petrous vein and greater superficial petrosal nerve. Methods : The authors conducted a retrospective study of 16 patients with PAMs operated by the senior author via the intradural transpetrosectomy between February 2012 to May 2017. We reviewed patient data regarding the general characteristics, surgical technique and surgery-related outcomes and adopted a combined follow-up strategy of clinic and telephone contacts to evaluate postoperative complications. Results : Simpson grade I and II resection was performed in 10 out of 16 cases (62.5%), and grade III resection were reported in the remaining six cases (37.5%) with no resultant mortality. The mean Karnofsky Performance Status score was 85.6 preoperatively and improved to 91.9 postoperatively, with a mean follow-up period of 34.4 months (range, 6-66 months). Tumor recurrence was found in two patients and they underwent the second surgical operation. Conclusion : PAMs could be completely resected by the intradural transpetrosectomy with an improved survival rate and postoperative life quality. Superior petrous vein and greater superficial petrosal nerve should be managed properly in avoidance of postoperative complications. Finally, most meningioma inside cavernous sinus or adhered to brainstem could be totally removed without postoperative complications.

Omental Free Shaped Flap Reinforcement on Anastomosis and Dissected Area (OFFROAD) Following Gastrectomy

  • Han, WonHo;Park, KyongLin;Kim, Deok-Hee;Kim, Young-Woo
    • Journal of Minimally Invasive Surgery
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    • v.21 no.4
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    • pp.180-182
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    • 2018
  • The frequency of anastomotic leakage after gastrectomy is reported to be 0.9~8%. To reduce deleterious outcomes of anastomotic leakage, we devised the "Omental Free-shaped Flap Reinforcement On Anastomosis and Dissected area" procedure not only to prevent fatal complications following anastomotic leakage but also to promote vascularity of anastomoses and other expected oncological benefits. This video illustrates the surgical procedure following a totally laparoscopic distal gastrectomy. After completion of the anastomosis, the remaining omentum was mobilized upward and divided into two sections. We placed the left section of the omental flap under the anastomosis between the stomach and pancreas. Finally, we grasped and curved the tip of the section to cover the anastomosis from behind, and we placed the right section of the omental flap above the anastomosis. These two sections were approximated with clips to the anterior wall of the stomach. The patient was discharged without complications.

A Review of Cognitive and Behavioral Interventions for Tic Disorder

  • Kim, Kyoung Min;Bae, Eunju;Lee, Jiryun;Park, Tae-Won;Lim, Myung Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.32 no.2
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    • pp.51-62
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    • 2021
  • Objectives: Tic disorder is a neurodevelopmental disorder characterized by multiple involuntary movements of muscles or vocalization. Although tic symptoms subside as the patient ages, some patients suffer from significant functional impairments related to severe tic symptoms. This manuscript aimed to review the latest scientific evidences for the effect of cognitive-behavioral interventions on tic disorder. Methods: The relevant studies were identified by searching medical research databases. We focused our search on studies published between 2000 and 2020 in order to reflect the latest scientific evidence. A total of 821 articles were identified in the initial database search and 27 articles were finally included for the review after the exclusion of duplicated and irrelevant articles. Results: Behavioral therapies including habit reversal training, Comprehensive Behavioral Intervention for Tics, and exposure and response prevention were the most widely studied interventions for tic disorder and are recommended as first-line treatments for tic disorders with high confidence. Cognitive psychophysiologic approaches were also reported to be effective. Conclusion: Further studies are needed to support the future treatment of tics with low-cost and more widely available treatments, in order to ensure better treatment outcomes.

Evaluation and treatment of facial feminization surgery: part II. lips, midface, mandible, chin, and laryngeal prominence

  • Dang, Brian N.;Hu, Allison C.;Bertrand, Anthony A.;Chan, Candace H.;Jain, Nirbhay S.;Pfaff, Miles J.;Lee, James C.;Lee, Justine C.
    • Archives of Plastic Surgery
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    • v.49 no.1
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    • pp.5-11
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    • 2022
  • Facial feminization surgery (FFS) refers to a set of procedures aimed at altering the features of a masculine face to achieve a more feminine appearance. In the second part of this two-part series, assessment and operations involving the midface, mandible, and chin, as well as soft tissue modification of the nasolabial complex and chondrolaryngoplasty, are discussed. Finally, we provide a review of the literature on patient-reported outcomes in this population following FFS and suggest a path forward to optimize care for FFS patients.

