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JYMS : Journal of Yeungnam Medical Science

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Some suggestions for pain physicians working in real-world clinical settings
Jung Hwan Lee, Min Cheol Chang
J Yeungnam Med Sci. 2023;40(Suppl):S123-S124.   Published online May 23, 2023
DOI: https://doi.org/10.12701/jyms.2023.00255
  • 635 View
  • 32 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Musculoskeletal pain is a common reason for patients visiting hospitals or clinics. Various therapeutic tools including oral medications, physical modalities, and procedures have been used to alleviate musculoskeletal pain. Numerous clinical trials have been conducted to demonstrate the therapeutic effect of each treatment and compare the efficacy of different protocols. These trials were conducted under controlled conditions with specific endpoints and timeframes, and the individual constraints of each patient were not considered. We believe that the findings of such studies may not accurately reflect clinical reality in real-world settings. In this article, we propose treatment principles for patients in pain clinics. We propose two principles for pain treatment: first, “Healing, in the end, is not healing.” and second, “The patient’s job is not a patient.” The main role of pain physicians is to quickly and actively reduce pain and help patients focus on their work and lives.

Citations

Citations to this article as recorded by  
  • Effectiveness of transcranial alternating current stimulation for controlling chronic pain: a systematic review
    Min Cheol Chang, Marie-Michèle Briand, Mathieu Boudier-Revéret, Seoyon Yang
    Frontiers in Neurology.2023;[Epub]     CrossRef
Algorithm for multimodal medication therapy in patients with complex regional pain syndrome
Min Cheol Chang, Donghwi Park
J Yeungnam Med Sci. 2023;40(Suppl):S125-S128.   Published online July 12, 2023
DOI: https://doi.org/10.12701/jyms.2023.00360
  • 1,076 View
  • 83 Download
  • 2 Crossref
AbstractAbstract PDF
Complex regional pain syndrome (CRPS), previously known as reflex sympathetic dystrophy and causalgia, is a clinical entity characterized by classic neuropathic pain, autonomic involvement, motor symptoms, and trophic changes in the skin, nails, and hair. Although various therapeutic modalities are used to control CRPS-related pain, severe pain due to CRPS often persists and progresses to the chronic phase. In this study, we constructed an algorithm for multimodal medication therapy for CRPS based on the established pathology of CRPS. Oral steroid pulse therapy is recommended for initial pain management in patients with CRPS. Oral steroid therapy can reduce peripheral and central neuroinflammation, contributing to the development of neuropathic pain during the acute and chronic phases. If steroid pulse therapy offers poor relief or is ineffective, treatment to control central sensitization in the chronic phase should be initiated. If pain persists despite all drug adjustments, ketamine with midazolam 2 mg before and after ketamine injection can be administered intravenously to inhibit the N-methyl D-aspartate receptor. If this treatment fails to achieve sufficient efficacy, intravenous lidocaine can be administered for 2 weeks. We hope that our proposed drug treatment algorithm to control CRPS pain will help clinicians appropriately treat patients with CRPS. Further clinical studies assessing patients with CRPS are warranted to establish this treatment algorithm in clinical practice.

