Objectives : To investigate changes in, and predictors of, metabolic syndrome(MetS) status over a 5-year period in chronic schizophrenic patients and to identify factors associated with the prevention of or recovery from MetS. Methods : In total, 107 patients, all of whom provided written informed consent, were followed from 2011 to 2016 at Naju National Hospital for this study. MetS was defined according to the revised National Cholesterol Education Program-Adult Treatment Panel III guidelines. Results : During follow-up period, 22(20.5%) patients were newly diagnosed to MetS, 14(13.1%) were disappeared, 77(66.4%) were not changed[MetS : 34(31.8%), No MetS 37(34.6%)]. Common significant factors in the two changed groups were triglyceride and waist circumference, not dose and type of antipsychotic medication. Multiple logistic regression analysis revealed that female gender(odds ratio[OR]=2.846, 95% confidence interval[CI] : 1.020-7.942), attending two or more outpatient visits per month(OR=3.155, 95% CI : 1.188-8.379) and taking antidepressant medication(OR=3.991, 95% CI : 1.048-15.205) were significantly associated with MetS after controlling for other confounding variables. Type and dose of antipsychotic medication were not significantly associated with MetS. Conclusions : Triglyceride and waist circumference were important manageable indicator of MetS. Adoption of a healthy lifestyle is more important than adjusting the dose or type of antipsychotic medication in the treatment of chronic schizophrenia patients with MetS.
Background: Multiple myeloma (MM) is characterized by a neoplastic proliferation of plasma cells primarily in the bone marrow. Bisphosphonates (BP) are used as supportive therapy in the management of MM. This study aimed to analyze the incidence, risk factors, and clinical outcomes of medication-related necrosis of the jaw (MRONJ) in MM patients. Methods: One hundred thirty MM patients who had previous dental evaluations were retrospectively reviewed. Based on several findings, we applied the staging and treatment strategies on MRONJ. We analyzed gender, age, type of BP, incidence, and local etiological factors and assessed the relationship between these factors and the clinical findings at the first oral examination. Results: MRONJ was found in nine male patients (6.9%). The mean patient age was 62.2 years. The median BP administration time was 19 months. Seven patients were treated with a combination of IV zoledronate and pamidronate, and two patients received single-agent therapy. The lesions were predominantly located in the mandible (n = 8), and the most common predisposing dental factor was a history of prior extraction (n = 6). Half of the MRONJ were related to diseases found on the initial dental screen. Patients with MRONJ were treated with infection control and antibiotic therapy. When comparing between the MRONJ stage and each factor (sign, location, etiologic factor, BP type, treatment, and outcome), there were no significant differences between stages, except for between the stage and sign (with or without purulence). Conclusions: For prevention of MRONJ, we recommend routine dental examinations and treatment prior to starting BP therapy.
Asthma is one of the most common chronic disease of childhood. Although an improved understanding of the pathophysiology of asthma has had a positive impact on the treatment and management of the disease, there has been a gradual but significant increase in asthma mortality. Also, mother's caring type is the essential factor in management of the child with asthma. The purpose of this study is to identify and understand the caring patterns of mathers of children with Athma by Q methodology. As a research method, 35 Q-statements were collected through individual interviews and review of related literatures. 37 subjects were interviewed and the data were analyzed by the PC QUANL program with principal component analysis. The were 3 different caring types classified as follows : Type I was the therapeutic compliance obeying type, compliancing medication and preventing cold etc. Type II was the physical strengthening type, taking Chinese medicine and folk remedy etc. Type III was the environment control type, managing house and environment clearly and ventilating room air etc. Therefore, it needs considering above each type in nursing care of the family and children with asthma.
