• Title/Summary/Keyword: Pharmacological treatment

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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.

Pharmacological Treatments of Headache (두통의 약물학적 치료)

  • Na, Eun-Jin;Park, Jong-Il;Yang, Jong-Chul
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.20-27
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    • 2016
  • Headache is one of the most common physical symptoms which almost everyone experience at least once during a life. Headache is often associated with disability, but rarely with secondary headache which could result in a serious life-threatening illness, i.e. brain tumor. However, in most cases, headache is a benign illness which comprises a primary headache, i.e. migraine or tension-type headache. The accurate diagnosis of headache is critical for clinicians and it begins with history taking and physical examination since there are no diagnostic tests for primary headaches. Nowadays, there are a wide variety of pharmacological treatments according to each headache disorder. The specific purposes of this review are introducing history of classification of headache disorder and presenting diagnostic process of headache disorder. Then, we discuss the effective pharmacological treatment strategies of each headache disorder.

Trigeminal neuralgia management after microvascular decompression surgery: two case reports

  • Hwang, Victor;Gomez-Marroquin, Erick;Enciso, Reyes;Padilla, Mariela
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.6
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    • pp.403-408
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    • 2020
  • Trigeminal neuralgia (TN) involves chronic neuropathic pain, characterized by attacks of repeating short episodes of unilateral shock-like pain, which are abrupt in onset and termination. Anticonvulsants, such as carbamazepine, are the gold standard first-line drugs for pharmacological treatment. Microvascular decompression (MVD) surgery is often the course of action if pharmacological management with anticonvulsants is unsuccessful. MVD surgery is an effective therapy in approximately 83% of cases. However, persistent neuropathic pain after MVD surgery may require reintroduction of pharmacotherapy. This case report presents two patients with persistent pain after MVD requiring reintroduction of pharmacological therapy. Although MVD is successful for patients with failed pharmacological management, it is an invasive procedure and requires hospitalization of the patient. About one-third of patients suffer from recurrent TN after MVD. Often, alternative treatment protocols, including the reintroduction of medications, may be necessary to achieve improvement. This case report presents two cases of post-MVD recurrent pain. Further research is lacking on the success rates of subsequent medication therapy after MVD has proven less effective in managing TN.

Use of Various Treatment Modalities for Autism Spectrum Disorder and Mental Retardation (정신지체 및 자폐스펙트럼장애에서 다양한 치료방법의 사용실태)

  • Kim, Kyung Min;Choi, In Chul;Lee, Seok Bum;Lee, Kyung Kyu;Paik, Ki Chung;Lee, Jeong Yeob;Lim, Myung Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.25 no.2
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    • pp.73-81
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    • 2014
  • Objectives : The purpose of this study was to investigate the use of various treatment modalities including pharmacotherapy, educational-behavioral therapy, and complementary alternative treatment for children with mental retardation (MR) or autism spectrum disorder (ASD) in Korea. Methods : The sample consisted of 50 parents who have children with MR (N=28) or ASD (N=22) : 38 boys, 12 girls ; mean age 14.06 (4.14) years old. A questionnaire was composed of the experienced modality, duration, cost, satisfaction, etc. Results : According to the results, 56.0%, 100.0%, and 36.0% of children with MR or ASD have experienced pharmacological treatment, educational-behavioral therapy and complementary alternative medicine (CAM), respectively. Children who experienced educational-behavioral therapy and CAM experienced 3.52 kinds of education-behavioral therapy and 2.78 kinds of CAM, respectively. Monthly cost of pharmacological treatment was lowest among three modality categories. Regarding treatment satisfaction by parental report, the lowest score was recorded for CAM. Conclusion : Parents who have a child with MR or ASD are trying many treatment modalities and feeling the burden of their treatment.

Insomnia in Patients with Hematopoietic Stem Cell Transplantation(HSCT) (조혈모세포 이식 환자의 불면증)

  • Lee, Sang-Shin;Kim, Hyunseuk
    • Journal of the Korean society of biological therapies in psychiatry
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    • v.24 no.3
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    • pp.142-155
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    • 2018
  • Insomnia in patients with hematopoietic stem cell transplantation(HSCT) has been underdiagnosed and undertreated. This study reviewed the frequency, characteristics, physical and psychological effects, and treatments of insomnia in HSCT patients to highlight clinical importance in this specialized population. Furthermore, the authors intended to suggest a model that would conceptualize insomnia in the context of HSCT. In the pre-transplant period, about half of patients with HSCT suffered from sleep disturbance. A substantial number of patients experienced distressing insomnia during the HSCT procedure and recovered to the level of the pre-transplant period. However, sleep disruption could be a chronic symptom in HSCT survivors and could negatively impact quality of control, cancer-related fatigue(CRF), immune function, and psychological distress. The 3P's model(Predisposing, Precipitating, Perpetuating) explains insomnia in cancer population and could be also relevant to HSCT patients with specific consideration of CRF, graft-versus-host diseases, specific properties of hematological disease, and protective isolated milieu. Effective treatment of insomnia in HSCT includes non-pharmacological(e.g., cognitive behavioral therapy, environmental modification) and pharmacological interventions. The decision of pharmacological treatment should be based on the issue of safety due to high risk of potential drug-drug interactions. Screening, treatment, and further research of insomnia in HSCT patients using validated subjective and/or objective measures are warranted.

