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"Therapeutics"

Guidelines

[English]
Clinical practice guidelines for the diagnosis and treatment of scabies in Korea: Part 2. Treatment and prevention — a secondary publication
Jin Park, Soon-Hyo Kwon, Young Bok Lee, Hei Sung Kim, Jie Hyun Jeon, Gwang Seong Choi
Ewha Med J 2024;47(4):e72.   Published online October 31, 2024
DOI: https://doi.org/10.12771/emj.2024.e72

Treatment should be initiated for all suspected, clinical, or confirmed cases of scabies. Patients affected should be adequately isolated, and high-risk groups with close contact histories should be treated regardless of their symptoms. Optimal treatment strategies can be selected based on age, clinical subtype, and the patient's health status. In Korea, commercially available preparations for scabies treatment include topical 5% permethrin, topical 10% crotamiton, and oral ivermectin. Topical 5% permethrin is the first-line selective treatment for both classic and crusted scabies. Alternative treatments include topical 10% crotamiton and oral ivermectin. After completing treatment, follow-up visits at 2 and 4 weeks are recommended to monitor the therapeutic response. Treatment is considered to have failed if scabies mites or burrows are detected, new clinical characteristics develop, or there is an aggravation of pruritus. Scabies itch should be adequately managed with emollients, oral antihistamines, and topical corticosteroids. Preventive measures, including personal hygiene, patient education, and environmental control, should besd implemented to reduce the transmission of scabies.

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Review Articles
[English]
Updates in the Management of Graves Disease in Children
Yun Jeong Lee
Ewha Med J 2023;46(s1):e31.   Published online December 31, 2023
DOI: https://doi.org/10.12771/emj.2023.e31
ABSTRACT

Graves disease (GD) is the primary cause of hyperthyroidism in children. The standard management options—namely, antithyroid drugs (ATD), radioactive iodine, and surgery—have not changed for many years. Although ATD therapy is often the first-line treatment for pediatric patients, the low likelihood of spontaneous remission means that most children will require a more permanent solution. Recent clinical trials and systematic reviews have shed light on the long-term outcomes of ATD therapy, radioactive iodine, and surgical interventions in managing pediatric GD. Additionally, novel therapies aimed at B-cells or the thyroid-stimulating hormone receptor, both implicated in the pathogenesis of GD, are under investigation. However, their definitive role in treating childhood GD has yet to be established. This review will cover the latest developments in the treatment of childhood GD, including information on emerging targeted therapies.

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  • Emerging Infectious Diseases at the End of the Fourth Year of the COVID-19 Pandemic and Recent Updates on Colorectal and Pediatric Endocrine Diseases
    Sun Huh
    The Ewha Medical Journal.2023;[Epub]     CrossRef
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[English]
Diagnostic and Therapeutic Strategies of Type 2 Diabetes Mellitus in Youth
Hwa Young Kim, Jae Hyun Kim
Ewha Med J 2022;45(3):e3.   Published online July 31, 2022
DOI: https://doi.org/10.12771/emj.2022.e3
ABSTRACT

The incidence of type 2 diabetes mellitus (T2DM) is increasing in youth, largely in correlation with an increase in childhood overweight and obesity. Youth-onset T2DM is a major public health concern worldwide, and tends to show more aggressive features than adult-onset T2DM. Early diagnosis and treatment are important to prevent the occurrence of complications and comorbidities. However, current treatment options are limited and only modestly successful in youth-onset T2DM. Over the last few decades, significant progress has been made in the understanding of youth-onset T2DM. This review summarizes the current understanding of the pathogenesis, diagnosis, and treatment of T2DM in youth. (Ewha Med J 2022;45(3):e3)

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[English]
Active Surveillance of Papillary Thyroid Cancer: Past, Present, and Future
Jong-Kyu Kim, Hyungju Kwon, Woosung Lim, Byung-In Moon, Nam Sun Paik
Ewha Med J 2021;44(2):37-40.   Published online April 30, 2021
DOI: https://doi.org/10.12771/emj.2021.44.2.37

Active surveillance (AS) of papillary thyroid microcarcinoma was first suggested by Dr. Akira Miyauchi at Kuma Hospital in 1993. Based on several subsequent evidences, AS was approved by the American Thyroid Association in 2015. AS is no longer an experimental treatment but has become an acceptable standard of care for patients with low-risk thyroid cancers. No molecular markers, such as BRAF mutations, have been identified to predict the prognosis of papillary thyroid cancer. However, future molecular studies may reveal the relationship between genetic mutations and thyroid cancer prognosis. AS involves closely monitoring thyroid cancer over time, instead of immediately treating it with surgery. Patients and medical doctors should consider these two options: observation or surgery.

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[English]
Clostridium difficile Infections in Children
Joo Hyun Gil, Jeong Wan Seo
Ewha Med J 2011;34(2):3-12.   Published online September 30, 2011
DOI: https://doi.org/10.12771/emj.2011.34.2.3

During the past decade, rates of Clostridium difficile infection (CDI) increased worldwide. Hypervirulent strains of C. difficile such as NAP1/BI/027 and PCR ribotype 078 have emerged that have changed the epidemiology of CDI. Especially, CDI rates also have increased in the community, in children previously thought to be at low risk. Recently, the use of gastric acid suppressant that facilitates intestinal transit of the bacteria and presence of inflammatory bowel disease has been reported as risk factors. Treatment for CDI usually relies on metronidazole or vancomycin, but recurrence rates remains high. New treatment options for multiple recurrence are challenging. In this article, we reviewed recent epidemiological changes, current knowledge of virulence factors, reasonable approach to the diagnosis, and optimal treatment of CDI. But, clinical guidelines for pediatric C. difficile disease have not been defined. It seems that the consensus and recommendations for managing pediatric CDI are urgently needed.

Citations

Citations to this article as recorded by  
  • Incidence and Characteristics ofClostridioides difficileInfection in Children
    Heera Jeong, Ji-Man Kang, Jong Gyun Ahn
    Pediatric Infection & Vaccine.2020; 27(3): 158.     CrossRef
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