• Korean Journal of Clinical Pharmacy
• /
• v.33 no.2
• /
• pp.113-121
• /
• 2023

Background: Globally, the number of patients with aspergillosis is increasing, and the mortality rate remains high. This study aimed to investigate prescribing patterns of antifungal drugs for patients with aspergillosis in South Korea using real-world data. Methods: This retrospective cross-sectional study was performed using National Patient Sample (NPS) data collected by the Health Insurance Review and Assessment Service (HIRA) during 2011-2020. The use of antifungal drugs in patients with aspergillosis was investigated. Results:A total of 1374 patients were identified: 333 patients with invasive pulmonary aspergillosis (IPA) (24.2%), 436 patients with other PA (31.7%), 73 patients with other forms of aspergillosis (5.3%), and 532 patients with unspecified aspergillosis (38.7%). The odds of receiving an antifungal prescription were higher for IPA than for other PA (aOR, 0.233; p<0.001), and higher for hematologic malignancies than for respiratory disorders other than cancer or infections (aOR, 10.018; p<0.001). During each hospitalization period, 56.1% (97/173) and 6.4% (11/173) of IPA hospitalizations received voriconazole and itraconazole monotherapy, respectively, whereas 44.3% (27/61) and 27.9% (17/61) of other PA hospitalizations received itraconazole and voriconazole monotherapy, respectively. Among outpatients with IPA, 67.5% (85/126) and 26.2% (33/126) received voriconazole and itraconazole alone, respectively, whereas among outpatients with other PA, 86.1% (68/79) and 12.7% (10/79) received itraconazole and voriconazole alone, respectively, during the year. Conclusion: In Korea, voriconazole monotherapy was preferred in IPA inpatients, and itraconazole monotherapy was preferred in other PA inpatients. In the ambulatory care settings for IPA and other PA, itraconazole monotherapy was preferred.

• Korean Journal of Clinical Pharmacy
• /
• v.33 no.2
• /
• pp.135-142
• /
• 2023

Background: Pharmacists communicate with a variety of healthcare experts to prevent medication errors. Situation-Background-Assessment-Recommendation (SBAR) is a tool used for concise and accurate communication. In 2018, we developed the pharmacy-SBAR (P-SBAR) to deliver pharmacists intervention more quickly and effectively through quality improvement activities. Objectives: This study evaluates the efficacy of P-SBAR on pharmacists' intervention activities before and after the implementation of P-SBAR applications. We assessed the impact of P-SBAR on reducing the burden of intervention work, promoting pharmacists' participation, and enhancing the acceptance rate. Methods: This is a retrospective study of the two groups before and after P-SBAR implementation. All pharmacists' intervention records during two periods (2016-2017 and 2019-2020) were extracted from the data warehouse system at Kyunghee University Hospital at Gangdong, Seoul. The outcome was the number of inpatients and pharmacists who participated in the prescription monitoring activity, the number of interventions, and the physicians' acceptance rate. Results: Although the total number of inpatients decreased (364,753 vs. 348,229), the number of pharmacists who participated in intervention activity increased (monthly mean: 15.8 vs. 18.0, p=0.001). The total number of interventions (2,767 vs. 4,389), the frequency of full acceptance (2,018 vs. 3,710), and the monthly acceptance rate increased significantly (73.8% vs. 83.8%, p<0.001). Conclusion: P-SBAR improved accessibility and convenience by digitalizing the intervention activities performed in an offline environment. Improvement in work burden and acceptance rate using P-SBAR is expected to contribute toward reducing medication errors.

• Hip & pelvis
• /
• v.35 no.1
• /
• pp.24-31
• /
• 2023

Purpose: A response to conservative treatment is usually obtained in cases of ischiogluteal bursitis. However, the time required to achieve relief of symptoms can vary from days to weeks, and there is a high recurrence rate, thus invasive treatment in addition to conservative treatment can occasionally be effective. Therefore, the aim of this study was to examine surgical excision in cases of refractory ischiogluteal bursitis and to evaluate patients' progression and outcome. Materials and Methods: A review of 21 patients who underwent surgical excision for treatment of ischiogluteal bursitis between February 2009 and July 2020 was conducted. Of these patients, seven patients were male, and 14 patients were female. Injection of steroid and local anesthetic into the ischial bursa was administered at outpatient clinics in all patients, who and they were refractory to conservative treatment, including aspiration and prescription drugs. Therefore, surgery was considered necessary. Excisions were performed by two orthopedic specialists using a direct vertical incision on the ischial area. A review of each patient was performed after excision, and quantification of the outcomes recorded using clinical scoring systems was performed. Results: The results of radiologic evaluation showed that the mean lesion size was 6.2 cm×4.5 cm×3.6 cm. The average disease course after excision was 21.6 days (range, 15-48 days). Measurement of clinical scores, including the visual analog scale and Harris hip scores, was performed during periodic visits, with scores of 0.7 (range, 0-2) and 98.1 (range, 96-100) at one postoperative month, respectively. Conclusion: Surgical excision, with an expectation of favorable results, could be considered for treatment of ischiogluteal bursitis that is refractory to therapeutic injections, aspirations, and medical prescriptions, particularly in moderate-to-severe cases.

