2.Stratified treatment and management of adenomyosis.
Journal of Zhejiang University. Medical sciences 2019;48(2):123-129
In recent years, surgical and non-surgical excision and drug therapy have replaced hysterectomy as the main therapeutic modalities for adenomyosis. It is suggested that the precise clinical diagnosis should be based on the reconstruction of digitized three-dimensional model with original image data of adenomyosis. Patients' age and clinical manifestations should also be considered, and the patients should be stratified according to reproductive requirements, so as to determine the best treatment. In view of the infiltration and diffuse growth of adenomyosis lesions in the myometrium of the uterus, it is suggested that long-term drug management should be adopted after surgical or non-surgical lesion resection.Gonadotropin releasing hormone agonists, levonorgestrel-releasing intrauterine system, dienogest and short-acting oral contraceptives should be recommended to consolidate the curative effect in order to delay the progress of the disease and prevent recurrence.
Adenomyosis
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diagnostic imaging
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prevention & control
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therapy
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Female
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Humans
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Recurrence
3.Change of culprit agent prevents recurrent hypersensitivity reactions to iodinated contrast media
Journal of the Korean Medical Association 2020;63(3):145-150
With technical advances in computed tomography and the introduction of non-ionic low- or iso-osmolar iodinated contrast media (ICM), the use of ICM and the occurrence of ICM-related hypersensitivity reactions (HSRs) has rapidly increased. Although ICM-related HSRs are known to be mild, they still represent life-threatening events in rare instances. It is therefore important to prevent recurrent HSRs in high-risk patients. Changing the culprit contrast agent is a powerful known tool for reducing the recurrence rate of HSRs. Based on the large body of evidence, the American College of Radiology manual on contrast media (latest version 10.3) suggests that changing the ICM within the same class may help reduce the likelihood of a subsequent contrast reaction. Furthermore, the European Society of Urogenital Radiology guidelines on contrast agents (latest version 10) also recommends using a different contrast agent with previous contrast agent reactors to reduce the risk of an acute reaction. In this article, we review the necessity and clinical efficacy of changing the culprit ICM for high-risk patients at the time of re-exposure to prevent ICM-related HSRs and minimize the risk of fatality.
Contrast Media
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Humans
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Hypersensitivity
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Primary Prevention
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Recurrence
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Treatment Outcome
5.Clinical analysis of different periods of liver transplantation at an organ transplantation centre.
Ting-bo LIANG ; Shu-sen ZHENG ; Wei-lin WANG ; Dong-sheng HUANG ; Yan SHEN ; Min ZHANG
Chinese Journal of Surgery 2003;41(1):6-9
OBJECTIVETo summarize our clinical experience in liver transplantation while considering the background in this field in China.
METHODSNinety-five patients who had received liver transplantation from April 1993 to March 2002 were analyzed retrospectively. Three periods were defined objectively as period I (1993 - 1997), II (1999) and III (2000 - 2002). Operative techniques, recipients, original diseases, complications and survival rates were compared among the three periods.
RESULTSMalignant liver lesions were the main cause for liver transplantation in period I and II. The ratio of number of malignant disease to total recipients decreased gradually from period I to III (100%, 53% and 35%, respectively). The 1-year survival rate in patients with benign liver disease was 85% and the total operative mortality was 5% in period III. The incidence of hepatitis B virus reactivation or reinfection was 24% twelve months after liver transplantation. Vascular complication decreased but biliary complications did not and remained a major long-standing problem. No veno-venous bypass technique was used in period III, and its advantages were obvious when comparing with those with veno-venous bypass in period I and II.
CONCLUSIONSStrict selection of recipients, fine operative technique, familiarity with various complications and correct therapeutic methods, prophylaxis of recurrence of hepatitis B and hepatocellular carcinoma are necessary to improve long-term results of liver transplantation in China.
Adult ; Female ; Hepatitis B ; prevention & control ; Humans ; Liver Transplantation ; mortality ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Recurrence ; Retrospective Studies
6.Revision endoscopic sinus surgery and combined therapy for recurrent sinusitis.
Liwei ZHU ; Hanqing ZHANG ; Jiongjiong HU ; Liyun YING ; Yingjun SHAN ; Zhenghua ZHU ; Changqing ZHAO
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2009;23(11):488-490
OBJECTIVE:
To investigate the efficacy of revision endoscopic sinus surgery and combined therapy on recurrent sinusitis and polyps.
METHOD:
Revision endoscopic sinus surgery was performed in 72 patients, of which endoscopic nasal lateral wall dissection was used in 3 cases, the endoscopic frontal sinus surgery (Draf I-II) was used in 16 cases, and all patients received combined therapy including peri-operation conservative management and nasal endoscopy examination during the follow-up period.
RESULT:
All patients were followed up for more than one year. Of 72 patients, 52 patients were successfully cured, 10 patients showed improvement, but there was no change in other 13 patients. The total efficacy rate was 91.67% (66/72). No serious complication occurred.
CONCLUSION
The treatment efficacy can be greatly improved by enough preoperative preparation, fine operation, combined pre-operation conservative therapy and postoperative follow-up.
Adult
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Aged
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Endoscopy
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Female
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Humans
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Male
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Middle Aged
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Nasal Polyps
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prevention & control
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surgery
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Recurrence
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Sinusitis
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prevention & control
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surgery
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Young Adult
7.Effects of a Relapse Prevention Program on Insight, Empowerment and Treatment Adherence in Patients with Schizophrenia.
Journal of Korean Academy of Nursing 2017;47(2):188-198
PURPOSE: The purpose of this study was to develop a relapse prevention program (RPP) and examine the effects of the RPP on insight, empowerment, and treatment adherence in patients with schizophrenia. METHODS: A non-equivalent control group pretest-posttest design was used. Participants were 54 inpatients who had a diagnosis of schizophrenia (experimental group: 26, control group: 28). The study was carried out from February 7, 2012 to February 6, 2013. Over a 10-day period prior to discharge each participant in the experimental group received three one-hour sessions of RPP a one-to-one patient-nurse interaction. Data were collected using Assess Unawareness of Mental Disorder (SUMD), Empowerment Scale, and Insight and Treatment Attitude Questionnaire (ITAQ) and analyzed using PASW 18.0 with chi-square test, independent t-test, Mann-Whitney U test, and ANCOVA. RESULTS: The experimental group had a significant increase in insight and treatment adherence compared to the control group. However, there was no significant difference in empowerment between the two groups. CONCLUSION: Findings indicate that the RPP for patients with schizophrenia was effective in improving insight and treatment adherence. A longitudinal study is needed to confirm the persistence of these effects of RPP in patients with schizophrenia.
Diagnosis
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Humans
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Inpatients
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Longitudinal Studies
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Mental Disorders
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Power (Psychology)*
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Recurrence*
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Schizophrenia*
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Secondary Prevention*