• 제목/요약/키워드: Treatment adherence

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Effect of Enterococcus faecalis strain PL9003 on Adherence and Growth of Helicobacter pylori

  • Nam, Hye-Ran;Ha, Mi-Sun;Lee, En-Jung;Lee, Yeon-Hee
    • Journal of Microbiology and Biotechnology
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    • 제12권5호
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    • pp.746-752
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    • 2002
  • The purpose of the present study was to examine the antagonistic activities of Enterococcus faecalis strain PL9003 (PL9003) on Helicobacter pylori. This strain was isolated from infant feces and found to inhibit both the growth of H. pylori and its in vitro adherence to the human gastric cell line MKN-45. The binding of PL9003 to MKN-45 was observed under a light microscope after Cram staining and under a scanning electron microscope. When detected with an FITC-conjugate antibody, both viable and nonviable PL9003 were found to decrease the number of H. pylori bound to MKN-45. When detected by an enzyme-linked immunoabsorbent assay, about 70% of the H. pylori bound on MKN-45 disappeared with the four-1314 addition of viable or nonviable PL9003. The spent culture supernatant (SCS) of PL9003 also decreased the viability of H pylori even after neutralization and pepsin treatment. The above results suggest that PL9003 has a potential as a new probiotic for the stomach.

외래치료 명령제의 실효성과 외래 치료 순응도에 관한 연구 (A Study of Effectiveness of Outpatient Treatment Orders and Compliance with Outpatient Treatment)

  • 장승호;박인환;이상열;노수희;서정석
    • 정신신체의학
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    • 제25권1호
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    • pp.46-55
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    • 2017
  • 연구목적 외래치료명령제는 정신질환을 앓고 있는 사람이 특정한 외래치료 프로그램에 참여하도록 법에 의해 명령을 내리는 사회적 강제 제도이다. 본 연구에서는 외래치료명령제 및 정신질환자들의 치료 순응도에 영향을 미치는 요인들에 관해 알아보고자 하였다 방법 정신건강의학과 전문의 60명을 대상으로 2016년 10월에서 11월까지 외래치료명령제 및 치료 순응도에 관한 설문조사를 실시하였다. 설문지 각 문항은 문헌조사를 통하여 초안을 작성하고 3명의 정신건강의학과 전문의 및 1명의 법학전문대학원 교수의 의견 조회 과정을 거쳐서 최종적으로 확정하였다. 설문에 응답한 대상자들의 답변을 기술 통계를 이용하여 분석하였으며, 외래치료명령제의 실효성 점수에 대해서는 중앙값과 최고치, 최저치를 알아보았다. 결과 60명의 정신건강의학과 전문의 중에서 45명(75.0%)이 외래치료명령제를 알고 있었지만, 지난 12개월 중에 이를 이용한 전문의는 2명(4.0%)이었고, 주관적 실효성 점수는 40점/100점으로 그 실효성은 매우 낮게 나타났다. 또한 재입원 환자 중 외래 치료를 지속적으로 받았던 환자의 비율은 37.7%, 외래치료를 임의 중단한 환자 비율은 53.1%로 임의 중단 환자가 차지하는 비율이 더 높았다. 퇴원 환자 중에서는 약 2/3가량이 지속적인 치료를 받고 있었다. 임의로 치료를 중단한 환자의 관리방법으로 '아무런 조치를 취하지 않는다'(n=27)와 '파악하지 않음'(n=15)가 대부분이었지만 '정신건강증진센터 연락한다'는 의견은 2명으로 매우 저조하였다. 또한 임의 중단 환자에 대한 효율적인 조치로서는 '정신건강증진센터에 연계해야한다'는 의견이 가장 많았다(n=30). 결론 현재 시행되는 외래치료명령제는 실효성이 낮고, 외래치료 환자의 치료순응도 또한 매우 저조하였다. 따라서 이에 대한 효과적인 개입을 위해 제도적, 행정적 개선이 필요하며, 향후 정신건강증진센터의 역할이 중요할 것으로 판단된다.

