XI. STRATEGIES FOR IMPROVING DIABETES CARE D iabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Bode (Ed.): Medical Management of Type 1 Diabetes (1), Burant (Ed): Medical Management of Type 2 Diabetes (2), and Klingensmith (Ed): Intensive Diabetes Management (3). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.

Standards of Medical Care in Diabetes

EASL-EORTC clinical practice guidelines : management of hepatocellular carcinoma

CA : A Cancer Journal for Clinicians

EASL–EORTC Clinical Practice Guidelines (CPG) on the management of hepatocellular carcinoma (HCC) define the use of surveillance, diagnosis, and therapeutic strategies recommended for patients with this type of cancer. This is the first European joint effort by the European Association for the Study of the Liver (EASL) and the European Organization for Research and Treatment of Cancer (EORTC) to provide common guidelines for the management of hepatocellular carcinoma. These guidelines update the recommendations reported by the EASL panel of experts in HCC published in 2001 [1]. Several clinical and scientific advances have occurred during the past decade and, thus, a modern version of the document is urgently needed. The purpose of this document is to assist physicians, patients, health-care providers, and health-policy makers from Europe and worldwide in the decision-making process according to evidencebased data. Users of these guidelines should be aware that the recommendations are intended to guide clinical practice in circumstances where all possible resources and therapies are available. Thus, they should adapt the recommendations to their local regulations and/or team capacities, infrastructure, and cost– benefit strategies. Finally, this document sets out some recommendations that should be instrumental in advancing the research and knowledge of this disease and ultimately contribute to improve patient care. The EASL–EORTC CPG on the management of hepatocellular carcinoma provide recommendations based on the level of evidence and the strength of the data (the classification of evidence is adapted from National Cancer Institute [2]) (Table 1A) and the strength of recommendations following previously reported systems (GRADE systems) (Table 1B).

http://www.bclc.cat/download/easl-guidelines.pdf

EASL-EORTC Clinical Practice Guidelines: Management of hepatocellular carcinoma European Association for the Study of the Liver ⇑ , European Organisation for Research and Treatment of Cancer

https://www.emcdda.europa.eu/attachements.cfm/att_231442_EN_INT17_easl-recommendations-on-treatment-of-hepatitis-C.pdf

EASL Recommendations on Treatment of Hepatitis C

Antiviral therapy with direct-acting antiviral (DAA) for patients infected by hepatitis C virus (HCV) has made a remarkable progress, enabling more patients eligible for treatment compared to interferon era. Indeed, DAA treatment with high efficacy and safety is an important major component of global strategy to eliminate HCV infection until 2030, proposed by the World Health Organization (WHO). The epidemiological and clinical characteristics related to HCV infection largely differ among regions and countries. Even in a region or country, these characteristics might be different between two time periods which are divided by introduction of DAA. Thus, it is relevant to figure out which characteristics are clinically significant in post-DAA period compared with pre-DAA period to help implement an effective program for HCV elimination. In this issue, Nam et al. investigated the changing epidemiological and clinical characteristics of HCV infection in South Korea between 2007 and 2017. A total of 2,758 patients with HCV viremia were prospectively enrolled at seven tertiary hospitals. Apart from various data collected from medical records, a survey was conducted using patient questionnaire to reveal risk factors for HCV infection. The overall characteristics of patients including mean age, disease severity ranging from chronic hepatitis, cirrhosis to hepatocellular carcinoma (HCC) and HCV genotypes were not much different from those previously reported. The major risk factors associated with HCV infection in South Korea were known to be multiple sexual partners, tattooing, history of transfusion, acupuncture and needle stick injuries. This article also confirms that multiple factors such as tattooing, piercing, blood transfusion and needle stick injuries contribute to HCV infection in South Korea. There was an epidemiological difference between males and females, showing a higher frequencies of intravenous drug use experiences, needle stick injuries and multiple sexual partners in males. Whereas such risk factors as history of transfusion, tattooing, piercing and acupuncture were more closely related to HCV infection in females, suggesting different risk factors by gender depend on the behavioral characteristics and degree of risk exposure. Several clinical characteristics differed between pre-DAA (2007 to 2014) and post-DAA (2015 to 2017) period. The mean age of patients recently enrolled (post-DAA period) was higher than those enrolled at pre-DAA period (60.6 years vs 56.15 years, p<0.001). Compared to pre-DAA period, there were more male patients, less patients with education above high-school level, more patients with HCC or cardiovascular disease in postDAA period. This observation might be partly explained by older age of patients in recent period. Since introduction of DAA in early 2000, treatment paradigm of HCV infection has been rapidly and dramatically evolved. A higher sustained virological response (SVR) rates, shorter treatment duration, better safety and tolerability resulted in higher treatment uptake rates at least in a special patient population. In a modeling study, combination of higher SVR rates, improved HCV diagnosis and higher treatment uptake rates was found to achieve HCV elimination until 2030 in South Korea. Then, are treatment uptake rates actually increasing in Korea? In this article, the overall treatment uptake rates were 52.8% and 56.1% in pre-DAA and post-DAA period, respectively. The reasons why there is not apparent increase in the treatment uptake rates

