• 제목/요약/키워드: supportive care

검색결과 411건 처리시간 0.023초

Perosomus elumbus fetal monster: a rare cause of dystocia in a beetal goat - a case report from Pakistan

  • Mubbashar Hassan;Sanan Raza;Ahmad Yar Qamar;Muhammad Ilyas Naveed;Abdul Mateen;Muhammad Noman;Sayed Aun Muhammad;Abid Hussain Shahzad
    • 한국동물생명공학회지
    • /
    • 제39권1호
    • /
    • pp.62-65
    • /
    • 2024
  • Dystocia, a challenging condition in obstetrics, can arise from various causes, including fetal monsters with structural abnormalities. This case report presents a unique case of dystocia due to a fetal monster known as Perosomus Elumbis in a beetal breed goat from Pakistan. The 4-years-old pregnant doe presented with prolonged straining and failure to deliver the fetus after 8 hours of labor. Upon examination, the cervix was dilated, and only the forelimbs of the fetus were visible in the birth canal. The subsequent delivery involved the application of manual traction by using a dystocia kit, and the removal of edematous fluid from the legs. The monster fetus exhibited absence of hair growth, along with the absence of thoracic vertebrae. Two other fetuses were present, with one found dead and the other alive. Posttreatment involved fluid therapy, antibiotics, and supportive care for the doe. This case report sheds light on the occurrence of Perosomus Elumbis fetal monsters and their impact on dystocia in goat breeding. Understanding the underlying causes and implementing appropriate management strategies are crucial for successful outcomes in similar cases.

Acute interstitial nephritis with acute kidney injury after COVID-19 vaccination: a case report

  • Jimin Lim;Jin Hyuk Paek;Hyeong Chan Shin;Woo Yeong Park;Kyubok Jin;Misun Choe;Seungyeup Han;Yaerim Kim
    • Clinical and Experimental Vaccine Research
    • /
    • 제13권1호
    • /
    • pp.68-71
    • /
    • 2024
  • In the context of the massive spread of coronavirus disease 2019 (COVID-19), the development of a COVID-19 vaccine is urgently needed. The Pfizer-BioNTech COVID-19 vaccine has been widely applied across global populations. Herein, we report a case of acute interstitial nephritis with acute kidney injury in a young healthy subject after administration of the COVID-19 vaccine. A 20-year-old man was admitted with abdominal discomfort and nausea. He had received the Pfizer-BioNTech COVID-19 vaccine 6 days before. At 9 days after vaccination, his kidney function was decreased, with serum creatinine levels of 1.8 mg/dL. Even with supportive care with hydration, his kidney function worsened, and he underwent a kidney biopsy. The pathology findings revealed diffuse interstitial infiltration of inflammatory cells, predominantly comprising lymphocytes, with preservation of the glomerulus. No abnormal findings were noted by immunofluorescence or electron microscopy. Based on a diagnosis of drug-related acute interstitial nephritis, we treated the patient with high-dose prednisolone. After administration of prednisolone, kidney function slowly improved. A close linkage between COVID-19 vaccination and acute interstitial nephritis should be considered in the clinic, despite the low incidence.

행위별 수가 지불제도 하에서의 사례관리시스템 개발 및 경제성 분석 (Development of Case Management System and Analysis of Economic Feasibility under the Fee-For-Service Reimbursement)

