• Title/Summary/Keyword: non-pharmacological

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Mesenchymal stem cells in the treatment of osteonecrosis of the jaw

  • Nifosi, Gianfilippo;Nifosi, Lorenzo;Nifosi, Antonio Fabrizio
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.2
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    • pp.65-75
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    • 2021
  • Medication-related osteonecrosis of the jaw (MRONJ) has recently associated to the increase in antiresorptive and anti-angiogenic drugs prescriptions in the treatment of oncologic and osteoporotic patients. The physiopathogenesis of MRONJ remains unclear and available treatments are unsatisfactory. Newer pharmacological treatments have shown good results, but are not curative and could have major side effects. At the same time as pharmacological treatments, mesenchymal stem cells (MSCs) have emerged as a promising therapeutic modality for tissue regeneration and repair. MSCs are multipotential non-hematopoietic progenitor cells capable to differentiating into multiple lineages of the mesenchyme. Bone marrow MSCs can differentiate into osteogenic cells and display immunological properties and secrete paracrine anti-inflammatory factors in damaged tissues. The immunomodulatory, reparative, and anti-inflammatory properties of bone marrow MSCs have been tested in a variety of animal models of MRONJ and applied in specific clinical settings. The aim of this review is to discuss critically the immunogenicity and immunomodulatory properties of MSCs, both in vitro and in vivo, the possible underlying mechanisms of their effects, and their potential clinical use as modulators of immune responses in MRONJ, and to identify clinical safety and recommendations for future research.

Comparative evaluation of the efficacy of wound healing with and without dehydrated human amniotic/chorionic membrane in alveoloplasty: a pilot study

  • Gajul, Monica;Bhate, Kalyani;Awate, Sayali;Kakodkar, Pradnya;Shah, Sonal
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.4
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    • pp.279-285
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    • 2021
  • Objectives: Wound healing is an integral part of any surgical procedure. Appropriate wound closure is critical to any successful surgical procedure, especially intraoral procedures. Various factors aid in wound healing, both pharmacological and non-pharmacological. Dehydrated human amniotic/chorionic membrane (dHACM) is an emerging bioinert material that contains anti-inflammatory properties, angiogenetic properties, osteogenic potential, and various growth factors. The purpose of this study was to evaluate the efficacy of wound healing properties of dHACM in bilateral alveoloplasty patients. Materials and Methods: A prospective split-mouth study was conducted on 10 patients. Site A received sutures with dHACM and site B was sutured without dHACM. Wound healing was assessed with the Landry, Turnbull, and Howley Index. Results: Sites A and site B were compared. A P<0.05 and a test value of 22 was obtained, indicating a statistical difference between the two sites. Conclusion: Our study showed better healing with dHACM than without.

Factors Affecting Nurses' Performance of Cancer Pain Management in a Tertiary Hospital

  • Kang, Minhwa;Seo, Minjeong
    • Journal of Hospice and Palliative Care
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    • v.25 no.3
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    • pp.99-109
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    • 2022
  • Purpose: More than 60% of patients with advanced cancer experience pain, and uncontrolled pain reduces the quality of life. Nurses are the closest healthcare providers to the patient and are suitable for managing cancer pain using pharmacological and non-pharmacological interventions. This study aimed to identify factors affecting the performance of cancer pain management among nurses. Methods: This study was conducted among 155 participating nurses working at a tertiary hospital who had experience with cancer pain management. Data collection was performed between October 18, 2021 and October 25, 2021. Data analysis was conducted using descriptive statistics, the independent-sample t-test, one-way analysis of variance, and hierarchical regression analysis. Results: There were 110 subjects (71.0%) who had no experience of cancer pain management education. The results of regression analysis indicated that barriers included medical staff, patients, and the hospital system for cancer pain management (𝛽=0.28, P<0.001). The performance of cancer pain management was also affected by experience of cancer pain management training (𝛽=0.22, P=0.007), and cancer pain management knowledge (𝛽=0.21, P=0.006). The explanatory power of the variable was 16.6%. Conclusion: It is crucial to assess system-related obstacles, as well as patients and medical staff, in order to improve nurses' cancer pain management performance. A systematic approach incorporating multidisciplinary interventions from interprofessional teams is required for effective pain management. Furthermore, pain management education is required both for cancer ward nurses and nurses in other wards.

