• Journal of Preventive Medicine and Public Health
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• 제55권4호
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• pp.321-333
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• 2022

Objectives: Extensive evidence links low vitamin D status and comorbidities with coronavirus disease 2019 (COVID-19) outcomes, but the results of published studies are contradictory. Therefore, we investigated the association of lower levels of vitamin D and comorbidities with the risk of COVID-19 infection. Methods: We searched MEDLINE (via PubMed), Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov for articles published until August 20, 2021. Sixteen eligible studies were identified (386 631 patients, of whom 181 114 were male). We included observational cohort and case-control studies that evaluated serum levels of vitamin D in COVID-19-positive and COVID-19-negative patients. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated. Results: Significantly lower vitamin D levels were found in COVID-19-positive patients (MD, -1.70; 95% CI, -2.74 to -0.66; p=0.001), but with variation by study design (case-control: -4.04; 95% CI, -5.98 to -2.10; p<0.001; cohort: -0.39; 95% CI, -1.62 to 0.84; p=0.538). This relationship was more prominent in female patients (MD, -2.18; 95% CI, -4.08 to -0.28; p=0.024) than in male patients (MD, -1.74; 95% CI, -3.79 to 0.31; p=0.096). Male patients showed higher odds of having low vitamin D levels (odds ratio [OR], 2.09; 95% CI, 1.38 to 3.17; p<0.001) than female patients (OR, 1.17; 95% CI, 0.74 to 1.86; p=0.477). Comorbidities showed inconsistent, but generally nonsignificant, associations with COVID-19 infection. Conclusions: Low serum vitamin-D levels were significantly associated with the risk of COVID-19 infection. This relationship was stronger in female than in male COVID-19 patients. Limited evidence was found for the relationships between comorbidities and COVID-19 infection, warranting large population-based studies to clarify these associations.

• Archives of Plastic Surgery
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• 제49권5호
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• pp.617-632
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• 2022

Tracheoesophageal puncture (TEP) and voice prosthesis insertion following laryngectomy may fail to form an adequate seal. When spontaneous closure of the fistula tract does not occur after conservative measures, surgical closure is required. The purpose of this study was to summarize the available evidence on surgical methods for TEP site closure. A comprehensive search across PubMed, Web of Science, SCOPUS, and Cochrane was performed to identify studies describing surgical techniques, outcomes, and complications for TEP closure. We evaluated the rate of unsuccessful TEP closure after surgical management. A meta-analysis with a random-effect method was performed. Thirty-four studies reporting on 144 patients satisfied inclusion criteria. The overall incidence of an unsuccessful TEP surgical closure was 6% (95% confidence interval [CI] 1-13%). Subgroup analysis showed an unsuccessful TEP closure rate for silicone button of 8% (95% CI < 1-43%), 7% (95% CI < 1-34%) for dermal graft interposition, < 1% (95% CI < 1-37%) for radial forearm free flap, < 1% (95% CI < 1-52%) for ligation of the fistula, 17% (95% CI < 1-64%) for interposition of a deltopectoral flap, 9% (95% CI < 1-28%) for primary closure, and 2% (95% CI < 1-20%) for interposition of a sternocleidomastoid muscle flap. Critical assessment of the reconstructive modality should take into consideration previous history of surgery or radiotherapy. Nonirradiated fields and small defects may benefit from fistula excision and tracheal and esophageal multilayer closure. In cases of previous radiotherapy, local flaps or free tissue transfer yield high successful TEP closure rates. Depending on the defect size, sternocleidomastoid muscle flap or fasciocutaneous free flaps are optimal alternatives.

