• Title/Summary/Keyword: Discontinuation duration

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The outcomes of retinopathy of prematurity in relation to duration of low dose oxygen therapy (저농도 산소의 사용기간에 따른 미숙아 망막병증의 진행과 예후에 관한 연구)

  • Lee, Pil Sang;Choe, Jae Won;Lee, Sang Geel
    • Clinical and Experimental Pediatrics
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    • v.52 no.1
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    • pp.50-55
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    • 2009
  • Purpose : This study aimed to determine the influence of low-dose oxygen ($FiO_2$ <25%) therapy through nasal cannulae on the progress and prognosis of retinopathy of prematurity (ROP) as well as methods of preventing ROP. Methods : Our subjects comprised premature infants (gestation period <37 weeks; birth weight <1,750 g) born in Daegu Fatima Hospital between February 1, 2001 and January 31, 2006. We retrospectively reviewed and analyzed the medical records of 273 patients who were available for eye examination and follow up over 6 months. Results : The factors maximally influencing the occurrence of ROP were low gestation age and low birth weight. We observed that the incidence of ROP increased with the increasing duration of low-dose oxygen therapy. ROP onset was delayed during ongoing oxygen therapy; however, rapid progression of ROP occurred after the discontinuation of oxygen therapy among premature infants up to the prethreshold stage. Conclusion : To prevent of occurrence of severe ROP and its rapid progression, the period of low-dose oxygen therapy needs to be shortened. Moreover, frequent eye examinations should be performed after the discontinuation of oxygen therapy.

Valproate-associated weight gain and potential predictors in children with epilepsy (Valproate 치료를 받는 간질환아에서 체중증가와 영향을 주는 인자)

  • Jang, Gook Chan;Kim, Eun Young;Rho, Young Il;Moon, Kyung Rye;Park, Sang Kee
    • Clinical and Experimental Pediatrics
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    • v.50 no.5
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    • pp.484-488
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    • 2007
  • Purpose : The purpose of this study was to determine the incidence and potential predictors of weight gain in older children and teens treated with valproate (VPA) for epilepsy. Methods : Sixty-five subjects aged 8 to 17 years of age, who began VPA treatment between January 1, 2001, and December 31, 2004, and who had documented weight and height measurements at medication initiation and at least one follow-up visit were retrospectively identified. Exclusion criteria were follow-up <6 months, discontinuation of VPA within 6 months, and concurrent therapy with medication known to affect weight (such as topiramate, carbamazepin). Body mass index (BMI) was calculated at initiation and either discontinuation of VPA or last follow-up and stratified into four categories: group 1, underweight <5%; group 2, appropriate 5-85%; group 3, potentially overweight 85-95%; group 4, overweight >95%. Results : Twenty-eight subjects (77.8%) remained within their same category and eight (22.2%) moved up at least one category. Weight gain (increase in BMI difference) was observed in 72.2% of the 36 subjects treated with VPA. Three factors, neurocognitive status (P=0.017), seizure type (P=0.001) and duration of VPA treatment (P=0.035) were identified to be significant predictors of BMI difference. Conclusion : VPA induces weight gain in children and teens with epilepsy. These factors which are normal neurocognitive status, primary generalized type and duration of VPA treatment over the 12 months were predictors for an increase of weight gain. Therefore potential weight gain should be discussed with patients before the initiation of therapy and BMI should be monitored closely.

Efficacy of 1:1000 Diluted Heparin versus 0.9% Normal Saline for Maintenance of Intermittent Intravenous Locks (희석된 헤파린과 생리식염수가 간헐적 말초정맥장치의 폐색, 유지기간 및 정맥염 발생에 미치는 영향)

