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Effects of Non-pharmacological Interventions on Primary Insomnia in Adults Aged 55 and Above: A Meta-analysis (수면장애가 있는 중장년 환자에게 적용한 비약물적 중재의 효과: 메타분석)

  • Kim, Ji Hyun;Oh, Pok Ja
    • Korean Journal of Adult Nursing
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    • v.28 no.1
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    • pp.13-29
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    • 2016
  • Purpose: This study was performed to evaluate the effects of non-pharmacological interventions on sleep disturbance amongst adults aged 55 and above. Methods: PubMed, Cochrane Library, EMBASE, CINAHL and several Korean databases were searched. The main search strategy combined terms including non-pharmacological interventions and presence of insomnia. Non-pharmacological interventions included cognitive behavioral therapy, auricular acupuncture, aromatherapy, and emotional freedom techniques. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. Data were analyzed by the RevMan 5.3 program of Cochrane Library. Results: Sixteen clinical trials met the inclusion criteria with a total of 962 participants. Non-pharmacological interventions was conducted for a mean of 5.5 weeks, 7.7 sessions, and an average of 70 minutes per session. The effects of non-pharmacological interventions on sleep quality (ES=-1.18), sleep efficiency (ES=-1.14), sleep onset latency (ES=-0.88), awakening time after sleep onset (ES=-0.87), and sleep belief (ES=-0.71) were significant, and their effect sizes were ranged from moderate to large. However, the effects on total sleep time and insomnia severity were not significant. Conclusion: The findings of the current study suggest that non-pharmacological interventions have a positive impact on attitudes and beliefs about sleep, sleep quality, sleep duration, and sleep efficiency. Therefore, the findings of the study provide an evidence to incorporate various non-pharmacological interventions into nursing practice to improve both sleep quality and quantity in patients with insomnia.

A Review of Research on the Effects of Acupuncture and Moxibustion Treatment to Complex Regional Pain Syndromes (복합부위통증증후군의 침구치료 효과에 대한 연구동향 고찰)

  • Kim, Ho Sun;Bae, Young Hyun;Kim, Hae Sol;Suh, Chang Yong;Kim, No Hyeon;Yang, Kyu Jin;Lee, Gi Bum
    • Journal of Acupuncture Research
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    • v.33 no.4
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    • pp.137-148
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    • 2016
  • Objectives : This study was performed to review articles concerning acupuncture or moxibustion treatment for Complex Regional Pain Syndromes. Methods : On-line databases including PubMed, Cochrane Library, Ovid-EMBASE, NDSL and OASIS were searched to find articles concerning acupuncture or moxibustion treatment for Complex Regional Pain Syndromes. Several overlapping articles and those not relevant to the topic were excluded, as well as review articles and commentaries. Results : 16 case reports were selected through the procedure, all of which presented successful treatment cases of Complex Regional Pain Syndromes with acupuncture and moxibustion. Most of them presented one single patient case and were published in Korea. However, almost half of them were printed in English, and had been continuously published since 2005. It was remarkable that pharmacopuncture was predominantly used to treat Complex Regional Pain Syndromes. Also, we noted that Chinese scalp acupuncture needs to be studied further as two successful cases were presented from the U.S army. Conclusion : The results show that several case reports have been published regarding Complex Regional Pain Syndromes treated with acupuncture and moxibustion. However, all of them were case reports which are given low status in Evidence-Based Medicine. We expect that a more diverse range of articles, including case control studies, cohort studies and randomized controlled trials will be performed in the near future, and that a unified outcome measure will be developed for Complex Regional Pain Syndromes.

Meta-Analysis of the Effectiveness on Foot-Reflexo-Massage for Cancer Patients (암환자에게 적용한 발반사 마사지 중재효과의 메타분석)

