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Association Between Pancreatitis and Subsequent Risk of Pancreatic Cancer: a Systematic Review of Epidemiological Studies

  • Tong, Gui-Xian;Geng, Qing-Qing;Chai, Jing;Cheng, Jing;Chen, Peng-Lai;Liang, Han;Shen, Xing-Rong;Wang, De-Bin
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권12호
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    • pp.5029-5034
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    • 2014
  • This study aimed to summarize published epidemiological evidence for the relationship between pancreatitis and subsequent risk of pancreatic cancer (PC). We searched Medline and Embase for epidemiological studies published by February $5^{th}$, 2014 examining the risk of PC in pancreatitis patients using highly inclusive algorithms. Information about first author, year of publication, country of study, recruitment period, type of pancreatitis, study design, sample size, source of controls and attained age of subjects were extracted by two researchers and Stata 11.0 was used to perform the statistical analyses and examine publication bias. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated with the random effects model. A total of 17 articles documenting 3 cohort and 14 case-control studies containing 14,667 PC cases and 17,587 pancreatitis cases were included in this study. The pooled OR between pancreatitis and PC risk was 7.05 (95%CI: 6.42-7.75). Howeever, the pooled ORs of case-control and cohort studies were 4.62 (95%CI: 4.08-5.22) and 16.3 (95%CI: 14.3-18.6) respectively. The risk of PC was the highest in patients with chronic pancreatitis (pooled OR=10.35; 95%CI: 9.13-11.75), followed by unspecified type of pancreatitis (pooled OR=6.41; 95%CI: 4.93-8.34), both acute and chronic pancreatitis (pooled OR=6.13; 95%CI: 5.00-7.52), and acute pancreatitis (pooled OR=2.12; 95%CI: 1.59-2.83). The pooled OR of PC in pancreatitis cases diagnosed within 1 year was the highest (pooled OR=23.3; 95%CI: 14.0-38.9); and the risk in subjects diagnosed with pancreatitis for no less than 2, 5 and 10 years were 3.03 (95%CI: 2.41-3.81), 2.82 (95%CI: 2.12-3.76) and 2.25 (95%CI: 1.59-3.19) respectively. Pancreatitis, especially chronic pancreatitis, was associated with a significantly increased risk of PC; and the risk decreased with increasing duration since diagnosis of pancreatitis.

Effectiveness of Education Interventions for the Management of Cancer Pain: A Systematic Review

  • Lee, Yoon Jae;Hyun, Min Kyung;Jung, Yea Ji;Kang, Min Joo;Keam, Bhumsuk;Go, Su Jin
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권12호
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    • pp.4787-4793
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    • 2014
  • Background: Many cancer patients experience poor pain control due to various factors, including misconceptions regarding the use of opioid analgesics. For management of cancer pain, interventions involving education of both patients and physicians have been attempted. Objectives: This review aimed to assess the current evidence of the benefits of education for the management of cancer pain. Methods: We searched the Medline, EMBASE, Cochrane library, and major Korean databases to identify relevant studies. We included most study designs, but excluded case series. The primary outcomes were pain intensity and quality of life (QoL). Two reviewers assessed the risk of bias using the Cochrane's tool for RCT and Risk of Bias Assessment tool for Non-randomized Studies (RoBANS) for non-randomized studies, independently. Results: After extensive searches, 3,324 publications were screened, and 32 studies were selected. The education interventions used in the included studies included a wide variety of education methods, but the most common method was a booklet produced for patients. Regardless of the education method used, the results of the meta-analysis were as follows. The SMDs of the most severe, average, and current pain in the RCTs were significant. The SMD of worst, average, and current pain were -0.34 (-0.55, -0.13), -0.40 (-0.64, -0.15), and -0.79 (-1.35, -0.23). In the non-randomized studies, the effects on average pain were significant, but those on worst and current pain were not. Conclusions: Education intervention reduced the pain of cancer patients. Therefore, patient education could be considered to be an effective method of cancer pain management. However, our data should be interpreted with caution, and studies using standardized protocols are needed to confirm these observations.

