• 제목/요약/키워드: Interventional Therapy

검색결과 123건 처리시간 0.029초

Key Strike Forces and Their Relation to High Level of Musculoskeletal Symptoms

  • Levanon, Yafa;Gefen, Amit;Lerman, Yehuda;Portnoy, Sigal;Ratzon, Navah Z.
    • Safety and Health at Work
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    • 제7권4호
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    • pp.347-353
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    • 2016
  • Background: This study aimed to investigate the relation between key strike forces and musculoskeletal symptoms (MSS). Moreover, this study presents a key strike force measurement method to be used in a workplace setting. The correlation between key strike force characteristics and MSS was previously studied, but the measurement methods used either a single-key switch or force platforms applied under the keyboard. Most of the studies were conducted in a laboratory setting. The uniqueness of measurement methods in the current study is their ability to measure forces applied to a specific key in a workplace setting and to provide more information about specific key strike forces during typing. Methods: Twenty-four healthy computer workers were recruited for the study. The demographic questionnaire, and self-reported questionnaires for psychosocial status (General Nordic Questionnaire for Psychological and Social Factors at Work) and for detecting MSS were filled up, which later helped in dividing the participants into two groups (12 participants with pain and 12 without pain). Participants typed a predetermined text that utilized the instrumented keys multiple times. The dynamic forces applied to the keys were recorded and collected, using four thin and flexible force sensors attached to the preselected keys according to their location. Results: The results demonstrated that participants with high levels of MSS, specifically in the back and neck, in the last year exerted significantly higher key strike forces than those with lower levels of symptoms (p < 0.005). Conclusion: The key strike force exerted while typing on a keyboard may be a risk factor for MSS, and should therefore be considered in ergonomic evaluations and interventional programs.

Somatostatin Analogues Do Not Prevent Carcinoid Crisis

  • Guo, Lin-Jie;Tang, Cheng-Wei
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권16호
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    • pp.6679-6683
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    • 2014
  • Background: Carcinoid crisis is a life-threating syndrome of neuroendocrine tumors (NETs) characterized by dramatic blood pressure fluctuation, arrhythmias, and bronchospasm. In the era of booming anti-tumor therapeutics, this has become more important since associated stresses can trigger carcinoid crisis. Somatostatin analogues (SSTA) have been recommended for prophylactic administration before intervention procedures for functioning NETs. However, the efficacy is still controversial. The aim of this article is to review efficacy of SSTA for preventing carcinoid crisis. Materials and Methods: PubMed, Cochrane Controlled trials Register, and EMBASE were searched using 'carcinoid crisis' as a search term combining terms with 'somatostatin'; 'octreotide'; 'lanreotide' and 'pasireotide' until December 2013. Results: Twenty-eight articles were retrieved with a total of fifty-three unique patients identified for carcinoid crisis. The most common primary sites of NETs were the small intestine and respiratory tract. The triggering factors for carcinoid crisis included anesthesia/surgery (63.5%), interventional therapy (11.5%), radionuclide therapy (9.6%), examination (7.7%), medication (3.8%), biopsy (2%) and spontaneous (2%). No randomized controlled trials (RCTs) were identified and two case-control studies were included to assess the efficacy of SSTA for preventing carcinoid crisis by meta-analysis. The overall pooled risk of perioperative carcinoid crisis was similar despite the prophylactic administration of SSTA (OR 0.44, 95% CI: 0.14 to 1.35, p=0.15). Conclusions: SSTA wasnot helpful for preventing carcinoid crisis based on a meta-analysis of retrospective studies. Attentive monitoring and careful intervention are essential. Future studies with better quality are needed to clarify any effect of SSTA for preventing carcinoid crisis.

