• Title/Summary/Keyword: medication therapy management

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The Relationship Between Fear-Avoidance Beliefs and Functional Status in Patients With Low Back Pain: A Cross-Sectional Study (요통 환자에서 나타나는 공포-회피 반응과 기능 수행 수준의 관계: 단면 연구)

  • Kim, Jin-Teak;Kim, Suhn-Yeop;Oh, Duck-Won
    • Physical Therapy Korea
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    • v.16 no.1
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    • pp.52-60
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    • 2009
  • The objectives of this study were to investigate the relationship between fear-avoidance beliefs and functional status in individuals suffering from low back pain, and to identify factors that influence on fear-avoidance beliefs, functional status and pain. A cross-sectional study included 214 individuals with low back pain. Each of subjects completed a fear-avoidance beliefs questionnaire (FABQ) which divided into two subscales, FABQ for physical activity (FABQ-PA) and FABQ for work(FABQ-W), Oswestry disability index (ODI) and numeric pain rating scale (NPRS). Individuals with radiating pain were significantly higher in FABQ-PA, FABQ-total, and ODI scores than with no radiation pain (p<.05). Individuals who had received surgery were significantly higher in FABQ-PA, FABQ-total, ODI and NPRS scores when compared with individuals who had not received it (p<.05). And individuals with taking medication were significantly higher in all variables (FABQ-PA, FABQ-W, FABQ-total ODI and NPRS) than individuals not taking medication (p<.05). In correlation analysis. age appeared to be significantly correlated with FABQ-PA, FABQ-total and ODI scores (p<.05), and all variables was significantly correlated with each other (p<.01). These findings indicate that individuals suffering from low back pain have psychosocial problems such as fear-avoidance beliefs as well as functional status and pain. Fear-avoidance beliefs may contribute to aggravate physical symptoms, and therefore it should be carefully considered for the management of individuals with low back pain.

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Trigeminal neuralgia management after microvascular decompression surgery: two case reports

  • Hwang, Victor;Gomez-Marroquin, Erick;Enciso, Reyes;Padilla, Mariela
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.6
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    • pp.403-408
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    • 2020
  • Trigeminal neuralgia (TN) involves chronic neuropathic pain, characterized by attacks of repeating short episodes of unilateral shock-like pain, which are abrupt in onset and termination. Anticonvulsants, such as carbamazepine, are the gold standard first-line drugs for pharmacological treatment. Microvascular decompression (MVD) surgery is often the course of action if pharmacological management with anticonvulsants is unsuccessful. MVD surgery is an effective therapy in approximately 83% of cases. However, persistent neuropathic pain after MVD surgery may require reintroduction of pharmacotherapy. This case report presents two patients with persistent pain after MVD requiring reintroduction of pharmacological therapy. Although MVD is successful for patients with failed pharmacological management, it is an invasive procedure and requires hospitalization of the patient. About one-third of patients suffer from recurrent TN after MVD. Often, alternative treatment protocols, including the reintroduction of medications, may be necessary to achieve improvement. This case report presents two cases of post-MVD recurrent pain. Further research is lacking on the success rates of subsequent medication therapy after MVD has proven less effective in managing TN.

Acre Improved by Oriental Medical Weight Management;2-Case Report (한방비만치료를 통해 여드름이 개선된 환자 2례)

  • Jin, Sung-Sun;Rhee, See-Hyung;Song, Yun-Kyung;Lim, Hyung-Ho
    • Journal of Korean Medicine for Obesity Research
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    • v.7 no.2
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    • pp.95-103
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    • 2007
  • Objectives The purpose of this study was to investigate the clinical effect of acre improved by oriental medical weight management. Methods We treated 2 cases of obese and acne patients with dietetic therapy, electro-acupuncture therapy and herb medication. Results After $5{\sim}6$weeks of oriental medicine therapy of obesity, a remarkable improvement was made for not only obesity but also acne. Conclusion The study suggests that oriental medicine therapy of obesity also effects acne. We think that it need further study and clinical trial for obesity and acne.

