• 제목/요약/키워드: Clinical Effectiveness

검색결과 2,296건 처리시간 0.193초

한의 중풍 진료 현황 파악 및 활성화 방안 모색을 위한 전자우편 설문조사 (E-mail survey on the current status of clinical practice and activation measures for Korean medicine in stroke care)

  • 김미경;한창호
    • 대한한의학회지
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    • 제38권3호
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    • pp.143-159
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    • 2017
  • Objectives: The aim of this study was to investigate the current status of and seek for measures to activate Korean medicine in stroke care. Methods: This is an e-mail survey targeting the members of Korean medical doctors registered at the association of Korean medicine. The project team of the society of stroke on Korean medicine for the development of clinical practice guideline for stroke has devised the items for the questionnaire. The survey was conducted for 15 days in November 2016. Results: The percentage of the respondents who have treated patients with stroke for the past month was 11.2% in the acute phase, 20.5% in the convalescent phase, and 32.4% in the chronic phase. Approximately 80% of the respondents answered they had a decrease in the number of patients compared to 10 years ago, regardless of the stroke phase. Most of the respondents were using Western medicine together with traditional Korean medicine for physical examination. Acupuncture and herbal medicine were the main therapeutic interventions. The two measures chosen by the most respondents to activate the Korean medicine usage for stroke care were the expansion of the insurance coverage (34.9%) and the generation of evidence on the effectiveness of traditional Korean medicine (25.1%) Conclusion: It is necessary to actively show the role of the Korean medicine through the establishment of the evidence on the effectiveness of Korean medicine and the promotion based on the evidence. In addition, optimal treatment methods should be derived based on the traditional knowledge and modern scientific research and the methods should be educated to every Korean medical clinics and hospitals so that they can be implemented in clinical practice. At the same time, the government should provide policy support to ensure that the optimal treatment can be timely and appropriately implemented.

COVID-19 Vaccination and Clinical Outcomes at a Secondary Referral Hospital During the Delta Variant-dominant Period in West Sumatra, Indonesia

  • Didan Ariadapa Rahadi;Elfira Yusri;Syandrez Prima Putra;Rima Semiarty;Dian Pertiwi;Cimi Ilmiawati
    • Journal of Preventive Medicine and Public Health
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    • 제56권3호
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    • pp.221-230
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    • 2023
  • Objectives: The second wave of coronavirus disease 2019 (COVID-19) cases in Indonesia, during which the Delta variant predominated, took place after a vaccination program had been initiated in the country. This study was conducted to assess the impact of COVID-19 vaccination on unfavorable clinical outcomes including hospitalization, severe COVID-19, intensive care unit (ICU) admission, and death using a real-world model. Methods: This single-center retrospective cohort study involved patients with COVID-19 aged ≥18 years who presented to the COVID-19 emergency room at a secondary referral teaching hospital between June 1, 2021 and August 31, 2021. We used a binary logistic regression model to assess the effect of COVID-19 vaccination on unfavorable clinical outcomes, with age, sex, and comorbidities as confounding variables. Results: A total of 716 patients were included, 32.1% of whom were vaccinated. The elderly participants (≥65 years) had the lowest vaccine coverage among age groups. Vaccination had an effectiveness of 50% (95% confidence interval [CI], 25 to 66) for preventing hospitalization, 97% (95% CI, 77 to 99) for preventing severe COVID-19, 95% (95% CI, 56 to 99) for preventing ICU admission, and 90% (95% CI, 22 to 99) for preventing death. Interestingly, patients with type 2 diabetes had a 2-fold to 4-fold elevated risk of unfavorable outcomes. Conclusions: Among adults, COVID-19 vaccination has a moderate preventive impact on hospitalization but a high preventive impact on severe COVID-19, ICU admission, and death. The authors suggest that relevant parties increase COVID-19 vaccination coverage, especially in the elderly population.

