• Title/Summary/Keyword: Medical adherence

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The Soluble Form of the Cellular Prion Protein Enhances Phagocytic Activity and Cytokine Production by Human Monocytes Via Activation of ERK and $NF-{\kappa}B$

  • Jeon, Jae-Won;Park, Bum-Chan;Jung, Joon-Goo;Jang, Young-Soon;Shin, Eui-Cheol;Park, Young Woo
    • IMMUNE NETWORK
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    • v.13 no.4
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    • pp.148-156
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    • 2013
  • The $PrP^C$ is expressed in many types of immune cells including monocytes and macrophages, however, its function in immune regulation remains to be elucidated. In the present study, we examined a role for $PrP^C$ in regulation of monocyte function. Specifically, the effect of a soluble form of $PrP^C$ was studied in human monocytes. A recombinant fusion protein of soluble human $PrP^C$ fused with the Fc portion of human IgG1 (designated as soluble $PrP^C$-Fc) bound to the cell surface of monocytes, induced differentiation to macrophage-like cells, and enhanced adherence and phagocytic activity. In addition, soluble $PrP^C$-Fc stimulated monocytes to produce pro-inflammatory cytokines such as $TNF-{\alpha}$, $IL-1{\beta}$, and IL-6. Both ERK and $NF-{\kappa}B$ signaling pathways were activated in soluble $PrP^C$-treated monocytes, and inhibitors of either pathway abrogated monocyte adherence and cytokine production. Taken together, we conclude that soluble $PrP^C$-Fc enhanced adherence, phagocytosis, and cytokine production of monocytes via activation of the ERK and $NF-{\kappa}B$ signaling pathways.

The Knowledge, Attitude and Practice of Blood Pressure Management from the Patient's Viewpoint: A Qualitative Study (고혈압 환자들의 관점에서 본 혈압관리에 대한 지식, 태도, 실천: 질적연구)

  • Lee, Sok-Goo;Jeon, So-Youn
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.4
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    • pp.255-264
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    • 2008
  • Objectives: This study adopted a qualitative method to explore the layman's beliefs and experience concerning high blood pressure and its management in order to develop a strategy to increase adherence to proper medical treatment. Methods: Semi-structured interviews that focused on personal experiences with hypertension and its management were conducted with 26 hypertensive patients. The participants were selected according to a BP above 140/90 mmHg (hypertension stage 1), based on the seventh report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure (JNC-VII). The interviews lasted for approximately 30 minutes (range: 20-60 minutes). The resulting questions were formulated into open-ended questions. The interview questionnaire was composed 17 items to examine non-adherence to treatment and 19 items to examine adherence to treatment. Results: Most participants recognized that the direct cause of high blood pressure was unhealthy behavior rather than inheritance. Thus, the hypertensive patient believed they could recover their blood pressure to a normal level through removing the direct cause of hypertension (weight reduction, diet, exercise) instead of taking drugs. The reasons for these statements were that the drugs for controlling hypertension are not natural or they are artificial, and they may have side effects, and drugs are not treatment for the root cause of hypertension. Most of the hypertensive patients chose to manage their behaviors as soon as they knew their blood pressure was high. Therefore, we should not divide the subjects into two groups according to their taking drugs or not, but they should be divided into two groups according to their willingness or not to manage their condition. Conclusions: For developing a strategy for an individual approach to hypertension management, we need to develop a client-centered attitude and strategy. That is, we need to tailor our approach to individual cases to avoid generalizations and stereotyping when developing an adherence increasing strategy.

