• 제목/요약/키워드: Clinical review

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뇌질환 환자에서 전산화 인지치료의 임상적 유용성 : 체계적 고찰 및 메타분석 (Clinical Benefit of Computerized Cognitive Therapy in Patients with Brain Disease : A Systematic Review and Meta-Analysis)

  • 송승일;박소원
    • 대한통합의학회지
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    • 제8권4호
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    • pp.277-289
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    • 2020
  • Purpose : This study aims to confirm the clinical usefulness of computerized cognitive therapy program for patients with brain diseases in Korea and to present basic data that can confirm the effectiveness of computerized cognitive therapy program to experts related to rehabilitation in the future. Methods : A systematic review and meta-analysis research method was used to confirm the clinical effectiveness of computerized cognitive therapy applied to patients with brain diseases in Korea. Based on the national institute of health and medical colleges association (NECA) systematic literature manual and preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines for conducting research through systematic review and meta-analysis methods. Systematic review was PICOST-SD was used to research and select papers. For meta-analysis, the data was input and analyzed separately by literature result using the revman manager 5.3 program and the results were presented visually through tables and forest, funnel plot figure. Results : As a result of comprehensive analysis of the contents of the finally selected literature, it as found that studies on stroke and dementia were mainly conducted. In addition, through the evaluation of the quality of the literature, most of the existing computerized cognitive therapy studies were identified as high-quality studies, but the results were insufficient for randomization and blinding. And through meta-analysis, the clinical effectiveness of computerized cognitive therapy on cognitive function, activities of daily living, and visual perception function of patients with brain disease was found. Conclusion : The research literature that applied computerized cognitive therapy to brain disease subjects was comprehensively analyzed and identified. It is thought that this could be used as basic data on the characteristics of cognitive therapy that should be applied to patients with brain diseases in the future and the usefulness of computerized cognitive therapy program in actual clinical practice.

사상의학적 중풍 후유증 치료에 대한 체계적 문헌 고찰 (A Systematic Review on the Treatment of Post-Stroke Patients Based on Sasang Constitutional Medicine)

  • 오현주;이정윤;이혜리;이준희
    • 사상체질의학회지
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    • 제34권2호
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    • pp.48-64
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    • 2022
  • Objectives The purpose of this study was to review and evaluate the clinical evidence of the efficacy and safety of treatment based on Sasang constitutional medicine (SCM) for post-stroke patients by systematic review and meta-analysis. Methods Randomized controlled trials (RCTs), published in 10 electronic databases up to December 2020, were searched. For the included studies, Cochrane's risk of bias assessment was performed to analyze the methodological quality. The strength of evidence was evaluated using the grading of recommendations assessment, development, and evaluation system based on the results of analyses. All review processes were performed by two independent researchers. Results Five RCTs were finally included. All included RCTs were conducted for one month on post-stroke patients in 60-80s, four studies on Tae-Eum patients and one study on So-Yang patients. Four types of constitution-specific herbal medicine (Chungpyesagan-tang, Cheongsimsanyak-tang, Yeoldahanso-tang, and Yangkyuksanhwa-tang) and constitution-specific acupuncture therapy were identified as interventions. More than half of the included studies were evaluated as low quality due to the high-risk of bias in selection, performance, and detection. The combination of constitution-specific herbal medicine, acupuncture, and conventional treatment was more effective in improving the patients' motor impairment, dysphagia, aphasia, and depression than conventional treatment alone. No serious adverse events by SCM treatment were reported. Conclusions SCM treatment may improve the sequelae of post-stroke patients safely in combination with conventional treatment. Since the quality of clinical evidence included in this study was low, higher quality clinical evidence obtained in well-designed clinical studies will be needed.

