Kim, Jae-Yeon;Abdi, Salahadin;Huh, Billy;Kim, Kyung-Hoon
The Korean Journal of Pain
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v.34
no.1
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pp.4-18
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2021
Except for carbamazepine for trigeminal neuralgia, gabapentinoid anticonvulsants have been the standard for the treatment of neuropathic pain. Pregabalin, which followed gabapentin, was developed with the benefit of rapid peak blood concentration and better bioavailability. Mirogabalin besylate (DS-5565, Tarlige®) shows greater sustained analgesia due to a high affinity to, and slow dissociation from, the α2δ-1 subunits in the dorsal root ganglion (DRG). Additionally, it produces a lower level of central nervous system-specific adverse drug reactions (ADRs), due to a low affinity to, and rapid dissociation from, the α2δ-2 subunits in the cerebellum. Maximum plasma concentration is achieved in less than 1 hour, compared to 1 hour for pregabalin and 3 hours for gabapentin. The plasma protein binding is relatively low, at less than 25%. As with all gabapentinoids, it is also largely excreted via the kidneys in an unchanged form, and so the administration dose should also be adjusted according to renal function. The equianalgesic daily dose for 30 mg of mirogabalin is 600 mg of pregabalin and over 1,200 mg of gabapentin. The initial adult dose starts at 5 mg, given orally twice a day, and is gradually increased by 5 mg at an interval of at least a week, to 15 mg. In conclusion, mirogabalin is anticipated to be a novel, safe gabapentinoid anticonvulsant with a greater therapeutic effect for neuropathic pain in the DRG and lower ADRs in the cerebellum.
Non-steroidal anti-inflammatory drugs (NSAIDs) are the most commonly used drugs worldwide for chronic pain, such as arthritis, and there are many different types depending on their composition and mechanism. After long-term use, various side effects can occur, such as gastrointestinal and cardiovascular complications. With a similar analgesic effect to that of traditional non-selective NSAIDs, cyclooxygenase-2-selective NSAIDs have been highly anticipated, because they could complement gastrointestinal tolerance. On the other hand, because of concerns about cardiovascular safety in 2004 and 2005, and the license withdrawals of rofecoxib and valdecoxib, the interest in the side effects of NSAIDs is increasing. Therefore, it is important to use the necessary drugs at a minimum, considering the side effects and interactions of each drug. This study examined the side effects and characteristics of each NSAID that may occur and reviewed the recent research and guidelines related to the use of non-selective NSAIDs and cyclooxygenase-2-selective NSAIDs.
Objectives : The purpose of this research was to examine the oriental medical term 'Yukjin(in chinese, liuchen)' i.e. 'good long-term storage of the six oriental medicinal herbs'. Yukjin has meant the six sorts of drugs which were well known for the older they stored, the better efficacious they were. This research was carried out to obtain more conclusive information about the time and the reason of the giving a naming Yukjin, and to arrange Yukjin's properties, toxicities and processes. Methods : We investigated the documents recorded in the medical classics of Yukjin and did the current issues and recent experimental researches of these medicines. Results : 1. The properties and flavors of Yukjin are pungent and bitter. When they were stored for a long time after gathering, their toxicities and stimuli were growing thinner, regarded as positive clinically with age and they should be used after processing. 2. The efficacies of Yukjin are not always in proportion to storage period. In case, they are stored too long, their efficacies and qualities may be deteriorated though volatility or pungent flavors are enfeebled. Conclusions : Consequently, toxicities and strong flavors of Yukjin can be reduced in various processes. So the traditional theory of long-term preservation is not necessarily retained. It may be desirable to store them for 1 to 3 years after harvest, to safen their toxicities and adverse reactions in the way of processing. If we use them properly according to oriental medicine method, it will be effective on treating and preventing the various diseases.
