• Title/Summary/Keyword: Multidisciplinary approach

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Current concepts of craniofacial fibrous dysplasia: pathophysiology and treatment

  • Dong Yeon Kim
    • Archives of Craniofacial Surgery
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    • v.24 no.2
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    • pp.41-51
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    • 2023
  • Fibrous dysplasia is an uncommon genetic disorder in which bone is replaced by immature bone and fibrous tissue, manifesting as slow-growing lesions. Sporadic post-zygotic activating mutations in GNAS gene result in dysregulated GαS-protein signaling and elevation of cyclic adenosine monophosphate in affected tissues. This condition has a broad clinical spectrum, ranging from insignificant solitary lesions to severe disease. The craniofacial area is the most common site of fibrous dysplasia, and nine out of 10 patients with fibrous dysplasia affecting the craniofacial bones present before the age of 5. Surgery is the mainstay of treatment, but the technique varies according to the location and severity of the lesion and associated symptoms. The timing and indications of surgery should be carefully chosen with multidisciplinary consultations and a patient-specific approach.

Kleefstra syndrome combined with vesicoureteral reflux and rectourethral fistulae: a case report and literature review

  • Chae Won Lee;Min Ji Park;Eun Joo Lee;Sangyoon Lee;Jinyoung Park;Jun Nyung Lee;So Mi Lee;Shin Young Jeong;Min Hyun Cho
    • Childhood Kidney Diseases
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    • v.26 no.2
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    • pp.111-115
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    • 2022
  • Kleefstra syndrome is a rare genetic disease characterized by mental retardation, hypotonia, and a characteristic facial appearance. Furthermore, in some cases, Kleefstra syndrome is associated with various anorectal and genitourinary complications, including imperforated anus, vesicoureteral reflux, hydronephrosis, and chronic kidney disease. Herein, we present a case of Kleefstra syndrome with recurrent urinary tractinfections associated with vesicoureteral reflux and rectourethral fistula, which was treated by a multidisciplinary approach.

The Mediating Effect of Acceptance Action in the Relationship between Diabetes Distress and Self-stigma among Old Adults with Diabetes in South Korea

  • Kim, Hyesun;Seo, Kawoun
    • Research in Community and Public Health Nursing
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    • v.33 no.4
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    • pp.446-455
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    • 2022
  • Purpose: This study investigated the mediating effects of acceptance action on the relationship between diabetes distress and self-stigma in older adults with diabetes. Methods: A descriptive research approach was adopted using 187 patients diagnosed with diabetes mellitus by an endocrinology doctor. The data were collected from 26 to 31 March, 2020 and were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficient analysis, and hierarchical multiple regression. Results: The mean scores for diabetes distress, self-stigma, and acceptance action were 2.98±0.64, 2.54±0.74, and 4.16±0.35, respectively. Acceptance action partially mediated the relationship between diabetes distress and self-stigma (z=1.98, p=.024), with an explanatory power of 51.0%. Conclusion: To reduce diabetes self-stigma among old adults in diabetes distress situations, it is necessary to improve their acceptance action and develop step-by-step differentiated acceptance action enhancement programs through multidisciplinary collaborations.

Management of Chronic Pain in Temporomandibular Disorders

  • Kyung-Hee Kim;Hye-Min Ju;Sung-Hee Jeong;Yong-Woo Ahn;Hye-Mi Jeon;Soo-Min Ok
    • Journal of Oral Medicine and Pain
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    • v.47 no.4
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    • pp.174-182
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    • 2022
  • In chronic temporomandibular disorders (TMDs), constituent tissues such as muscles are sensitive to pain and psychological stress, which negatively affect the quality of life. In addition, since chronic TMDs is often accompanied by diseases such as psychological disorders and other chronic pain disorders, the diagnosis of those diseases and patient referrals are mandatory. The management of chronic pain in TMDs requires a multidisciplinary and holistic approach. Pharmacological therapy using cyclobenzaprine, serotonin and norepinephrine reuptake inhibitors, tricyclic antidepressants, progressive relaxation, and psychological approaches using cognitive behavioral therapy such as shifting negative thoughts about pain are all valid treatment options.