Effect of anti-rheumatic agents on periodontal parameters and biomarkers of inflammation: a systematic review and meta-analysis

  • Han, Ji-Young;Reynolds, Mark A.
    • Journal of Periodontal and Implant Science
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    • 제42권1호
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    • pp.3-12
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    • 2012
  • Purpose: Anti-rheumatic agents target common molecular pathways of inflammation in rheumatoid arthritis (RA) and periodontitis. The purpose of this study was to determine the relative effect of anti-rheumatic agents on the levels of inflammatory biomarkers and periodontal inflammation in RA patients with periodontitis. Methods: A systematic review and meta-analysis were conducted of studies comparing periodontal parameters of inflammation, such as bleeding on probing, and biomarkers of inflammation in RA patients with periodontitis and healthy adults with and without periodontitis. The search included the electronic databases MEDLINE, Cochrane Database of Systematic Reviews, and Google Scholar, inclusive through October 2011, with no language restrictions. Hand searches were conducted of the bibliographies of related journals and systematic reviews. Observational and interventional studies assessing the effects of antirheumatic therapy qualified for inclusion. Two reviewers performed independent data extraction and risk-of-bias assessment. Of the 187 identified publications, 13 studies fulfilled the inclusion criteria. Results: When compared to healthy adults without periodontitis, RA subjects were found to have significantly higher levels of bleeding on probing and limited evidence of higher levels of interleukin-$1{\beta}$ and tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) in gingival crevicular fluid and saliva. No consistent differences were found in periodontal parameters and inflammatory biomarkers between RA subjects and adults with periodontitis. Studies evaluating the effect of anti-TNF-${\alpha}$ therapy in RA subjects with periodontitis have yielded inconsistent results. Conclusions: There are limited data, however, to suggest that anti-TNF-${\alpha}$ agents can reduce local production of inflammatory cytokines and periodontal inflammation in RA patients with periodontitis.

수술 환아의 불안에 적용한 비약물적 중재의 효과: 체계적 문헌고찰 및 메타분석 (The Effectiveness of Non-pharmacological Interventions on Anxiety in Children Undergoing Surgery: A Systematic Review and Meta-analysis)

  • 김현영;신선화
    • 동서간호학연구지
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    • 제27권1호
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    • pp.1-13
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    • 2021
  • Purpose: The purpose of this study was to examine the effectiveness of non-pharmacological interventions for reducing perioperative anxiety in children undergoing surgery. Methods: A systematic review of randomized controlled trials (RCTs) with the primary outcome of children's perioperative anxiety was conducted. The literature search was performed using various databases, including Cochrane Library, CINAHL, EMBASE, PubMed, and Korean electronic databases with confined to RCTs between 2000 and 2020. A total of sixteen studies were suitable the inclusion criteria and were systematically reviewed. The bias risk of randomized studies was evaluated using Cochrane's risk of bias tool. For the meta-analysis, RevMan 5.4 was used to analyze effect sizes of interventional factors. Results: Finally, twelve RCTs studies were used for meta-analysis. The non-pharmacological interventions implemented to reduce perioperative anxiety in children were therapeutic play, clown therapy and information provision. First, therapeutic play had a significant effect on reducing preoperative anxiety, with an effect size of -1.46 (95% CI=-1.78~-1.14). Second, clown therapy had a significant effect on reducing preoperative anxiety, with an effect size of -0.97 (95% CI=-1.45~-0.49). Finally, the provision of information had a significant effect on reducing preoperative anxiety, with an effect size of -0.75 (95% CI=-0.99~-0.51). Conclusion: This meta-analysis suggests that non-pharmaceutical interventions provide effective methods of reducing perioperative anxiety in children. Therefore, the findings verify evidence that various non-pharmacological interventions are effective means for reducing children's preoperative anxiety.

