• Journal of Korean Critical Care Nursing
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• v.12 no.3
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• pp.74-83
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• 2019

Purpose : The routine evaluation of gastric residuals (RGR) is considered standard care for premature infants. This study evaluated the usefulness of RGR in premature infants. Methods : The study retrospectively investigated 208 premature infants (gestational aged under 34 weeks) who underwent gavage feeding in a neonatal intensive care unit at a tertiary hospital. The patients were divided into two groups: RGR (n=104) and no-RGR (n=104). Those in the no-RGR group had their gastric residuals checked only if signs of feeding intolerance were present. Clinical outcomes, including the time to reach full enteral feeding (FEF) and the incidences of gastrointestinal disorders such as feeding intolerance (FI) and necrotizing enterocolitis (NEC), were compared. Data were analyzed with SPSS ver. 21, using a Mann-Whitney U test, chi-squared test, and Fisher's exact test. Results : There was no statistically significant difference for the time to FEF (z=-0.61, p=.541), incidence of FI ($X^2=0.38$, p=.540), and NEC ($X^2=1.42$, p=.234) between the two groups. Conclusion : No-RGR did not increase the risk for FI or NEC. These results suggest that RGR evaluation may not improve nutritional outcomes in premature infants. Recommendations for further research and practice guidelines will be provided.

• Journal of radiological science and technology
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• v.45 no.3
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• pp.255-262
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• 2022

In this study, by analyzing the examination time for each procedure, the appropriate workload of radiologic technologist is analyzed based on the actual examination time in the current clinical setting by comparing with the examination time in the radiology field setting of the health insurance review and assessment service. In addition, this result is introduced into the calculation of relate value units; it was attempted to provide accurate and objective evidence in the field of radiology. From May 2020 to December 2021, the study retrospectively investigated the examination times recorded in the electronic medical record and picture archiving and communication system at 5 tertiary general hospitals and 1 general hospital. The total of 16 examination parts are applied in this study, including the head, sinuses, chest, ribs, abdomen, pelvis, cervical, thoracic, lumbar, shoulder, elbow, wrist, hip, femur, knee, and ankle. The minimum number of images that could be obtained per radiation generator was 3.6 images for one hour, and the maximum was 6.4 images. When 50% median of procedure time is calculated, the minimum number of images that could be obtained was 16.7 images and maximum was 35.3 images; in addition, minimum examination time is 1.7 minutes, and maximum time is 3.6 minutes. In conclusion, it is judged that there will be insufficient explanation time for basic infection instructions such as hand hygiene during the examinations in current clinical practice. It is believed that radiologic technologists will contribute to providing higher-quality of radiation examination services to the public by complying with guidelines for work and setting appropriate workload on their own.

• Journal of Korean Critical Care Nursing
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• v.17 no.1
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• pp.68-82
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• 2024

Purpose : This scoping review was designed to identify gaps in knowledge and guide future directions for clinical nursing practices and research on oral hygiene care for endotracheally intubated patients in Korean intensive care units. Methods : We conducted a scoping review using the methodological framework proposed by Arksey and O'Malley. PubMed, CINAHL, RISS, Science On, and DBpia databases were searched. Two reviewers independently selected the studies and extracted data. A total of 445 studies were identified, of which 17 were included in the final analysis. Results : No research has been conducted from 2021 to the present. A total of 12 instruments were utilized in 13 studies to assess the effectiveness of oral hygiene care. All studies investigating the effectiveness of oral hygiene care have consistently documented that chlorhexidine has the most significant effect. The frequency and time of oral hygiene care were each examined in one study. Conclusion : A research study is necessary to develop a measurement tool for assessing the effectiveness of oral hygiene care suitable for endotracheal intubated patients in intensive care units. Interventional studies should be conducted to determine the effects of chlorhexidine and the appropriate frequency and time of oral hygiene care. Thereafter, revision of domestic evidence-based clinical practice guidelines by integrating these results will be necessary.

