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A Systematic Review and Meta-analysis on the Effect of Delirium Prevention Intervention in Korean Intensive Care Units (국내 중환자실 섬망 예방 중재에 관한 체계적 고찰 및 메타분석)

  • Kang, Jiyeon;Choi, Min Jeong
    • Journal of Korean Critical Care Nursing
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    • v.14 no.3
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    • pp.141-156
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    • 2021
  • Purpose : This study aimed to systematically review the preventive interventions for delirium in Korean intensive care unit (ICU) patients and evaluate their efficacy. Methods : For this systematic review and meta-analysis, we searched the literature and selected studies from data sources that included the RISS, KISS, National Central Library, National Assembly Library, DBpia, Science on, MEDLINE, and Cochrane Library. We used Cochrane's revised tool for risk of bias in randomized trials and non-randomized studies of intervention tools to assess the quality of the selected studies. The effect size of the intervention was calculated as odds ratio (OR) and standardized mean difference (SMD). Results : Preventive interventions reported in 23 studies with a total of 4,799 ICU patients were effective in reducing the occurrence of delirium (OR=0.64, 95% CI : 0.49~0.91, p=.011), but not the duration (SMD=-0.22, 95% CI : -0.51~0.08, p=.148). As a result of a subgroup analysis, non-pharmacological interventions were effective in reducing the occurrence of delirium (OR=0.66, 95% CI : 0.47~0.94, p=.020), while pharmacological interventions had no effect (OR=0.68, 95% CI : 0.33~1.40, p=.295). Among the non-pharmacological interventions, multi-component intervention had the largest effect size (OR=0.38, 95% CI : 0.26~0.55, p<.001). Conclusion : Non-pharmacological interventions were effective in reducing the occurrence of delirium. We recommend the development and application of multi-component interventions to prevent delirium in the Korean ICU patients.

Effect of Herbal Bath for Duration of Pediatric Fever : a Systematic Review and Meta-analysis (한약재 약욕요법이 소아 발열기간에 미치는 영향 : 체계적 문헌고찰 및 메타분석)

  • Kim, Ye Ji;Park, So Hyun;Seo, Hae Sun;Park, Sul Gi;Lee, Sun Haeng;Lee, Jin Yong
    • The Journal of Pediatrics of Korean Medicine
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    • v.35 no.3
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    • pp.53-66
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    • 2021
  • Objective The purpose of this study is to evaluate whether herbal bath shortens the duration of pediatric fever. Methods Databases, such as Medline, EMBASE, Cochrane library, OASIS, KISS, KMBASE, CNKI, Wanfang Med Online were used to search randomized controlled trials. Those trials that included children younger than 18-year-old were evaluated for the clinical efficacy of herbal bath in fever by analyzing 'body temperature (BT) drop start time' and 'time to return to normal BT'. Results 12 studies or 1306 participants were analyzed in the study. When applying herbal bath in combination with the controlled treatment, 'BT drop start time' was decreased by 0.11 hours, and 'time to return to normal BT' was decreased by 10.94 hours compared to the controlled group. When comparing herbal bath with tepid bath, 'time to return to normal BT' was reduced by 8.19 hours in herbal bath group. In regards to safety, 3 studies out of 12 studies mentioned about its adverse events: 2 studies did not have any adverse events, and a minor needle-shaped bleeding had occurred in one of the studies. Conclusion Use of herbal bath as a treatment of fever in children was associated with shortened duration of fever. However, cautious interpretation is necessary due to its limited safety data.

Effects of garlic intake on cancer: a systematic review of randomized clinical trials and cohort studies

  • Lee, Jounghee;Zhao, Naisi;Fu, Zhuxuan;Choi, Jihee;Lee, Hae-Jeung;Chung, Mei
    • Nutrition Research and Practice
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    • v.15 no.6
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    • pp.773-788
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    • 2021
  • BACKGROUND/OBJECTIVES: Due to the rapid increase of global cancer incidence and mortality and a high level of interest in cancer prevention, a systematic review of garlic intake and cancer risk is needed. SUBJECTS/METHODS: We implemented a systematic review to examine the effects of varying levels of garlic intake on cancer. We conducted comprehensive literature searches in three electronic databases (MEDLINE, Embase, and Web of Science) for studies published between database inception and July or September of 2018. Two investigators independently screened abstracts and full-texts, extracted data, and assessed risk of bias (RoB). A total of one medium-quality randomized controlled trial (RCT) and 13 cohort studies graded as high RoB were included. RESULTS: The 1-year follow-up results from a RCT showed that a significant decrease in the number and size of colorectal adenomas among participants with colorectal adenomas who received high-dose aged garlic extract (AGE) compared with those who received low-dose AGE (P < 0.05). The results of prospective observational studies provided inconsistent associations of colorectal cancer risk with garlic supplements and garlic intake as food. CONCLUSIONS: In summary, the AGE was effective in reducing the number and magnitude of colorectal adenomas in one RCT, but there were inconsistent associations between garlic intake and colorectal cancer in cohort studies. Therefore, we could not draw a firm conclusion regarding the effects of garlic on cancer, because the current strength of evidence is inadequate due to a lack of number of high-quality RCTs.

