• Title/Summary/Keyword: individualized treatment

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Bertolotti Syndrome: A Diagnostic and Management Dilemma for Pain Physicians

  • Jain, Anuj;Agarwal, Anil;Jain, Suruchi;Shamshery, Chetna
    • The Korean Journal of Pain
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    • v.26 no.4
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    • pp.368-373
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    • 2013
  • Background: Bertolotti's syndrome (BS), a form of lumbago in lumbosacral transitional vertebrae, is an important cause of low back pain in young patients. The purpose of this study was to assess the etiology of low back pain and the efficacy of treatment offered to patients with BS. Methods: All patients of BS Castellvi type1a during a period of 6 months were enrolled in the study. The patients underwent interventional pain procedures for diagnosis and pain relief. Response to the therapy was assessed based on VAS and ODI scores. A 50% decrease in VAS score or a VAS score less than 3 would be considered adequate pain relief. Results: All 20 patients diagnosed with BS during the 6-month observation period had scoliosis. Common causes of back pain were the ipsilateral L5-S1 facet joint, neoarticulation, the SI joint, and disc degeneration. Responses to various interventions for pain relief were different and inconsistent from patient to patient. In particular, responses to interventions for neoarticular pain were generally poor. Conclusions: Pain in patients with BS does not usually respond to interventional pain treatment. A very dynamic treatment approach must be pursued while managing BS patients, and the treatment plan must be individualized at various stages in order to obtain satisfactory pain relief.

Long-term results of unilateral cleft lip repair with multiple infantile hemangiomas including one involving the cleft side of the upper lip

  • Jeong, Dae Kyun;Lee, Jae Woo;Choi, Soo Jong;Bae, Yong Chan
    • Archives of Plastic Surgery
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    • v.47 no.3
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    • pp.263-266
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    • 2020
  • Infantile hemangiomas have a growth phase and an involution phase. For this reason, serial observation has generally been recommended as the treatment for uncomplicated infantile hemangiomas. Recently, however, individualized approaches have been emphasized. Although cleft lip and infantile hemangioma are common congenital diseases, infantile hemangiomas on the cleft side (i.e., in the operative field of the cleft lip) are extremely rare, and no clear guidelines have been established for their treatment. We experienced a case in which a patient with a cleft lip had an infantile hemangioma on the cleft side. In accordance with general treatment guidelines, cleft repair was performed 3 months after birth. The Millard rotation-advancement technique, which involves the use of a lower small triangular flap, was used for the repair. No intraoperative complications, such as massive bleeding, or postoperative complications were noted. The patient has received regular follow-up for the past 18 years, and other than a reddish scar on the lower lip, he currently has no related issues. Therefore, this case demonstrates that cleft lip repair performed according to cleft lip treatment guidelines produces good outcomes, even in cases involving a hemangioma on the cleft side.

Xerostomia and halitosis : A review and current concepts (구강건조증과 구취 : 최신 지견의 고찰)

  • Lee, Yeon-Hee
    • The Journal of the Korean dental association
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    • v.55 no.9
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    • pp.640-656
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    • 2017
  • Xerostomia is usually caused by a reduced salivary flow or by changes in the biochemical composition of saliva. Halitosis or oral malodor is an offensive odor usually originating from the oral cavity. Halitosis can lead to anxiety and psychosocial embarrassment. The occurrence of halitosis closely related with intraoral conditions including the presence of xerostomia. Especially, the relationship between xerostomia and halitosis is prominent in elderly patients receiving polypharmacy with at least two systemic diseases. This study is a review of the update literature of xerostomia and halitosis. A large number of papers have been searched and identified using the words , , , , , , and . Papers not relevant to the issue were removed reducing the entries to 79 only. Most of identified papers were systematic reviews, non-systematic reviews, and observational studies. With a proper diagnosis, identification of the etiology and timely referrals certain steps are taken to create a successful individualized therapeutic approach. It is significant to highlight the necessity of an interdisciplinary method for the treatment of xerostomia and halitosis to prevent misdiagnosis or unnecessary treatment. This article concisely focuses on the development of a systemic flow of events to come to the proper treatment of the xerostomia and halitosis.

