• Title/Summary/Keyword: Pharmacologic therapy

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What Can We Apply to Manage Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Acute Respiratory Failure?

  • Kim, Deog Kyeom;Lee, Jungsil;Park, Ju-Hee;Yoo, Kwang Ha
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.2
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    • pp.99-105
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    • 2018
  • Acute exacerbation(s) of chronic obstructive pulmonary disease (AECOPD) tend to be critical and debilitating events leading to poorer outcomes in relation to chronic obstructive pulmonary disease (COPD) treatment modalities, and contribute to a higher and earlier mortality rate in COPD patients. Besides pro-active preventative measures intended to obviate acquisition of AECOPD, early recovery from severe AECOPD is an important issue in determining the long-term prognosis of patients diagnosed with COPD. Updated GOLD guidelines and recently published American Thoracic Society/European Respiratory Society clinical recommendations emphasize the importance of use of pharmacologic treatment including bronchodilators, systemic steroids and/or antibiotics. As a non-pharmacologic strategy to combat the effects of AECOPD, noninvasive ventilation (NIV) is recommended as the treatment of choice as this therapy is thought to be most effective in reducing intubation risk in patients diagnosed with AECOPD with acute respiratory failure. Recently, a few adjunctive modalities, including NIV with helmet and helium-oxygen mixture, have been tried in cases of AECOPD with respiratory failure. As yet, insufficient documentation exists to permit recommendation of this therapy without qualification. Although there are too few findings, as yet, to allow for regular andr routine application of those modalities in AECOPD, there is anecdotal evidence to indicate both mechanical and physiological benefits connected with this therapy. High-flow nasal cannula oxygen therapy is another supportive strategy which serves to improve the symptoms of hypoxic respiratory failure. The therapy also produced improvement in ventilatory variables, and it may be successfully applied in cases of hypercapnic respiratory failure. Extracorporeal carbon dioxide removal has been successfully attempted in cases of adult respiratory distress syndrome, with protective hypercapnic ventilatory strategy. Nowadays, it is reported that it was also effective in reducing intubation in AECOPD with hypercapnic respiratory failure. Despite the apparent need for more supporting evidence, efforts to improve efficacy of NIV have continued unabated. It is anticipated that these efforts will, over time, serve toprogressively decrease the risk of intubation and invasive mechanical ventilation in cases of AECOPD with acute respiratory failure.

Factors Related to the Outpatient Visits for Blood Pressure Management in Patients diagnosed with Hypertension (고혈압 진단자의 혈압 관리를 위한 외래 방문 영향요인)

  • Cho, Hyung-Kyung;Lee, Hyun-Ji;Seol, Jin-Ju;Lee, Kwang-Soo
    • Korea Journal of Hospital Management
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    • v.26 no.2
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    • pp.56-67
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    • 2021
  • Background: Regular doctor visits are vital for hypertension patients, especially for who have never received hypertension medication or non-pharmacologic therapy. This study purposed to study factors affecting outpatient visits for patients diagnosed with hypertension. Methods: This study included 59,009 respondents with hypertension over 30 from 2019 Community Health Survey data. Outpatient visits were defined by having hypertension treatments such as medication or non-pharmacologic therapy. Logistic regression was used to examine the factors affecting outpatient visits using SAS ver. 9.3. Results: 57,081(96.73%) patients with hypertension were identified as those having a outpatient visit for hypertension treatments, whereas 1,928(3.27%) patients did not have visits. Patient's characteristics such as gender, age, periods of hypertension, education level, perception of the blood pressure, hypertension management education, place of living, body mass index, depression and diabetes were found to have statistically significant relationship with the outpatient visits. Practical Implications: There is a need to select patients with high blood pressure who are unlikely to visit for hypertension treatments based on the study results. For those, establishing a personalized management plan such as health education and counseling programs will be helpful for the successful implementation of national chronic disease management program.