Effects of applying nerve blocks to prevent postherpetic neuralgia in patients with acute herpes zoster: a systematic review and meta-analysis

  • Kim, Hyun Jung;Ahn, Hyeong Sik;Lee, Jae Young;Choi, Seong Soo;Cheong, Yu Seon;Kwon, Koo;Yoon, Syn Hae;Leem, Jeong Gill
    • The Korean Journal of Pain
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    • 제30권1호
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    • pp.3-17
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    • 2017
  • Background: Postherpetic neuralgia (PHN) is a common and painful complication of acute herpes zoster. In some cases, it is refractory to medical treatment. Preventing its occurrence is an important issue. We hypothesized that applying nerve blocks during the acute phase of herpes zoster could reduce PHN incidence by attenuating central sensitization and minimizing nerve damage and the anti-inflammatory effects of local anesthetics and steroids. Methods: This systematic review and meta-analysis evaluates the efficacy of using nerve blocks to prevent PHN. We searched the MEDLINE, EMBASE, Cochrane Library, ClinicalTrials.gov and KoreaMed databases without language restrictions on April, 30 2014. We included all randomized controlled trials performed within 3 weeks after the onset of herpes zoster in order to compare nerve blocks vs active placebo and standard therapy. Results: Nine trials were included in this systematic review and meta-analysis. Nerve blocks reduced the duration of herpes zoster-related pain and PHN incidence of at 3, 6, and 12 months after final intervention. Stellate ganglion block and single epidural injection did not achieve positive outcomes, but administering paravertebral blockage and continuous/repeated epidural blocks reduced PHN incidence at 3 months. None of the included trials reported clinically meaningful serious adverse events. Conclusions: Applying nerve blocks during the acute phase of the herpes zoster shortens the duration of zoster-related pain, and somatic blocks (including paravertebral and repeated/continuous epidural blocks) are recommended to prevent PHN. In future studies, consensus-based PHN definitions, clinical cutoff points that define successful treatment outcomes and standardized outcome-assessment tools will be needed.

The Efficacy of P2Y12 Reactive Unit to Predict the Periprocedural Thromboembolic and Hemorrhagic Complications According to Clopidogrel Responsiveness and Safety of Modification of Dual Antiplatelet Therapy : A Meta-Analysis

  • Kim, Hyun Jung;Oh, Jae Sang;Park, Sukh Que;Yoon, Seok Mann;Ahn, Hyeong Sik;Kim, Bum Tae
    • Journal of Korean Neurosurgical Society
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    • 제63권5호
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    • pp.539-549
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    • 2020
  • The efficacy of P2Y12 reaction unit (PRU) of VerifyNow still remains as a controversial issue in neurointervention. So we investigated the usefulness of PRU of VerifyNow to predict the peri-procedural thromboembolic events (TE) and hemorrhagic events (HE). And we evaluated the safety of modified dual antiplatelet therapy (DAPT) or triple antiplatelet therapy (TAPT) for clopidogrel hyporesponders. We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science and Scopus on August 19 2018. Data was collected the 1) incidence of TE between clopidogrel responder and clopidogrel hypo-responder, 2) incidence of HE between clopidogrel hyper-responder and clopidogrel responder and hypo-responder, and 3) incidence of TE and HE between modified DAPT or TAPT and standard DAPT in clopidogrel hypo-responder. High cut-off value of PRU was defined as PRU >40% or <220. Fifteen studies were enrolled. Clopidogrel responder showed lower incidence of TE than hypo-responder (risk ratio [RR], 0.32; 95% confidence interval [CI], 0.17-0.61; p<0.001). With the high cut-off value of PRU, clopidogrel responder showed more lower incidence of TE than hypo-responder (RR, 0.11; 95% CI, 0.02-0.45; p=0.002). The incidence of periprocedural HE have higher on clopidogrel hyper-responder than clopidogrel responder and hypo-responder (RR, 4.26; 95% CI, 1.10-16.44; p=0.04; I2=66%). The incidence of periprocedural TE after changing regimen of DAPT for clopidogrel hypo-responder have a tendency to reduce, but there was no significant difference between modified DAPT or TAPT group and standard DAPT group (p>0.05). The incidence of periprocedural HE after changing regimen of DAPT for clopidogrel hypo-responder was no significant difference between modified DAPT or TAPT group and standard DAPT group (p>0.05). PRU is a useful tool as a predictor of peri-procedural TE or HE on neurointervention. PRU has a threshold effect of cut-off value to predict the peri-procedural TE. Modified DAPT or TAPT to prevent TE in clopidogrel hypo-responders could not reduce the incidence of TE. We should investigate the further research about modification of regiment on neurointervention.

