Alcohol use disorder is a one of major psychiatric problems in Korea. But after detoxification treatment, relapse is very frequent. Psychosocial therapy is a crucial element in alcoholism treatment and prognosis. There are so many psychosocial treatment modalities. In this article, various psychosocial treatments are explained. The main lists of introduced recent psychosocial treatments on alcoholism are as follows: therapeutic community, cognitive-behavioral therapy, motivation enhancement therapy, twelve step facilitation therapy, network therapy, and other community-based treatment. In Korea, in contrast to the importance of huge alcoholic problems, comprehensive alcoholism treatment system is weak. Therefore well-modified and Korean styled psychosocial treatment programs on alcoholism is requested.
Alcoholics ; Alcoholism* ; Humans ; Korea ; Motivation ; Prognosis ; Recurrence ; Therapeutic Community

OBJECTIVETo evaluate the efficacy and safety of Reduning injection for treating community-acquired pneumonia.

METHODLiteratures about randomized controlled trials of Reduning injection for treating community-acquired pneumonia were reviewed. The methodological quality of the trials was assessed by the Jadad scale, and evaluation was performed.

RESULTSeven RCTS were included. Reduning combined group (Reduning injection plus antibiotics and basic therapy) was compared with antibiotics group (antibiotics plus basic therapy). Meta-analysis showed that the relative risk (RR) for the total cure rate was 1.34, and 95% confidence interval (CI) was [1.19, 1.51]; RR for the total effective rate was 1.10, and 95% CI was [1.06, 1.15]. The weighted mean difference (WMD) in disappearance time of fever between the two groups was - 1.42, and 95% CI was [- 2.58, -0.26]; The WMD between the two groups for the total obvious effect rate of cough and expectoration were - 2.36, and 95% CI was [- 3.41, - 1.31]; Improve the time of pulmonary rales MD -2.30, 95% CI [- 2.61, - 2.00]; The WMD between the two groups in absorption of chest x-ray shadow was -2.36 and 95% CI [-2.52, -2.20]. Serious systematic adverse reactions had not been reported in the trials.

CONCLUSIONThe effect of combined therapy with Reduning injection plus antibiotics and basic therapy is better than that of antibiotics plus basic therapy. Reduning injection can improve the symptoms of cough and expectoration, shorten the fever time and facilitate the absorption of chest x-ray shadow without any significant adverse reactions. However, further high quality trials are needed.

Community-Acquired Infections ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Injections ; Pneumonia ; drug therapy

PURPOSE: The purpose of this study was to explore the recovering process of men who had abused alcohol and has lived in a therapeutic community. METHODS: Individual in-depth interviews were used to collect data from 10 of these men who has lived in the therapeutic community for more than one year. Qualitative data from field notes and transcribed notes were analyzed using the grounded theory methodology developed by Strauss and Corbin. RESULTS: The core category about the recovering process of the men who had abused alcohol and are now in the therapeutic community was identified as “reconstructing a broken life”. The recovering process of these men in the therapeutic community consisted of four phases; ‘self-awareness stage’, ‘unfreezing stage’, ‘readjustment stage’, and ‘challenging stage’. CONCLUSION: In this study “reconstructing a broken life”, as the core category vividly showed joys and sorrows of men who had abused alcohol and has lived in the recovering process of managing the yoke of life-long disease. In this process of recovery from alcoholic dependence the men gradually adjusted themselves to their given condition. Also they gained coping strategies to care for, and protect themselves. Therefore health care providers can establish supportive programs in the clinical field to empower these men by reflecting their proactive coping strategies.
Alcoholics ; Grounded Theory ; Health Personnel ; Humans ; Male ; Qualitative Research ; Therapeutic Community*

