• Title/Summary/Keyword: Patient guideline

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Surgery for Myocardial Bridging - A report of two cases - (심근교(Myocardial Bridging)에 대한 수술적 치료 -2예 보고)

  • Kim, Jae-Hyun;Oh, Sam-Sae;Yie, Kil-Soo;Jeong, In-Seok;Youn, Hyo-Chul;Kim, In-Sub;Na, Chan-Young
    • Journal of Chest Surgery
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    • v.40 no.9
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    • pp.629-632
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    • 2007
  • Most myocardial bridgings are found incidentally without symptoms, but myocardial bridging may induce symptoms such as angina, myocardial infarction, and ventricular arrythmia. In a patient who has symptoms despite of proper medication, stent insertion, supra-arterial myotomy or coronary artery bypass grafting have been applied without a definite guideline of treatment. We report two surgical cases of myocardial bridging with a review of the literature.

Longitudinal management of recurrent temporomandibular joint ankylosis from infancy to adulthood in perspective of surgical and orthodontic treatment

  • Lim, Seung-Weon;Choi, Jin-Young;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.49 no.6
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    • pp.413-426
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    • 2019
  • This study was performed to describe the longitudinal management of recurrent temporomandibular joint (TMJ) ankylosis from infancy to adulthood in perspective of surgical and orthodontic treatment. A 2-year-old girl was referred with chief complaints of restricted mouth opening and micrognathia due to bilateral TMJ ankylosis. For stage I treatment during early childhood (6 years old), high condylectomy and interpositional arthroplasty were performed. However, TMJ ankylosis recurred and symptoms of obstructive sleep apnea (OSA) developed. For stage II treatment during early adolescence (12 years old), gap arthroplasty, coronoidectomy, bilateral mandibular distraction osteogenesis, and orthodontic treatment with extraction of the four first premolars were performed. However, TMJ ankylosis recurred. Because the OSA symptoms reappeared, she began to use a continuous positive airway pressure device. For stage III treatment after completion of growth (20 years old), low condylectomy, coronoidectomy, reconstruction of the bilateral TMJs with artificial prostheses along with counterclockwise rotational advancement of the mandible, genioglossus advancement, and orthodontic treatment were performed. After stage III treatment, the amount of mouth opening exhibited a significant increase. Mandibular advancement and ramus lengthening resulted in significant improvement in the facial profile, Class I relationships, and normal overbite/overjet. The OSA symptoms were also relieved. These outcomes were stable at the one-year follow-up visit. Since the treatment modalities for TMJ ankylosis differ according to the duration of ankylosis, patient age, and degree of deformity, the treatment flowchart suggested in this report could be used as an effective guideline for determining the appropriate timing and methods for the treatment of TMJ ankylosis.

A Survey on the Clinical Practice Patterns of Irritable Bowel Syndrome in Korean Medicine (과민대장증후군(Irritable Bowel Syndrome)의 한의임상 진료현황에 대한 설문조사 연구)

  • Jun, Hyejin;Kim, Keumji;Ko, Seok-Jae;Park, Jae-Woo
    • The Journal of Internal Korean Medicine
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    • v.42 no.4
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    • pp.532-546
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    • 2021
  • Objective: This study investigated the perception, diagnosis, and treatment of irritable bowel syndrome (IBS) in the general population, in patients, and in Korean medicine doctors (KMDs) in order to provide basic information for the development of Korean medicine clinical practice guidelines for IBS. Methods: A questionnaire was developed in two versions, one for the general population/patients and one for KMDs. The questions were about the general perception, diagnosis, and treatment of IBS. Both online and offline surveys were conducted using these questionnaires. Results: In total, 213 general population/patients and 435 KMDs responded to the survey. The results of the analysis were as follows. Most of the KMDs diagnosed IBS based on clinical aspects. Acupuncture was the most common treatment, followed by prescription herbal medicine, moxibustion, and manufactured herbal medicine. 34.3% of KMDs used clinical practice guidelines for IBS patient treatment. 57.8% of patients were diagnosed with IBS by doctors at primary medical institutions, and 53.1% were diagnosed with colonoscopy. More than half of the IBS patients who have been treated with Korean medicine said they experienced improvement of symptoms and prevention of recurrence, but more than 70% of the respondents said future safety and effectiveness studies of Korean medicine were needed. Conclusions: In spite of the positive perception of IBS treatment with Korean medicine, actual utilization was relatively low. The development and promotion of, as well as education about, appropriate and reasonable Korean medicine practice guidelines for IBS is necessary.

