• Title/Summary/Keyword: Korean medicine Clinical Practice Guideline

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The Prevalence and Associated Factors of the Metabolic Syndrome in Pre-menopausal Housewives: An Analysis of the 2010~2015 Korean National Health and Nutrition Examination Survey (폐경 전 전업주부의 대사증후군 관련 요인: 2010~2015년 국민건강영양조사자료분석)

  • Kim, Chul-Gyu;Kim, Youngji
    • Research in Community and Public Health Nursing
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    • v.29 no.1
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    • pp.108-119
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    • 2018
  • Purpose: The purpose of this study is to estimate the prevalence of the metabolic syndrome in pre-menopausal housewives and to explore controllable and uncontrollable factors regarding metabolic syndrome. Methods: The study population of this cross-sectional survey was from the Korean Health and Nutrition Examination Survey (KHANES) 2010 through 2015, including the fifth and sixth population-based studies. The criteria for metabolic syndrome include waist circumference, blood pressure, fasting plasma glucose, triglyceride, high-density lipoprotein (HDL) based on Korean Clinical Practice Guideline for Metabolic Syndrome by the Korean Academy of Family Medicine 2015. Results: Among the 2,498 subjects, 247 subjects had metabolic syndrome and the prevalence was estimated to be 9.9%. The number of subjects who met the criterion of HDL was 936 (36.2%), which was the most prevalent among the criteria for metabolic syndrome. Statistically significant (p<.05) factors include age, livinghood benefit group, perceived health status, obesity, family history of DM, sleeping time, awareness of stress,leukocyte, and erythrocyte count. The odds ratio of obesity in the BMI ${\geq}25$ group was 12.59 times as high as that of the BMI <25 group (p<.001) for metabolic syndrome. Conclusion: The prevalence of metabolic syndrome in pre-menopausal housewives in the survey was not low, and it is necessary to develop and apply comprehensive health habit management programs to improve controllable factors including exercise and food intake.

Identify the status of pretreatment on antithrombotic agents in practice at the dentist's office (치과에서 시행되고 있는 시술 전 항혈전제 관련 처치에 대한 실태 파악)

  • Han, A Lum
    • 한국노년학
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    • v.40 no.2
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    • pp.227-237
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    • 2020
  • The purpose of this study is to understand using of antithrombotic agents in clinical settings. The number of patients receiving antithrombotic therapy is increasing in the long term due to the increased prevalence of cardiovascular disease in the elderly. There is a guideline for discontinuation of antithrombotic treatment before dental treatment, but the present study shows that there is a difference from the actual clinical situation. We used an online survey methodology to involve 1000 participants. The questionnaires were asked about general items and Clinical experience such as history of antithrombotic history, experience of complications due to antithrombotics, discontinuation of use, reasons for discontinuing use. The result is as follows. The incidence of delayed bleeding was found to be 55.1%, and discontinuation of antithrombotic therapy before withdrawal was 87.8%. Among respondents 98.3% responded that they stopped antithrombotics because of delayed bleeding and 57.4% responded that they would stop for three to five days. Korean dentists maybe cope with delayed bleeding considering the emotional problem of the patient, the relationship with the patient's physician, and the additional socioeconomic problems.

The Plasma Concentrations and Systemic Toxicity of Lidocaine after Maximal or Supramaximal Recommended Doses of Epidural Administration (경막외 Lidocaine의 최대사용량과 혈중농도에 대한 고찰)

  • Park, Han-Suk;Chung, Chan-Jong;Chin, Young-Jhoon
    • The Korean Journal of Pain
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    • v.12 no.1
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    • pp.36-42
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    • 1999
  • Background: The current maximal recommended doses of lidocaine are 7 mg/kg with $5\;{\mu}g/ml$ of epinephrine. But in clinical practice, sometimes more doses of lidocaine are required to produce adequate regional anesthesia. Method: Twenty-two healthy women patients were divided into two groups and pretreated with valium 5 mg p.o., morphine 5 mg i.m., and midazolam 2 mg i.v. before operation. Of these, 7 mg/kg of 2% lidocaine with $5\;{\mu}g/ml$ of epinephrine were given to 11 patients epidurally. Initial 3 ml of epinephrine mixed lidocaine was given as a test dose and remaining doses were given 5 ml/30 sec with 3 min intervals. Radial arterial blood were drawn at 5, 10, 15, 20, 30, 45, 60, 90, 120 min to measure plasma lidocaine concentrations. After confirming all of the peak plasma concentrations of 7 mg/kg lidocaine were absolutely under $5\;{\mu}g/ml$, the other 11 patients were given 10 mg/kg of 2% lidocaine with $5\;{\mu}g/ml$ of epinephrine epidurally and blood samplings were taken according to the same method of 7 mg/kg group. The peak plasma concentration ($C_{max}$), time to reach to $C_{max}$ ($T_{max}$), time to reach to $T_4$, maximal sensory block level, systemic toxicity, and vital sign changes were investigated. Result: $C_{max}$ was significantly higher in 10 mg/kg group ($5.1{\pm}1.3\;{\mu}g/ml$) than 7 mg/kg group($3.3{\pm}0.5\;{\mu}g/ml$), but $T_{max}$ ($10.5{\pm}2.7$ min vs $10.9{\pm}3.1$ min) was not different. Time to reach $T_4$ was significantly shorter in 10 mg/kg group ($9.5{\pm}2.7$ min) than 7 mg/kg group ($12.7{\pm}3.2$ min) but maximal sensory block level ($T_{3.7{\pm}0.7}$ vs $T_{2.7{\pm}1.0}$) was not different. In four patients of 10 mg/kg group, peak plasma concentrations exceeded $5\;{\mu}g/ml$, but no systemic toxicities appeared. No significant vital sign changes were observed. Conclusion: The current maximal recommended doses of lidocaine, merely based on body weight are not always appropriate. Further studies are needed to determine more precise guideline of maximal doses that include various pharmacokinetic components.