The Long-Term Outcome and Rehabilitative Approach of Intraventricular Hemorrhage at Preterm Birth

  • Juntaek Hong;Dong-wook Rha
    • Journal of Korean Neurosurgical Society
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    • v.66 no.3
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    • pp.289-297
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    • 2023
  • Technological advances in neonatology led to the improvement of the survival rate in preterm babies with very low birth weights. However, intraventricular hemorrhage (IVH) has been one of the major complications of prematurity. IVH is relevant to neurodevelopmental disorders, such as cerebral palsy, language and cognitive impairments, and neurosensory and psychiatric problems, especially when combined with brain parenchymal injuries. Additionally, severe IVH requiring shunt insertion is associated with a higher risk of adverse neurodevelopmental outcomes. Multidisciplinary and longitudinal rehabilitation should be provided for these children based on the patients' life cycles. During the infantile period, it is essential to detect high-risk infants based on neuromotor examinations and provide early intervention as soon as possible. As babies grow up, close monitoring of language and cognitive development is needed. Moreover, providing continuous rehabilitation with task-specific and intensive repetitive training could improve functional outcomes in children with mild-to-moderate disabilities. After school age, maintaining the level of physical activity and managing complications are also needed.

Current understanding of angiosarcoma: disease biology and evolving treatment

  • Woo Ju Kim;Han Koo Kim
    • Archives of Craniofacial Surgery
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    • v.24 no.5
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    • pp.203-210
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    • 2023
  • Angiosarcoma is a very rare soft tissue sarcoma that originates from endothelial cells and typically has a poor prognosis. It is most commonly found in elderly white men and can occur anywhere in the body, particularly in the head, neck, and scalp. Patients who have undergone previous radiation treatment or who have chronic lymphedema also face an elevated risk of this condition. Various genetic changes are suspected to contribute to the development of angiosarcoma, and these changes have been identified as potential targets for treatment. For localized disease, wide surgical resection is often the prudent course of action. A multidisciplinary approach, which may include surgery, radiotherapy, systemic chemotherapy, or immunotherapy, is typically the most effective way to achieve favorable outcomes. In this review, we discuss the general understanding of angiosarcoma and its management, with a particular focus on the current evolving treatments for the disease.

Early Hospice Consultation Team Engagement for Cancer Pain Relief: A Case Report

  • Jisoo Jeong
    • Journal of Hospice and Palliative Care
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    • v.27 no.2
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    • pp.77-81
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    • 2024
  • This case report explores the challenges and complexities associated with opioid management of cancer pain, emphasizing the importance of early involvement of a hospice consultation team and the adoption of a multidisciplinary approach to care. A 56-year-old man with advanced pancreatic cancer experienced escalating pain and inappropriate opioid prescriptions, highlighting the shortcomings of traditional pain management approaches. Despite procedural intervention by the attending physician and increased opioid dosages, the patient's condition deteriorated. Subsequently, the involvement of a hospice consultation team, in conjunction with collaborative psychiatric care, led to an overall improvement. The case underscores the necessity of early hospice engagement, psychosocial assessments, and collaborative approaches in the optimization of patient-centered palliative care.

A Case Study of PBL in a College General Art Class (융복합수업모형으로서의 PBL(Problem-Based Learning) : 대학교양미술 수업사례를 중심으로)

  • Kang, Inae;Lee, Hyun-Min
    • The Journal of the Korea Contents Association
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    • v.15 no.11
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    • pp.635-657
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    • 2015
  • The current society characterized by knowledge-based information technology and multiculturalism put more emphasis on problem-solving skills, creative thinking, and communication skills than any other periods did. In response to the demand of the current times, multidisciplinary, or convergence courses and majors are being created and conducted in college education, yet, with the lack of specific teaching and learning model for the convergence courses. In this context, this study aimed to examine PBL as an instructional model for the convergent approaches in classroom, since PBL has been regarded as a model for fostering the 21st century learning capabilities for student coupled with the learning principles of authentic tasks, learner-centeredness, collaborative learning. This study, after conducted a PBL course for the general art education during the summer semester of 2014, analyzed the result using data collected from students' reflective journals, in-depth interviews, and SNS posts among the students. The result presented students' enhanced self-respect, increased interest in their learning and communication skills, and their recognition of the value on diversity and empathetic attitudes toward each others. In conclusion, PBL showed its potential as an alternative instructional model for the multidisciplinary and convergent learning in college education.

