• 제목/요약/키워드: withdrawal symptoms

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반코마이신 투여 후 발생한 약물 과민성 증후군 1예 (A case of vancomycin-induced drug hypersensitivity syndrome)

  • 민경선;최우연;송은송;한동균;조영국;마재숙
    • Clinical and Experimental Pediatrics
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    • 제51권11호
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    • pp.1228-1231
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    • 2008
  • 반코마이신 투여 후에 발생하는 약물 과민성 증후군은 아주 드물게 보고되고 있다. 저자들은 11세 여자 환아에서 감염성 심내막염에 대한 치료로 반코마이신을 투여한 후 18일째부터 발열, 반구진성 발진이 관찰되어, 반코마이신 투여 중단 및 코르티코스테로이드를 투여한 지 24시간 이내에 임상 증상의 호전을 보인 약물 과민성 증후군 1예를 경험하였다. 본 증례의 환아에서는 발열, 반구진성 발진, 간염, 급성 신부전 등이 약물 과민성 증후군의 증상으로 관찰되었다.

거짓침을 이용한 침연구의 현황 (Current evidence on acupuncture from sham needle studies)

  • 이향숙
    • Korean Journal of Acupuncture
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    • 제23권1호
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    • pp.95-109
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    • 2006
  • Objectives : There has been a considerable debate about how to best control for placebo effects in clinical trials of acupuncture. Recently several sham needles were developed and validated. This study aimed at summarising the validation studies of these needles and evaluating the outcomes of the randomised controlled trials (RCTs) using them. Methods : Computerised literature searches were performed using 'acupuncture' AND 'placebo OR sham' with a limitation of the results to RCTs in Medline via PubMed and the Cochrane Library. Only formally validated sham needle controlled studies were included. Data were extracted regarding study design, condition, sample size, credibility testing, intervention and outcomes. Methodological quality was assessed using a modified Jadad scale. Results : Three validated sham needles by Streitberger, Park, and Fink, were identified. Acupuncture's effectiveness for various conditions was tested using these needles in 12 RCTs. Real acupuncture was superior to sham acupuncture for rotator cuff tendonitis and hypertension. No significant differences between real acupuncture and sham acupuncture emerged for chemotherapy-related nausea and vomiting, postoperative nausea and vomiting, menstrually related migraine, acute stroke rehabilitation, chronic/episodic tension-type headache, neutrophil respiratory burst in healthy volunteers, alcohol withdrawal symptoms and chronic poststroke leg spasticity. Conclusions : The new sham devices have been adequately validated and may be useful tools for investigating specific research question. In spite of the sham needle's limits, the results of RCTs using such devices tend to suggest that the clinical effects of acupuncture are largely due to a placebo response.

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개별적 상호작용을 통한 대학생 흡연자의 금연목표 달성률 및 금연특성 조사연구 (A Study through Individual Interaction on the Achievement Rate of Smoking Cessation Goal and Characteristics Related to Smoking Cessation in College Smokers)

  • 최인희
    • 지역사회간호학회지
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    • 제16권4호
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    • pp.478-487
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    • 2005
  • Purpose: This study was to examine the achievement rate of smoking cessation, to identify obstacles to smoking cessation, and to find means to achieve the goal of smoking cessation in college smokers. Method: This study was conducted from April 26th to September 13th 2004 and used a one-shot design. The subjects selected by convenient sampling were 29 college smokers who smoked over one cigarette a day, had a positive level of urine cotinine, participated in smoking cessation education 3 times. Thereafter, individual interaction was processed between the researcher and the subject using an interaction instrument. Data were analyzed based on frequencies.,percentages and means using SPSS/Win 10.0. Results: The achievement rate of smoking cessation was 20.7% (6 students). The biggest obstacles smoking cessation were smoking stimuli (29 students) and lack of control (25 students). Among detailed obstacles, the biggest one was smoking at regular times, which was followed by withdrawal symptoms, smoking on drinking, and company with other smokers. The most effective means of smoking cessation mentioned by the subjects were in order of avoiding drinking situations, taking deep breaths, and exercising. Conclusion: The results of this study, using King's theory, showed that individual interaction is effective in achieving smoking cessation. Therefore, it is suggested to make further study and broaden smoking cessation education for college smokers.

