RESUMO
Cerebrotendinous xanthomatosis is a rare autosomal recessive disease that involves multiple organs, including the peripheral nervous system. The present study is the first to report the ultrasonographic findings of peripheral nerves in a patient with cerebrotendinous xanthomatosis. The patient presented with bilateral Achilles tendon enlargement and foot hypesthesia. Sonographic examination revealed hypoechoic, swollen peripheral nerves with enlarged bilateral Achilles tendons. Since the ultrasonographic findings revealed peripheral involvement, the diagnosis of cerebrotendinous xanthomatosis was established after laboratory and genetic studies along with clinical findings.
Assuntos
Humanos , Tendão do Calcâneo , Diagnóstico , Pé , Hipestesia , Nervos Periféricos , Sistema Nervoso Periférico , Polineuropatias , Ultrassonografia , Xantomatose CerebrotendinosaRESUMO
OBJECTIVE: To develop the Korean version of the Cognitive Assessment Scale for Stroke Patients (K-CASP) and to evaluate the test reliability and validity of the K-CASP in stroke patients. METHODS: The original CASP was translated into Korean, back-translated into English, then reviewed and compared with the original version. Thirty-three stroke patients were assessed independently by two examiners using the K-CASP twice, with a one-day interval, for a total of four test results. To evaluate the reliability of the K-CASP, intra-class correlation coefficients were used. Pearson correlations were calculated and simple regression analyses performed with the Korean version of Mini-Mental State Examination (K-MMSE) and the aphasia quotient (AQ) to assess the validity. RESULTS: The mean score was 24.42±9.47 (total score 36) for the K-CASP and 21.50±7.01 (total score 30) for the K-MMSE. The inter-rater correlation coefficients of the K-CASP were 0.992 on the first day and 0.995 on the second day. The intra-rater correlation coefficients of the K-CASP were 0.997 for examiner 1 and 0.996 for examiner 2. In the Pearson correlation analysis, the K-CASP score significantly correlated with the K-MMSE score (r=0.825, p<0.001). The coefficients of determination (r²) of the AQ were 0.586 for the K-MMSE and 0.513 for the K-CASP in the simple regression analysis. CONCLUSION: The K-CASP is a reliable and valid instrument for cognitive dysfunction screening in post-stroke patients. It is more applicable than other cognitive assessment tools in stroke patients with aphasia.
Assuntos
Humanos , Afasia , Transtornos Cognitivos , Programas de Rastreamento , Testes Neuropsicológicos , Reprodutibilidade dos Testes , Acidente Vascular CerebralRESUMO
OBJECTIVE: This study investigated the prescription patterns for Korean patients with schizophrenia with a particular focus on antipsychotic polypharmacy. All data were gathered from patients presenting at 41 tertiary university hospitals and 8 secondary hospitals. METHODS: Data from three multicenter studies conducted in Korea were retrospectively reviewed and integrated to identify patients with schizophrenia who had their antipsychotic medication switched to paliperidone extended-release between 2008 and 2009. The rates for antipsychotic polypharmacy, combined use of different antipsychotic classes with a special focus on atypical antipsychotics, and psychotropic polypharmacy using benzodiazepines, mood stabilizers, and other relevant drugs were identified. RESULTS: Of the 851 Korean patients analyzed in this study, 20.4% (n=173) had been prescribed antipsychotic polypharmacy. Of the 678 patients receiving antipsychotic monotherapy, 6.9% (n=47) were prescribed a typical antipsychotic and 93.1% (n=631) were prescribed an atypical antipsychotic. Of the 173 patients receiving a combination of antipsychotic drugs, only 6.4% (n=11) had been prescribed polypharmacy with typical antipsychotics, while 46.82% (n=81) were prescribed atypical+atypical antipsychotics or typical+atypical antipsychotics. The highest co-prescription rates for other psychotropic drugs in conjunction with antipsychotics included benzodiazepines (30.3%), anticholinergic drugs (28.8%), antidepressants (13.3%), beta-blockers (10.1%), and mood stabilizers (8.7%). CONCLUSION: The present findings demonstrate that the rate of antipsychotic polypharmacy is relatively low in Korea and that Korean clinicians prefer to prescribe atypical, rather than typical, antipsychotic drugs. This suggests that there is a distinct prescription pattern in Korea that is focused on antipsychotic polypharmacy.