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The Effects of Postural Control based on Bobath Approach for Body Schema and Visual Perception of Middle Cerebral Artery Infarcts : Case Report (보봐스 개념에 기초한 중대뇌동맥 경색 환자의 자세조절이 신체도식과 시지각에 미치는 영향 : 단일사례연구)

  • Lee, Dae-Hee;Ro, Hyo-Lyun
    • Journal of the Korean Society of Physical Medicine
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    • v.4 no.3
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    • pp.193-200
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    • 2009
  • Purpose:In this study is to verify the effects postural control training based on Bobath approach for body schema and visual perception on Middle Cerebral Artery(MCA) Infarcts. Methods:The subject was a 46 years old man with MCA infaction, lives in B city. An AB design for a single-subject research was used for this study. The procedures consisted of 1 time of baseline phase(A), 20 times of treatment phase(B). We applied the Bobath approach at the subject. Treatments included to facilitate trunk alignment and stability, and to train weight bearing and shifting, to facilitate pelvis movement, and to train walk especially stance phase and assist up-down stairs locomotion in environment similar to actual daily life. Results:With this treatment, the majority of body schema and visual perception and postural control was improved in treatment phase compared with in baseline phase. Therefore, this study supported the effectiveness of postural control training based on Bobath approach for body sechma and visual perception of hemiplegia. Conculusion:This study is integrated postural control training with Bobath approach that are widespread for hemiplegia and measured outcomes based on individualized therapy goals. Consequently the study is suggested the meaning of quality effectiveness of Bobath approach.

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Predictors of Long-term Abstinence Among Chinese Smokers Following Treatment: The Role of Personality Traits

  • Leung, Doris Y.P.;Au, Doreen W.H.;Lam, Tai-Hing;Chan, Sophia S.C.
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5351-5354
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    • 2013
  • Four hundred and thirty-five Chinese smokers who had attended the first smoking cessation clinic and received stage-matched individualized cessation counseling in Hong Kong during the period of August 2000 to January 2002 were successfully followed-up between February and August 2008. Some 38% of the participants (165/495) had stopped smoking during the 12-month follow-up after treatment. Participants with higher conscientiousness score (OR = 1.65, 95% CI: 1.09 - 2.48) and lower openness to experience score (OR = 0.64, 95% CI: 0.45 - 0.92) showed a greater likelihood of quitting smoking after controlling the effect of daily cigarettes smoked and stage of readiness at baseline. The study suggests an important role of conscientiousness and openness to experience on long-term quitting behaviors following treatment, and provides useful information for the development of matched intervention for smoking cessation among Chinese smokers.

Endoscopic Mucosal Resection (내시경 점막 절제술)

  • Kim, Gwang Ha
    • Korean Journal of Bronchoesophagology
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    • v.17 no.1
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    • pp.23-28
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    • 2011
  • Diagnosis of early esophageal cancer has become more frequent as a result of improved endoscopic technology, surveillance programmes, and increasing experience and awareness on the part of endoscopists. In early esophageal cancer, squamous cell carcinoma and early adenocarcinoma must be managed differently because they have different origins, pathogenesis. and clinical characteristics. The current treatment options vary widely, from extended resection with lymphadenectomy to endoscopic mucosal resection (EMR) or ablation. None of these treatment options can be recommended universally. Instead, an individualized strategy should be based on the depth of tumor infiltration into the mucosa or submucosa, the presence or absence of lymph node metastases, the multicentricity of tumor growth, the length of the segment of intestinal metaplasia, and comorbidities of the patient. EMR has become increasingly important, both as a diagnostic tool for the staging of esophageal carcinomas and as a method of carrying out definitive treatment when the cancer meets certain criteria in which the risk of lymph-node metastasis is negligible. EMR may be sufficient in a subset of patients who have m1 or m2 squamous cell carcinoma and in patients who have isolated foci of high-grade intraepithelial neoplasia or mucosal cancer.

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Remissions of Crohn's Disease at Onset and Relapse Using Herbal Medicine: A Case Report (발병과 재발에 한약으로 관해가 유도된 크론병 증례 보고)

  • Lee, Byung-Hee;Won, Jiyoon;Park, Jae Rang;Lee, Hyangsook
    • Korean Journal of Acupuncture
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    • v.37 no.3
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    • pp.183-190
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    • 2020
  • This case report details two remissions at onset and relapse after 4 years each with Korean herbal medicine treatment in a 33-year-old male patient diagnosed as Crohn's disease (CD) by clinical and colonoscopic examination. He presented bloody diarrhea and severe abdominal pain, and his symptoms were persistent even with usual Western medications, so he was offered surgery and biologics. He was then given Sayeok-Tang for 8 months and remission was induced. Four years later he had a relapse and this time he was given Banha-Sasim-Tang, and Baekduong-Ga-Gamcho-Agyo-Tang, based on pattern changes with intense symptom monitoring. Clinical and endoscopic remission was confirmed after 4 months of herbal medicine treatment and no adverse events were reported. This case report shows that individualized Korean herbal medicine treatment has the potential for induction of remission of CD and further research is warranted.

