• Title/Summary/Keyword: Pharmacologic therapy

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Pharmacologic therapy for nonalcoholic steatohepatitis focusing on pathophysiology

  • Yoon, In Cheol;Eun, Jong Ryeol
    • Journal of Yeungnam Medical Science
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    • v.36 no.2
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    • pp.67-77
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    • 2019
  • The paradigm of chronic liver diseases has been shifting. Although hepatitis B and C viral infections are still the main causes of liver cirrhosis and hepatocellular carcinoma (HCC), the introduction of effective antiviral drugs may control or cure them in the near future. In contrast, the burden of nonalcoholic fatty liver disease (NAFLD) has been increasing for decades, and 25 to 30% of the general population in Korea is estimated to have NAFLD. Over 10% of NAFLD patients may have nonalcoholic steatohepatitis (NASH), a severe form of NAFLD. NASH can progress to cirrhosis and HCC. NASH is currently the second leading cause to be placed on the liver transplantation list in the United States. NAFLD is associated with obesity, type 2 diabetes, dyslipidemia, and metabolic syndrome. The pathophysiology is complex and associated with lipotoxicity, inflammatory cytokines, apoptosis, and insulin resistance. The only proven effective treatment is weight reduction by diet and exercise. However, this may not be effective for advanced fibrosis or cirrhosis. Therefore, effective drugs are urgently needed for treating these conditions. Unfortunately, no drugs have been approved for the treatment of NASH. Many pharmaceutical companies are trying to develop new drugs for the treatment of NASH. Some of them are in phase 2 or 3 clinical trials. Here, pharmacologic therapies in clinical trials, as well as the basic principles of drug therapy, will be reviewed, focusing on pathophysiology.

Cognitive Behavioral Therapy of Paraphilia or Sexual Offenders (성도착증 혹은 성적 가해자의 인지행동치료)

  • Lim, Myung Ho;Yoo, Dong Soo;Lee, Jae Woo
    • Anxiety and mood
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    • v.10 no.2
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    • pp.85-94
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    • 2014
  • Non-pharmacological treatments have long been used for paraphilia or sexual offenders, but few clinical studies were conducted. However, recently there were issued cognitive behavioral therapy of paraphilia or sexual offenders based on the research findings obtained so far. In addition, there were the changes of Diagnostic and Statistical Manual of Mental Disorder by American Psychiatric Association at 2014. The methods of cognitive behavioral therapy for paraphilia or sexual offenders were electric aversion therapy, olfactory aversion therapy, ammonia aversion therapy, covert sensitization, masturbatory reconditioning, directed masturbation, verbal satiation, social skill training, assertiveness training etc. By synthesizing the newly reported foreign guidelines for treatment and review articles, the aim of this study is to investigate the non-pharmacologic therapies used for treatment of paraphilia or sexual offenders.

Effectiveness of Non-Pharmacologic Interventions in Chemotherapy Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis (항암화학요법 관련 말초신경병증에 적용한 비약물적 중재의 효과: 체계적 문헌고찰 및 메타분석)

  • Oh, Pok-Ja;Kim, You Lim
    • Journal of Korean Academy of Nursing
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    • v.48 no.2
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    • pp.123-142
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    • 2018
  • Purpose: This study was conducted to evaluate the effectiveness of non-pharmacologic interventions in chemotherapy-induced peripheral neuropathy (CIPN). Methods: PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL, and several Korean databases (Until August 2017) were searched. The main search strategy combined terms for peripheral neuropathy and presence of neoplasms. The risk of bias was assessed using the Cochrane's Risk of Bias tool for randomized studies and the Risk of Bias Assessment tool for non-randomized studies. To estimate the effect size, a meta-analysis of the studies was performed using the Rev Man 5.3 program of the Cochrane Library random-effects models were used in the analyses. Results: Twenty-two studies with a total of 954 participants met the inclusion criteria. Of the 22 studies, 12 were used to estimate the effect size of the non-pharmacologic interventions. The non-pharmacologic interventions used in patients with CIPN were exercise, acupuncture, massage, and foot bath. The acupuncture significantly reduced CIPN symptoms and signs (d=-0.71) and CIPN pain (d=-0.73) (p<.001). Massage and foot bath were also effective in reducing CIPN symptoms (d=-0.68; 95% CI=-1.05, -0.30; p<.001; $I^2=19%$).Exercises were effective in improving muscle strength and endurance(d=-0.55) and quality of life (d=-2.96), but they were not significantly effective in improving CIPN. Conclusion: Although these results provide little evidence of the effectiveness of acupuncture, massage, and foot bath in the treatment of CIPN, they suggest that these interventions can reduce CIPN symptoms in patients with cancer. However, the findings of this study should be interpreted with caution as there is a relative lack of data in this field, and additional well-designed studies are needed. PROSPERO registration: CRD42017076278.

