• Title/Summary/Keyword: systemic symptom

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Adverse Drug Reactions with Oseltamivir Treatment in the South Korea Outbreak of 2009 Pandemic Influenza A(H1N1) (2009년 국내 신종플루 유행시기의 Oseltamivir 부작용 평가)

  • Do, Youn-A;Lee, Suk-Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.4
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    • pp.353-363
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    • 2011
  • The World Health Organization (WHO) declared the outbreak of H1N1 pandemic in 2009. South Korea also had outbreaks of H1N1 virus and used oseltamivir in large volume with increased reports of adverse drug reaction(ADR). The present study was aimed to investigate the ADR frequency, the factors related to ADR, and characteristics of oseltamivir's ADR. Participants for the study were patients randomly drawn from those who were prescribed oseltamivir for treatment from CHA Bundang Medical Center during October 1 and October 30. The information examined as factors related to ADR were collected by a subsequent cross-sectional telephone survey. The factors are the following; a) age; b) gender; c) patient medical history; d) diagnosis of H1N1 virus; e) adherence; f) whether taking other medication with oseltamivir or not; and g) the number of combined medications. We also asked ADR after taking oseltamivir. Total subjects were 86 patients. The average age is $22.6{\pm}18.48$ years old. The gender was 45.3% women and 54.7% men. Half (50%) of all respondents showed one or more ADR, 67.4% were positively diagnosed for H1N1 virus, and 54.7% were completed the full course of oseltamivir (i.e. twice daily x 5days). The most frequently reported ADR symptoms were: dizziness (15.1%), nausea (11.6%), lethargy (10.4%), diarrhea (10.4%), abdominal pain (8.1%), headache and vomiting (6.9%). ADR classifications by categories are gastro intestinal (44.2%), neuropsychiatric events (22.1%), systemic symptom (20.9%), skin events (5.8%), eye events (4.7%), and other cases (2.3%). The onset of ADR 'after taking 1~3 doses' was 69.7%. No increase in neuropsychiatric events was detected in children and adolescents. No factors examined for the study do have significant influence on the presence of ADR. This study showed that ADR of oseltamivir have occurred in half of the patients. The use of oseltamivir is essential for treatment and prophylaxis of influenza A(H1N1). But mass treatment should be properly monitored for ADR.

SWEET SYNDROME INITIALLY MANIFESTING ODONTOGENIC BUCCAL CELLULITIS; REPORT OF A CASE (치성 협부 봉와직염의 증상으로 발현된 Sweet 증후군; 증례 보고)

  • Kim, Yong-Jin;Byun, Soo-Hwan;Kim, Jun-Young;Ahn, Kang-Min;Jeon, Ju-Hong;Lee, Bu-Kyu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.6
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    • pp.538-542
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    • 2007
  • Sweet syndrome is characterized by acute onset of fever. neutrophilic leukocytosis, painful erythematous plaque on the face and extremities, infiltration of mature neutrophils in the dermis. Cutaneous lesion and clinical symptoms rapidly improve after treatment with systemic corticosteroids. The cause of sweet syndrome is unknown but the associations with hypersensitivity to bacteria, virus, or tumor antigen have been reported. Sweet syndrome itself can be a premonitory manifestation of malignancy, so diagnostic work up for other internal malignancy is recommended. Because of fever and leukocytosis, cutaneous infections are important differentials. Sweet syndrome can be divided into 4 categories according to associated disease and symptom. (Idiopathic Sweet syndrome, Parainflammatory Sweet syndrome, Paraneoplastic Sweet syndrome, Pregnacy associated Sweet syndrome.) Sweet syndrome is relatively rare disease and the association with myelodisplastic syndrome has been reported. We report a case of Sweet syndrome associated with myelodisplastic syndrome which has initial manifestation of odontogenic buccal cellulites.