Remission of ulcerative colitis with severe diarrhea by herbal medicine treatment: A case report (한약으로 관해가 유도된 극심한 설사의 궤양성대장염 환자 증례보고)

  • Lee, Byung-Hee;Won, Jiyoon;Lee, Hyangsook
    • Herbal Formula Science
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    • v.29 no.3
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    • pp.147-153
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    • 2021
  • Ulcerative colitis (UC) is one of inflammatory bowel diseases (IBD) with unknown etiopathogenesis. This case report details remission of UC induced by Korean herbal medicine treatment. A 31-year-old male patient diagnosed as UC after a series of examinations including endoscopy and fecal calprotectin (FC) test. He had severe bloody diarrhea over 10-20 times a day despite taking 5-aminosalicylic acid and steroid. He was given individualized Korean herbal medicine Dowha-tang according to pattern identification. After taking Dowha-tang for 7 months, clinical remission was achieved. The symptoms disappeared and FC level went down to normal level. No adverse events were reported. This case report shows that Korean herbal medicine treatment may have the potential for clinical remission of UC. Further investigation is warranted.

Evaluating the Efficacy of Pharmacological Therapy for Prader-Willi Syndrome: A Systematic Review and Meta-analysis

  • Alim Yoo;Sohyeon Park;Heeyoung Lee
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.4
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    • pp.336-351
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    • 2022
  • Background: Prader-Willi Syndrome (PWS) is a rare genetic disorder. To improve the health deterioration of PWS, investigating optimal treatment options for PWS is required. Thus, we aimed to evaluate the efficacy of pharmacotherapies compared with supportive care or placebos in patients with PWS. Methods: PubMed and EMBASE databases were used to search for randomized controlled trials (RCTs) evaluating the efficacy of pharmacotherapy in PWS patients. Only RCTs that evaluating the efficacy of pharmacotherapy in PWS patients were retrieved. Results: A total of 26 studies were included to evaluate body composition, hormones, glucose levels and hyperphagia behavioral status. Pharmacological treatment group showed a significant decrease of body fat (mean difference (MD): -6.32, 95% confidence interval (CI): -10.58 to -2.06, p=0.004), a significant increase of lean body mass (LBM) (MD: 1.86, 95% CI: 1.43 to 2.30, p<0.00001) and insulin-like growth factor 1 (IGF-1) levels (MD: 241.62, 95% CI: 68.59 to 414.64, p=0.006) compared with the control group. Nevertheless, based on other outcomes evaluated by the current systematic review, pharmacological options showed different efficacy in treating PWS. Conclusion: Pharmacological therapies were effective to decrease significantly in body fat and increase significantly on LBM and IGF-1 levels in patients with PWS. However, still, individualized therapies should be considered in real-world practice in PWS treatment.

A prospective study on changes in body composition and fat percentage during the first year of cancer treatment in children

  • Yang, Hye Ran;Choi, Hyoung Soo
    • Nutrition Research and Practice
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    • v.13 no.3
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    • pp.214-221
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    • 2019
  • BACKGROUNDS/OBJECTIVES: Cancer treatment may lead to significant body composition changes and affect growth and disease outcomes in pediatric cancer patients. This prospective study aimed to evaluate short- and long-term body compositions changes focused on body fat during the first year of cancer treatment in children. SUBJECTS/METHODS: A prospective study was conducted in 30 pediatric cancer patients (19 hematologic malignancies and 11 solid tumors) and 30 age- and sex-matched healthy controls. Anthropometric measurements and body composition analysis using whole body dual energy X-ray absorptiometry were performed at baseline and 1, 6, and 12 month(s) of cancer treatment. Kruskal-Wallis tests, Wilcoxon paired t tests, and generalized estimation equation (GEE) were applied for statistical analysis. RESULTS: At baseline, no differences in weight, height, body mass index, abdominal circumferences, body fat, and fat-free mass were observed between 30 controls and 30 pediatric cancer patients. Total fat mass (P < 0.001) and body fat percentage (P = 0.002) increased significantly during the first month, but no changes were observed from 1 to 12 months; however, no changes in the total mass were observed during the first year of cancer treatment. Meanwhile, the total fat-free mass decreased during the first month (P = 0.008) and recovered between 6 and 12 months of follow-up (P < 0.001). According to GEE analysis, there was a significant upward trend in body fat percentage during the first year, especially the first month, of cancer treatment in children with hematologic malignancies, but not in those with solid tumors. CONCLUSIONS: Our results indicate that cancer treatment is related to significant body composition changes and rapid body fat gain, particularly during the first month after initiating cancer treatment, in children with hematologic malignancies. Therefore, individualized dietary strategies to prevent excessive fat gain are needed in pediatric cancer patients for better outcomes.