Clinical Outcomes of Multidisciplinary Team Care on the Regulation of Chronic Kidney Disease - Mineral and Bone Disorder (CKD-MBD) in Patients Undergoing Dialysis (미네랄 골질환 합병증을 가진 투석환자에서 다학제 팀 서비스의 임상적 성과)

  • Han, Nayoung;Lee, Sang-Min;Hong, Jin Yi;Noh, Hye Jin;Ji, Eunhee;Song, Yun-Kyoung;Song, Jeeyoun;Kim, In-Wha;Kim, Yon Su;Oh, Jung Mi
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.4
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    • pp.318-323
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    • 2016
  • Background: Multidisciplinary team care (MTC) is a collaborative approach to treatment plan and ongoing care. We aimed to evaluate the clinical effect of MTC on the regulation of chronic kidney disease-mineral and bone disorder (CKD-MBD) complications in dialysis patients. Methods: This retrospective observational study was approved by the institutional review board. Among patients who have undergone dialysis at admission, the patients admitted to the nephrology ward were allocated to MTC group, and the others to usual care (UC) group. The MTC group had collaborative care by nephrologists, nurses, pharmacists, and nutritionists. The endpoints were the regulation of corrected calcium (cCa) and phosphate (P), the percent of patients in target level of cCa-P product ($cCa{\times}P$), and the prescription rate of non-calcium based P-binders. Results: A total of 163 patients were included from January to December 2009. A significant difference was shown in the percentage of patients in target $cCa{\times}P$ level at admission (MTC vs. UC, 81.40% vs. 91.67%; P = 0.038), but there was no significant difference at discharge. During admission, the cCa and P levels of patients in only UC group were significantly changed. In addition, compared with UC group, patients in MTC group were more likely prescribed appropriate P-binders, when they had higher $cCa{\times}P$ levels than $55mg^2/dL^2$ (P <0.001). Conclusion: It was found that MTC had beneficial effect on improving the regulation of CKD-MBD and the appropriate phosphate binder uses. Therefore, application of the MTC is anticipated to enhance quality of clinical care in chronic diseases.

A Comparative Bibliometric Analysis of Substance Use Disorder Research in Social Science, Natural Science and Technology, and Multidisciplinary Field (사회과학, 자연과학기술 및 융복합 분야의 약물중독 연구에 대한 계량서지학적 비교 분석 연구)

  • Nam, Dongin;Park, Ji-Hong
    • Journal of the Korean Society for information Management
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    • v.39 no.2
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    • pp.203-232
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    • 2022
  • Drug addiction or substance use disorder is continuously observed worldwide for its risks and prevalence. In this context, numerous studies have been conducted regarding this issue. However, bibliometric analysis related to drug addiction is insufficient. In particular, it is difficult to find research that utilizes a macro-level bibliographic approach that comprehensively reflects various characteristics related to drug addiction. In this study, to reflect the multidimensional features of drug addiction, research trends in drug addiction in social science, natural science, and multidisciplinary studies were compared and analyzed. This study collected drug addiction research articles from 2002 to 2021 by searching from the Web of Science, and classified academic disciplines based on SCI(E) and SSCI information. Author keyword co-occurrence analysis was also conducted, which provided confirmation that natural science mainly studied psychoactive substances and the reward system in the brain, while drug addiction studies reflecting demographic characteristics were conducted in the domain of social science. In the multidisciplinary field, all of the above topics were covered. Author co-citation analysis was also employed, which showed that there are superstars (i.e., authors who receive a rigorous amount of citation) in the field of natural science, while in the social science domain, authors were highly cited not only at the individual level but also at the institutional level.