No abstract available.
Child* ; Humans

Anxiety disorders are the most common comorbid psychiatric disorders in patients with bipolar disorder. Managing anxiety symptoms in comorbid conditions is challenging and has received little research interest. The findings from preclinical research on fear conditioning, an animal model of anxiety disorder, have suggested that memory reconsolidation updating (exposure-based therapy) combined with valproate might facilitate the amelioration of fear memories. Here, three cases of successful amelioration of agoraphobia and panic symptoms through valproate adjuvant therapy for cognitive behavioral therapy in patients who failed to respond to two to three consecutive standard pharmacotherapy trials over several years are described. To the best of the author’s knowledge, this is the first attempt to combine CBT with valproate in patients with panic disorder, agoraphobia, and comorbid bipolar disorder. Additionally, the background preclinical research on this combination therapy based on the reconsolidation-updating mechanism, the inhibition of histone deacetylase 2, and critical period reopening, off-label use of valproate in panic disorder, plasticity-augmented psychotherapy, and how to combine valproate with CBT is discussed.

The incidence of hematologic malignancy increases with age; thus, the number of older patients who require intensive chemotherapy is expected to increase with the aging population. In Korea, 61.8%, 59.3%, 47.0%, and 46.7% of newly diagnosed cases of multiple myeloma, myelodysplastic syndrome, myeloproliferative disorder, and non-Hodgkin lymphoma, respectively, occurred in patients aged ＞65 years in 2018. Health status among older patients, defined by frailty, age-related syndrome of physiological decline and increased vulnerability, is associated with adverse health outcomes. Health status is highly heterogeneous among older patients, and treatment outcomes vary according to frailty and physiologic age rather than chronologic age. Comprehensive geriatric assessment (CGA) is a multidimensional and multidisciplinary diagnostic and treatment process that identifies multiple domains, including functional status, cognition, comorbidities, medications, socioeconomic status, and nutritional status, to develop a coordinated plan to improve treatment-related outcomes and quality of life. Frailty can be assessed with CGA findings, and CGA is considered the “gold standard of care” for frail, older patients. Through CGA, unidentified problems can be assessed, and pre-emptive and non-oncologic interventions can be delivered. CGA is an objective and reliable tool for predicting further treatment-related complications and identifying patients for whom intensive chemotherapy with curative intent is appropriate. CGA should be considered a routine practice before starting treatment planning in older patients diagnosed with hematologic malignancies who require intensive chemotherapy. Further study is needed to allocate individualized treatment plans or multidisciplinary geriatric interventions according to CGA results.

Sleep is essential for physiological recovery and the maintenance of health. Over 15% of the population uses sleep medications and lacks access to effective cognitive-behavioral therapy for insomnia (CBT-I). CBT-I, which includes techniques such as sleep hygiene education, sleep diaries, relaxation techniques, stimulus control, and sleep restriction, is a standard treatment proven effective for chronic insomnia. This review aims to explain the significance of CBT-I techniques based on normal sleep regulation mechanisms. It discusses the principles of sleep hygiene education according to theories of circadian rhythms, homeostatic regulation, and conditioning. Furthermore, it examines zeitgebers such as light, melatonin, physical activity, diet, and social activities that regulate circadian rhythms, as well as habits that can disrupt these rhythms and how they can be effectively managed. The review explores how patients with insomnia can identify its causes, correct their habits, or seek professional help using wearable devices.

Sleep is essential for physiological recovery and the maintenance of health. Over 15% of the population uses sleep medications and lacks access to effective cognitive-behavioral therapy for insomnia (CBT-I). CBT-I, which includes techniques such as sleep hygiene education, sleep diaries, relaxation techniques, stimulus control, and sleep restriction, is a standard treatment proven effective for chronic insomnia. This review aims to explain the significance of CBT-I techniques based on normal sleep regulation mechanisms. It discusses the principles of sleep hygiene education according to theories of circadian rhythms, homeostatic regulation, and conditioning. Furthermore, it examines zeitgebers such as light, melatonin, physical activity, diet, and social activities that regulate circadian rhythms, as well as habits that can disrupt these rhythms and how they can be effectively managed. The review explores how patients with insomnia can identify its causes, correct their habits, or seek professional help using wearable devices.

