• Title/Summary/Keyword: Treatment Guideline

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Current Guidelines on the Management of Dyslipidemia (이상지질혈증의 국내 및 국외 치료 가이드라인 비교)

  • Choi, Yunjeong;Lee, Song;Kim, Ju Young;Lee, Kyung Eun
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.4
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    • pp.276-283
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    • 2017
  • Objective: Dyslipidemia is recognized as a prominent risk factor for cardiovascular and cerebrovascular diseases but it is manageable through therapeutic and lifestyle intervention. Interpreting the latest guidelines is essential for an application of recommendation from guidelines into clinical practice. Therefore, this study aimed to compare the most recent guidelines on dyslipidemia treatment recommendations in Korea and USA. Methods: This study analyzed and compared 2015 Korean guidelines for the management of dyslipidemia, 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline and 2016 supportive guidelines from ACC. Results: A comparison was made focused on the following: target patients based on cardiovascular risk assessment, target goal, and treatment strategies including statin and non-statin therapies. Four target patient groups by risk were suggested in 2015 Korean guideline and cardiovascular risk factors were also considered for initiation of lipid lowering therapy. Titrated statin regimen was recommended by Korean guideline to reach LDL cholesterol and non-HDL cholesterol target level. In 2013 ACC/AHA guideline, four statin benefit group was introduced considering ASCVD risk and high intensity statin or intermediate intensity statin use were recommended without dose titration. 2016 update was to support non-statin therapy based on updated evidence and new consideration of ezetimibe, PCSK9-inhibitor and bile acid sequestrant was brought up. Conclusion: Guidelines are continuously updating as new and important clinical data are constantly released along with the advent of newly approved drugs for lipid disorder. This article provides resources that facilitates uptake of these recommendations into clinical practice.

A Combination of Herbal Medicine and Moxibustion Treatment is Effective for a Recalcitrant Cutaneous Warts in a Pediatric Patient: A Case Report

  • Lee, Ji-Yeon;Kim, Sul-Ki;Jeon, Cheon-Hoo;Shim, Soo-Bo;Ahn, Hae In;Kim, NamKwen
    • Journal of Acupuncture Research
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    • v.38 no.3
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    • pp.233-235
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    • 2021
  • Although warts are a common skin condition/disease that recurs in childhood, treatment completion is difficult owing to the pain associated with conventional therapies. In this case, Korean herbal medicine, Guijakjihwang-Tang, and indirect moxibustion was used to treat a recalcitrant cutaneous wart without pain and recurrence. A 7-year-old boy presented with recurrent cutaneous warts on his right hand and received cryotherapy 3 times in the previous year. The wart recurred during the course of cryotherapy treatment, and the patient did not want to suffer any more pain from the previous treatment. Therefore, parents sought an efficient and painless therapy. The patient was treated for 2 months using Guijakjihwang-Tang combined with indirect moxibustion. The prominent lesion separated in the 2nd month of treatment and completely recovered without adverse events in the 3rd month. There was no recurrence over 12 months of follow-up. This report provides meaningful insights into the use of Korean medicine as a safe, painless and efficient treatment for warts in pediatric patients.

The Discussion on Treatment Based on Pattern Identification in Guidelines for Traditional Chinese Medical Treatment of COVID-19 in China (COVID-19 중국 진료방안의 변증론치에 대한 고찰)

  • Sanghyun, Kim
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.36 no.5
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    • pp.163-168
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    • 2022
  • After the outbreak of COVID-19 in China, the national health commission of the people's republic of China distributed guidelines for the diagnosis and treatment of COVID-19. Based on that, each region of China made guidelines for traditional Chinese medical treatment of COVID-19 applicable to clinical field. Under the hypothesis that each region's guideline contains regional characteristics, a comparison was made on pattern identification among each region's guidelines and central guidelines. At the beginning of the analysis of the cases, opinions on pattern identification vary from region to region, and the diversity is mainly reflected in the early stage of the disease. When the guideline is organized to a certain level due to the accumulation of clinical cases, there is a strong tendency to enumerate various types of pattern identification. It means that as a specific infectious disease progresses, it can appear in various cases due to variables. In some guidelines, disease stages were analyzed by only a limited pathological mechanism, but no regional characteristics were found here. Rather, it may mean that unique characteristics for disease can be derived.

Development of a Clinical Practice Guideline : Benign Prostatic Hyperplasia (전립선비대증의 진료지침 개발)

