Impact of an Education Program for Caregivers of Patients with Alzheimer's Disease on Treatment Discontinuation and Compliance in Korea

Background and PurposeReportedly 30–50% of patients being treated for chronic illnesses do not adhere to their medication regimen. We assessed the impact of a nurse-led education program for caregivers of Korean de novo Alzheimer''s disease patients who had newly been prescribed donepezil.MethodsThis multicenter study analyzed 93 participants in a caregiver education group and 92 participants in a caregiver no-education group. At every visit up to the end of the study (1 year), caregivers in the education group were given educational brochures regarding Alzheimer''s disease and the efficacy and adverse events of donepezil treatment. The primary endpoint was the discontinuation rate of donepezil treatment during the 1-year observation period. The secondary endpoints included the effect of education on compliance with donepezil treatment assessed at each visit using a clinician rating scale (CRS) and visual analog scale (VAS), and changes from baseline in cognitive assessment tests.ResultsThe donepezil discontinuation rates at 1 year were 5.38% (5/93) and 6.52% (6/92) in the caregiver education and no-education groups, respectively (p=0.742). No significant between-group differences in donepezil compliance rates on the CRS and VAS were observed, but significant changes were observed in some cognitive tests from baseline to the end of the study.ConclusionsCaregiver education had no significant effect on treatment discontinuation, but this may have been due to the low severity of cognitive impairment among the included population at baseline. In addition, the low discontinuation rates meant that no significant difference in treatment compliance was observed.     

Effects of Cognitive-Behavioral Therapy Based Music Therapy in Korean Adolescents with Smartphone and Internet Addiction

Objective The purpose of this study was to evaluate the effects of adding music therapy (MT) to cognitive-behavioral therapy (CBT) on symptoms of smartphone/internet addiction and psychiatric comorbidities. Methods Overall, 155 patients diagnosed with addiction were assigned to either the CBT-MT group or CBT group. Both groups received CBT for 8 weeks, while the CBT-MT group received additional MT. The intervention was completed by 67 and 71 participants in the CBT-MT and CBT groups, respectively. Results The total scores of Young Internet Addiction Scale (YIAT) and Smartphone Addiction Proneness Scale (SAPS) decreased significantly (p<0.001 for both) in both groups, while the total scores of State Anxiety Inventory for Children (SAIC) (p<0.001), Trait Anxiety Inventory for Children (TAIC) (p<0.001), Conners-Wells’ Adolescent Self-Report Scale-Short form (CASS(S)) (p=0.048), and Barratt Impulsiveness Scale-11 (BIS-11) (p<0.001) decreased only in the CBT-MT group. The decrements in YIAT (p=0.025), SAIC (p=0.043), TAIC (p=0.011), and BIS-11 (p=0.012) in the CBT-MT group were significantly greater than those in the CBT group. Conclusion Combined MT and CBT improved the symptoms of smartphone/internet addiction, anxiety, and impulsivity in adolescents. This combination could therefore be an effective treatment of smartphone or internet addiction along with behavioral disorders such as anxiety and impulsivity.     

Profile Analysis of Sexual Assault Experiences among Adult Women and Their Implications for Mental Health

ObjectiveExtant studies indicate that just one characteristic of sexual assault cannot properly represent the whole experience of sexual assault and, especially, the severity of sexual assault. This study aimed to understand the totality of sexual assault experiences and elucidate subtypes of sexual assault victims based on the detailed characteristics of their sexual assault experiences and those relationships with mental health. MethodsA total of 255 adult sexual violence victims who used intervention services and a comparison group were included. Information on their sexual assault experiences was gleaned from case records data. ResultsThe following four distinctive profile groups were identified: “Sexual Touching” (19.6%), “Rape/Social Relation” (30.4%), “Intimate Partner Violence (IPV)” (18.8%), and “Rape/Stranger” (31.3%). The subgroups differed in terms of secondary victimization and adverse childhood experiences. The Rape/Social Relation and IPV subgroups most frequently experienced secondary victimization and childhood adversity. The four profile subgroups demonstrated different relationships with mental health outcomes, with a complicated pattern. The Rap/Social Relation and IPV subgroups scored higher on mental health problem screening measures compared to other groups. However, a considerable proportion of victims in the Sexual Touching subgroup also reported suicidal behaviors and self-injury. ConclusionBased on the results, theoretical and clinical implications were discussed.     

Effects of Organic Light-Emitting Diodes on Circadian Rhythm and Sleep

ObjectiveOrganic light-emitting diodes (OLEDs) emit less blue light than traditional light-emitting diodes (LEDs), and we previously found that early-night OLED light exposure (LE) delays the melatonin phase by less than LED at a color temperature of 4,000 K. As a follow-up study, we investigated the effects of OLED and LED at a different color temperature (3,000 K) on melatonin profile, sleep, and vigilance. Methods24 healthy subjects (27.5±5.1 years) were exposed to three light conditions [OLED, LED, and dim light (DL)] from 17:30 to 24:00, in a random order and with a 1-week interval. Saliva samples for melatonin were taken every hour from 18:00 to 24:00. Polysomnography (PSG) and a psychomotor vigilance test (PVT) were performed. ResultsMelatonin onset time was significantly delayed under OLED and LED compared with DL, with no significant difference between OLED and LED. The mean melatonin level at 24:00 under LED was lower than that under DL, but there was no significant difference between OLED LE and DL. The percentage of slow wave sleep (N3) in LED was significantly lower than in OLED. ConclusionExposure to light in the evening can suppress melatonin secretion late at night and disturb deep sleep, and those effects are slightly worse under LED than OLED.     