Fabry disease: current treatment and future perspective

  • Han-Wook Yoo
    • Journal of Genetic Medicine
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    • 제20권1호
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    • pp.6-14
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    • 2023
  • Fabry disease (FD), a rare X-linked lysosomal storage disorder, is caused by mutations in the α-galactosidase A gene gene encoding α-galactosidase A (α-Gal A). The functional deficiency of α-Gal A results in progressive accumulation of neutral glycosphingolipids, causing multi-organ damages including cardiac, renal, cerebrovascular systems. The current treatment is comprised of enzyme replacement therapy (ERT), oral pharmacological chaperone therapy and adjunctive supportive therapy. ERT has been introduced 20 years ago, changing the outcome of FD patients with proven effectiveness. However, FD patients have many unmet needs. ERT needs a life-long intravenous therapy, inefficient bio-distribution, and generation of anti-drug antibodies. Migalastat, a pharmacological chaperone, augmenting α-Gal A enzyme activity only in patients with mutations amenable to the therapy, is now available for clinical practice. Furthermore, these therapies should be initiated before the organ damage becomes irreversible. Development of novel drugs aim at improving the clinical effectiveness and convenience of therapy. Clinical trial of next generation ERT is underway. Polyethylene glycolylated enzyme has a longer half-life and potentially reduced antigenicity, compared with standard preparations with longer dosing interval. Moss-derived enzyme has a higher affinity for mannose receptors, and seems to have more efficient access to podocytes of kidney which is relatively resistant to reach by conventional ERT. Substrate reduction therapy is currently under clinical trial. Gene therapy has now been started in several clinical trials using in vivo and ex vivo technologies. Early results are emerging. Other strategic approaches at preclinical research level are stem cell-based therapy with genome editing and systemic mRNA therapy.

결막염에 대한 한방 점안액의 효과 비교 : 체계적 문헌 고찰과 메타 분석 (Comparison of the Effectiveness of Herbal Medicine Eye Drops on Conjunctivitis : A Systematic Literature Review and Meta-Analysis)

  • 임희영;김지희;고우신;윤화정
    • 한방안이비인후피부과학회지
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    • 제35권3호
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    • pp.48-65
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    • 2022
  • Objectives : This study was conducted to find out the effectiveness and safety of herbal medicine eye drops on conjunctivitis. Methods : We searched randomized controlled trials on conjunctivitis through 10 DBs from the start to April 27, 2022. Study collection and data extraction, and evaluation of risk of bias were conducted by two independent researchers. The evaluation of the risk of bias in included RCTs was carried out by using Cochrane risk-of-bias tool. And the data synthesis was conducted by using Review Manager(RevMan, ver.5.4). Results : Total of 106 studies are researched and 7 studies of them are finally included. 1. The herbal medicine eye drops are more effective on than the western medicine eye drops, but the heterogeneity was very high. So we conducted sensitivity analysis and compared to the herbal medicine eye drops and the western medicine eye drops, the total effective rate was higher in the herbal medicine eye drops and the heterogeneity was somewhat reduced. 2. In the subgroup analysis, Fufang Xiongdan eye drops and Houttuynia cordata Thunb eye drops are more effective than the western medicine. It may represent substantial heterogeneity. 3. In the subgroup analysis, the herbal medicine eye drops are more effective than antibiotic and antiviral eye drops on acute bacterial conjunctivitis, but showed high heterogeneity. On the other hand, the herbal medicine eye drops are more effective than antibiotic and antiviral eyed drops on acute viral conjuctivitis and showed low heterogeneity. 4. In the subgroup analysis, we compared the effectiveness of herbal and western medicine eye drops according to total effectiveness rate evaluation methods. When comparing the studies calculating the total effective rate by the sum of 'Cured', 'Significantly Impaired', and 'Improved', the effective rate of the herbal medicine eye drops was higher than that of the western medicine eye drops, and the heterogeneity was very low. 5. In most studies, side effects of herbal medicine eye drops were absent or mild. Conclusions : This study shows that herbal medicine eye drops may be more effective than western medicine eye drops and have safety. But further researches are needed to resolve the heterogeneity of this study.