Objectives: This study aimed to evaluate the efficacy and safety of heat stimuli (e.g., fire needling, warm needling) in acupuncture for acute gout. Methods: Four international online databases (PubMed, Cochrane, Embase, and Chinese National Knowledge Infrastructure) were searched to identify randomized, controlled trials (RCTs) that used fire needling and warm needling for acute gout. The methodological quality of the RCTs was evaluated using the Cochrane risk-of-bias (RoB) tool. Thirteen RCTs (840 patients) were included and analyzed. Three evaluation tools (total effective rate, uric acid level, and pain score) were mainly used. Comparisons were made between Western medicine (WM) and i) fire needling or warm needling treatment alone, ii) fire needling and bloodletting combination treatment, iii) combination of fire needling, bloodletting, and herbal medicine, iv) warm needling (concurrently). Heat stimuli in acupuncture alone or in combination treatment were more effective in terms of the total efficacy rates, uric acid levels, and pain scores than WM alone. Results: In all the evaluation tools, the treatment effects in the fire needling alone or warm needling alone treatment group and the fire needling and bloodletting combination intervention group were significantly better than those in the WM control group. The warm needling and WM combination intervention groups also experienced significantly better treatment effects in terms of total efficacy rates and uric acid levels. Only the pain scores in the fire needling, bloodletting, and herbal medicine combination groups demonstrated significant improvement. Only four studies mentioned adverse reactions: one reported loss of appetite; three studies reported none. According to the Cochrane RoB tool, most studies showed either high or uncertain RoB. Conclusion: Heat stimuli during acupuncture could be effective for acute gout. However, as the included studies were regionally biased, more high-quality studies are needed to confirm the level of evidence.
Objectives We aimed to analyze changes in growth indicators before and after Korean medicine treatment in patients treated at the pediatric department of a hospital. Methods We analyzed the medical records of children and adolescents under 18 years of age who underwent growth assessment between January 1, 2017 and December 31, 2022. Results A total of 21 patients were selected for this study. After treatment, there was a significant increase in the height percentile, whereas bone age-chronological age (BA-CA) and predicted adult height (PAH) did not show significant changes. No major adverse reactions were observed during the treatment. Growth reassessment was conducted twice for 10 participants. When comparing the growth indicators between the assessment sessions, the height percentile showed an increasing trend between the initial and the first growth reassessment. However, there were no significant differences between BA-CA and PAH across the different assessment periods. Conclusions There is a need to establish evidence for the efficacy and safety of continuous Korean medicine growth treatment through the long-term observation of growth indicators in patients undergoing treatment for two or more periods, as well as observational studies on liver and renal function indicators.
Objectives This study was written to report Korean medicine treatment for obese children. Methods This study included obese children who visited the Department of Korean Pediatrics at the Daejeon Korean Medicine Hospital of Daejeon University from September 18, 2020 to March 30, 2023. Height and weight at the first visit and on the day of the last herbal medicine termination were measured, and changes before and after treatment were observed. Liver function tests were performed before and after the treatment. Results Of the nine obese children who received Korean medicine treatment, five were male (55.6%) and four, female (44.4%). In term of age, there were five 8-year-olds (55.6%), two 6-year-olds, and two 10-year-olds (22.2%); the patients' mean age was 8.00 ± 1.414 years. The treatment period was more than three months, and the average treatment period was 177.11 ± 106.013 days. After treatment with Korean medicine, the patients' heights increased, and the body mass index (BMI) percentile and obesity decreased. Liver levels were maintained within the normal range without abnormal liver function after herbal medicine treatment, and no adverse reactions were observed during Korean medicine treatment. As a result of the pattern identification analysis, gastrointestinal damp-heat type and yin deficiency with internal heat were reported at a high frequency. Conclusions Korean medical treatment can reduce the degree of obesity without hindering the growth of childhood obesity.
Jihyeon Seo;Jungmin Lee;Sua Kim;Minji Lee;Hyunwon Yang
Development and Reproduction
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v.26
no.4
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pp.135-144
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2022
As the number of coronavirus disease 2019 (COVID-19) vaccinations increases, various side effects are being reported, and menstrual abnormalities have been reported as a side effect in women. However, it is still unclear whether the COVID-19 vaccine has detrimental effects on the female reproductive system. Therefore, we investigated the effect of excessive immune response on reproductive function by administering Lipopolysaccharides (LPS) instead of the COVID-19 vaccine. The immune response in mice was induced by injection of LPS. Mice injected with saline 5 times were used as a control group, and mice injected with LPS 5 times were used as an experimental group. Repeated administration of LPS significantly reduced the number of corpus luteum (CL). On the other hand, the injection of LPS did not affect the development of follicles leading before the CL. The expression of the apoptosis-related genes Fas and Fas-L increased in the experimental group. In addition, the expression of the inflammation-related genes increased in the experimental group. In this study, we confirmed that LPS had detrimental effects on the uterus and ovaries in mice. These results suggest that injection of LPS can cause immune reactions within the uterus and ovaries and cause hormonal changes, which can have adverse effects such as abnormal operation or bleeding of the menstrual cycle. These results are expected to help determine the cause of decreased reproductive function, infertility, or physiological disorders caused by the COVID-19 vaccine.
