Foreign body ingestion is a common emergency that necessitates endoscopic intervention. Although many foreign bodies are easily removed, removal of magnets, blades, barbs, and unusually shaped objects, such as toothbrushes is challenging. Toothbrush ingestion may potentially cause complications such as pressure ulcers and perforations. We present a rare case of a 26-year-old woman with schizophrenia, who ingested multiple foreign bodies but was asymptomatic. Radiography showed multiple toothbrushes in the stomach. Emergency non-sedated endoscopy revealed eight toothbrushes in the stomach; five toothbrushes lodged in the great curvature of the stomach and three in the duodenal bulb were successfully removed using a snare and a technique that involved neck hyperextension to facilitate passage. This report describes a case of non-sedated endoscopic removal of multiple toothbrushes, which is rarely reported in the literature. This case highlights that even complex foreign bodies can be safely removed via endoscopy without surgical intervention. To our knowledge, this is the first report in the English literature that discusses endoscopic removal of more than five toothbrushes and underscores the role of customized approaches in the management of ingestion of unusual foreign bodies.

Background: and Purpose: This clinical practice guideline provides evidence-based recommendations for treatment of dementia, focusing on cholinesterase inhibitors and N-methyl-D-aspartate (NMDA) receptor antagonists for Alzheimer’s disease (AD) and other types of dementia. Methods: Using the Population, Intervention, Comparison, Outcomes (PICO) framework, we developed key clinical questions and conducted systematic literature reviews. A multidisciplinary panel of experts, organized by the Korean Dementia Association, evaluated randomized controlled trials and observational studies. Recommendations were graded for evidence quality and strength using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Results: Three main recommendations are presented: (1) For AD, cholinesterase inhibitors (donepezil, rivastigmine, galantamine) are strongly recommended for improving cognition and daily function based on moderate evidence; (2) Cholinesterase inhibitors are conditionally recommended for vascular dementia and Parkinson’s disease dementia, with a strong recommendation for Lewy body dementia; (3) For moderate to severe AD, NMDA receptor antagonist (memantine) is strongly recommended, demonstrating significant cognitive and functional improvements. Both drug classes showed favorable safety profiles with manageable side effects. Conclusions This guideline offers standardized, evidence-based pharmacologic recommendations for dementia management, with specific guidance on cholinesterase inhibitors and NMDA receptor antagonists. It aims to support clinical decision-making and improve patient outcomes in dementia care. Further updates will address emerging treatments, including amyloid-targeting therapies, to reflect advances in dementia management.

Systemic corticosteroids play an essential role in the management of asthma. During acute exacerbation, the short-term use of systemic corticosteroids is recommended. For patients with uncontrolled asthma and severe asthma, long-term and low-dose oral corticosteroids (OCS) have frequently been advocated. However, both short-term and long-term use of systemic corticosteroids carry the risk of adverse events (AEs), including various morbidities and even mortality. Despite recent progress in adult severe asthma management and the availability of new treatment options, the current domestic guidelines for asthma do not provide specific recommendations for oral corticosteroid tapering in patients with severe asthma. Therefore, the task force team of the severe asthma working group in the Korean Academy of Allergy, Asthma, and Clinical Immunology has proposed a tapering protocol for systemic corticosteroid use in severe asthma. This includes practical recommendations for monitoring OCS-related AE, particularly for adrenal insufficiency and osteoporosis, which suggests corticosteroid-sparing strategies that include alternative therapies, modifying treatable traits, timely specialist assessment, and shared decision-making with patients. However, further real-world research and collaboration with doctors from primary and academic institutes, patients, and policymakers are necessary to establish an OCS stewardship approach. This should include realistic OCS-tapering strategies for patients with severe asthma using regular OCS, education, and campaigns for patients, the public, and healthcare providers about the burden of severe asthma, as well as improving timely access to specialized severe asthma services for optimal management.