Conservative treatment modalities for patients with temporomandibular joint(TMJ) disorders (임상가를 위한 특집 1 - 턱관절장애의 보존적 치료)

  • Kim, Cheul
    • The Journal of the Korean dental association
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    • v.51 no.2
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    • pp.74-83
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    • 2013
  • In the management of temporomandibular joint(TMJ) disorders, dental practioner should conduct the reversible, conservative, and inexpensive treatment modalities prior to the irreversible and invasive treatment. That is to say, behavioral, pharmacologic, and physical therapy should be conducted firstly, and then the occlusal appliance therapy could be considered. If patients do not react to these conservative treatments, we have to consider surgical treatments. If the accurate diagnosis is confirmed by intimate history taking, clinical and imaging examinations, we can rehabilitate the normal TMJ function and relieve the clinical symptoms with only conservative treatments in most TMJ disorder cases.

Exacerbation Prevention and Management of Bronchiectasis

  • Joon Young Choi
    • Tuberculosis and Respiratory Diseases
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    • v.86 no.3
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    • pp.183-195
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    • 2023
  • Bronchiectasis, which is characterized by irreversibly damaged and dilated bronchi, causes significant symptoms, poor quality of life, and increased economic burden and mortality rates. Despite its increasing prevalence and clinical significance, bronchiectasis was previously regarded as an orphan disease, and ideal treatment of this disease has been poorly understood. The European Respiratory Society and British Thoracic Society have recently published guidelines to assist physicians in the clinical field. Guidelines and reports suggest comprehensive management that includes both non-pharmacological and pharmacological treatment. Physiotherapy and pulmonary rehabilitation are two of the most important non-pharmacologic therapies in bronchiectasis patients; long-term inhaled antibiotics and macrolide therapy have gained significant evidence in reducing exacerbation risk in frequent exacerbators. In this review, we summarize recent updates on bronchiectasis treatment to prevent exacerbation and manage clinical deterioration.

The Analysis of the Korean Nursing Research Trends on Complementary and Alternative Therapies for Cancer Patients (암환자에게 적용한 보완.대체요법 관련 국내 간호연구 분석 - 간호학술지를 중심으로 -)

  • Jun, Myung-Hee;Uhm, Dong-Choon;Jeong, Seong-Hee
    • Asian Oncology Nursing
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    • v.9 no.1
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    • pp.67-75
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    • 2009
  • Purpose: The purpose of this study was to analyze nursing research trends on the complementary and alternative therapies (CAT) for the cancer patients in Korea. Method: Thirty eight articles published in 17 nursing-related journal from 1987 to 2008 were analyzed. Results: Nursing Researches on CAT for the cancer patients have increased since 2000. Among the 38 studies, 34 studies used Quasi-experimental design and 13 studies (33%) were conducted for the breast cancer patients. Mind-body therapy (53%), manual healing therapy (42%), and pharmacologic and biological therapy (5%) were the often used CAT types. Nausea, vomiting, vital signs, immune cell, pain, and fatigue were measured as physiologic outcome variables; anxiety, depression, and hope as psychological outcome variables; and quality of life as social outcome variables. Conclusion: More CAM studies are needed targeting the patients with various cancer types and home-based cancer patients.

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Study on Alternative Medicine in Cancer Therapy (서구(西區) 대체의학(代替醫學)의 암(癌) 치료(治療)에 관(關)한 연구(硏究))

