No abstract available.
Child* ; Humans ; Scrub Typhus*

No abstract available.
Arthritis, Rheumatoid* ; Humans ; Hyperplasia* ; NF-kappa B*

Purpose: This study aimed to examine the impact of using an early warning score for shift patient handover on nurse and patient outcomes. Methods: A before-and-after study was conducted with nurses and patients in three general wards in a tertiary teaching hospital. A short-time nurse education on the National Early Warning Score 2 and the use of a checklist for score calculation were performed from June 4, 2019 to June 30, 2019. Outcomes of nurse response (safety competency, handover quality, teamwork, safety climate, and documentation of vital signs and clinical concerns), patient response (deterioration occurrence postadmission, hospitalization length, and discharge status), and adverse events (mortality, cardiopulmonary arrest, and unplanned intensive care unit admission) were measured using questionnaires and medical record reviews. Data from 89 nurses and 388 patients were analyzed. Results: Regarding nurse outcomes, handover quality (p < .001), teamwork (p = .004), safety climate (p = .018), and recordings of vital signs (p = .047) and clinical concerns (p = .008) increased after early warning score use. However, no significant change in the safety competency scores was observed. Regarding patient outcomes, there were no significant changes in the occurrence of deterioration, hospitalization length, discharge status, and occurrence of adverse events between preintervention and postintervention. Conclusion Despite no significant changes in patient outcomes, using a simple, evidence-based early warning score for patient handover enhanced socio-cultural factors for patient safety, with improved patient monitoring. The findings provide evidence that supports the active implementation of an early warning score to improve patient safety.

OBJECTIVE: In order to investigate more accurate patterns of intrauterine growth in twin fetuses, we constructed the twin-specific growth curve based on gestational age in live-born non-anomalous infants. METHODS: 563 twin pairs, 1,126 infants delivered between January 1994 and October 1999 were comprised our study population. The newborns were grouped according to gestational age and the median, 10th, 50th, and 90th percentile birth weight for each gestational week were calculated. Curves were plotted for the general population and for each gender and parity and compared with previously reported singleton's growth curve. RESULTS: After 32 weeks gestation, birth weight of twins falls below that of singleton, so that by 38 weeks the 50th percentile for twins falls below the singleton 10th percentile. This difference was also present among all subgroups of twins, such as gender and parity. And the mean birth weight in male twin infant was heavier than in female twin infant throughout all gestational week. CONCLUSION: The pattern of growth in twin infants differed from those of singleton. We recommend twin-specific growth curve for clinical use in the management of twin gestations.
Birth Weight ; Female ; Fetus ; Gestational Age* ; Humans ; Infant ; Infant, Newborn ; Male ; Parity ; Pregnancy ; Twins*

PURPOSE: Acute otitis media is one of the most prevalent diseases of childhood and can cause serious complications such as hearing loss. The exact diagnosis is extremely important but may be hard to make because of probabilities of over- and underdiagnosis. We performed impedance audiometry(IA) in routine examinations for acute otitis media and applied it for screening and follow-up methods of acute otitis media. METHODS: We performed IA randomly on whomever were suspected of having acute otitis media due to symptoms and otoscopic appearance. These 95 patients were aged from 1 month to 10 years, and visited our out-patient clinic from December 1998 to February 2000. RESULTS: Male to female ratio was 2:1, Fifty eight patients(61.1%) were under 2 years-old and the most prevalent age group was the 1 year-old group(35.8%). Sixty two cases(65.3%) had abnormal tympanograms, B type, 43 cases(45.3%); C type, 12 cases(12.6%) and As type, 7 cases (7.4%). The follow-up studies of abnormal tympanogram after antibiotics administration showed improved tympanograms(39 cases), chronic otitis media(7 cases) needed to insert ventilation tubes, and congenital cholesteatoma(1 case); and follow-up losses(15 cases). CONCLUSION: Tympanometry played an irnportant role in detecting the middle ear pathology in childhood. So we recommend initial screening tympanometry for acute otitis media and at least two screenings prior to major management decisions.
Acoustic Impedance Tests* ; Anti-Bacterial Agents ; Child* ; Child, Preschool ; Diagnosis ; Ear, Middle ; Electric Impedance* ; Female ; Follow-Up Studies ; Hearing Loss ; Humans ; Male ; Mass Screening ; Otitis Media* ; Otitis* ; Outpatients ; Pathology ; Ventilation