Latissimus dorsi detrusor myoplasty for bladder acontractility: a systematic review

  • Forte, Antonio Jorge;Boczar, Daniel;Huayllani, Maria Tereza;Moran, Steven;Okanlami, Oluwaferanmi O.;Ninkovic, Milomir;Broer, Peter N.
    • Archives of Plastic Surgery
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    • v.48 no.5
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    • pp.528-533
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    • 2021
  • Bladder acontractility affects several thousand patients in the United States, but the available therapies are limited. Latissimus dorsi detrusor myoplasty (LDDM) is a therapeutic option that allows patients with bladder acontractility to void voluntarily. Our goal was to conduct a systematic review of the literature to determine whether LDDM is a better option than clean intermittent catheterization (CIC) (standard treatment) in patients with bladder acontractility. On January 17, 2020, we conducted a systematic review of the PubMed/MEDLINE, Cochrane Clinical Answers, Cochrane Central Register of Controlled Trials, Embase, and ClinicalTrials.gov databases, without time frame limitations, to identify articles on the use of LDDM for bladder acontractility. Of 75 potential articles, 4 fulfilled the eligibility criteria. The use of LDDM to treat patients with bladder acontractility was reported in four case series by the same group in Europe. Fifty-eight patients were included, and no comparison groups were included. The most common cause of bladder acontractility was spinal cord injury (n=36). The mean (±standard deviation) operative time was 536 (±22) minutes, postoperative length of hospital stay ranged from 10 to 13 days, and follow-up ranged from 9 to 68 months. Most patients had complete response, were able to void voluntarily, and had post-void residual volume less than 100 mL. Although promising outcomes have been obtained, evidence is still weak regarding whether LDDM is better than CIC to avoid impairment of the urinary tract among patients with bladder acontractility. Further prospective studies with control groups are necessary.

The global prevalence of Toxocara spp. in pediatrics: a systematic review and meta-analysis

  • Abedi, Behnam;Akbari, Mehran;KhodaShenas, Sahar;Tabibzadeh, Alireza;Abedi, Ali;Ghasemikhah, Reza;Soheili, Marzieh;Bayazidi, Shnoo;Moradi, Yousef
    • Clinical and Experimental Pediatrics
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    • v.64 no.11
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    • pp.575-581
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    • 2021
  • Background: Toxocariasis is a zoonotic parasitic disease caused by Toxocara canis and Toxocara cati in humans. Various types of T. canis are important. Purpose: The current study aimed to investigate the prevalence of Toxocara spp. in pediatrics in the context of a systematic review and meta-analysis. Methods: The MEDLINE (PubMed), Web of Sciences, Embase, Google Scholar, Scopus, and Cumulative Index of Nursing and Allied Health databases were searched to identify peer-reviewed studies published between January 2000 and December 2019 that report the prevalence of Toxocara spp. in pediatrics. The evaluation of articles based on the inclusion and exclusion criteria was performed by 2 researchers individually. Results: The results of 31 relevant studies indicated that the prevalence of Toxocara spp. was 3%-79% in 10,676 cases. The pooled estimate of global prevalence of Toxocara spp. in pediatrics was 30 (95% confidence interval, 22%-37%; I2=99.11%; P=0.00). The prevalence was higher in Asian populations than in European, American, and African populations. Conclusion: Health policymakers should be more attentive to future research and approaches to Toxocara spp. and other zoonotic diseases to improve culture and identify socioeconomically important factors.

