• 대한이식학회지
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• 제32권4호
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• pp.92-103
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• 2018

Background: Currently, trimethoprim-sulfamethoxazole is used for Pneumocystis jirovecii pneumonia (PJP) prophylaxis, but it is associated with frequent adverse effects. This study evaluated the efficacy and safety of the current protocol and proposes an individualized risk-based prophylaxis protocol. Methods: The PJP incidence and risk factors during the first 6 months (early PJP) and afterwards (late PJP) was assessed in renal transplant recipients with (prophylaxis group) and without (no-prophylaxis group) 6-month PJP prophylaxis. Results: In 578 patients, there were 39 cases of PJP during a median follow-up of 51 months. Renal adverse events were encountered frequently during trimethoprim-sulfamethoxazole prophylaxis, leading to premature discontinuation. Patients without the prophylaxis had a significantly higher incidence of early PJP (n=27, 6.6%) compared to patients with the prophylaxis (n=0). The incidence of late PJP was 2.2%, without between-group differences. The factors associated with early PJP were preoperative desensitization and acute rejection within 1 month, whereas late PJP was associated with age, deceased donor transplant, and acute rejection requiring antithymocyte globulin treatment. Conclusions: Based on the simulation results of several risk-based scenarios, the authors recommend universal prophylaxis up to 6 months post-transplant and extended selective prophylaxis in patients aged ${\geq}57$ years and those with a transplant from deceased donors.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제26권5호
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• pp.231-238
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• 2023

Purpose: This systematic review and meta-analysis aimed to compare endoscopy as primary versus secondary prophylaxis to prevent future bleeding in children with esophageal varices. Methods: A systematic literature search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method was conducted using the Scopus, PubMed, and Cochrane databases for relevant studies on the outcome of rebleeding events after endoscopy in primary prophylaxis compared to that in secondary prophylaxis. The following keywords were used: esophageal varices, children, endoscopy, primary prophylaxis and bleeding. The quality of eligible articles was assessed using the Newcastle-Ottawa Scale and statistically analyzed using RevMan 5.4 software. Results: A total of 174 children were included from four eligible articles. All four studies were considered of high-quality based on the Newcastle-Ottawa Quality Assessment Scale. Patients who received primary prophylaxis had 79% lower odds of bleeding than those who received secondary prophylaxis (odds ratio, 0.21; 95% confidence interval [CI], 0.07-0.66; I²=0%, p=0.008). Patients in the primary prophylaxis group underwent fewer endoscopic procedures to eradicate varices than those in the secondary prophylaxis group, with a mean difference of 1.73 (95% CI, 0.91-2.56; I²=62%, p<0.0001). Conclusion: Children with high-risk varices who underwent primary prophylaxis were less likely to experience future bleeding episodes and required fewer endoscopic procedures to eradicate the varices than children who underwent secondary prophylaxis.

• Clinical and Experimental Pediatrics
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• 제56권7호
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• pp.291-297
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• 2013

Purpose: The aim of this study was to investigate prophylactic treatment effects in Korean patients with severe hemophilia A. Methods: A prospective study of 32 severe hemophilia A patients was conducted with the approval of the Institutional Review Board at the Eulji University Hospital. Two patients received primary prophylaxis; whereas, the other 30 patients were divided into 2 groups-secondary prophylaxis (n=15) and on-demand (n=15)-on the basis of their consent for secondary prophylaxis. A 20-25 IU/kg dose of factor VIII concentrate was administered to the primary and secondary prophylaxis group patients every 3 days for 1 year. The prophylactic effect was evaluated by observing changes in the Pettersson scores, annual number of total and joint bleeds, and factor VIII consumption for 1 year. Results: No moderate or severe bleeding was observed, and the Pettersson scores remained unchanged during the prophylaxis period in the patients who received primary prophylactic treatment. After the treatment was changed from on-demand to secondary prophylaxis, the annual number of total and joint bleeds in the secondary prophylaxis group decreased by $64.4%{\pm}13.0%$ and $70.0%{\pm}15.2%$, respectively. The average increase in Pettersson scores within 1 year was $0.5{\pm}0.8$ and $1.3{\pm}1.1$ in the secondary prophylaxis and on-demand groups, respectively. Prophylactic effects were also observed in patients >17 years who had nearly the same initial Pettersson scores. Conclusion: Intermediate-dose prophylactic treatment may delay hemarthropathy progression and prevent its occurrence in Korean severe hemophilia A patients.

• Clinical and Experimental Pediatrics
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• 제64권4호
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• pp.172-179
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• 2021

Background: Evidence shows that fluconazole prophylaxis is an effective treatment against invasive fungal infections in preterm neonates, however, the most efficient schedule of fluconazole prophylaxis for the colonization and mortality of invasive candidiasis (IC) is unknown. Purpose: This systematic review and meta-analysis aimed to assess the efficiency of different prophylactic fluconazole schedules in controlling IC colonization, infection, and mortality in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants in neonatal intensive care units. Methods: We searched the PubMed, Scopus, Embase, and Cochrane databases using the keywords "candida," "invasive candidiasis," "IC," "fluconazole prophylaxis," "preterm infants," "very low birth weight infants," "VLBW," "extremely low birth weight," and "ELBW." Results: Mortality was significantly decreased in a meta-analysis of studies using different fluconazole prophylaxis regimens. The meta-analysis also indicated a significant decrease in the incidence of IC-associated mortality in ELBW infants using the same fluconazole prophylaxis schedules. Conclusion: Future studies should explore the effectiveness of other different fluconazole prophylaxis schedules on IC colonization, infection, and mortality.

