ABSTRACT
Coronavirus disease 2019 (COVID-19) has been spreading globally since 2019；however, comprehensive rehabilitation of elderly patients with COVID-19 pneumonia remains a challenge. A 76-year-old American woman with COVID-19 pneumonia was admitted to our hospital. Because her disease was complicated by acute respiratory distress syndrome (ARDS), she was treated with intensive care, including invasive ventilation and extracorporeal membrane oxygenation (ECMO). During and after intensive care, she exhibited physical symptoms such as weakness, pain, shortness of breath, and difficulty in movement and exercise. Furthermore, during approximately 3.5 months of hospitalization, she received swallowing and speech therapies along with physical therapy. These rehabilitation therapies enabled her to get home in the United States. Her rehabilitation schedule had to be carefully planned according to her symptoms and infectiousness of COVID-19. This paper highlights few important points regarding the difficulty in rehabilitation including that of physical function, mental health, and cognitive function of patients with COVID-19. Furthermore, this report provides a problem-solving approach for long-term rehabilitation in elderly patients with COVID-19 pneumonia.
ABSTRACT
We report two cases effectively treated with Kampo medicines for comorbid sleep disorder in developmental disorder. Case 1 was a 15-year-old woman diagnosed Asperger's syndrome, and her main complaints were difficulty in rising, difficulty in falling asleep and fatigability. We thought that the symptoms might be caused by in and ketsu deficiency, which lost control of kanki hyperactivity and evoked tension/excitement state easily. The difficulty in rising was improved with yokukansan and kambakutaisoto and she was able to go to school every day. Case 2 was a 17-year-old man diagnosed the attention-deficit/hyperactivity disorder. His symptoms were difficulty in rising, feeling of weariness, fatigability, and frequent tension/excitement state. The previous use of shokenchuto had improved the symptoms slightly. After shigyakusan was added to cure kanki dysregulation, he succeeded in going to school every day. In the oriental medicine, ketsu has important roles in mental stability and sleep, whereas qi and ketsu tend to be insufficient in childhood. Our results suggest that replacement of in and ketsu would be useful in treating comorbidities in developmental disorder.
ABSTRACT
Kyukichoketsuin is commonly used for <i>ki</i>-deficiency and <i>ketsu</i>-deficiency, especially postpartum physical and mental complaints. However it does not contain <i>ninjin </i>and <i>ogi</i>, which are actually known to be major crude drugs for <i>ki</i>-deficiency. The 16th century <i>Manbyokaishun </i>gives many ways of treatment, some including the use of <i>ninjin </i>and <i>ogi </i>with kyukichoketsuin.<br>We report 2 cases treated with kyukichoketsuin and hokizai. The first case was a 33-year-old woman who had dyspnea with exertion and general malaise undergoing treatment for amenorrhea. The second case was a 39-year-old woman who had fatigue, irregular menstruation and headache after childbirth. We treated the first with kyukichoketsuin and hochuekkito extract, and the second with kyukichoketsuin and rikkunshito extract. In both cases, the symptoms improved remarkably over a few weeks with kyuchichoketsuin and hokizai. Thus, this combination therapy may have efficacy for gynecological symptoms with remarkable signs of <i>ki</i>-deficiency.