Over the last few decades, the rates of pediatric obesity have more than doubled regardless of sociodemographic categorization, and despite these rates plateauing in recent years there continues to be an increase in the severity of obesity in children and adolescents. This review will discuss the pediatric obesity mediated cardiovascular disease (CVD) risk factors such as attenuated levels of satiety and energy metabolism hormones, insulin resistance, vascular endothelial dysfunction, and arterial stiffness. Additionally, early intervention to combat pediatric obesity is critical as obesity has been suggested to track into adulthood, and these obese children and adolescents are at an increased risk of early mortality. Current suggested strategies to combat pediatric obesity are modifying diet, limiting sedentary behavior, and increasing physical activity. The effects of exercise intervention on metabolic hormones such as leptin and adiponectin, insulin sensitivity/resistance, and body fat in obese children and adolescents will be discussed along with the exercise modality, intensity, and duration. Specifically, this review will focus on the differential effects of aerobic exercise, resistance training, and combined exercise on the cardiovascular risks in pediatric obesity. This review outlines the evidence that exercise intervention is a beneficial therapeutic strategy to reduce the risk factors for CVD and the ideal exercise prescription to combat pediatric obesity should contain both muscle strengthening and aerobic components with an emphasis on fat mass reduction and long-term adherence.
Introduction Chronic idiopathic urticaria in patients diagnosed with an unfavorable pattern in Soyangin and Taeumin based on Sasang medicine showed a significant improvement after herbal medicine treatment. Methods The patients had treatment with both herbal medication and antihistamine. We checked the patients' cutaneous manifestation, original symptoms, and the number of antihistamine doses in each visit. We evaluated the medical records retrospectively. Results After one month of treatment, the patients showed cutaneous manifestation relief. Each patient reduced and withdrew antihistamine at four moths and eight months respectively, and the cutaneous manifestation did not recur. We maintained the herbal medicine prescription until the origin symptoms improved. Throughout the subsequent follow-up, the patients showed both urticaria and the original symptoms in good condition without treatment. Discussion Sasang medicine treatment can be an effective treatment for chronic idiopathic urticaria and long-term management is necessary for an unfavorable pattern which can take more than 6 months.
The purpose of this study is to cover dental hygienists who work for metropolitan dental hospitals or clinics in Seoul city, Incheon city and Gyeonggi province from January to April 2009 and profile their awareness of Long-term Senior Care Insurance System (hereinafter called 'LSCI (System)', so that it may provide material reference data to contribute to expanding and establishing oral health medical services in the framework of LSCI System. As a result, this study could come to the following conclusions: 1. It was found that the highest priority of dental hygienists' visiting oral hygienic services under LSCI System was focused on 'caring and preventive treatment', and their secondary priority was focused upon 'oral health education.' 2. In response to a question item about whether dental hygienists need dentist's prescription in written before performing their visiting oral hygienic services, it was found that 38.2% dental hygienists answered 'Yes (necessary)' and 61.8% answered 'No (unnecessary).' 3. In response to a question item about whether dental hygienists may open up long-term senior care center, it was found that absolute majority of dental hygienists (93.4%) answered 'No' and only 6.6% dental hygienists answered 'Yes.' The standardized professional education are thought to be needed to be developed aiming at the success in oral-hygiene service within a LSCI, by strengthening professionalism in dental hygienists.