Drug Treatment of Insomnia : Sedative-Hypnotics (불면증의 약물 치료:진정수면제)

  • Park, Doo-Heum
    • Sleep Medicine and Psychophysiology
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    • v.6 no.1
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    • pp.5-18
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    • 1999
  • A growing number of people are concerned about their sleep. There are many people with chronic sleep disorders. Sedativehypnotics including benzodiazepine and non-benzodiazepine have been widely used in chronic insomniacs. It is widely accepted that current hypnotics are efficient in alleviating subjective symptoms of insomnia. Non-benzodiazepine hypnotics include zolpidem, zopiclone, and melatonin. These novel non-benzodiazepine hypnotics that have efficacy comparable to benzodiazepines were developed with more understanding of benzodiazepine receptor pharmacology. Their unique pharmacologic profiles may offer few significant advantages in terms of adverse effects of benzodiazepines. However, most of hypnotics including non-benzodiazepine have some of dependence, tolerance, impaired daytime function and rebound insomnia. Currently, it is accepted that combination therapy with pharmacologic and behavioral intervention is the most effective for chronic insomniacs.

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Cardiac Resynchronization Therapy (심장재동시화치료)

  • Kim, Hyong-Jun;Shin, Dong-Gu
    • Journal of Yeungnam Medical Science
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    • v.22 no.2
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    • pp.131-140
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    • 2005
  • Heart failure is a clinical syndrome comprised of a number of symptoms and signs associated with congestion and/or hypoperfusion. Specific pharmacologic therapies have been developed to slow disease progression from early to more advanced stages. Once symptoms have developed, aggressive multimodality interventions are instituted to alleviate symptoms and improve clinical status and quality of life; especially in those patients that present symptoms. Recently, an evolving adjunctive therapeutic modality, that involves using implanted electrical devices: cardiac resynchronization with or without implantable cardioverter defibrillators (ICD). has been used for management. Cardiac resynchronization therapy (CRT) is a proven treatment for selected patients with heart failure-induced conduction disturbances and ventricular dyssynchrony. When used in combination with stable, optimal medical therapy, CRT is designed to reduce symptoms and improve cardiac function by restoring the mechanical sequence of ventricular activation and contraction. This review summarizes the rationale, procedure, clinical trials, and clinical indications for CRT.

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Effects of Conservative Treatment on Scoliosis According to Early Detection (조기발견을 통한 보존적 치료가 척추 측만증에 미치는 영향)

  • Yu, Jae-Ho;Jung, Sang-Mi
    • The Journal of Korean Physical Therapy
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    • v.22 no.4
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    • pp.65-71
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    • 2010
  • Purpose: The aim of this study was to describe the effects of conservative treatment intervention for individual with scoliosis. Methods: Studies were selected through a search of computerized databases of the literature (KERIS, 2000-2010) using "early detection", "conservative treatment", "exercise", "physical therapy", "manipulation", "chiropractic", "therapy", "taping" and "orthosis" as keywords. Selected articles were classified by research design and statistical methods. Results: Application of the search strategy to the KERIS databases resulted in 132 articles. Based on titles and abstracts, 17 studies were selected, excluding articles of overlapping study, surgery, pharmacologic therapy and no correcting aim under conservative treatment. Among the 17 selected studies, the majorityof study design consisted of one group pretest-posttest design and additionally most of these studies were paired (or independent) t-test. The most frequently used intervention was exercise therapy. Conclusion: All articles showed that interventions were effective. Thus, early detection of scoliosis may be connected participation of early conservative treatment. It is important to reduce prevalence of scoliosis in adolescents using regular evaluation as an effective measure.

Analysis of Patients with Mandibular Nerve Damage after Root Canal Therapy (근관치료 후 발생한 하악신경 손상 환자에 대한 분석)