https://ir.ymlib.yonsei.ac.kr/bitstream/22282913/179061/1/T202001868.pdf

Awareness and Access to Therapy in Hepatitis C Virus Infected Patients, Key Barriers to Eliminate the Virus?

/pdf/simple-palatal-releasing-incision-for-minimally-invasive-48btlzi0gj.pdf

Simple Palatal Releasing Incision for Minimally Invasive Soft Tissue Closure: Case Report Simple Palatal Releasing Incision for Minimally Invasive Soft Tissue Closure: Case Report

Closing the Brief Case: Bergeyella zoohelcum Bacteremia in an Immunocompromised 69-Year-Old Patient

The present invention relates to a composition for preventing or treating liver disease containing a lipid extract of half dried herring. The intake of the lipid extract of half dried herring reduces the expression of CYP2E1, a major mechanism associated with alcoholic liver damage, and has the effect of alleviating the blood chemistry indicators associated with liver damage. Therefore, the composition can be effectively used as a pharmaceutical composition and health functional food which can prevent, ameliorate, and treat hepatitis or fatty liver induced by alcohol consumption.

Composition comprising lipid extract of Guamegi for preventing or treating liver diseases

Background Alopecia areata (AA) is a chronic disease with an unpredictable course and can have a severe psychological impact on an individual. Objective To provide evidence and consensus-based statements regarding the treatment of patients with AA in Korea. Methods We searched for relevant studies from inception to May 2021 regarding the systemic treatment of AA. Evidence-based recommendations were also prepared. The evidence for each statement was graded and classified according to the strength of the recommendations. Hair experts from the Korean Hair Research Society (KHRS) voted on the statement, and an agreement of 75% or greater was considered as having reached consensus. Results Current evidence supports the efficacy of systemic corticosteroids, oral cyclosporine monotherapy or combination with systemic corticosteroids, and oral Janus kinase inhibitors in severe AA patients. Systemic steroids may be considered for pediatric patients with severe AA. A consensus was achieved in three out of nine (33.3%), and one out of three (33.3%) statements pertaining to systemic treatment in adult and pediatric AA, respectively. Conclusion The present study produced up-to-date, evidence-based treatment guidelines for AA associated with the consensus obtained by experts based on the Korean healthcare system.

Do Young Kim

Papers

Awareness and Access to Therapy in Hepatitis C Virus Infected Patients, Key Barriers to Eliminate the Virus?

Simple Palatal Releasing Incision for Minimally Invasive Soft Tissue Closure: Case Report Simple Palatal Releasing Incision for Minimally Invasive Soft Tissue Closure: Case Report

Closing the Brief Case: Bergeyella zoohelcum Bacteremia in an Immunocompromised 69-Year-Old Patient

Composition comprising lipid extract of Guamegi for preventing or treating liver diseases

Guidelines for the Management of Patients with Alopecia Areata in Korea: Part II Systemic Treatment