• 제목/요약/키워드: early treatment

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Early Biologic Treatment in Pediatric Crohn's Disease: Catching the Therapeutic Window of Opportunity in Early Disease by Treat-to-Target

  • Kang, Ben;Choe, Yon Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제21권1호
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    • pp.1-11
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    • 2018
  • The emergence of mucosal healing as a treatment goal that could modify the natural course of Crohn's disease and the accumulating evidence showing that biologics are most effective in achieving mucosal healing, along with the success of early treatment regimens for rheumatoid arthritis, have led to the identification of early Crohn's disease and development of the concept of catching the therapeutic window during the early disease course. Thus, an increasing number of pediatric gastroenterologists are adopting an early biologic treatment strategy with or without an immunomodulator. Although early biologic treatment is effective, cost and overtreatment are issues that limit its early use. Currently, there are insufficient data on who will benefit most from early biologics, as well as on who will not need early or even any biologics. For now, top-down biologics should be considered for patients with currently known high-risk factors of poor outcomes. For other patients, close, objective monitoring and accelerating the step-up process by means of a treat-to-target approach seems the best way to catch the therapeutic window in early pediatric Crohn's disease. The individual benefits of immunomodulator addition during early biologic treatment should be weighed against its risks and decision on early combination treatment should be made after comprehensive discussion with each patient and guardian.

발달장애아의 조기치료에 영향을 미치는 요인 분석 (Analysis of Factors Influencing on the Early Treatment of Children With Developmental Disability)

  • 박혜정;김선혜
    • 한국전문물리치료학회지
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    • 제6권1호
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    • pp.47-61
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    • 1999
  • The purpose of this study was to investigate factors influencing on the early treatment of children with developmental disability. Data was collected from 102 mothers of children with developmental disability who were treated at 4 rehabilitation facilities in Kyunggi-Do and Kangwon-Do. The results were as follows: 1) Of a total of 102, 63 children began to receive rehabilitation therapy during the period 0~12 months (early treatment group), 38 children after 1 year of age (delayed early treatment group). 2) There were statistically significant differences between the early treatment group and delayed early treatment group for prematurity, low birth weight, the time to discover developmental abnormalities, the time of first diagnosis, and first treatment (p<0.05). 3) There were no statistically significant differences in the two groups for level of education, economic status, risk factors (except prematurity and birth weight), home care, family's cooperation and commuting time (p>0.05). Based on this study, the important factors for early treatment were early detection, early diagnosis and constant follow-up for high-risk babies.

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Novel Directions in Adjuvant Chemotherapy for Early Stage Epithelial Ovarian Cancer

  • Sakarya, Derya Kilic;Yetimalar, M Hakan;Ozbasar, Demir
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권10호
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    • pp.4157-4160
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    • 2015
  • Treatment of early stage ovarian cancer remains controversial despite advances in chemotherapeutic options. Over the past 30 years, molecular and clinicopathologic studies accelerated and treatment of ovarian cancer has undoubtedly improved although there is a debate as to whether this impacts outcome or not. More recently, the introduction of targeted therapy started a new era. Probably it is because early stage disease comprises a small portion of the epithelial ovarian cancer, studies have mostly ignored this group and still there is no clear consensus regarding systemic treatment of early-stage lesions. However this group of patients has the best chance of cure. In this review, we focus on current developments in the treatment of early stage ovarian cancer and query the options.

뇌성마비의 조기치료에 관한 문헌적 고찰 - 최근 중의 잡지 중심으로 - (A Literary Review on Early Treatment of Cerebral Palsy - Centered on the Chinese Medical Journal -)