Effects of Herbal Medicines on Bone Mineral Density Score in Osteoporosis or Osteopenia: Study Protocol for a Systematic Review and Meta-Analysis (한약이 골다공증 혹은 골감소증 환자의 골밀도에 미치는 영향: 체계적 문헌고찰 및 메타분석을 위한 프로토콜)

  • Hong, Su Min;Lee, Eun Jung
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.2
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    • pp.49-55
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    • 2021
  • Objectives The impact of social and economic losses on society due to the occurrence of osteoporosis patients is serious. The purpose of this study is to identify the types and effects of herbal medicine for osteoporosis and osteopenia. Methods We will investigate 8 online databases (MEDLINE/PubMed, Cochrane library, EMbase, China National Knowledge Infrastructure [CNKI], J-stage, National Digital Science Library [NDSL], Research Information Sharing Service [RISS], Koreanstudies Information Service System [KISS]) without language, publication date limitation for the clinical study of herbal medicine for osteoporosis and osteopenia published between the start of the database and 2021. The frequency, duration and pattern of the any type of herbal medicine utilization will be analyzed. Results Randomized controlled trials about herbal medicine or herbal medicine extracts for osteoporosis and osteopenia should be included in the study. Cochrane risk in bias tools will be used to evaluate the methodological quality of the study. A risk ratio or mean difference with a 95% confidence interval will show the effects of herbal medicine or herbal medicine extracts for osteoporosis and osteopenia. Conclusions The results of the systematic review will reflect the current status of herbal medicine treatment for osteoporosis and osteopenia, and it can be expected to verify the validity of the effectiveness, and provide it as a basic data for the use of herbal medicine in clinical utilization.

MicroRNAs and periodontal disease: a qualitative systematic review of human studies

  • Mico-Martinez, Pablo;Alminana-Pastor, Pedro J.;Alpiste-Illueca, Francisco;Lopez-Roldan, Andres
    • Journal of Periodontal and Implant Science
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    • v.51 no.6
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    • pp.386-397
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    • 2021
  • Purpose: MicroRNAs (miRNAs) are epigenetic post-transcriptional regulators that modulate gene expression and have been identified as biomarkers for several diseases, including cancer. This study aimed to systematically review the relationship between miRNAs and periodontal disease in humans, and to evaluate the potential of miRNAs as diagnostic and prognostic biomarkers of disease. Methods: The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines (reference number CRD42020180683). The MEDLINE, Scopus, Cochrane Library, Embase, Web of Science, and SciELO databases were searched for clinical studies conducted in humans investigating periodontal diseases and miRNAs. Expression levels of miRNAs across the different groups were analysed using the collected data. Results: A total of 1,299 references were identified in the initial literature search, and 23 articles were finally included in the review. The study designs were heterogeneous, which prevented a meta-analysis of the data. Most of the studies compared miRNA expression levels between patients with periodontitis and healthy controls. The most widely researched miRNA in periodontal diseases was miR-146a. Most studies reported higher expression levels of miR-146a in patients with periodontitis than in healthy controls. In addition, many studies also focused on identifying target genes of the differentially expressed miRNAs that were significantly related to periodontal inflammation. Conclusions: The results of the studies that we analysed are promising, but diagnostic tests are needed to confirm the use of miRNAs as biomarkers to monitor and aid in the early diagnosis of periodontitis in clinical practice.

Systematic review: agreement between the latent tuberculosis screening tests among patients with rheumatic diseases

  • Pyo, Junhee;Cho, Soo-Kyung;Kim, Dam;Sung, Yoon-Kyoung
    • The Korean journal of internal medicine
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    • v.33 no.6
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    • pp.1241-1251
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    • 2018
  • Background/Aims: To estimate the level of agreement and positivity rates of latent tuberculosis infection (LTBI) tests prior to the use of tumor necrosis factor (TNF) inhibitors in relation to underlying rheumatic diseases and endemic tuberculosis levels. Methods: The Ovid-Medline, Embase, and Cochrane Libraries were searched for articles before October 2013 involving LTBI screening in rheumatic patients, including rheumatoid arthritis (RA), ankylosing spondylitis (AS), juvenile idiopathic arthritis (JIA), and psoriatic arthritis. Results: In pooled analyses, 5,224 rheumatic patients had undergone both a tuberculin skin test (TST) and an interferon-gamma release assay (IGRA) before TNF inhibitors use. The positivity of TST, QuantiFERON-TB Gold In Tube (QFT-GIT), and T-SPOT.TB (T-SPOT) tests were estimated to be 29%, 17%, and 18%, respectively. The agreement percentage between the TST and QFT-GIT, and between the TST and T-SPOT were 73% and 75%. Populations from low-to-moderate endemic TB presented with slightly less agreement (71% between TST and QFT-GIT, and 74% between TST and T-SPOT) than patients from high endemic countries (73% between TST and QFT-GIT, and 81% between TST and T-SPOT). By underlying disease stratification, a lower level of agreement between TST and QFT-GIT was found among AS (64%) than among JIA (77%) and RA patients (73%). Conclusions: We reaffirm the current evidence for accuracy of LTBI test done by TST and IGRA among rheumatic patients is inconsistent. Our stratified analysis suggests different screening strategies might be needed in clinical settings considering the endemic status in the patient's country of origin and the precise nature of underlying diseases.

