ABSTRACT
Objective This study aimed to evaluate the impact of a pharmacist-led intervention on improving adherence and practice of inhaler use in outpatients with asthma at a hospital in Vietnam. Methods A pre-post interventional study was conducted at Hue University Hospital. An adapted checklist for both metered-dose inhalers and/or dry powder inhalers was used to evaluate the inhaler technique. Adherence was assessed by using the Test of Adherence to Inhalers questionnaire. The means of interventions comprised "Face-to-face training," "Creating the leaflet for patients," and "Watching guidance video." Results The number of participants with complete data was 79. Before the intervention, 54.4% of patients had misused inhalers, especially inappropriate posture when using devices (70.2%) and not exhaling before inhalation (46.8%). Non-adherence accounted for 55.7% of patients, and the erratic pattern was the highest, with 83.5%. The intervention had remarkably raised the number of good practice and good adherence patients after three months (P < 0.001). Conclusion Pharmacist-led intervention has a positive impact on improving the adherence to inhalers and inhalation techniques of patients with asthma. Practice Implications The pharmacist-led education model could be considered as an effective and feasible solution for asthma management in outpatients and better medication use. Key Points (1) The most frequently observed mistakes in this study were inappropriate posture and inhalation skill when using devices. (2) Pharmacist-led training remarkably improved patients' practice of inhaler use as well as medication adherence.
Subject(s)
Asthma , Outpatients , Humans , Pharmacists , Nebulizers and Vaporizers , HospitalsABSTRACT
Objective: This study aims to compare 1-month's efficacy and safety of single-session ethanol ablation and radiofrequency ablation for treating both purely cystic nodules and predominantly cystic thyroid nodules. Materials and methods: This short-term retrospective study was approved by the Ethics Committee of the Institutional Review Board of Danang Family hospital, and written informed consent for procedures was obtained for all patients. Thirty-nine patients who presented with cystic thyroid nodules and met inclusion criteria were extracted from the computerized medical records. The internal fluid of cystic thyroid nodules was aspirated as much as possible. Ethanol ablation was performed using 18-gauge needles with 99.5% ethanol, and RFA used a cooled-electrode RFA system and 18-gauge internally cooled electrodes via the trans-isthmic approach, moving-shot technique. Nodule volume, therapeutic success rate, the largest diameter, thyroid function tests, and complications were evaluated and compared before and after treatment in each group. Results: Among 39 patients, 17 patients were undergone EA (mean age of 47.35 years; the proportion of female of 76.5%; purely thyroid cyst percentage of 41.4%) and 22 patients were undergone RFA (mean age of 46.63 years; the proportion of female of 86.4%; purely thyroid cyst percentage of 54.5%). Both treatment techniques showed a significant reduction of the largest diameter and nodule volume (p<0.05) without complications. RFA reduced nodule volume and the largest nodule size greater than EA treatment at 1-month post-ablation (p<0.05). In addition, the therapeutic success rate in the RFA group was higher than in the EA group. Conclusion: Both RFA and EA treatment with single-session confirm the efficacy and safety for cystic thyroid nodules at 1-month follow-up, RFA reduced greater in nodule volume and the largest nodule size than the EA treatment. Thus, the therapeutic success rate in the RFA group was higher than in the EA group.
ABSTRACT
The systemic toxicity of lidocaine is an extremely rare complication of thyroid RFA procedure, and it can be life-threatening. The quick recognization of its symptoms and intravenous use of lipid emulsion are essential to preventing mortality.
ABSTRACT
OBJECTIVE: The aims of this study are to evaluate the safety and efficacy of RFA in the treatment of benign thyroid nodule(s) and to find independent factors related to the volume reduction rate of the nodule(s). MATERIALS AND METHODS: This short-term prospective study from a single medical center was conducted on 93 benign thyroid nodules in 93 patients treated with RFA. Two basic techniques were used: the trans-isthmic approach and moving-shot technique. Clinical and ultrasonography examinations were performed at 1- and 3-month follow-up after the treatment session. Primary outcomes included volume reduction ratio (VRR) at 1-month and 3-month follow-ups; secondary outcomes were therapeutic success rate and complications. Multiple linear regression analysis was used to determine independent factors associated with VRR. RESULTS: A final sample of 78 patients with 78 nodules, given participant rate 83.8% (including 60 solid nodules, 16 predominantly cystic nodules, and 2 thyroid cysts), was followed up for 3 months. The mean volume reduction ratio was 41.47% and 64.72% after 1-month and 3-month follow-ups, respectively. The therapeutic success rate was 30.8% at 1-month and 84.6% at 3-month follow-ups. Symptom score and cosmetic score improved significantly. There was no change in thyroid function tests. Two minor complications (transient voice change) were found. The multiple linear regression analysis showed that the internal component of the nodules significantly related to the VRR during the 3-month follow-up (ß = 23.00; 95%CI (7.59-38.45)). CONCLUSION: RFA was demonstrated as a safe and effective option for benign thyroid nodules treatment. It can be used as an alternative treatment with encouraging results.
ABSTRACT
BACKGROUND: Psychometric properties are regarded as one of the significant contributors related to diabetes treatment efficacy. Diabetes-related distress (DD) is one of the emotional burdens. The aims of this study were to investigate the prevalence of DD and to determine its associated factors among Vietnamese diabetic patients. METHODS: A cross-sectional study was conducted at a single medical center in the central of Vietnam. A total of 138 eligible DM outpatients were invited and a total of 112 patients who completed the questionnaire were utilized in this analysis using convenience sampling. DD was assessed using the diabetes distress scale (DDS). The participant's sociodemographic and clinical information was obtained through face-to-face interviews and medical records. Multivariate logistic regression was used to determine independent factors associated with the presence of DD. RESULTS: Approximately, 12.5% of the patients experienced DD based on DDS self-administered questionnaire. The rates of mild/moderate and high distress were 8.0% and 4.5%, respectively. DD was found to be significantly higher in type 1 DM (p=0.04), insulin only in treatment regime (p=0.04), physical inactivities (p=0.02), times of mild hypoglycemia (time/month) (p=0.01), and fasting plasma glucose (mmol/l) (p=0.04). The occurrence of distress among DM patients was negatively correlated with their age and amount of physical exercise. Meanwhile, poor HbA1c control (HbA1c≥7%) was associated with an increased occurrence of diabetes distress. CONCLUSION: The findings of single medical center in Vietnam highlights that DD is prevalent among DM patients. It should be of marked concerns, particularly the type 1 diabetic patients, younger age, and poor glycemic control patients.
ABSTRACT
This report describes a patient who presented with a large thyroid nodule and compressive symptoms. Immunohistochemical staining showed diffuse marked reactivity for vimentin and focal reactivity for CD68 and Ki-67 that is compatible with primary undifferentiated pleomorphic sarcoma of the thyroid. This report emphasizes and discusses extremely rare thyroid cancer type.