• Journal of Dental Anesthesia and Pain Medicine
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• v.24 no.3
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• pp.161-171
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• 2024

The efficient management of pain and discomfort is essential for successful dental treatment and patient compliance. Dental professionals are commonly evaluated for their ability to perform treatment with minimal patient discomfort. Despite advancements in traditional local dental anesthesia techniques, the pain and discomfort associated with injections remain a concern. This scoping review aims to provide a comprehensive overview of the literature on novel dental anesthetics and associated devices designed to alleviate pain and discomfort during dental procedures. The Joanna Briggs Institute and the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews guidelines were used to prepare the review. Six databases and two sources of gray literature were searched. This review analyzed 107 sources from 1994 to 2023. Local anesthesia devices were grouped into computer-controlled local anesthetic delivery (CCLAD) systems, intraosseous anesthesia (IOA), vibratory stimulation devices, and electronic dental anesthesia (EDA). CCLAD systems, particularly the Wand and Single-Tooth Anesthesia, have been the most researched, with mixed results regarding their effectiveness in reducing pain during needle insertion compared to traditional syringes. However, CCLAD systems often demonstrated efficacy in reducing pain during anesthetic deposition, especially during palatal injections. Limited studies on IOA devices have reported effective pain alleviation. Vibrating devices have shown inconsistent results in terms of pain reduction, with some studies suggesting their primary benefit is during needle insertion rather than during the administration phase. EDA devices are effective in reducing discomfort but have found limited applicability. These findings suggest that the CCLAD systems reduce injection pain and discomfort. However, the evidence for other devices is limited and inconsistent. The development and research of innovative technologies for reducing dental pain and anxiety provides opportunities for interdisciplinary collaboration and improved patient care in dental practice.

• Korean Journal of Clinical Pharmacy
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• v.33 no.4
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• pp.261-269
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• 2023

Background: Acute rhinosinusitis (ARS) is a common condition encountered in ambulatory practice and is one of the most common reasons for antibiotic prescriptions. This study aimed to evaluate the potentially inappropriate antibiotic prescribing for ARS in South Korea and identify influencing factors. Methods: We analyzed Health Insurance Review and Assessment Service-National Patient Samples data. We selected outpatients aged 20 to 64 with ARS, prescribed antibiotics between February and November 2020. Potentially inappropriate antibiotic prescribing was categorized as: 1) inappropriate antibiotic selection and 2) inappropriate antibiotic dosage or duration. Multiple logistic regression was conducted to estimate the impact of various factors on inappropriate antibiotic prescribing. Results: Of 1,210 patients, 80.83% received potentially inappropriate ARS antibiotic prescriptions. Inappropriate antibiotic selection accounted for 43.55%, and inappropriate antibiotic dosage and duration contributed to 37.28%. Otolaryngologists had higher odds ratio (OR) of potentially inappropriate antibiotic prescribing compared to internal medicine practitioners, while dentists had lower OR. Patients aged 20 to 29 years had a higher OR than other age groups, and those who visited primary care clinics had a higher OR than those who visited hospitals. Conclusion: Potentially inappropriate antibiotic prescribing for ARS is prevalent in South Korea. This study identified physician specialty, patient age group, and the level of healthcare facility as factors influencing potentially inappropriate antibiotic prescriptions. Addressing this issue through targeted interventions, such as improved guidelines adherence and patient education, is imperative to mitigate the risks associated with antibiotic misuse and antibiotic resistance.

