• Title/Summary/Keyword: Systemic therapy

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Patterns of Ulcerative Colitis Treatments and Factors Affecting the Prescribing of Systemic Corticosteroid using Health Insurance Claims Database (건강보험 청구자료를 이용한 궤양성 대장염 치료제의 처방 양상과 전신 스테로이드 처방에 미치는 영향요인)

  • Kim, Jiyool;Park, So-Hee;Shin, Ju-Young
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.2
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    • pp.102-112
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    • 2020
  • Objective: To analyze the prescription patterns for the treatment of ulcerative colitis (UC) and to investigate factors co-occurring with systemic corticosteroid use. Methods: We used patient-level data from Korean National Health Insurance claims database to identify patients diagnosed with UC (ICD-10 code : K51) and their medications prescribed for UC between January 1 and Decemeber 31, 2017. We found that medications for UC treatment were 5-aminosalicylic acid (5-ASA), immunomodulators, biologics, and corticosteroids. We presented the prescription pattern according to the sex, age group, type of health insurance, site of UC, type of medical institution, and concomitant medication. To evaluate factors associated with prescription of systemic corticosteroids for UC, we used a multivariate logistic regression model to estimate adjusted odds ratios (aORs) and their 95% confidence intervals (CIs). Results: Of 1,469 UC patients, 74.5% used 5-ASA and 15.2% used systemic corticosteroids. 5-ASA constituted 77.5% of all prescriptions and systemic corticosteroids accounted for 13.1%. The most widely used therapy was 5-ASA monotherapy (54.8%), followed by a double therapy with 5-ASA and immunomodulators (8.2%) or 5-ASA and systemic corticosteroids (7.2%). Systemic corticosteroids were more likely to be prescribed with immunomodulators (aOR=1.88, 95% CI=1.54-2.28) and biologics (aOR=2.82, 95% CI=2.28-3.50) than without them. Conclusions: We found that 15.2% of UC patients were prescribed with a systemic corticosteroid, which is less than reported previously. Systemic corticosteroids were more likely to be prescribed with immunomodulators and biologics.

Effectiveness of Exercise Therapy on Physical Function in Patients With Ankylosing Spondylitis: Systemic Review and Meta-Analysis (강직성 척추염 환자의 신체기능에 대한 운동치료의 효과: 체계적 고찰과 메타분석)

  • Shim, Jae-Hun
    • Physical Therapy Korea
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    • v.16 no.3
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    • pp.50-59
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    • 2009
  • The aim of the study was to evaluate the effectiveness of exercise therapy on physical function of patients with anklyosing spondylitis (AS) through the systemic review and meta-analysis. The 54 studies were identified from computerized search of published researches on PubMed, Embase, CINAHL, PEDro, KISS, KERIS database until February, 2008 and review of reference lists. The main search terms were the combination "ankylosing spondylitis", "exercise", "spondyloarthropathy and exercise", "ankylosing spondylitis and physical therapy". The subgroup analysis was performed by the publication year, quality score, type of disease, content of intervention, intervention provider, type of intervention, method of intervention, intervention period and the point of outcome measured. Two reviewers independently selected trials for inclusion, assessed the quality and extracted the data. The result was as follows: The 10 trials were eligible for inclusion criteria, then the systematic review and meta-analysis was assessed on effectiveness of exercise therapy. The meta-analysis of 10 studies based on the random effect model showed that the exercise therapy was beneficial in treating the diseases (effect size .55; 95% confidence interval -.3.75~.61). The findings suggest that the exercise therapy would be appropriate to manage the physical function of AS with evidence based on Meta-analysis. Therefore, the exercise therapy supervised by physical therapist should be recognized as the essential approach to manage the AS and necessarily recommended to improve physical function.