The Revised Korean Practice Parameter for the Treatment of Attention-Deficit Hyperactivity Disorder (III) - Pharmacological Treatment - (주의력결핍 과잉행동장애 한국형 치료 권고안 개정안(III) - 약물치료 -)

  • Kim, Hyo-Won;Kim, Eunjoo;Kim, Ji-Hoon;Park, Jangho;Bahn, Geon Ho;Lee, Yeon Jung;Jhung, Kyungun;Shin, Dongwon
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.28 no.2
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    • pp.70-83
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    • 2017
  • The objective of this review is the revision of the Korean practice parameters for the pharmacological treatment of attention-deficit hyperactivity disorder (ADHD) based on the change in the diagnostic system from DSM-IV-TR to DSM-5 and psychopharmacological developments. For the evidence-based approach, the authors conducted a review of the literature, including controlled clinical trials, studies of the side effects of drugs, toxicology and meta-analyses from the United States and Europe, as well as recent research conducted in Korea. The review committee composed of Korean experts on ADHD reviewed the revised parameters. This revised version reveals how to use central nervous system psychostimulants, non-stimulants such as atomoxetine and alpha2 agonists, and other medication for ADHD, and how to manage the adverse effects of such medication. At the end of this revised version, the authors propose recommendations for the pharmacotherapy of ADHD.

The Effect of Exercise Therapy after Cerebral Endovascular Surgery on the Level of Discomfort, Low Back Pain, Hemorrhage, and Hematoma (뇌혈관 내 수술 후 운동요법이 불편감, 요통, 출혈 및 혈종에 미치는 효과)

  • Jang, Kyung Hye;Lee, Eun Ja
    • Journal of Korean Clinical Nursing Research
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    • v.19 no.1
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    • pp.69-80
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    • 2013
  • Purpose: This study aimed to prove the effect of exercise therapy on discomfort and low back pain after cerebral endovascular surgery through femoral artery. Methods: The study employed a non-equivalent control group pretest-posttest design. Data were collected from 74 participants and were divided equally into two groups as experimental and control groups. In the experimental group, exercise therapy was applied in 2 hours, 4 hours, and 6 hours after cerebroendovascular surgery. The level of discomfort, back pain, hemorrhage, and hematoma was observed and recorded as a pretest. In the posttest, low back pain, hemorrhage, and hematoma were measured in 2.5 hours, 4.5 hours, and 6.5 hours, and discomfort was measured in 6.5 hours. The study was conducted from April to September, 2012. Data were analyzed with descriptive study, Chi-square test, t-test, repeated measure ANOVA and Bonferroni using SPSS/WIN 18.0 version. Results: The exercise therapy after cerebral endovascular surgery helps in reducing the level of discomfort (t=-2.37, p=.020) and low back pain (F=5.15, p=.005) without the side effects of hemorrhage or hematoma. Conclusion: Therefore, the exercise therapy was an efficient intervention for patients after cerebral endovascular surgery with discomfort and low back pain. Nurses could apply non-pharmacological interventions such as exercise therapy to avoid pharmacological side-effects.

Effect of Acupuncture on Young-gol and Gang-ap-hyul on the Blood Pressure (영골(靈骨).강압혈(降壓穴) 자극(刺鍼)이 혈압(血壓)에 미치는 영향(影向))