한국인의 이상지질혈증 발생 위험 요인 및 약물복용이행 영향 요인 평가: 2013-2015 국민건강영양조사 자료 이용 (Risk Factors of Dyslipidemia and Related Factors of Medication Adherence in Korea Adults: KNHANES 2013-2015)

  • 전미양;최원희;서영미
    • Journal of Korean Biological Nursing Science
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    • 제19권3호
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    • pp.131-140
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    • 2017
  • Purpose: Dyslipidemia was a known risk factor for cardiovascular disease and was a leading cause of mortality in worldwide. This study aimed to determine the factors associated with prevalence and medication treatment of dyslipidemia in Korean adult population. Methods: In this study, based on the criteria set by the Korean Society of Lipidology and Atherosclerosis, the factors associated with prevalence and medication treatment of dyslipidemia was evaluated in a population of 12,506 people ($age{\geq}20$), who participated in the Korean National Health and Nutrition Examination Survey (2013-2015). The findings were tested by using multivariate logistic regression. Results: Dyslipidemia prevalence rate was 36.5%. Among populations with dyslipidemia, 17.5% were treated with lipid-lowering drugs. In the multivariate logistic regression model, male, increase in age, lower education level, non-drinker, current smoking, less physical activity, increase of body mass index, hypertension, and diabetes were associated with an increased odd of dyslipidemia. Female, increase in age, higher income, excess fat intake, hypertension, diabetes, myocardial infarction, and angina were associated with an increased odd of medication treat. Conclusion: The results of this study could be used to screen patients at the high risk for dyslipidemia or to predict medication adherence.

Effect of Defibrotide on Rat Reflux Esophagitis

  • Kim, Hyoung-Ki;Choi, Soo-Ran;Choi, Sang-Jin;Chio, Myung-Sup;Shin, Yong-Kyoo
    • The Korean Journal of Physiology and Pharmacology
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    • 제8권6호
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    • pp.319-327
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    • 2004
  • This study was aimed at evaluating the effect of defibrotide on the development of the surgically induced reflux esophagitis, on gastric secretion, lipid peroxidation, polymorphonuclear leukocytes (PMNs) accumulation, polymorphonuclear leukocytes adherence, superoxide anion and hydrogen peroxide production in PMNs, scavenge of hydroxyl radical and hydrogen peroxide, cytokine (interleukin-1 ${\beta}$, tumor necrosis $factor-{\alpha}$) production in blood, and intracelluar calcium mobilization in PMNs. Defibrotide did not inhibit the gastric secretion and not change the gastric pH. Treatment of esophagitis rats with defibrotide inhibited lipid peroxidation, and myeloperoxidase (MPO) in the esophagus in comparison with untreated rats. Defibrotide significantly decreased the PMN adherence to superior mesenteric artery endothelium in a dose-dependent manner, Superoxide anion and hydrogen peroxide production in $1{\mu}M$ formylmethionylleucylphenylalanine (fMLP)- or $0.1{\mu}g/ml$ N-phorbol 12-myristate 13-acetate (PMA)-activated PMNs was inhibited by defibrotide in a dose-dependent fashion. Defibrotide effectively scavenged the hydrogen peroxide but did not scavenge the hydroxyl radical. Treatment of esophagitis rats with defibrotide inhibited interleukin-1 ${\beta}$ production in the blood in comparison with untreated rats, but tumor necrosis $factor-{\alpha}$ production was not affected by defibrotide. The fMLP-induced elevation of intracellular calcium in PMNs was inhibited by defibrotide. The results of this study suggest that defibrotide may have partly beneficial protective effects against reflux esophagitis by the inhibition lipid peroxidation, PMNs accumulation, PMNs adherence to endothelium, reactive oxygen species production in PMNs, inflammatory cytokine production(i.e. interleukin-1 ${\beta}$), and intracellular calcium mobilization in PMNs in rats.