• 한국치위생학회지
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• 제9권1호
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• pp.15-26
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• 2009

The purpose of this study was to prepare improved education guideline by grasping parts and items felt difficult to apply instruments by the students of the dental hygiene department in the practice of oral prophylaxis using manikin and analyzing factors influencing the satisfaction at the oral prophylaxis subject. To achieve this purpose, 285 senior students of the dental hygiene department located in the Kwangju. Jeonnam area who took theory and practice courses of oral prophylaxis but only practiced the manikin from the second semester of 1st year were selected as the subjects. The following results were obtained. 1. In the manikin, the most difficult part was maxillary anterior lingual in the use of explorer, sickle scaler, and universal curet, and maxillary right posterior lingual was in the use of gracey curet. In the dentiform, the most difficult item was instrument stroke in the use of explorer, sickle scaler, universal curet and gracey curet. 2. The highest stressor was the lack of knowledge and skill in practice of oral prophylaxis, followed by the lack of confidence, and difference between theory and practice in oral prophylaxis. The overall practice satisfaction was 3.23 at oral prophylaxis. The highest satisfaction was found in patient and operator position(3.51), followed by basic skill(3.34), the way to use hand instrumentation(3.16), and the way to use oral examination instrumentation(3.01). 3. According to school records, satisfaction at oral prophylaxis practice satisfaction was 3.36 of good, 3.24 of fair, and 3.06 of poor, suggesting significant difference(p<0.05). Students who participated just in practice during a school term showed 3.47 of satisfaction. The highest satisfaction was found in a full-time professor as a professor in charge(3.24) and there was significant difference(p<0.05). 4. The highest correlated factor between oral prophylaxis theory and practice satisfaction was curriculum satisfaction. The use of hand instrumentation was found to have the greatest effect on the practice satisfaction at oral prophylaxis, followed by basic skill, the way of basic instrumentation, and position. There was statistically significant difference(p<0.01).

• 대한의용생체공학회:의공학회지
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• 제39권1호
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• pp.36-42
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• 2018

The risk of venous thromboembolism (VTE) is known higher in cancer patients and lower incidence in the east country. This study was conducted in order to check the incidence rate of VTE in the Korean high risk patients who are treated in the intensive care unit (ICU), and to verify the correlation of the incidence of VTE and prophylaxis methods. This study was conducted as a retrospective study for 492 cancer patients from April 2011 to December 2014. According to the medical records of subjects, their prophylaxis methods and the incidence of VTE were surveyed and then correlation of them was investigated with statistical methods. 385 patients met the inclusion criteria. VTE occrred in 17 of them (4.4%). The prophylaxis methods are consisted of medical method (136 subjects), mechnical method(33 subjects), and medical & mechnkcal method (124 subjects). VTE occurred in 14 patients (4.8%) from 293 patients (76%) who were given at least one prophylaxis method. From all of 93 patients without prophylaxis, three patients experienced VTE (3.3%). The target patients were high risk in VTE, but the incidence rate of VTE was lower than reported in previous studies. The reason of this is considered that more active prophylaxis intervention was applied to the subjects because of their high risk status. As a result, it is considered that in the high risk patients, it would be effective to apply active and complex prophylaxis intervention for the prevention of VTE.

• Clinical and Experimental Pediatrics
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• 제50권4호
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• pp.348-354
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• 2007

목 적 : B형 간염 바이러스 주산기 감염은 현재 감소하고 있지만 HBeAg 양성 산모로부터 분만된 신생아의 10%는 예방조치에도 불구하고 보유자가 된다. 비록 예방조치 실패의 원인이 아직 불확실하나 산모의 분만시 HBV-DNA 수치의 중요성이 제시되고 있다. 본 연구는 산모의 분만시 HBV-DNA 수치가 주산기 예방조치 결과의 유용한 예측인자임을 확인하기 위하여 시행하였다. 방 법 : 주산기 예방조치의 결과를 이미 알고 있는 29명의 HBeAg 양성 산모를 선정하였다. 산모의 HBV-DNA 양을 측정하기 위하여 WHO International Standard For Hepatitis B Virus DNA For NAT Assay를 이용한 정량적 PCR을 시행하였다. 결 과 : 주산기 예방조치 실패군 산모의 로그 HBV-DNA 수치가 성공군 산모의 수치보다 유의하게 높았다(7.99 vs. 6.72, P=0.015). 주산기 예방조치 결과를 예측할 수 있는 산모의 HBV-DNA 수치의 기준은 $2.83{\times}10^7$ 개체/mL(100 pg/mL)로 정할 수 있었는데, 산모의 HBV-DNA 수치가 기준치 미만인 16명 중 예방조치에 실패한 경우는 없었으며(0%), 기준치 이상인 경우는 13명 중 5명(38.5%)이 실패하였다. 결 론 : 현재의 예방조치법으로는 분만시 높은 HBV-DNA 수치를 가지는 산모의 주산기 예방조치 결과는 좋지 않을 가능성이 높다. 따라서 주산기 예방조치의 실패율을 낮추기 위해서는 이러한 위험요인이 있는 경우에 보다 강력한 방법을 적용시켜야 하겠다.