  • Yim, Young-Nam;Sim, Sung-Yong;Han, Ji-Wan;Ko, Ho-Yeon;Park, Chong-Hyeong;Han, Yang-Hee;Chun, Chan-Yong;Kim, Dong-Woo
    • The Journal of Internal Korean Medicine
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    • v.25 no.2
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    • pp.167-173
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    • 2004
  • Objective : The purpose of this study is to evaluate the clinical effect of the non-pharmacological anti-hypertension method, acupuncture, for hypertensive patients. Methods : 26 patients diagnosed with hypertension were each treated by one of three methods: an anti-hypertension drug(adalat soft capsule), venepuncture, and acupuncture. In cases of rising blood pressure, patients were treated by their one of the three methods, and blood pressure was measured at regular intervals. Result : As for the group of acupuncture treated patients on Young-gol(ling-gu) and Gang-ap-hyul(jiang-ya-xue), readings dropped 18.0mmHg in systolic blood pressure and 6.50mmHg in diastolic blood pressure. This was a greater effect than that seen in the venepuncture treated patients. Blood pressure checked one hour after acupuncture treatment showed a greater difference than blood pressure checked after thirty minutes. Conclusion : Safe reductions in blood pressure were observed through the non-pharmacological method of acupuncture on Young-gol(ling-gu) and Gang-ap-hyul(Jiang-ya-xue).

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Non-pharmacological interventions for depression in Persian medicine

  • Yousofpour, Mohammad;Kamalinejad, Mohammad;Esfahani, Mohammad Mahdi;Iran-nejad, Sharzad;Shorofi, Seyed Afshin;Shams, Jamal
    • CELLMED
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    • v.5 no.4
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    • pp.22.1-22.7
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    • 2015
  • Depression is an important medical problem in today's world. Despite its high prevalence, treatment of depression remains problematic, as its cause is still not fully understood. Of the ways recommended to tackle this problem is implementing the potentials of various medical schools. A medical school which has played an important role in the history of medicine in the world is Persian medicine. This study was intended to identify non-pharmacological interventions for depression in the most reliable references on Persian medicine, classify these interventions and compare them with the latest medical findings. The study was set to review the most reliable references on Persian medicine. In addition, relevant keywords were used to search the PubMed and Scopus databases. In Persian medicine sources, melancholia is categorized into three main types. One type is regarded as cerebral melancholia, which resembles modern psychiatry's depression closely. Therefore, some key points put forth by Persian medicine scholars regarding melancholia can be used to answer questions concerning depressive disorders and their etiology and treatment. Although recent studies have confirmed most approaches offered by Persian medicine physicians in ancient Persia, it is imperative to design and conduct clinical trial studies according to these approaches.

Comparison of Biological Activities on Rehmanniae Radix and Fermented Rehmanniae Radix (지황(地黃)과 발효(醱酵) 지황(地黃)의 생리활성 비교 연구)

  • Kim, Eun-Hyu;Kim, Kyoung-Shin;Chae, Suhn-Kee;Kim, Byoung-Soo;Kang, Jung-Soo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.3
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    • pp.306-313
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    • 2012
  • Herbal medicines are medicinal products containing a single or a mixture of two or more different herbal substances or herbal preparations as active principles. Recently, much attention has been paid to developing various kinds of fermented herbal extracts, a new type of traditional herbal medicine in the field of Korean traditional medicine. The fermentation of medicinal herbs is intended to exert a favorable influence on bioestability, bioavaliablilty and pharmacological activity of herbal extract in the gastrointestinal tract as well as intensifying the nutritional and pharmacological aspects of the medicinal herbs. The purpose of this study was to investigate biological activities of fermented Rehmanniae Radix by lactic acid bacteria at $30^{\circ}C$ for 3 days in comparison with those for Rehmanniae Radix The fermented Rehmanniae Radix exhibited different chemical profile to Rehmanniae Radix generated with HPLC, indicating production of new ingredients during fermentation. Rehmanniae Radix served as good nutritional sources for the growth of lactic acid bacteria showing increased number of bacteria during fermentation. Toxic effect of the fermented Rehmanniae Radix to cells were not seen judged by the MTT assay. The fermented Rehmanniae Radix exhibited better antioxidant effect than non-fermented Rehmanniae Radix analyzed by a SOD-likely assay. Both hypoglycemic and hypotensive effects of the fermented Rehmanniae Radix were also detected and better than those for Rehmanniae Radix in showing dose-dependent inhibitory effects on alpha-glucosidase and ACE, respectively. In conclusion, fermented Rehmanniae Radix appears to have more biological activities than non-feremented Rehmanniae Radix showing not only antioxidant effect but also cardiovascular protection.

