• Title/Summary/Keyword: Discontinuation

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One Year Naturalistic Outcome Study of Panic Disorder Patients (공황장애 환자의 1년 자연 경과 추적 연구)

  • Kim, Min-Hoo;Lee, Dong-Eoun;Chung, Seock-Hoon;Song, Hae-Cheol;Hahn, Oh-Su;Lee, Seon-Hyung;Kwon, Soo-Hee;Hong, Jin-Pyo
    • Anxiety and mood
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    • v.2 no.2
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    • pp.108-114
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    • 2006
  • Objectives : Only a few prospective studies of panic disorder are available. This study investigated naturalistic outcome of panic disorder patients at twelve months after the initial diagnosis. Methods : A total of 84 subjects were diagnosed with panic disorder by diagnostic interview, Structured Clinical Interview for DSM-IV (SCID-IV) and Anxiety Disorder Interview Schedule for DSM-IV (ADISIV). Among them, 80 subjects could be evaluated by means of Panic Disorder Severity Scale (PDSS) at follow-up interview after twelve months. Treatment continuation was also examined at follow-up interview. Results : At initial intake, 80 patients were classified into 22% with mild, 33% with moderate-to-marked, and 45% with severe symptoms on the basis of their PDSS total score. At twelve months, 20% of patients reached remission, 65% had mild and 15% had moderate-to-marked symptoms. Initial panic symptom severity, presence of agoraphobia, panic symptom duration before diagnosis, number of comorbid Axis I disorders were associated with significantly higher PDSS total score at twelve months. Forty six percent of total patients continued medication and 23% have stopped treatment by clinician's recommendation and 31% have selfdiscontinued their medication. At twelve months, all three groups were improved but self-discontinuation group had significantly higher PDSS total score. Conclusion : In the one-year naturalistic outcome study of panic disorder patients, high percentage of patients achieved remission or had mild symptoms.

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Do the Different Reasons for Lactation Discontinuation Have Similar Impact on Future Breast Problems?

  • Ghadiri, Fereshteh;Iranpour, Negar;Yunesian, Masud;Shadlou, Zahra;Kaviani, Ahmad
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.10
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    • pp.6147-6150
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    • 2013
  • Background: Breast feeding is considered to be mutually beneficial for both mothers and infants, though the effect of lactation problems on development of breast lesions (whether benign or malignant) is not clear. Objectives: This study was conducted to identify possible relations between lactation problems and benign and malignant breast disease. Materials and Methods: 308 patients referred to two referral breast clinics in Tehran, the capital city of IR Iran, between January 2008 and January 2011, were recruited. They were interviewed by a standard questionnaire regarding breast feeding problems. The study population was classified in 3 major groups; breast feeding without any problem, unwillingness to breast feed according to whether mothers' preference not to feed or some breast problems like mastitis, and finally insufficient milk that caused the mothers to feed their babies with formula. Results: Recruiting binary logistic regression method, mother's unwillingness to feed her child by breast milk, and also breast problems such as mastitis and abscess during lactation period showed significant relation with both benign and malignant breast diseases (p value<0.01). Surprisingly, inadequate milk was not associated with any of these conditions. Conclusions: We concluded that lactation problems which involve normal milk drainage from the breast may play an important role in whether the mother wll subsequently develope both benign and malignant pathologies. In contrast in the situation that the production of the milk is not sufficient and there are no intentional or unintentional problems in drainage of the produced milk, future problems would not be more common.

A Case of Rifampin-induced Acute Renal Failure (리팜핀에 의한 급성 신부전)

