• 제목/요약/키워드: Evidence Combination

검색결과 370건 처리시간 0.024초

The Role of Bronchodilators in Preventing Exacerbations of Chronic Obstructive Pulmonary Disease

  • Beeh, Kai M.
    • Tuberculosis and Respiratory Diseases
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    • 제79권4호
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    • pp.241-247
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    • 2016
  • Bronchodilators are the cornerstone of symptomatic chronic obstructive pulmonary disease (COPD) treatment. They are routinely recommended for symptom reduction, with a preference of long-acting over short-acting drugs. Bronchodilators are classified into two classes based on distinct modes of action, i.e., long-acting antimuscarinics (LAMA, once-daily and twice-daily), and long-acting ${\beta}2$-agonists (LABA, once-daily and twice-daily). In contrast to asthma management, evidence supports the efficacy of both classes of long-acting bronchodilators as monotherapy in preventing COPD exacerbations, with greater efficacy of LAMA drugs versus LABAs. Several novel LAMA/LABA fixed dose combination inhalers are currently approved for COPD maintenance treatment. These agents show superior symptom control to monotherapies, and some of these combinations have also demonstrated superior efficacy in exacerbation prevention versus monotherapies, or combinations of inhaled corticosteroids plus LABA. This review summarizes the current data on clinical effectiveness of bronchodilators alone or in combination to prevent exacerbations of COPD.

강섬유 보강 철근 콘크리트 단순보와 연속보의 거동 (The Behavior between Steel fiber Reinforced Concrete Both Simple and Continuous Beams)

  • 곽계환;김원태;김기순;장화섭
    • 한국전산구조공학회:학술대회논문집
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    • 한국전산구조공학회 2003년도 봄 학술발표회 논문집
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    • pp.167-174
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    • 2003
  • It is absolutely natural to be interested in durability and safety of the structure under shear behavior. To fulfill this desire, a comparison on the shear behavior between steel fiber reinforced concrete both simple and continuous beams is done to use in the field working. Several operations are conducted : First of all, plan for optimal combination is standardized. Second, resistance for shear has been generalized in that it is decided by combination of individual elements. Third, as the fracture of tensile bar leads to destruction of specimen, shear behavior of whole specimen is decided by stress working on tensile bar. It should be generalized for other specimens also. Forth, evidence of the softness of steel fiber reinforced concrete beam by experiment lead to application in the fields. Finally, numeral values of the steel fiber reinforced concrete are analyzed and the result is compared to those of experiments. With these consequences, this study was done for the application to dynamic structures such as bridges and the repair and rehabilitation.

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중풍 후유증으로 인한 실어증 환자에 한방치료와 언어치료를 병행한 경험2례 (Two cases of Combination Therapy of Acupuncture, Herbal medication and Speech Therapy for Aphasic Stroke Patients)

  • 양태규;박정미
    • 대한한의학회지
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    • 제23권4호
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    • pp.196-202
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    • 2002
  • Aphasia is frequent in stroke patients and most patients with aphasia exhibit spontaneous progressive improvement in language abilities over time, but few recover completely. Neurological variables, especially initial severity of aphasia and time post-onset, appear to have influence on improvement. Effect of speech therapy and pharmacotherapy has been studied and some drugs, like amphetamine are proved to be benefit for recovery of aphasia following stroke. But there has been few evidence to facilitate recovery from aphasia by acupuncture or herbal medication therapy. So we report two cases of aphasic stroke patients who treated by combination therapy of acupuncture, herbal medication(Cheongsinhaeo-tang) and speech therapy over 6 months and improved in language abilities. Further clinical studies will be needed to explore the effects of acupuncture and herbal medication therapy for aphasia. Researchers should examine the long term effect of these treatment, and whether it is more effective than speech therapy and western pharmacotherapy or not..