The Relationships among Chemotherapy-Induced Nausea and Vomiting (CINV), Non-Pharmacological Coping Methods, and Nutritional Status in Patients with Gynecologic Cancer (부인암 환자의 항암화학요법으로 인한 오심과 구토, 비약물적 대처방법과 영양상태간의 관계)

  • Lee, Haerim;ChoiKwon, Smi
    • Journal of Korean Academy of Nursing
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    • v.47 no.6
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    • pp.731-743
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    • 2017
  • Purpose: Chemotherapy-induced nausea and vomiting (CINV) can cause severe malnutrition. However, relationships between CINV levels, non-pharmacological coping methods, and nutritional status of female cancer patients have rarely been investigated. Therefore, this study aimed to analyze their relationships in gynecologic cancer patients. Methods: Participants receiving a highly and moderately emetogenic chemotherapy were recruited. The level of CINV was assessed using a numeric rating scale. Coping methods were determined using multiple-choice self-report questionnaires and categorized into seven types for statistical analysis. Nutritional status was evaluated using biochemical and anthropometric parameters. Results: Among all the 485 patients, 200 eligible inpatients were included. Despite the administration of prophylactic antiemetics, 157 patients (78.5%) still experienced CINV, and several used nonmedically recommended coping methods, such as just enduring the symptom or rejecting food intake. A total of 181 patients (90.5%) had nutritional disorders. Although the level of CINV was indirectly related to the occurrence of nutritional disorders, patients who rejected food (${\beta}=1.57$, p=.023) and did not use physical measures (${\beta}=-1.23$, p=.041) as coping methods were under the high risk of nutritional disorders. Conclusion: Korean gynecologic cancer patients had high levels of CINV and were at high risk of nutritional disorders, which may be related to the use of nonscientific coping methods, possibly due to cultural backgrounds and lack of proper nutritional program. Therefore, developing a culturally appropriate educational program for the cancer patients with CINV is urgently needed.

Implementation of the Feed and Swaddle Technique as a Non-Pharmacological Strategy to Conduct Brain Magnetic Resonance Imaging in Very Low Birth Weight Infants

  • Yoo, Yeong Myong;Park, Ji Eun;Park, Moon Sung;Lee, Jang Hoon
    • Neonatal Medicine
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    • v.28 no.3
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    • pp.108-115
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    • 2021
  • Purpose: Magnetic resonance imaging (MRI) is a useful tool for evaluating brain injury and maturation in preterm infants and often requires sedation to acquire images of sufficient quality. Infant sedation is often associated with adverse events, despite extreme precautions. In this study, the swaddling technique was investigated as an alternative non-pharmacological strategy to obtain brain MRIs of sufficient quality. Methods: We applied the feed and swaddle technique during routine brain MRI as a quality improvement project and compared its morbidity with that of sedation in a historic age-matched group. Seventy-nine very low birth weight infants in the neonatal intensive care unit of Ajou University Hospital (Suwon, Korea) were enrolled. Thirty-two (40.5%) infants were in the feed and swaddling group, and 47 (59.5%) were in the sedation group. Results: The morbidity associated with the cardiopulmonary system (swaddling group vs. sedation group: 53.13% [n=17] vs. 63.83% [n=30], P=0.723) and central nervous system (40.63% [n=13] vs. 29.79% [n=14], P=0.217) were not significantly different between groups. The MRI failure rate was not significantly different (swaddling group vs. sedation group: 12.5% [n=4] vs. 4.3% [n=2], P=0.174). The MRI scanning time was longer in the swaddling group than in the sedation group (76.5±20.3 minutes vs. 61.5±13.6 minutes, P=0.001). Cardiopulmonary adverse events were significantly less common in the swaddling group than in the sedation group (3.13% [n=1] vs. 34.04% [n=16], P=0.002). Conclusion: The success rate of MRI was comparable between the swaddling technique and sedation. Furthermore, despite the drawback of prolonged scan time, cardiopulmonary adverse events are fewer with swaddling than with sedative agents. Therefore, swaddling can be an alternative to sedation or anesthesia when performing neonatal MRI scans.