  • Lee, Dong-Hwa;Park, Te-Gue;Lee, Je-Sung;Kim, Heui-Sik;Kim, Kyoung-Hyun;Ha, Young-Jun;Jung, Sung-Bok;Do, Jun-Young;Yoon, Kyung-Woo
    • Journal of Yeungnam Medical Science
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    • v.15 no.1
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    • pp.173-181
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    • 1998
  • Rifampin is common drug to treat tuberculosis. Rifampin induced acute renal failure, hemolytic anemia and thrombocytopenia is rare and severe complication. We have experienced a case of rifampin induced acute renal failure, hemolytic anemia and thrombocytopenia. Forty-six years old male was suffered from reactivation of pulmonary tuberculosis, and had to medicate antituberculosis drugs including rifampin(600mg/day). Seven years ago, antituberdulosis medication were successfully administered to treat pulmonary tuberculosis without any side effects of drugs. But eight days after readministration of rifampin, fever, abdominal pain, vomiting, oliguria, elevated BUN and creatinine were developed. And thrombocytopenia was also identified after administration of rifampin. The patient was recovered slowly after discontinuation of rifampin & intensive medical care. The renal function was normalized at 55 days after cessation of rifampin. The renal pathologic findings were interstitial nephritis and acute tubular necrosis. And, the rifampin dependent antibodies were identified by indirect antiglobulin test in the presence of rifampin. So we report this case with a brief review of literature.

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Risk of Cancer with Combined Oral Contraceptive Use among Iranian Women

  • Vaisy, Afasaneh;Lotfinejad, Shirin;Zhian, Faegh
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5517-5522
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    • 2014
  • Oral contraceptive use is the most common type of contraception. More than 300 million women worldwide take oral contraceptives every day. However, there is a concern about the relationship with the incidence of cancer. This analytical retrospective study aimed to investigate the relationship between the incidence of cervical and breast cancers and oral contraceptive use in 128 Iranian patients with cervical cancer, 235 with breast cancer and equal numbers of controls. Data were collected through interviews with an organized set of questions. Details were also extracted from patient files. Data were analyzed using Student's t-test, chi-square and Fisher's exact tests, and Pearson's correlation analysis. The result revealed correlations between both cervical and breast cancers and history of contraceptive pills use. While cervical cancer significantly correlated with duration of use of pills, breast cancer had significant correlations with the type of oral contraceptive and age at first use. No significant relationships were found between the two types of cancer and age at discontinuation of oral contraceptives, patterns of use, and intervals from the last use. The use of oral contraceptives may triple the incidence of cervical cancer and doubles the incidence of breast cancer. Therefore, performing Pap smears every six months and breast cancer screening are warranted for long-term oral contraceptive users.

HISTOLOGICAL CHANGES AND EXPRESSION OF NERVE GROWTH FACTOR IN THE INFERIOR ALVEOLAR NERVE AFTER DISTRACTION OSTEOGENESIS (하악골 신장술 후 하치조신경의 조직학적 변화와 신경성장인자의 발현에 대한 연구)

  • Park, Bong-Wook;Kim, Jong-Ryoul;Byun, June-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.5
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    • pp.415-423
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    • 2005
  • Distraction osteogenesis (DO) is frequently used technique in reconstruction of bony defects resulted from tumor resection, congenital deformity, and trauma in the maxillofacial region. Although the histologic and ultrastructural changes associated with distraction osteogenesis have been extensively described, the exact changing of the surrounding tissues, such as nerve tissues, were still unclear. This study observed the histological changes and the expression of nerve growth factor (NGF) in the inferior alveolar nerve (IAN) after distraction osteogenesis. Unilateral mandibular distraction (0.5 mm twice per day for 10 days) was performed in eight mongrel dogs. Two animals were sacrificed at 7, 14, 28 and 56 days after completion of distraction, respectively. The distracted IAN and contralateral control nerve were harvested and processed for histological and innunohistochemical examinations. The signs of acute nerve injuries, such as demyelination and partial discontinuation of nerver fiber, were observed in the distracted IAN on 7 and 14 days after distraction. The initial remyelination and regeneration of distracted IAN were showed at 14 days after completion of distraction. At 56 days later, the histologic features of distracted IAN was similar to those of the normal control IAN. The expression of NGF was significantly increased in most distracted nerve tissues on 7, 14 and 28 days after distraction. On 56 days after distraction, the expression of NGF returned to the normal level. This study suggested that the acute IAN injury caused by mandibular distraction were mostly recovered during consolidation period. The NGF was seemed to be induced from Schwann cell and damaged nerve tissues, and it may have important roles in the initial healing of damaged nerves.