Seo, Mi Hyun;Eo, Mi Young;Myoung, Hoon;Kim, Soung Min;Lee, Jong Ho
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.46
no.1
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pp.19-27
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2020
Objectives: Pentoxifylline (PTX) is a methylxanthine derivative that has been implicated in the pathogenesis of peripheral vessel disease and intermittent lameness. The purpose of this study was to investigate the effect of PTX and tocopherol in patients diagnosed with osteoradionecrosis (ORN), bisphosphonate-related osteonecrosis of the jaw (BRONJ), and chronic osteomyelitis using digital panoramic radiographs. Materials and Methods: This study was performed in 25 patients who were prescribed PTX and tocopherol for treatment of ORN, BRONJ, and chronic osteomyelitis between January 2014 and May 2018 in Seoul National University Dental Hospital. Radiographic densities of the dental panorama were compared prior to starting PTX and tocopherol, at 3 months, and at 6 months after prescription. Radiographic densities were measured using Adobe Photoshop CS6 (Adobe System Inc., USA). Blood sample tests showing the degree of inflammation at the initial visit were considered the baseline and compared with results after 3 to 6 months. Statistical analysis was performed using the Mann-Whitney test and repeated measurement ANOVA using IBM SPSS 23.0 (IBM Corp., USA). Results: Eight patients were diagnosed with ORN, nine patients with BRONJ, and the other 8 patients with chronic osteomyelitis. Ten of the 25 patients were men, average age was 66.32±14.39 years, and average duration of medication was 151.8±80.65 days (range, 56-315 days). Statistically significant increases were observed in the changes between 3 and 6 months after prescription (P<0.05). There was no significant difference between ORN, BRONJ, and chronic osteomyelitis. Only erythrocyte sedimentation rate (ESR) was statistically significantly lower than before treatment (P<0.05) among the white blood cell (WBC), ESR, and absolute neutrophil count (ANC). Conclusion: Long-term use of PTX and tocopherol can be an auxiliary method in the treatment of ORN, BRONJ, or chronic osteomyelitis in jaw.
A 7-year-old spayed female domestic shorthair cat was referred for chronic intermittent vomiting. The frequency of vomiting increased recently, and the cat showed anorexia at presentation. There were no remarkable abnormalities on the blood analyses and diagnostic imaging. However, the endoscopic examination revealed focal erosions of the gastric body mucosa, and subsequent multiple biopsies were obtained. Histopathologic examination indicated mild to moderate lymphocytic gastritis. The vomiting was completely disappeared 7 days after the administration with prednisolone (PDS). However, because of side effects caused by the long-term PDS administration, cyclosporine was added on the prescription with tapered dose of PDS. The dog's condition improved with continued cyclosporine treatment, and no further vomiting and anorexia episodes have been noted. This case describes the successful management with administration of cyclosporine in feline lymphocytic gastritis.
Metal problems in herbal medicine are not regulate properly by law and public management around world country until this time. General people belief as safety about herbal since natural material. And almost all persons can also purchase by their-self and use by self-prescription in reality. As this result herbal medicines can always occur acute and chronic toxicity by not proper use problems, side-effect and overdose. Heavy metal toxic diseases in historical view point was big accidents that didnot forget including minamata and itai-itai in Japan. These accident's teach to us must not use toxic metal level and not include or at least Pb Hg As Cd in all kind material use and intake by people, especially herbal. Herbal contamination research is beginner state that had not many papers until nowadays. Even if this pan had some papers, it had negative result and bigger and larger than problems level because of one way research trend of not many sample case-report and screening test of dried herbal form in chiefly. Many persons have afraid and risk thinking about herbal, animal and minerals since these cause. Further research related this subject will be needed at fact of epidemiology including case-control and cohort study for more precision research affecting in short and long term intake of oriental medicines
Objective: We conducted a survey to understand the current state of pharmacy services and pharmacists' thoughts in the future of the community pharmacy setting. Methods: A questionnaire was distributed to 229 pharmacists and gathered from 95 respondents. Results: We asked to pharmacists about what the ideal pharmacy duty should be in the next 10 years at the community pharmacy setting in Korea. For this question, the respondents said drug counselling (19.4%), dispensing (13.8%), long-term care of chronic disease and healthcare education (12.8%), and OTC counselling (11.5%). When asked about how much time they were spending doing certain tasks in the pharmacy, the main tasks were dispensing (23.5%), counselling (17.1%), prescription review (10.1%), and OTC counselling (5.5%). When asked about what the most important duty of a pharmacist was, medication counselling (45.4%) was the most important task that they identified and the reasons for not being able to fulfill this role properly was time shortage (78.9%) followed by the lack of counselling spaces, up-to-date knowledges, and focus on financial gains over patient counselling. Conclusion: Korean pharmacists are mainly focusing on dispensing in their daily work. Their basic responsibilities can be easily mechanized over the next few years, but the social expectations of disease-prevention and public health promotion both in current and future can not be replaced by such mechanical measures. Therefore, pharmaceutical services in Korea should be developed in more diverse and professional ways.
Polypharmacy is increasing owing to an increase in the elderly population and multimorbidities associated with the increased risk of administration of potentially inappropriate medications (PIMs). The negative effects of polypharmacy on various health conditions and aspects, such as fall, fracture, mortality, cognitive function, and dementia, have been reported. The management of excess and inappropriate polypharmacy through proper interventions and local or national guidelines has been highlighted. The purpose of polypharmacy management is to appropriately prescribe medicines that are essential to treat diseases in patients and to avoid inappropriate polypharmacy, such as interactive or duplicate medicines under prescription and PIMs for specific diseases. Community pharmacists in Australia, the EU, USA, and Japan are collaborating with prescribers to review medications to ensure that the patients can be prescribed appropriate medications. The service cost is reimbursed by public or private insurers. A study in the United States has shown that even with medication review costs, the overall medication cost has reduced. In Korea, various projects such as Drug Utilization Review service and safe use of medicines have been conducted; however, no national guidelines or management measures have been established. It is necessary to implement a national long-term plan on polypharmacy management. Furthermore, a phased implementation plan is required. Shortly, active medication review services and education programs for healthcare professionals with the support of the government should be considered in Korea with reference to other countries in order to raise awareness of seriousness and risks of inappropriate polypharmacy.
Dizman, Aysen;Coskun-Breuneval, Mehtap;Altinisik-Inan, Gonca;Olcay, Gokce Kaan;Cetindag, Mehmet Faik;Guney, Yildiz
Asian Pacific Journal of Cancer Prevention
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v.15
no.8
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pp.3561-3566
/
2014
Background: Recurrent nasopharyngeal carcinoma (NPC) after previous radiotherapy is challenging. There is no standard approach for salvage treatment. Here we present toxicity and treatment results for recurrent NFC patients who underwent fractionated stereotactic radiotherapy (FSRT) as second line radiotherapy (RT). Materials and Methods: Between April 2009 and July 2012, 24 patients, with a male to female ratio of 3:1, were treated with CykerKnife$^{(R)}$ FSRT for recurrent NFC in our institution. Seven out of 24 patients had metastatic recurrent disease. Median age was 53 years (range, 20-70 years). Initial RT dose was 70Gy. The time period between initial RT and FSRT was a median of 33.2 months. The median prescription dose for FSRT was 30Gy (range, 24-30 Gy) in a median of 5 fractions (range, 4-6). Results: The median follow-up for all patients was 19.5 months (IQR: 12.2.-29.2 months). The locoregional control; progression free survival and overall survival (OS) rates for 1-, 2- and 3-year were 64%, 38%, 21%; 60%, 30%, 17% and 83%, 43%, 31%, respectively. Median OS for the entire cohort was 22 months (95% CI: 16.5-27.5). On multivariate analysis recurrent tumor stage was the only prognostic factor for OS (p=0.004). One patient exhibited grade III temporal lobe necrosis. One died because of grade IV mucositis and overlapping infection. Conclusions: The treatment of recurrent NPC is controversial. Fractionated stereotactic radiotherapy is promising. However, the published trials are heterogeneous with respect to the selection criteria and treatment details. Prospective studies with long term follow-up data are warranted.
Objective: Although prophylactic antiepileptic drug (AED) use in patients with aneurysmal subarachnoid hemorrhage (SAH) is a common practice, lack of uniform definitions and guidelines for seizures and AEDs rendered this prescription more habitual instead of evidence-based manner. We herein evaluated the incidence and predictive factors of seizure and complications about AED use. Methods: From July 1999 to June 2007, data of a total of 547 patients with aneurysmal SAH who underwent operative treatments were reviewed. For these, the incidence and risk factors of seizures and epilepsy were assessed, in addition to complications of AEDs. Results: Eighty-three patients (15.2%) had at least one seizure following SAH. Forty-three patients (79%) had onset seizures, 34 (6.2%) had perioperative seizures, and 17 (3.1%) had late epilepsy. Younger age (< 40 years), poor clinical grade, thick hemorrhage, acute hydrocephalus, and rebleeding were related to the occurrence of onset seizures. Cortical infarction and thick hemorrhage were independent risk factors for the occurrence of late epilepsy. Onset seizures were not predictive of late epilepsy. Moreover, adverse drug effects were identified in 128 patients (23.4%) with AEDs. Conclusion: Perioperative seizures are not significant predictors for late epilepsy. Instead, initial amount of SAH and surgery-induced cortical damage should be seriously considered as risk factors for late epilepsy. Because AEDs can not prevent early postoperative seizures (< 1 week) and potentially cause unexpected side effects, long-term use should be readjusted in high-risk patients.
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