• 대한한방부인과학회지
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• 제34권3호
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• pp.137-156
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• 2021

Objectives: The purpose of this study is to assess the effect of taking herbal medicine for the postpartum lactation. Methods: We searched 9 databases for recent three years, that contained four english, two chinese, one japanese and two korean database from September 17, 2016 to December 31, 2020. Randomized controlled trials (RCTs) were eligible. Measurement of outcome included total curative effective rate, volume of lactation, volume of milk supplement, and serum prolactin concentration. The risk of bias was assessed by two independent authors using the Cochrane risk of bias tool. Results: Total 725 of studies was screened, 11 RCTs were finally selected. Number of participants per study ranged from 60 to 257. The treatment group of taking a herbal medicine is effective for improving total curative effective rate, volume of lactation, volume of milk supplement, and serum prolactin concentration compared with control group. Because most of the studies had considerable heterogeneity in terms of type of intervention and comparison for outcome measurement, meta analysis for quantitative analysis was impossible. Conclusions: This studies showed that taking a herbal medicine is effective on increasing volume of lactation and speeding up the start of the first breastfeeding. However, included studies suffered from incomplete reporting, high or unclear risk of bias and substantial heterogeneity between studies. In the Future, further high-quality RCTs are needed to prove effectiveness of herbal medicine for breastfeeding and reduce the risk of bias.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.41.1-41.11
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• 2020

Background: Orthognathic surgery such as bilateral sagittal split ramus osteotomy (BSSRO) for the treatment of mandibular deformities is one of the most common procedures in maxillofacial operations that may lead to neurosensory disturbance. In this study, we aimed to evaluate the effectiveness of low-level laser therapy (LLLT) on augmenting recovery of neurosensory disturbance of inferior alveolar nerve (IAN) in patients who underwent BSSRO surgery. Methods: A comprehensive literature search was conducted by two independent authors in PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, Embase, and Google Scholar electronic databases. Besides, a manual search of all textbooks and relevant articles were conducted. Searches took place in August 2020 and were limited to published and peer-reviewed articles from 2000 to 2020. All analysis was performed using the comprehensive meta-analysis (CMA) and the STATA MP (version:16) software. The weighted mean difference (WMD) using the inverse variance method and the standard mean difference (SMD) was considered for continuous variables. Results: Seventy-four papers were retrieved after removing duplicate studies and finally, eight studies were assessed for qualitative synthesis and five for meta-analysis. Totally, 94 patients were included in the meta-analysis. Based on the meta-analysis, it was shown that LLLT was not effective in a short interval (0 to 48 h) after surgery, but in a period of more than 1 month after surgery, the positive results of treatment can be observed strikingly. Also, LLLT side/group showed no significant difference in some aspects of neurosensory recovery such as thermal sensation compared to the placebo side/group. Conclusions: The meta-analysis of randomized controlled trials revealed that LLLT generally improves IAN sensory disturbance caused by BSSRO. Further high-quality clinical trials with longer follow-up periods and larger sample sizes are recommended.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권3호
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• pp.228-239
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• 2022

Purpose: To compare the effectiveness, tolerability, acceptability, and safety of sodium picosulphate with magnesium citrate (PS/Mg) and polyethylene glycol (PEG) in children (≤18 years) preparing for colonoscopy. Methods: Three electronic databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials) were searched till July 2020. Only randomized controlled trials (RCTs) were included. At least two authors independently selected studies and performed risk of bias assessment and data extraction. Results: Four RCTs (n=390), with overall good quality were included. A meta-analysis of two trials (n=224) found no statistically significant difference between the groups with respect to the proportion of patients who had excellent and good scores (≥6 points) according to the Boston Bowel Preparation Scale (relative risk: 0.99; 95% confidence interval [CI]: 0.90 to 1.08). Excellent and good scores were observed in both groups in approximately 90% of children. A meta-analysis of two other trials (n=150) showed no significant difference between the groups with respect to the mean total score for the Ottawa Bowel Preparation Scale (mean difference: 0.20; 95% CI: -0.74 to 1.14). Both regimens provided a comparable safety profile; however, PS/Mg was significantly superior to high volume PEG in terms of tolerability (abdominal pain, nausea, vomiting, bloating/flatulence/fullness) and acceptability (ease of formulation consumption, taste acceptance, need for nasogastric tube, compliance with full dose). Conclusion: PS/Mg provides a quality and safety profile similar to PEG for bowel cleansing; however, it has better acceptance and tolerance in children preparing for colonoscopy.

