• Title/Summary/Keyword: Therapeutic guidelines

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Clinical Practice Guideline on Prostate Cancer in Korean Medicine (전립선암 치료의 한방 임상 진료 지침)

  • Song, Bong-Keun;Lee, Eun-Jung;Yoo, Hwa-Seung
    • Journal of Korean Traditional Oncology
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    • v.21 no.2
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    • pp.1-35
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    • 2016
  • Objectives : The aim of this preliminary study is to suggest a clinical approach on prostate cancer through the analysis of existing clinical practice guidelines or clinical studies. Materials and Methods : The data related on the treatment of prostate cancer were collected using various search engines such as Pub Med, KIOM OASIS, CNKI. Then, data were analyzed to evaluate the validity of recommendation of treatment. Results : Prostate cancer has the highest prevalence around the world. Recently, the incidence of prostate cancer in Korea is rapidly increasing. Especially, it was reported that incidence rate rose up to 80% by age 80 years. In recent studies, applying combined traditional and conventional medicine were reported to improve the survival, quality of life, immune function, and suppress of tumor growth in prostate cancer. However there has not been an objective and systemic clinical guideline for prostate cancer in Korean Medicine. Accordingly, it has been difficult for doctors to apply optimized therapeutic treatment in clinics. This study will show a preliminary approach to establish clinical practice guideline for prostate cancer of Korean Medicine. Conclusion : Further objective and systemic clinical studies by Korean Medicine are needed to develop more advanced clinical practice guidelines of prostate cancer.

Probiotics as a Potential Immunomodulating Pharmabiotics in Allergic Diseases: Current Status and Future Prospects

  • Sharma, Garima;Im, Sin-Hyeog
    • Allergy, Asthma & Immunology Research
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    • v.10 no.6
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    • pp.575-590
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    • 2018
  • The prevalence of allergic disorders has dramatically increased over the past decade, particularly in developed countries. Apart from gastrointestinal disorders, neoplasia, genital and dermatological diseases etc., dysregulation of gut microbiota (dysbiosis) has also been found to be associated with increased risk of allergies. Probiotics are increasingly being employed to correct dysbiosis and, in turn, to modulate allergic diseases. However, several factors like strain variations and effector metabolites or component of them in a bacterial species can affect the efficacy of those as probiotics. On the other hand, host variations like geographical locations, food habits etc. could also affect the expected results from probiotic usage. Thus, there is a glaring deficiency in our approach to establish probiotics as an irrefutable treatment avenue for suitable disorders. In this review, we explicate on the reported probiotics and their effects on certain allergic diseases like atopic dermatitis, food allergy and asthma to establish their utility. We propose possible measures like elucidation of effector molecules and functional mechanisms of probiotics towards establishing probiotics for therapeutic use. Certain probiotics studies have led to very alarming outcomes which could have been precluded, had effective guidelines been in place. Thus, we also propose ways to secure the safety of probiotics. Overall, our efforts tend to propose necessary discovery and quality assurance guidelines for developing probiotics as potential immunomodulatory 'Pharmabiotics.'

Diagnosis and Management of Gastroesophageal Reflux Disease in Infants and Children: from Guidelines to Clinical Practice

  • Gonzalez Ayerbe, Jeaneth Indira;Hauser, Bruno;Salvatore, Silvia;Vandenplas, Yvan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.2
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    • pp.107-121
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    • 2019
  • The diagnosis and management of gastro-esophageal reflux (GER) and GER disease (GERD) in infants and children remains a challenge. Published guidelines and position papers, along with Embase, MEDLINE, and the Cochrane Database were reviewed and summarized with the intent to propose a practical approach and management of GER and GERD for healthcare providers and to standardize and improve the quality of care for infants and children. For this purpose, 2 algorithms were developed, 1 for infants <12 months of age and the other for older children. None of the signs and symptoms of GER and GERD are specific and there is no gold standard diagnostic test or tool. Nutritional management is recommended as a first-line approach in infants, while in children, a therapeutic trial with antacid medication is advised for early management. The practical recommendations from this review are intended to optimize the management of GER in infants and older children and reduce the number of investigations and inappropriate use of medication.