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A Case Report: Korean Medicine Treatment for a Systemic Lupus Erythematosus Patient Persistently Complaining of Fatigue and Chest Tightness (피로와 가슴답답함(胸悶)을 주증으로 하는 전신성 홍반성 루푸스 환자에 대한 한의치료 1례)

  • Min-joo Kim
    • The Journal of Internal Korean Medicine
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    • v.44 no.2
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    • pp.117-128
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    • 2023
  • Objective: This study reported the improved symptoms of integrative Korean medicine-based treatment in a patient diagnosed with Systemic Lupus Erythematosus (SLE) who persistently complained of fatigue and chest tightness. Methods: A 51-year-old female SLE patient persistently complaining of fatigue and chest tightness underwent an 18-day treatment with Kracie Shihogayonggolmoryo-tang, Cheongpajeon-H, Gwanjeol-go, acupuncture, pharmacopuncture, cupping therapy, deep tissue meridian hot pack therapy, manual therapy, Interferential Current Therapy, and Extracorporeal Shock Wave Therapy. The Brief Fatigue Inventory (BFI) and Numeric Rating Scale (NRS) for each symptom were measured on admission, at one week, two weeks of hospitalization, and upon discharge. Clinical outcomes were assessed using these two figures. Results: After treatment, there was a reduction in the BFI score (7 to 3). The NRS score of chest tightness with hot flashes decreased from 8 to 5, neck pain lessened from 7 to 5, pain in both ankles diminished from 6 to 4, the cold hypersensitivity of both feet fell from 6 to 4, and heartburn decreased from 5 to 2. In order, the biggest clinical improvement was to heartburn, fatigue, and chest tightness with hot flashes. Conclusion: This case study shows that integrative Korean medicine-based treatment can improve symptoms of a Systemic Lupus Erythematosus patient persistently complaining of fatigue and chest tightness with hot flashes and suggests that Shihogayonggolmoryo-tang may be an effective option for managing and treating SLE patients.

A Clinical Case of Systemic Psoriasis with Korean Medical Treatment (전신성 건선 환자의 한방 치료 임상 보고 1례)

  • Kim, Ji-Hee
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.31 no.1
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    • pp.91-105
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    • 2018
  • Objectives : The purpose of this study is to report the Sik-yang-seng(食養生) therapy with Korean Medicine and acupuncture on a chronic psoriasis patient who is occurred to latrogenic cushing's syndrome. Methods : The patient who has been diagnosed psoriasis had symptoms with latrogenic Cushing's syndrome. The patient was treated with Sik-yang-seng(食養生) therapy including Korean Medicine and acupuncture. Evaluation was done by PASI score, itching score, statistics and pictures. Results : After treatment, the PASI score of patients with Sik-yang-seng(食養生) therapy including Korean Medicine and acupuncture was 1.8 which means 95.5% improvement. Conclusions : Korean medical treatment performed with Sik-yang-seng(食養生) therapy can help recovery of Biwi(脾胃)function therefore can increase effect of the treatment of psoriasis and latrogenic Cushing's syndrome.

The Treatment of Hemangioma in Lower Lip (하순에 발생한 혈관종 환자의 치험례)

  • Lee, Eun-Young;Kim, Kyoung-Won;Lee, Ji-Yeoun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.4
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    • pp.373-377
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    • 2010
  • Vascular anomalies are common birthmarks. A eight-month-old male infant had a small size, bright red swelling on the lower lip since birth. On cutaneous examination there was a small brightly erythematous, lobulated, soft plaque on the left side of the lower lip of $10{\times}8{\times}5$ mm. Ultrasonogram examination revealed the lesion and confirmed the diagnosis of capillary hemangioma. The decision to initiate treatment is based on many factors, including size, location and risks and benefits of the proposal therapy. Systemic corticosteroids are decided to prevent the scarring and deforming. Prednisolone was given at a dose of 2 mg/kg/day for 2 weeks followed by tapering for 6 weeks for treatment. After eight weeks there was 80% reduction in the size of the lesion and the left lower lip almost completely cleared without intraoral bleeding. Furthermore, intervention by way of systemic steroids, laser therapy or surgical debulking is appropriate and safe in a select group of patients presenting with a proliferating hemangioma. This report describes a case that was sucessfully treated by systemic steroid therapy for hemangima in intraoral region.

