Trends in the prescription of opioids and gabapentinoids in patients with failed back surgery syndrome in Korea: a population-based study
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- The Korean Journal of Pain
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- v.37 no.1
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- pp.73-83
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- 2024
Background: Failed back surgery syndrome (FBSS) is a chronic condition that is characterized by persistent back pain following one or more spinal surgeries. Pharmacological interventions, such as the use of opioids and gabapentinoids, are frequently used in the treatment of FBSS. However, prolonged and excessive use of these medications can lead to dependence and adverse effects. This study investigates trends in opioid and gabapentinoid prescriptions among patients with FBSS in Korea from 2016 to 2020. Methods: Data from the Health Insurance and Review Agency were analyzed, and claims listing FBSS were selected for the study. Prescription patterns of opioids and gabapentinoids were classified based on the number of days prescribed per year. Results: Of the 390,095 patients diagnosed with FBSS, 41.6% of the patients were prescribed gabapentinoids, and 42.0% of them were prescribed opioids, while 10.6% of the patients were classified as long-term gabapentinoid users, 11.4% as long-term opioid users, and 7.4% of the patients were found to have long-term prescriptions for both drugs. The proportion of patients who received both gabapentinoid and opioid prescriptions increased annually. The doses of opioids prescribed have also increased along with the increase in the number of patients receiving opioid prescriptions. Conclusions: The prescription rates of opioids and gabapentinoids among patients with FBSS in Korea continue to increase steadily, posing potential risks of addiction and adverse effects. Further research is needed to better understand the actual status of addiction in patients with FBSS.
The purpose of this study is to investigate the change of balance ability on aging by measuring balance ability of elderly females whose age is over 65. The subjects are ten elderly women (the mean age: 71.9) able to walk without assistants, the assistant equipments and drug dependence and ten young healthy women (the mean age: 23.2). We measured stability index (ST), Fourier index (F), weight distribution (WD), weight distribution index (WDI), synchronization index (SI) and fall index (FI) by using Tetrax (Tetra-ataxiometric Posturography). In result, STs and Fs at the low frequency region (F1) represented the significant difference between two groups at all postures with PO (pillow with eye open) exception (p<.01). Fs at the other frequency regions (F2~F8) represented the significant difference between two groups (p<.05). WDI of the elderly women represented the higher values than the young women at all postures but there are the significant difference at PO and PC (pillow with eye closed) only. These results may be due to age-related ability decline of somatesthesia, vestibular organ, central nervous system.
Background: There is very limited data present on smoking cessation rates in outpatient departments of pulmonology. In this study, we aimed to investigate the effectiveness of a brief smoking cessation intervention program in an outpatient department of pulmonology and identify predictors of smoking cessation failure. Methods: After a brief recommendation of smoking cessation from pulmonologists, smokers willing to quit smoking were given individual counseling and supplement drugs. Fifty smokers were included in this study and baseline characteristics, smoking history and success rate were reviewed at 3 months. Results: The mean age of the patients was
Background: Chemotherapy is one of the common approaches in treatment of cancers, especially leukemia. However, drug resistance phenomena reduce the likelihood of treatment success. Resveratrol is a herbal compound which through complicated processes makes some selected cells sensitive to treatment and induction of apoptosis. In the present study, the effects of resveratrol on the expression of miR 15a and miR16-1 and apoptosis in the CCRF-CEM cell line were investigated. Materials and Methods: The CCRF-CEM cell line was cultured under standard conditions and changes in miR 15a and miR 16-1 expression were analyzed by real time-PCR technique, with attention to reveratrol dose and time dependence. Also, apoptosis is evaluated by flow cytometry using annexin V and PI. Results: CCRF-CEM cells underwent dose-dependent apoptotic cell death in response to resveratrol. MiR 15a and miR 16-1 expression was up-regulated after 24 and 48 hours resveratrol treatment (p<0.05). Conclusions: The results of our study indicate that resveratrol induces apoptosis in a time and dose-dependent manner in CCRF-CEM cells. Also, increased expression level of miR 16-1 and miR 15a by means of resveratrol in CCRF-CEM cells might have a role in apoptosis induction and predisposition. According to our results resveratrol can be regarded as a dietary supplement to improve efficacy of anti-leukemia therapies.
Objectives : Since acupuncture was accepted as an useful therapy for the drug addiction, a lot of studies about acupuncture have been carried out. This study was performed to review the articles about morphine addiction which used acupuncture as a treatment and to interpret the use of acupoints from the viewpoint of Six-meridian (Yuk Gyeong, three yin and three yang) theory. Methods : The authors searched 255 articles in PubMed with the key word of "morphine, acupuncture" and 629 articles in KISS (Koreanstudies Information Service System) with the key word of "morphine". The articles written in English only were included. The articles related with morphine (abuse, dependence, sensitization, addiction, intake, withdrawal sign, withdrawal syndrome, reinstatement, craving) only were included. The articles which used manual- or electro-acupuncture only were included and auricular acupuncture was excluded. Both of clinical and experimental study were reivewed. Results : The most frequently used acupoint was ST36-SP6 (electroacupuncture), and the second was HT7. LI4 was the third, and BL23 and PC6 were also used. Conclusions : The acupoints used in the morphine study seem to influence the brain through diverse mechanisms and it is thought that control of the reaction against stress appears to be related with these mechanisms.