Foreign body ingestion is a common emergency that necessitates endoscopic intervention. Although many foreign bodies are easily removed, removal of magnets, blades, barbs, and unusually shaped objects, such as toothbrushes is challenging. Toothbrush ingestion may potentially cause complications such as pressure ulcers and perforations. We present a rare case of a 26-year-old woman with schizophrenia, who ingested multiple foreign bodies but was asymptomatic. Radiography showed multiple toothbrushes in the stomach. Emergency non-sedated endoscopy revealed eight toothbrushes in the stomach; five toothbrushes lodged in the great curvature of the stomach and three in the duodenal bulb were successfully removed using a snare and a technique that involved neck hyperextension to facilitate passage. This report describes a case of non-sedated endoscopic removal of multiple toothbrushes, which is rarely reported in the literature. This case highlights that even complex foreign bodies can be safely removed via endoscopy without surgical intervention. To our knowledge, this is the first report in the English literature that discusses endoscopic removal of more than five toothbrushes and underscores the role of customized approaches in the management of ingestion of unusual foreign bodies.

Foreign body ingestion is a common emergency that necessitates endoscopic intervention. Although many foreign bodies are easily removed, removal of magnets, blades, barbs, and unusually shaped objects, such as toothbrushes is challenging. Toothbrush ingestion may potentially cause complications such as pressure ulcers and perforations. We present a rare case of a 26-year-old woman with schizophrenia, who ingested multiple foreign bodies but was asymptomatic. Radiography showed multiple toothbrushes in the stomach. Emergency non-sedated endoscopy revealed eight toothbrushes in the stomach; five toothbrushes lodged in the great curvature of the stomach and three in the duodenal bulb were successfully removed using a snare and a technique that involved neck hyperextension to facilitate passage. This report describes a case of non-sedated endoscopic removal of multiple toothbrushes, which is rarely reported in the literature. This case highlights that even complex foreign bodies can be safely removed via endoscopy without surgical intervention. To our knowledge, this is the first report in the English literature that discusses endoscopic removal of more than five toothbrushes and underscores the role of customized approaches in the management of ingestion of unusual foreign bodies.

Background: and Purpose: This clinical practice guideline provides evidence-based recommendations for treatment of dementia, focusing on cholinesterase inhibitors and N-methyl-D-aspartate (NMDA) receptor antagonists for Alzheimer’s disease (AD) and other types of dementia. Methods: Using the Population, Intervention, Comparison, Outcomes (PICO) framework, we developed key clinical questions and conducted systematic literature reviews. A multidisciplinary panel of experts, organized by the Korean Dementia Association, evaluated randomized controlled trials and observational studies. Recommendations were graded for evidence quality and strength using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Results: Three main recommendations are presented: (1) For AD, cholinesterase inhibitors (donepezil, rivastigmine, galantamine) are strongly recommended for improving cognition and daily function based on moderate evidence; (2) Cholinesterase inhibitors are conditionally recommended for vascular dementia and Parkinson’s disease dementia, with a strong recommendation for Lewy body dementia; (3) For moderate to severe AD, NMDA receptor antagonist (memantine) is strongly recommended, demonstrating significant cognitive and functional improvements. Both drug classes showed favorable safety profiles with manageable side effects. Conclusions This guideline offers standardized, evidence-based pharmacologic recommendations for dementia management, with specific guidance on cholinesterase inhibitors and NMDA receptor antagonists. It aims to support clinical decision-making and improve patient outcomes in dementia care. Further updates will address emerging treatments, including amyloid-targeting therapies, to reflect advances in dementia management.

Systemic corticosteroids play an essential role in the management of asthma. During acute exacerbation, the short-term use of systemic corticosteroids is recommended. For patients with uncontrolled asthma and severe asthma, long-term and low-dose oral corticosteroids (OCS) have frequently been advocated. However, both short-term and long-term use of systemic corticosteroids carry the risk of adverse events (AEs), including various morbidities and even mortality. Despite recent progress in adult severe asthma management and the availability of new treatment options, the current domestic guidelines for asthma do not provide specific recommendations for oral corticosteroid tapering in patients with severe asthma. Therefore, the task force team of the severe asthma working group in the Korean Academy of Allergy, Asthma, and Clinical Immunology has proposed a tapering protocol for systemic corticosteroid use in severe asthma. This includes practical recommendations for monitoring OCS-related AE, particularly for adrenal insufficiency and osteoporosis, which suggests corticosteroid-sparing strategies that include alternative therapies, modifying treatable traits, timely specialist assessment, and shared decision-making with patients. However, further real-world research and collaboration with doctors from primary and academic institutes, patients, and policymakers are necessary to establish an OCS stewardship approach. This should include realistic OCS-tapering strategies for patients with severe asthma using regular OCS, education, and campaigns for patients, the public, and healthcare providers about the burden of severe asthma, as well as improving timely access to specialized severe asthma services for optimal management.