Factors Affecting Adherence to Pharmacotherapy in Children with Attention-Deficit Hyperactivity Disorder: A Retrospective Study (주의력결핍 과잉행동장애 아동의 약물치료 순응도에 영향을 미치는 요인 : 후향적 연구)

  • Kim, Yoon-Jung;Oh, So-Young;Lee, Ji-Ah;Moon, Su-Jin;Lee, Won-Hae;Bahn, Geon-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.21 no.3
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    • pp.174-181
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    • 2010
  • Objectives: To identify the factors affecting long-term adherence to methylphenidate treatment in children with attention-deficit hyperactivity disorder (ADHD). Methods: A retrospective medical record review of 239 ADHD patients (mean age $9.3{\pm}2.6$ years, range 6.0-17.4 years) who had visited the child and adolescent psychiatry clinic at a university hospital, in Seoul, Korea from March 2005 to February 2008. Subjects were diagnosed as ADHD based on the criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders 4th edition, text revision version (DSM-IV-TR) and underwent neuropsychological tests including the continuous performance test (CPT). Treatment discontinuation was defined as the last prescription date when the medication possession rate (MPR) became less than 0.80. Subjects were divided into three groups and labeled as Group I, non-adherence without pharmacotherapy, Group II, non-adherence with short-term pharmacotherapy, and Group III, adherence with long-term pharmacotherapy. Results: Ninety (37.7%) patients were grouped as non-adherent (Groups I+II) and 149 (62.3%) as adherent (Group III). The adherence group exhibited lower intelligence, higher symptom severity, and a higher number of comorbid psychiatric disorders than controls. The use of stimulants was significantly associated with long-term adherence to treatment. Additionally, the duration of interval between the date of the first visit and the date of the first prescription was positively associated with long-term adherence. Conclusion: About two-thirds of patients diagnosed as ADHD adhered to the treatment six months after the first visit. With respect to patient evaluation and the development of treatment strategies, factors affecting early drop-out and longer follow-up must be considered.

Impact of Satisfaction with Physical Education, General Education Courses on Exercise Adherence in University Students (대학생들의 교양체육 수업만족도가 운동지속의사에 미치는 영향)

  • Han, Gun-Soo;Han, Do-Soo;Cho, Byung-Jun;Moon, Tae-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.9
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    • pp.3380-3389
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    • 2010
  • The purpose of this study was to examine the impact of the satisfaction level of university students with Physical Education. general education courses on their exercise adherence, to seek ways of boosting college Physical Education. general education and ultimately to provide some information on how to urge students to keeping getting exercise. The subjects in this study were 486 male and female students who attend university in the city of Daejeon and Chungnam in 2009. After a survey was conducted, the collected data were analyzed with a SPSS 14.0 program. A frequency analysis, reliability analysis, descriptive statistics analysis, t-test, one-way ANOVA and correlation analysis were carried out. The findings of the study were as follows: as for the relationship of demographic characteristics to satisfaction with Physical Education. general education courses and exercise adherence, there were partially significant gaps in the two regards according to gender, major and academic year. All the subfactors of satisfaction with the instruction had a positive correlation to exercise adherence, and satisfaction with Physical Education. general education courses exerted a great influence on exercise adherence. It implied that better satisfaction with the instruction led to stronger exercise adherence, which suggests how college Physical Education. general education courses should be offered to encourage students to enjoy lifelong sports.

Identification of a High-yield Technique for Isolating Endometrial Epithelial Cells from the Mouse Uterus : A Comparison of Mechanical and Sedimentation-adherence Methods

  • Sohn, Jie Ohn;Jo, Yoon Mi;Park, Hye Jin;Ahn, Ji Yeon;Song, Hyun Jin;Lim, Jeong Mook;Lee, Seung Tae
    • Journal of Embryo Transfer
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    • v.31 no.1
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    • pp.73-80
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    • 2016
  • An in vitro assay following culture of endometrial epithelial cells is essential for understanding epithelial cell function in reproduction. Several diverse techniques have been developed for isolating endometrial epithelial cells, although an optimal technique has not been identified. In this study, we describe a sedimentation-adherence (S-A) isolation technique with a high-yield cell-separating ability to isolate endometrial epithelial cells from 8-week-old female C57BL/6 mice. We analyzed total cell number, viability, morphology, and expression of cytokeratin 18 as an endometrial epithelial cell-specific marker in cells isolated using a mechanical method compared to the S-A technique. There were no significant differences in the total number, viability, or morphology of the putative endometrial epithelial cells with either method. In contrast, significantly more endometrial epithelial cells harvested using the S-A method were positively stained for cytokeratin 18 than those isolated using the mechanical method. These results confirm that the S-A method is more efficient for retrieving endometrial epithelial cells than a mechanical method.