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신규간호사 '태움(Taeoom)'에 대한 개념 분석 (A Concept Analysis of 'Taeoom' to Newly Employed Nurses)

  • 김지원;배성윤
    • 한국병원경영학회지
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    • 제25권3호
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    • pp.1-13
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    • 2020
  • Purpose: This study was conducted to identify the conceptual definition and attributes of 'Taeoom' (or workplace bullying) inflicted to newly employed nurses in Korea. Method: Walker & Avant(2011)'s eight-stage process was used to perform a conceptual analysis of 'Taeoom'. Literature review of 40 studies published between Jan. 2009 and March 2018 published in Korea was followed by the in-depth interview with nine newly employed hospital nurses and the ex-post review of results by nursing experts. Findings: 'Taeoom' was associated with five attributes: (1) bullying for no reason, (2) peer rejection for no reason, (3) decreased physical function and psychological withdrawal, and (4) verbal abuse, defamation and nagging, (5) impotent feeling due to power imbalance. Four antecedents found in this study include offensive action, distrust, power imbalance, and undue workload exceeding capacity. As consequences of Taeoom, negative physical and psychological symptoms and turnover intention were increased while nursing performance was decreased. Conclusion: This study suggests the need for more qualitative researches with more comprehensive approach on Taeoom and the development of effective program to improve the organizational culture in nursing field. This study is significant in that it provides a qualitative but comparative review on the attributes, antecedents and consequences of Taeoom through literature review accompanied by focus group interview and expert review.

중독(Addiction)에 대한 개념분석 (Concept Analysis of Addiction)

  • 도은영;정복례;도복늠
    • 지역사회간호학회지
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    • 제12권1호
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    • pp.261-268
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    • 2001
  • Recently, social concerns about addiction problems not only to substances like alcohol and drug but also to gambling or internet have been increasing. Addiction is caused by a combined influence of biological, psychological. and social factors. However, addiction may also occur due to weak will-power or poor education on addiction. Even though addicted behavior provides temporal mood change such as euphoria, satisfaction. or relaxation. it leads to serious physical and mental disorder of the addicted person and its family members, which possibly results in fatal consequences. Nurses are in an environment to meet and take care of those who are addicted or vulnerable to addiction in order to help the clients to recover or to prevent people from addiction. Despite the importance of nurses role in addiction problems, there is a lack of consistency of addiction is often interchangeably used with other similar concepts in the society. In this study, a concept analysis of addiction was performed to more clearly and comprehensively understand addiction and to develop effective nursing intervention methods for addicted clients. The analysis is conducted according to a series of processes described by Walker and Avant. The defining attributes of addiction identified in this study are as follows: 1) existence of object 2) control loss 3) withdrawal symptoms 4) continued use despite adverse consequences.

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Long lasting mesalazine-induced pancytopenia in a patient with ulcerative colitis

  • Ko, Juyeon;Song, Hyun Joo;Han, Sanghoon;Moon, Chiyoon
    • Journal of Medicine and Life Science
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    • 제16권2호
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    • pp.46-51
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    • 2019
  • Inflammatory bowel disease (IBD) is an immune-mediated chronic inflammatory intestinal condition. With development of various treatment options for IBD, 5-aminosalicylic acid (5-ASA) agents became the drugs of choice due to high efficacy and low risk of complication, specifically effective at inducing and maintaining remission in ulcerative colitis(UC). Pancytopenia caused by 5-ASA agents, especially by mesalazine, has been rarely reported compared with azathioprine, which is commonly used for glucocorticoid-dependent IBD and known to have risk of bone marrow suppression. In the present report, we describe the case of a 57-year-old woman diagnosed with UC, who developed pancytopenia due to adverse effect of mesalazine after recovery from azathioprine-induced pancytopenia. After withdrawal of mesalazine, the laboratory values consistent with myelosuppression continued for 3 months while pancytopenia from azathioprine remained only for 2 weeks. Since pancytopenia can be fatal due to its risk of severe bleeding and infection, close monitoring of clinical presentation is important when starting mesalazine and laboratory data should be evaluated whenever the patients present related symptoms. Furthermore, we suggest that complete blood cell counts should be considered when resuming mesalazine following the development of pancytopenia from any cause, as routinely recommended for azathioprine use.

스테로이드 및 면역 억제제 치료 중단 후 사물탕(四物湯) 합(合) 소요산(逍遙散)을 통한 화폐상 습진 치험 증례 (Case Report of Nummular Eczema after Withdrawal of Steroid and Immunosuppression Drugs Improved with Samul-tang Hap Soyo-san)

  • 강유정;하동림;김준형;안수빈;최유민;오용택
    • 한방안이비인후피부과학회지
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    • 제34권4호
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    • pp.228-236
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    • 2021
  • Objective : The purpose of this study is to report the clinical effectiveness of herbal decoction(Samul-tang hap Soyo-san.) on whole body nummular eczema. Method : A patient suffering from nummular eczema received herbal decoction(Samul-tang hap Soyo-san), acupuncture, and electronic-moxibustion treatment. The effectiveness of treatment was evaluated by EASI, DLQI, photography and subjective evaluation of the patient's improvement of symptoms. Results : After treatment, eczema lesions were remarkably improved. Compared to its peak, EASI improved by 69% and DLQI by 53%. According to photo and symptom changes, purulent exudates were stopped and pruritus was decreased. Conclusion : This study suggests that Samul-tang hap Soyo-san could show effectiveness on nummular eczema.