• 대한한방부인과학회지
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• 제35권4호
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• pp.37-56
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• 2022

Objectives: The purpose of this study is to assess the effect of electroacupuncture for treating postpartum hypogalactia. Methods: We searched 9 databases on May, 2022, which contained four English, two Chinese, one Japanese, and two Korean databases. Randomized controlled trials (RCTs) were eligible. Measurement of outcome included total effective rate, lactation amount, serum prolactin level, and degree of breast fullness. The risk of bias was assessed by two independent authors using the Cochrane risk of bias tool. Results: 101 trials were screened, 5 RCTs were finally selected. Number of participants per study ranged from 56 to 273. The treatment group was effective of improving total effective rate, lactation amount, serum prolactin level compared with control group, and the result was stastically significant. The quality of the evidence for specific comparisons ranged from low to high. Conclusions: Included studies showed that electroacupuncture on acupoints related to lactation would be effective way to increase milk supply among mothers who are suffering from postpartum hypogalactia. In the future, further high-quality RCTs are needed to prove effectiveness of electroacupuncture for relieving hypogalactia with low risk of bias.

• 대한한방부인과학회지
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• 제36권2호
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• pp.55-68
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• 2023

Objectives: The purpose of this study is to analyze the effectiveness of Guibi-tang that are used for postpartum depression. Methods: We searched on five databases [Korean studies Information Service (KISS), Oriental medicine advanced searching integrated system (OASIS), The Cochrane Library, PubMed, and China national knowledge infrastructure (CNKI)] with keywords for Postpartum depression (English, Korean, and Chinese) and evaluated the risk of bias. Meta-analysis was performed on the selected studies. Results: 8 potentially relevant articles were retrieved for further evaluation. There was evidence that Guibi-tang compared with Western medicine was significantly higher rate in total effect rate (RR 1.20, 95% CI 1.04, 1.39, p=0.01). Also, the combined therapeutic effects of Guibi-tang and Psychological intervention compared with Psychological intervention were statistically significant in total effect rate (RR 1.14, 95% CI 1.05, 1.24, p=0.002). And they showed improvement on scores of HAMD (Hamilton depression scale, HAMD) and SF-36 (36-Item short form health survey, SF-36). Conclusion: Guibi-tang appears to be more effective compared to Western medicine in the treatment of postpartum depression. The combination Guibi-tang and Psychological intervention was more effective than psychological intervention alone treated for postpartum depression. However, since unclear risk of bias, the result of this study should be considered carefully. Further clinical trials should be carried out in order to academical clinical progress regarding treatment of Postpartum Depression.

• 대한한방부인과학회지
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• 제22권2호
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• pp.209-221
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• 2009

목 적: 이 논문은 제왕절개 분만을 위한 척수마취로 인해 수술 중 또는 그 후에 발생할 수 있는 오심 및 구토에 대한 침관련 치료의 항구토 효과를 규명하기 위한 계통적 리뷰 논문이다. 방 법: 제왕절개 분만을 위한 척수마취로 인해 발생할 수 있는 오심 및 구토를 예방하기 위한 침관련 치료에 대한 randomized clinical trials(RCT's)를 검색하기 위해 2008년 3월까지 수록된 6개의 데이터베이스(MEDLINE, EMBASE, The Cochrane Library, CINAHL, AMED and PsycINFO)를 검색하였다. 논문의 선정 기준은 원저이며, 플라시보 대조군을 설정한 무작위 임상시험이고, 오심 또는 구토에 대한 결과가 실려 있는 것으로 하였다. 결 과: 총 5개의 논문을 선정하였으며 각 논문들의 연구방법은 일반적으로 좋은 편이었다. 5개의 논문들을 종합한 결과는 수술중 오심 발생률(OR=0.468, 95%CI:0.250 -0.876, P=0.018), 수술 후 오심 발생률(OR=0.616, 95%CI:0.042-0.942, P=0.026), 수술 후 구토 발생률(OR=0.640, 95%CI:0.432-0.948, P=0.026)이 침관련 치료군이 대조군에 비해서 통계적으로 의미있게 적었다. 결 론: 본 문헌 고찰을 통해 제왕절개 수술을 위해 시행한 척수 마취로 인해 수술중 또는 수술후 발생한 오심 및 구토에 대해 침관련 치료가 예방효과가 있음을 밝힐 수 있었다.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• 제62권2호
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• pp.75-81
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• 2019