Park, Mi Seon;Lee, Ji Hee;Lee, Heung Bum;Kim, Ju Sin;Choi, Eun Joo
Korean Journal of Clinical Pharmacy
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v.32
no.1
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pp.27-36
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2022
Background: Medication-related problems (MRPs) frequently occur during the discharge period. Elderly patients, particularly, are at high risk for these problems due to polypharmacy and the use of potentially inappropriate medications. The purpose of this study was to build and implement collaboration between general hospital and community pharmacies to address MRPs among high-risk elderly patients before/after discharge. Methods: This retrospective study was conducted between June and December of 2020. The inclusion criteria were patients with aged ≥65 years; residents of Jeonju; discharged from Jeonbuk National University hospital; either on medication of exceeding 10 medications (or high-risk medications) after hospitalization through the emergency room, or having severe illness. Patients received medication reconciliation and counselling by hospital pharmacists before discharge and home-visit pharmaceutical care as follow-up by community pharmacists after discharge. Results: Twenty-two patients agreed to home-visit pharmaceutical services. Fifteen and 11 patients completed the first and second home-visit pharmaceutical care service, respectively. Forty-two MRPs were identified in 15 patients. The types of high-frequency MRPs were incorrect administration of drug, adverse drug reactions, medication non-compliance, drug-drug interactions, lifestyle modifications, and expired medication disposal. After consultation with the pharmacist, 34 out of 42 MRPs were resolved. Conclusions: Transitional care for high-risk elderly patients before and after discharge was successfully built and implemented through a collaboration between general hospital and community pharmacies. This study suggests that home-visit pharmaceutical services may have positive effects on the safe use of drugs during the transition period; however, additional research is needed to expand on these findings.
Lee, Young Min;Choi, Won-Jung;Park, Minsun;Kim, Eosu
Journal of Korean geriatric psychiatry
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v.16
no.1
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pp.17-23
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2012
The diagnosis of Alzheimer's disease (AD) is still obscure even to specialists. To improve the diagnostic accuracy, to find at-risk people as early as possible, to predict the efficacy or adverse reactions of pharmacotherapy on an individual basis, to attain more reliable results of clinical trials by recruiting better defined participants, to prove the disease-modifying ability of new candidate drugs, to establish prognosis-based therapeutic plans, and to do more, is now increasing the need for biomarkers for AD. Among AD-related biochemical markers, cerebrospinal beta-amyloid and tau have been paid the most attention since they are materials directly interfacing the brain interstitium and can be obtained through the lumbar puncture. Level of beta-amyloid is reduced whereas tau is increased in cerebrospinal fluid of AD patients relative to cognitively normal elderly people. Remarkably, such information has been found to help predict AD conversion of mild cognitive impairment. Despite inconsistent findings from previous studies, plasma beta-amyloid is thought to be increased before the disease onset, but show decreasing change as the disease progress. Regarding other peripheral biochemical markers, omics tools are being widely used not only to find useful biomarkers but also to generate novel hypotheses for AD pathogenesis and to lead new personalized future medicine.
Purpose: The Sinovac and AstraZeneca vaccines are the primary coronavirus disease 2019 vaccines in Indonesia. Antibody levels in vaccine-injected individuals will decline substantially over time, but data supporting the duration of such responses are limited. Therefore, this study aims to quantitatively evaluate antibody responses resulting from the completion of Sinovac and AstraZeneca administration in Indonesian adults. Materials and Methods: Participants were divided into two groups based on their vaccine type. Both groups were then assessed on the anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) receptor binding domain (anti-SRBD) concentrations. The anti-SRBD level was measured using Elecsys anti-SARS-CoV-2 S assay and analyzed every month until 3 months after the second vaccination. Results: The results presented significant differences (p=0.000) in immunoglobulin G (IgG) titers among the vaccines' measurement duration, where all samples observed a decrease in IgG titers over time. The mean titer levels of anti-SRBD IgG in the group given Sinovac were high in the first month after vaccination and decreased by 55.7% in 3 months. AstraZeneca showed lesser immune response with a slower decline rate. Adverse effects following immunization (AEFI) showed that systemic reactions are the most reported in both vaccines, with a higher percentage in the second dose of AstraZeneca type vaccines. Conclusion: Sinovac induced more significant titers of anti-SRBD IgG 1 month after the second dose but generated fewer AEFIs. In contrast, AstraZeneca generated more AEFIs, in mild to moderate severity, but provided lower levels of anti-SRBD IgG.
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