  • 최미영;채영문;탁관철;김인숙;천자혜
    • 한국의료질향상학회지
    • /
    • 제11권1호
    • /
    • pp.46-60
    • /
    • 2004
  • Background : Recently, we have experienced various changes in the healthcare environment. Healthcare organizations are facing a financial crisis due to more competitive relationships among themselves as well with low health insurance fees. The purposes of the current study were: (1) to develop a data warehouse-based system for evaluating and monitoring the case management activities, and (2) to measure and analyze its effects. Methods : In order to collect the data for the study, the database on discharged patients was utilized at a university hospital located in Seoul from June 1, 2002 through December 31, 2002. Initially, a data warehouse was built for the case management system. The case management activities were analyzed using structured methodology to establish the case management system. Results : The findings of this study were as follows: (1) A case management system was developed to make it possible to monitor of healthcare quality and resource utilization. The Case management System included monitoring functions regarding utilization reviews, critical pathways, and clinical indicators. (2) Utilizing the case management system, unplanned readmissions were documented among total discharged patients during two months from November 1, 2002 through December 31, 2002. The unplanned readmission rate was 2.3%(276 patients) in total of 11,960 discharged patients. Among them 81 patients(0.7% of total discharges, 29.3% of unplanned readmission) were readmitted to the same physician in charge under the same diagnosis. No significant differences were found in the demographic variables such as gender and age among the patients. (3) After implementing the case management system, 2.9% of average length of stay reduced. Applying cost-benefit analysis, the 2.9% reduction of length of stay represents net profit of ${\backslash}$ 279,592,000 in the year of 2004. In addition, applying value acceleration analysis, cumulative net benefit of ${\backslash}$ 1,481,000,000 was expected by the year of 2007. Also we were able to expect ${\backslash}$ 247,800,000 of cumulative benefit for the prospective 5 years in value linkage analysis. It represents average ${\backslash}$ 787,700,000 of pure net benefit a year. Conclusion : The value of present study would be not only implementing the knowledge management system into the existing case management activities, but also evaluating its effects and estimating its financial benefits. This study suggested that the case management system would be a supportive tool for monitoring and improving the quality of healthcare, and a cost-effective tool for increment of healthcare organization's financial benefit.

  • PDF

지역중심 가정양육지원사업의 운영 실태에 대한 연구: 진주시 육아종합지원센터 운영사례를 중심으로 (A Study on the Operational Status of Locally Oriented Family Nurturing Support Projects: with a Focus on the Operational Cases of the Child Care Support Center of Jinju City)

  • 김은주;연희정;이영경
    • 한국보육지원학회지
    • /
    • 제11권1호
    • /
    • pp.209-230
    • /
    • 2015
  • 본 연구의 목적은 지역중심 가정양육지원사업의 운영 실태를 알아보는데 있다. 기존에 이루어진 정부차원의 양육지원정책은 각 가정의 다양한 요구를 반영하기 어려우며 실질적인 도움을 주지 않는다는 지적을 받고 있다. 따라서 이러한 한계점을 극복하기 위하여 지역사회 차원에서의 다양한 양육지원정책 사업을 운영하고 있는 진주시 육아종합지원센터의 운영 사례에 주목하였다. 지역중심 가정양육지원사업의 운영실태를 알아보기 위하여 진주시 가정양육지원사업과 관련된 문헌자료의 수집, 업무 담당자 및 참여자 면담, 참여관찰을 하였다. 연구결과 지역중심 가정양육지원사업의 운영실태를 통해 지방자치단체를 중심으로 한 보육공공성의 실현, 사업의 일관된 방향성, 지역사회의 다양한 특성과 요구를 반영한 지원네트워크 형성이라는 특성을 살펴볼 수 있었다. 본 연구는 새로운 전환기를 맞는 육아종합지원센터의 정착과 운영에 유용한 참고자료가 될 것이며, 지역중심 가정양육지원사업이 나아가야 할 바람직한 방향을 위한 기초자료를 제공하였다는 점에서 의의를 찾을 수 있다.

마리화나 남용환자의 역동적인 발달요인과 문제해결 (Dynamic Developmental Factors and their Problem Solving of Patients that Abuse Marihuana)