건강기능식품의 기능성을 중심으로 한 오메가-3 지방산 함유유지의혈행개선 효과에 대한 체계적 고찰 (Systematic review of the effect of omega-3 fatty acids on improvement of blood flow while focused on evaluation of claims for health functional food)

  • 정세원;김지연;백주은;김주희;곽진숙;권오란
    • Journal of Nutrition and Health
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    • 제46권3호
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    • pp.226-238
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    • 2013
  • Omega-3 polyunsaturated fatty acids are essential fatty acids because humans cannot synthesize them de novo and must obtain them in their diet. Fish and fish oil are rich sources of omega-3 fatty acids, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Significant evidence of the beneficial role of dietary intake of omega-3 fatty acids in blood flow has been reported and putative mechanisms for improvement of blood flow include anti-thrombotic effects, lowered blood pressure, improved endothelial function, and anti-atherogenic effects. Edible oils containing omega-3 fatty acids were registered as functional ingredients in the Korea Health Functional Food Code. Although omega-3 fatty acids have been evaluated by the Korea Food and Drug Administration (KFDA) based on scientific evidence, periodic re-evaluation may be needed because emerging data related to omega-3 fatty acids have accumulated. Therefore, in this study, we re-evaluated scientific evidence for the effect of omega-3 fatty acids as a functional ingredient in health functional food on improvement of blood flow. A comprehensive literature search was conducted for collection of relevant human studies using the Medline and Cochrane, KISS, and IBIDS databases for the years 1955-2012. Search keywords were used by combination of terms related to omega-3 fatty acids and blood flow. The search was limited to human studies published in Korean, English, and Japanese. Using the KFDA's evidence based evaluation system for scientific evaluation of health claims, 112 human studies were identified and reviewed in order to evaluate the strength of the evidence supporting a relation between omega-3 fatty acids and blood flow. Among 112 studies, significant effects on improvement of blood flow were reported in 84 studies and the daily intake amount was ranged from 0.1 to 15 g. According to this methodology of systematic review, we concluded that there was possible evidence to support a relation between omega-3 fatty acid intake and blood flow. However, because inconsistent results have recently been reported, future studies should be monitored.

메타 분석을 통한 만성 관절염 환자의 통합 프로그램과 운동 프로그램의 효과 비교 (The Comparison Between the Effects of Integrated Arthritis Self-helf Programs and the Effects of Arthritis Exercise Programs Through Meta-analysis)

  • 오현수;서연옥
    • 대한간호학회지
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    • 제28권4호
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    • pp.941-957
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    • 1998
  • The purpose of this study was to use meta-analysis to analyze result of 17 studies which investigated the effects of integrated programs, and 11 studies which examined the effects of exercise programs on pain, depression, and disability. The 28 studies analyzed in this work were selected from the following sources. MEDLINE Search, bibliographies of related studies, main academic journals of nursing in Korea, and journals on arthritis issues. For the analysis of the data, homogeniety of effect sizes which were calculated based on data in the 28 studies was tested and its average effect size was computed by using meta analysis software package which was developed by Song(1992, 1998). The results can be summarized as follows : 1) Homogeneity tests were conducted on integrated programs on pain. In the prelimiary homogeneity tests on effect size of all 17 studies, no homogeneity was found. When homogeneity tests on the effect size of the remaining 15 studies were performed, excluding two studies which had extremely larger effect size compared to other studies, the 15 studies were found to be homogeneous(Q=16.38, p=.23). The obtained average effect size, D(Mean Standardized Difference Between Means), was .25. When homogeneity tests on effect size on pain was conducted for the excercise programs, effect size for all nine studies were found to be homogeneous (Q=7.42, p=.49) and the average effect size D=.30. Therefore, Hypothesis 1 was rejected from the results, that an average effect size of the integrated programs on pain was not significantely different from that of the exercise programs on pain. 2) Since only two studies investigated the effect of exercise programs on depression, comparison between the average effect size of integrated programs and that of exercise programs on depression could not be conducted, and hypothesis 2 could not be tested. Thereby, only the average effect size of integrated programs on depression was obtained. Eight studies were tested to be positive on the homogeneity of effect sizes(Q=18.31, p=.02) at $\alpha$<.01 and its average effect size was D=.11. 3) For the analysis of integrated program on disability, 13 studies, except for four which had an extremely large effect size compared to the others were found to be homogeneous at $\alpha$<.01 (Q=22.30, p=.04) and the average effect size on disability was D=.16. For analysis of the exercize programs on disability, eight studies, except for one which had an extremely large effect size compared to others, were found to be homo geneous(Q=7.87, p=.34) and the average effect size on disability was D=.60. Therefore, Hypothesis 3 was accepted from the results that an average effect size of exercise programs on disability was significantly larger than that of integrated programs on disability.