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갑상선 유두암의 외과적 절제술 이후 발생한 후유증에 대한 면역요법을 병행한 한방 치험 3례 (A Case Report on Papillary Thyroid Cancer Patients after Thyroidectomy Treated with Korean Medicine and Immunotherapy)

  • 고은비;장권준;양정민;오재성
    • 대한한방내과학회지
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    • 제42권5호
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    • pp.746-759
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    • 2021
  • Objectives: This study assessed the effect of a combination of Korean medicine and immunotherapy on three papillary thyroid cancer patients following thyroidectomy. Methods: The three patients who underwent thyroidectomy received Korean medical treatments, including acupuncture, moxibustion, pharmacopuncture, and immunotherapy. To evaluate the patients, symptoms were measured using the Numerical Rating Scale (NRS) and Karnofsky Performance Status Scale (KPS). Blood tests, including thyroid function tests, were conducted during treatment. Results: After treatment, postoperative pain and general weakness were gradually alleviated. Conclusions: These cases provide evidence that treatment with a combination of Korean medicine and immunotherapy can have substantial benefits for postoperative complications following thyroidectomy.

Oral Health Diagnosis by Using Combination of Evidence in Dezert-Smarandache Theory

  • Fadhillah, Muhammad Kamil;Listio, Syntia;Choi, Yong Keum;Lee, Hyun
    • International journal of advanced smart convergence
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    • 제7권4호
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    • pp.185-196
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    • 2018
  • Based on World Health Organization (WHO) children and adults have a problem with their oral health, such as Dental cavities and periodontal disease. It is not easy to obtain the high convince level of result of the dental and periodontal diseases. Because each of them have different degrees of uncertainty and there have several discounting factors (error rates) in different of survey. To solve this problem we propose the Dezert-Smarandache Theory (DSmT) for efficient combination of uncertain, imprecise and highly conflicting sources of information. Moreover, we apply the SEFP as a context reasoning. Finally, we make the simulation by using 12 surveys and compare Propotional Conflict Redistribution 5 (PCR5) and Dempster-Shafer Theory (DST) to show the belief or probability for the low, a heavy, high and ultra-high risk situation.

분포함수 기반 Mass 함수 추정을 통한 Dempster-Shafer 영상융합

  • 이상훈
    • 대한원격탐사학회:학술대회논문집
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    • 대한원격탐사학회 2006년도 춘계학술대회 논문집
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    • pp.311-314
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    • 2006
  • 본 연구에서는 서로 다른 센서간의 영상 자료 융합을 위하여 Dempster-Shafer 기법을 제안하고 있다. 제안 된 Dempster-Shafer 기법은 불확실성의 최소 값을 대표하는 Belief 함수와 불확실성의 최대 값을 나타내는 Plausibility 함수를 사용한다. 이러한 두 함수의 차이는 Belief Interval 로 정의되며 이 값은 분석 대상에 존재하는 불확실 정도의 Measure 로 사용되며 Evidence Combination의 이론에 근거하여 서로 다른 센서간의 자료 융합이 가능하며 분류 결과로 클래스 맵 뿐 만 아니라 분류 결과에 대한 불확실성 정도를 나타내는 Belief 함수 값과 Plausibility 함수 값을 생성하여 분류 결과에 대한 보충적인 분석을 가능하게 하여 사용자의 분석 정확성을 증대 시킬 수 있다.

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Continuous-infusion Ifosfamide and Doxorubicin Combination as Second-Line Chemotherapy for Recurrent or Refractory Osteosarcoma Patients in China: a Retrospective Study