Evaluation of the Quality of Case Reports of the Journal of Korean Medicine for Obesity Research from 2013 to 2018 According to the CARE (CAse REport) Guidelines (CARE (CAse REport) 지침에 의한 한방비만학회지 증례 논문에 대한 보고의 질 평가: 2013년~2018년 증례보고를 중심으로)

  • Park, Kyung Moo;Choi, Sung Youl;Lee, Ju Ah;Song, Yun Kyung
    • Journal of Korean Medicine for Obesity Research
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    • v.18 no.2
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    • pp.144-151
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    • 2018
  • Objectives: The purpose of this study is to evaluate the quality of case reports of the Journal of Korean Medicine for Obesity Research by the Case Report (CARE) guidelines. Methods: Case reports published in the Journal of Korean Medicine for Obesity Research from January 2013 to July 2018 were searched from Oriental Medicine Advanced Searching Integrated System (OASIS). We assessed the quality of reporting based on CARE guidelines. Results: A total of 8 case reports were finally included for the assessment. There was a deviation in the sub-item reporting rate by a maximum 75% and a minimum 57.14% in case reports. The 10 sub-items mentioned below, such as 'Timeline', 'Diagnostic challenges', 'Diagnostic reasoning including other diagnoses considered', 'Prognostic characteristics', 'Changes in intervention', 'Important follow-up diagnostic evaluations and other test results', 'Intervention adherence and tolerability', 'Adverse and unanticipated events', 'Patient perspective' and 'Informed consent' were reported below 30%. Conclusions: Efforts to diversify the subject of the case study and to apply appropriate reporting guidelines are needed to improve the quality of the case report contributed to the Journal of Korean Medicine for Obesity Research.

Quality Assessment and Implications for Further Study of Acupotomy: Case Reports Using the Case Report Guidelines and the Joanna Briggs Institute Critical Appraisal Checklist

  • Jun, Hyungsun;Yoon, Sang-Hoon;Roh, Minyeong;Kim, Seon-hye;Lee, Jisu;Lee, Jihyun;Kwon, Miri;Leem, Jungtae
    • Journal of Acupuncture Research
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    • v.38 no.2
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    • pp.122-133
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    • 2021
  • This review aimed to evaluate the quality of case reports where acupotomy was performed according to the CAse REport (CARE) guidelines and the Joanna Briggs Institute (JBI) critical appraisal checklist. Case reports on acupotomy published in Korea from 2013 to October 2020 were included in this review. A total of 28 acupotomy related case reports were selected, and a quality evaluation was verified using the CARE guidelines and JBI critical appraisal checklist. Among the case reports, spinal conditions/diseases were most commonly reported. The overall complete reporting rate for each study was relatively high (median of 63.4% according to the CARE guidelines and 73.4% according to JBI critical appraisal checklist for case reports and 62% for case series). However, low reporting rates were determined in several subcategories namely, "Intervention adherence and tolerability," "Timeline," "Diagnostic challenges," "Patient perspective," and "Adverse or unanticipated events" for case reports, and "Reporting of the presenting site/clinic," "Demographic information," "Statistical analysis," and "Clear criteria for inclusion" for case series. When reporting cases where acupotomy was performed, it is recommended that the CARE guidelines are followed to improve the quality of research. In addition, new guidelines and tools for the clinical situation of Korean medicine should be developed.

A Prospective Case Series Protocol for Clinical Pathway of Carpal Tunnel Syndrome (손목터널증후군의 한의표준임상경로 임상시험 프로토콜)

  • Park, Hye-Jin;Kim, Hyun-Tae;Park, Sun-Young;Heo, In;Hwang, Man-Suk;Shin, Byung-Cheul;Hwang, Eui-Hyoung
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.4
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    • pp.73-82
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    • 2022
  • Objectives The purpose of this study is to develop a case study protocol to complete final version of Korean medicine clinical pathway (CP) by applying Korean medicine CP based on carpal tunnel syndrome Korean medicine clinical practice guidelines developed by clinical experts to clinical field. Methods After applying previously developed CP, 10-point Likert scale questionnaires on satisfaction of CP, appropriateness and improvement on out patient department (OPD) treatments are carried out in the 2nd week of OPD treatment. An open-ended questionnaire is also carried out to ask if there is any requirement to be added or improved among CP interventions. Results Final version of CP is going to be completed based on the questionnaire, excluding articles of which average or median value is less than 5 from 10-point Likert scale. Conclusions This evidence-based case study protocol is expected to contribute development of carpal tunnel syndrome clinical pathway.

Development of Korean Medicine Clinical Pathways for Carpal Tunnel Syndrome (손목터널증후군의 한의표준임상경로 개발)

  • Hye-Jin Park;Hyun-Tae Kim;Sun-Young Park;In Heo;Man-Suk Hwang;Byung-Cheul Shin;Eui-Hyoung Hwang
    • Journal of Korean Medicine Rehabilitation
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    • v.33 no.2
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    • pp.57-76
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    • 2023
  • Objectives This study aims to develop Korean Medicine Clinical Pathway (CP) based on Clinical Practice Guideline of carpal tunnel syndrome to improve quality of treatment and reduce medical cost to maximize the quality of patient management. Methods A draft version of CP for carpal tunnel syndrome is developed by expert agreement and a prospective case study was carried out based on the draft CP. Twenty experts working at various medical institution answered validity verification survey of developed CP. Fifteen patients enrolled in the prospective case study answered survey on demand and satisfaction. Qualification and adjustment process of the draft CP was conducted based on results of both surveys. Results Final version of CP for carpal tunnel syndrome is confirmed after qualification and adjustment on the draft version. Conclusions CP for carpal tunnel syndrome will provide patients with standardized, high-quality Korean medicine treatment and also reduce financial burden of health insurance by reducing medical cost.