OBJECTIVE: To investigate the use of antibiotics in children with community-acquired pneumonia (CAP) in multiple regions of China, and to provide a reference for CAP standard treatment and rational antibiotic use in children. METHODS: The medical data of 1 383 children with CAP who were hospitalized in the department of pediatrics in 10 grade A tertiary hospitals from 9 cities between April 14, 2014 and January 1, 2016 were reviewed, to analyze the status of antibiotic use in hospitalized children in North China, Northeast China, East China, and South China. RESULTS: The overall rate of antibiotic use in children with CAP was 89.08%, with 88.7% in North China, 95.5% in Northeast China, 83.3% in East China, and 86.6% in South China. The main types of antibiotics used were cephalosporins, macrolides, compound preparations of β-lactam antibiotics, polyphosphoric broad-spectrum antibiotics and other β-lactam antibiotics. The selection of antibiotics was generally rational, but antibiotics were still used in some patients with viral infection alone or a combined use of ≥2 kinds of antibiotics were noted in some patients with infection caused by one kind of pathogen. Irrational antibiotic use was observed in 131 children (10.63%). CONCLUSIONS There are high rates of antibiotic use and irrational use of antibiotics among children with CAP. Standard management of antibiotic use in children with CAP should be strengthened.
Anti-Bacterial Agents ; therapeutic use ; Child ; Child, Hospitalized ; China ; Community-Acquired Infections ; drug therapy ; Humans

PURPOSE: The purpose of this study was to describe the experience of Korean university students who participated in a therapeutic community. METHODS: Qualitative descriptive research was used. A focus group, in-depth interviews, participant-observation, and self-reports were used to collect data from 9 Korean university students. Participants lived with drug addicts for 6 weeks at DAYTOP in New York, USA. Thematic analysis was used for data analysis. RESULTS: Seven themes and 32 subthemes were found: 1) understanding myself through mutual observation: self-discovery, self-acceptance, self-differentiation, career choices, breaking an addictive habit; 2) healing emotional wounds: trust building, self-closure, recognition of emotional wounds, peaceful mind; 3) being honest with my emotions: understanding addicts, expression of emotions, attitudes about confrontation, confronting others: 4) expressing myself: time management, expression of thanks, I-message, behavior modification, taking a stand; 5) balancing responsibility: attitudes about leaders and work, sharing work, supplementing, sharing opinions; 6) becoming interested in others: understanding family members, recognition of differences, asking about concerns of others, asking for forgiveness, conversation with family members ; 7) becoming interested in the community: attitudes about community, keeping rules, role model, active participation. CONCLUSION: These results show that a therapeutic community can be effective in changing participants' inner selves and behaviors.
Behavior Therapy ; Career Choice ; Drug Users ; Focus Groups ; Forgiveness ; Humans ; Statistics as Topic ; Therapeutic Community* ; Time Management ; Wounds and Injuries

Anti-Bacterial Agents ; administration & dosage ; therapeutic use ; Child ; Community-Acquired Infections ; diagnosis ; epidemiology ; therapy ; Humans ; Pneumonia ; diagnosis ; epidemiology ; therapy

The rationale for the antibiotic treatment of viral community-acquired pneumonia (CAP) in adults was analyzed to develop a clinical reference standard for this condition. Clinical data from 166 patients diagnosed with viral pneumonia across 14 hospitals in Beijing from November 2010 to December 2017 were collected. The indications for medications were evaluated, and the rationale for the use of antibiotics was analyzed. A total of 163 (98.3%) patients with viral pneumonia were treated with antibiotics. A combination of C-reactive protein (CRP) and procalcitonin (PCT) was used as markers to analyze the possible indications for antibiotic use. With threshold levels set at 0.25 µg/L for PCT and 20 mg/L for CRP, the rate of unreasonable use of antibiotics was 55.2%. By contrast, at a CRP level threshold of 60 mg/L, the rate of antibiotic misuse was 77.3%. A total of 39 of the 163 (23.9%) patients did not meet the guidelines for drug selection for viral CAP in adults. The unreasonable use of antibacterial drugs for the treatment of viral CAP in adults is a serious concern. Clinicians must reduce the unnecessary use of antibiotics.
Adult ; Anti-Bacterial Agents/therapeutic use* ; Biomarkers ; Calcitonin ; Community-Acquired Infections/drug therapy* ; Humans ; Pneumonia/drug therapy* ; Protein Precursors

Child ; Humans ; Pneumonia, Mycoplasma/epidemiology* ; Macrolides/therapeutic use* ; Singapore/epidemiology* ; Child, Hospitalized ; Mycoplasma pneumoniae ; Anti-Bacterial Agents/therapeutic use* ; Drug Resistance, Bacterial ; Community-Acquired Infections/drug therapy*

BACKGROUNDGemifloxacin is a fluoroquinolone antibiotic with broad spectrum of antibacterial activity. The aim of the study was to evaluate the comparative effectiveness and safety of gemifloxacin for the treatment of patients with community-acquired pneumonia (CAP) or acute exacerbation of chronic bronchitis (AECB).