Systemic corticosteroids play an essential role in the management of asthma. During acute exacerbation, the short-term use of systemic corticosteroids is recommended. For patients with uncontrolled asthma and severe asthma, long-term and low-dose oral corticosteroids (OCS) have frequently been advocated. However, both short-term and long-term use of systemic corticosteroids carry the risk of adverse events (AEs), including various morbidities and even mortality. Despite recent progress in adult severe asthma management and the availability of new treatment options, the current domestic guidelines for asthma do not provide specific recommendations for oral corticosteroid tapering in patients with severe asthma. Therefore, the task force team of the severe asthma working group in the Korean Academy of Allergy, Asthma, and Clinical Immunology has proposed a tapering protocol for systemic corticosteroid use in severe asthma. This includes practical recommendations for monitoring OCS-related AE, particularly for adrenal insufficiency and osteoporosis, which suggests corticosteroid-sparing strategies that include alternative therapies, modifying treatable traits, timely specialist assessment, and shared decision-making with patients. However, further real-world research and collaboration with doctors from primary and academic institutes, patients, and policymakers are necessary to establish an OCS stewardship approach. This should include realistic OCS-tapering strategies for patients with severe asthma using regular OCS, education, and campaigns for patients, the public, and healthcare providers about the burden of severe asthma, as well as improving timely access to specialized severe asthma services for optimal management.

Background: and Purpose: This clinical practice guideline provides evidence-based recommendations for treatment of dementia, focusing on cholinesterase inhibitors and N-methyl-D-aspartate (NMDA) receptor antagonists for Alzheimer’s disease (AD) and other types of dementia. Methods: Using the Population, Intervention, Comparison, Outcomes (PICO) framework, we developed key clinical questions and conducted systematic literature reviews. A multidisciplinary panel of experts, organized by the Korean Dementia Association, evaluated randomized controlled trials and observational studies. Recommendations were graded for evidence quality and strength using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Results: Three main recommendations are presented: (1) For AD, cholinesterase inhibitors (donepezil, rivastigmine, galantamine) are strongly recommended for improving cognition and daily function based on moderate evidence; (2) Cholinesterase inhibitors are conditionally recommended for vascular dementia and Parkinson’s disease dementia, with a strong recommendation for Lewy body dementia; (3) For moderate to severe AD, NMDA receptor antagonist (memantine) is strongly recommended, demonstrating significant cognitive and functional improvements. Both drug classes showed favorable safety profiles with manageable side effects. Conclusions This guideline offers standardized, evidence-based pharmacologic recommendations for dementia management, with specific guidance on cholinesterase inhibitors and NMDA receptor antagonists. It aims to support clinical decision-making and improve patient outcomes in dementia care. Further updates will address emerging treatments, including amyloid-targeting therapies, to reflect advances in dementia management.

Foreign body ingestion is a common emergency that necessitates endoscopic intervention. Although many foreign bodies are easily removed, removal of magnets, blades, barbs, and unusually shaped objects, such as toothbrushes is challenging. Toothbrush ingestion may potentially cause complications such as pressure ulcers and perforations. We present a rare case of a 26-year-old woman with schizophrenia, who ingested multiple foreign bodies but was asymptomatic. Radiography showed multiple toothbrushes in the stomach. Emergency non-sedated endoscopy revealed eight toothbrushes in the stomach; five toothbrushes lodged in the great curvature of the stomach and three in the duodenal bulb were successfully removed using a snare and a technique that involved neck hyperextension to facilitate passage. This report describes a case of non-sedated endoscopic removal of multiple toothbrushes, which is rarely reported in the literature. This case highlights that even complex foreign bodies can be safely removed via endoscopy without surgical intervention. To our knowledge, this is the first report in the English literature that discusses endoscopic removal of more than five toothbrushes and underscores the role of customized approaches in the management of ingestion of unusual foreign bodies.