  • Kim, Min-Young;Oh, Pok-Ja
    • Asian Oncology Nursing
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    • v.11 no.2
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    • pp.127-135
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    • 2011
  • Purpose: This study was performed to analyze the characteristics and effect sizes of intervention studies on foot-reflexo-massage applied to cancer patients. Methods: For meta-analysis, a total of 159 studies were retrieved from search engines such as RISS, nanet, KISS, richis and KoreaMed. 16 studies published from 1990 to 2010 were selected based on the inclusion criteria. The data were analyzed with the RevMan 5.0 program of Cochrane library. Results: 1) The mean score of 1 implement time on foot-reflexo-massage was 25.62 minutes, the average number of days was 4.12 days, and the total number of average intervention frequency was 4.25 times. 2) Intervention studies on foot-reflexo-massage included 9 studies on anxiety (56.3%), 7 for pain (43.8%), 5 for BP/pulse (31.3%), 5 for fatigue (31.3%), 3 for nausea/vomiting (18.8%), 3 for sleep satisfaction (18.8%), and 2 for depression (12.5%). 3) The effect sizes of the intervention studies that showed higher effect size were in order, anxiety (d=-1.76), fatigue (d=-1.43), depression (d=-1.03), nausea and vomiting (d=-0.83), pain (d=-0.77), pulse rate (d=-0.61), blood pressure (d=-0.55), and sleep satisfaction (d=0.43). Conclusion: This study suggests that foot-reflexo-massage can increase sleep satisfaction, whereas decreasing blood pressure, pulse rate, anxiety, fatigue, depression, nausea, vomiting and pain.

Research of Traditional Herbal Medicines for Anti-aging, Inhibition Effect of Wrinkle and Whitening Effect in the Skin (피부의 노화와 주름 억제, 미백효과를 가지는 전통 한약재의 탐색)

  • Kim, Soo-Hwa;Jung, Hee;Shin, Yong-Cheol;Ko, Seong-Gyu
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.3
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    • pp.691-698
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    • 2008
  • The aims of this study are to search herbal medicines that have anti-aging, anti-wrinkle, anti-oxidant and whitening effects. This is preliminary study as a finding for excellent and specific natural agents which inhibit the skin aging and whitening formation. In this study, the articles and the documents, which have been published in domestically or internationally, have been searched and analyzed. Articles were gathered by taking advantage of Society of Cosmetic Scientists of Korea's documents, Pub med database, Korean Medical Database and Korean Studies Information Service System. Among the many species of herbal medicines, we selected the herbal medicines showing superoxide scavenging activities, and 1.1-diphenyl-2-picrylhydrazyl(DPPH) scavenging effects. The herbal medicines were showed anti-wrinkle effects on Metrixmetallo proteinase (MMP-1) inhibition activity and elastase inhibition activity. Also we found herbal medicines that have highly effect of tyrosinase inhibition, L- DOPA inhibition and melanin synthesis inhibition.

Fatal Balamuthia Amebic Encephalitis in a Healthy Child: A Case Report with Review of Survival Cases

  • Krasaelap, A.;Prechawit, S.;Chansaenroj, J.;Punyahotra, P.;Puthanakit, T.;Chomtho, K.;Shuangshoti, S.;Amornfa, J.;Poovorawan, Y.
    • Parasites, Hosts and Diseases
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    • v.51 no.3
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    • pp.335-341
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    • 2013
  • Balamuthia mandrillaris is one of the 4 amebas in fresh water and soil that cause diseases in humans. Granulomatous amebic encephalitis (GAE), caused by B. mandrillaris, is a rare but life-threatening condition. A 4-year-old, previously healthy, Thai girl presented with progressive headache and ataxia for over a month. Neuroimaging studies showed an infiltrative mass at the right cerebellar hemisphere mimicking a malignant cerebellar tumor. The pathological finding after total mass removal revealed severe necrotizing inflammation, with presence of scattered amebic trophozoites. Cerebrospinal fluid (CSF) obtained from lumbar puncture showed evidence of non-specific inflammation without identifiable organisms. A combination of pentamidine, sulfasalazine, fluconazole, and clarithromycin had been initiated promptly before PCR confirmed the diagnosis of Balamuthia amebic encephalitis (BAE). The patient showed initial improvement after the surgery and combined medical treatment, but gradually deteriorated and died of multiple organ failure within 46 days upon admission despite early diagnosis and treatment. In addition to the case, 10 survivors of BAE reported in the PubMed database were briefly reviewed in an attempt to identify the possible factors leading to survival of the patients diagnosed with this rare disease.

Review of Current Clinical Studies for Herbal Medicine of Parkinson’s Disease in Traditional Chinese Medicine (파킨슨병의 한약 치료에 대한 최신 임상연구 동향 고찰 - 2010년부터 2014년까지 중국 논문을 중심으로 -)

  • Lim, Su Yeon;Kim, Ha Ri;Choi, