Feeding is an interaction between a child and caregiver, and feeding difficulty is an umbrella term encompassing all feeding problems, regardless of etiology, severity, or consequences, while feeding disorder refers to an inability or refusal to eat sufficient quantities or variety of food to maintain adequate nutritional status, leading to substantial consequences, including malnutrition, impaired growth, and possible neurocognitive dysfunction. There are 6 representative feeding disorder subtypes in young children: infantile anorexia, sensory food aversion, reciprocity, posttraumatic type, state regulation, and feeding disorders associated with concurrent medical conditions. Most feeding difficulties are nonorganic and without any underlying medical condition, but organic causes should also be excluded from the beginning, through thorough history taking and physical examination, based on red-flag symptoms and signs. Age-appropriate feeding principles may support effective treatment of feeding difficulties in practice, and systematic approaches for feeding difficulties in young children, based on each subtype, may be beneficial.
Michelini, Ilaria;Falchi, Anna Giulia;Muggia, Chiara;Grecchi, Ilaria;Montagna, Elisabetta;De Silvestri, Annalisa;Tinelli, Carmine
Nutrition Research and Practice
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v.8
no.1
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pp.94-102
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2014
Diet attrition and failure of long term treatment are very frequent in obese patients. This study aimed to identify pre-treatment variables determining dropout and to customise the characteristics of those most likely to abandon the program before treatment, thus making it possible to modify the therapy to increase compliance. A total of 146 outpatients were consecutively enrolled; 73 patients followed a prescriptive diet while 73 followed a novel brief group Cognitive Behavioural Treatment (CBT) in addition to prescriptive diet. The two interventions lasted for six months. Anthropometric, demographic, psychological parameters and feeding behaviour were assessed, the last two with the Italian instrument VCAO Ansisa; than, a semi-structured interview was performed on motivation to lose weight. To identify the baseline dropout risk factors among these parameters, univariate and multivariate logistic models were used. Comparison of the results in the two different treatments showed a higher attrition rate in CBT group, despite no statistically significant difference between the two treatment arms (P = 0.127). Dropout patients did not differ significantly from those who did not dropout with regards to sex, age, Body Mass Index (BMI), history of cycling, education, work and marriage. Regardless of weight loss, the most important factor that determines the dropout appears to be a high level of stress revealed by General Health Questionnaire-28 items (GHQ-28) score within VCAO test. The identification of hindering factors during the assessment is fundamental to reduce the dropout risk. For subjects at risk, it would be useful to dedicate a stress management program before beginning a dietary restriction.
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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v.32
no.4
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pp.13-28
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2019
Objectives : The purpose of this study is to report the effectiveness of Korean medical treatment on 222 patients with alopecia areata. Methods : The subjects of this study were 222 patients who had received Korean medical treatment among the patients who visited the Balmer's Korean Medicine Clinic from January 1, 2016 to December 31, 2017. The extent of the alopecia areata was measured every month to determine the improvement. We analyzed the relationship between the types of alopecia areata, the extent of hair loss, duration of illness, age at first visit, and the treatment of alopecia areata. Results : 1. There were 100 males(45.0%) and 122 females(55.0%). The mean age of patients was 35.3 years old. 2. Of the 222 patients, 142(64%) were "cured". 31(14%) showed "good", 21(9.5%) showed "fair", 28(12.6%) showed "poor" improvement. 3. According to clinical records, of the 64 patients with alopecia areata(AA), 48(75.0%) were cured. Of the 100 patients with alopecia areata multiplex(AAM), 68 patients (68.0%), 12(50.0%) out of 24 patients with ophiasis, 5(55.6%) out of 9 with alopecia semi-totalis(AST), 3(50.0%) out of 6 patients with alopecia totalis(AT), 6(31.6%) out of 19 patients with alopecia universalis(AU) were cured. 4. Patients with the wider hair loss extent and with more severe type of alopecia areata required longer treatment period to cure, and the cure rate was lowered(p<0.05). 5. The shorter duration of the disease was related to the higher cure rate(p<0.05). If the treatment was started after six months of the duration, the cure rate was lowered. Therefore, beginning treatment within six months of the onset is recommended. 6. The period until terminal hair showed was 1.5 months for AA, 1.7 months for AAM, 1.6 months for ophiasis, 1.9 months for AST, 2.3 months for AT, 3.2 months for AU. 7. The treatment period to cure was 4.9 months for AA, 7.3 months for AAM, 7.7 months for ophiasis, 6.8 months for AST, 7.7 months for AT, 16.3 months for AU. 8. The major prognostic factors were extent and type of alopecia, duration of the disease and relapse. Conclusions : We analyzed the effectiveness of Korean medical treatment through cure rate according to the prognostic factors. This study will provide useful data for the treatment of alopecia areata.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.30
no.1
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pp.49-55
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2004
The management of mandibular condylar fractures in children has long been a matter of controversy. The fracture, if not treated appropriately, may result in complications such as disturbance of mandibular growth and temporomandibular joint ankylosis. They are usually treated nonsurgically, which has been proved to be satisfactory in the long term results. Nineteen children with 25 condylar fractures experienced during their growth period (age at trauma from 10 months to 12 years, mean 7.0 years) were studied. All patients were treated by arch bars and intermaxillary fixation for $7{\sim}14$ days. They have been evaluated with clinical and radiographic examination. The maximum mouth opening and lateral movement of the mandible were within normal limits. There was no malocclusion or ankylosis. Beginning of remodelling was evident at postoperative $1{\sim}3$ months. Remodelling of the condyle was good in 21, while partial adjustment occured in the other 4 condyles. These results suggest that the conservative treatment of condylar fractures in growing children results in good functional results and good remodelling of the condyle.
Airway stenosis in children may be classified into congenital and acquired forms. The incidence of acquired forms is increasing mainly due to increase in prolonged intubation and trauma. In congenital stenosis with significantly compromised airway, the patient may be tracheotomized and allowed some waiting period while expecting spontaneous resolution as the child grows. However, with this treatment policy, there is a considerably higher mortality and morbidity for the acquired disease as to often warrant surgical reconstruction. The authors reviewed the medical records of 22 pediatric patients under the age of 15 who have had airway reconstruction at the authors' department from the beginning of January, 1988 through the end of December, 1992. The prognosis was analyzed in light of the etiology, site and severity of the stenosis, and the type of reconstructive measures.
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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v.29
no.4
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pp.142-155
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2016
Objectives: The purpose of this study is to examine whether there is a significant efficacy difference on infant and young child atopic dermatitis patients treated with Korean Medicine Treatment through 6 months between topical steroid used group and non-steroid group. Methods: The degree of atopic dermatitis was measured by the Objective SCORAD Index (OSI) with photographs of patients. Detailed analysis of the OSI score was compared based on the use of topical steroid. Results: 1. There was not a significant difference between the topical steroid group and the non-steroid group in regards of gender, age and initial OSI score. 2. The non-steroid group's OSI score decreased significantly from 50.17 to 29.20. 3. The topical steroid group's OSI score decreased significantly from 54.21 to 34.95. 76.19% of the patients in the topical steroid group discontinued steroid use within the 6-month period. The average time of discontinuation since the beginning of treatment was 3.36 months. 4. The OSI Improvement rate comparison of topical steroid group with non-steroid group did not show a significant difference over a 3-month and 6-month period. 5. Distribution of severe cases decreased in Both topical steroid and non-steroid group after 6 month treatment. Conclusions: The OSI score of infant and young child atopic dermatitis patients in both topical steroid and non-steroid group was decreased significantly with Korean medicine treatment through 6 months. There was no significant difference between topical steroid group and non-steroid group in OSI improvements over a 3-month period and 6-month period.
Structural studies have been performed on precipitation hardening and microstructural variations found in Ti-Al-Cr ternary $L1_0$- and $L1_2$-phase alloys using transmission electron microscopy. Both the $L1_0$ and $L1_2$ phase alloys harden by aging at 973 K after solution annealing at higher temperatures. The amount of age hardening of the $L1_2$ phase alloy is larger than that of the $L1_0$ phase alloy. The phase separation between $L1_0$ and $L1_2$ phase have not been observed by aging at 973 K. But $Al_2Ti$ was formed in each matrix alloy during aging. The crystal structure of the $Al_2Ti$ phase is a $Ga_2Zr$ type in the $L1_0$ and a $Ga_2Hf$ type in the $L1_2$ phase, respectively. At the beginning of aging the fine coherent cuboidal $Al_2Ti$-phase are formed in the $L1_0$ phase. By further aging, two variants of $Al_2Ti$ precipitates grow along the two {110} habit planes. On the other hand, in the $L1_2$ phase, the $Al_2Ti$ phase forms on the {100} planes of the $L1_2$ matrix lattice. After prolonged aging the precipitates are rearranged along a preferential direction of the matrix lattice and form a domain consisting of only one variant. It is suggested that the precipitation of $Al_2Ti$ in each matrix alloy occurs to form a morphology which efficiently relaxes the elastic strain between precipitate and matrix lattices.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.11
no.1
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pp.100-109
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2000
Objective:This was conduced to evaluate the effect of early intervention to promote the development of children with developmental disorders. Methods:49 children(31 in PDD group and 18 in DLD group) participated in a one year day treatment program conduced from 1996 to 1999. They were performed PEP, CARS, and SMS. They were grouped by diagnosis, comorbidity, chronological age and CARS score at the beginning of the program and the treatment effect was compared. Results:The children who participated in the day treatment program showed significant increase in their PEP, SMS score, and decrease trend in their CARS score. When children were grouped by diagnosis, comorbidity, chronological age, and severity in CARS score we did not find out significant difference between groups. Conclusion:Our data suggest that the day treatment program which emphasis on development is effective in treating children with developmental disorders.
Journal of agricultural medicine and community health
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v.18
no.1
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pp.43-54
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1993
In order to find the factors associated with the death of hypertensives, 12 year follow-up study for 267 hypertensives whose average blood pressure were 140/90 mmHg or above during their first health screening in 1979-1980 at YongJin Township, Wanju Country, North Cholla Province by the Community Health Team of Chonju Presbyterian Medical Center. The study results are as follows : 1. Initial general characteristics of hypertensives were studied. The age distribution of studied hypertensives showed 27.3% in 40-49 years, 25.8% in 50-59 years, 29.6% in 60-69 years and 17.2% In 70 + years old group. Marital status showed that 82.8% of hypertensives had their wife or husband. 74. 5% were employed on agriculture. 56.5% of hypertensives were illiterate. 2. Among the hypertensives, 91.6% of male and 22.8% of female reported that they were smokers. 82.6% of hypertensives had body mass index lower than 25 Kg/$m^2$. 46.8% of average systolic blood pressure were 160mmHg or above and 54.3% of average diastolic blood pressure were 95mmHg or above. 3. Twenty percent of hypertensives reported that they were treating hypertension at the beginning of follow up, while 68.5% reported that they were not treated. 28.1% reported that they were treating hypertension within 6 months before last follow-up. but 69.3% reported that they were not treated for hypertension within Ii months before last follow up. So 50.6% were classified as never treated group and 41.2% as treated group. 4. Average blood pressure for initial 3 years were calculated. The change of average systolic blood pressure was observed as $161.3{\pm}19.4mmHg$ at the first year, $145.6{\pm}28.0mmHg$ at the second year and $141.4{\pm}37.2mmHg$ at the third year. Average diastolic blood pressure were changed from $96.2{\pm}14.4mmHg$ at the first year to $90.6{\pm}18.6mmHg$ at the second year and $86.4{\pm}22.9mmHg$ at the third year. 5. By the follow-up of hypertensives, 54 hypertensives (46.2%) among 117 male hypertensives and 50 hypertensives (33.3%) among 150 female hypertensives died for 12 years. 42.6% of male death and 52.0% of female death were caused by cerebrovascular diseases. 6. Through univariate statistical test about the association between general characteristics or cardiovascular risk factors of hypertensives and mortality for 12 years, age variable among male and among female age, marital status, occupation. educational level. systolic blood pressure and treatment status were shown as significant variable to influence upon the mortality. 7. By multiple logistic regression analysis, among male age and systolic blood pressure were selected as significant variable to be associated with the total mortality for 12 years. Among female age, systolic blood pressure and treatment status were selected as statistically significant variable to be associated with the total mortality for 12 years.
The birth of the scientific revolution, brought forth by Vesalius and Copernicus in 1543, marked the beginning of a new age. However, the changes such as treatment effectiveness, survival rate, prevalence of specific diseases, etc. had not yet become clear during the 16th century. In the early 17th century, Boerhaave emphasized bedside teaching and practice. His attitude influenced numerous students and educators, so many medical students visited hospital wards where he worked. From the late 18th to 19th centuries, Jenner's smallpox vaccination, Pasteur's anthrax and rabies vaccinations, and Koch's four postulates used to detect pathogens were developed using the scientific research method, which initiated big changes for medicine. Flexner, credited for reporting the new medical education system, adopted scientific medicine. He believed medical students must study basic medical science since it could be the foundation of clinical medicine and lead to a revolution in the field. He proposed a new medical curriculum composed of two-years of basic medicine and two-years of clinical medicine, which has been used more than 100 years. During the late 20th century, bedside teaching rounds decreased gradually as scientific medicine has become popular. Many medical educators in many articles have proposed bedside education as an effective method for medical learning. Despite the advent of the age of artificial intelligence and the changing of medical environments in the near future, bedside education will be more useful and important for medical students, educators, and patients as it is a traditional method and essential for patients who desire a more personal approach.
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