• Title/Summary/Keyword: pharmacotherapy

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Mindfulness-Based Therapy for Insomnia (마음챙김명상과 불면증)

  • Lee, Hwa-Young
    • Sleep Medicine and Psychophysiology
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    • v.28 no.1
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    • pp.13-17
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    • 2021
  • Sleep disturbance is a common health complaint affecting an estimated 10-25% of the general population. Pharmacotherapy is a traditional treatment and cognitive behavioral therapy is well demonstrated as an efficacious treatment for insomnia. There is a growing interest in the effectiveness of mindfulness meditation for sleep disturbed populations. Mindfulness involves focused, purposeful, nonjudgmental attention to a particular idea. In clinical application of mindfulness practice, mindfulness-based stress reduction and mindfulness-based cognitive therapy are used widely. Clinical trials support the effectiveness of meditation for the treatment of insomnia. The aim of this article is to review the effect of mindfulness meditation on insomnia.

Acute Malocclusion Related to Posterior Disc Displacement According to Complete Disc Tearing: Two Case Reports

  • Jo-Eun Park
    • Journal of Oral Medicine and Pain
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    • v.49 no.2
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    • pp.29-34
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    • 2024
  • Acute malocclusion can occur in conditions related to temporomandibular joint (TMJ) disorders. This report presents two cases of acute malocclusion related to posterior disc displacement according to complete disc tearing. A 65-year-old male and an 88-yearold female presented with TMJ pain and occlusal discrepancies. Clinical examination, computed tomography, and magnetic resonance imaging revealed complete disc tearing and posterior displacement of a partial disc fragment. Dental cast analysis revealed a slight anterior and lateral deviation of the mandible toward the non-affected side; however, clinically, significant occlusal changes were not observed. This was attributed to the displacement of a small disc fragment rather than the entire disc. Including the cases presented, most instances of complete disc tearing responded well to conservative treatment such as pharmacotherapy and physical therapy, resulting in pain alleviation, and residual occlusal changes were tolerable for the patients in their daily activities. However, persistent occlusal changes or severe chewing difficulty may require surgical intervention.

Recent Progression of Incretin-Based Obesity Treatment (인크레틴 기반 비만 치료제의 최근 발전 상황)

  • Dughyun Choi
    • The Korean Journal of Medicine
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    • v.99 no.2
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    • pp.78-83
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    • 2024
  • Incretin-based obesity treatments are making remarkable progress, marking a new era in the field of obesity pharmacotherapy. These treatments not only meet the long-standing demands for safety and sustainability in obesity medications but also go beyond, significantly improving complications associated with obesity, such as cardiovascular diseases. This review explores the advancement in obesity treatments through the latest research findings on semaglutide and tirzepatide, two incretin-based obesity treatments currently receiving considerable attention.

A Study of Temporomandibular Disorders and Food Intake Ability among Dental Clinic Outpatients (일부 치과 외래환자의 측두하악장애 실태와 음식섭취능력에 관한 연구)