  • Yu, Seung-Hum;Chai, Soo Eung;Kim, Chun-Bae;Kang, Myung Geun;Song, Jae Mann;Lee, Eun Sik;Lee, Jung Gu;Lee, Tchun Yong;Hong, Sung Joon
    • Quality Improvement in Health Care
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    • v.3 no.2
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    • pp.36-51
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    • 1997
  • Background : Clinical practice guidelines define "systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances" and help to improve patient care. The purpose of this study is to develop a clinical practice guideline for the most effective diagnoses and treatments of benign prostatic hyperplasia based on patient preference and clinical need. Methods : For this research project, extensive literature searches (208 articles) were conducted. As well, critical reviews and syntheses (meta-analysis) were used to evaluate empirical evidence and significant outcomes of the BPH literature. Questionnaires about clinical practice for BPH patients were distributed and consensus meetings were undertaken to grasp variations in clinical practice and to reach agreement on the guideline's development. The guideline was promoted under the sponsorship of the Korean Medical Association and the Korean urological Cancer. Society. For the task, the Benign Prostatic Hyperplasia Guideline Panel was composed of multidisciplinary experts in the field. Results : BPH is a disease that affects a patient's quality of life. This Clinical Practice Guideline was developed for the typical man over age 50 with symptoms of prostatism, but with no significant medical morbidities such as diabetes or other known causes of voiding dysfunction, such as urethral stricture or neurogenic bladder. The guidelines detail the relative benefits and obstacles associated with all diagnostic and treatment approaches, including watchful waiting. Conclusion : This guideline provides a cornerstone for our medical association. It represents the most current scientific knowledge regarding the development, diagnosis, and treatment of BPH. It will be revised and updated as needed.

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Clinical Practice Guidelines of Korean Medicine for Malignant Lymphoma (악성 림프종 치료에 대한 한의 임상진료지침)

  • Jung, Hyun-sik;Lee, Sang-hun;Yoo, Hwa-seung;Kim, Kyung-suk
    • The Journal of Internal Korean Medicine
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    • v.37 no.3
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    • pp.453-466
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    • 2016
  • Objective: The purpose of this study was to present the clinical practice guideline of Korean medicine for malignant lymphoma.Background: Malignant lymphoma is the tenth most common cancer in Korea. The two main types of lymphoma are Hodgkin’s disease and non-Hodgkin’s lymphoma. Non-Hodgkin’s lymphomas are more common, comprising nearly 95 percent of all lymphomas. In China, the traditional Chinese medicine clinical guidelines for malignant lymphoma were published in 2014. Therefore, there is growing need for a clinical practice guideline in Korea, which has not thus far existed. This clinical practice guideline was created by reviewing the Chinese clinical practice guideline and Korean clinical reports. This study will be helpful in understanding malignant lymphoma and in understanding its treatment in Korean medicine.Conclusion: Further clinical research on malignant lymphoma is needed to develop a more advanced clinical guideline.

A Basic Study for Development of Clinical Practice Guidelines of Korean Medicine in Autism Spectrum Disorder -Based on Pre-existing Clinical Practice Guidelines of Autism Specturm Disorder- (자폐스펙트럼장애의 치료에 대한 한의 임상 가이드라인 개발을 위한 기초연구 -기존에 개발된 자폐스펙트럼장애 가이드라인을 중심으로-)

  • Kim, Sang Min;Lee, Jin Yong;Lee, Sun Haeng;Chang, Gyu Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.31 no.1
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    • pp.52-62
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    • 2017
  • Objectives The purpose of this study is to review pre-existing clinical practice guidelines for autism spectrum disorders, and refer those in developing a new practice guideline. Methods A total of 9 existing clinical practice guidelines for autism spectrum disorder developed from 2010 to 2016 were searched by Google scholar and Pubmed, and were reviewed those literatures in three parts: general, diagnosis & evaluation, and intervention. Results There were no consistency in the recommendation methods of 9 clinical care guidelines (such as the method of rating and recommendation intensity for diagnosis, evaluation, and treatment). However, in the diagnosis and evaluation section, frequently used evaluation and diagnostic tools are mentioned in most clinical practice guidelines, and the types of pharmacologic and non-pharmacological treatments that are mainly recommended in treatment are equally mentioned in most clinical practice guidelines could confirm. Conclusions 1. Some guideline recommendations are graded according to each criterion. Recommendations presented in various databases were based on systematic reviews or other literatures. The most utilized database were PsycINFO, CINAHL, Cochrane. 2. DSM-5 and ICD-10 were the most common used diagnostic criteria, and DSM-IV was used as a diagnostic standard in the guideline published before 2013. The tools used for diagnosis and evaluation were also varied. However, most recommended ones were ADI-R, ADOS-G, and DISCO. 3. Treatment was largely divided into pharmacological intervention and non-pharmacological intervention. In some guideline, the interventions were divided into pediatric and adult. Most of the pharmacological interventions were not recommended due to lack of evidence, but in cases in which specific symptoms were aimed, they recommended to seek professional help. 4. In addition to interventions, each guideline referred to supportive interventions that may be helpful in the daily life of patients with ASD, which may need to be addressed in future clinical guidelines.