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Developing a Diagnostic Bundle for Bronchiectasis in South Korea: A Modified Delphi Consensus Study

  • Choi, Hayoung;Lee, Hyun;Ra, Seung Won;Jang, Jong Geol;Lee, Ji-Ho;Jhun, Byung Woo;Park, Hye Yun;Jung, Ji Ye;Lee, Seung Jun;Jo, Kyung-Wook;Rhee, Chin Kook;Kim, Changwhan;Lee, Sei Won;Min, Kyung Hoon;Kwon, Yong-Soo;Kim, Deog Kyeom;Lee, Jin Hwa;Park, Yong Bum;Chung, Eun Hee;Kim, Yae-Jean;Yoo, Kwang Ha;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.1
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    • pp.56-66
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    • 2022
  • Background: Because the etiologies of bronchiectasis and related diseases vary significantly among different regions and ethnicities, this study aimed to develop a diagnostic bundle for bronchiectasis in South Korea. Methods: A modified Delphi method was used to develop expert consensus statements on a diagnostic bundle for bronchiectasis in South Korea. Initial statements proposed by a core panel, based on international bronchiectasis guidelines, were discussed in an online meeting and two email surveys by a panel of experts (≥70% agreement). Results: The study involved 21 expert participants, and 30 statements regarding a diagnostic bundle for bronchiectasis were classified as recommended, conditional, or not recommended. The consensus statements of the expert panel were as follows: A standardized diagnostic bundle is useful in clinical practice; diagnostic tests for specific diseases, including immunodeficiency and allergic bronchopulmonary aspergillosis, are necessary when clinically suspected; initial diagnostic tests, including sputum microbiology and spirometry, are essential in all patients with bronchiectasis, and patients suspected with rare causes such as primary ciliary dyskinesia should be referred to specialized centers. Conclusion: Based on this Delphi survey, expert consensus statements were generated including specific diagnostic, laboratory, microbiological, and pulmonary function tests required to manage patients with bronchiectasis in South Korea.

NEW ANTIDEPRESSANTS IN CHILD AND ADOLESCENT PSYCHIATRY (소아청소년정신과영역의 새로운 항우울제)

  • Lee, Soo-Jung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.12-25
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    • 2003
  • Objectives:As increasing number of new antidepressants have been being introduced in clinical practice, pharmacological understanding has been broadened. These changes mandate new information and theories to be incorporated into the treatment process of children with depressive disorders. In light of newly coming knowledge, this review intended to recapitulate the characteristics of new antidepressants and to consider the pivotal issues to develope guidelines for the treatment of depression in childhood and adolescence. Methods:Searching the Pub-Med online database for the articles with the key words of 'new', 'antidepressants' and 'children' ninety-seven headings of review articles were obtained. The author selected the articles of pertinent subjects in terms of either treatment guideline or psychopharmacology of new antidepressants. When required, articles about the clinical effectiveness of individual antidepressants were separatedly searched. In addition, the safety information of new antidepressants was acquired by browsing the official sites of the United States Food and Drugs Administration and Department of Health and Human Services. Results:1) For the clinical course, treatment phase, and treatment outcome, the reviews or treatment guidelines adopted the information from adult treatment guidelines. 2) Systematic and critical reviews unambiguously concluded that selective serotonin reuptake inhibitors(SSRIs) excelled tricyclic antidepressants( TCAs) for both efficacy and side effect profiles, and were recommend for the first-line choice for the treatment of children with depressive disorders. 3) New antidepressants generally lacked treatment experiences and randomized controlled clinical trials. 4) SSRIs and other new antidepressants, when used together, might result in pharmacokinetic and/or pharmacodynamic drug-to-drug interaction. 5) The difference of the clinical effectiveness of antidepressants between children and adults should be addressed from developmental aspects, which required further evidence. Conclusion:Treatment guidelines for the pharmacological treatment of childhood and adolescence depression could be constructed on the basis of clinical trial findings and practical experiences. Treatment guidelines are to best serve as the frame of reference for a clinician to make reasonable decisions for a particular therapeutic situation. In order to fulfill this role, guidelines should be updated as soon as new research data become available.

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