  • Huang, Yu-Jing;He, Ai-Na;Sun, Yuan-Jue;Shen, Zan;Min, Da-Liu;Yao, Yang
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권6호
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    • pp.2391-2395
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    • 2015
  • Objective: The aim of this retrospective study was to evaluate the feasibility and efficacy of response to continuous-infusion ifosfamide and doxorubicin combination as second-line chemotherapy for patients with recurrent or refractory osteosarcoma. Materials and Methods: Eighteen recurrent or refractory osteosarcoma patients who were treated with continuous-infusion ifosfamide and doxorubicin combination between May 1999 and April 2011 were included in the analysis. Ifosfamide at $12g/m^2$ was administered by intravenous continuous infusion over 3 days, and doxorubicin $60mg/m^2$ was administered as an intravenous bolus injection on day 1. The combination therapy was repeated every 3 weeks. Treatment was continued until evidence of disease progression or unacceptable toxicity. Results: The patients (ages 7-53 years) received a total of 42 cycles of chemotherapy (median: 2 courses; range: 2-5 courses). The overall response rate was 0% and the disease control rate was 22.3%, with four patients having stable disease. The median time to progression and overall survival time were 2 months (range: 2-5 months) and 9 months (range: 3-29 months), respectively. Major severe toxicities were leucopenia 7 (38.9%), nausea and vomiting 3 (16.7%) and alopecia 9 (50%). There were no treatment-related deaths. Conclusions: In our experience, continuous-infusion ifosfamide and doxorubicin combination therapy at this dosage and schedule was found to be well tolerated and moderate effective, which could be considered as salvage therapy for patients with recurrent or refractory osteosarcoma. Further assessment is necessary to confirm the safety and efficacy of this treatment.

Inhibition of Tumor Growth in Vitro by a Combination of Extracts from Rosa Roxburghii Tratt and Fagopyrum Cymosum

  • Liu, Wei;Li, Su-Yi;Huang, Xin-En;Cui, Jiu-Jie;Zhao, Ting;Zhang, Hua
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권5호
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    • pp.2409-2414
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    • 2012
  • Objective: Traditional Chinese herbal medicines have a very long history. Rosa roxburghii Tratt and Fagopyrum cymosum are two examples of plants which are reputed to have benefits in improving immune responses, enhancing digestive ability and demonstrating anti-aging effects. Some evidence indicates that herbal medicine soups containing extracts from the two in combination have efficacy in treating malignant tumors. However, the underlying mechanisms are far from well understood. The present study was therefore undertaken to evaluate anticancer effects and explore molecular mechanisms in vitro. Methods: Proliferation and apoptosis were assessed with three carcinoma cell lines (human esophageal squamous carcinoma CaEs-17, human gastric carcinoma SGC-7901 and pulmonary carcinoma A549) by MTT assay and flow cytometry, respectively, after exposure to extract from Rosa roxburghii Tratt (CL) and extract from Fagopyrum cymosum (FR). $IC_{30}$ of CL and FR were obtained by MTT assay. Tumor cells were divided into four groups : control with no exposure to CL or FR; CL with $IC_{30}$ CL; FR with $IC_{30}$ FR; CL+FR group with 1/2 ($IC_{30}$ CL + $IC_{30}$ FR). RT-PCR and Western blot analysis were used to detect the expression of Ki-67, Bax and Bcl-2 at mRNA and protein levels. Results: Compared with the CL or FR groups, the combination of CL+FR showed significant inhibition of cell growth and increase in apoptosis; the mRNA and protein expression levels of Ki-67 and Bcl-2 in CL+FR group were all greatly decreased, while the expression of Bax was markedly increased. Conclusions: These results indicate that the synergistic antitumor effects of combination of CL and FR are related to inhibition of proliferation and induction of apoptosis.

비만에 대한 고지혈증 치료제와 수영운동의 병합처방의 효과 (The effect of swimming plus hypolipidemic agent on obesity)