Treatment Adherence of Osmotic-Controlled Release Oral Delivery System Methylphenidate in Korean Children and Adolescents with Attention-Deficit Hyperactivity Disorder (주의력결핍 과잉행동장애 아동에서 Osmotic-Controlled Release Oral Delivery System Methylphenidate의 치료순응도)

  • Kim, Bongseog;Lee, Jeong-Seop;Kim, Eui-Jung;Sung, Hyung-Mo;Shin, Yun Mi;Hwang, Seong-Hye;Yoo, Hanik K.
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.25 no.2
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    • pp.65-72
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    • 2014
  • Objectives : The objective of this study was to evaluate the treatment duration and adherence of osmotic-controlled release oral delivery system (OROS) methylphenidate for treatment of attention-deficit hyperactivity disorder (ADHD). Methods : A total of 843 children with ADHD were recruited : 213 children (25.3%) who had previously taken medications for ADHD and 630 drug-na$\ddot{i}$ve children (74.7%) were recruited. The dosage was adjusted according to the clinician's judgment. The primary efficacy endpoint of this study was treatment retention rate, which was estimated at Week 12 and Week 20 using the Kaplan-Meier curve. The Swanson, Nolan and Pelham-IV (SNAP-IV), Clinical Global Impression-Severity (CGI-S), Clinical Global Impression-Improvement, and the side effect rating scale were measured at every visit. Remission rates were presented based on SNAP-IV and CGI-S, respectively. Results : The treatment retention rate at 12 weeks and at 20 weeks was 76.2% and 66.8%, respectively. Divided according to 6-8, 9-11, 12-14 and 15-18 years of age, younger children tended to show a statistically higher treatment retention rate (p=.02). Based on SNAP-IV and CGI scores, children with better response to medication showed tendencies of statistically higher treatment retention rate. The most common adverse events included loss of appetite (7.1%) and insomnia (3.3%). There was no serious adverse event related to the treatment, such as death. Conclusion : The use of OROS methylphenidate for treatment of ADHD was safe and tolerable for children. In this study, lower age and better treatment response showed a statistically significant relationship with higher treatment adherence. Boys showed a trend of high treatment adherence. The treatment adherence at 20 weeks was satisfactory, however, the treatment adherence after 20 weeks showed a sharp decrease. Therefore, treatment persistence for six months after the beginning of ADHD treatment is important. In addition, the positive role of psycho-education for children and parents is necessary for increasing treatment adherence.

Self-care adherence in kidney transplant recipients: Convergence factors and elapsed time analysis (신장이식환자의 자가간호이행 영향 요인 및 경과기간별 이행정도)

  • Bae, Su-Jung;Kim, Min-Young
    • Journal of Digital Convergence
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    • v.15 no.3
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    • pp.259-266
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    • 2017
  • The purpose of this study was to survey the effects of convergence factors and time elapsed after kidney transplantation on self-care adherence. The study included 235 patients; the data was collected from September, to October, 2014. Old age, female gender and duration of transplantation were identified as factors significantly affecting self-care adherence. Self-care adherence also showed significant differences depending on the elapsed time, and the decrease in self-care compliance was most evident between 1 and 5 years after kidney transplantation. Therefore, development of a nursing strategy that would provide education and self-care improvement programs is needed to improve self-care based on convergence factors and elapsed time.