알코올의존 환자에서의 수면장애에 대한 아침 광치료의 임상시도 (Open Clinical Trial of Morning Light Therapy in Sleep Disturbance of Alcohol Dependent Patients)

  • 고영훈;조숙행;전승규;김병규;권성민
    • 정신신체의학
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    • 제11권2호
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    • pp.196-204
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    • 2003
  • 연구목적: 알코올의존 환자의 수면 장애에 대한 치료에 있어서 기존의 진정수면제 등의 약물은 교차 내성을 일으키고, 수면의 질을 악화시키기도 한다. 광치료는 일주기리듬장애, jet-lag, 순환제교대근무에서 나타나는 수면장애와 노화와 관련된 수면 장애의 치료에 효과적인 비약물적 치료중재이다. 따라서 저자들은 이미 여러 질환의 수면장애에 시도되고 있던 광치료의 회복기 알코올의존환자의 수면장애에 대한 치료적 효과를 알아보고자 하였다. 연구방법: 알코올 금단 증상을 보이지 않는 13명의 알코올의존 환자들을 대상으로 하여 2500Lux의 광상자로 하루에 오전 1시간 씩 3일에 걸쳐 광치료를 시행하였다. 총수면시간, 실제수면시간, 수면잠복기, 수면효율, 각성빈도 등을 수면기록지를 통해 평가하였으며, visual-analogue scale을 통해 주관적인 수면의 만족도를 평가하였다. 오전 8시, 오후 2시, 오후 8시 3차례에 걸쳐 연구대상자의 졸림 정도를 스탠포드졸림척도를 통해 평가하였으며, visual-analogue scale을 통해 불안, 우울 기분 및 피로감을 평가하였다. 수면상태를 반영하는 수행 능력의 평가를 위하여 기초단계와 연구 4일째에 기호잇기검사(trail making test)A, B 및 기호바꿔쓰기검사(digit symbol substitution test)를 시행하였다. 각 측정값은 반복측정분산분석법을 이용하여 비교하였으며 수행능력의 평가는 사전사후차이검증을 이용하였다. 결 과: 수면기록지로 평가된 수면잠복기, 수면효율은 광치료의 효과를 확인할 수 있었으며 기초 단계에 비해 연구 1일째부터 유의한 차이를 보였다. 수면에 대한 만족도도 광치료에 따라 유의하게 증가하였으며 연구 1일째부터 유의한 차이를 나타내었다. 오후 2시에 평가된 졸림은 광치료의 효과를 확인할 수 없었지만 오전 8시에는 광치료에 따라 졸림이 유의하게 감소하였고 오후 8시에는 유의하게 증가하였다. 기호잇기검사와 기호바꿔쓰기검사에서 환자들은 광치료 전후 수행 시간이 유의하게 감소하였다. Visual analogue scale에 의한 피로감의 평가에서 오후 2시와 오후 8시에 광치료에 따라 유의하게 피로감의 감소가 나타났으며 우울기분과 불안은 광치료의 효과를 확인할 수 없었다. 결 론: 본 연구에서는 금단 증상에서 회복된 후에도 지속적으로 수면장애를 호소하는 알코올의존 환자들에 있어 비록 제한적이지만 광치료의 효과를 확인할 수 있었고, 임상 실제에서 알코올중독 환자들의 수면장애에 단기간의 광치료가 효과적인 치료도구가 될 수 있음을 제시하고 있다. 추후 보다 객관적인 수면 평가 도구를 이용한 장기간의 대조군 연구가 필요할 것으로 생각된다.

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비외상성 피질하 뇌혈관질환 환자에서 병소의 편측성에 따른 인지기능, 정신행동증상 및 일상생활기능의 차이에 대한 연구 (A Study on the Differences of Cognitive Functions, Neurobehavioral Symptoms and Daily Living Functions According to the Lateralization of Lesion in Patients with Non-Traumatic Subcortical Cerebrovascular Disease)