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상지의 단일신경병증에 대한 수기치료의 국내외 동향 (Literature Review of Manual Therapy for Mononeuropathies of Upper Limb)

  • 김형석;신우철;전준영;박재현;배준형;김세윤;박혜성;윤예지;윤정민;조재흥;정원석
    • 한방재활의학과학회지
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    • 제27권4호
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    • pp.21-31
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    • 2017
  • Objectives This study aimed to review manual therapies for mononeuropathies of upper limb through domestic and foreign studies designed for human body. Methods We searched databases (KMbase, OASIS, RISS, NDSL, KISS, KoreaMed, MEDLINE/Pubmed, CENTRAL, EMBASE) on the 1st to 31th of July 2017 to find related literatures that published after 2000. Results Twenty-eight studies were finally included. Of these, 13 articles were published after 2010. Twenty-two studies were clinical trials and 6 were observational studies. Carpal tunnel syndrome were the most researched type of diseases (85.7%). Most frequently used method of manual therapies was neurodynamic mobilization (35.7%). Pain scales and questionnaires were generally employed for evaluation. Significantly effective studies were 72.2% in controlled trials and 90% in the studies without control group. Conclusions In this study, we reviewed literatures concerning manual therapies on mononeuropathies of upper limb. Further studies are needed on the various diseases of mononeuropathies of upper limb to retain the evidence for the effectiveness of manual therapies.

G894T and 4a/b Polymorphisms of NOS3 Gene are Not Associated with Cancer Risk: a Meta-analysis

  • Haque, Shafiul;Mandal, Raju K;Akhter, Naseem;Panda, Aditya K;Hussain, Arif;Khan, Saif;Lohani, Mohtashim
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권7호
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    • pp.2929-2937
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    • 2015
  • Endothelial nitric oxide synthase (eNOS or NOS3) produces nitric oxide and genetic polymorphisms of NOS3 gene play significant roles in various processes of carcinogenesis. The results from published studies on the association between NOS3 G894T and NOS3 intron 4 (4a/b) polymorphisms and cancer risk are conflicting and inconclusive. However, i n order to assess this relationship more precisely, a meta-analysis was performed with PubMed (Medline), EMBASE and Google web searches until February 2014 to select all published case-control and cohort studies. Genotype distribution data were collected to calculate the pooled odd ratios (ORs) and 95% confidence intervals (CIs) to evaluate the strength of association. A total of 10,546 cancer cases and 10,550 controls were included from twenty four case-control studies for the NOS3 G894T polymorphism. The results indicated no significant association with cancer risk as observed in allelic (T vs G: OR=1.024, 95%CI=0.954 to 1.099, p=0.508), homozygous (TT vs GG: OR=1.137, 95%CI=0.944 to 1.370, p=0.176), heterozygous (GT vs GG: OR=0.993, 95%CI=0.932 to 1.059, p=0.835), recessive (TT vs GG+GT: OR=1.100, 95%CI=0.936 to 1.293, p=0.249) and dominant (TT+GT vs GG: OR=1.012, 95%CI=0.927 to 1.105, p=0.789) genetic models. Similarly, a total of 3,449 cancer cases and 3,691 controls were recruited from fourteen case-control studies for NOS3 4a/b polymorphism. Pooled results indicated no significant association under allelic (A vs B: OR=0.981, 95%CI=0.725 to 1.329, p=0.902), homozygous (AA vs BB: OR=1.166, 95%CI=0.524 to 2.593, p=0.707), heterozygous (BA vs BB: OR=1.129, 95%CI=0.896 to 1.422, p=0.305), dominant (AA+BA vs BB: OR=1.046, 95%CI=0.779 to 1.405, p=0.763) and recessive (AA vs BB+BA: OR=1.196, 95%CI=0.587 to 2.439, p=0.622) genetic contrast models. This meta-analysis suggests that G894T and 4a/b polymorphisms of NOS3 gene are not associated with increased or decreased risk of overall cancer.