Citations

Citations to this article as recorded by  
  • Problems of diagnosis and treatment of chronic pain syndrome in patients with variants of the structure of peripheral nerves. A series of clinical cases
    Al'bert R. Bulatov, Tatyana A. Kolesnik, Александра A. Boykova, Igor' V. Litvinenko, Nikolay V. Tsygan
    Russian Military Medical Academy Reports.2023; 42(4): 413.     CrossRef
  • Experience from a single-center study on multimodal medication therapy for patients with complex regional pain syndrome
    Donghwi Park, Jin-Woo Choi, Min Cheol Chang
    Journal of Back and Musculoskeletal Rehabilitation.2023; : 1.     CrossRef
Odynophagia in individuals with neck pain: the importance of differential diagnosis in physiotherapy practice
Massimiliano Polastri, Luca Di Marco, Ernesto Andreoli
J Yeungnam Med Sci. 2023;40(Suppl):S129-S133.   Published online November 14, 2023
DOI: https://doi.org/10.12701/jyms.2023.00843
  • 873 View
  • 66 Download
AbstractAbstract PDF
Odynophagia refers to painful swallowing caused by various underlying factors that must be excluded to determine the best treatment approach. Neck pain is a debilitating condition requiring treatment in rehabilitative settings. There are several circumstances in which odynophagia and neck pain coexist, such as tendinitis of the longus colli muscle and paravertebral calcification, prevertebral and retropharyngeal abscess, esophageal perforation, aortic dissection, thyroid cartilage fracture, thyrohyoid ligament syndrome, pneumomediastinum and subcutaneous emphysema, and after physical exercise. Physiotherapists are professionals most likely to encounter individuals with neck pain and provide interventions such as massage, manual therapy, exercise, and electrotherapy. Therefore, it is important to recognize that neck pain can stem from different clinical conditions that require interventions other than physiotherapy. A differential diagnosis is crucial to ensure appropriate referrals for therapeutic interventions.
The art of diabetes care: guidelines for a holistic approach to human and social factors
Muhammad Jawad Hashim
J Yeungnam Med Sci. 2023;40(2):218-222.   Published online November 11, 2022
DOI: https://doi.org/10.12701/jyms.2022.00577
  • 1,496 View
  • 75 Download
AbstractAbstract PDF
A holistic approach to diabetes considers patient preferences, emotional health, living conditions, and other contextual factors, in addition to medication selection. Human and social factors influence treatment adherence and clinical outcomes. Social issues, cost of care, out-of-pocket expenses, pill burden (number and frequency), and injectable drugs such as insulin, can affect adherence. Clinicians can ask about these contextual factors when discussing treatment options with patients. Patients’ emotional health can also affect diabetes self-care. Social stressors such as family issues may impair self-care behaviors. Diabetes can also lead to emotional stress. Diabetes distress correlates with worse glycemic control and lower overall well-being. Patient-centered communication can build the foundation of a trusting relationship with the clinician. Respect for patient preferences and fears can build trust. Relevant communication skills include asking open-ended questions, expressing empathy, active listening, and exploring the patient’s perspective. Glycemic goals must be personalized based on frailty, the risk of hypoglycemia, and healthy life expectancy. Lifestyle counseling requires a nonjudgmental approach and tactfulness. The art of diabetes care rests on clinicians perceiving a patient’s emotional state. Tailoring the level of advice and diabetes targets based on a patient’s personal and contextual factors requires mindfulness by clinicians.
The pros and cons of entry restrictions: are entry restrictions really effective in preventing the spread of SARS-CoV-2?
Donghwi Park, Mathieu Boudier-Revéret, Min Cheol Chang
J Yeungnam Med Sci. 2022;39(4):344-346.   Published online January 14, 2022
DOI: https://doi.org/10.12701/yujm.2021.01599
  • 3,202 View
  • 85 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread worldwide, leading the World Health Organization to declare coronavirus disease 2019 (COVID-19) a pandemic. To curb the unchecked spread of SARS-CoV-2 infection, most countries have enforced travel restrictions. However, it is debatable whether such restrictions are effective in containing infections and preventing pandemics. Rather, they may negatively impact economies and diplomatic relationships. Each government should conduct an extensive and appropriate analysis of its national economy, diplomatic status, and COVID-19 preparedness to decide whether it is best to restrict entering travelers. Even if travelers from other countries are allowed entry, extensive contact tracing is required to prevent the spread of COVID-19. In addition, governments can implement “travel bubbles,” which allow the quarantine-free flow of people among countries with relatively low levels of community transmission. An accurate evaluation of the benefits and losses due to entry restrictions during the COVID-19 pandemic would be helpful in determining whether entry restrictions are an effective measure to reduce the spread of infection in future pandemics.

Citations

Citations to this article as recorded by  
  • “Exceptionally challenging time for all of us”: Qualitative study of the COVID-19 experiences of partners of diplomatic personnel
    Samantha K. Brooks, Dipti Patel, Neil Greenberg, Joseph Adu
    PLOS ONE.2023; 18(11): e0293557.     CrossRef
Yeungnam University type drive-through (YU-Thru) coronavirus disease 2019 (COVID-19) screening system: a rapid and safe screening system
Wan Seok Seo, Seong Ho Kim, Si Youn Song, Jian Hur, Jun Lee, Sunho Choi, Yoojung Lee, Dai Seg Bai
Yeungnam Univ J Med. 2020;37(4):349-355.   Published online September 18, 2020
DOI: https://doi.org/10.12701/yujm.2020.00640
  • 9,798 View
  • 99 Download
  • 3 Crossref
AbstractAbstract PDF
Active and prompt scale-up screening tests are essential to efficiently control the coronavirus disease 2019 (COVID-19) outbreak. The goal of this work was to identify shortcomings in the conventional screening system (CSS) implemented in the beginning of the outbreak. To overcome these shortcomings, we then introduced a novel, independently developed system called the Yeungnam University type drive-through (YU-Thru), and distributed it nationwide in Korea. This system is similar to the drive-throughs utilized by fast food restaurants. YU-Thru system has shortened the time taken to test a single person to 2–4 minutes, by completely eliminating the time required to clean and ventilate the specimen collection room. This time requirement was a major drawback of the CSS. YU-Thru system also reduced the risk of subjects and medical staff infecting one another by using a separate and closed examination system. On average, 50 to 60 tests were conducted per day when using the CSS, while now up to 350 tests per day are conducted with the YU-Thru system. We believe that the YU-Thru system has made an important contribution to the rapid detection of COVID-19 in Daegu, South Korea. Here, we will describe the YU-Thru system in detail so that other countries experiencing COVID-19 outbreaks can take advantage of this system.

Citations

Citations to this article as recorded by  
  • Experience of operating a medical humanities course at one medical school during the COVID-19: a retrospective study
    Yu Ra Kim, Hye-won Shin, Young Hwan Lee, Seong-Yong Kim
    Journal of Yeungnam Medical Science.2023; 40(2): 179.     CrossRef
  • Lessons Learned From an Analysis of the Emergency Medical Services’ COVID-19 Drive-Through Testing Facilities in Israel
    Itay Zmora, Evan Avraham Alpert, Uri Shacham, Nisim Mishraki, Eli Jaffe
    Disaster Medicine and Public Health Preparedness.2022; 16(5): 2091.     CrossRef
  • A study on the mental health of students at a medical school during COVID-19 outbreak: a retrospective study
    Yu Ra Kim, Hye Jin Park, Bon-Hoon Koo, Ji Young Hwang, Young Hwan Lee
    Journal of Yeungnam Medical Science.2022; 39(4): 314.     CrossRef

JYMS : Journal of Yeungnam Medical Science