Sleep is essential for physiological recovery and the maintenance of health. Over 15% of the population uses sleep medications and lacks access to effective cognitive-behavioral therapy for insomnia (CBT-I). CBT-I, which includes techniques such as sleep hygiene education, sleep diaries, relaxation techniques, stimulus control, and sleep restriction, is a standard treatment proven effective for chronic insomnia. This review aims to explain the significance of CBT-I techniques based on normal sleep regulation mechanisms. It discusses the principles of sleep hygiene education according to theories of circadian rhythms, homeostatic regulation, and conditioning. Furthermore, it examines zeitgebers such as light, melatonin, physical activity, diet, and social activities that regulate circadian rhythms, as well as habits that can disrupt these rhythms and how they can be effectively managed. The review explores how patients with insomnia can identify its causes, correct their habits, or seek professional help using wearable devices.

Sleep is essential for physiological recovery and the maintenance of health. Over 15% of the population uses sleep medications and lacks access to effective cognitive-behavioral therapy for insomnia (CBT-I). CBT-I, which includes techniques such as sleep hygiene education, sleep diaries, relaxation techniques, stimulus control, and sleep restriction, is a standard treatment proven effective for chronic insomnia. This review aims to explain the significance of CBT-I techniques based on normal sleep regulation mechanisms. It discusses the principles of sleep hygiene education according to theories of circadian rhythms, homeostatic regulation, and conditioning. Furthermore, it examines zeitgebers such as light, melatonin, physical activity, diet, and social activities that regulate circadian rhythms, as well as habits that can disrupt these rhythms and how they can be effectively managed. The review explores how patients with insomnia can identify its causes, correct their habits, or seek professional help using wearable devices.

No abstract available.
Child* ; Humans ; Plasma* ; Renal Veins* ; Renin* ; Veins*

OBJECTIVES: The most common chromosomal abnormality contributing to recurrent abortion is the balanced chromosomal translocation. However the exact incidence of fetal losses are still unknown. The objectives of this study were to evaluate the incidence of fetal chromosomal abnormalities and outcome of pregnancy in recurrent miscarriage couples with balanced translocation. DESIGN: A retrospective analysis of recurrent spontaneous abortion patients with balanced chromosomal translocation. MATERIALS AND METHODS: Cytogenetic analysis was performed in 56 couples with history of recurrent abortions from 1995 to 1999. The use of high resolution banding technique and fluorescent in situ hybridization (FISH) in the chromosomal analysis has made the precise evaluation of chromosome aberrations. RESULTS: Among 56 couples, 42 patients had reciprocal translocation and 14 had Robertsonian translocation. Chromosomal aberrations were more frequent in women (36 cases) than in men (20 cases). Prenatal cytogenetic analyses were carried out in 14 subsequent pregnancies for carrier couples with balanced translocation. The fetal karyotypes showed that 5 cases (35.7%) was normal, 8 (57.1%) were balanced translocation, and 1 (7.1%) was unbalanced translocations. And cytogenetic analyses were done on 15 subsequent chorionic villi samples of abortuses for carrier couples with balanced translocations. Fourteen of fifteen abortuses (93.3%) were abnormal karyotype. CONCLUSIONS: Although the incidence of chromosomal imbalance in the fetuses was relatively low in prenatal cytogenetic analysis, individuals with balanced translocations are predisposed to giving birth to malformed offsprings with chromosomal imbalance (partial trisomy or monosomy). Therefore we recommend preimplantation genetic diagnosis (PGD) for recurrent abortions with balanced translocation and preventing the birth of offspring with chromosomal abnormalities.
Abnormal Karyotype ; Abortion, Habitual* ; Abortion, Spontaneous ; Chorionic Villi ; Chromosome Aberrations* ; Cytogenetic Analysis ; Family Characteristics* ; Female ; Fetus ; Humans ; In Situ Hybridization, Fluorescence ; Incidence* ; Karyotype ; Male ; Parturition ; Pregnancy ; Preimplantation Diagnosis ; Retrospective Studies ; Translocation, Genetic ; Trisomy

No abstract available.
Renal Artery* ; Ureter* ; Veins*