Managing Mental Health during the COVID-19 Pandemic: Recommendations from the Korean Medicine Mental Health Center

  • Hyo-Weon Suh;Sunggyu Hong;Hyun Woo Lee;Seok-In Yoon;Misun Lee;Sun-Yong Chung;Jong Woo Kim
    • 대한한의학회지
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    • 제43권4호
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    • pp.102-130
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    • 2022
  • Objectives: The persistence and unpredictability of coronavirus disease (COVID-19) and new measures to prevent direct medical intervention (e.g., social distancing and quarantine) have induced various psychological symptoms and disorders that require self-treatment approaches and integrative treatment interventions. To address these issues, the Korean Medicine Mental Health (KMMH) center developed a field manual by reviewing previous literature and preexisting manuals. Methods: The working group of the KMMH center conducted a keyword search in PubMed in June 2021 using "COVID-19" and "SARS-CoV-2". Review articles were examined using the following filters: "review," "systematic review," and "meta-analysis." We conducted a narrative review of the retrieved articles and extracted content relevant to previous manuals. We then created a treatment algorithm and recommendations by referring to the results of the review. Results: During the initial assessment, subjective symptom severity was measured using a numerical rating scale, and patients were classified as low- or moderate-high risk. Moderate-high-risk patients should be classified as having either a psychiatric emergency or significant psychiatric condition. The developed manual presents appropriate psychological support for each group based on the following dominant symptoms: tension, anxiety-dominant, anger-dominant, depression-dominant, and somatization. Conclusions: We identified the characteristics of mental health problems during the COVID-19 pandemic and developed a clinical mental health support manual in the field of Korean medicine. When symptoms meet the diagnostic criteria for a mental disorder, doctors of Korean medicine can treat the patients according to the manual for the corresponding disorder.

Statin 계열 약물의 제네릭 및 브랜드 제품 간 임상 치료결과 비교를 위한 체계적 문헌 고찰 (Systematic Review on Clinical Equivalence of Generic and Brand-name Drugs in Statin Therapy)

  • 심해리;이인향
    • 한국임상약학회지
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    • 제27권2호
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    • pp.105-112
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    • 2017
  • Background: Generic medications are approved on the basis of bioequivalence with brand medications in healthy volunteers rather than the target population, there remains a substantial uncertainty regarding their clinical effectiveness and safety. The object of this paper is to compare the clinical equivalence of generic statin drugs in patients. Methods: Literature published before September 2016, which is indexed in PubMed, EMBASE, RISS, comparing generic to brand products in statins. Outcomes included blood lipid level, proportion of days covered (adherence), hospitalization and mortality. Results: 511 citations were screened, of which 11 studies met eligibility criteria (6 randomized clinical trials, 5 observational studies). Generic atorvastatin was clinical equivalent with brand drugs in blood lipid level (3 RCTs) and generic simvastatin was also clinical equivalent with brand drugs (2 RCTs). 2 of 3 studies reported no significant difference in proportion of days covered except 1 study which reported generic statin significantly enhance proportion of days covered (p<0.001). Hospitalization was no significant difference in all studies (p>0.05). 1 study reported that all cause of mortality was significantly low in generic drugs (p<0.0001). Conclusion: Published data on comparing clinical efficacy of generic and brand statins were insufficient in both quantity and quality. This systematic review suggests that additional studies on clinical equivalence and safety of generic medications in patients would be needed.

A Systematic Review of Domestic Research on Clinical Practice in Emergency Medical Technicians

  • Lee, Chang Hee;Yoon, Byoung Gil
    • International Journal of Advanced Culture Technology
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    • 제10권2호
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    • pp.140-147
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    • 2022
  • This study analyzes research trends by systematically examining research about domestic emergency medical services' clinical practice, and it is aimed to present the basic data needs in development plan in clinical practice education in the future. The thesis was searched through the electronic data research (Science Direct, PubMed, Medline, and 55 academic DB interworking) from the library of Konyang University from 2010 to 2021. The main keywords were "Emergency Medical Technician(EMT) Student" and "Clinical Practice," and 6 pieces of researches were selected, finally. As the result of analyzing the qualitative level of selected research, all the 6 pieces of research subjects(100.0%) were pertinent to level IV(survey research) which is low-qualitative level. As the principal subjects, "Clinical practice experience" got the highest frequency as 6(100%), "Satisfaction of clinical practice" was 3(50%), "Self-efficient, Major satisfaction" and "Stress, Depression, Coping" showed 2 (33.3%), and "Change after clinical practice", "Clinical practice improvement plan" was 1(16.7%) each. From this time on, it is confirmed that the quantitative and qualitative growth in domestic emergency medical clinical practice is necessary. This is expected to contribute to establishing a practical and systematic development plan of clinical practice education.

