Background: Malignant mesothelioma (MM) is an insidious tumor with poor prognosis, arising from mesothelial surfaces such as pleura, peritoneum and pericardium. We here aimed to evaluate the demographic, clinical, and radiological features of patients with MM followed in our center as well as their survival. Methods: The study included 228 patients (131 male, 97 female) who were followed up in our institution between 1993 and 2010 with the diagnosis of MM. Results: The mean age was 59.1 years in men and 58.7 years in women and the sex ratio was 1.4:1 in favor of males. Environmental asbestos exposure was present in 86% of the patients for a mean duration of $40{\pm}20$ years (range: 3-70). Pleural effusion and thoracic/abdominal pain were the most common presenting signs and symptoms (70.2% and 57.8%, respectively). One hundred-thirteen (66%) patients were treated with platinum-based combination chemotherapy (PBCT) plus supportive care (SC) and 67 (34%) patients received SC alone. The median follow-up time was 10.0 months. The median overall survival was significantly improved with PBCT plus SC compared to SC alone (11.4 vs. 5.1 months; p=0.005). The 6, 12, 18, and 24-month survival rates were significantly improved with PBCT plus SC compared to SC alone (72%, 43%, 19%, and 2% vs. 49%, 31%, 11%, and 1%). Conclusion: The survival of patients with MM improved in patients treated with PBCT. The survival advantage continued 12- and 24-month after the initial time of combination chemotherapy.
Background: The purpose of this study was to assess the effectiveness of a recombinant human epidermal growth factor (EGF)-based cream for the prevention of acute radiation dermatitis in breast cancer patients receiving radiotherapy (RT). Materials and Methods: Between December 2012 and April 2013, 40 breast cancer patients who received postoperative RT were prospectively enrolled in this study and randomly assigned to receive human recombinant EGF-based cream (intervention group) or general supportive skin care (control group). The grade of radiation dermatitis and pain score were examined at weekly intervals during RT and 6 weeks after RT completion. Results: All patients completed the planned RT and complied well with instructions for applying the study cream and general supportive skin care. In the intervention group, radiation dermatitis of maximum grade 3, 2, and 1 developed in 3 (15%), 11 (55%), and 6 patients (30%), respectively. In comparison, in the control group, radiation dermatitis of maximum grade 3, 2, and 1 developed in 8 (40%), 10 (50%), and 2 patients (10%), respectively. The intervention group showed lower incidence of grade 3 radiation dermatitis than the control group (p=0.068 in univariate analysis and p=0.035 in multivariate analysis). There was no statistically significant difference in the maximal pain score between the two groups (p=0.934). Conclusions: This single-blind randomized preliminary study showed that recombinant human EGF-based cream can have a beneficial role in preventing or minimizing radiation dermatitis in breast cancer patients. To confirm the results of our study, additional studies with a large sample size are required.
Purpose: This qualitative study aimed to develop a substantive theory of the process of adaptation to motherhood in Central Asian-Korean immigrants to Korea. Methods: Individual, in-depth interviews were conducted from July to September 2017, with 18 women who emigrated of Korean ethnicity from Central Asia to Korea, and took care of their baby for at least a year after their first delivery in Korea. The interviews were audio-recorded and transcribed verbatim. Data from the transcriptions were analyzed through Strauss and Corbin's grounded theory method, and data analysis was conducted simultaneously with data collection. Results: As a result of categorizing the interview data through the process of open coding, 10 categories, with 31 subcategories and 102 concepts were drawn, and "growth as a Central Asian-Korean mother in an unfamiliar, historical hometown" was found to be the core category of the process of adaptation to motherhood in Central Asian-Korean immigrants to Korea. Conclusion: A characteristic of the process of adaptation to motherhood in Central Asian-Korean immigrants to Korea, drawn from this study, is that it differs according to the level of initiative to carry out interaction strategies, and the use of various supportive social resources. The findings indicate the need for Medicare eligibility adjustment for antenatal care, the extension of the visa renewal period during childbirth, the development of web- or mobile application-based educational programs in Russian language, and the establishment of integrated visiting healthcare services, community service resources, and policy support to enable these women to utilize various supportive social resources.
This study explored the relationships between Husband's emotional support and the mother's postpartum depression. The purpose of this study was to contribute to theoretical understanding of the relationships among these two variables and eventually to direct the planning of nursing care that enhance the health status of mothers in the postpartum period. Data were collected from January to June, 1995, with 47 postpartum Korean mothers in NewHampshire state in The United States of America. Postpartum depression was measured by Jung's Self-rating Depression Scale and husband's support was measured by Husband's support scale developed by Cho, Young Sook. Postpartum depression and husband's support were measured by postpartum mothers on the 3rd postpartum day and 2 weeks. The data were analysed by an SPSS computerized program and Percentages, t-test, paired t-test. ANOVA, Pearson correlation coefficients, and Stepwise multiple regression were used. The result of this study were summerized as follows ; 1. Mother's postpartum depression was greater at two weeks than the 3rd day (t=-2.64, p<.05). 2. Mother's percieved husband's supportive behavior was lower at 2 weeks than the 3rd day(t=-3.14,p<.01) 3. The higher the husband's supportive behavior, the lower the postpartum mother's depression (r=-2650,-2845;p<.01) 4. In this study, variables related to the mother's postpartum depression were husband's support, how much the husband liked the baby, occupation, and the knowledge of how to care for the baby. 5. In addition, by using Stepwise multiple regression analysis, it was determined that the main influencing factors on the postpartum depression. The variables - husband's support, how much the husband liked the baby and job made it possible to explain 48.61% of variance in postpartum depression. In conclusion, this study revealed that husband's support is an important factor that decrease the immigrant mother's postpartum depression.