  • Park Mi-Mi;Kim Chang-Hee;Cho Eun-Suk;Lee Mi-Jung;Kim Hae-Suk
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.2
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    • pp.208-221
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    • 2000
  • The objective of this research was to compare the flushing effects using 1:1,000 diluted heparin or 0.9% normal saline in relation to needle gauge and frequency of IV medications. The comparative categories were clotting, duration of patency, and incidence of phlebitis. The design of research was a Nonequivalent Control group, Post test, Nonsynchrorized Design. The independent variable was 0.9% normal saline flushing the IV locks and the dependent variables were clotting, duration of patency, and incidence of phlebitis. Subjects were medical-surgical inpatients over 15 years old and with peripherally placed IVs who were hospitalized in a university medical center. Exclusion criteria included foreigners and those who were rejected for this research. The final sample for data analysis included 295 IV sites in 194 patients; 154 were in the saline group and 141 were in the heparin group. Subjects were assigned to have IV locks is flushed with 0.9% normal saline in the experimental group and to have IV lock flushed with 1:1,000 diluted heparin(100 units) in the control group. In order to increase reliability, the nurses who were assigned to the units involved in the study received an explanation on the standard method for locking an IV, recording method for observational data and criteria for the detection of phlebitis. Data were collected for a period of 2 weeks, from March 16, 2000 to March 29, 2000. Total duration of IV was defined the time of IV insertion to the time of discontinuation. Phlebitis was defined as the presence of the following : pain, swelling. erythema at the insertion site. Chi-square was used to determine the association between the degree of clotting, duration of patency, and incidence of phlebitis for the diluted heparin or the normal saline and needle gauge and frequency of IV medications. The results are summarized as follows : (a) There was difference in the degree of clotting between two groups($X^2=5.882$, p=.015). (b) There was no difference in the degree of duration of patency between two groups($X^2=2.439$, p=.295). (c) There was no difference in the incidence of phlebitis between two groups($X^2=0.190$, p=.663). (d) There was difference in the degree of clotting($X^2=6.209$, p=.013) and in the degree of duration of patency($X^2=6.978$, p=.031) according the needle guage between the two groups. (e) There was difference in the incidence of phlebitis($X^2=5.008$, p=.025) according to the frequencies of IV injection between two groups.

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Effect of 2-6 weeks of systemic steroids on bone mineral density in children

  • Kuniyil, Athira;Pal, Somdipa;Sachdev, Namrita;Yadav, Tribhuvan Pal
    • Clinical and Experimental Pediatrics
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    • v.65 no.5
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    • pp.254-261
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    • 2022
  • Background: The use of systemic steroids for 6+ weeks in children is associated with decreased bone mineral content (BMC) and density (BMD). However, the effects of a shorter duration of use on BMD are unknown. Purpose: To determine the effect of the use of systemic steroids for 2-6 weeks on BMD and BMC in pediatric patients. Methods: Twenty-five pediatric patients (21 with tuberculosis, 2 with systemic juvenile idiopathic arthritis, 1 with inflammatory bowel disease, 1 with autoimmune hemolytic anemia) who received systemic steroids for 2-6 weeks and 25 age- and sex-matched controls were enrolled. BMC, BMD, and z scores of the whole body (WB), lumbar spine (LS), nondominant distal radius (DR), and total body less the head (TBLH) were determined by dual-energy x-ray absorptiometry at baseline, the end of steroid therapy or 6 weeks (whichever was earlier; first follow-up), and at the end of 3 months from baseline (second follow-up) in patients and at baseline in controls. The values were adjusted for confounding variables. Continuous and categorical variables were compared using Student t test and the chi-square test or Fisher exact test, respectively. Pairwise comparisons employed Bonferroni correction. Results: Statistically significant decreases in BMC, BMD, and all z scores were observed. BMC declined by 5.37%, 2.08%, 1.82%, and 2.27%, and 11.42%, 3.75%, 3.34%, and 4.17% for WB, LS, DR, and TBLH, respectively, at the first and second follow-ups, respectively. Similarly, BMD declined by 2.01%, 2.31%, 2.18%, and 1.70% and 4.59%, 3.76%, 3.14%, and 3.50% for the WB, LS, DR, and TBLH, respectively, at the first and second follow-ups, respectively. A significant negative correlation was found among bone densitometric parameters, duration, and cumulative dose. Conclusion: The use of systemic steroids for 2-6 weeks in pediatric patients decreased the BMD and BMC of trabecular and cortical bones, an effect that persisted after discontinuation.

Real time Motion Graphics produce study of methods that use LED device (LED 장치를 응용한 실시간 모션그래픽스 구현방법에 관한 연구)

  • Lee, Min Young
    • Journal of Korea Society of Digital Industry and Information Management
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    • v.7 no.1
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    • pp.63-74
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    • 2011
  • LED design works make user experience the conditions of time and space, and enable maximized spatial exploration and pursuit of ultimate sources. Light itself includes an ample dimension of time and, through the process of on and off, time-duration, similarity, and discontinuation is reorganized. LED design works make people experience the conditions of time and space, and enable maximized spatial exploration and pursuit of ultimate sources. LED design have been approached more from the viewpoint of material than from the viewpoint of aesthetics. LED based environmental design will be embedded deeply into our life with the technology of ubiquitous city. As the problem of the light intensity, tempo of change LED motion graphic and colors, substitutability is almost completely resolved now, LED is have more potentials than any other material as a tool of motion graphic. These result well make that using of LED is could be better useful from now on. In edition, users could be offered better beneficial lighting environment, and they will enjoy their better lives in the future.