시뮬레이션 실습 교육에서 나타난 간호대학생의 임상수행능력에 대한 개념분석 (Conceptual analysis of nursing students' clinical competency in simulation-based practical training)

  • 이초원;김은영
    • 한국응용과학기술학회지
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    • 제40권5호
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    • pp.1176-1190
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    • 2023
  • 본 연구의 목적은 시뮬레이션 실습 교육에서 임상수행능력에 대한 명확한 개념의 속성을 규명하고 이를 조직화하여 임상수행능력에 대한 이론적 근거를 마련하기 위해 시도되었다. 연구 방법으로는 Walker And Avant의 개념분석 방법을 사용하였다. KISS, KMbase, DBpia, RISS, PubMed, CINAHL, Medline의 데이터베이스에서 보건의료인 교육을 위한 시뮬레이션 교육이 권고된 시점인 2000년부터 2023년 4월까지 보고된 논문을 수집하였다. 연구 결과 임상수행능력의 속성은 (1) 지식, 판단, 기술의 종합적인 능력, (2) 의료 환경 변화에 능숙히 대처하는 능력, (3) 간호 대상자의 요구에 적절하게 대응하여 간호 역할을 수행하는 능력이다. 본 연구는 시뮬레이션 실습 교육에서 임상수행능력에 대한 연구가 활발한 상황에서 간호학적 관점의 중요성을 인식하고, 개념분석을 한 연구로서 의의가 있다. 본 연구에서 나타난 시뮬레이션 실습 교육에서 임상수행능력 속성을 포함한 훈련 프로그램 및 도구를 개발하고 이를 활용하여 프로그램의 효과를 측정하는 것이 필요할 것으로 사료된다.

진무탕으로 치료한 Muscular atrophy 환자 치험 1례 (A Clinical Report of Muscular Atrophy treated by Jinmutang)

  • 안세승
    • 대한상한금궤의학회지
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    • 제4권1호
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    • pp.67-74
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    • 2012
  • Objective : This research is to prove the effectiveness of Jinmutang in curing muscular atrophy Method : To achieve the goal of this research, we gave Jinmutang to the selected patients and observed the progress. Results & Conclusions: The results indicate the followings 1. After the treatment with Jinmu-tang, the symptoms of muscular atrophy were significantly improved. 2. JinmuTang based on sanghanron, as shown in the example above, has an effect on Muscle atrophy of the legs, But we need to study this pharmacologic and biological mechanism.

The Role of Intensity Modulated Radiotherapy in Cancer Treatment

  • Cheung, Kin-Yin
    • 한국의학물리학회:학술대회논문집
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    • 한국의학물리학회 2002년도 Proceedings
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    • pp.6-8
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    • 2002
  • Intensity modulated radiotherapy (IMRT) is an advanced but expensive form of 3-dimensional conformal radiation therapy technique. While the initial clinical data appear to be promising for some treatment sites, the cost effectiveness of the treatment modality has yet to be justified by long-term clinical outcome. This presentation reviews the potential efficacy and limitation of IMRT in respect of the practicality, dosimetry, and resource aspects. It tries to explore and draw conclusions on the strategies for using this sophisticated and expensive treatment technique from AFOMP perspective.