This study was a quasi-experimental study of nonequivalent control group pretest- posttest design to investigate the effect of aerobic walking exercise program on the physical & psychological functions of home stayed stroke patients. The data were collected during the period of May 20th to August 15th, 2001. The subjects for this study were 40 hemiplegic stroke patients with the experimental group consisting of 19 patients and the control group being composed of 21 patients. The patients selected for this study were: (a)living in J city who had been diagnosed with stroke and at home after being discharged from the hospital, (b)suffering from stroke for 6 months to 5 years, (c)without recognition disorder with the MMSE-K score above 25, (d)below 2 on the modified Ashworth scale, (e)free from heart and pulmonary disease (f)able to walk beyond 15 minutes for themselves. The aerobic walking exercise program for the experimental group was aerobic exercise and education and supportive care. The aerobic exercise was 8 weeks' period, three times a week, 35 to 50 minutes a day. And the education and supportive care was consisted of one home visiting and 2 times telephoning a week. The data were analysed by $X^2$-test, paired t-test and unpaired t-test and ANCOVA through SAS/PC program. The results of the study were as follows: 1. There was insignificant difference in the gait length experimental and control group. There was significant difference in the gait speed between the two groups. 2. There was significant difference in the dynamic valance between the two groups. 3. There was significant difference in ADL score between the two groups. 4. There was no significant difference in the depression between the two groups. As shown above, the results of 8 weeks' the aerobic walking exercise program for home stayed stroke patients produced positive effects on gait speed, dynamic valance, ADL score. And this program was expected that it was more effective in different intervention period, verified program. Also it was needed follow study.
Although re-expansion pulmonary edema (RPE) is rare (incidence rate <1%), it is associated with a mortality rate of >20%; therefore, early diagnosis and treatment are important. We report a case of RPE following chest tube insertion in a patient with spontaneous pneumothorax. We have specifically focused on the mechanism underlying RPE and the possible etiology. An 82-year-old man with a history of chronic anemia, chronic obstructive pulmonary disease, diabetes mellitus, and hypertension was referred to the emergency department for management of recurrent right-sided pneumothorax. We performed emergency closed thoracostomy for suspected tension pneumothorax, which led to stabilization of the patient's vital signs; however, he coughed up frothy pink sputum accompanied by severe right-sided chest pain 30 min postoperatively. The patient showed new-onset right pulmonary consolidation on chest radiography, as well as desaturation, tachycardia, and tachypnea and was diagnosed with RPE. He was transferred to the intensive care unit for mechanical ventilation and supportive treatment using diuretics, ionotropic agents, and prophylactic antibiotics. RPE gradually resolved, and the patient was extubated 3 days after admission. He has not experienced recurrent pneumothorax or pulmonary disease for 4 months. We emphasize the importance of RPE prevention and that aggressive ventilator care and supportive treatment can effectively treat RPE following an accurate understanding of the underlying pathogenetic mechanisms and risk factors.
Schmalz, Gerhard;Kummer, Max Kristian;Kottmann, Tanja;Rinke, Sven;Haak, Rainer;Krause, Felix;Schmidt, Jana;Ziebolz, Dirk
Journal of Periodontal and Implant Science
/
제48권4호
/
pp.251-260
/
2018
Purpose: The aim of this retrospective cross-sectional study was to evaluate whether salivary findings of active matrix-metalloproteinase 8 (aMMP-8) chairside (point of care; POC) tests were associated with periodontal risk assessment parameters in patients receiving supportive periodontal therapy (SPT). Methods: A total of 125 patients receiving regular SPT were included, and their records were examined. The following inclusion criteria were used: a diagnosis of chronic periodontitis, at least 1 non-surgical periodontal treatment (scaling and root planning) with following regular SPT (minimum once a year), at least 6 remaining teeth, and clinical and aMMP-8 findings that were obtained at the same appointment. In addition to anamnestic factors (e.g., smoking and diabetes), oral hygiene indices (modified sulcus bleeding index [mSBI] and approximal plaque index), periodontal probing depth simultaneously with bleeding on probing, and dental findings (number of decayed, missing, and filled teeth) were recorded. Salivary aMMP-8 levels were tested using a commercial POC test system (Periomarker, Hager & Werken, Duisburg, Germany). Statistical analysis was performed using the t-test, Mann-Whitney U test, Fisher's exact test, and ${\chi}^2$ test, as appropriate (P<0.05). Results: Only the mSBI was significantly associated with positive salivary aMMP-8 findings (aMMP-8 positive: $27.8%{\pm}20.9%$ vs. aMMP-8 negative: $18.0%{\pm}14.5%$; P=0.017). No significant associations were found between aMMP-8 and smoking, diabetes, periodontal parameters, or parameters related to the maintenance interval (P>0.05). Conclusions: Salivary aMMP-8 chairside findings were not associated with common parameters used for periodontal risk assessment in patients receiving SPT. The diagnostic benefit of POC salivary aMMP-8 testing in risk assessment and maintenance interval adjustment during SPT remains unclear.