• Journal of Korean Medicine Rehabilitation
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• v.20 no.2
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• pp.63-77
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• 2010

Objectives : It is known that abdominal obesity increases the possibility of cardiovascular diseases, early death, and metabolic syndrome including dyslipidemia and insulin resistance. Clinical trials have been under way to verify the effectiveness of treatment for abdominal obesity. The objective of this study is to set criteria about how effective oriental medicine and acupuncture are in abdominal obesity. Methods : I manually search "www.clinicaltrial.gov", 4 Korean medical databases and 4 Korean medical journals of abdominal obesity. Search terms used were "abdominal obesity" or "visceral obesity". In order to see detail review, searching was performed from 01, 01, 2005 to 11, 31, 2009. And I classified all the searched studies into design, intervention, purpose, end point, diseases, condition and etc. Results : 1. I could search total 67 trials in "www.clinicaltrial.gov". I found 9, 10, 13, 8, 6 clinical trial from 2005 to 2009 every year. 2. Test on both gender and adult or adult and senior have been most frequent. 3. Randomization clinical trial is 51 cases that occupied 96.2%. 38 cases use control group. 4. Body mass index(BMI) and waist circunference(WC) are major criteria of abdominal obesity clincal trial. WC, BMI, abdominal fat mass, body weight are measured at end point of abdominal obesity clincal trial. 5. I could search total 86 cases in domestic study. I found 15, 23, 23, 20, 5 cases from 2005 to 2009 every year. 6. Test on female and adult have been most frequent in domestic study. 7. Randomization clincal trial is only 2 cases that occupied 2.3%. 62 cases use control group in domestic study. 8. BMI, body fat percent, WC, visceral-subcutaneous fat ratio(VSR), waist-hip ratio(WHR) are criteria of abdominal obesity clincal trial in domestic study. WC, BMI, abdominal fat mass, body weight are measured at end point of abdominal obesity clincal trial in domestic study. Conclusions : To improve abdominal obesity study in traditional korean medicine, it is need to activate clinical trial, meta analysis, develope of clinical practice guidelines, co-works with conventional medicine and etc.

• Korean Circulation Journal
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• v.53 no.7
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• pp.425-451
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• 2023

Most patients with heart failure (HF) have multiple comorbidities, which impact their quality of life, aggravate HF, and increase mortality. Cardiovascular comorbidities include systemic and pulmonary hypertension, ischemic and valvular heart diseases, and atrial fibrillation. Non-cardiovascular comorbidities include diabetes mellitus (DM), chronic kidney and pulmonary diseases, iron deficiency and anemia, and sleep apnea. In patients with HF with hypertension and left ventricular hypertrophy, renin-angiotensin system inhibitors combined with calcium channel blockers and/or diuretics is an effective treatment regimen. Measurement of pulmonary vascular resistance via right heart catheterization is recommended for patients with HF considered suitable for implantation of mechanical circulatory support devices or as heart transplantation candidates. Coronary angiography remains the gold standard for the diagnosis and reperfusion in patients with HF and angina pectoris refractory to antianginal medications. In patients with HF and atrial fibrillation, longterm anticoagulants are recommended according to the CHA₂DS₂-VASc scores. Valvular heart diseases should be treated medically and/or surgically. In patients with HF and DM, metformin is relatively safer; thiazolidinediones cause fluid retention and should be avoided in patients with HF and dyspnea. In renal insufficiency, both volume status and cardiac performance are important for therapy guidance. In patients with HF and pulmonary disease, beta-blockers are underused, which may be related to increased mortality. In patients with HF and anemia, iron supplementation can help improve symptoms. In obstructive sleep apnea, continuous positive airway pressure therapy helps avoid severe nocturnal hypoxia. Appropriate management of comorbidities is important for improving clinical outcomes in patients with HF.

• Journal of Bone Metabolism
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• v.25 no.4
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• pp.195-211
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• 2018