At this moment, because there're lots of necessity to have an attention on diabetus mellitus (DM), in this article searched over all the Korean oriental medical academic journals about DM from 2003 to 2007, Method: Through data base system that Daegu Haany University affiliated information center & Korean Studies Information Center manage, selected 60 articles worthy to look up that are searched by the keyword 'DM' & '消渴'. Result and Conclusion: 5 articles of observing 'DM' & '消渴' itself academically, 29 articles of experimental study, 8 articles of clinical research study and 18 articles of case report. For experimental study, mostly it were concerning type II DM modeled rat medicated herb and its effect, so there were only a few type I experimental study. For observing articles, generally the causes, pathology, treatments, acupuncture methods and medication et al., variable studies were done. In clinical research, diverse categories were subject, which is to prove the efficacy of medication, acupuncture, physical therapy and diet supplements. And in case reports, focused not only on improvement in blood sugar level but also its complications.
Purpose: Dyssynergic defecation (DSD) is one of the important causes of chronic constipation in children. We aimed to analyze the clinical features, diagnostic test results, and treatments for DSD in children. Methods: Children diagnosed with DSD using fluoroscopic defecography were enrolled in this study. Clinical data, including the results of colon transit time (CTT) test and biofeedback (BF) therapy, were collected from medical records retrospectively. Results: Nineteen children were enrolled. The median age was 9 years (6-18 years), the median frequency of bowel movement was 1/7 days (1-10 days), the median duration of constipation was 7.0 years (2-18 years), the median age of onset of constipation was 2.5 years (1-11 years). In the CTT test, outlet obstruction type was noted in 10/18 (55.6%), slow transit type in 5/18 (27.8%), and normal transit in 1/18 (5.6%). The median CTT was 52 hours (40-142 hours). Initial medical therapy was performed with the polyethylene glycol 4000, and the response was good in 9/19 (47.4%), fair in 9/19 (47.4%), and poor in 1/19 (5.0%). BF was performed in 8/19, with good results in 6/8 (75.0%) children and failure in 2/8 (25.0%) children. After long-term medical therapy (11/19), 3/5 showed good response with medication alone, 6/8 showed good response with BF and medication combined. Conclusion: DSD should be considered as a cause of chronic constipation in children, especially in those with abnormal CTT test results. BF combined with medical therapy is effective even with age-limited cooperation.
Objectives : Cognitive therapy is the most extensively researched psychological treatment for nonpsychotic unipolar outpatient depressive disorders. This review focused on the utility of this approach in severe or chronic depressive disorders, in relapse prevention and also on the potential benefits of combining cognitive therapy with medication. Methods : The author reviewed original studies and quantitative analyses on the effects of cognitive therapy, predictors of response, and neuroimaging studies of cognitive therapy in major depressive disorder. The sources used for the literature search were data bases : PubMed, EMBASE, CDSR on the internet, references in papers or books. Results : This review suggests that cognitive therapy is as effective as antidepressant medication in severe depressive disorders. And cognitive therapy can be an effective alternative to antidepressant medication. Patients benefited significantly more from combined cognitive therapy and antidepressant treatment than from either treatment alone. Most importantly, the addition of cognitive therapy to usual treatment appears to protect against future relapse in individuals known to be at high risk of repeated episodes of depression. In addition, subjects who received cognitive therapy showed significantly greater improvements in chronic depression than receiving antidepressant medication. Pooled data suggests that there is a significant relationship between the therapist's level of training or experience, the type of therapy used and patient outcome. Recent functional imaging studies examining brain changes following cognitive therapy report a variety of regional effects, but there is no consistent pattern across the few published studies. Conclusion : Cognitive therapy has proved beneficial in treating depressive patients. Despite empirical data supporting its efficacy, there are still problems in gaining access to cognitive therapy in clinical practice.
