Open-Label Observational Study for Evaluating the Short-term Benefits of Rabeprazole Medication on Laryngopharyngeal Reflux

OBJECTIVES: The aims of this study were to determine the benefits of short-term empirical proton pump inhibitor (PPI) medication on laryngopharyngeal reflux (LPR) and to determine whether scores on the reflux symptom index (RSI) and the reflux finding score (RFS) could be combined to identify subgroups of patients that will more likely to improve with this medication. METHODS: Fifty-one Korean Otolaryngology Board-certified specialists joined this prospective, multi-center, and open-label observational study. A total of 1,142 adult patients with LPR was enrolled for 12 weeks of rabeprazol medication. According to pre-treatment scores on RSI and RFS, patients were divided into 4 subgroups. RFS and RSI were measured repeatedly with a month interval along the treatment period. Changes of RSI and RFS were analyzed in an overall study cohort as well as in each subgroup. RESULTS: Approximately 40% (n=455) of enrolled patients were followed up until 12 weeks of PPI treatment. Significant improvement in RSI was obtained in 29%, 58%, and 75% of patients after 4, 8, and 12 weeks of PPI medication. RFS was improved in 16%, 42%, and 57% of the patients with 4, 8, and 12 weeks of PPI medication. All subgroups showed improvement regardless of their pre-treatment scores on the RSI and RFS. CONCLUSION: Even though RSI and RFS may be used as a general guideline for LPR management, pre-treatment RSI and RFS are not useful in predicting the patients' response to short-term PPI medication in the usual pattern of practice for LPR, which is mostly based on the physical evaluation and history taking.

Psicoterapia breve operacionalizada e crise por expectativa de perda: um estudo de caso / Operationalized short term therapy and crisis by expectation of loss: a case study

O presente artigo propõe ilustrar o tratamento de um paciente em situação de crise por expectativa de perda com a utilização do método da Psicoterapia Breve Operacionalizada (PBO). A partir de um estudo de caso, aplicou-se a Escala Diagnóstica Adaptativa Operacionalizada (EDAO) como instrumento diagnóstico, no início e no fim da PBO de uma paciente. O arsenal conceitual e instrumental constitutivos da EDAO e da PBO demonstrou relevante importância na prática da psicoterapia breve, uma vez que oferece meios de identificar e atuar com eficiência em situações em que a paciente experimentava crise por expectativa de perda. A técnica utilizada possibilitou o atendimento em suas necessidades emergenciais, o que resultou na redução da intensidade da crise. A ajuda pontual e focada na situação de crise permitiu que a paciente pudesse fazer uso de seus recursos elaborativos, sem se precipitar numa atuação destrutiva que poderia colocar em risco a realização de seu desejo.

This article proposes to illustrate the treatment procedure within a case of expectation of loss, based on theoretical reference of Operationalized Short Term Therapy (OSTT). From a case study, Operationalized Adaptative Diagnostic Scale (OADS) was applied as a diagnostic tool at the beginning and at the end of patient’s treatment. The conceptual and instrumental arsenal that constitutes OADS and OSTT showed relevant importance on the practice of short term psychotherapy, since it provides means to identify and act effectively in situations where the patient is experiencing crisis by expectation of loss. This technique allowed the care in her emergency needs, resulting in the reduction of the crisis intensity. The aid focused on the crisis allowed the patient to make use of its elaborative resources, without rushing into a destructive action that could endanger the accomplishment of its desire.

Two cases of endobronchial actinomycosis that were cured by bronchoscopic removal and short-term antibiotic therapy / 대한내과학회지

Actinomycosis is an uncommon, chronic granulomatous, suppurative disease related to Actinomyces israelii, which is a natural inhabitant of the oropharyngeal cavity and the major human pathogen of actinomycosis. In the past, dramatic presentation of thoracic actinomycosis, in conjunction with prominent chest pain and cutaneous fistulas that discharge sulfur granules, has frequently been reported. However, more recent data indicate that chest wall or rib involvement is now much less common than was previously encountered. This could result in more favorable responses to short-term intravenous antibiotic therapy. Foreign-body-associated actinomycosis is a very rare type of thoracic actinomycosis. We report two cases of endobronchial actinomycosis associated with a foreign body. In both cases, the foreign body was successfully removed by bronchoscopy. Each patient was treated with antibiotics for about 70 days. The duration of antibiotic therapy was relatively short, as compared to conventional therapy. Nevertheless, there was no recurrence or complications over 1 year.

The Efficacy and Safety of Short-term Therapy with Itraconazole Melt-Extrusion Tablet in The Hyperkeratotic Type of Tinea Pedis and/or Tinea Manus / 대한의진균학회지

BACKGROUND: The many antifungal agents have been used in fungal infections. In usual trial agents, itraconazole still remains difficult to absorption in gastrointestinal tract. OBJECTIVE: The purpose of this study is to evaluate the clinical efficacy and adverse reactions of short-term itraconazole melt-extrusion tablet increased in hyperkeratotic type of tinea pedis and/or tinea mauns. METHODS: From November 1998 to February 1999, a total of 60 patients with palmoplantar type of tinea pedis and/or tinea manus at Department of Dermatology of 5 general hospital, were enrolled in a subject group for the study. Itraconazole melt-extrusion tablet was administered, 200mg twice daily, in one week. Clinical symptoms and signs with mycological findings were assessed. RESULTS: Fifty-six patients (male 33, female 23; mean age 36.1+/-10.7; mean duration 6.5+/-4.8) completed the follow-ups. Direct KOH smear examination was positive in all them. Decrease in initial percentages of patients showing symptoms at the last follow-up 2 months after starting therapy: for scale, from 100% to 85.4%; for ertyema, from 91.1% to 10.7%; for hyperkeratosis from 100% to 32.3%; for pruritus, from 82.1% to 10.7%. Mycologic cure rate was 92.9% at the last follow-up. Overall clinical responses evaluated at the last follow-up were 'cured' in 6 pathients(10.7%), 'markedly improved' in 38 patiendts(67.9%), making a clinical response rate of 78.6%. During therapy, transient epigastria pain and indigeastion developed in 5 patients(8.9%). CONCLUSION: With these results, itraconazole melt-extrusion table is considered an effective and safe treatment modality for hyperkeratotic type of tinea pedis and/or tinea manus.