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Clinical Evaluation of 3 patients with Paradoxical Vocal Cord Movement (역설적 성대운동을 보이는 3명의 환자에 대한 임상분석)

  • 최선명;임길채;한광우;남순열
    • Korean Journal of Bronchoesophagology
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    • v.9 no.1
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    • pp.83-86
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    • 2003
  • Background and Objectives : Paradoxical vocal cord movement is a series of paroxysmal adduction of the anterior two-thirds of the vocal cords during respiration or during phonation. The choking, stridor, and wheezing in this condition occur primarily on inhalation, rather than on exhalation. The two pathognomonic diagnostic criterias that need to be assessed during an acute presentation are laryngoscopy with direct visualization of paradoxical adduction of the vocal cords and pulmonary function testing. Materials and Methods : A retrospective review of 3 patients who were referred to otolaryngologist from pulmonology department, and were confirmed by typical laryngoscopic findings with paradoxical adduction of the vocal cords was conducted. Results The patients were misdiagnosed as exercised-induced asthma, and unresponsive to corticosteroid and bronchodilators. Improvement was achieved only by diagnosis with paradoxial vocal cord movement. Biofeed back therapy, voice therapy, treatment for reflux laryngitis improved symptoms. Conclusion The etiology of paradoxical vocal cord movement is unknown. It may be functional or emotional. The functional factors that were proposed are neurologic deficit and gastroesophageal reflux. Management methods of this condition consist of psychological counselling, voice therapy, and antireflux medication.

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Management of severe hidradenitis suppurativa with biologic therapy and wide excision

  • Lim, Shi Yu Derek;Cheong, Ee Cherk;Oon, Hazel H.
    • Archives of Plastic Surgery
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    • v.46 no.3
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    • pp.272-276
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    • 2019
  • Hidradenitis suppurativa (HS) is a chronic inflammatory follicular occlusive disease that involves the intertriginous areas. Treatment methods include conventional topical and systemic medication, radiotherapy, biologic agents, and surgical excision. Of late, there has been an increased focus on the use of biologic agents in patients with moderate to severe HS. Here, we present the case of a 46-year-old man with Hurley stage III HS for whom wide excision was ultimately curative, after aggressive medical therapy with the use of infliximab and adalimumab had succeeded in limiting the body surface area affected by the disease. This case demonstrates the effective treatment of severe HS with a combination of biologic therapy and surgery.

Perceived Importance and Performance of Intravenous Fluid Therapy by Nurses in Small-Medium General Hospitals (중소 종합병원 간호사가 인지하는 정맥수액요법의 중요도와 수행정도)

  • Kim, Jong Im;Lee, Jihyun;Chang, Ockja
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.20 no.4
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    • pp.372-380
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    • 2013
  • Purpose: This study was done to investigate nurses' perceived importance of, and performance of intravenous fluid therapy. Methods: Data were collected from a convenience sample of 234 nurses (return rate: 93%) working in 3 small-medium general hospitals. Results: The score for perceived importance of intravenous fluid therapy ($3.65{\pm}0.37$) was higher than that of performance ($3.45{\pm}0.39$). There were positive correlations between perceived importance and performance (r=.576, p<.001). There were 180 (80.8%) errors in intravenous fluid therapy. Perceived importance and performance scores were higher in nurses who had not experienced medication errors in intravenous fluid therapy. Conclusion: The results indicate a need to develop appropriate strategies to improve perceived importance and performance and enhance safety management during intravenous fluid therapy for nurses in small-medium general hospitals.

A Study on the Priorities in the Roles of Community Pharmacists in Aged Society Using AHP (AHP를 이용한 고령사회 약국약사의 역할에 대한 우선순위 연구)

  • Kang, Eunjeong;Jang, Sunmee;Kil, Tae Soo
    • The Journal of the Korea Contents Association
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    • v.19 no.6
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    • pp.402-411
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    • 2019
  • This study aimed to identify priorities in community pharmacist's roles in aged society using Analytic Hierarchy Process. We developed a survey questionnaire for AHP, which consisted of 19 pharmacist's roles selected from the FIP/WHO guidelines. The AHP survey questionnaire was self-administered by 127 pharmacists. The results showed that pharmacists put medication therapy management at the highest priority, preparation, dispense, distribution of medication at the second priority, and efficient healthcare system at the lowest priority. Among the 19 roles, new roles such as monitoring of medication therapy results, team-based health care, and transitions of care obtained relatively high priority.