Background: To develop guidelines and recommendations to prevent and treat glucocorticoid (GC)-induced osteoporosis (GIOP) in Korea. Methods: The Korean Society for Bone and Mineral Research and the Korean College of Rheumatology have developed this guideline based on Guidance for the Development of Clinical Practice Guidelines ver. 1.0 established by the National Evidence-Based Healthcare Collaborating Agency. This guideline was developed by adapting previously published guidelines, and a systematic review and quality assessment were performed. Results: This guideline applies to adults aged ${\geq}19years$ who are using or plan to use GCs. It does not include children and adolescents. An initial assessment of fracture risk should be performed within 6 months of initial GC use. Fracture risk should be estimated using the fracture-risk assessment tool (FRAX) after adjustments for GC dose, history of osteoporotic fractures, and bone mineral density (BMD) results. All patients administered with prednisolone or an equivalent medication at a dose ${\geq}2.5mg/day$ for ${\geq}3months$ are recommended to use adequate calcium and vitamin D during treatment. Patients showing a moderate-to-high fracture risk should be treated with additional medication for osteoporosis. All patients continuing GC therapy should undergo annual BMD testing, vertebral X-ray, and fracture risk assessment using FRAX. When treatment failure is suspected, switching to another drug should be considered. Conclusions: This guideline is intended to guide clinicians in the prevention and treatment of GIOP.

• Journal of Korean Medicine for Obesity Research
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• v.9 no.1
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• pp.15-22
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• 2009

Objectives The aim of this study is to review and analyze the status on the recent clinical trials of 'obesity' and 'metabolic syndrome'. Methods We search 'www.clinicaltrail.gov' for research trend of Obesity and metabolic syndrome. Search terms used were 'obesity' and 'metabolic syndrome'. In order to see detail review, searching was performed from 01, 01, 2007 to 05, 31, 2009 with intervention, phase III or phase IV, And we classified all the searched studies into design, intervention, purpose, end point, diseases and condition Results We could search total 232 trials. Of them, we found 32 trials with intervention, phase III or phase IV from 01, 01, 2007 to 05, 31, 2009 Also we could see various design of clinical trials. Conclusion To improve obesity and metabolic study in Traditional Korean Medicine, it is need to activate clinical trial, meta analysis, develope of clinical practice guidelines, co-works with conventional medicine and etc.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.3067-3074
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• 2013

Background: Faced with highly prevalent and recalcitrant cancer-related fatigue (CRF), together with the absence of any official guidelines on management, numerous groups have been striving to seek and test alternative therapies including acupuncture and moxibustion. However, different patients have various feedbacks, and the many clinical trials have given rise to varied conclusions. In terms of the therapeutic effect of acupuncture and moxibustion, there exist vast inconsistencies. Objective: The aim of the study was to evaluate the auxiliary effectiveness of acupuncture and moxibustion in the treatment of CRF, and to provide more reliable evidence to guide clinical practice. Methods: Randomized controlled trials (RCTs) published before December 2012 were all aggregated, focusing on evaluation of acupuncture or moxibustion for CRF. The quality of the included studies was assessed basing on Cochrane handbook 5.1.0, and the available data were analyzed with RevMan software (version 5.2.0). Descriptive techniques were performed when no available data could be used. Results: A total of 7 studies involving 804 participants were eligible. With real acupuncture versus sham acupuncture, subjects receiving true acupuncture benefited more in the reduction of fatigue. With real acupuncture versus acupressure or sham acupressure, fatigue level appeared 36% improved in the acupuncture group, but 19% in the acupressure group and only 0.6% with sham acupressure. When real acupuncture plus enhanced routine care was compared with enhanced routine care, the combination group improved mean scores for general fatigue, together with physical and mental fatigue. With real acupuncture versus sham acupuncture or wait list controls, the real acupuncture group displayed significant advantages over the wait list controls at 2 weeks for fatigue improvement and better well-being effects at 6 weeks. When moxibustion plus routine care was compared with routine care alone, the meta-analyses demonstrated the combination had a relatively significant benefit in improving severe fatigue and QLQ-C30. Conclusion: Up to the search date, there exist few high quality RCTs to evaluate the effect of acupuncture and moxibustion, especially moxibustion in English. Yet acupuncture and moxibustion still appeared to be efficacious auxiliary therapeutic methods for CRF, in spite of several inherent defects of the included studies. Much more high-quality studies are urgently needed.