Opioid-induced constipation: a narrative review of therapeutic options in clinical management

  • Lang-Illievich, Kordula;Bornemann-Cimenti, Helmar
    • The Korean Journal of Pain
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    • v.32 no.2
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    • pp.69-78
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    • 2019
  • Pain therapy often entails gastrointestinal adverse events. While opioids are effective drugs for pain relief, the incidence of opioid-induced constipation (OIC) varies greatly from 15% to as high as 81%. This can lead to a significant impairment in quality of life, often resulting in discontinuation of opioid therapy. In this regard, a good doctor-patient relationship is especially pivotal when initiating opioid therapy. In addition to a detailed history of bowel habits, patient education regarding the possible gastrointestinal side effects of the drugs is crucial. In addition, the bowel function must be regularly evaluated for the entire duration of treatment with opioids. Furthermore, if the patient has preexisting constipation that is well under control, continuation of that treatment is important. In the absence of such history, general recommendations should include sufficient fluid intake, physical activity, and regular intake of dietary fiber. In patients of OIC with ongoing opioid therapy, the necessity of opioid use should be critically reevaluated in terms of an with acceptable quality of life, particularly in cases of non-cancer pain. If opioids must be continued, lowering the dose may help, as well as changing the type of opioid. If these measures do not suffice, the next step for persistent OIC is the administration of laxatives. If these are ineffective as well, treatment with peripherally active ${\mu}$-opioid receptor antagonists should be considered. Enemas and irrigation are emergency measures, often used as a last resort.

Evaluation of hematologic profile may be needed for patients treated with oxcarbazepine

  • Jung, Gu Hyun;You, Su Jeong
    • Clinical and Experimental Pediatrics
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    • v.62 no.8
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    • pp.312-316
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    • 2019
  • Purpose: The major side effects of treatment with oxcarbazepine (OXC) are skin rash and hyponatremia. Hematologic side effects are reported rarely. The aim of this study was to investigate the rate and types of the hematologic side effects of OXC. Methods: The medical records of 184 patients diagnosed with epilepsy or movement disorder and on OXC monotherapy, at the Department of Pediatrics of Inje University Sanggye Paik Hospital from July 2001 to July 2018, were retrospectively reviewed. Results: Of the 184 patients, 10 (5.4%) developed leukopenia in addition to pancytopenia and 2 (1.0%) developed pancytopenia. Leukopenia developed in 11 days to 14 years after OXC administration and was more frequent in males than in females (male vs. female, 9 vs. 1; Fisher exact test, P<0.05). Of the eight patients with leukopenia alone, 7 continued OXC treatment; 6 improved without intervention; 1 was lost to follow-up; and 1 received a reduced OXC dose, who improved after intervention. Pancytopenia developed within 2 months of initiation of OXC treatment. Both patients initially continued OXC. One improved within 1 month and continued treatment with OXC, but the other showed progression of the side effect, leading to the discontinuation of OXC and subsequent improvement within 1 month. There were no significant differences in the ages of the patients, OXC dose, and duration of OXC treatment between patients with and without these side effects of OXC (P>0.05, t-test). Conclusion: OXC-induced leukopenia is not rare and may result in pancytopenia. Patients being treated with OXC should be regularly monitored for abnormal complete blood count profiles.

Efficacy and Safety of Cyclosporine Therapy in Children with Nephrotic Syndrome (소아 신증후군에서의 Cycplosporine의 치료효과 및 안전성)