The objective of this study was to perform a systematic review of the literature for application of intranasal sodium citrate in the patients with olfactory dysfunction to help determine the sodium citrate treatments for this condition. Two authors independently searched the data base (Medline, Scopus, and the Cochrane database) for relevant studies from inception to January 2018. Included studies were randomized controlled studies published in English comparing topical sodium citrate application (treatment group) with saline (control group) in patients who had olfactory dysfunction. Outcomes of interest included the change of olfactory identification and threshold during 2 hours post-treatment. Three studies were enrolled in the meta-analysis. Compared with control group, treatment group did not increase posttreatment score of olfactory identification [standardized mean difference (SMD)=-0.03; 95% confidence interval (CI)=-0.29-0.24; I²=0%] and olfactory threshold (SMD=0.18; 95% CI=-0.09-0.45; I²=0%) significantly. In the degree of pre-post improvement of two outcomes, although treatment group statistically showed the significant improvement in olfactory threshold (SMD=0.30; 95% CI=0.05-0.55; I²=17%), the clinical significance of this outcome was meaningless. Similarly, there was no significant difference in olfactory identification between two groups (SMD=0.17; 95% CI=-0.11-0.45; I²=22%). Unlike the recent favorable results, our summated results presented the uselessness for the local application of sodium citrate in improving patient's olfactory function. However, we also had some limitation such as small sample size and inconsistent application methods. Therefore, larger trials and standardized methodology are needed to reach more stronger and exact results.

• Korean Journal of Radiology
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• 제25권3호
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• pp.301-313
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• 2024

Objective: The current body of evidence lacks clarity regarding the comparative efficacy and safety of radiofrequency ablation (RFA) and microwave ablation (MWA) as minimally invasive treatments for benign thyroid nodules. The primary objective of this study is to clarify these concerns. Materials and Methods: A comprehensive search was conducted using the Cochrane Library, Scopus, Europe PMC, and Medline databases until October 10th, 2023, using a combination of relevant keywords. This study incorporated literature that compared RFA and MWA for benign thyroid nodules. The primary outcome was the volume reduction ratio (VRR) from baseline to follow-up. Secondary outcomes were symptom score, cosmetic score, ablation time, major complications rate, hemorrhage, hoarseness, skin burn, cough, and sympathetic nerve injury. We used Risk of Bias in Non-randomized Studies - of Interventions (ROBINS-I) tool to assess the risk of bias in the included studies. We employed random effects models to analyze the standardized mean difference (SMD) and odds ratio for the presentation of outcomes. Results: Nine studies with 2707 nodules were included. The results of our meta-analysis indicated similar efficacy between RFA and MWA in terms of VRR during the 1 (SMD 0.06; 95% confidence interval [CI]: -0.13 to 0.26; P = 0.52) and 3 (SMD 0.11; 95% CI: -0.03 to 0.25; P = 0.12) months of follow-up. VRR was significantly higher in RFA than in MWA at the 6 (SMD 0.25; 95% CI: 0.06-0.43; P = 0.008) and 12 month of follow-up (SMD 0.38; 95% CI: 0.17 to 0.59; P < 0.001). There were no significant differences between RFA and MWA in symptom scores, cosmetic scores, or the incidence of complications, including hemorrhage, hoarseness, skin burn, cough, and sympathetic nerve injury. Conclusion: RFA showed a higher VRR than MWA at 6 and 12-month follow-ups, with a comparable safety profile.