Comparative Efficacy and Safety of Long-acting Injectable and Oral Second-generation Antipsychotics for the Treatment of Schizophrenia: A Systematic Review and Meta-analysis

  • Park, Seon-Cheol;Choi, Mi Young;Choi, Jina;Park, Eunjung;Tchoe, Ha Jin;Suh, Jae Kyung;Kim, Young Hoon;Won, Seung Hee;Chung, Young-Chul;Bae, Kyung-Yeol;Lee, Sang-Kyu;Park, Chan Mi;Lee, Seung-Hwan
    • Clinical Psychopharmacology and Neuroscience
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    • v.16 no.4
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    • pp.361-375
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    • 2018
  • We aimed to compare the efficacy and safety of long-acting injectable (LAI) and oral second-generation antipsychotics (SGAs) in treating schizophrenia by performing a systematic review and meta-analysis. MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Library, as well as five Korean databases, were systemically searched to identify studies published from 2000 to 16 April 2015, which compared the efficacy and safety of LAI and oral SGAs. Using data from randomized controlled trials (RCTs), meta-analyses were conducted. In addition, the GRADE (the Grading of Recommendations, Assessment, Development and Evaluation) approach was applied to explicitly assess the quality of the evidence. A total of 30 studies including 17 RCTs and 13 observational studies were selected. The group treated with LAI SGAs was characterized by significantly lower relapse rates, longer times to relapse and fewer hospital days, but also by a higher occurrence of extrapyramidal syndrome and prolactin-related symptoms than that in the group treated with oral SGAs. Our findings demonstrate that there is moderate to high level of evidence suggesting that in the treatment of schizophrenia, LAI SGAs have higher efficacy and are associated with higher rates of extrapyramidal syndrome and prolactin-related symptoms. Additionally, the use of LAI SGAs should be combined with appropriate measures to reduce dopamine $D_2$ antagonism-related symptoms.

Effective Medicinal Plants in the Treatment of the Cyclic Mastalgia (Breast Pain): A Review

  • Niazi, Azin;Rahimi, Vafa Baradaran;Hatami, Hooman;Shirazinia, Reza;Esmailzadeh-dizaji, Reza;Askari, Nafiseh;Askari, Vahid Reza
    • Journal of Pharmacopuncture
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    • v.22 no.3
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    • pp.131-139
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    • 2019
  • Introduction: Mastalgia is the most common benign breast disorder during the fertility period of women. So far a wide range of natural or complementary medicines is used to cure mastalgia. Sanitary organizations need complete and suitable details to help women, for making the proper decision for alternative treatment based on the evidence. The aim of the present study is to introduce medicinal plant-based treatments about mastalgia and summarizes clinical trials about this disorder. Method: The articles were provided using mixture of keywords including cyclic pain, breast, treatment, therapeutics, therapy, clinical trial, herbal, drug, mastalgia and all the probable terms, in national and international databases SID, Iran Medex, Magiran, PubMed, Scopus, Medline, Science direct and Cochrane library, in both Persian and English languages. All cross-sectional and review articles about herbal treatment of mastalgia until 2018 November were studied. Results: Nineteen articles from all of the available articles (45 cases) and a sample size about of (1987 cases) were included in our study. The articles were clinical trials. The results revealed that mastalgia could be healed by Nigella sativa, Vitex agnus-castus, curcumin, Hypericum perforatum, Citrus sinensis, wheat germ, and Ginkgo biloba. Conclusion: Most of the evaluated medicinal plants possessing antioxidant compounds with anti-inflammatory and analgesic properties, exhibited healing effects in the treatment of mastalgia. Thus, medicinal plants can be considered in the treatment of mastalgia; however, further investigations are needed to obtain more details about their probable side effects.