• Title/Summary/Keyword: Supportive therapy

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Diagnosis and management of toxic shock syndrome after breast reconstructive procedures with silicone implants

  • Kim, Minseo;Ku, Inhoe;Jin, Ung Sik
    • Archives of Plastic Surgery
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    • v.48 no.2
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    • pp.189-193
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    • 2021
  • Breast implant insertion is one of the most commonly used methods for breast reconstruction after total mastectomy. However, infection is a common postoperative complication of implant insertion. In most cases, these infections can be managed with antibiotics and supportive therapy. However, severe septic conditions, such as toxic shock syndrome (TSS), can sometimes occur. TSS is an extremely rare but life-threatening complication, for which early diagnosis and proper management play a crucial role in determining patients' outcome. Although only 16 cases of TSS after breast implant insertion have been reported in the literature, most of those cases involved a serious clinical course. The reason for the seriousness of the clinical course of TSS in these cases is that the initial impression and presentation of these patients are nonspecific, and patients can easily be misdiagnosed as having a simple upper respiratory infection, causing the underlying condition to be neglected. Herein, we present two patients who were diagnosed with TSS after receiving breast reconstruction surgery via a silicone implant after total mastectomy. Both patients were misdiagnosed at the initial examination since they showed no local infectious signs on the postoperative wound.

Motilitone toxicity in a dog

  • Kim, Yoon-Hwan;Ahn, Jin-Ok;Jeong, Yunho;Kang, Min Soo;Choi, Jung Hoon;Chung, Jin-Young
    • Korean Journal of Veterinary Research
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    • v.61 no.2
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    • pp.15.1-15.5
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    • 2021
  • A three-month-old, intact male Maltese dog was presented to the hospital with lethargy after taking a human medication, Motilitone. Physical examination, including a neurological examination, revealed no remarkable findings, but cholinergic crisis symptoms appeared gradually. Blood and radiological examinations showed no remarkable findings. The dog was tentatively diagnosed with a cholinergic crisis associated with Motilitone intake. Treatment included intravenous administration of atropine (0.02 mg/kg) every 30 minutes and supportive fluid therapy. After 12 hours of treatment, the patient's clinical signs were resolved. This is the first case report describing Motilitone toxicity in a dog.

Chronic progressive external ophthalmoplegia in a Saudi patient with a mutation in the POLG gene successfully managed with bilateral frontalis sling

  • Algahtani, Hussein;Shirah, Bader;Alsaggaf, Khalid;Al-Qahtani, Mohammad H.;Abdulkareem, Angham Abdulrahman;Naseer, Muhammad Imran;Abuzinadah, Ahmad R.
    • Journal of Genetic Medicine
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    • v.18 no.2
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    • pp.121-126
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    • 2021
  • Chronic progressive external ophthalmoplegia (CPEO) is a complex slowly progressive mitochondrial disorder characterized by extraocular muscle weakness with or without multisystem involvement. The mainstay of therapy in a patient with CPEO is supportive. However, in moderate cases, surgery might be indicated including surgeries for ptosis and strabismus. In this article, we report a Saudi patient with CPEO due to compound heterozygous variants in the DNA polymerase gamma (POLG) gene c.2246T>C p.(Phe749Ser) and c.1735C>T p.(Arg579Trp), which are classified as pathogenic. Proper diagnosis with genetic testing confirmation is important to guide the management and counsel the patient about the prognosis and the management options. The patient was successfully managed with bilateral frontalis sling and illustrates the importance of surgical intervention to improve vision and cosmetic appearance in patients with CPEO. We emphasize the importance of multidisciplinary care in the management of cases of mitochondriopathy, especially CPEO.

Effectiveness of Danazol as an adjunctive therapy in dogs with immune-mediated hemolytic anemia

  • Yo, Sechul;Park, Hyung-Jin;Song, Kun-Ho
    • Korean Journal of Veterinary Service
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    • v.45 no.3
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    • pp.165-169
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    • 2022
  • Immune-mediated hemolytic anemia (IMHA) is autoimmune disease which is anemia caused by own immune system destroying the red blood cells (RBC). It can be diagnosed with spherocytosis, positive auto-agglutination of RBCs and direct antiglobulin test (DAT, Coomb's test). The treatment for IMHA are blood transfusion, immunosuppressive agents including glucocorticoids and other supportive therapies. Danazol is synthetic androgen that has effect of interfering the autoimmune reaction to RBCs. It can be used as an adjunctive agent in addition to glucocorticoids. To investigate its effectiveness, the medical records of 10 IMHA-diagnosed dogs were evaluated. All subjects were treated with blood transfusion, prednisolone, mycophenolate mofetil, and intravenous human immunoglobulin G. Additionally, 6 subjects were administered with danazol and 4 subjects were not. The results of initial blood examination and responses to the treatment for IMHA were compared between the groups. There were significant differences in the number of blood transfusions; once in group with danazol, twice in group without danazol, duration of recovery to normal hematocrit; 7.67±3.08 days in group with danazol, 22.00±5.66 days in group without danazol, and hospitalization; 5.17±0.75 days in group with danazol, 12.75±2.22 days in group without danazol. Therefore, danazol has potential effective on treating IMHA for rapid improvement.