Objectives: This clinical study investigates the status of psychiatric consultation from 2001 to 2003 at Maryknoll General Hospital, located in Busan to evaluate the characteristic patterns of current psychiatric consultation and to contribute for further data of consultation study. Methods : The subjects of this study were hospitalized at Maryknoll General Hospital from 1 January, 2001 to 31 December, 2003, who were referred for psychiatric consultation during hospitalization. This study was analysed demographic data, reason for referral, psychiatric diagnosis by patient's chart and psychiatrist's report retrospectively. Results : 1) The psychiatric consultation rates was 1.72%. 2) There was 47.8% in referral among the age group over 60 years, especially the age group over 70 years was 20.3%. 3) The most frequent referral source was department of internal medicine(72.5%). 4) The frequency of psychiatric consultation was the highest at March and the lowest at December. 5) The reasons of psychiatric consultation, according to frequency, were affective change, somatic symptom without abnormal finding. And drug intoxication. alcohol problem were increased. 6) Somatoform disorder was the most common psychiatric diagnosis followed by depressive disorder, organic mental disorder. The diagnosis of somatoform disorder, depressive disorder, alcohol dependence were increased, but anxiety disorder, organic mental disorder were decreased. 7) Pharmacotherapy was the most recommendation, and diagnostic procedure and psychotherapy were increased. Conclusion : In review of consultation referral subjects, the referral rate was 1.72%. The consultation referral of the old(over 60 years) was 42.8%, and annually increased. The most frequent request source was from department of internal medicine. The reasons of consultation referral was the most due to affect change. The recommendation of pharmacotherapy was the most numerous. and psychotherapy was increased annually. Further studies warranted on geriatric psychiatric consultation, pattern change of consultation.
This study was intended to investigate actual conditions and problems relating to a variety of substance which have been used by students. A Questionnaire survey was carried out with the subject of 2411 students in an academic boys' high school, academic girls' high school, technical boys' high school and technical girls' high school in Pusan, from the 15th day to 29th day of March, 1989. The summarized results were as follows. There was not a remarkable difference in distribution of these subjects in boys' & girls' high school. The common and good health condition of subjects accounted for 90 percent or higher. 24.4 percent of them also had smoking experience, 11.6 percent of which continues to smoking. The understanding rate of these substances name other than sedative, psychostimulants and antihypnotic accounted for 90 percent or higher. The experience rate taking these substances for one year showed that anodyne, digestive and nutritive tonic accounted for 70 percent, antihypnotic for 15.6 percent, sedative for 1.4 percent, respectively, and psychostimulants for 0.5 percent. Moreover. it was shown that drugs accounted for 1.5 percent, bond for 1.4 percent, and thinner for 0.5 percent. The rate of the daily experiencers who took anodyne, digestive, nutritive tonic, sedatives, and psychostimulants and so on was 7.7 percent, 6.2 percent, 5.2 percent, 5.9 percent, and 5.0 percent respectively. This fact implied that there was a serious problem in high school students' non - narcotic abuse. The usage rate of these substances for treatment purpose showed that anodyme accounted for 90 percent or higher, and digestive for 70-80 percent, respectively, where girl students showed higher rate than one of boy students. Additionally, there was higher the usage rate for other purposes. The usage rate of drugs was highest when these students felt melancholy and curiousity. Their obtaining place appeared that these students mainly obtained these drugs, bonds and thinners from a small shop or peddler and their friend while they usually obtained other substance from the pharmacy and medical institute. The first usage time of these substances appeared during the middle school (the age of 14-15) which was the highest rate. The smoker of all subjects used remarkly large substances as compared with one of no-smoker. Particularly, it appeared that the usage of drugs was very closely related to smoking. The large number of students did not use these substances for oesrable purposes even though they understood the name of these substances. For this reason, from primasy schools it is required to teach the students dependence and harmful effects caused by these substances abuse. Moreover, it was shown that these students firstly used these substances during the middle school (the age of 14-15)due to curiosity. As a result, it is very urgent to give the students health education suitabale for prevention of these substance abuse, when considering harmful effects of these substances. And so health education for no-smoking. Finally, considering that it is very easy to obtain these substances from a small shop and pharmacy, the regulation of these substances control should be considered and completed in the future.
Objectives: Insomnia is not only the most common sleep-related disorder, but also is one of the most important. Knowledge of the comorbidities of insomnia is essential for proper treatment including pharmacological and non-pharmacological methods to prevent disease chronification. This study aimed to determine sleep clinic patients' knowledge of insomnia. Methods: This study recruited 44 patients (24 males and 20 females; mean age
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70