Adverse Effects of Air Pollution on Pulmonary Diseases

  • Ko, Ui Won;Kyung, Sun Young
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.4
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    • pp.313-319
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    • 2022
  • Environmental exposure to air pollution is known to have adverse effects on various organs. Air pollution has greater effects on the pulmonary system as the lungs are directly exposed to contaminants in the air. Here, we review the associations of air pollution with the development, morbidity, and mortality of pulmonary diseases. Short-and long-term exposure to air pollution have been shown to increase mortality risk even at concentrations below the current national guidelines. Ambient air pollution has been shown to be associated with lung cancer. Particularly long-term exposure to particulate matter with a diameter <2.5 ㎛ (PM2.5) has been reported to be associated with lung cancer even at low concentrations. In addition, exposure to air pollution has been shown to increase the incidence risk of chronic obstructive pulmonary disease (COPD) and has been correlated with exacerbation and mortality of COPD. Air pollution has also been linked to exacerbation, mortality, and development of asthma. Exposure to nitrogen dioxide (NO2) has been demonstrated to be related to increased mortality in patients with idiopathic pulmonary fibrosis. Additionally, air pollution increases the incidence of infectious diseases, such as pneumonia, bronchitis, and tuberculosis. Furthermore, emerging evidence supports a link between air pollution and coronavirus disease 2019 transmission, susceptibility, severity and mortality. In conclusion, the stringency of air quality guidelines should be increased and further therapeutic trials are required in patients at high risk of adverse health effects of air pollution.

Internet Gaming Disorder Treatment Options in the Hospital Setting (임상환자를 대상으로 한 인터넷 게임장애의 치료방법 고찰)

  • Park, Jeong Ha;Hyun, Gi Jung;Son, Ji Hyun;Lee, Young Sik
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.26 no.2
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    • pp.75-85
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    • 2015
  • Internet gaming disorder (IGD), one of the common subtypes of internet addiction, is now classified in Section 3 of DSM-5 and is increasingly regarded as a growing health concern in many parts of the world. Consequently, many psychotherapeutic and psychopharmacological approaches have been considered and some research regarding therapeutic strategies has been conducted. However, treatment of IGD is in its early stages and therefore is not yet well established. This article reviews multiple therapeutic modalities including our own treatment model for IGD according to clinical and biological effects, thus providing suggestions for standard treatment strategies. The two main streams are psychopharmacological treatment and cognitive-behavior treatment, and the cognitive-behavior approach includes cognitive reconstruction, psychoeducation, and parenting coach. Many other non-pharmacological treatments are also recommended for personalized treatment of IGD.

Guideline Development to Evaluate the Safety and Performance of Intense Pulsed Light(IPL) (Intense Pulsed Light의 안전성 및 성능평가를 위한 시험 항목 및 시험방법(안) 연구)

  • Kang, Dong-Yeon;Son, Tae-Yoon;Joo, Yea-Il;Choi, Eung-Ho;Jung, Byung-Jo
    • Journal of Biomedical Engineering Research
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    • v.31 no.2
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    • pp.129-133
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    • 2010
  • Intense pulsed light(IPL) is a photo-therapeutic medical device using xenon lamps with optical characteristics of incoherence, defocusing, and polychromatic. IPL has been recognized as a representative medical therapeutic device with growth of domestic skin care market. However, there is no standard regulation manual and guideline to evaluate the safety and performance of IPL. International Electrotechnical Commission(IEC) is being statued "Technical Report IEC TR 60825-16" which is a guidelines for the safe use of intense light source equipment on humans and animals. In this study, a standard Korea Food & Drug Administration (KFDA) regulation for the safety and performance of IPL was suggested by developing minimal evaluation methods for optical parameters of IPL such as output energy density, pulse mode, spot size, wavelength and uniformity of output light. We expect that this study may be a step to statue a standard regulation manual and guideline for IPLs used in domestic.

The Effects of Comorbid Anxiety Disorder and Substance use Disorder on Major Depressive Disorder (공존하는 불안장애와 물질사용장애가 주요우울증에 미치는 영향)

  • Shin, Jae Hyun;Kim, Jung Bum;Jung, Sung Won
    • Anxiety and mood
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    • v.9 no.2
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    • pp.93-100
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    • 2013
  • Major depressive disorder causes significant dysfunction and disability. Many of depressed patients tend to have cormobid anxiety disorders, substance use disorders and personality disorders, and so on. In this study, we reviewed researches about the effects of comorbid anxiety disorder, substance use disorder on depressive symptoms, progress, treatment, etc. In addition, the latest knowledges related to treatment was reviewed. If the symptoms of anxiety disorder coexist, They leads to the deterioration of the course and has an adverse effect on treatment response. Comorbid substance use disorder, such as alcohol dependence, causes worsening of symptoms and progression, and a loss of therapeutic response. Therapeutic clinical guidelines and instructions to comorbid psychiatric disorders on major depressive disorder was not established clearly, but consensus-based or evidence-based studies will be necessary for treatment for comorbid psychiatric disorders on major depressive disorder.