  • Lee, Ji-Soo;Song, Ji-Hee;Kim, Young-Gun;Kim, Seong-Taek
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.3
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    • pp.327-336
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    • 2011
  • Reported causes of mandibular nerve injury in relation to neuropathic pain in dentistry include extraction, dental implant surgery, oral and maxillofacial surgery, periodontal treatment, and root-canal therapy. This study analyzed the characteristics of pharmacologic management of neuropathy after root-canal therapy. 32 patients who complain of abnormal sensation or pain after root-canal therapy and were referred to Department of Oral Medicine and the Temporomandibular Joint and Orofacial Pain Clinic at the Dental Hospital of Yonsei University, Seoul, Korea from 2004 to 2011 enrolled in this analysis and improvement of symptom was evaluated after pharmacologic management. Thirty-two patients who had hypoesthesia or dysesthesia at the initial visit were analyzed(9 men, 23 women; mean age: 44 years). The causes of neuropathy were local anesthesia(46.9%), chemical trauma from the sealant in root-canal(25%), endodontic surgery(15.6%), and unknown causes(12.5%). Medications such as steroids, anticonvulsants, antidepressants, and analgesics were took for improvement of symptoms and titrated for a variety of period from 1 week to 11 months. It was found that neuropathy of the inferior alveolar nerve and the lingual nerve was in 25 and 7 patients. The improvement of neurosensory disturbance and no improvement after pharmacotherapy was in 21(66%) and 11(34%) patients respectively. The hypoesthesia and dysesthesia was improved 67% and 65% respectively. These results suggest that symptomatic improvement by pharmacologic management can be possible in patients with neuropathy after root-canal therapy. But improvement of symptoms was influenced by the causes and degree of nerve injury, the periods of pharmacotherapy, and the choice of treatment methods. So, further investigation is needed by quantitative measurement of more variables in more individuals.

Current Concept and Future of the Management of Spinal Cord Injury: A Systematic Review (척수손상 치료 약제의 현재와 미래: 체계적 고찰)

  • Choi, Il;Ha, Jin Gyeong;Jeon, Sang Ryong
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.63-73
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    • 2013
  • Spinal cord injury (SCI) is a serious condition associated with social and familial burden, as well as significant neurologic deficit. Despite the many advances in the treatment of spinal cord injury, a fundamental treatment for neurologic functional recovery has not yet been developed. In this article, we review two directions of development for spinal cord injury treatment: neuroprotective pharmacological agents and axon-regenerating cell therapy. We expect developments in these two to lead to improve functional recovery in patients with spinal cord injuries and to reduce burdens on society, as well as the patients' families.

The Study of Promoting Method for VR Contents to Reduce Pain of Child Patient - Focusing on The Case Studies of VR Contents at Home and Abroad (아동의 통증 감소를 위한 VR 콘텐츠 활성화 방안 연구 - 국내·외 VR 콘텐츠의 사례 연구를 중심으로)

  • Kim, Ho-Da;Joo, Ae-Ran
    • The Journal of the Korea Contents Association
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    • v.20 no.6
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    • pp.167-176
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    • 2020
  • Meanwhile the service of public health are being improved and the patient-friendly medical environment is constructed due to the development of the medical industry, we need to take more concern for child patient's pain undergoing this change of the medical environment. Currently, pain of child patient is treated by both pharmacologic and non-pharmacologic method. The application of virtual reality(VR) is emerging as a kind of attention-conversion therapy among non-pharmacologic method both at home and abroad. This study has examined and analyzed the development cases and related studies of VR among the world. And derived 'Presence', 'Interactivity', 'Social Interaction', 'Customization', 'Embodiment' as characteristics to be considered in the clinical application of VR for children. Based on this, six measures are proposed to promote VR contents to reduce pain of child patient.

Trends of Tuina Therapy on Depression and Its Efficacy -based on CNKI-

  • Kwon, Chan-Young;Choi, Eun-Ji;Kim, Jong-Woo;Chung, Sun-Young
    • Journal of Oriental Neuropsychiatry
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    • v.26 no.3
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    • pp.251-266
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    • 2015
  • Objectives: The purpose of this study is to investigate the research about using tuina therapy for depression and to determine its efficacy. Methods: All relevant articles were searched in the China National Knowledge Infrastructure using the terms 'tuina' and 'depression'. Results: Forty-one studies were selected, 34 randomized controlled trials (RCTs) and 7 prospective studies. The Chinese Classification of Mental Disorders and Hamilton Depression Rating Scale were used most frequently as diagnostic criteria and an assessment tool, respectively. Conduction exercise therapy was used in all studies; in contrast, Zheng Xing exercise therapy was used in only 1 study of depression patients with neck vertebrae disease. In 9 RCTs that showed scores of more than 2 points on a modified Jadad scale, tuina therapy had significant antidepressant efficacy compared with conventional treatment. However, more high-quality studies are required. Conclusions: Tuina therapy has a valid therapeutic effect on depression according to studies published in China; if evidence accumulates from high-quality studies, it can be considered a non-pharmacologic treatment for depression in Korean medicine, as well.