  • Yoo, Hwa-Seung;Lee, Yong-Yeon;Seo, Sang-Hoon;Choi, Woo-Jin;Cho, Jung-Hyo;Lee, Yeon-Weol;Son, Chang-Kyu;Cho, Chong-Kwan
    • THE JOURNAL OF KOREAN ORIENTAL ONCOLOGY
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    • v.6 no.1
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    • pp.125-148
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    • 2000
  • At here, we investigated the historical background, current stage, and concrete therapies of alternatives in cancer therapy. We obtained the conclusion below. 1. Alternative medicine(AM) is a unothodoxial medical physiology, medical practice or intervension that overcome the side effects, faults, limits of coventional medicine. 2. Recentely, as emerging New-age movement, collapse of Decarte's mecanical cosmology, and emphasis on patient rights, the interest of AM is increased, and foreign & domestic use rates of AM are risen. 3. After coventional medicine in cancer therapies that depends on operations, radiations, and chemotherapy is bounded, Alternatives in cancer therapy are rapidly developed, and the majority of users are often considered satisfactory. 4. Alternatives in cancer therapy are classified six boundaries; Diet and Nutrition, Mind-body Technique, Integrated System, Pharmacologic and Biologic treatments, Immuno Enhanced Therapy, Natural and herbal medicine. 5. Looking at contents of Alternatives in cancer therapy, we get to know most of them are similar to the treatment of oriental medicine in holistic method, therapy, philosophy. If we synthesize the alternative medicine's treatment mentioned above and investigate it with oriental medical viewpoint, that may help us approach the conquest of cancer and improve the rate of cure. 6. It is certain that foreign AM will be imported reversely, and we must prepare for rebuilding of Korean traditional AM systemically, investing for activity positively, making national policy for medical system.

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Improving Cognitive Abilities for People with Alzheimer's Disease: Application and Effect of Reality Orientation Therapy (ROT) (알츠하이머병 치매 환자의 인지재활: 현실감각훈련(ROT)의 적용과 효과)

  • Kim, JungWan
    • Phonetics and Speech Sciences
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    • v.5 no.1
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    • pp.27-38
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    • 2013
  • Healthcare providers in Korea are using conservative pharmacological treatment for Alzheimer's disease (AD) to delay the progress of the disease or to mitigate its behavioral and neurological symptoms. However, there is a growing need for interventions using practical non-pharmacologic treatment, as the effects of pharmacological treatments has faced limitations. This research provided a cognitive rehabilitation program to 3 AD patients and used a multiple baseline design across subjects to examine the effects. Performing reality orientation therapy (ROT) for 1 cycle (4 weeks) resulted in a slight increase in accuracy and responsiveness on an orientation task, mainly with patients with mild cases of AD. Also, in the sub-domain of the Korean-Mini Mental Status Examination performed to examine changes in cognitive ability, there were minimal changes in place orientation. In functional communication, however, there were no significant differences before and after the intervention. In conclusion, we found that ROT was an effective intervention for improving accuracy and responsiveness in the orientation of patients with mild cases of AD. In future studies, the effect of non-pharmacological interventions can be evaluated more reliably by examining the interaction effects of sample size, length of the intervention, outcome measurements, and pharmacological intervention.

THE RESULT OF THE DENTAL BEHAVIOR TREATMENT FOR THE PATIENTS WITH THE DEVELOPMENTAL DISORDER IN SEOUL DENTAL HOSPITAL FOR DISABLED (서울시장애인치과병원의 발달장애아동에 대한 치과행동치료 결과)

  • Lee, Hyo-Seol;Yang, Jun-Woo;Kim, Myung-Jin;Baek, Seung-Ho
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.6 no.2
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    • pp.84-93
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    • 2010
  • The developmental disorder(intellectual disorder(ID) and autism spectrum disorder(ASD)) can severely impair a patient's ability to communicate and socialize. So they require physical management techniques, pharmacologic agents, and general anesthesia more than the normal at the dental clinic. The behavior therapy is a kind of the psychotherapy and is applied to the patient with behavioral problems. Seoul Dental Hospital for Disabled(SDHD) set up the Dental Behavior Clinic for the patients with developmental disorder and treated 32 patients with ID or ASD, blind. 18 patients were treated according to the ordinary plans, 14 patients stopped the treatment by different reasons. The various results of the treatment were produced by the kind or severity of the diseases, age and cooperation of the patients and the caregivers. Especially, the behavior therapist helped to figure out the characteristics of the patients and to make individualized treatment plans. In the future, it will be necessary to treat more patients and to make the dental behavior therapy objectify. And through the dental behavior therapy, it will be expected that the patients will become more cooperative to the dental clinic and can receive regular check-up peacefully, reducing the frequency of the general anesthesia.