The Effects of Circuit Training and Circuit Training with Whole Body Vibration on Pulmonary Function in Adolescent

  • Jun, Hyun ju;Jeong, Chan Joo;Yang, Hoe Song;Jeong, Ye rim;Jegal, Hyuk;Yoo, Young Dae
    • Journal of International Academy of Physical Therapy Research
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    • v.6 no.2
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    • pp.902-907
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    • 2015
  • The purpose of this study was to parallel circuit training and circuit training with sonic systemic mechanism was to compare the differences in pulmonary function and chest expansion in adult men. This study was performed on 20 subjects. 20 subjects were divided into two groups; Circuit training group(n=10), Circuit training with sonic systemic mechanism(n=10). Both of the group performed the exercise 3 times a week for 5 weeks. The data was analyzed by the Repeated t-test for comparing before, during and after changes of factors in each group and the Independent t-test for comparing the between groups. The result are as follows. Circuit training group was statistically significant difference FVC, FEV1/FVC(p<.05), Circuit training with sonic systemic mechanism group was statistically significant difference PEF, VC in pulmonary function(p<.05). Circuit training group was statistically significant difference FEV1/FVC of between the two group in pulmonary function(p<.05). Circuit training group and circuit training with sonic systemic mechanism group was statistically significant difference in chest expansion(p<0.05) and there was no statistically significant difference of between the two group in chest expansion(p>.05).

Effect of scaling and root planing combined with systemic doxycycline therapy on glycemic control in diabetes mellitus subjects with chronic generalized periodontitis: a clinical study

  • Gaikwad, Subodh P.;Gurav, Abhijit N.;Shete, Abhijeet R.;Desarda, Hitesh M.
    • Journal of Periodontal and Implant Science
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    • v.43 no.2
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    • pp.79-86
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    • 2013
  • Purpose: The purpose of study was to compare glycemic control using glycated hemoglobin levels ($HbA_{1c}$) in diabetic patients with chronic generalized periodontitis (CGP) undergoing scaling and root planing (SRP) with and without systemic doxycycline. Methods: Fifty subjects with type 2 diabetes mellitus ($T_2DM$) and CGP receiving antidiabetic therapy were selected for study. The selected subjects were randomly assigned to two groups (test group [TG] and control group [CG]) comprising 25 patients each. The TG received SRP followed by systemic doxycycline. The CG received treatment with SRP only. The periodontal parameters were recorded at baseline (day zero), and every 1 month for 4 months and included probing depth, clinical attachment level, plaque index, gingival index, and $HbA_{1c}$ level were recorded at baseline (day zero) and at the end of 4 months. Results: A statistically significant effect was demonstrated for the periodontal parameters for both the TG and CG. $HbA_{1c}$ values did not show a statistically significant difference in the treatment group as compared to the CG. Conclusions: The authors concluded that nonsurgical periodontal therapy improved glycemic control in patients with $T_2DM$ in both groups, but no statistical difference was observed with adjunctive systemic doxycycline therapy. A further study with a larger sample size is required.

The Management of Systemic Voice Disorders (전신질환과 관련된 음성장애의 치료)

  • Woo, Joo Hyun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.27 no.1
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    • pp.5-10
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    • 2016
  • Variable systemic diseases affect larynx and vocal fold and result in voice change. Asthma and chronic obstructive pulmonary disease make increase of intra-abdomimal pressure followed by reflux of gastric acid, which stimulate vagal-bronchopulomary reflex aggravating cough and respiratory disturbance. Fungal laryngitis in the general population is extremely rare, but can occur in immunocompromised AIDS patients. Although, initially, empirical antifungal therapy for candidiasis is often given without biopsy, diagnostic direct laryngoscopy and biopsy is imperative if a substantial clinical response is not rapidly achieved. In the highly active anti-retroviral therapy era, HIV-positive patients are living longer and are at higher risk for developing non-AIDS-defining malignancies. The incidence of head and neck cancer (HNC) which is related with human papilloma virus infection has increased. The survival is significantly lower among the AIDS-HNC patients with CD4 counts ${\leq}200cells/{\mu}L$. Rheumatoid arthritis (RA) cause voice disturbance by developing cricoarytenoid joints fixation or nodule on vocal fold. Post-menopausal voice disorder (PMVD) is caused by decreased secretion of estrogen-progesterone resulting in decrease of fundamental frequency (F0). Hormonal replacement therapy is helpful to reduce F0 decrease. RA and PMVD result in slight voice change, but it could crucial in professional voice user.