Developing Telephone Guidelines for Symptom Management of Cancer for Outpatients with Cancer after Chemotherapy (항암화학요법 후 퇴원한 암 환자의 증상관리를 위한 전화상담 가이드라인 개발)

  • Park, Ihn Sook;Kim, Eun Mi;Oh, Pil Ju;Kim, Soo Jin;Kim, Hye Jin;Kim, Bo Kyung;Hwang, Eun Kyung;Park, Se Rim;Lee, Mi Jeong
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.2
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    • pp.317-328
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    • 2012
  • Purpose: This study was done to provide oncology nurses systemic guidelines designed to perform telephone counseling in outpatient settings treating patients with chemotherapy. Methods: Symptoms which are frequently questioned were identified through case reports recorded by 4 clinical nurse specialists from January 4 to December 31. 2010. Fifteen clinical experts and two hemato-oncologists reviewed the developed draft. Their opinions were synthesized to arrive at consensus on the ideal guidelines. This process confirmed content validity. The two hemato-oncologists also verified the face validity. Results: The six symptoms which were most frequently asked about were identified through 4,644 case reports and concerned pain, fever, skin alteration, nausea/vomiting, stomatitis and diarrhea. Evidence-based telephone triage guidelines for the 6 major symptoms in patients receiving chemotherapy were developed. Conclusion: These guidelines will help oncology nurses from novice to expert incorporate evidence-based telenursing into their practice.

Case Report : Temporomandibular Joint Involvement in Rheumatoid Arthritis (증례보고: 류마티스 관절염 환자에서 측두하악관절의 이환)

  • Lim, Hyun-Dae;Lee, You-Mee
    • Journal of Oral Medicine and Pain
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    • v.31 no.3
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    • pp.231-236
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    • 2006
  • Rheumatoid arthritis(RA) is an of autoimmune inflammatory systemic disease. It is characterized by uncontrolled proliferation of synovial tissue and a wide array multisystem comorbidities. The disease may involve any joint of the body, but often statrs in the peripheral joints. It was reported that more than 50% of RA patients exhibit clinical involvement of TMJ. This report is a case report of dental management and progression for 16 months in patients who had severe bony change in TMJ involved rheumatoid arthritis Dental management was included palliative treatment such as interocclusal splints, physical therapy, mouth opening exercise. Although it was progressed rapidly osteolytic bone change during follow-up, no more advanced occulsal change and improved symptom and jaw motion. Further investigations about rule of dentistry in TMJ involvement in RA maybe needed.

Transfusion Associated Graft-Versus-Host Disease After Open Heart Surgery (개심술 후 발생한 수혈 관련 이식편대숙주병 -1례 보고-)

  • 전양빈;이창하;이재웅;박철현;박국양
    • Journal of Chest Surgery
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    • v.35 no.6
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    • pp.471-474
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    • 2002
  • Transfusion associated graft-versus-host disease is a rare but fatal disease reported after open heart surgeries mainly in Asian people. It can be prevented by pretransfusion gamma irradiation of the fresh whole blood. In this presentation, we report a case of transfusion associated graft-versus-host disease following coronary artery bypass surgery in a 61 year-old male patient. Postoperatively the patient was transfused urgently with 2 units of fresh whole blood from his two sons. He was discharged on postoperative 10 day with only symptom of mild diarrhea. Two days after discharge, he was readmitted because of persistent diarrhea, systemic erythema and high fever. On laboratory examinations, he showed findings of failure in liver, kidney, gastrointestinal tract, and bone marrow. Hemodynamically he deteriorated acutely and died of multiple organ failure on 17th postoperative day. This has been our first experience since we started open heart program at our hospital and we changed our policy for the transfusion of the fresh whole blood after this event.