Oncological Treatment of Advanced Gastric Cancer (진행성 위암의 항암 약물 요법에 대하여)

  • Hee Seok Moon;Hyun Yong Jeong
    • Journal of Digestive Cancer Research
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    • v.6 no.1
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    • pp.16-24
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    • 2018
  • Gastric cancer is not a single, uniform disease, but rather heterogeneous in nature. It is generally not possible to cure patients with inoperable advanced or metastatic stomach cancer. In the absence of chemotherapy, the median survival time is 3 to 6 months. Therefore, several studies have confirmed the superiority of chemotherapy to the best supportive treatment, in terms of improving the quality of life and prolonging life. Various chemotherapies have been used in the past to treat advanced gastric cancer. Recently, various target therapies and immunotherapy have been introduced. However, compared to other malignancies, the quality of life and life expectancy remain relatively poor in patients with gastric cancer. We expect to overcome these difficulties in the future, with better elucidation of the molecular biology of gastric cancer.

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Biomarkers and Associated Immune Mechanisms for Early Detection and Therapeutic Management of Sepsis

  • Alissa Trzeciak;Anthony P. Pietropaoli;Minsoo Kim
    • IMMUNE NETWORK
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    • v.20 no.3
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    • pp.23.1-23.20
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    • 2020
  • Sepsis is conceptually defined as life-threatening organ dysfunction that is caused by a dysregulated host response to infection. Although there has been significant advancement in recent decades in defining and understanding sepsis pathology, clinical management of sepsis is challenging due to difficulties in diagnosis, a lack of reliable prognostic biomarkers, and treatment options that are largely limited to antibiotic therapy and fundamental supportive measures. The lack of reliable diagnostic and prognostic tests makes it difficult to triage patients who are in need of more urgent care. Furthermore, while the acute inpatient treatment of sepsis warrants ongoing attention and investigation, efforts must also be directed toward longer term survival and outcomes. Sepsis survivors experience incomplete recovery, with long-term health impairments that may require both cognitive and physical treatment and rehabilitation. This review summarizes recent advances in sepsis prognosis research and discusses progress made in elucidating the underlying causes of prolonged health deficits experienced by patients surviving the early phases of sepsis.

A Case Report of Prolonged Hemorrhage Following Traditional Phlebotomy (Fasd)

  • Sajjad Sadeghi
    • Journal of Pharmacopuncture
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    • v.27 no.1
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    • pp.47-52
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    • 2024
  • Phlebotomy, a therapeutic method of bloodletting typically performed using a needle, has a traditional technique known as "Fasd." In this method, blood is extracted by creating a longitudinal incision on a vein (3-5 mm) with a surgical scalpel blade, usually blade No. 11. Due to the incision in the vessel wall, establishing hemostasis is more challenging compared to conventional methods. Hemostasis is usually achieved within minutes after Fasd. We present a case highlighting an uncommon yet significant complication of traditional phlebotomy. A 55-year-old man with no prior medical conditions underwent traditional phlebotomy at an academic traditional medicine clinic. Senior MD-PhD students in Iranian Traditional Medicine, under professor supervision, performed Fasd. A sterile scalpel blade No. 11 was used to create a longitudinal incision of approximately 4 mm on the patient's median basilic vein in the right hand. After removing 400 cc of blood, a pressure dressing was applied to the incision site. Despite attempts such as hand elevation, ice pack application, prolonged direct pressure, and tight elastic bandaging, bleeding from the incision persisted. After an hour of supportive therapy, hemostasis was eventually achieved within a few minutes using burnt cotton dressing (a traditional method for blood hemostasis). Following intravenous hydration, the patient was discharged in stable condition and reported no issues during the one-month follow-up. The traditional phlebotomy (Fasd) carries the risk of serious complications, including uncontrolled and prolonged bleeding. Further research on the efficacy and safety of burnt cotton dressing for controlling hemostasis is recommended.