Therapeutic Considerations of Percutaneous Sacroplasty for the Sacral Insufficiency Fracture

  • Choi, Kyung-Mi;Song, Joon-Ho;Ahn, Sung-Ki;Choi, Hyun-Chul
    • Journal of Korean Neurosurgical Society
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    • v.47 no.1
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    • pp.58-63
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    • 2010
  • Sacral insufficiency fracture is a debilitating injury not easily found in general radiologic examinations and is rarely diagnosed, since its symptoms are obscure. It is known to frequently occur in patients with osteoporosis, but the treatment has not yet been established and various kinds of treatment methods are being attempted. Sacroplasty is sometimes performed by applying percutaneous vertebroplasty which is known to be a less invasive treatment. Since the course of diagnosis of sacral insufficiency fracture is difficult and clear guidelines for treatments have not yet been established, many spine surgeons fail to diagnose patients or speculate on treatment methods. We report our experience in diagnosing a sacral insufficiency fracture in a 54-year-old healthy female patient using MRI and treating her with sacroplasty. From a therapeutic point of view, we then cover the usefulness, effects and characteristics relating to the complications of sacroplasty, along with literature review.

Clinical Guidelines for Hwabyung IV. (Medications & Acupuncture and Moxibustion) (화병 임상진료지침 IV. (약물치료와 침구치료))

  • Kang, Hyung-Won;Lee, Seung-Gi;Lee, Jae-Hyuk;Park, Bo-Ra;Lyu, Yeoung-Su
    • Journal of Oriental Neuropsychiatry
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    • v.24 no.spc1
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    • pp.37-46
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    • 2013
  • Objectives : The Hwabyung Research Center of The Korean Society Of Oriental Neuropsychiatry has attempted to develop the 'Clinical Guidelines for Hwabyung'. Methods : The Hwabyung Research Center constructed a committee of experts and advisory group. Relevant literature was collected and evaluated in order to find out effective Pharmacotherapy (Herbal medicine), acupuncture and moxibustion, and cupping of Hwabyung. Results : We found some evidences that proved the effectiveness of Pharmacotherapy (Herbal medicine), acupuncture and moxibustion, and cupping in the treatment of Hwabyung. 1) We recommend Pharmacotherapy (Herbal medicine), acupuncture and moxibustion, cupping, psychotherapy and management, other therapeutic approaches and education for Hwabyung. 2) Pharmacotherapy (Herbal medicine) should be determined according to the pattern identification of Korean medicine. Further, the prescription should be cost-effective, safe and have no side effects. Also, the interaction between Herbal and Western drugs should be considered carefully. 3) There are general acupuncture, scalp acupuncture, Pharmacopuncture, Sa-am acupuncture as well as acupuncture treatments for Hwabyung. 4) Moxibustion and cupping are useful, relieving various somatic symptoms of Hwabyung. Conclusions : Pharmacotherapy (Herbal medicine), Acupuncture and Moxibustion, Cupping for Hwabyung were studied. We hope that the 'Clinical Guidelines for the Treatment of Hwabyung' are helpful for oriental medical doctors and patients.

Lipid emulsion therapy of local anesthetic systemic toxicity due to dental anesthesia

  • Rhee, Seung-Hyun;Park, Sang-Hun;Ryoo, Seung-Hwa;Karm, Myong-Hwan
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.4
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    • pp.181-189
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    • 2019
  • Local anesthetic systemic toxicity (LAST) refers to the complication affecting the central nervous system (CNS) and cardiovascular system (CVS) due to the overdose of local anesthesia. Its reported prevalence is 0.27/1000, and the representative symptoms range from dizziness to unconsciousness in the CNS and from arrhythmias to cardiac arrest in the CVS. Predisposing factors of LAST include extremes of age, pregnancy, renal disease, cardiac disease, hepatic dysfunction, and drug-associated factors. To prevent the LAST, it is necessary to recognize the risk factors for each patient, choose a safe drug and dose of local anesthesia, use vasoconstrictor, confirm aspiration and use incremental injection techniques. According to the treatment guidelines for LAST, immediate application of lipid emulsion plays an important role. Although lipid emulsion is commonly used for parenteral nutrition, it has recently been widely used as a non-specific antidote for various types of drug toxicity, such as LAST treatment. According to the recently published guidelines, 20% lipid emulsion is to be intravenously injected at 1.5 mL/kg. After bolus injection, 15 mL/kg/h of lipid emulsion is to be continuously injected for LAST. However, caution must be observed for >1000 mL of injection, which is the maximum dose. We reviewed the incidence, mechanism, prevention, and treatment guidelines, and a serious complication of LAST occurring due to dental anesthesia. Furthermore, we introduced lipid emulsion that has recently been in the spotlight as the therapeutic strategy for LAST.