Allopurinol-induced severe cutaneous adverse reactions: A report of three cases with the HLA-B58:01 allele who underwent lymphocyte activation test

  • Kim, Eun-Young;Seol, Jung Eun;Choi, Jae-Hyeog;Kim, Na-Yul;Shin, Jae-Gook
    • Translational and Clinical Pharmacology
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    • v.25 no.2
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    • pp.63-66
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    • 2017
  • Allopurinol-induced severe cutaneous adverse reactions (SCARs) such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome are reportedly associated with the $HLA-B^{\star}58:01$ genotype. Three patients who developed SCARs after allopurinol administration were subjected to HLA-B genotyping and lymphocyte activation test (LAT) to evaluate genetic risk and to detect the causative agent, respectively. All three patients given allopurinol to treat gout were diagnosed with DRESS syndrome. Symptom onset commenced 7-24 days after drug exposure; the patients took allopurinol (100-200 mg/d) for 2-30 days. HLA-B genotyping was performed using a polymerase chain reaction (PCR)-sequence-based typing (SBT) method. All patients had a single $HLA-B^{\star}58:01$ allele: $HLA-B^{\star}13:02/^{\star}58:01$ (a 63-year-old male), $HLA-B^{\star}48:01/^{\star}58:01$ (a 71-year-old female), and $HLA-B^{\star}44:03/^{\star}58:01$ (a 22-year-old male). Only the last patient yielded a positive LAT result, confirming that allopurinol was the causative agent. These findings suggest that patients with $HLA-B^{\star}58:01$ may develop SCARs upon allopurinol administration. Therefore, HLA-B genotyping could be helpful in preventing serious problems attributable to allopurinol treatment, although PCR-SBT HLA-B genotyping is time consuming. A simple genotyping test is required in practice. LAT may help to identify a causative agent.

Oral symptoms experienced by adolescents based on Body Mass Index (체질량지수에 따른 청소년의 구강증상 경험)

  • Kim, Young-Suk
    • Journal of the Korea Convergence Society
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    • v.12 no.3
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    • pp.317-323
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    • 2021
  • The purpose of this study was to analyze the oral symptoms experienced by adolescents according to Body Mass Index. We analyzed the data using the Korea Youth Risk Behavior Web-based Survey and conducted complex-sample descriptive statistics on 55,728 participants. The prevalence of sensitive teeth, tooth pain, gingival bleeding, and swelling was highest in the overweight group (36.8%, 23.9%, and 19.2%) and lowest in the underweight group (34.6%, 20.8%, and 17.0%) (p<0.001). Tooth pain, gingival bleeding, and swelling were significantly higher (all 1.08) in the overweight group than in the normal group. Halitosis was 1.19-and 1.43-higher in the overweight and obese groups, respectively. The relationship between systemic diseases and oral health among adolescents should be further investigated.

Symptomatic Temporomandibular Joint Herniation through the Foramen of Huschke: A Case Report

  • Song, Hee-Jeong;Lee, Yuni;Choi, Hang-Moon;Kim, Young-Jun;Kim, Cheul;Park, Moon-Soo
    • Journal of Oral Medicine and Pain
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    • v.46 no.4
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    • pp.161-164
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    • 2021
  • The foramen of Huschke (FH) or foramen tympanicum is a persistent bony defect connecting the external auditory canal (EAC) to the temporomandibular joint (TMJ). It arises from an incomplete ossification of the tympanic part of the temporal bone that persists after the age of 5. If a herniation exists in the TMJ, otological symptoms may occur. An 80-year-old female patient complained of noise in her left TMJ and otorrhea in her left ear. On her cone beam computed tomography images, there were only degenerative joint disease signs on her left mandibular condyle. However, her computed tomography images revealed that the soft tissue of the TMJ herniate into the EAC. Additional examination was planned for the further evaluation. But the patient no longer visited the hospital due to her systemic health status, and symptoms disappeared spontaneously without any treatments. Usually this type of herniation is very rare, but years of mechanical stress from mastication may result in weakening and widening of the foramen with age. Therefore, although FH is usually congenital, sometimes it may be acquired in the elderly. The treatment plan should be determined in consideration of the patient's symptom level and the patient's general health status. If the clinical symptoms are not severe, no treatment is required.

