Journal of Yeungnam Medical Science

Communication

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

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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.

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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

Review article

Diagnosis and treatment of multidrug-resistant tuberculosis: Jong Geol Jang, Jin Hong Chung; Yeungnam Univ J Med. 2020;37(4):277-285. Published online September 4, 2020; DOI: https://doi.org/10.12701/yujm.2020.00626

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Abstract PDF

Tuberculosis (TB) is still a major health problem worldwide. Especially, multidrug-resistant TB (MDR-TB), which is defined as TB that shows resistance to both isoniazid and rifampicin, is a barrier in the treatment of TB. Globally, approximately 3.4% of new TB patients and 20% of the patients with a history of previous treatment for TB were diagnosed with MDR-TB. The treatment of MDR-TB requires medications for a long duration (up to 20–24 months) with less effective and toxic second-line drugs and has unfavorable outcomes. However, treatment outcomes are expected to improve due to the introduction of a new agent (bedaquiline), repurposed drugs (linezolid, clofazimine, and cycloserine), and technological advancement in rapid drug sensitivity testing. The World Health Organization (WHO) released a rapid communication in 2018, followed by consolidated guidelines for the treatment of MDR-TB in 2019 based on clinical trials and an individual patient data meta-analysis. In these guidelines, the WHO suggested reclassification of second-line anti-TB drugs and recommended oral treatment regimens that included the new and repurposed agents. The aims of this article are to review the treatment strategies of MDR-TB based on the 2019 WHO guidelines regarding the management of MDR-TB and the diagnostic techniques for detecting resistance, including phenotypic and molecular drug sensitivity tests.

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Case report

Transpedal lymphatic embolization for lymphorrhea at the graft harvest site after coronary artery bypass grafting: Jung Guen Cha, Sang Yub Lee, Jihoon Hong, Hun Kyu Ryeom, Gab Chul Kim, Young Woo Do; Yeungnam Univ J Med. 2021;38(1):74-77. Published online July 20, 2020; DOI: https://doi.org/10.12701/yujm.2020.00297

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Abstract PDF

Lymphorrhea is a rare but potentially severe complication that occurs after various surgical procedures. Untreated lymphorrhea may lead to wound dehiscence, infection, and prolonged hospital stay. Currently, there is no standard effective treatment. Early management usually includes leg elevation, drainage, and pressure dressing. However, these methods are associated with prolonged recovery and high recurrence rates. We report a case of lymphorrhea from a calf wound after endoscopic great saphenous vein (GSV) harvesting for coronary artery bypass grafting (CABG). The patient presented with intractable oozing from the postoperative wound on the right calf. Lymphorrhea perGsisted for 6 weeks despite negative-pressure wound therapy with a long-acting somatostatin. We performed unilateral pedal lymphangiography that confirmed wound lymphorrhea, followed by glue embolization. No recurrence was observed after 8 months of follow-up. This case report demonstrates the successful use of lymphangiography with glue embolization in the control of lymphorrhea after GSV harvesting for CABG.

Citations

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Supermicrosurgical lymphatic venous anastomosis for intractable lymphocele after great saphenous vein harvesting graft
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