Assuntos
Humanos , Antidepressivos , Antipsicóticos , Benzodiazepinas , Hospitais Universitários , Coreia (Geográfico) , Polimedicação , Prescrições , Psicotrópicos , Estudos Retrospectivos , EsquizofreniaRESUMO
OBJECTIVES: The aim of this study was to examine attitudes of middle-school students toward happiness, suicide, and factors associated with suicide. METHODS: A self-administered questionnaire was used in a cluster sample of 1,319 middle-school students (male 793, female 526). Data were obtained on a wide range of constructs regarding their attitude towards happiness, suicidal ideation and attempts, and factors associated with suicide. RESULTS: Middle-school students choose 'love within family' as most important factor for their happiness. Subjective mental health status was mostly associated with happiness. Subjects in lower socioeconomic status tended to respond their mental health status was not good and have more suicidal idea. 48.7% of subjects had permissive attitudes toward suicide, especially, girls. However, 65.0% responded that suicide was preventable problem. Compared to older people, middle-school students perceived that environmental factors were more important than innate and personal factors for suicide. CONCLUSION: Results of the study indicate that middle-school students have permissive attitudes toward suicide, but positive attitudes for the prevention of suicide. This suggest that education in these age group could be effective for the prevention of suicide. Also, approaches to suicide prevention programs should be developed based on the family intervention. Especially, we should care about girls and adolescents in lower socioeconomic status.
Assuntos
Adolescente , Feminino , Humanos , Felicidade , Saúde Mental , Classe Social , Ideação Suicida , Suicídio , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: Although antipsychotic polypharmacy is widely used in the pharmacotherapy of schizophrenia, its effectiveness is controversial. In particular, clinicians tend to avoid switching to monotherapy in patients who have been prescribed polypharmacy. In the present study, the authors investigate whether there is difference in time to discontinuation of antipsychotics between patients on previous monotherapy or polypharmacy. METHODS: Pooled analysis was conducted on two 24-week, multicenter, open-label, non-comparative studies that were originally designed to investigate the effectiveness of switching to paliperidone extended-release (ER) in patients with schizophrenia. Patients were divided into two groups according to previously prescribed antipsychotics, that is, to a polypharmacy group or a monotherapy group. The primary outcome measure was time to discontinuation of paliperidone ER. In addition, the authors sought to identify clinical variables that influence time to discontinuation. RESULTS: Before switching to paliperidone ER, 535 of 673 (79.5%) patients were prescribed antipsychotic monotherapy, and the remaining 138 (20.5%) patients were prescribed antipsychotic polypharmacy. No significant differences in time to discontinuation of paliperidone ER were observed between the polypharmacy and monotherapy groups. Personal and social performance scale score was the only factor found to influence time to discontinuation of paliperidone ER. No differences in psychopathology or adverse effects were found between the monotherapy and polypharmacy groups. CONCLUSION: Our results suggest that number of antipsychotics prescribed before switching to monotherapy does not influence clinical prognosis in patients with schizophrenia.
Assuntos
Humanos , Antipsicóticos , Tratamento Farmacológico , Avaliação de Resultados em Cuidados de Saúde , Polimedicação , Prognóstico , Psicopatologia , Esquizofrenia , Resultado do TratamentoRESUMO
Assuntos
Humanos , Anquilose , Artroplastia , Queixo , Dor Crônica , Assimetria Facial , Articulações , Dente Molar , Boca , Higiene Bucal , Articulação TemporomandibularRESUMO
Assuntos
Humanos , Anestesia Local , Sedação Consciente , Articulações , Boca , Recidiva , Contenções , Irrigação TerapêuticaRESUMO
This study was due to investigate the dietary intakes, serum lipids and other hematological indices in female adolescent smokers. The subjects were 85 smokers, whose average pack-year(smoking years on the basis of one pack of cigarettes per day) was 1.26 and 87 nonsmokers who were female high school students in Seoul. An anthropometric measreument was performed and % body fat was also analyzed by the Bioelectrical Impedance Fatness Analyzer(GIF-891). Dietary intakes and food habits were examined through questionnaires and nutrient intakes were analyzed by the Computer Aided. Nutritional analysis program for professional(CAN-pro). Serum TG, HDL-cholesterol and total-cholesterol levels were measured with test kits. Serum glucose, albumin, GOT and GPT were measured by automated dry chemistry system, SPOTCHEM 4410. Hemoglobin, hematocrit, RBC, WBC and MCV were determined by Semi Automated Microcell Counter(F-520). All data were statistically analyzed by SAS PC package program. There was no significant difference in the anthropometric measurements between smokers and nonsmokers. The caloric intake in adolescent smokers tended to be higher than that of nonsmokers but the difference was not statistically significant. In addition, there was no significant difference between smokers and nonsmokers in biochemical indices. Analysis of serum lipids showed that the serum levels of total-cholesterol and LDL-cholesterol of nonsmokers were unexpectedly significantly higher(p<0.05) than those of smokers. Overall results indicate that smoking itself with short pack-year in healthy female adolescent did not seem to influence apparent health and nutritional status.