  • Han, Se-Young;Yu, Ji-Su
    • Journal of dental hygiene science
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    • v.11 no.3
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    • pp.285-292
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    • 2011
  • The purpose of this study was to analyze and investigate temporomandibular disorders(TMD) and dental clinic outpatients by food intake ability to improve the quality of life. A survey of questionnaires with 208 subjects visiting a dental clinics located in Daejeon city from January to September in 2010 was performed. Analysis were performed with survey results, in which a symptoms of TMD, parafunctional habits and abnormal functions, food intake ability : 1. The main symptoms of TMD showed pain on TMJ(45.7%), pain on joint sound(45.2%), pain during chewing(41.3%), pain during mouth opening(38.0%), pain during non chewing(19.7%) and pain on joint dislocation(13.0%) in turn. 2. The symptoms of TMD by gender showed joint dislocation of 18.0% for male and 8.3% for female(p=0.038); pain on chewing of 49.0% for male and 34.3% for female(p=0.031), which were statistically significant. 3. The parafunctional habits and abnormal functions by gender showed clenching habit of 35.0% for male and 22.0% for female; bruxism of 21.0% for male and 9.3% for female, which were statistically significant. 4. The symptoms of TMD by age showed 52.8% of 27.8% for often and 25.0% for sometimes of 21-30 age in pain on TMJ, which were statistically significant(p=0.001). 5. The parafunctional habits and abnormal functions by age showed over 31 age of 48.3%, which were statistically significant(p=0.003). 6. The food intake ability by symptoms of TMD showed no joint sound(p=0.000), no pain on chewing(p=0.000) and without pain on TMJ(p=0.000), which were statistically significant. 7. The food intake ability by parafunctional habits and abnormal functions showed no clenching habit(p=0.000), no bruxism(p=0.000) and no headache, which were statistically significant. 8. The distribution type of operation by symptoms of TMD showed 30.8% of rest, 24.0% of physical medicine and 16.4% of pharmacotherapy. The pain on chewing showed 36.0% of pharmacotherapy; 52.4% of pain on TMJ for often and 40.5% for sometimes, in which pharmacotherapy and physical medicine were statistically significant(p=0.000). These results showed that management run parallel with survey for multiple factors in TMD we consider aspect of physical, social, physiology to enhance quality of life to increase food intake, construction of program for treatment and prevention because the individual differences need to be multifaceted, further research is suggested to continue.

A FOUR TO SEVEN YEAR FOLLOW-UP STUDY OF SYMPTOMS OF AUTISTIC CHILDREN IN TAEGU AND KYUNGPOOK PROVINCE (대구 ${\cdot}$ 경북지역 일부 자폐장애 환자의 4 ${\sim}$ 7년후 추적 연구 - 자폐장애의 증상 중심으로 -)

  • Jung, Chul-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.2
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    • pp.186-197
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    • 2000
  • This study evaluated the improvement of autistic symptoms during the 4-7 year follow-up in autistic children. Fifty subjects(44 males and 6 females whose age ranged between one to 13 years) diagnosed with DSM-III-R autistic disorder were included in this study. Their autistic symptoms were assessed with DSM-III-R diagnostic criteria of autistic disorder(grouped as A, B and C which include 5, 6 and 5 items respectively). The mean of follow-up duration was 6.4${\pm}$1.1 years. Symptoms between baseline and follow-up were examined according to treatment types, age, sex, IQ and physical problems of them were identified. There were statistically significant decreases of symptom items at follow-up as a whole and A, B and C, respectively. The most symptom decrease occurred in communication and followed social interaction, and activities and interests at follow-up assessment. Symptom items that decreased more than 50% at follow-up evaluation include A1, A2, A3 and B1, B2, B3, B4, B5, and C1, C3. Groups with special education only and combined treatment of special education and seizure pharmacotherapy showed better improvement of symptoms than the group with psychiatric pharmacotherapy with special education. Age was a significant factors in the improvement of symptoms. The author concluded that some autistic children improved with aging, therefore they should be treated actively with special education, pharmacothrapy and other scientific methods.

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Development of the Korean Practice Parameter for Adult Attention-Deficit/Hyperactivity Disorder

  • Bahn, Geon Ho;Lee, Young Sik;Yoo, Hanik K.;Kim, Eui-Jung;Park, Subin;Han, Doug Hyun;Hong, Minha;Kim, Bongseog;Lee, Soyoung Irene;Bhang, Soo Young;Lee, Seung Yup;Hong, Jin Pyo;Joung, Yoo-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.31 no.1
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    • pp.5-25
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    • 2020
  • Objectives: Adult attention-deficit/hyperactivity disorder (ADHD) is an important mental health problem that needs resolution, especially considering the high rates of ADHD continuation from childhood to adolescence/adulthood and the high prevalence of ADHD in adults. Adults with ADHD have lifelong negative impacts and require close monitoring with long-term follow-up. Hence, the establishment of a Korean practice parameter for adult ADHD is necessary to minimize discontinuation of treatment and enable information sharing among Korean mental health professionals. Methods: The Korean practice parameter was developed using an evidence-based approach consisting of expert consensus survey coupled with literature review. Results: According to the expert consensus survey, the most commonly used diagnostic methods were clinical psychiatric interview (20.66%) and self-report scales (19.25%) followed by attention (14.71%) and psychological tests (14.24%). Key evaluation instruments currently available in Korea are the World Health Organization Adult ADHD Self-Report Rating Scale, Korean Adult ADHD Rating Scale, Diagnostic Interview for ADHD in Adults, Barkley Deficits in Executive Functioning Scale for adults, Comprehensive Attention Test, Conners' Continuous Performance Test, and the subtests of Wechsler Adult Intelligence Scale, Digit Span and Letter-Number Sequencing. Although pharmacotherapy is recommended as the first-line of treatment for adult ADHD, we recommend that it be followed by a multimodal and multidisciplinary approach including psychoeducation, pharmacotherapy, cognitive behavior therapy and coaching. Conclusion: The Korean practice parameter introduces not only general information for the diagnosis and treatment of adult ADHD on a global scale, but also the process of diagnosis and treatment options tailored to the Korean population.