In vitro shear bond strength of 2 resin cements to zirconia and lithium disilicate: An in vitro study

Statement of problemThere is little evidence on how the multiple layers of zirconia (ZrO₂) or glazed material will affect the shear bond strength (SBS) of different resin cements.PurposeThe purpose of this in vitro study was to compare the SBS of 2 resin cements with the different layers of a monolithic polychromatic ZrO₂ ceramic, both glazed and nonglazed, and a lithium disilicate (LDS) ceramic.Material and methodsOne hundred and sixty-eight composite resin cylinders and 48 monolithic polychromic ZrO₂ plates were prepared. Twenty-four were milled and sintered, and 24 were milled and sintered and had a glaze cycle applied with no liquid glaze. These plates and 12 LDS plates were mounted in autopolymerized acrylic resin. Bonding surfaces were polished, airborne-particle abraded, and cleaned ultrasonically. The different layers (cubic, hybrid, and tetragonal) of the ZrO₂ plates were identified and marked. The plates were assigned to 2 cement groups: a self-adhesive, autopolymerized resin cement, and a dual-polymerizing, adhesive resin cement (DPRC). Bonding surfaces were cleaned and treated according to the cement manufacturer’s instructions. Three composite resin cylinders were luted to the ZrO₂ plates at the appropriate layer, and 2 cylinders were luted to each LDS plate. The specimens were stored in a moist environment for 24 hours at 37 °C. The SBS test was performed with a universal testing machine. Visual inspections of the debonded surfaces were compared under magnification. The data were analyzed with a 2-way ANOVA and a subsequent Student t test (α=.05).ResultsThe 2-way ANOVA found no difference among luting agent and LDS and ZrO₂. The SBSs of the nonglazed tetragonal and cubic layer to the ZrO₂ were higher than to the surface exposed to a glazing cycle (P=.001). The bonded surfaces were examined tactilely and under ×3.5 magnification, followed by light and scanning electron microscopy and recorded as either adhesive, cohesive, or mixed. Almost all failures in the glazed ZrO₂ were mixed and cohesive. However, more adhesive failures were observed in the DPRC group of nonglazed ZrO₂.ConclusionsNo differences were found between the 2 luting agents for the LDS. For the ZrO₂ cubic and tetragonal layers, the DPRC had higher bond strengths to the nonglazed surfaces.     

A Case Report of Non-Hodgkin Low-grade B-cell Mucosa-associated Lymphoid Tissue Lymphoma Presenting as a Suspected Endodontic Lesion

Extranodal mucosa-associated lymphoid tissue lymphoma is a rare oral disease. This case report describes a 71-year-old woman who presented for endodontic evaluation and treatment for swelling on the right posterior palatal. The case details the evaluation and diagnostic processes and treatment course. The case report draws attention to the importance of performing a biopsy, having proper sampling, and the additional steps sometimes required to arrive at a definitive diagnosis. This case report is the first to document a definitive low-grade B-cell mucosa-associated lymphoid tissue lymphoma mimicking endodontic pathology. The case shows the importance of proper examination, clinical imaging, and pathologic testing to arrive at a definitive diagnosis. It highlights that collaboration with other medical and dental specialties is essential for appropriate diagnosis and treatment and describes the “buttonhole” diagnostic strategy.     

The Model for End-Stage Liver Disease Score-Based System Predicts Short Term Mortality Better Than the Current Child-Turcotte-Pugh Score-Based Allocation System during Waiting for Deceased Liver Transplantation

To adopt the model for end-stage liver disease (MELD) score-based system in Korea, the feasibility should be evaluated by analysis of Korean database. The aim of this study was to investigate the feasibility of the MELD score-based system compared with the current Child-Turcotte-Pugh (CTP) based-system and to suggest adequate cut-off to stratify waiting list mortality among Korean population. We included 788 adult patients listed in waiting list in Seoul National University Hospital from January 2008 to May 2011. The short-term survival until 6 months after registration was evaluated. Two hundred forty six (31.2%) patients underwent live donor liver transplantation and 353 (44.8%) patients were still waiting and 121 (15.4%) patients were dropped out due to death. Significant difference was observed when MELD score 24 and 31 were used as cut-off. Three-months survival of Status 2A was 70.2%. However, in Status 2A patients whose MELD score less than 24 (n=82), 86.6% of patients survived until 6 month. Furthermore, patients with high MELD score (≥31) among Status 2B group showed poorer survival rate (45.8%, 3-month) than Status 2A group. In conclusion, MELD score-based system can predict short term mortality better and select more number of high risk patients in Korean population.