  • Chon, Myoung-Hun;Lee, Suk-Hyang;Jin, Dong-Kyu;Sohn, Kie-Ho;Choi, Kyung-Eob
    • Korean Journal of Clinical Pharmacy
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    • v.14 no.1
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    • pp.11-23
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    • 2004
  • Although most children with idiopathic nephrotic syndrome respond to corticosteroid therapy, many responders show steroid dependency and frequent relapse. In these children, one of the major problems is the serious side effects resulting from continuous steroid therapy. Thus, this study was conducted to assess the therapeutic efficacy and safety of six-month cyclosporine treatment with the low-dose deflazacort therapy in children with nephrotic syndrome. Thirty children with steroid dependence (SD), frequent relapse (FR) and steroid resistance (SR) were enrolled in this study. They were treated with 6-month oral cyclosporine $(Cypol-N^{(R)})$ plus the low-dose deflazacort $(Calcort^{(R)})$ therapy at Samsung Medical Center from September 2002. The dosage of cyclosporine was started at 5 mg/kg/day and was monthly adjusted to maintain clinical remission and/or a trough blood level, while deflazacort dosage was reduced gradually. Clinical evaluation and monitoring of cyclosporine toxicity were performed every $2\sim4$ weeks. Outcomes were compared to the latest sir-month period of steroid only therapy before cyclosporine treatment. Student's t-test and ANOVA were used for statistical analysis. Out of 28 children with SD and FR, 23 $(82.1\%)$ sustained remission, and 5 $(17.9\%)$ experienced 1 or 2 relapses during therapy. Out of 2 children with SR, 1 child sustained remission, and 1 child showed no response. The mean duration of remission and occurrence of relapse were significantly improved (p <.0001). In addition, the mean dosage of steroid was significantly reduced (p=.003). Although a number of adverse effects occurred in this study, they were not so serious as to necessitate discontinuation of the therapy. No nephrotoxicity was observed. Twenty out of the 28 children who had been in remission relapsed after withdrawal of cyclosporine. Fifteen of these children showed relapse within a month. These results demonstrated that the combination of cyclosporine with the low-dose deflazacort was efficient and safe in children with SD and FR during the six-month treatment. However, further studies are necessary in order to resolve the problem of high relapse rate after discontinuation of cyclosporine.

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A Study on Body Image Perception and Obesity Stress by the Degree of Obesity in College Women

  • Lee, Ji-Eun;Kim, Jung-Hyun;Jung, In-Kyung
    • Preventive Nutrition and Food Science
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    • v.14 no.2
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    • pp.116-122
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    • 2009
  • The principal objective of this study was to assess the weight control behavior, body shape satisfaction, and obesity stress depending on the degree of obesity in college students who applied for a weight control program. The average BMI of the participants was $21.4\;kg/m^2$ which was in the normal range, and 76.3% of the participants were of normal body weight. Ideal BMI in this participant was $18.1\;kg/m^2$, which is in the underweight range. In terms of body perception, participants generally overestimated their body weight. The overweight and normal weight groups were less satisfied with their body shape than was the underweight group. The overweight group also expressed fears of showing their bodies to others. Additionally, the overweight and normal groups exhibited higher obesity stress than the underweight group. 97.0% of participants were interested in weight control as a way to improve their appearance. They usually obtained their weight control information from the internet and mass media. More than 80% of participants had weight control experience, having undergone weight control attempts for duration of less than a month. However, after the discontinuation of weight control efforts, these participants regained the weight. As a consequence, they were generally unsatisfied with the outcomes of weight control programs. This study demonstrated that the college women who had applied for the weight control program were unsatisfied with their body shape owing to distorted notions of the ideal body shape, and these women had generally undertaken frequent efforts to control their body weights. These results underline the importance of educating college-aged women on proper body perception and the maintenance of healthy body weight and shape.

Long-Term Tolerability of Escitalopram in Korean Adolescents

  • Goo, Ae-Jin;Won, Eun-Kyung;Lee, Cheolsoon;Lee, Jong-Il;Jung, Hee-Yeon;Kim, Yeni
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.24 no.4
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    • pp.207-212
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    • 2013
  • Objectives : We investigated the long-term tolerability of escitalopram in Korean adolescents. Methods : The subjects were 37 adolescents, who had been diagnosed with depressive disorder in accordance to DSM-IV. Clinical effectiveness was assessed by Clinical Global Impression-Improvement (CGI-I) scale at the final follow-up visit. Tolerability was assessed through a medical record of the reason for discontinuation of escitalopram and documented adverse events. Results : The mean duration of treatment was $78.1{\pm}89.5$ days, and the mean dosage was $10.0{\pm}4.4$mg/day. Out of the total 37 patients, two (5%) patients sustained use of escitalopram. Twelve patients (32.4%) discontinued use of escitalopram due to target symptom remission, and 23 patients (61.9%) due to insufficient efficacy. Six patients (16.2%) had at least one documented adverse event. However, no suicidal ideation or self-injurious behavior was reported. Significant differences in clinical symptom improvement efficacy were seen between the patients who were receiving escitalopram for less than 8 weeks (4.3%, 1/13) and those for more than 8 weeks (92.9%, 13/14). There was no significant difference between the tolerability of monotherapy compared to the concomitant use group. Conclusion : The results of this study suggest that long-term use of escitalopram may result in superior efficacy than shortterm use, and is tolerable in Korean adolescents with depression.