A study on the current state of Korean medicine treatment in infertile women: an observational multi-center study protocol (여성 난임환자의 한의치료 현황 및 경과 관찰을 위한 전향적 다기관 관찰연구 프로토콜)

  • Choi, Su-Ji;Kim, Dong-Il
    • The Journal of Korean Medicine
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    • v.43 no.2
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    • pp.42-50
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    • 2022
  • Objectives: The purpose of this study is to investigate the characteristics of female infertility patients who come to Korean medicine clinics and analyze the trends of Korean medicine treatment methods and the effects of female infertility by registry data. Methods: We are recruiting study participants from Korean medicine hospitals and clinics. If female infertility patients come, we will ask them to register for this study. After enrollment, we will collect demographic information, treatment methods, pregnancy results, adverse events, and treatment costs. Result: First, we will analyze the characteristics of patients, the status of the use of Korean medicine treatment interventions, the cost status of Korean medicine infertility treatment, and the delivery characteristics of pregnant women after Korean medicine treatment. Second, we will analyze the effectiveness of Korean medicine treatment. The primary outcome is clinical pregnancy rate, and secondary outcomes are 12-week pregnancy maintenance rate, degree of dysmenorrhea and premenstrual syndrome, stress level, and health-related quality of life score. Discussion: This study is the first observational multi-center study in Korea for female infertility. By establishing the registry, we are creating a resource that contains patient-reported outcome measures for female infertility. The registry is expected to provide valuable data for developing Korean medicine Clinical practice guidelines for female infertility.

Is conservative treatment (enucleation using modified Carnoy's solution) of odontogenic keratocyst in the maxilla good prognosis?

  • Woo Young Jeon;Jung Ho Park;Jeong-Kui Ku;Jin-A Baek;Seung-O Ko
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.5
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    • pp.287-291
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    • 2023
  • Odontogenic keratocysts (OKCs) located in the maxillae have rarely been reported in the literature. Standard treatment modalities for OKC range from marsupialization to marginal resection. However, most of the studies on OKC treatment have been related to mandibular OKCs. The anatomical structure and loose bone density of the maxillae and the empty space of the maxillary sinus could allow rapid growth of a lesion and the ability to tolerate tumor occupancy in the entire maxilla within a short period of time. Therefore, OKCs of the maxillae require more aggressive surgery, suchas resection. As an alternative, this report introduces a modified Carnoy's solution, a strong acid, as an adjuvant chemotherapy after cyst enucleation. This report describes the clinical outcomes of enucleation using a modified Carnoy's solution in patients with large OKCs on the posterior maxillae. In three cases, application of a modified Carnoy's solution had few side effects or morbidity. Each patient was followed for four to six years, and none showed any signs of recurrence. In conclusion, adjuvant treatment with a modified Carnoy's solution can be considered a treatment option capable of reducing the recurrence rate of OKC in the maxillae.

Meek Micrografting Technique for Reconstruction of Extensive Necrotizing Fasciitis of the Anterior Abdomen and Bilateral Femoral Region: A Case Report

  • Jyi Cheng Ng;Ahmad Ibrahim Ahmad Zaidi;Jun De Lee;Mohd Faisal Jabar
    • Archives of Plastic Surgery
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    • v.50 no.6
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    • pp.610-614
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    • 2023
  • Necrotizing fasciitis is an uncommon yet fatal soft tissue infection. Current recommended treatment includes antibiotics with repeat surgical exploration and wound debridement followed by reconstruction. In burn patients, the Meek micrograft has demonstrated a higher true expansion ratio, faster reepithelialization rate, more resilient toward infection, and reduced risk of graft failure as compared with meshed graft. To our best knowledge, the use of Meek micrografting technique in reconstruction of postdebridement wounds of necrotizing fasciitis has not been reported. Hereby, we present a case of a 57-year-old gentleman who was referred to us for wound reconstruction after surgical debridement of Fournier's gangrene and extensive necrotizing fasciitis involving the anterior abdomen and bilateral femoral region. Meek micrografting technique was used to reconstruct the anterior abdomen as the wound bed was large. Although the graft was complicated with a small area of localized infection, it did not spread across the entire graft and was successfully treated with topical antibiotics and regular wound dressing. In our case, wound reconstruction using Meek micrografting technique in a patient with extensive necrotizing fasciitis was successful and showed positive outcome. Therefore, we suggest further studies to be conducted to investigate the applications and outcomes of the Meek micrografting technique, especially in patients with extensive wound bed and limited donor site availability.