  • 곡수영;이승연;유선애
    • 대한한방소아과학회지
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    • 제22권3호
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    • pp.35-62
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    • 2008
  • Objectives : This study has been carried out to look into the methods of early treatment of cerebral palsy and the treatment effect by ages. Methods : The fifteen theses dealing with treatment effects by ages were analyzed, which were selected from the 121 theses retrieved out of the wu-ruan(五軟), wu-chi(五遲), wu-ying(五硬), naotan(腦癱), naoxing-tanhuan(腦性癱癱), during the period between the January 2004 to August 2008 by using the China Academic Journal(CAJ) of China National Knowledge Infrastructure(CNKI). Results : 1. Among the study objects in the 15 theses, it was identified that there were 1.97 times more boys with cerebral palsy than that of girls, and it appeared that there was no significant relationship between gender and the treatment. 2. The early treatment referred to the treatment which was carried out based on the early diagnosis within 6 months to one year after the birth. This is the time when the adaptability and plasticity of the brain are high, and it was found out that the treatment effective as babies are young. 3. For the treatment of cerebral palsy, the combination of Traditional Chinese and Western Medicine Therapy was more frequently used than the exclusive Chinese medical treatment method, and it was more effective. Especially in the case, the Chinese medical treatment was focused on the acupuncture and the Tuina Massage. Conclusions : 1. For the treatment of cerebral palsy, when the age between one and two years old was established as the standard. The younger the babies were, the higher treatment effects were obtained. 2. It appeared that the early treatment of oriental medicine had relatively excellent effects on cerebral palsy, but it turned out that we needed more studies for accurate results.

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악안면 형태학적 특성을 고려한 유치열기 반대교합의 치료 (ANTERIOR CROSSBITE CORRECTION FOLLOWING CRANIOFACIAL ORPHOLOGIC PATTERN IN THE EARLY DECIDUOUS DENTITION)

  • 진근호
    • 대한치과교정학회지
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    • 제23권1호
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    • pp.57-74
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    • 1993
  • Anterior crossbite is a common malocclusion in the early deciduous dentition. Even today, many these malocclusion patients are not treated until the mixed or permanent dentition. And the purpose here is to emphasize the need for early diagnosis and possible treatment for these anterior crossbite malocclusions and their associated facial patterns. Case histories of 4 patients selected from the author's practice are presented. Different methods of treatment are evaluated. Some improvement was achieved in all patients from an early interceptive regimen, although ultimately corrective orthodontic treatment may still be needed in some. It is concluded that early interception of deciduous anterior crossbite malocclusion should by attempted in patients ; there should be no delemma in reaching such a decision. And it is essential for diagnosis and treatment to determine exact variations in growth when some appliance are used, it is recommended that growth-related records be made as early as possible.

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Health Economics Evaluation of a Gastric Cancer Early Detection and Treatment Program in China

  • Li, Dan;Yuan, Yuan;Sun, Li-Ping;Fang, Xue;Zhou, Bao-Sen
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권13호
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    • pp.5133-5136
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    • 2014
  • Objective: To use health economics methodology to assess the screening program on gastric cancer in Zhuanghe, China, so as to provide the basis for health decision on expanding the program of early detection and treatment. Materials and Methods: The expense of an early detection and treatment program for gastric cancer in patients found by screening, and also costs of traditional treatment in a hospital of Zhuanghe were assessed. Three major techniques of medical economics, namely cost-effective analysis (CEA), cost-benefit analysis (CBA) and cost-utility analysis (CUA), were used to assess the screening program. Results: Results from CEA showed that investing every 25, 235 Yuan on screening program in Zhuanghe area, one gastric cancer patient could be saved. Data from CUA showed that it was cost 1, 370 Yuan per QALY saved. Results from CBA showed that: the total cost was 1,945,206 Yuan with a benefit as 8,669,709 Yuan and an CBR of 4.46. Conclusions: The early detection and treatment program of gastric cancer appears economic and society-beneficial. We suggest that it should be carry out in more high risk areas for gastric cancer.

Early Detection is Important to Reduce the Economic Burden of Gastric Cancer

  • Kim, Jie-Hyun;Kim, Sung Soo;Lee, Jeong Hoon;Jung, Da Hyun;Cheung, Dae Young;Chung, Woo-Chul;Park, Soo-Heon
    • Journal of Gastric Cancer
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    • 제18권1호
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    • pp.82-89
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    • 2018
  • Purpose: Early detection of gastric cancer is important to improve prognosis. Early detection enables local treatment, such as endoscopic submucosal dissection (ESD). Therefore, we investigated whether early detection of gastric cancer could reduce healthcare costs by comparison according to stage and treatment modalities. Materials and Methods: Medical care costs were investigated according to tumor stage and initial treatment modality in 1,188 patients newly diagnosed with gastric cancer at 7 medical institutions from December 2011 to June 2012. Total medical care costs during the first-year after diagnosis (total first-year costs) were examined, including the costs of initial treatment, post-initial treatment, and inpatient and outpatient visits. Results: Stage I (75.3%) was the most common cancer stage. ESD was the second most common treatment following surgery. Total first-year costs increased significantly from stages I to IV. The costs of initial treatment and post-initial treatment were lowest in patients with stage I cancer. Among patients with stage I cancer, total first-year costs were significantly lower when treated by ESD; in particular, initial ESD treatment costs were much lower than others. Conclusions: The cost of healthcare has increased significantly with increasing cancer stages. ESD can greatly reduce medical care costs of gastric cancer. Thus, early detection of gastric cancer is important to reduce healthcare costs.