Predictive factors associated with successful response to utrasound guided genicular radiofrequency ablation

  • Kose, Selin Guven;Kose, Halil Cihan;Celikel, Feyza;Akkaya, Omer Taylan
    • The Korean Journal of Pain
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    • 제35권4호
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    • pp.447-457
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    • 2022
  • Background: Ultrasound-guided genicular nerve radiofrequency (RF) procedures are of interest in the management of chronic knee pain. A wide variety of demographic, clinical, and procedural characteristics can affect treatment success. This study aimed to determine predictive factors to provide superior treatment outcomes. Methods: The demographic, clinical, and technical data of patients who received genicular nerve RF for knee pain between September 2016 and September 2021 were evaluated. A positive outcome was defined as at least 50% pain relief on a pain score for at least 6 months. Logistic regression analysis was performed to determine the factors associated with a successful response to genicular RF. Results: Among 206 patients who underwent genicular RF, 62% of the patients reported successful outcomes at 6 months. In the multivariate model, targeting 5 nerves (odds ratio [OR], 6.184; 95% confidence interval [CI], 2.291-16.690; P < 0.001) was the most significant predictor of successful outcomes. Multivariable logistic regression analysis showed that prognostic genicular nerve block with a 50% cut-off value (OR, 2.109; 95% CI, 1.038-4.287; P = 0.039), no opioid use (OR, 2.753; 95% CI, 1.405-5.393; P = 0.003), and depression (OR, 0.297; 95% CI, 0.124-0.713; P = 0.007) were the predictive factors significantly associated with response to genicular RF. Conclusions: Clinical and technical factors associated with better treatment outcomes were ultimately targeting more nerves, performing prognostic block, no opioid use, and no depression. These results are expected to be considered when selecting patients for genicular RF.

Effectiveness of hyaluronic acid in the management of oral lichen planus: a systematic review and meta-analysis

  • Manjushri, Waingade;Raghavendra S, Medikeri;Shamali, Gaikwad
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제22권6호
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    • pp.405-417
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    • 2022
  • Oral lichen planus (OLP) is a chronic inflammatory immune-mediated condition that has been identified as a potentially malignant oral disorder. Various therapies have been proposed for its management as alternative to corticosteroids. However, no definitive treatment has been identified that can result in complete remission or minimal recurrence. Hyaluronic acid has recently been used as an alternative therapy for the management of OLP. This study aimed to systematically review the effectiveness of Hyaluronic acid in the management of symptomatic OLP. Online electronic databases and manual searches were performed for randomized controlled trials (RCTs) published in English between January 2010 and April 2022. RCTs were identified that compared the efficacy of hyaluronic acid and other interventional therapies at baseline and during follow-up. The Cochrane Risk of Bias tool was used to assess the quality of the included studies. Visual analog scale (VAS) scores, Thongprasom sign scores, lesion size, degree of erythema, clinical severity, and disease severity were assessed both quantitatively and qualitatively. Seven studies were analyzed. Five studies reported a high risk of bias while the remaining two studies reported an unclear risk of bias. The overall quantitative assessment of size, symptoms, degree of erythema, and sign score in OLP lesions treated with HA was not statistically significant compared to that in the control group (P > 0.05). In addition, subgroup analysis comparing HA with placebo or corticosteroids did not yield statistically significant (P > 0.05) results. Qualitatively, both HA and tacrolimus resulted in an effective reduction in signs and symptoms. Clinical/disease severity index/scores were inconsistent. A high degree of heterogeneity was observed among the included studies. None of the included studies reported the side effects of HA. These findings suggest that corticosteroids, tacrolimus, placebo, and HA could be equally effective in OLP management. The clinical/disease severity index or score reduction cannot be determined with certainty. Thus, OLP can be treated with HA as an alternative therapy. Owing to limited clinical trials on HA, high heterogeneity, and high risk of bias in the included studies, definitive conclusions cannot be derived.