Treatment of refractory IgA vasculitis with dapsone: a systematic review

  • Lee, Keum Hwa;Hong, Sung Hwi;Jun, Jinhae;Jo, Youngheun;Jo, Woogyeong;Choi, Dayeon;Joo, Jeongho;Jung, Guhyun;Ahn, Sunghee;Kronbichler, Andreas;Eisenhut, Michael;Shin, Jae Il
    • Clinical and Experimental Pediatrics
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    • v.63 no.5
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    • pp.158-163
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    • 2020
  • IgA vasculitis, formerly known as Henoch-Schönlein purpura, is a systemic IgA-mediated vasculitis of the small vessels commonly seen in children. The natural history of IgA vasculitis is generally self-limiting; however, one-third of patients experience symptom recurrence and a refractory course. This systematic review examined the use of dapsone in refractory IgA vasculitis cases. A literature search of PubMed databases retrieved 13 articles published until June 14, 2018. The most common clinical feature was a palpable rash (100% of patients), followed by joint pain (69.2%). Treatment response within 1-2 days was observed in 6 of 26 patients (23.1%) versus within 3-7 days in 17 patients (65.4%). Relapse after treatment discontinuation was reported in 17 patients (65.4%) but not in 3 patients (11.5 %). Four of the 26 patients (15.4%) reported adverse effects of dapsone including arthralgia (7.7%), rash (7.7%), and dapsone hypersensitivity syndrome (3.8%). Our findings suggest that dapsone may affect refractory IgA vasculitis. Multicenter randomized placebo-controlled trials are necessary to determine the standard dosage of dapsone at initial or tapering of treatment in IgA vasculitis patients and evaluate whether dapsone has a significant benefit versus steroids or other medications.

Prevalence, Patterns of Use, and Perceived Efficacy of Alternative Therapies in Patients with Rheumatoid Arthritis (류마티스 관절염 환자의 대체요법에 대한 이용율, 이용행태 및 지각된 효과에 대한 연구)

  • Lee, Eun-Nam
    • Journal of muscle and joint health
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    • v.8 no.2
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    • pp.250-261
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    • 2001
  • Alternative therapy for rheumatoid arthritis has become worldwide phenomenon this decade without scientific validation. This study was undertaken to explore the prevalence, patterns of use, and perceived efficacy of alternative therapies by patients attending a rheumatology clinic. We conducted a crossectional survey of 142 RA patients with structured questionnaire at outpatient rheumatic clinic from July to August in 2001. Results of this study were summarized as follows : 1. 85.9% of subjects were woman. Mean age was 49.97years, duration of rheumatoid arthritis was 5.6years. Mean pain score was 5.29cm. 2. 74.6% of subjects perceived rheumatoid arthritis as a controllable disease. 31% of patients combined medical treatments with alternative therapies. 58.5% of patients perceived that combining medical treatments with alternative therapies is the most effective strategy in controlling disease. 3. 77.5% had used more than one alternative therapy since the diagnosis was made. The major reason of discontinuation of use was no effect for the treatment of their disease. 4. 34.5% were currently using an alternative therapies and 50.9% were going to use alternative therapies in future. 5. 42.7% reported that alternative therapies was effective and only 3.6% reported side effects. 6. The perceived effect score was 3.14cm in general expecially the physiological score 2.91cm, psychological score 4.16cm. In conclusion, our results demonstrate a high use of alternative therapies by rheumatoid arthritis patients. And the perceived effect score of physiological aspect was not higher than one of psychological aspect. Therefore it should be considered in education program for the use of alternative therapies.