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Anti-Hyperalgesic Effects of Meloxicam Hydrogel via Phonophoresis in Acute Inflammation in Rats; Comparing Systemic and Topical Application

  • Kim, Tae-Youl;Kim, Young-Il;Seo, Sam-Ki;Kim, Soo-Hyeun;Yang, Kyu-Ho;Shin, Sang-Chul
    • Biomolecules & Therapeutics
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    • v.17 no.3
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    • pp.305-310
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    • 2009
  • The aim of this study was to determine if a meloxicam hydrogel could be administered in vivo via phonophoretic transdermal delivery using pulsed ultrasound by examining its anti-hyperalgesic effects in a rat carrageenan inflammation model. Carrageenan (1%) was injected into the plantar surface of the right hindpaw, and meloxicam hydrogel was administered via phonophoretic transdermal delivery. Changes in the mechanical and thermal hyperalgesia, as well as swelling, showed that phonophoretic delivery of meloxicam exhibited significantly better anti-hyperalgesic and anti-inflammatory effects than pulsed ultrasound. Topical and systemic application of meloxicam hydrogel using phonophoresis showed similar anti-hyperalgesic effects. These findings suggest that the transdermal administration of a meloxicam hydrogel using phonophoresis by pulsed ultrasound might be useful for treating acute inflammation.

Extracranial systemic antitumor response through the abscopal effect induced by brain radiation in a patient with metastatic melanoma

  • D'Andrea, Mark A.;Reddy, G.K.
    • Radiation Oncology Journal
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    • v.37 no.4
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    • pp.302-308
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    • 2019
  • The abscopal effect is a term that has been used to describe the phenomenon in which localized radiation therapy treatment of a tumor lesion triggers a spontaneous regression of metastatic lesion(s) at a non-irradiated distant site(s). Radiation therapy induced abscopal effects are believed to be mediated by activation and stimulation of the immune system. However, due to the brain's distinctive immune microenvironment, extracranial abscopal responses following cranial radiation therapy have rarely been reported. In this report, we describe the case of 42-year-old female patient with metastatic melanoma who experienced an abscopal response following her cranial radiation therapy for her brain metastasis. The patient initially presented with a stage III melanoma of the right upper skin of her back. Approximately 5 years after her diagnosis, the patient developed a large metastatic lesion in her upper right pectoral region of her chest wall and axilla. Since the patient's tumor was positive for BRAF and MEK, targeted therapy with dabrafenib and trametinib was initiated. However, the patient experienced central nervous system (CNS) symptoms of headache and disequilibrium and developed brain metastases prior to the start of targeted therapy. The patient received radiation therapy to a dose of 30 Gy delivered in 15 fractions to her brain lesions while the patient was on dabrafenib and trametinib therapy. The patient's CNS metastases improved significantly within weeks of her therapy. The patient's non-irradiated large extracranial chest mass and axilla mass also shrank substantially demonstrating the abscopal effect during her CNS radiation therapy. Following radiation therapy of her residual chest lesions, the patient was disease free clinically and her CNS lesions had regressed. However, when the radiation therapy ended and the patient continued her targeted therapy alone, recurrence outside of her previously treated fields was noted. The disease recurrence could be due to the possibility of developing BRAF resistance clones to the BRAF targeted therapy. The patient died eventually due to wide spread systemic disease recurrence despite targeted therapy.