  • 정선효
    • 한국응용과학기술학회지
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    • 제36권1호
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    • pp.34-46
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    • 2019
  • 비만은 대사증후군과 밀접한 관련이 있다. 본 연구는 8주간 고지방식이를 섭취한 쥐에서 고지혈증 치료제인 피노피브레이트(fenofibrate) 단독처방, 수영운동 단독처방 및 fenofibrate와 수영운동의 병합처방이 비만을 조절하는지를 조사하고, fenofibrate와 수영운동의 병합처방이 fenofibrate 단독처방에 비해 효과적으로 비만을 조절하는지를 분석하였다. Fenofibrate 단독처방과 수영운동 단독처방 모두 대조군에 비해 비만과 관련된 요소들인 몸무게, 지방무게, 혈청 지질성분 및 지방세포 크기를 감소시켰다. 쥐는 fenofibrate와 수영운동의 병합처방 되었을 경우 fenofibrate 단독처방 되었을 경우에 비해 비만과 관련된 요소들이 더 효과적으로 감소되었다. 대조군에 비해 fenofibrate 단독처방, 수영운동 단독처방 및 fenofibrate와 수영운동의 병합처방 모두 혈청 포도당 수치를 감소시켰다. 본 연구는 fenofibrate와 수영운동의 병합처방이 비만과 혈당을 효과적으로 조절함으로써 고지방식이 섭취로 인해 발생되는 대사증후군의 억제에 공헌할 것임을 제시하고 있다.

정신병적 우울증의 치료 전략 (Treatment Strategies for Psychotic Depression)

  • 이소영;정한용
    • 생물정신의학
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    • 제13권4호
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    • pp.234-243
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    • 2006
  • 정신병적 우울증의 심한 정도와 나쁜 예후, 그리고 현재까지의 연구 실적을 고려했을 때, 임상의사들은 정신병적 증상을 동반한 우울증과 정신병적 증상을 동반하지 않는 우울증을 구분하여 치료계획을 수립하는 것이 바람직하다. 저자들은 체계적인 검색을 통해 광범위하게 조사를 하였으나, 정신병적 우울증 환자의 약물치료에 대한 근거는 아직 부족한 것으로 생각한다. 소수의 연구 결과들이지만 현재까지 발표된 근거에 의하면, 항우울제와 항정신병약물의 병합치료와 전기충격요법이 그 효과에 대한 근거 수준이 가장 높아서 정신병적 우울증 환자를 위한 일차적 치료법으로 생각된다. 그러나 최근에 항우울제 단독치료가 항우울제와 항정신병약물의 병합치료에 비해 효과 면에서 떨어지지 않는다는 분석 결과가 발표되면서 항우울제-항정신병약물 병합치료법과 항우울제를 사용하다가 필요시에 항정신병약물을 추가하는 방법 둘 다 권고된 바 있다. 이는 기존 치료 권고 사항과 대조가 되기 때문에, 향후 이러한 관점에서 기존의 치료 전략들이 어떻게 영향을 받을지 주목된다. 그러나 적어도 정신병적 우울증 환자에게 항정신병약물을 단독으로 사용하는 것은 항우울제와 병합하였을 때 보다 덜 효과적이므로 항정신병약물 단독으로 시작하는 것은 바람직하지 않다는 데에는 연구자들 간에 의견이 일치하고 있다. 항우울제 중에서는 삼환계 항우울제에 대한 근거 수준이 가장 높고 선택적 세로토닌 재흡수 차단제의 경우 현재는 근거가 부족하나 앞으로 유망할 것으로 보인다. 항우울제와 항정신병약물 병합 치료에 반응이 없거나 부작용으로 인해 투여할 수가 없을 경우에는 항우울제의 종류를 바꾸거나 lithium을 강화하는 방법을 고려할 수 있다. 실제 임상에서는 환자 개개인의 위험과 이득을 고려하여 약물을 선택하는 것이 중요하다. 또한 선택된 약물을 충분한 양, 그리고 충분한 기간 동안 시도했는지도 중요하다. 이와 함께 부작용의 출현에 대해 잘 모니터링을 해야 하고, 특히 우울증 자체가 악화되는 것과 구분해야 한다. 결론적으로, 임상의사들은 정신병적 증상을 동반하는 우울증 환자의 치료 전략을 현재까지 수행된 연구 근거의 양과 수준을 감안하여 받아들여야 하고, 아직까지 명백한 결론을 이끌어내기에는 부족하기 때문에 향후 이에 대한 많은 체계적 연구들이 필요할 것이다.

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