Chemical Composition and Pharmacological Activities of Vietnamese Ginseng, Panax viehamensis

  • Duc, Nguyen-Minh;Nham, Nguyen-Thoi
    • Proceedings of the Ginseng society Conference
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    • 1998.06a
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    • pp.127-137
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    • 1998
  • From the underground part of Panax vietnamensis Ha et Grushv., commonly known as Vietnamese ginseng, 50 triterpene glycosides including 24 new dammarane saponins named visa-ginsenosides-Rl-24 were isolated and identified. The structure of the new saponins was elucidated based on chemical and spectroscopic evidence. The saponin composition of Vietnamese ginseng is almost similar to that of ginseng (Panax ginseng C.A. Meyer) and other cultivated Panax spp. However, the content of ocotillos-type saponins, especially that of the major saponin, majonoside-R2 (5.29% yield), was surprisingly very high. The pharmacological activities of Vietnamese ginseng are essentially similar to those of ginseng. In addition, it has marked antibacterial activity against pathogenic Streptococcus app. and is effective in treatment of granular angina. The chemical composition and pharmacological activities have made Vietnamese ginseng an interesting member of Panax spp. from chemotaxonomical and pharmacological points of view,

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Real-world Treatment Pattern and Outcomes of Hypercalcemia among Solid Tumor Patients (성인 고형암 환자의 고칼슘혈증 치료현황과 치료효과 분석)

  • Shin, Da Eun;Park, Seol Hee;Kim, Sung Hwan;Suh, Sung Yun;Jo, Yun Hee;Cho, Yoon Sook;Im, Seock-Ah;Lee, Ju-Yeun
    • Korean Journal of Clinical Pharmacy
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    • v.29 no.3
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    • pp.166-172
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    • 2019
  • Background: Hypercalcemia is an important metabolic emergency condition in cancer patients. Bisphosphonate is the treatment of choice for hypercalcemia, whereas calcitonin and hydration with furosemide are recommended for acute supportive therapy. However, data regarding real-world treatment patterns and outcomes of pharmacological treatments are limited. Therefore, we aimed to investigate the treatment patterns and clinical outcomes of hypercalcemia treatment in solid tumor patients. Methods: Electronic medical records of 123 adults with solid cancers and albumin-corrected calcium levels >10.5 mg/dL or ionized calcium levels >1.35 mmol/L were reviewed. We retrospectively analyzed the pharmacological treatment and recovery rate according to the severity of hypercalcemia. Results: A total of 177 cases were identified, of which 49 were not treated and 30 were treated with hydration only. In moderate-to-severe cases, 86.5% received pharmacological treatment. Thirty-four cases (19.2%) were treated with bisphosphonate alone and 58 cases (32.8%) were treated with bisphosphonate and calcitonin. In mild hypercalcemia cases, the recovery rate was higher for those receiving hydration only or pharmacological treatment (79.7%) than for those receiving no treatment (61.4%, p = 0.041). Most moderate-to-severe cases were treated with medication and of those treated, 56.3% recovered. The recovery rate was lower in those treated with bisphosphonate alone (38.2%) than in those who underwent calcitonin combination treatment (73.7%, p = 0.001). Conclusions: Bisphosphonate combined with calcitonin was found to be more effective than bisphosphonate alone for the treatment of moderate-to-severe hypercalcemia. Considering the current shortage of calcitonin, further efforts are required to ensure its stable supply.

Dental treatment in patients with severe gag reflex using propofol-remifentanil intravenous sedation

  • Shin, Sooil;Kim, Seungoh
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.1
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    • pp.65-69
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    • 2017
  • Patients with severe gag reflex (SGR) have difficulty getting the treatment they require in local clinics, and many tend to postpone the start of their treatment. To address this problem, dentists have used behavioral techniques and/or pharmacological techniques for treatment. Among the pharmacological methods available, propofol IV sedation is preferred over general anesthesia because it is a simpler procedure. Propofol in combination with remifentanil is characterized by stable sedative effects and quick recovery, leading to a deep sedation. Remifentanil acts to reduce the pain caused by lipid-soluble propofol on injection. The synergistic effects of propofol-remifentanil include reduction in the total amount of drug required to achieve a desired sedation level and anti-emetic effects. In this case report, we outline how the use of propofol-remifentanil IV sedation enabled us to successfully complete a wide range of dental treatments in a patient with SGR.

Treatment for Burning Mouth Syndrome: A Clinical Review

  • YoungJoo Shim
    • Journal of Oral Medicine and Pain
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    • v.48 no.1
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    • pp.11-15
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    • 2023
  • Burning mouth syndrome (BMS) is a chronic idiopathic orofacial pain. BMS is currently classified as a neuropathic pain condition, but it is difficult to pinpoint the precise neuropathic mechanisms involved in each patient. It is challenging to complete the cure for BMS. Clinicians should treat BMS patients based on evidence. There is pharmacological and non-pharmacological therapy in the treatment modalities of BMS. The provision of objective information and reassurance as part of cognitive behavioral therapy is critical in the treatment of BMS. This paper will review the evidence-based treatment of BMS and discuss what we need to do.

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.