The effect of pretreating resorbable blast media titanium discs with an ultrasonic scaler or toothbrush on the bacterial removal efficiency of brushing

  • Koh, Minchul;Park, Jun-Beom;Jang, Yun-Ji;Ko, Youngkyung
    • Journal of Periodontal and Implant Science
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    • 제43권6호
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    • pp.301-307
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    • 2013
  • Purpose: This in vitro study was performed to assess the adherence of Porphyromonas gingivalis to a resorbable blast media (RBM) titanium surface pretreated with an ultrasonic scaler or toothbrush and to evaluate the effects of the treatment of the RBM titanium discs on the bacterial removal efficiency of brushing by crystal violet assay and scanning electron microscopy. Methods: RBM titanium discs were pretreated with one of several ultrasonic scaler tips or cleaned with a toothbrush. Then the titanium discs were incubated with P. gingivalis and the quantity of adherent bacteria was compared. The disc surfaces incubated with bacteria were brushed with a toothbrush with dentifrice. Bacteria remaining on the disc surfaces were quantified. Results: A change in morphology of the surface of the RBM titanium discs after different treatments was noted. There were no significant differences in the adherence of bacteria on the pretreated discs according to the treatment modality. Pretreatment with various instruments did not produce significant differences in the bacterial removal efficiency of brushing with dentifrice. Conclusions: Within the limits of this study, various types of mechanical instrumentation were shown to cause mechanical changes on the RBM titanium surface but did not show a significant influence on the adherence of bacteria and removal efficiency of brushing.

한국형 양극성 장애 약물치료 알고리듬 2018 : 안정성과 내약성 (Korean Medication Algorithm for Bipolar Disorder 2018 : Safety and Tolerability)

  • 손인기;박원명;윤보현;전덕인;서정석;김원;이정구;우영섭;정종현;김문두;정영은;심세훈;송후림;민경준
    • 우울조울병
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    • 제16권3호
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    • pp.134-139
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    • 2018
  • Objectives : Treatment for bipolar disorder is often complicated by various clinical situations. We undertook a survey of expert opinions to facilitate clinical decisions in special situations such as weight gain, metabolic syndrome, hyperprolactinemia, genetic counseling, and treatment adherence. Methods : A written survey that asked treatment strategies related to safety and tolerability, was prepared focused on weight gain, antipsychotic related hyperprolactinemia, lamotrigine related skin rash, treatment non-adherence and genetic counseling. Sixty-one experts of the review committee completed the survey. Results : In the case of weight gain related to medications, experts preferred exercise and education for diet-control. First chosen medications were lamotrigine, aripiprazole and ziprasidone. Recommendations based on expert survey results for treatment of bipolar patients in other special situations are outlined. Conclusion : With limitation of expert opinions, authors hope that results of this study provide valuable information to make clinical decisions about treatment of bipolar disorder in complicated situations.

A Peer-support Mini-counseling Model to Improve Treatment in HIV-positive Pregnant Women in Kupang City, East Nusa Tenggara, Indonesia

  • Artha Camellia;Plamularsih Swandari;Gusni Rahma;Tuti Parwati Merati;I Made Bakta;Dyah Pradnyaparamita Duarsa
    • Journal of Preventive Medicine and Public Health
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    • 제56권3호
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    • pp.238-247
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    • 2023
  • Objectives: Low adherence to antiretroviral (ARV) therapy in pregnant women with human immunodeficiency virus (HIV) increases the risk of virus transmission from mother to newborn. Increasing mothers' knowledge and motivation to access treatment has been identified as a critical factor in prevention. Therefore, this research aimed to explore barriers and enablers in accessing HIV care and treatment services. Methods: This research was the first phase of a mixed-method analysis conducted in Kupang, a remote city in East Nusa Tenggara Province, Indonesia. Samples were taken by purposive sampling of 17 people interviewed, consisting of 6 mothers with HIV, 5 peer facilitators, and 6 health workers. Data were collected through semi-structured interviews, focus group discussions, observations, and document review. Inductive thematic analysis was also performed. The existing data were grouped into several themes, then relationships and linkages were drawn from each group of informants. Results: Barriers to accessing care and treatment were lack of knowledge about the benefits of ARV; stigma from within and the surrounding environment; difficulty in accessing services due to distance, time, and cost; completeness of administration; drugs' side effects; and the quality of health workers and HIV services. Conclusions: There was a need for a structured and integrated model of peer support to improve ARV uptake and treatment in pregnant women with HIV. This research identified needs including mini-counseling sessions designed to address psychosocial barriers as an integrated approach to support antenatal care that can effectively assist HIV-positive pregnant women in improving treatment adherence.