A Survey of Korean Medical Doctors on the Items and Importance of Lifestyle Management for Infertile Couple (난임 부부의 섭생 지도 항목과 중요도에 대한 한의사 대상 설문조사)

  • Yu-Kyung Jeong;Dong-Il Kim;Young-Jin Yoon;Jang-Kyung Park
    • The Journal of Korean Obstetrics and Gynecology
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    • v.36 no.3
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    • pp.114-128
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    • 2023
  • Objectives: This study was conducted to reflect Korean Medicine doctors (KMD)' perception of lifestyle management in the process of developing a Korean Medicine (KM) Clinical Practice Guidelines (CPG) of female infertility. Methods: We sent four e-mails containing links to online questionnaires to 25,286 KMD belonging to the Association of Korean Medicine. The questionnaire consisted of sexual intercourse, weight, diet, exercise, drinking, smoking, caffeine intake, stress etc. KMD responded to self-administered questionnaires, and we analyzed 786 responds. Results: KMD put stress first among the infertile women's lifestyle management items, weight and sexual intercourse were next. Also KMD put stress first among the spouses' lifestyle management items, drinking and sexual intercourse were next. In relation to sexual intercourse, 'Recognizing the Fertile Window' was the most important. In relation to stress in the emotional domain, 'Depression' and 'Anxiety' were the most important, and in relation to stress in the relationship domain, 'Deteriorating of marital relationship' was the most important. Conclusions: We surveyed the status of KMD' awareness of infertility lifestyle management for patient education, and reflected it in the modification of the CPG for female infertility.

Matching-adjusted Indirect Comparison (MAIC) of Tralokinumab Versus Dupilumab for the Treatment of Moderate to Severe Adult Atopic Dermatitis (트랄로키누맙과 두필루맙의 매칭 조정 간접 비교)

  • Taekyung Kim;Keun Soo Shin;Hyojin Kim;Eugene Kim;Leejung Choi;Dong Hun Lee
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.3
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    • pp.178-185
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    • 2023
  • Objective: Atopic dermatitis (AD) is a chronic, recurrent inflammatory skin disease. Both tralokinumab and dupilumab have been recommended in the European Guideline for the treatment of adult patients with severe AD. In Korea, dupilumab has been approved for patients with moderate to severe AD, and reimbursed for those with severe AD. Since there is no clinical trial directly comparing tralokinumab and dupilumab, we conducted indirect comparison to assess the clinical usefulness in patients with AD. Methods: We selected clinical trials for indirect comparison through a systematic literature review. Individual patient data were available for the tralokinumab clinical trial, and aggregated data were available for the dupilumab clinical trial. Therefore, we employed the Matching-Adjusted Indirect Comparison (MAIC) method. The treatment efficacy was assessed based on whether patients achieved a 75% reduction on the Eczema Area and Severity Index (EASI 75) after drug administration. Results: The difference in the proportion of patients achieving EASI 75 between tralokinumab and dupilumab was 4.7% (95% CI: -7.9 to 17.3). Considering the non-inferiority margin for the EASI 75 achievement rate is -10%, tralokinumab is deemed non-inferior to dupilumab as the lower bound of the CI for the difference in the EASI 75 achievement rate between tralokinumab and dupilumab was within -10%. Conclusion: We conducted a MAIC analysis comparing tralokinumab and dupilumab based on EASI 75 achievement. The findings of this study show that tralokinumab is non-inferior to dupilumab and can be implemented in Korean clinical settings with a therapeutic position comparable to dupilumab.

Development of antibiotic prescription guidelines for antibiotic prescription quality management (항생제 처방 질 관리를 위한 항생제 처방 지침의 개발)

  • Kim, Hyesung;Oh, Jeongkyu
    • Journal of Korean Academy of Dental Administration
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    • v.5 no.1
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    • pp.45-54
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    • 2017
  • The purpose of this article is to cope with the abuse of antibiotics in the clinic, to determine the necessity of antibiotic administration, to share information on the selection and proper use of appropriate antibiotics, and to increase the appropriateness of antibiotic prescription through continuous monitoring. In line with the latest research and guidelines trends of various agencies, we will supplement the antibiotic prescription guidelines and use them for the treatment in Apple Tree Dental Hospital. Specially, by history taking and the penicillin allergy test, amoxicillin is prescribed as a primary selective antibiotic for 1 day. The complaints and treatment effects of the first antibiotic should be evaluated at the next visit. If the primary antibiotic was ineffective, we replaced it with a broad-spectrum antibiotic. If there was no improvement in symptoms, the patient would be referred to upper grade hospital. The staff of the Apple Tree Dental Hospital regularly monitored and educated antibiotic prescriptions. The current guidelines should be supplemented continually and positively affect the abuse of antibiotics and the habit of dental practice.