  • 원정숙
    • 대한간호학회지
    • /
    • 제4권3호
    • /
    • pp.105-116
    • /
    • 1974
  • This study was made on patients who were Hospitalized due to sickness caused by the abuse of marihuana at the Psychiatric Section of a hospital during the period from Feb. to Oct., 1974. The following conclusion was obtained by reviewing the literature with respect to the nursing, and problem solving of those patients. 1. It appears that marihuana is a comparatively mild intoxicant in ordinary preparation without causing physical dependence or tolerance. 2. According to the status of men who are marihuana smokers, approximately 20% of them were college students, those preparing to retake college entrance examinations, non-employed and pharmacists. The men belong mostly to the middle foreigner′s mistress of higher, income bracket, and in the case of women, most of the smokers were US. servicemen entertainers. 3. Dynamic developmental factors: Case 1. : The patient had a characteristic, hysterical and emotionally unitable character, and was of low intelligence, In addition, to this already existing problem, the added uses of marihuana caused a mental illness to develope. Case 2 : The character, was reserved and introspective, her creative power and sentiment was fading and his ability of self-control was weakened. She used the smoking of marihuana to get rid of her own feeling of inferiority complex and tensions coming from interpersonal relationships. Case 3 : The patient was unconditionally resistive to the authoritativeness of superiors and irresponsible in his relationship with women, in his attitude concerning sex in general. He smoked marihuana because he felt become peace-loving and get enchanted experience through smoking it. 4. The points of issue appearing from the above case; (1) Movement of anti-social feelings against the "established system" by the youngsters. (2) Family problem. (3) Shamelessness, loss of motivation, disorderly attitude toward the sex, (4) Worries concerning the future. (5) Lack of knowledge concerning smoking of cigarette and marihuana. Chronic use of marihuana made, those youngman who had originally been ambitions to achieve something in life, lazy, inefficient, unable to make long-term plans, are such weak mined persons that they did not try to overcome problems when encountered. This will pose a great and important question in the mental health of the society, 5. Treatment and Problem sieving According to the literature, we will have to place importance upon hospitalized treatment The phases of treatment were divided into five parts. (1) Prehospital phase (2) Withdrawal Phase (3) Rehabilitation phase (4) Transitional phase (5) After-care phase The experiments have proved that there was much progress in the recovery of patients through environment therapy, supportive therapy and group psychotherapy. This was the above mentioned 5 phases of treating process in accordance with the weekly schedule of the hospital. It was thought that the patients would require prolonged after care management even after they were released from the hospital and that they will also require periodic visit, to the hospital and doctor′s interview with their family. In conclusion, the question of the young generation and marihuana smoking is becoming a great social problem in which their resistances to the "established system" and society is growing in the from of antiestablishment movements. In our country, the smoking of marihuana is gradually developing, therefore, I think, that it would be a very fortunate thing for us, if this report could be helpful for the motivation of further study on the questions of the young generation and its problems.

  • PDF

임신경과에 영향을 미치는 건강위험행위 (Health Risk Behaviors Affecting the Process of Pregnancy)

  • 박재순;문미선;홍진희;이정은
    • 여성건강간호학회지
    • /
    • 제6권4호
    • /
    • pp.549-565
    • /
    • 2000
  • Comprehensive review of the literature was conducted to determine 1) selected risk factors and its impact that affect pregnancy outcome such as smoking, alcohol consumption, and substance abuse 2) these factors can facilitate future strategies for health promotion and prevention for both pregnant women and fetus. Review of literature were extracted from searching MEDLINE(1966 - Oct. 2000). CINAHL (1982 - Oct. 2000) and the domestic literature. The following factors were identified: 1. The effects of risk behaviors on pregnancy. ${\cdot}$Maternal smoking was associated with the occurrence of premature or LBW delivery, fetal growth retardation, extremities defects, heart defects and sudden infant death syndrome. ${\cdot}$Maternal alcohol consumption was associated with spontaneous abortion, premature or LBW delivery, morphologic/neurologic problems, especially fetal alcohol syndrome. ${\cdot}$Heroin was associated with withdrawal after birth in which were born to heroine addicts for gestational age and lung maturation in animal studies. ${\cdot}$Cocaine was associated with spontaneous abortion, abruptio placenta and a poor response to environmental stimuli. ${\cdot}$So far, the effects of caffeine on pregnancy was controversial, but severe caffeine consumption was associated with premature or LBW delivery, spontaneous abortion, still birth and dystocia. 2. Intervention methods and its effects identified were as follows ${\cdot}$Conducted intervention for smoking, alcohol and drug consumption were single or combined. ${\cdot}$Intervention methods were counseling, phone contact, mailing, use of educational videotape, booklet, support person and alternatives such as nicotine patch. ${\cdot}$The interventions increased the rates of smoking cessation during pregnancy and awareness of the risk of drug consumption, and decreased amount of alcohol consumption. ${\cdot}$The intervention outcome found positive effect on birth weight and length. 3. Our recommendations were as follows ${\cdot}$The personal and social cognition should be enhanced through education and the mass media. ${\cdot}$It's necessary to educate and give information of preconceptional care, planned pregnancy and early prenatal care for optimal pregnancy outcome. ${\cdot}$It's necessary to develop comprehensive assessment tool which is reliable and valid on smoking, alcohol consumption and substance abuse to identify supportive or interventional program.