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Comparison of Silymarin, Penicillin, N-acetylcysteine in Patient with Amatoxin Poisoning: A Systematic Review (Amatoxin 중독 환자에서 Silymarin, Penicillin, N-acetylcysteine의 효과 비교: 체계적 고찰)

  • Choi, Min Woo;Ko, Dong Ryul;Kong, Taeyoung;Choa, Min Hong;You, Je Sung;Chung, Sung Phil
    • Journal of The Korean Society of Clinical Toxicology
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    • v.16 no.1
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    • pp.33-41
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    • 2018
  • Purpose: This study was conducted to evaluate the clinical efficacy of pharmacologic treatment of amatoxin poisoning patients. Methods: Literature was accessed through PubMed, EMBASE, Cochrane library, KoreaMed, KISS and KMBASE. Studies relevant to human use of pharmacologic therapy including silymarin, penicillin and N-acetylcysteine (NAC) for amanita poisoning were included. Case reports, letters, editorials and papers with insufficient information were excluded. Comparison of clinical outcomes (especially mortality and liver transplantation rate) in each study was analyzed. Results: The final analysis included 13 retrospective studies. None of these studies showed direct comparisons of individual agents. Among 12 studies comparing silymarin vs penicillin, eight showed clinical superiority of silymarin. Among eight studies comparing silymarin with NAC, six showed clinical superiority of silymarin. Among seven studies of NAC vs penicillin, five showed clinical superiority of NAC. Conclusion: This systematic review suggested that clinical superiority of various pharmacological agents used to treat amatoxin poisoning is debatable. Nevertheless, the available evidence suggests it is reasonable to consider combinations of multiple agents for patients with amanita poisoning. Further studies are required to establish a treatment regimen for amanita poisoning.

Bone Health Evaluations and Secondary Fragility Fractures in Hip Fracture Patients

  • Emily M. Pflug;Ariana Lott;Sanjit R. Konda;Philipp Leucht;Nirmal Tejwani;Kenneth A. Egol
    • Hip & pelvis
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    • v.36 no.1
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    • pp.55-61
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    • 2024
  • Purpose: This study sought to examine the utilization of bone health evaluations in geriatric hip fracture patients and identify risk factors for the development of future fragility fractures. Materials and Methods: A consecutive series of patients ≥55 years who underwent surgical management of a hip fracture between September 2015 and July 2019 were identified. Chart review was performed to evaluate post-injury follow-up, performance of a bone health evaluation, and use of osteoporosis-related diagnostic and pharmacologic treatment. Results: A total of 832 patients were included. The mean age of the patients was 81.2±9.9 years. Approximately 21% of patients underwent a comprehensive bone health evaluation. Of this cohort, 64.7% were started on pharmacologic therapy, and 73 patients underwent bone mineral density testing. Following discharge from the hospital, 70.3% of the patients followed-up on an outpatient basis with 95.7% seeing orthopedic surgery for post-fracture care. Overall, 102 patients (12.3%) sustained additional fragility fractures within two years, and 31 of these patients (3.7%) sustained a second hip fracture. There was no difference in the rate of second hip fractures or other additional fragility fractures based on the use of osteoporosis medications. Conclusion: Management of osteoporosis in geriatric hip fracture patients could be improved. Outpatient follow-up post-hip fracture is almost 70%, yet a minority of patients were started on osteoporosis medications and many sustained additional fragility fractures. The findings of this study indicate that orthopedic surgeons have an opportunity to lead the charge in treatment of osteoporosis in the post-fracture setting.