• 한국치위생학회지
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• 제6권3호
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• pp.187-201
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• 2006

The purpose of this study is to examine the satisfaction for college life and oral prophylaxis subject and improve the satisfaction for this subject by satisfying students' desire through the results of correlation, and to inspire a professional sense by helping students enjoy healthy college life. In order to achieve these purposes, 127 senior students of the Dental Hygiene Department, Kwangju Health College took part in this study to examine the satisfaction for a study course, a lab, professors, a college, and subjects. The following results were obtained. 1. The overall satisfaction for the Dental Hygiene Department was 2.83 and the highest dissatisfaction factors included difficult subjects and non-aptitude. The overall satisfaction for professors was 3.33 and students wanted professors' human contact with students and a well-prepared lecture. The overall satisfaction for college life was 2.65, suggesting not very high satisfaction, and the highest dissatisfaction factors included similar life to high school and surrounding environment. 2. The overall satisfaction for theory was 3.83 and for practice was 3.91 in oral prophylaxis. While the highest satisfaction was found in 'the objective and direction of class' and 'class and a supplementary lesson in not giving a lecture', the lowest satisfaction was found in 'experience in reading textbook-related materials or books'. 3. The correlation of the satisfaction of theory and practice of oral prophylaxis was examined. The satisfaction of oral prophylaxis theory was positively correlated with a school course, professors, and college, while the satisfaction of oral prophylaxis practice was positively correlated with a school course, professors, college, satisfaction of oral prophylaxis theory, and present health condition(p<0.05). 4. Factors influencing the satisfaction for the theory of oral prophylaxis included professors, while factors influencing the satisfaction for the practice were statistically significant in professors and health condition(p<0.05). Based on these results, in order for professional dental hygienists to be developed as professionals serving society, it is recommended to enhance the satisfaction for an oral prophylaxis subject and that professors should provide warm-hearted support and become a role model as an educator.

• Journal of Trauma and Injury
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• 제37권3호
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• pp.209-213
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• 2024

Purpose: Trauma patients are at an elevated risk of developing venous thromboembolism (VTE), with the subsequent mortality in patients requiring intensive care unit admission ranging from 25% to 38%. There remains significant variability in clinical practice related to VTE prophylaxis in trauma patients due to the frequent presence of contraindications impacting the timing and consistency of application. This study aimed to assess the effectiveness of the current practice of chemical VTE prophylaxis in trauma patients at a single Australian center. Methods: A prospective review was conducted on patients admitted to the ACT Trauma Service (Canberra, Australia) from July to November 2022. The included patients were 18 years or older, without a direct contraindication to anticoagulation, who received chemical VTE prophylaxis with low-molecular-weight heparin (enoxaparin) for at least three doses and underwent subsequent testing of anti-factor Xa (aFXa) levels. Results: During the study period, 187 patients were admitted, of whom 63 were included in the study. Of these, 47 patients achieved therapeutic levels of anticoagulation as determined by their aFXa levels, while 16 were subtherapeutic. The only statistically significant difference between the two groups was in weight, with patients in the subtherapeutic group weighing an average of 91.9 kg compared to 79.1 kg in the therapeutic group (P<0.05). Conclusions: A fixed-dose enoxaparin regimen was utilized, with limited individualization based on patient factors, such as injuries, comorbidities, and other biological factors. Sixteen patients (25%) had subtherapeutic VTE prophylaxis, as measured by aFXa levels. Higher weight was significantly correlated with inadequate VTE prophylaxis dosing. While age, sex, and smoking status might play important roles in clinical decision-making, weight-based dosing of low-molecular-weight heparin may be more effective in achieving adequate VTE prophylaxis.

• 대한한방내과학회지
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• 제40권4호
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• pp.637-648
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• 2019

Objective: The aim of this study was to investigate the effect of acupuncture on migraine prophylaxis. Method: Articles were searched from the online databases: PubMed, OASIS, NDSL, and RISS. The search keywords were "migraine prophylaxis" and "acupuncture." The inclusion criterion was randomized clinical trial. The exclusion criteria were in vivo, vitro, and review articles. Results: Eighty-nine articles were found among those published until March 2019. After reviewing the title, abstract, and original article, 10 articles were selected to show the effect of acupuncture for migraine prophylaxis. Conclusion: The effect of acupuncture for the frequency and number of days of a migraine and for the intensity of the pain seems to be effective, but the mechanism does not appear to be clear. Therefore, further research is needed in future acupuncture for migraine prevention.