  • PDF

입원아동과 간호사가 지각한 돌봄에 대한 연구 (Hospitalized Children and Their Nurses각 Perception of Caring)

  • 김정선;김신정
    • 대한간호학회지
    • /
    • 제22권3호
    • /
    • pp.297-315
    • /
    • 1992
  • Caring has been identified as the essence and unifying domin of nursing(Leininger). Many nurses believe that the art of nursing is comprised of actions that are predominantly caring in nature. Although caring has been the traditional ideology of nurses, it is only now beginning to emerge as the central construct for the development of nut sing research, theory and practice. The problem addressed by this study was to identify how hospitalized children and their nurses express the meaning of caring, how they think nurses should care for children and to describe their experiences of being cared for. The purpose was to provide theoretical understanding of caring as perceived in Korea to contribute to the development of Korean nursing knowledge. The subjects were 76 hospitalized children admitted to pediatric units in five teaching hospitals and 66 nurses who were caring for these children. In this descriptive study, data were collected from Nov 11, 1991 to Jan 30, 1992 by interviews and an open-ended questionnaire and analysed by van Kaam's method. Caring themes perceived by the children and their nurses were classified into eight categories, -helping, comfort, love, warmth(only by children), recovery from illness, health maintenance (only by nurses), presence, nurturance and responsibility. Ideal caring behaviors perceived by the children and their nurses were six categories, -to give help, provide comfort, give love, stay with, treat warmly and aid recovery. Subcategories of giving help were promptness and competence, detailed explanations and support and encouragement. Other subcategories of giving help reported only by nurses were individualizing care, recognizing needs and providing a familiar enviornment. Subcategories of maintaining comfort were making comfortable, alleviating pain ; one subcategory reported only by children was consolating. A subcategory of giving love was concern, two subcategories reported only by nurses were compassion and respect. Subcategories of staying with were playing with and touching : only nurses reported empathy, Subcategories of treating warmly were tenderness and kindness. In the experience of caring, there were 4 categories, -to give help, stay with, show concern and provide comfort. Both the hospitalized children and their nurses had experienced caring primarily from their mothers. Mothers' caring behaviors were direct, personal, basic, supportive nursing acts. On the other hand, nurses caring behaviors were task oriented skilled procedures and medically delegated acts. This study contributes understanding of the complexity of caring, more specifically the meaning and experience of caring and ideal caring behaviors. Research may be able to move into verification when instruments are developed to measure the complexity of caring beliefs, values and behaviors in Korea and other cultural settings.

  • PDF

가족지지개념을 다룬 국내 간호연구 분석 (Family Support: a Review of Nursing Literature on its Trends and Implementations)

  • 박신애;강경숙;정미영;차남현;김순영
    • 지역사회간호학회지
    • /
    • 제12권3호
    • /
    • pp.639-646
    • /
    • 2001
  • The purpose of this study is to analyze the trend of nursing research related to family support and to provide an effective direction for future research by conducting a review of the Korean nursing literature from 1980 to 2000. A total of 73 studies were analyzed with the following results. 1) The number of studies related to family support has been rapidly increasing since 1984, and 77% of those were conducted in the 1990s. 48 studies, 65% of those analyzed. were degree-based research including 4 doctoral theses (4%) and 45 master's theses (62%). 2) Based on the objective frame of study types developed by Lee et al. (991), the types of studies were analyzed: 56 studies, 76.6% of those reviewed, belonged to factor-relating: 9 studies (12.4%) belonged to factor-isolating: 7 studies (9.6%) belonged to situation-producing: and only 1 study (1.4%) belonged to situation-relating research, respectively. 3) In terms of research design, most studies of analyzed (90.4%) were conducted by non-experimental design, and 7 studies (9.6%) were conducted by experimental design. But, qualitative research related to family support was not found. 4) In terms of research subjects, target populations of experimental studies were patients with arthritis, mental disorder, tuberculosis, coronary artery disease and hypertension. In correlational studies, 51 studies, 69.9% of those analyzed, were conducted to patients with renal failure, cancer and hemiplegia, and 5 studies (6.8%) were conducted to aged people and adolescents. 5) Study concepts used in correlational studies were quality of life, anxiety and depression, self-esteem, hope, role behavior, compliance and self-care activities. The quality of life was most often used among studies with 12.5% of those analyzed. 6) Nursing interventions, including diet therapy, family involving education and supportive care, used in experimental studies mostly showed positive effects on client involvement and home health improvement. However, the nursing interventions of mental health rehabilitation and resistance exercise showed neutral and negative results. The findings of this study provide evidence that more empirical research including experimental or qualitative studies should be conducted actively to improve nursing practice related to family support. Also, to promote more diverse nursing interventions, a family assessment tool especially for Korean families needs to be developed.