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인삼의 임상적 연구의 실상과 향후전망 (Clinical Studies on Korean Ginseng in Korea)

  • 윤택구
    • Journal of Ginseng Research
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    • 제20권4호
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    • pp.520-539
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    • 1996
  • Based upon Shennong's Ancient Chinese Medical Textbook and Tsorngji Mingyi Byelu. Ginseng has been widely used for over 2,000 years in oriental countries. Scientific basic medical study or clinical study on ginseng was seal·toed 1910's in Eastern countries and from the 1950's in Western countries To obtain kotvledge of clinical studies on Korean ginseng. I investigated the following items 1) Oriental pharmacological documents. 2) the start and corrent state of ginseng research. 3) Clinical studies, 4) epidemiological studies. 5) non-medical human studies. 6) Foreign evaluation in published papers, and 7) future perspectives of clinical study. Although wide and profound research has been carried on the effect of ginseng (diabetes cardiovascular diseases, hypertension, liver diseases. gastrointestinal disorders soress, bram function. aging, antiradiation effect. anemia. hemopoiesis. immuomodulating effect. and tonic effect). Systemic clinical study to determine the therapeutic effects of speciblc disease have hardly been done even in other countries Clinical study or researches with human as the target. on ginseng has been performed in the field of body tenperazure. Pulse, clinical symptoms and hematological findings . fatigue, porformances. anemia. essential hypertension. blood sugar. serum cholesterol. lipid and prolactin. adrenocortical function. impotence. hypospermia. male sterility, climacteric disorder. anticancer effects. cancer preventive effects. and viral hepatitis. adverse effects. and prefered type of ginseng. At the same time as trying preventives or therapeutics from dietary oi natural products scientific research to support that ginseng is not a mystery. should be porformad to prove the effectiveness of Korean ginseng in the treatment of certain diseases using scientific methods or epidemiological approach.

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국외 임상술기센터의 임상교육 현황과 시사점 (A review on clinical education in clinical skills centers worldwide and its implications)

  • 신홍임;이승희;김승호
    • 의학교육논단
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    • 제10권2호
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    • pp.1-7
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    • 2008
  • Purpose : The establishment of clinical skills centers(CSCs) to facilitate the teaching and assessment of clinical skills is one of the more recent developments occurring in medical schools worldwide. The aim of this study is to review experiences of CSCs in other medical schools and learn how to design a CSC in our school. Methods : This study was undertaken in two steps. In the first step, educational activities of CSCs in 6 medical schools were reviewed. In the second step, a search for articles of journals regarding clinical skills education in CSCs was conducted. Results : The review of CSCs programs reveals variations among centers in teaching and assessment activities. However there are increasing trends of utilizing CSCs in teaching and learning in CSCs. The delivery of clinical skills is expanded by an increasing use of simulated patients and realistic simulators. Through an audio/video technology, availability of more detailed monitoring and feedback. CSCs also provide greater opportunity for assessment of communications skills, physical examination and practical procedures. Conclusions: CSCs contribute to the effectiveness in clinical teaching and assessment. Educational benefits of a CSC can be maximized by utilizing new delivery methods, implementing educational strategies and staff development programmes.

자궁경부 이형성증 진단을 받은 환자 3례에 대한 임상적 고찰 (Clinical Study on 3 Cases of Cervical Dysplasia)

  • 박찬수;정혁상;손영주
    • 대한한방부인과학회지
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    • 제21권4호
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    • pp.237-246
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    • 2008
  • Purpose: Recently people who want to treatment of cervical dysplasia by Traditional Korean Medicine (TKM) were increased. The purpose of these studies are to confirm the clinical effectiveness of TKM treatment to clinical symptoms of the patients who diagnosed as cervical dysplasia. Methods: The patients who diagnosed as cervical dysplasia, had elytrorrhagia, leukorrhea, dysmenorrhea et al. The patients were treated by TKM such as herb medication and acupuncture therapy. Results: After the oriental medical treatment. the clinical symptoms such as elytrorrhagia, leukorrhea, dysmenorrhea were improved. Conclusion: To treatment and management of cervical dysplasia, we were based on improvement of clinical symptoms. And we used TKM to the clinical symptoms of patients with cervical dysplasia, in result clinical symptoms of cervical dysplasia were improved. TKM is expected to have positive effects on clinical symptoms of cervical dysplasia.

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