• The Korean Journal of Pain
• /
• v.37 no.2
• /
• pp.119-131
• /
• 2024

There are growing concerns regarding the safety of long-term treatment with opioids of patients with chronic non-cancer pain. In 2017, the Korean Pain Society (KPS) developed guidelines for opioid prescriptions for chronic non-cancer pain to guide physicians to prescribe opioids effectively and safely. Since then, investigations have provided updated data regarding opioid therapy for chronic non-cancer pain and have focused on initial dosing schedules, reassessment follow-ups, recommended dosage thresholds considering the risk-benefit ratio, dose-reducing schedules for tapering and discontinuation, adverse effects, and inadvertent problems resulting from inappropriate application of the previous guidelines. Herein, we have updated the previous KPS guidelines based on a comprehensive literature review and consensus development following discussions among experts affiliated with the Committee on Hospice and Palliative Care in the KPS. These guidelines may assist physicians in prescribing opioids for chronic non-cancer pain in adult outpatient settings, but should not to be regarded as an inflexible standard. Clinical judgements by the attending physician and patient-centered decisions should always be prioritized.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.37 no.3
• /
• pp.29-48
• /
• 2024

Objectives : The purpose of this study is to investigate recent trends in herbal medicine treatment for xerostomia. Methods : We searched for Randomized Controlled Trial(RCT) studies on xerostomia published after 2015 in the China National Knowledge Infrastructure(CNKI). Studies were analyzed based on the year of publication, characteristics of patient groups, herbal medicine treatments and assessment scales. Results : A total of 16 RCT studies were selected. The most frequently used herbal prescription was Zengye Decoction(增液湯). Liriope Tuber(麥門冬), Rehmanniae Radix(生地黃), Glycyrrhizae Radix(甘草), Schisandrae Fructus(五味子), Scrophulariae Radix(玄蔘), Dendrobii Herba(石斛) and Gypsum Fibrosum(石膏) were commonly used herbs. Herbal medicine treatment demonstrated effectiveness in treating xerostomia across all the studies, and this effect was statistically significant. Conclusions : Herbal medicine treatment is effective in treating xerostomia. We anticipate that more high quality studies will be conducted in the future.

• Clinical Nutrition Research
• /
• v.11 no.1
• /
• pp.9-19
• /
• 2022

This study was conducted to analyze the status of medical food selection process in hospitals within Busan and Gyeongnam area. The survey was distributed to 396 hospitals (general, tertiary and long-term care hospitals) and finally 68 surveys were used for analysis. The questionnaire consisted of 9 general items and 10 items related to enteral nutrition (EN). From the survey we found out that general hospitals and tertiary hospitals normally hire clinical dietitian, while long-term care hospitals hire dietitians with no further qualifications (χ² = 27.918, p < 0.001). A significant relationship was found between hospital size and the priority for choosing medical foods for patients (χ² = 11.852, p < 0.05). In general and tertiary hospitals, medical foods were provided exactly according to the doctor's prescription, whereas in long-term care hospitals, only half followed the doctor's direction and half of them provided the products that has been conventionally used. There was also a significant relationship between hospital size and the method for determination of nutrition requirements (χ² = 20.496, p < 0.001). Finally, the priority of considerations when developing a 'medical food guidelines' was shown in the following order; 1) the type of medical food that can be selected according to the disease state, 2) the nutrient content and comparison table for commercial products, and 3) how to manage complications that may occur when supplying medical food for patients. Developing an EN practice guideline for making a sensible selection of medical foods will provide a valuable information for better patient care.