Korean Guideline for the Prevention and Treatment of Glucocorticoid-induced Osteoporosis

  • Park, So Young;Gong, Hyun Sik;Kim, Kyoung Min;Kim, Dam;Kim, Ha Young;Jeon, Chan Hong;Ju, Ji Hyeon;Lee, Shin-Seok;Park, Dong-Ah;Sung, Yoon-Kyoung;Kim, Sang Wan
    • Journal of Bone Metabolism
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    • v.25 no.4
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    • pp.195-211
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    • 2018
  • Background: To develop guidelines and recommendations to prevent and treat glucocorticoid (GC)-induced osteoporosis (GIOP) in Korea. Methods: The Korean Society for Bone and Mineral Research and the Korean College of Rheumatology have developed this guideline based on Guidance for the Development of Clinical Practice Guidelines ver. 1.0 established by the National Evidence-Based Healthcare Collaborating Agency. This guideline was developed by adapting previously published guidelines, and a systematic review and quality assessment were performed. Results: This guideline applies to adults aged ${\geq}19years$ who are using or plan to use GCs. It does not include children and adolescents. An initial assessment of fracture risk should be performed within 6 months of initial GC use. Fracture risk should be estimated using the fracture-risk assessment tool (FRAX) after adjustments for GC dose, history of osteoporotic fractures, and bone mineral density (BMD) results. All patients administered with prednisolone or an equivalent medication at a dose ${\geq}2.5mg/day$ for ${\geq}3months$ are recommended to use adequate calcium and vitamin D during treatment. Patients showing a moderate-to-high fracture risk should be treated with additional medication for osteoporosis. All patients continuing GC therapy should undergo annual BMD testing, vertebral X-ray, and fracture risk assessment using FRAX. When treatment failure is suspected, switching to another drug should be considered. Conclusions: This guideline is intended to guide clinicians in the prevention and treatment of GIOP.

Draft Guideline Matching the Treatment Technology to the Soil Contaminated Site Based on the Site Properties in Korea (국내 부지 특성을 고려한 오염토양 정화기술매칭기준안)

  • Lee, Jae-young;Lee, Minhee;Yu, Mokryun
    • Journal of Soil and Groundwater Environment
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    • v.21 no.6
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    • pp.1-13
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    • 2016
  • The programmable logic array to match the treatment technology to the soil contaminated site based on the site properties in Korea was developed. Based on the previous technology screening system of FRTR (Federal Remediation Technology Roundtable) in USA, total 9 evaluation factors indicating the site characteristics were used for the technology matching process and 8 factors among them were quantitatively weighed in the order of importance. The class interval for each evaluation factor was linearly distributed to give the weighed score and 8 scores were summed up to prioritize the treatment technology. The optimal treatment technology for a specific site was determined according to the total score acquired from 8 evaluation factors used in this technology matching process. The reliability test for the developed technology matching system was done by using information of two real cleanup sites in Korea, suggesting that this guideline will be available to determine the most effective treatment technology to cleanup the soil contaminated site and also to assist the government or the company to design a successful and cost-effective site cleanup plan in Korea.

Analysis research about awareness of demanders of recuperation allowance for dental clinic health insurance in Daejun and Chunchung area (대전·충청지역 치과건강보험 요양급여비용 청구자의 인식도 분석조사)

  • Kim, Sung-Hee;Kim, Min-Ja;Nam, Yong-Ok
    • Journal of Korean society of Dental Hygiene
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    • v.11 no.2
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    • pp.275-289
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    • 2011
  • Objectives : The recognition rate for issues and improving resolution for the recuperation income expense claim policy was examined. Methods : 1,135 copies of survey have been sent to the group of people who have claimed the dental recuperation income expense to dental recuperation institutions in Daejeon, Chungcheong Do that are registered to the health insurance evaluation and estimation office as of the May 2010 and 207 surveys that were regarded to be sincere for answering were analyzed. Results : Majority of respondence were belonged to the dentist institutions with more than 5 years of claim experiences as well as 10~50% of claim rate. The recognition of medical fee evaluation guideline was normal level, and negative recognition was higher to the health center with daily charge policy compare to the dental hospital and university affiliated dental center with treatment charge policy, Highest opinion for inappropriateness of dentist with significance was found (p<0.05). The openness of evaluation cases are regarded to be discharged through the transparent evaluation and most of the opinions for insurance claim evaluation adjustment are within the both 'Do not understand the evaluation guideline and program error of disease category, code and program' with significance(p<0.05). The reaction after the evaluation adjustment was high in reflection on the claim process after examining the reason for the evaluation adjustment through the evaluation and estimation office and university affiliated dental institution and dental center was regarded to be most active and deputy reclaimment was seemed to be most actively discharge the objection registration task (p<0.05). The claim error improving resolution recognition was highly prioritized to the accurate charting for the disease title and treatment description, improving the setting of claim program, and most highly recognized by the university affiliated dental hospital/dental center and comparably low by health center(p<0.05). and although the most of the responds of treatment description and browsing the medical fee was positive, 50% of dentists disagreed the idea so that this was creating a significant discrepancy with other groups(p<0.05). Conclusions : From this research, the recognition of medical fee evaluation guideline for dental (university) hospital and dentists were negative and high adjustment experience was examined as lacking of evaluation guideline understanding and error of disease name, code and programs and deputy reclaimment, university affiliated dental hospital/dental center were most actively handle the objection registration tasks and dentists have objection on the treatment description and browsing the treatment fee so that if these indexes can be referred to implement into the recuperation income claim process, this can be regarded to be a opportunity to create mutual credibility between recuperation institution, treatment pensioner and the evaluation institutions.