  • 박영수;이영호;최영희;고대관;정영조;박병관;김수지;정숙회;고병희;송병일;박건우;이대희
    • 수면정신생리
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    • 제3권1호
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    • pp.56-67
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    • 1996
  • Objectives : This study was designed to find clinical factors that could be differentiated by the lateralization of lesion and also find clinical factors to predict the lateralization of lesion. Methods : The subjects were 65 cooperative inpatients and outpatients with non-traumatic subcortical cerebrovascular disease without neurologic and psychiatric history from January 1995 to September 1995 ; 48 patients in Kyung Hee University, Oriental Medicine Hospital, 35 patients in Anam Hospital, Korea University were examined as subjects, but authors excluded 20 patients whose data were incomplete or who had uncertain lesions on brain CT or MRI. The 65 patients were divided into three groups-group with left hemispheric lesion, group with right hemispheric lesion, group with both hemispheric lesion-according to the finding of brain imaging study. Their cognitive functions were evaluated by the Benton Neuropsychological Assessment(BNA), their subjective neurobehavioral symptoms by Symptom Check List-90-R(SCL-90-R), their objective neurobehavioral symptoms by Neurobehavioral Rating Scale, and their daily living functions by Geriatric Evaluation by Relative's Rating Instrument(GERRl) and Instrumental Activities of Daily Living Scale(IADLs). Results : The results were as follows : 1) The results of cognitive function test indicated that the group with right hemispheric lesion showed low functions in Tactile Form Perception(left), the group with left hemispheric lesion showed low functions in Finger localization(right), the group with right hemispheric lesion showed low functions in Finger Localization(left). 2) Though, there were little significant differences in subjective neurobehavioral symptoms, the group with right hemispheric lesion showed higher scores in all symptoms except hostility. 3) Though, there were little significant differences in objective neurobehavioral symptoms, the group with both hemispheric lesion showed higher scores in cognition, guilty/disinhibition, the group with left hemispheric lesion showed higher scores in lability of mood, the group with right hemispheric lesion showed highest scores in psychotism, neurotism, agitation-hostility and decreased motivation/emotional withdrawal. 4) There were little significant differences among three groups in Daily Living Functions, but the group with right hemispheric lesion showed the lowest functions in Instrumental Activities of Daily Living. 5) As a result of discriminant analysis on each factor's contribution to the prediction of lesion, Finger Localization(left), Phoneme Discrimination and Tactile Form Perception(right) showed that they had the potentiality to predict lesion. Conclusion : The results suggest that there are little significant differences among the groups of three non-traumatic subcortical cerebrovascular disease in cognitive functions, but the group with right hemispheric lesion showed more serious and various changes in subjective and objective neurobehavioral symptoms, and showed low functions in Instrumental Activities of Daily Living. This results suggest the possibility that the decline of the daily living function in the group with right hemispheric lesion were due to various symptoms, not due to cognitive dysfunction. The confirmation of the possibility should be worked out through the follow-up study of some groups containing cortical lesion. Apart from these findings, Finger Localization, Tactile Form Perception(right) and Phoneme Discrimination suggest that they can be used as clinically valuable cognitive parameters that predict the lateralization of lesion in non-traumatic cerebrovascular disease.

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독활 약침이 신경병리성 통증 유발 흰쥐에 미치는 영향 (Effects of Araliae Continentalis Radix Pharmacopuncture on a Neuropathic Pain Rat Model)

  • 김명식;김재홍;윤대환;조명래
    • Korean Journal of Acupuncture
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    • 제37권2호
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    • pp.104-121
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    • 2020
  • Objectives : Since neuropathic pain shows a variety of symptoms via various mechanisms, there are many difficulties in treatment and various treatments have been tried. This study was conducted to investigate the effects of Araliae Continentalis Radix pharmacopuncture (ACR) on neuropathic pain. Methods : After dividing the white rats into six groups, the sciatic nerves of five groups except the normal group were excised to induce neuropathic pain. Except normal and control group, the other four groups were given: saline (Saline group), ACR 1.100 mg/kg (ACR 1 group), ACR 2.743 mg/kg (ACR 2 group), and ACR 5.486 mg/kg (ACR 3 group) at GB30, twice a week for a total of six times in three weeks. Withdrawal response react time and force intensity, c-Fos, TNF-α, IL-6, and IFN-γ were observed to investigate the efficacy of ACR in each group. Body weight, WBC, RBC, HGB, PLT, AST, ALT, BUN, and Cr changes were observed to check the safety of ACR. Results : Both withdrawal response react time & force intensity were significantly increased in the ACR2 and ACR3 groups at 3 weeks. C-Fos tended to decrease in all ACR groups and significantly decreased in ACR3 group. In blood serum, TNF-α showed a tendency to decrease in all ACR groups and a significant decrease in ACR3 group. But IL-6 and IFN-γ did not change significantly in all experimental groups. In the spinal cord, IFN-γ was significantly decreased in the ACR3 group. But TNF-α and IL-6 were not significantly changed in all experimental groups. Body weight was not changed significantly in all experimental groups. RBC increased significantly in ACR2 group, HGB increased in ACR3 group, and PLT increased significantly in all experimental groups. ALT significantly decreased in ACR1 group, and there were no significant changes in AST, BUN, and Cr in all experimental groups. Conclusions : At high concentrations, ACR pharmacopuncture reduced c-Fos, and TNF-α in the blood serum and IFN-γ in the spinal cord thereby suppressed allodynia. More in-depth studies about pharmacopuncture concentration or mechanism are needed.