Contribution of Macrophage Migration Inhibitory Factor -173G/C Gene Polymorphism to the Risk of Cancer in Chinese Population

  • Wang, Cheng-Di;Li, Tai-Ming;Ren, Zheng-Ju;Ji, Yu-Lin;Zhi, Liu-Shou
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권11호
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    • pp.4597-4601
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    • 2015
  • Background: Macrophage migration inhibitory factor (MIF) -173G/C (rs755622) gene polymorphism has been associated with cancer risk. Previous studies have revealed that MIF -173G/C gene polymorphism may increase cancer in the Chinese population, while results of individual published studies remain inconsistent and inconclusive.We performed this meta-analysis to derive a more precise estimation of the relationship. Materials and Methods: We conducted a search on PubMed, Embase, MEDLINE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), Wanfang, Weipu on Dec 31, 2014.Odds ratio (OR) and 95% confidence interval (95% CI) were used to assess the association. A total of eight studies including 2,186 cases and 2,285 controls were involved in this meta-analysis. Results: The pooled results indicated the significant association between MIF -173G/C polymorphism and the risk of cancer for Chinese population (CC + CG vs GG: OR=1.14, 95%CI=1.02-127, pheterogeneity<0.01; P=0.023; CC vs CG+GG: OR=1.12, 95%CI=1.02-1.23, pheterogeneity<001; P=0.017;CC vs GG: OR=1.18, 95%CI=1.04-1.33, pheterogeneity<001; P=0.008; CG vs GG:OR=1.03, 95%CI=0.91-1.15, pheterogeneity<001; P=0.656; C vs G:OR=1.24, 95%CI=1.14-1.25, pheterogeneity<001; P<001). Subgroup analysis showed that in patients with "solid tumors", heterogeneity was very large (OR=0.94,95%CI=0.83-1.06,pheterogeneity=0.044; p=0.297). Within "non-solid tumors", the association became even stronger (OR=6.62, 95 % CI=4.32-10.14, pheterogeneity<0.001; p<0.001). Conclusions: This study suggested that MIF -173G/C gene polymorphism may increase increase cancer in the Chinese population.Furthermore, more larger sample and representative population-based casees and well-matched controls are needed to validate our results.

Updated Assessment of the Association of the XRCC1 Arg399Gln Polymorphism with Lung Cancer Risk in the Chinese Population

  • Yang, Hai-Yan;Yang, Si-Yu;Shao, Fu-Ye;Wang, Hai-Yu;Wang, Ya-Dong
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권2호
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    • pp.495-500
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    • 2015
  • Background: Published studies have reported relationships between X-ray repair cross-complementing group 1 (XRCC1) Arg399Gln polymorphism and lung cancer risk in Chinese population. However, the epidemiological results remained controversial. The objective of this study was to clarify the association of XRCC1 Arg399Gln polymorphism with lung cancer risk in the Chinese population. Materials and Methods: Systematic searches were performed through the database of Medline/Pubmed, Web of Science, Embase, CNKI and WanFang Medical Online. Odds ratios (ORs) with 95% confidence interval (95%CI) were calculated to estimate the strength of the association. Results: Overall, we observed an increased lung cancer risk among subjects carrying XRCC1 codon 399 Gln/Gln genotype (OR=1.36, 95%CI: 1.09-1.71) in the Chinese population on the basis of 19 studies with 5,416 cases and 5,782 controls. We did not observe any association between XRCC1 codon 399 Arg/Gln and Arg/Gln+Gln/Gln polymorphisms and lung cancer risk (OR=1.00, 95%CI: 0.92-1.08 and OR=1.05, 95%CI: 0.97-1.13, respectively). Limiting the analysis to studies with controls in agreement with Hardy-Weinberg equilibrium (HWE), we observed an increased lung cancer risk among subjects carrying XRCC1 codon 399 Gln/Gln genotype (OR=1.18, 95%CI: 1.01-1.38). When stratified by source of control, we observed an increased lung cancer risk among subjects carrying XRCC1 codon 399 Arg/Gln+Gln/Gln genotype on the basis of hospitalized patient-based controls (OR=1.21, 95%CI: 1.04-1.42) and among subjects carrying XRCC1 codon 399 Gln/Gln genotype on the basis of healthy subject-based controls (OR=1.22, 95%CI: 1.04-1.43). Conclusions: Our findings indicated that certain XRCC1 Arg399Gln variants might affect the susceptibility of lung cancer in Chinese population. Larger sample size studies are required to confirm our findings.