임신초기 교통사고로 입원한 환자 3례에 대한 경과보고 (Three Cases Report of Patients Caused by Traffic Accident during Early Pregnancy)

  • 이승혜;박영선;김동철
    • 대한한방부인과학회지
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    • 제23권4호
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    • pp.187-195
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    • 2010
  • Purpose: The purpose of this report is to report the clinical application and safety of oriental treatment to pain and symptoms caused by traffic accident during early pregnancy. Methods: The three patients who suffered from several pain and symptoms caused by traffic accident during early pregnancy were treated with herbal medicine, acupuncture, moxibustion, cupping therapy and physical treatment during their admission. And we followed up by phone call after their delivery. Results: Patients' pain and symptoms of this case were improved with oriental treatment during their admission. And serious side effects were not found on the patients and infants after treatment. Conclusion: This report shows that oriental treatment can be effective for those who suffering from several pain and symptoms caused by traffic accident during early pregnancy.

Change in the treatment strategy for pediatric Crohn's disease

  • Kim, Mi-Jin;Choe, Yon-Ho
    • Clinical and Experimental Pediatrics
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    • 제53권9호
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    • pp.830-833
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    • 2010
  • Crohn's disease is characterized by chronic inflammation involving any portion of the gastrointestinal tract. Treating Crohn's disease is a major challenge for clinicians, as no curative therapy currently exists. Pediatric Crohn's disease is characterized by frequent relapses, a wide extent of disease, a high prevalence of extraintestinal manifestations, and a severe clinical course. The classic therapeutic approach is known as the 'step-up' strategy, and follows a progressive course of treatment intensification as disease severity increases. Although this approach is usually effective for symptom control, many patients become either resistant to or dependent on corticosteroids. The efficacy of infliximab suggests that, rather than a progressive course of treatment, early intense induction may reduce complications associated with conventional treatment and improve quality of life. Intensive early therapy with infliximab is known as the 'top-down' strategy. Such therapy offers the potential for altering the natural history of Crohn's disease, and is changing treatment paradigms. However, the relatively new concept of an early aggressive or 'top-down' treatment approach is not yet widely accepted, especially in pediatric patients. The results of our current study demonstrate that early and intensive treatment of pediatric Crohn's disease patients with infliximab, at initial diagnosis, was more effective for maintaining remission and reducing flares.

Early Intervention for Low-Temperature Burns: Comparison between Early and Late Hospital Visit Patients

  • Choi, Matthew Seung Suk;Lee, Ho Joon;Lee, Jang Hyun
    • Archives of Plastic Surgery
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    • 제42권2호
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    • pp.173-178
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    • 2015
  • Background Various focal heating devices are popular in Korea under the cultural influence of the traditional ondol under-floor method of home heating. These devices can cause severe burn-like injuries resulting from device malfunction or extended with low heat contact. In addition to injuries under these high heat contact, burns can be occurred by low heat exposure with prolonged periods despite the devices are properly functioning. In order to develop strategies to reduce the duration of periods of illness due to low-temperature burns, we analyzed and compared treatment methods and therapeutic periods for this type of injury. Methods This retrospective study included 43 patients burned under low heat conditions. Patients were divided into an operative group and a conservative group. The patients in the operative group underwent at least one surgical excision, and were further subdivided into early and late visit groups. The conservative group was treated only with dressings. We compared the treatment periods between the operative group and the conservative group, and also compared the preparation periods and treatment periods between the two operative groups. Results The average treatment period was significantly shorter in the operative group (P=0.02). In the early visit operative group, both wound preparation and treatment were briefer than in the late visit group. Conclusions We recommend that early proper burn care and early surgical intervention, including appropriate excision, are feasible ways to reduce the treatment period of lowtemperature burn patients.