Retrospective Statistical Analysis on Patients Admitted to a Korean Medicine Hospital by Traffic Accident (교통사고로 한방병원에 입원한 환자에 대한 후향적 통계 분석)

  • Kim, Hong-Kyoung;Kim, Jeong-il;Kim, Young-il
    • The Journal of Korean Medicine
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    • v.42 no.1
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    • pp.26-45
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    • 2021
  • Objectives: The purpose of this study was to investigate characteristics of patients who were admitted to an oriental medicine hospital by traffic accident. Methods: The medical charts of 346 patients admitted to an oriental medicine hospital from June 1, 2017 to May 31, 2018 were analyzed. The Numbering Rating Scale (NRS) and duration of hospitalization were used to evaluate characteristics of the patients. Results: Acupuncture, Moxibustion, Infralux were used to treat all the patients. The most frequently used herbal medication was Danggwisu-san(22.25%). 87 patients(25.14%) visited the outpatient department after being discharged from the hospital. The most frequent complaint in terms of pain was cervical pain(82.7%) and of systemic symptom was headache(23.7%). Men and younger aged patients showed higher therapeutic effect than women and older ages. The most common duration of hospitalization was 2~4 days(42.73%) and positively correlated with therapeutic effect. The most frequent interval between time of injury and visit to the hospital was from 0-1 days(68.90%) and showed no relationship with therapeutic effect. The most frequent admission pathway was "Directly to the hospital"(57.51%). Admission pathway was proportionally associated with duration of hospitalization and treatment results were not. The most common vehicle type involved in the traffic accidents was a sedan(72.25%), accident type was a rear-end collision(43.64%) and showed no relationship with therapeutic effect. Conclusions: In this study, therapeutic effects were highly correlated among men, younger ages, and duration of hospital stay, and was not for interval days, admission pathway, vehicle type, and accident type.

Diagnostic Usefulness of Digital Infrared Thermal Image in Carpal Tunnel Syndrome (수근관 증후군에서 적외선 체열 검사의 진단적 유용성)

  • Park, Jihyun;Lee, Jang Woo;Lee, Sang Eok;Kim, Byung Hee;Park, Dougho
    • Clinical Pain
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    • v.18 no.2
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    • pp.70-75
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    • 2019
  • Objective: The purpose of this study is to evaluate the usefulness of infrared thermography in patients with carpal tunnel syndrome by comparing with electrodiagnostic and ultrasonographic findings. Method: From January 2014 to October 2017, electrodiagnosis, ultrasound, and digital infrared thermal image (DITI) of unilateral carpal tunnel syndrome diagnosed in a single hospital were retrospectively analyzed. The subjects with bilateral symptoms of carpal tunnel syndrome, peripheral vascular disease, diabetes, thyroid disease, fibromyalgia, rheumatic disease, systemic infection, inflammation, malignant tumor, and other musculoskeletal disorders such as finger osteoarthritis, peripheral neuropathy, cervical radiculopathy, and the previous history of surgery were excluded. Results: Of 53 patients diagnosed with carpal tunnel syndrome, 11 were male and 42 were female. The visual analogue scale was 4.9 ± 1.9, and the duration of symptom was 11.8 ± 12.5 months. There was no statistically significant difference in the body surface temperature between the unaffected and affected sides. The severity of symptoms, electrodiagnostic findings, and cross-sectional area of the median nerve significantly correlates to each other. The temperature difference between the second fingers of the affected and unaffected sides showed a weak correlation with the amplitude of sensory nerve action potential and onset latency of compound muscle action potential, when there was no significant correlation with the other parameters. Conclusion: The difference in temperature on the surface of the body, which can be confirmed by DITI, is little diagnostic value when DITI is performed in unilateral carpal tunnel syndrome patients, especially when compared with ultrasonography.