중환자의 경관영양 공급 지표로서 위 잔여량의 임상적 효용성: 체계적 문헌고찰 (Clinical Usefulness of Gastric Residual Volume as An Indicator to Provide Approximately Enteral Nutrition for Patients in Intensive Care Units: A Systematic Literature Review)

  • 김현정;장선주
    • Journal of Korean Biological Nursing Science
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    • 제16권4호
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    • pp.267-275
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    • 2014
  • Purpose: The practice of enteral nutrition with gastric residual volumes (GRVs) as a clinical indicator is poorly standardized in intensive care units. This study aims to summarize the results from studies that evaluated the clinical outcomes related to the GRVs. Methods: This systematic review study analyzed 11 studies consisting of four randomized controlled trials, one non-randomized controlled trial, and six observational studies. Results: No consistent relationship between GRV thresholds and clinical outcomes was observed. Higher GRVs were not consistently correlated with clinical outcomes such as higher gastrointestinal complications, aspiration pneumonia, or mortality. Higher GRVs significantly generate complications more often. Findings show that a single GRV more than 200 mL or two consecutive GRVs more than 150 mL should raise concern about negative consequences. Conclusion: Critical care nurses need to monitor GRVs closely during their practice of enteral nutrition. For critically ill patients receiving enteral nutrition, a GRV threshold of 200 ml would be a desirable limit to provide safe and adequate nutrition with a conservative approach.

봉약침의 임상 응용에 대한 체계적 문헌 고찰 (A Systematic Review of Clinical Study of Bee Venom Acupuncture)

  • 김현지;지영승;이승민;전주현;김영일
    • Journal of Acupuncture Research
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    • 제30권4호
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    • pp.151-159
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    • 2013
  • Objectives : The purpose of this systematic review was to overview and evaluate the current state of the usage of bee venom acupuncture. Methods : We collected 173 articles on bee venom acupuncture(BVA) clinical study from eight electronic databases from January 2002 to June 2013. Results : BVA was used in musculoskeletal diseases for 66 %, and the chosen acupoints were various. The ratio of the reports which had collected below 10 cases was 43 %. The concomitant treatment and evaluation tools showed diversity in each article. Conclusions : Bee venom clinical study shows the lack of unity and consistent regulation, and has low clinical cases. Future studies should correct these limits and promote more varied research to develop the therapy of bee venom acupuncture.

간호학 실습교육에서 시뮬레이션기반학습의 방향 고찰 (Directions of Simulation-Based Learning in Nursing Practice Education: A Systematic Review)

  • 임경춘
    • 한국간호교육학회지
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    • 제17권2호
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    • pp.246-256
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    • 2011
  • Purpose: With the decrease in available clinical sites, a decrease in adequately prepared clinical faculty, and demand to prepare health care students to begin work, we need alternative methods to teach clinical skills for health care professionals. The use of simulation as an educational process that can replicate clinical practices is becoming popular in nursing. Therefore, this study was conducted to review directions of simulation-based learning in nursing education. Methods: A systematic review of quantitative studies was undertaken using Medline, KERIS, and KISS. The primary search terms were simulation and nursing. Reference lists from relevant papers and the websites of relevant nursing organizations were also searched. Nine studies met inclusion criteria and were analyzed in detail. Results: All studies reported simulation as a valid teaching/learning strategy. Six of the studies (66.7%) showed that simulation technology was a practical and successful model to use in teaching a variety of clinical skills for nursing students and nurses. Conclusion: Simulation may have some advantages over other teaching methods, depending on the scenario, context, topic, and method. Further study is needed to determine the effect of team size on learning and to develop a universal method of outcome measurement.

적외선 체열영상을 이용한 최신 해외 임상연구 동향 (Review of Clinical Trials on Infrared Thermography Using Search of Papers in Medline within 5 Years)

  • 황덕상;박경선;김은경;이창훈;장준복;이경섭
    • 대한한방체열의학회지
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    • 제8권1호
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    • pp.13-17
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    • 2010
  • Purpose : This study is to the recent trends of clinical trial using infrared thermography and to review its application in medicine. Methods : We searched for papers which had used infrared thermography in Medicine within 5 years, using English. Results : A total of 23 papers were but 8 were found, but 8 were not related to non-invasive infrared thermography. The other 15 papers were clinical trials about the effect of acupuncture and therapeutic massage, evaluation of post-hepatic neuralgia, sleep disorder, and regional circulation. Conclusion : These results suggest that infrared thermography can be used as a reliable and helpful method in many clinical trials.

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