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Computed Tomographic Findings of Segmental Caudal Vena Cava Aplasia in Two Dogs (개에서 컴퓨터단층촬영에 의해 진단된 후대정맥 분절 무형성증 2 례)

  • Lee, In;Choi, Soo-Young;Lee, Ki-Ja;Choi, Ho-Jung;Lee, Young-Won
    • Journal of Veterinary Clinics
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    • v.32 no.2
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    • pp.196-199
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    • 2015
  • A 7-year-old intact female dachshund (Dog 1) and a 17-year-old intact male Yorkshire terrier (Dog 2) were presented for evaluation of mammary gland tumor and a regular checkup, respectively. Incidentally, segmental caudal vena cava aplasia was detected on CT images in both dogs. Absent postrenal segment (Dog 1) or discontinuation of caudal vena cava (Dog 2) were detected, but prerenal segment of caudal vena cava was continued to the dilated azygos vein. Segmental CVC aplasia should be considered when an abdominal vascular anomaly was evaluated with CT angiography in dogs.

Retrogasserian glycerol Injection as a Treatment of Tic Doulouruex -Report of twelve cases- (삼차 신경절 액조내 글리세롤 주입에 의한 삼차신경통 치험(12예 보고))

  • Park, Wook;Hwang, Kyung-Ho;Kim, Yong-Ik;Kim, Il-Ho;Song, Hoo-Bin;Kim, Sung-Yell
    • The Korean Journal of Pain
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    • v.1 no.2
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    • pp.154-163
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    • 1988
  • In 1983, Sten H$\ddot{a}$kanson first reported the clinical safety and efficacy of retrogasserian glycerol injection as a treatment of typical trigeminal neuralgia in 96 of 100 patients during a follow-up period of 1~6 years. Since September 1987, we have injected sterile pure glycerol into the trigeminal cistern using an anterior percutaneous approach via the foramen ovale (H$\ddot{a}$rtel route) for treatment of tic douloureux in 12 patients who were suffering from attacks pain of following discontinuation of carbamazepine. The results were as follows; 1) Eight patients were completely free from pain attacks with a single dose of glycerol (0.4 ml). The remaining four patients needed a second dose (0.4 ml) several days later following the single dose. The degree of patient's subjective satisfaction by those injections was very good in 11 and fair in one. 2) During the follow-up period (1~13 months), persistent sensory deficit as determined by the pin prick test, appeared to be mild in 10 and moderate in one patient. There was no sensory deficit in one patient. further attacks of pain from those injections were still noted. 3) As a transient complication, there was headache in all patient, facial hematoma in 4, nausea and vomiting in two each, and vertigo and herpes simplex in one each. In conclusion, we confirmed that the above glycerol injections into the trigeminal cistern were clinically very effective as a treatment of tic douloureux even though the follow-up period was short.

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Nitrous Oxide Enhances the Level of Sensory Block by Epidural Lidocaine (리도카인을 이용한 경막외 마취시 Nitrous Oxide가 감각차단에 미친 영향)

  • Goo, Young-Gwon;Woo, Soo-Young;Cho, Kang-Hee
    • The Korean Journal of Pain
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    • v.12 no.1
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    • pp.43-47
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    • 1999
  • Backgroud: Systemic administration of opioid can prolong the duration of epidural anesthesia. The authors examined the effect of nitrous oxide ($N_2O$) on the level of sensory block induced by epidural lidocaine. Methods: Twenty minutes after epidural injection of 2% lidocaine (below 70 years : 20 ml, 70 years and above : 15 ml), the level of sensory block was assessed (2nd stage). Patients were randomly assigned to receive either medical air (control group, n=15) or 50% $N_2O$ in oxygen ($N_2O$ group, n=15) for 10 minutes, the level of block was reassessed (3rd stage). Pateints were given room air (control group) or 100% oxygen for 5 minutes and room air for 5 minutes ($N_2O$ group), and the level of block was reassessed (4th stage). Results: At the 3rd stage, $N_2O$ group showed 4.3 cm cephalad increase in the level of sensory block (p=0.005), but control group revealed 1.43 cm regression. After discontinuation of gas, the level of block regressed in both group (p=0.000). At the 4th stage, $N_2O$ group revealed 3.5 cm cephalad increase (p=0.048) and control group 1.97 cm regression (p=0.001) as compared with the 2nd stage. Conclusions: The level of sensory block induced by epidural lidocaine was significantly increased cephalad by concommitant use of 50% $N_2O$ for 10 minutes.

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