Seong, Han Yu;Lee, Moon Kyu;Jeon, Sang Ryong;Roh, Sung Woo;Rhim, Seung Chul;Park, Jin Hoon
Journal of Korean Neurosurgical Society
/
v.60
no.4
/
pp.456-464
/
2017
Objective : Although little is known about its origins, neck pain may be related to several associated anatomical pathologies. We aimed to characterize the incidence and features of chronic neck pain and analyze the relationship between neck pain severity and its affecting factors. Methods : Between March 2012 and July 2013, we studied 216 patients with chronic neck pain. Initially, combined tramadol (37.5 mg) plus acetaminophen (325 mg) was administered orally twice daily (b.i.d.) to all patients over a 2-week period. After two weeks, patients were evaluated for neck pain during an outpatient clinic visit. If the numeric rating scale of the patient had not decreased to 5 or lower, a cervical medial branch block (MBB) was recommended after double-dosed previous medication trial. We classified all patients into two groups (mild vs. severe neck pain group), based on medication efficacy. Logistic regression tests were used to evaluate the factors associated with neck pain severity. Results : A total of 198 patients were included in the analyses, due to follow-up loss in 18 patients. While medication was successful in reducing pain in 68.2% patients with chronic neck pain, the remaining patients required cervical MBB. Lateral cervical curvature, such as a straight or sigmoid type curve, was found to be significantly associated with the severity of neck pain. Conclusion : We managed chronic neck pain with a simple pharmacological management protocol followed by MBB. We should keep in mind that it may be difficult to manage the patient with straight or sigmoid lateral curvature only with oral medication.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.47
no.1
/
pp.20-24
/
2021
Objectives: The aim of this study was to evaluate the profile of patients on antiresorptive therapies for cancer treatment and assess presence of oral lesions, oral hygiene status, and knowledge regarding medication-related osteonecrosis of the jaw (MRONJ). Materials and Methods: This was an observational cross-sectional study that evaluated patients treated with antiresorptive medication at a single cancer hospital. Clinical data were collected and oral examination was performed to assess patient oral health. Results: From July 2017 to December 2018, 90 patients were assessed; 64 were female and 26 were male, and the mean age was 61 years. The most common drug was an intravenous bisphosphonate, zoledronic acid. Among the 90 patients, 47 presented with some type of oral disease, isolated or associated. Among these 47 patients, 9 patients (10%) developed osteonecrosis. Oral hygiene was evaluated, and most patients, with or without MRONJ, presented with regular to poor condition. Regarding patient knowledge of the risks of MRONJ and the risks associated with dental surgery, 60% stated that they were not aware of the risks. Conclusion: Identifying the profile of patients and their needs facilitates not only the preventive process, but also the emergence of new therapeutic options. Our study shows that most patients are weakened both by metastatic disease and antineoplastic treatment as well as by issues associated with aging because most were over 60 years of age. Collectively, this information should be considered for management of preventive and therapeutic measures.
Tardive dyskinesia(TD), typically appearing as an undesirable side effect of a long term antipsychotic drug treatment has gained increased attention in recent times due to the discovery of many TD variants. This is a single case study of a patient who has undergone more than 8 years of high dosage antipsychotic treatment. After altering the type and dosage of antipsychotic medication 3 months prior to visit, the patient showed relatively abrupt onset symptoms of severe tremor and dystonia. These symptoms, appearing in clear consciousess, got better to a certain degree after 48 hours, worsened for 12 hours, and then improved again. Subsequently there was no continuing movement disorder. Several tests and consultation were carried out. However except for the medication factor, no other possible causes for such disabling symptoms were found. This clinical condition was thought to be akin to tardive tremor, a variant of TD. Furthermore, the course was atypical.
We experienced one case of pulmonary lymphangioleiomyomatosis in 26-year-old female patient. She had taken antituberculous medication under the impression of miliary tuberculosis on simple chest X-ray at peripartum period. On outpatient follow-up she complained of progressive exertional dyspnea in spite of medication. Through careful history taking and physical examination, high resolutional CT, and open lung biopsy she was diagnosed as pulmonary lymphangioleiomyomatosis combined with incomplete type of tuberous sclerosis. So, we presented the case with the brief review the literatures.
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