The Evaluation of Potential Hepatotoxicity by Calcium Channel Blockers, Renin-Angiotensin System Blockade and Diuretics (칼슘채널차단제, 레닌-안지오텐신시스템 차단제, 이뇨제의 잠재적 간독성 평가)

  • Kim, Jae Yun;Lee, Ok Sang;Jung, Sun Hoi;Lee, Hye-Suk;Lee, Chang Ho;Kim, Sang Geon;Lim, Sung Cil
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.4
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    • pp.330-339
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    • 2012
  • Background : Hypertension is treated with both lifestyle modification and pharmacotherapy. The Seventh Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7), published in 2003, provides a streamlined management approach to hypertension for the primary care physician. The JNC-7 is the gold standard also in Korea. According to the JNC-7, special therapeutic considerations are recommended for high-risk individuals with compelling indications. The presence of compelling indications in any given patient should be considered when selecting specific pharmacotherapy to treat hypertension. However, in patients with compelling indications, it is unknown that hepatotoxicity is caused by Calcium Channel Blocker (CCB), one of 1st anti-hypertensive drugs. Now, the CCB is the most used 1st anti-hypertensive drug in Korea Therefore, we evaluated the changes in blood liver function parameters (ALT, AST, Total bilirubin, serum albumin) for the study group. Methods : We randomly collected and retrospectively analyzed Electronic Medical Record data (n=28,788) of patients, and who took calcium channel blockers(non-dihydropyridines; diltiazem, verapamil, dihydropyridines; amlodipine, barnidipine, benidipine, clinidipine, efonidipine, felodipine, isradipine, lacidipine, lercanidipine, nicardipine, nifedipine, nimodipine), with having liver function tests (LFTs) from July 1st 2009 to June 30th 2010 at the Seoul National University Hospital in Korea. Control groups are two antihypertensive agents: RAS blockade (ARB; candesartan, irbesartan, losartan, olmesartan, telmisartan, valsartan, ACE-I; cilazapril, enalapril, fosinopril, imidapril, perindopril, ramipril) and, Diuretics (loop; furosemide, torsemide, thiazide; hydrochlorothiazide[HCTZ], indapamide). Patients not having LFT results at these three standard points of time(baseline, during, medication, and after finishing medication) were excluded. The collected data were analyzed by using the SPSS (Version12.0) and Microsoft Excel (Version2007). Results : 711 patients who were treated CCB (297), RAS blockade (232) or Diuretics (182) monotherapy were selected for the study. In selected patients, liver damage degree(changes of each LFTs value) was higher in diuretics group than other groups, followed by RAS blockade and CCB. In diuretics group's was loop-diuretics group was higher than thiazide-diuretics group. In CCB group, Nondihydropyridine-CCB's damage degree was higher than Dihydropyrine-CCB's that. Conclusions : Despite the limitations due to the retrospective study, among patients with abnormal LFTs, the use of CCBs led to a less liver damage than other 1st anti-hypertensive agents. It can be recommended CCBs as one of the initial treatments of hypertension in patients with liver disease.