METHODSWe performed a meta-analysis of randomized controlled trials (RCTs) comparing gemifloxacin with other approved antibiotics. The PubMed, EMBASE, Chinese Biomedical Literature Database and the Cochrane Central Register of Controlled Trials were searched, with no language restrictions.

RESULTSTen RCTs, comparing gemifloxacin with other quinolones (in 5 RCTs) and β-lactams and/or macrolides (in 5 RCTs), involving 3940 patients, were included in this meta-analysis. Overall, the treatment success was higher for gemifloxacin when compared with other antibiotics (odds ratio 1.39, 95% confidence interval 1.15 - 1.68 in intention-to-treat patients, and 1.33, 1.02 - 1.73 in clinically evaluable patients). There was no significant difference between the compared antibiotics regarding microbiological success (1.19, 0.84 - 1.68) or all-cause mortality (0.82, 0.41 - 1.63). The total drug related adverse events were similar for gemifloxacin when compared with other quinolones (0.89, 0.56 - 1.41), while lower when compared with β-lactams and/or macrolides (0.71, 0.57 - 0.89). In subgroup analyses, administration of gemifloxacin was associated with fewer cases of diarrhoea and more rashes compared with other antibiotics (0.66, 0.48 - 0.91, and 2.36, 1.18 - 4.74, respectively).

CONCLUSIONSThe available evidence suggests that gemifloxacin 320 mg oral daily is equivalent or superior to other approved antibiotics in effectiveness and safety for CAP and AECB. The development of rash represents potential limitation of gemifloxacin.

Anti-Bacterial Agents ; therapeutic use ; Bronchitis, Chronic ; drug therapy ; Community-Acquired Infections ; drug therapy ; Fluoroquinolones ; therapeutic use ; Humans ; Naphthyridines ; therapeutic use ; Pneumonia ; drug therapy ; Quinolones ; therapeutic use ; Randomized Controlled Trials as Topic ; Treatment Outcome

BACKGROUNDCommunity-acquired pneumonia (CAP) is a common infectious disease throughout the world and the incidence continues to grow as the population ages. Aspiration is an important pathogenic mechanism for pneumonia in the elderly and the management of patients with community-acquired pneumonia with aspiration factors is a major medical problem. Our study aimed to assess whether moxifloxacin in comparison to levofloxacin plus metronidazole are effective and safe in the treatment of community-acquired pneumonia with aspiration factors.

METHODSIn this prospective, multicenter, open-label, randomized controlled trial, 77 patients with mild-to-moderate community-acquired pneumonia with aspiration factors were enrolled and randomly assigned to receive moxifloxacin or levofloxacin plus metronidazole. The primary efficacy variables were clinical outcomes in evaluable patients at a follow-up visit 7 to 14 days after the end of therapy.

RESULTSSeven days after the end of therapy a clinical cure was achieved for 76.7% (23 of 37) of efficacy-evaluable patients in the moxifloxacin group and 51.7% (15 of 40) of patients in the levofloxacin plus metronidazole group. There was a significant difference between the two groups (χ(2) = 4.002, P < 0.05). Bacteriological success rates were similar in the moxifloxacin group (93.3%) and levofloxacin plus metronidazole group (96.4%), there was no significant difference between the two groups (P > 0.05). The overall adverse event rate was 10.8% (4/37) in the moxifloxacin group versus 17.5% (7/40) in the levofloxacin plus metronidazole group, there was no significant difference between the two groups (P > 0.05). No serious adverse events were observed.

CONCLUSIONSMoxifloxacin is effective and safe for treatment of community-acquired pneumonia with aspiration factors. And the regimen of moxifloxacin monotherapy is more convenient compared with levofloxacin plus metronidazole.

Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; therapeutic use ; Community-Acquired Infections ; drug therapy ; Female ; Fluoroquinolones ; therapeutic use ; Humans ; Levofloxacin ; therapeutic use ; Male ; Metronidazole ; therapeutic use ; Middle Aged ; Pneumonia ; drug therapy ; Prospective Studies