Clinical Characteristics of Celiac Disease and Dietary Adherence to Gluten-Free Diet among Saudi Children

  • Al Sarkhy, Ahmed;El Mouzan, Mohammad I.;Saeed, Elshazaly;Alanazi, Aziz;Alghamdi, Sharifa;Anil, Shirin;Assiri, Asaad
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.1
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    • pp.23-29
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    • 2015
  • Purpose: To describe the clinical characteristics of celiac disease (CD) among Saudi children and to determine the adherence rate to gluten free diet (GFD) and its determinant factors among them. Methods: A cross-sectional study was conducted, in which all the families registered in the Saudi Celiac Patients Support Group were sent an online survey. Only families with children 18 years of age and younger with biopsy-confirmed CD were included. Results: The median age of the 113 included children was 9.9 years, the median age at symptom onset was 5.5 years and the median age at diagnosis was 7 years, the median time between the presentation and the final diagnosis was 1 year. Sixty two of the involved children were females. Ninety two percent of the patients were symptomatic at the diagnosis while eight percent were asymptomatic. The commonest presenting symptoms included: chronic abdominal pain (59.3%), poor weight gain (54%), abdominal distention, gases, bloating (46.1%) and chronic diarrhea (41.6%). Sixty percent of the involved children were reported to be strictly adherent to GFD. Younger age at diagnosis and shorter duration since the diagnosis were associated with a better adherence rate. Conclusion: CD has similar clinical presentations among Saudi children compared to other parts of the ward; however, the adherence to GFD is relatively poor. Younger age at diagnosis and shorter duration since the diagnosis were associated with a better adherence rate.

Analysis of Factors Affecting Medication Adherence to Improve Life Care in Patients with Hypertension (고혈압 환자의 라이프케어 증진을 위한 약물 순응도 영향요인 분석)

  • Gil, Eun-Ha
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.2
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    • pp.213-224
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    • 2020
  • Purpose: This study is a descriptive and secondary analytical study that uses panel data to identify the factors of medication adherence to improve life care of hypertensive patients. Methods: The subjects of this study were 2,484 patients who were taking medication after hypertension using Korea Medical Panel 2015 data (β-version 1.0). Data analysis was performed using Chi-Square, Scheffe's test, and logistic regression using SPSS/win 22.0. Results: The level of medication adherence in patients with hypertension was 94.2%. The factors of medication adherence were gender and age in Model I of demographic factors, and the presence of disability, smoking, and drinking in Model II. Model III, which added drug use factors, was identified as drinking, drug duration, side effects, drug satisfaction, and payment of drug costs. Conclusion: In order to improve life care for hypertension patients, education and interventions on the importance of take medication and side effects of medications and how to take them will be needed in the early stages of diagnosis.

Substrate reduction therapy in three patients with Gaucher disease

  • Kim, Soo Hyun;Kang, Eungu;Kim, Yoon-Myung;Kim, Gu-Hwan;Choi, In-Hee;Choi, Jin-Ho;Yoo, Han-Wook;Lee, Beom Hee
    • Journal of Genetic Medicine
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    • v.13 no.2
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    • pp.72-77
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    • 2016
  • Purpose: Gaucher disease (GD) is the most common lysosomal storage disease caused by beta-glucocerebrosidase (GBA) deficiency. Oral substrate reduction therapy with miglustat ($Zavesca^{(R)}$) was approved for the treatment of adults with GD type 1, for whom enzyme replacement therapy (ERT) is unsuitable or not a therapeutic option. In this study, we report the effect of miglustat ($Zavesca^{(R)}$) in three Korean GD patients. Materials and Methods: Clinical findings comprising age at diagnosis, presenting signs, laboratory findings at diagnosis, GBA activity and mutations, and clinical courses of the three patients were reviewed. Results: Miglustat was administered to three patients who reported allergic reactions during intravenous imiglucerase infusions. One patient withdrew after 15 months of miglustat administration owing to continuous elevation of disease biomarker levels (chitotriosidase, acid phosphatase, and angiotensin-converting enzyme). Poor adherence to medication was suspected but was denied by the patient. In the other two patients, platelet count and levels of hemoglobin and other biomarkers remained stable during miglustat administration. However, they suffered from severe diarrhea and weight loss, which led to miglustat discontinuation after 1 and 12 months of administration. Conclusion: Our study shows that although miglustat is suggested to GD patients as an alternative treatment to ERT, significant adverse reactions may lead to discontinuation of miglustat. In addition, it is difficult to monitor the drug adherence.