Ultrasound-guided PENG block versus intraarticular corticosteroid injection in hip osteoarthritis: a randomised controlled study

  • Selin Guven Kose;Halil Cihan Kose;Feyza Celikel;Serkan Tulgar;Omer Taylan Akkaya
    • The Korean Journal of Pain
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    • 제36권2호
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    • pp.195-207
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    • 2023
  • Background: This study aimed to compare the effectiveness of the pericapsular nerve group (PENG) block and intra-articular injection (IAI) of steroid-bupivacaine in the treatment of hip osteoarthritis (OA). Methods: After randomization, patients received either a PENG block or IAI under ultrasound-guidance. Clinical evaluations were recorded at baseline, day 1, and weeks 1, 4, and 8 post-intervention. The numerical rating scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Harris Hip Scale (HHS) scores, pain medication use determined by a quantitative analgesic questionnaire, and patient satisfaction were evaluated. Results: Sixty patients were included in this study. NRS scores improved significantly for both groups during the follow-up compared to pretreatment (P < 0.001), with better pain scores for the PENG group (P < 0.001) at day 1 with larger effect size (Cohen's d = 4.62), and IAI group at 4 (Cohen's d = 5.15) and 8 (Cohen's d = 4.33) weeks (P < 0.001). There was no significant difference in pain medication consumption (P = 0.499) and patient satisfaction (P = 0.138) between groups. Patients in the IAI group experienced significant improvement in HHS (Cohen's d = 2.16, P = 0.007) and WOMAC (Cohen's d = 1.02, P = 0.036) scores at 8 weeks compared to the PENG group. Conclusions: The ultrasound-guided PENG block provides effective pain relief which improves functionality and quality of life in hip OA patients up to 2 months. The PENG block can be considered an easy, safe, and useful alternative treatment modality for hip OA.

대학생의 감각처리특성에 따른 여가활동과 자기효능감 (Leisure Activities and Self-efficacy according to Sensory Processing Feature of University Students)

  • 이춘엽;박영주
    • 대한지역사회작업치료학회지
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    • 제8권3호
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    • pp.13-23
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    • 2018
  • 목적 : 본 연구는 대학생의 감각처리특성에 따른 여가활동과 자기효능감을 알아보고자 하였다. 연구방법 : 본 연구는 2018년 3월부터 동년 6월까지 설문조사방법을 실시하였다. 전라지역과 경상지역의 대학생 235명을 대상으로 감각처리특성을 알아보기 위해 청소년/성인 감각프로파일(Adolescent/Adult Sensory Profile)을 사용하였고, 여가활동을 알아보기 위해 여가활동 설문지를 사용하였으며, 자기효능감을 알아보기 위해 자기효능감척도(Self-Efficacy Scale)를 사용하였다. 대학생의 여가활동 빈도를 파악하고, 감각처리특성에 따른 여가활동 빈도와 자기효능감, 감각찾기 유형의 특성에 따른 여가활동을 알아보았다. 결과 : 대학생의 감각처리특성에 따른 여가활동 빈도 및 자기효능감을 보면, 여가활동 빈도는 감각찾기 유형만 통계학적으로 유의한 차이가 있었고, 자기효능감은 모든 감각처리유형의 특성에 따라 유의한 차이가 나타났다(p<.05). 감각찾기 유형의 특성에 따른 여가활동은 헬스, TV시청, 쇼핑, 인터넷 검색과 웹서핑에서 통계학적으로 유의한 차이를 나타내었다(p<.05, p<.01). 결론 : 대학생의 감각찾기 유형에서 특성에 따라 여가활동과 자기효능감은 차이를 나타내었다. 대학생의 여가활동을 장려하고 그들의 자기효능감을 향상시키기 위해 감각처리특성에 대한 이해를 기반으로 한 중재적 접근이 필요할 것이다.

태변흡인증후군에서 폐표면활성제 사용이 호흡기지표에 미치는 영향에 대한 체계적 문헌고찰과 메타분석 (The Effect on Pulmonary Indices of Surfactant Therapy for Meconium Aspiration Syndrome: Systematic Review and Meta-analysis)