Diagnosis and Management of Low Back Pain (요통의 진단과 치료)

  • Jang, Jae Hong;Kim, Byung-Jo
    • Annals of Clinical Neurophysiology
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    • v.14 no.1
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    • pp.1-6
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    • 2012
  • Low back pain is a common clinical condition with heterogeneous causes and challenges to manage. High prevalence and numerous assessments result in an enormous socioeconomic burden. Clinician must conduct efficient and stepwise evaluation process to rule out serious spinal pathology, neurologic involvement, and identify risk factors for chronicity. The process can be achieved through the focused history taking and physical examination. Certain factors related to serious spinal pathology include age (>50 years), trauma, unexplained fever, recent urinary or skin infection, unrelenting night or rest pain, unexplained weight loss, osteoporosis, immunosuppression, steroid use, and widespread neurological symptoms. In non-specific low back pain, diagnostic imaging and laboratory studies are often unnecessary and can disturb an appropriate management. For the management of acute low back pain, patient education and medication such as acetaminophen, non-steroidal anti-inflammatory drugs, and muscle relaxants are recommended. For chronic low back pain, behavior therapy, back exercise, and spinal manipulation are beneficial. The evidence based approach could improve success rate of management, result in prevention of acute low back pain from being chronic intractable pain.

A Case of Occipital Neuralgia in the Greater and Lesser Occipital Nerves Treated with Neurectomy by Using Transcranial Doppler Sonography: Technical Aspects

  • Jung, Sang-Jin;Moon, Seong-Keun;Kim, Tae-Young;Eom, Ki-Seong
    • The Korean Journal of Pain
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    • v.24 no.1
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    • pp.48-52
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    • 2011
  • Occipital neuralgia is usually defined as paroxysmal stabbing pain in the greater or lesser occipital nerve (GON or LON) distribution. In occipital neuralgia patients, surgical considerations are carefully taken into account if medical management is ineffective. However, identification of the occipital artery by palpation in patients with thick necks or small occipital arteries can be technically difficult. Therefore, we established a new technique using transcranial Doppler (TCD) sonography for more accurate and rapid identification. The patient was a 64-year-old man who had undergone C1-C3 screw fixation and presented with intractable stabbing pain in the bilateral GON and LON distributions. In cases in which pain management was performed using medication, physical therapy, nerve block, or radiofrequency thermocoagulation, substantial pain relief was not consistently achieved, and recurrence of pain was reported. Therefore, we performed occipital neurectomy of the bilateral GON and LON by using TCD sonography, which helped detect the greater occipital artery easily. After the operation, the patient’s headache disappeared gradually, although he had discontinued all medication except antidepressants. We believe that this new technique of occipital neurectomy via a small skin incision performed using TCD sonography is easy and reliable, has a short operative time, and provides rapid pain relief.

Benefits of the Various Pain Procedures as Therapeutic Option in Low Back Pain

  • Kim, Jung-Hee;Kong, Min-Ho;Hong, Hyun-Jong;Song, Kwan-Young;Kang, Dong-Soo
    • Journal of Korean Neurosurgical Society
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    • v.39 no.3
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    • pp.204-209
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    • 2006
  • Objective : The authors retrospectively evaluate the benefits of the various pain procedures for the treatment of low back pain unresponsive to conservative management. Methods : Over a period of 2 years from May 2002 and June 2004, the authors had performed various pain procedures on 106 patients with low back pain. Epidural block, facet joint block, sacroiliac joint block, and myofascial block were included among various pain procedures. The pain improvement, period of analgesic use, and degree of satisfaction were evaluated 1 day, 4 weeks, and 6 months after injections. The outcome of pain procedures was analyzed by using a modified Macnab criteria. Results : Sixty-four patients had a single procedure with no combination and 42 patients [39.6%] received the combination of the various pain procedure. Regardless of the single or combination cases of procedure, combination of appropriate spinal level on each procedure was conducted in 104 [98.1%]. Mean follow up period was 12.2 months. Eighty-two patients [77.4%] experienced significant pain relief and overall analgesic medication was reduced in 91 patients [85.8%] at 6 months after procedure. Unfavorable results were demonstrated in 10 patients. Permanent procedural complications did not occur. Conclusion : The various pain procedures are the possible therapeutic option for low back pain unresponsive to conservative management including medication or physical therapy.