Intravenous tissue plasminogen activator (IV-tPA) is the standard treatment for acute ischemic stroke. Acute myocardial infarction (AMI) as a complication of IV-tPA therapy is rarely reported. A 56-year-old man was diagnosed with the left middle cerebral artery territory infarction. IV-tPA was administered, and AMI developed 2-hours thereafter. Coronary angiography demonstrated occlusion of the left anterior descending artery and; immediate recanalization was perfomed. The patient recovered without neurological sequelae. We report herein an unusual case of AMI that developed following IV-t-PA therapy for acute ischemic stroke.
Arteries ; Coronary Angiography ; Humans ; Infarction ; Middle Aged ; Middle Cerebral Artery ; Myocardial Infarction* ; Stroke* ; Tissue Plasminogen Activator

No abstract available.
Interleukin-4* ; Interleukins* ; Receptors, Interleukin-4* ; Rheumatic Diseases*

Prolapse of the fallopian tube into the vaginal vault after hysterectomy is a rare phenomenon and it occurs more frequently after vaginal hysterectomy than abdominal hysterectomy. The exact incidence of tubal prolapse is unknown, because most of cases remain undiagnosed and may resolve before detection. The tubal prolapse may be suspected when granulation tissue or tender friable tissue are detected in vaginal cuff in women complaining lower abdominal pain, dysparenunia, vaginal discharge, or postcoital spotting. The definitive diagnosis of fallopian tube prolapse is made only by histologic confirmation. Reported methods of treatment have included transvaginal excision or transabdominal excision, cautery, and combined vaginal and laparoscopic salpingectomy. We experienced a case of fallopian tube prolapse after abdominal hysterectomy in a 40-year-old woman. We present this case with a brief review of the literature.
Abdominal Pain ; Adult ; Cautery ; Diagnosis ; Fallopian Tubes* ; Female ; Granulation Tissue ; Humans ; Hysterectomy* ; Hysterectomy, Vaginal ; Incidence ; Metrorrhagia ; Prolapse* ; Salpingectomy ; Vaginal Discharge

OBJECTIVE: To investigate the effects of a shoulder sling on balance in patients with hemiplegia. METHODS: Twenty-seven hemiplegic stroke patients (right 13, left 14) were enrolled in this study. The subjects' movement in their centers of gravity (COGs) during their static and dynamic balance tests was measured with their eyes open in each sling condition-without a sling, with Bobath's axillary support (Bobath sling), and with a simple arm sling. The percent times in quadrant, overall, anterior/posterior, and medial/lateral stability indexes were measured using a posturography platform (Biodex Balance System SD). Functional balance was evaluated using the Berg Balance Scale and the Trunk Impairment Scale. All balance tests were performed with each sling in random order. RESULTS: The COGs of right hemiplegic stroke patients and all hemiplegic stroke patients shifted to, respectively, the right and posterior quadrants during the static balance test without a sling (p<0.05). This weight asymmetry pattern did not improve with either the Bobath or the simple arm sling. There was no significant improvement in any stability index during either the static or the dynamic balance tests in any sling condition. CONCLUSION: The right and posterior deviations of the hemiplegic stroke patients' COGs were maintained during the application of the shoulder slings, and there were no significant effects of the shoulder slings on the patients' balance in the standing still position.
Arm ; Gravitation ; Hemiplegia ; Humans ; Orthotic Devices ; Postural Balance ; Shoulder* ; Stroke*

PURPOSE: To evaluate the diagnostic value of MRI, we compared MR images of primary scalp mass with pathological findings. MATERIAL & METHODS: Eight cases in seven patients who had presented primary scalp mass during the previous three years were evaluated by MRI and confirmed with surgical excision and pathologic evaluation. 0.38T(Resonex 4000, USA) MRI was used and all MR images were analysed retrospectively. RESULTS: Eight pathologically confirmed cases consisted of three cases of epidermal cysts, one of steatocystoma simplex, three of neurofibromatosis and one of lymphangioma. All epidermal cysts were located in the occipital area and showed ahigher signal intensity than CSF in T1WI, and proton density and variable signal intensity in T2WI. The Steatocystoma showed a signal iniensity similar to fat in T1WI and proton density and a lower signal intensity than fat in T2WI. Neurofibromatosis accounted for three cases in two neurofibromatosis patients ; one was locatedin the right parieto-occipital area and accompanied by hematoma and skull defect ; two cases were located in the occipital and posterior cervical area of the same patient. The masses showed a higher signal intensity than musclein T1WI and hyper or iso intensity in T2WI with well enhancement. The lymphangioma showed a signal intensity similar to CSF in all pulse sequences and contained a fat component. CONCLUSION: MRI is a useful modality for evaluating primary scalp mass.
Epidermal Cyst ; Hematoma ; Humans ; Lymphangioma ; Magnetic Resonance Imaging ; Neurofibromatoses ; Protons ; Retrospective Studies ; Scalp* ; Skull