A CASE OF PERVASIVE DEVELOPMENTAL DISORDER NOS WITH REPETATIVE SELF-INJURIOUS BEHAVIOR (반복적으로 머리를 때리는 전반성발달장애 환아 1례)

  • Kim, Jeong-Lim;Chung, Bo-In;Cho, Soo-Churl;Hong, Kang-E;Lim, Myung-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.2
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    • pp.244-251
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    • 1999
  • Self-injurious behavior is often showed in mental retardation, especially in autism. Self-injurious behavior has been regarded as a symptom cluster rather than a disease but it is an emergent clinical situation that can directly affect mortality. This case is about a refractory autistic patient who showed a self-injurious behavior of hitting the head repetitively. He was hospitalized and was treated by pharmacotherapy and behavior therapy and for this reason this clinical experience is reported with literature review. The patient is a 7-year old boy who was ward admitted from 1999 April 20 till July 10 into OO hospital OO ward because of self-injurious behavior. During the 12 weeks he had admission treatment. As for the pharmacotherapy, haloperidol was dosed up from 0.5mg to 1.0mg from the 4th week and combination drug therapy was done during the admission with naltrexone 25-50mg. As for the behavioral therapy, Differential Reinforcement of Other behavior was used and regular play therapy was done. To remove the physical restraint, headgear and hard sleeve was used. Currently, OPD follow up treatment is being done and haloperidol 0.5mg and naltrexone 50mg is maintained. The patient’s mother is educated and play therapy is done an hour daily at home. When the patient was released form the hospital, self-injurious behavior was decreased more than the moderate state and remission state is still being maintained at the outpatient clinic.

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Pharmacotherapy for Patients Complaining With Somatic Symptoms (신체증상을 호소하는 환자의 약물치료)

  • Lee, Kyung-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.95-101
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    • 2021
  • Patients complaining with somatic symptoms are very common in clinical practice, and are often consulted to medical department. But it is difficult to treat well. The treatment of somatic symptom disorder is multi-modal as none of the methods on their own provide a satisfactory outcome. The treatment of somatic symptoms disorders is complicated by lack of boundary, conceptual clarity, and overemphasis on psychosocial causation and effectiveness of psychological treatments. In clinical practice all classes of psychotropics are used to treat somatic symptoms disorder. Drugs such as tricyclic antidepressants, serotonin reuptake inibitors(SSRI), serotonin and noradrenalin reuptake inhibitors (SNRI), atypical antipsychotics are studied. The evidence indicates that these drugs are effective in somatic symptom disorders. All classes of antidepressants seem to be effective against somatic symptom disorders. SSRIs are more effective against hypochondriasis and body dysmorphic disorder, and SNRIs appear to be more effective than other antidepressants when pain is predominant. The author suggest that psychiatrists should know how to treat patients complaining with somatic symptoms by using not only psychotherapeutic approach but also pharmacological treatment. It will be helpful to reduce suffering and increase quality of life of these patients.

The Clinical Observation on 5 Cases of Patient with Hemifacial Spasm (편측안면경련 환자 5 예에 대한 증례보고(證例報告))

  • Cho, Hyun-Seok;Choi, Yoo-Haeng;Jang, Jun-Hyouk
    • Journal of Acupuncture Research
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    • v.17 no.4
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    • pp.188-199
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    • 2000
  • In the treatment of hemifacial spasm, the operative methods, such as neurovascular decompression, rhizotomy etc. are the most efficacious therapy on its control. But, due to some side effects and complication, pharmacotherapy has been the first attempted by first intention of hemifacial spasm. The cabamazepine is the most commonly used agent, however it is often inefficacious in some cases, and attenuates as the time passes, engages in some symptoms, such as dizziness, nausea, vomiting, and causes an aplastic anemia, it has many deficiencies in becoming the first intention. Acupuncture is a simple, effective and conservative spasm control modality. It is so simple to use in hemifacial spasm. We had observed 5 cases of hemifacial spasm which were treated by acupuncture in our hospital recently. We reported these cases and reviewed related literatures briefly. The results of treatment are as follows : The average grade of spasm intensity classified by Scott's description was 3 before acu-therapy and it became 2 after the therapy. These results suggest that acupuncture and ear-acupuncture were effective as the first intention in healing hemifacial spasm.

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