Purpose: This study aimed to examine the prevalence and abundance of 9 representative periodontal pathogens in the saliva samples of periodontally healthy subjects (PH) and patients with periodontitis who underwent supportive periodontal therapy (SPT). The age-specific distribution of these pathogens in periodontally healthy individuals was also analyzed. Methods: One hundred subjects (aged >35 years) were recruited (50 each in the PH and SPT groups) between August 2016 and April 2019. The prevalence and abundance of periodontal pathogens in the PH group were compared with those in periodontally healthy young subjects (94 subjects; aged <35 years), who were included in our previous study. DNA copy numbers of Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Treponema denticola (Td), Prevotella intermedia (Pi), Fusobacterium nucleatum (Fn), Campylobacter rectus (Cr), Peptostreptococcus anaerobius (Pa), and Eikenella corrodens (Ec) were analyzed using real-time polymerase chain reaction. Results: The detection frequencies of all pathogens, except Aa, were high in the PH and SPT groups. The ranking order of pathogen DNA copy numbers was similar in both groups. In both groups, Fn had the highest abundance, Aa had the lowest abundance. Additionally, Td was significantly more abundant in men than in women in both groups (P<0.05). Compared with the PH group, the SPT group exhibited significantly lower total bacteria and Fn abundance and higher Pg abundance (P<0.05). The age-specific pathogen distribution analysis revealed a significantly low Aa abundance and high Tf and Cr abundance in the PH group. Conclusions: The clinical parameters and microbial profiles were similar between the SPT and PH groups. However, patients with periodontitis require supportive care to prevent recurrence. As the abundance of some bacteria varied with age, future studies must elucidate the correlation between age-related physiological changes and periodontal bacterial composition.
Background: In this study, we tried to comprehensively explore clinical dental hygienist's experience of a prevention-based incremental oral health care program, which was pilot-operated by dental clinics, define prevention-based incremental oral health care as experienced in the field, and identify factors to be considered. Methods: This study conducted a focus group interview with five dental hygienists who participated in an ongoing oral management pilot project in 2016. The interview was conducted by a researcher, and the co-research team attended as progress assistants and recorded characteristics of the participants, main dictations, and non-verbal characteristics. All interviews were recorded and underwent thematic analysis to examine the questions of the study as the main axis. Results: As a result of the study, 65 meaningful statements were extracted by code, integrated into 24 sub-categories, and structured into 11 categories. Finally, four keywords were drawn: characteristics, facilitating factors, conflicting factors, and improvement measures for prevention-based incremental oral health care. Regarding prevention-based incremental oral health care in dental clinics, dental hygienists were highly aware of the physical and mental burdens of personalized treatment and education for each individual. They were responsible for the patient and for facilitating changes in the behavior of the client, leading to professional satisfaction. The dental team's cooperation and supportive attitude were found essential to continue oral health care in the dental clinic. Conclusion: Through dental team-based treatment philosophy sharing and collaboration, it is possible to provide prevention-based incremental oral health care in dental clinics. In future, it is necessary to develop a system for establishing a sustainable preventative management system for public health promotion.
Background: Having been known as a virulent disease in 1970s, cancer is now onsidered a chronic disease and 64% of cancer patients live for five years after diagnosis. Home care has gradually gained more importance and it is a great burden on the shoulders of caregivers. Caregivers have to undertake the responsibility of the cancer patient's home management, and organize care and arrange health care services according to the ever-changing condition of patients. Caregivers should be prepared for home care so they can provide accurate and complete care to patients. This descriptive study aims to investigate challenges that caregivers encounter in the home care of patients and the reasons for these challenges. Materials and Methods: The research group consisted of caregivers of outpatients in a daily treatment center in a university hospital. The research sampling consisted of 137 voluntary caregivers of patients who attended the Daily Treatment Center for control, chemotherapy or other supportive cares services between January-June, 2011. Data were collected with face-to-face interviews in the Daily Treatment Center. Ethics Committee approval was taken university hospital; caregivers and their patients were informed about the research and their approval was taken as well. Results: It was found that 54.01% of caregivers help patient's nutrition, 50.36% help medicine use, 26.28% help oral hygiene, 26.28% help to meet urinary needs and 51.82% help to change clothes, 69.34% of caregivers help to change bed sheets, 38.69% help the patient to communicate with their environment and 71.53% help to bring the patient to hospital or outside. Conclusions: This study, it was found that caregivers experience challenges due to following factors: patient nutrition, medicine use, oral and body hygiene, colostomy maintenance and stomach tube feeding, concern of dropping the patient, feeling incompetency in body temperature and fever control, fatigue, and lack of personal time.
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