  • PDF

혈액종양 입원 환자 대상 임상약사의 처방중재활동 및 회피비용 분석 (Cost Avoidance and Clinical Pharmacist Interventions on Hospitalized Patients in Hematologic malignancies)

  • 김예슬;홍소연;김윤희;최경숙;이정화;이주연;김은경
    • 한국임상약학회지
    • /
    • 제32권3호
    • /
    • pp.215-225
    • /
    • 2022
  • Background: Patients with hematologic cancers have a risk of drug-related problems (DRPs) from medications associated with chemotherapy and supportive care. Although the role of oncology pharmacists has been widely documented in the literature, few studies have reported its impact on cost reduction. This study aimed to describe the activities of oncology pharmacists with respect to hematologic diseases and evaluate the associated cost avoidance. Methods: From January to July 2021, patients admitted to the department of hemato-oncology at Seoul National University, Bundang Hospital were studied. The activities of oncology pharmacists were reported by DRP type following the Pharmaceutical Care Network version 9.1 guidelines, and the acceptance rate was calculated. The avoided cost was estimated based on the cost of the pharmacy intervention, pharmacist manpower, and prescriptions associated with the intervention. Results: Pharmacists intervened in 584 prescriptions from 208 patients during the study period. The most prevalent DRP was "adverse drug event (possibly) occurring" (32.4%), followed by "effect of drug treatment not optimal" (28.6%). "Drug selection" (42.5%) and "dose selection" (30.3%) were the most common causes of DRPs. The acceptance rate of the interventions was 97.1%. The total avoidance cost was KRW 149,468,321; the net profit of the avoidance cost, excluding labor costs, was KRW 121,051,690; and the estimated cost saving was KRW 37,223,748. Conclusion: Oncology pharmacists identified and resolved various types of DRPs from prescriptions for patients with hematologic disease, by reviewing the prescriptions. Their clinical service contributed to enhanced patient safety and the avoidance of associated costs.

호발암 생존자의 미충족 수요에 대한 문헌 고찰: 유방암, 갑상선암, 대장암, 폐암을 중심으로 (A Literature Review on Unmet Needs of High-Prevalence Cancer Survivors: Focus on Breast Cancer, Thyroid Cancer, Colorectal Cancer, and Lung Cancer)

  • 김다슬;김선미;서정석
    • 정신신체의학
    • /
    • 제31권2호
    • /
    • pp.50-62
    • /
    • 2023
  • 연구목적 유방암, 대장암, 폐암, 갑상선암 환자의 미충족 수요를 확인하고 관련 요인을 파악하고자 하였다. 방법 학술 검색을 통해 2010년 이후 출간된 암 환자 미충족 수요에 대한 논문을 선정하여 검토하였다. 결과 측정 도구는 암 생존자의 미충족 수요, 지지적 간호요구조사 설문이 주로 사용되었으며, 폐암 환자의 미충족 수요가 상대적으로 높았다. 유방암 환자는 의료시스템 및 정보, 갑상선암 환자는 사후관리와 심리문제, 대장암 환자는 심리, 종합적 암 치료, 폐암 환자는 신체 및 일상생활관리에서 미충족 수요가 높았다. 연령, 경과시간, 불안, 우울 및 디스트레스, 삶의 질은 미충족 수요와 관련이 있었다. 결론 각 환자군의 미충족 요구를 고려한다면 더욱 효과적인 치료 및 지원 프로그램 개발에 도움이 될 것이다.