지역사회 뇌졸중 환자들의 이차 예방을 위한 치료 지속률과 약물 순응도 관련 요인 (Predictors of Persistence and Adherence with Secondary Preventive Medication in Stroke Patients)

  • 김영택;박기수;배상근
    • 농촌의학ㆍ지역보건
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    • 제40권1호
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    • pp.9-20
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    • 2015
  • 지역사회 뇌졸중환자들의 치료 지속률과 약물 순응도에 대한 연구는 아직 많이 실시되지 않았다. 그러나 치료 지속률과 약물 순응도가 뇌졸중의 재발 및 사망과 밀접한 관련이 있다는 것은 많이 알려진 사실이다. 이에 본 연구는 지역에 거주하고 있는 뇌졸중환자들을 임의 추출하여 이들의 치료 지속률과 약물 순응도를 평가하고 이에 영향을 미치는 요인을 찾기 위하여 실시되었다. 연구대상자는 429명으로 이들의 뇌졸중 치료율과 현재 복용하고 있는 약물의 순응률을 파악하였으며 약물 순응도는 의도적 비순응군과 비의도적 비순응군으로 구분하여 조사하였다. 연구 결과 치료 지속률은 86.5%였으며 이들 중 약물 순응도는 41.2%였다. 치료 지속률에 영향을 미치는 요인으로는 보건교육 경험뿐이었으며, 비의도적 약물 비순응에 영향을 미치는 요인은 mRS와 보건교육 경험 그리고 의도적 약물 비순응에 영향을 미치는 요인은 mRS와 우울감 정도 그리고 약물에 대한 신념(필요성, 염려)이었다. 결론적으로 지역사회 뇌졸중환자의 재발방지와 사망률감소를 위하여 약물복용을 중요하게 교육하여야 할 것이며 순응도 향상을 위해서는 약물에 대한 필요성은 올리고 염려 수준을 낮추도록 교육하여야 할 것이다.

Continued Innovation in Respiratory Care: The Importance of Inhaler Devices

  • Bosnic-Anticevich, Sinthia Zrinka
    • Tuberculosis and Respiratory Diseases
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    • 제81권2호
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    • pp.91-98
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    • 2018
  • When it comes to the use in inhalers in the management of chronic obstructive pulmonary diseases, there are many options, considerations and challenges, which health care professionals need to address. Considerations for prescribing and dispensing, administering and following up, education, and adherence; all of these factors impact on treatment success and all are intrinsically linked to the device selected. This review brings together relevant evidence, real-life data and practice tools to assist health care professionals in making decisions about the use of inhalers in the management of chronic obstructive pulmonary diseases. It covers some of the key technical device issues to be considered, the evidence behind the role of inhalers in disease control, population studies which link behaviors and adherence to inhaler devices as well as practice advice on inhaler technique education and the advantages and disadvantages in selecting different inhaler devices. Finally, a list of key considerations to aid health care providers in successfully managing the use of inhaler devices are summarized.

The art of diabetes care: guidelines for a holistic approach to human and social factors

  • Muhammad Jawad Hashim
    • Journal of Yeungnam Medical Science
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    • 제40권2호
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    • pp.218-222
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    • 2023
  • A holistic approach to diabetes considers patient preferences, emotional health, living conditions, and other contextual factors, in addition to medication selection. Human and social factors influence treatment adherence and clinical outcomes. Social issues, cost of care, out-of-pocket expenses, pill burden (number and frequency), and injectable drugs such as insulin, can affect adherence. Clinicians can ask about these contextual factors when discussing treatment options with patients. Patients' emotional health can also affect diabetes self-care. Social stressors such as family issues may impair self-care behaviors. Diabetes can also lead to emotional stress. Diabetes distress correlates with worse glycemic control and lower overall well-being. Patient-centered communication can build the foundation of a trusting relationship with the clinician. Respect for patient preferences and fears can build trust. Relevant communication skills include asking open-ended questions, expressing empathy, active listening, and exploring the patient's perspective. Glycemic goals must be personalized based on frailty, the risk of hypoglycemia, and healthy life expectancy. Lifestyle counseling requires a nonjudgmental approach and tactfulness. The art of diabetes care rests on clinicians perceiving a patient's emotional state. Tailoring the level of advice and diabetes targets based on a patient's personal and contextual factors requires mindfulness by clinicians.