• Progress in Medical Physics
• /
• v.35 no.2
• /
• pp.36-44
• /
• 2024

Purpose: This study assessed and compared the dosimetric performance of HyperArc and RapidArc in stereotactic radiosurgery (SRS) for a single brain metastasis. Methods: Twenty patients with intracranial brain metastases, each presenting a distinct target volume, were retrospectively selected. Subsequently, volumetric modulated arc therapy (VMAT) plans were designed using RapidArc (VMAT_RA) and HyperArc (VMAT_HA) for each patient. For planning comparisons, dose-volumetric histogram (DVH) parameters for planning target volumes (PTVs) and normal brain regions were computed across all VMAT plans. Subsequently, their total monitor units (MUs), total beam-on times, and modulation complexity scores for the VMAT (MCS_v) were compared. A statistical test was used to evaluate the dosimetric disparities in the DVH parameters, total MUs, total beam-on times, and MCS_v between the VMAT_HA and VMAT_RA plans. Results: For the PTVs, VMAT_HA presented a higher homogeneity index (HI) than VMAT_RA. Moreover, VMAT_HA presented significantly smaller gradient index (GI) values (P<0.001) than VMAT_RA. Thus, VMAT_HA demonstrated better performance in the DVH parameters for the PTV than VMAT_RA. For normal brain tissues, VMAT_HA presented lower volume receiving 50% of the prescription dose and V_2Gy to the normal brain tissues than VMAT_RA (P<0.0001). While the total MUs required for VMAT_HA was significantly higher than those for VMAT_RA, the total beam-on time for VMAT_HA was superior to that for VMAT_RA. Conclusions: Thus, VMAT_HA exhibited superior performance in achieving rapid dose fall-offs (as indicated by the GI) and a higher HI at the PTV compared to VMAT_RA in brain SRS. This advancement positions HyperArc as a significant development in the field of radiation therapy, offering optimized treatment outcomes for brain SRS.

• Journal of Korean Ophthalmic Optics Society
• /
• v.19 no.3
• /
• pp.323-329
• /
• 2014

Purpose: To understand the pattern of prescribing contact lenses in Korea from 2010 to 2013. Methods: Four hundred survey questionnaires were randomly posted to Korean Optometric clinics for 4 years. The questionnaire was the same form as a form used for International Contact Lens Prescribing Trend. It was also designed to collect information about the contact lenses prescribed to the first 10 patients after its receipt. Results: 1937 fits were used for the analysis among the four hundred survey questionnaires. The average patient age was $26.2{\pm}7.0$ in 2010, $26.1{\pm}7.6$ in 2011, $24.7{\pm}6.6$ in 2012 and $24.8{\pm}7.2$ in 2013. The patients were mainly women (75%). Of all the soft contact lenses, silicon hydrogel lenses were 18% of fits (17% in 2010, 10% in 2011, 20% in 2012, 24% in 2013). By degine, the percentage of toric design lenses accounted for 17% of soft lenses fits and had increased during 4 years (10% in 2010, 18% in 2011, 16% in 2012, 22% in 2013), and cosmetic contact lens made up for 29% (15% in 2010, 20% in 2011, 40% in 2012, 41% in 2013). Conclusions: The contact lenses wearers were mostly women and the average patient age becomes slightly younger. In relation to the increase in the mumber of younger female contact lens wearers,the percentage of cosmetic lenses prescription was much higher (29%) than the global average (7%), and it has gradually increased for last 4 years. This trend could be related to the growth of beauty market in Korea. By emphasizing on toric lens marketing in manufactures, the prescription rate has been gradually increased.

• Journal of Acupuncture Research
• /
• v.21 no.3
• /
• pp.215-229
• /
• 2004

Objective : We had a clinical report in headache but didn't in migraine. We have planned this study in order to get the basic data of migraine in oriental medicine. Methods : The patient of 36 in migraine checked sex, age, onset, family history, severity of pain, influences of life, induced cause, clinical pain characteristics, associated symptom, treatment style, and prescription, frequency, using period of analgesics by a questionnaire and differentiated syndromes in migraine and evaluated autonomic bioelectric response recorder(ABR-2000). Results : There are 23.4% in prevalence rate of migraine. The ratio of sex is M:F=1:17. The age of an attack is the highest in thirties. The patient are the most in forties. The mean duration of illness is $12.0{\pm}9.9$ years. 83.4% had a family history. 61.1% had a moderate grade in severity of pain. 77.8% selected fatigue in induced cause of migraine. 69.4% had tingling sense, nausea and vomiting in the associated symptoms. 91.7% used analgesics for treatment and 51.5% of them used analgesics voluntarily. 61.9% of them take analgesics less than once in a week. 33.6% had the phlegm syncope headache in differentiation of syndrome. In ABR-2000 results, item of graph showed low tendency mostly. Conclusions : We expected that this report of clinical progress, differentiation of syndromes and ABR-2000 results in migraine would be used basic data by oriental medicine to treat migraine.

• Journal of the Korean Data and Information Science Society
• /
• v.28 no.5
• /
• pp.1027-1041
• /
• 2017

Hyperlipidemia, the status of blood with high level of low-density lipoprotein cholesterol (LDL-C), is known as a main cause of coronary artery diseases such as myocardiac infarction or brain infarct. Statin is the representative prescription to hyperlipidemia and the effects of it depend on the patient's individual conditions such as health-caring habits or adherence to medication. The main effect of statin is reducing LDL-C, which should reach the target range based on National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) guideline. In this research, the reduction of LDL-C and attainment to patient's target range are considered effects of statin. The association between factors - individual conditions and adherence to medication of patients - and the effects of statin is analyzed with National Health Insurance Service-National Sample Cohort (NHIS-NSC).