  • 최현진;한서경;이순민;김한석;배종우
    • Neonatal Medicine
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    • 제18권2호
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    • pp.189-196
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    • 2011
  • 목적: 최근 폐표면활성제는 태변흡인증후군 환자에서 호흡곤란을 호전시키기 위한 치료 중 하나로 사용되고 있다. 본 연구에서는 태변흡인증후군에서 폐표면활성제가 치료결과로서 호흡기지표에 미치는 영향을 살펴보았다. 방법: MEDLINE, EMBASE, CENTRAL 등의 주요 데이터베이스 및 초록 등을 검색하여 2011년 6월까지 보고된 관련 무작위 배정연구를 선별하였다. OI 또는 a/A $PO_2$와 같은 호흡기 지표를 포함한 자료를 추출하여 폐표면활성제 보충요법과 폐표면활성제 세정요법 각각에 대해 메타분석을 수행하였다. 비뚤림 위험 및 임상적, 통계적 이질성을 평가하였다. 결과: 두 건의 폐표면활성제 보충요법 연구와 두 건의 폐표면 활성제 세정요법 연구가 분석에 포함되었다. 폐표면활성제 보충요법의 경우 OI에서는 두 연구 결과 사이의 이질성이 큰 반면, a/A $PO_2$에서는 보충요법 후 시간이 경과할 수록 군 간의 차이가 유의하게 나타났다(12시간째 WMD 0.08, 95% CI 0.04, 0.12; 24시간째 WMD 0.17, 95% CI 0.06, 0.28). 폐표면활성제 세정요법의 경우 통합하여 분석하였을 때 치료군이 대조군에 비해 임상 경과가 좋은 경향을 보였으나 통계적인 유의성은 확보하지는 못하였다. 결론: 태변흡인증후군에서 폐표면활성제 사용은 임상경과를 호전시키는 것으로 보인다. 기존의 연구수가 제한되어 있고 대상환자의 중증도 및 폐표면활성제 투여방법 또한 서로 다르므로 추가적인 연구를 통한 보충적인 근거가 도움이 될 것이다.

Myeloid-Derived Suppressor Cells Are Associated with Viral Persistence and Downregulation of TCR ζ Chain Expression on CD8+ T Cells in Chronic Hepatitis C Patients

  • Zeng, Qing-Lei;Yang, Bin;Sun, Hong-Qi;Feng, Guo-Hua;Jin, Lei;Zou, Zheng-Sheng;Zhang, Zheng;Zhang, Ji-Yuan;Wang, Fu-Sheng
    • Molecules and Cells
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    • 제37권1호
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    • pp.66-73
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    • 2014
  • Myeloid-derived suppressor cells (MDSCs) play an important role in impairing the function of T cells. We characterized MDSCs in two chronic hepatitis C (CHC) cohorts: a cross-sectional group that included 61 treatment-naive patients with CHC, 14 rapid virologic response (RVR) cases and 22 early virologic response (EVR) cases; and a longitudinal group of 13 cases of RVR and 10 cases of EVR after pegylated-interferon-${\alpha}$/ribavirin treatment for genotype 1b HCV infection. Liver samples from 32 CHC patients and six healthy controls were subjected to immunohistochemical analysis. MDSCs frequency in treatment-naive CHC was significantly higher than in RVR, EVR, or healthy subjects and was positively correlated with HCV RNA. Patients infected with HCV genotype 2a had a significantly higher frequency of MDSCs than those infected with genotype 1b. Decreased T cell receptor (TCR) ${\zeta}$ expression on $CD8^+$ T cells was significantly associated with an increased frequency of MDSCs in treatment-naive CHC patients and was restored by L-arginine treatment in vitro. Increased numbers of liver arginase-$1^+$ cells were closely associated with the histological activity index in CHC. The TCR ${\zeta}$ chain was significantly downregulated on hepatic $CD8^+$ T cells in CHC. During antiviral follow up, MDSCs frequency in peripheral blood mononuclear cells was directly correlated with the HCV RNA load in the plasma and inversely correlated with TCR ${\zeta}$ chain expression in $CD8^+$ T cells in both RVR and EVR cases. Notably, the RVR group had a higher frequency of MDSCs at baseline than the EVR group. Collectively, this study provides evidence that MDSCs might be associated with HCV persistence and downregulation of CD8 ${\zeta}$ chain expression.