Continuous renal replacement therapy in neonates weighing less than 3 kg

  • Sohn, Young-Bae;Paik, Kyung-Hoon;Cho, Hee-Yeon;Kim, Su-Jin;Park, Sung-Won;Kim, Eun-Sun;Chang, Yun-Sil;Park, Won-Soon;Choi, Yoon-Ho;Jin, Dong-Kyu
    • Clinical and Experimental Pediatrics
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    • v.55 no.8
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    • pp.286-292
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    • 2012
  • Purpose: Continuous renal replacement therapy (CRRT) is becoming the treatment of choice for supporting critically ill pediatric patients. However, a few studies present have reported CRRT use and outcome in neonates weighing less than 3 kg. The aim of this study is to describe the clinical application, outcome, and complications of CRRT in small neonates. Methods: A retrospective review was performed in 8 neonatal patients who underwent at least 24 hours of pumped venovenous CRRT at the Samsung Medical Center in Seoul, Korea, between March 2007 and July 2010. Data, including demographic characteristics, diagnosis, vital signs, medications, laboratory, and CRRT parameters were recorded. Results: The data of 8 patients were analyzed. At the initiation of CRRT, the median age was 5 days (corrected age, $38^{+2}$ weeks to 23 days), and the median body weight was 2.73 kg (range, 2.60 to 2.98 kg). Sixty-two patient-days of therapy were reviewed; the median time for CRRT in each patient was 7.8 days (range, 1 to 37 days). Adverse events included electrolyte disturbances, catheter-related complications, and CRRT-related hypotension. The mean circuit functional survival was $13.9{\pm}8.6$ hours. Overall, 4 patients (50%) survived; the other 4 patients, who developed multiorgan dysfunction syndrome, died. Conclusion: The complications of CRRT in newborns are relatively high. However, the results of this study suggest that venovenous CRRT is feasible and effective in neonates weighing less than 3 kg under elaborate supportive care. Furthermore, for using potential benefit of CRRT in neonates, efforts are required for prolonging filter survival.

Development of Imagery-Focused Music Listening Program to Improve Emotion Regulation Among Infertile Women (난임 여성의 정서조절기술 향상을 위한 심상 중심 음악감상 프로그램 개발)

  • Rho, Yoonhee
    • Journal of Music and Human Behavior
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    • v.17 no.2
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    • pp.29-56
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    • 2020
  • The purpose of this study was to develop and validate an imagery-focused music listening program for improving emotion regulation among infertile women. For the program development in this study, the literature on emotional issues and coping strategy of infertile women was analyzed to establish theoretical foundation; and the literature on Supportive Music and Imagery (SMI) was analyzed to identify intervention components. Based on the established theoretical framework, the program was developed and finalized after evaluation of validity by four SMI professionals. The developed program was found to systematically target changes in emotions in the step-wise process of discovery, reinforcement, and affirmation of positive emotional resources. The list of music for future use was also identified and presented after systematic analysis of musical features in relation to valence and arousal of emotions. The imagery-focused music listening program was an initial approach to infertile women with SMI, which indicates the possibility of extended application for broadened clinical population.

Comparison of conservative therapy and steroid therapy for Bell's palsy in children

  • Yoo, Hye Won;Yoon, Lira;Kim, Hye Young;Kwak, Min Jung;Park, Kyung Hee;Bae, Mi Hye;Lee, Yunjin;Nam, Sang Ook;Kim, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.61 no.10
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    • pp.332-337
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    • 2018
  • Purpose: Bell's palsy is characterized by sudden onset of unilateral facial weakness. The use of corticosteroids for childhood Bell's palsy is controversial. This study aimed to identify clinical characteristics, etiology, and laboratory findings in childhood Bell's palsy, and to evaluate the efficacy of corticosteroid treatment. Methods: We conducted a retrospective analysis of children under 19 years of age treated for Bell's palsy between January 2009 and June 2017, and followed up for over 1 month. Clinical characteristics, neuroimaging data, laboratory findings, treatments, and outcomes were reviewed. Patients with Bell's palsy were divided into groups with (group 1) and without (group 2) corticosteroid treatment. Differences in onset age, sex, laterality, infection and vaccination history, degree of facial nerve palsy, and prognosis after treatment between the groups were analyzed. Results: One hundred patients were included. Mean age at presentation was $7.4{\pm}5.62years$. A total of 73 patients (73%) received corticosteroids with or without intravenous antiviral agents, and 27 (27%) received only supportive treatment. There was no significant difference in the severity, laboratory findings, or neuroimaging findings between the groups. Significant improvement was observed in 68 (93.2%) and 26 patients (96.3%) in groups 1 and 2, respectively; this rate was not significantly different between the groups (P=0.48). Conclusion: Childhood Bell's palsy showed good prognosis with or without corticosteroid treatment; there was no difference in prognosis between treated and untreated groups. Steroid therapy in childhood Bell's palsy may not significantly improve outcomes.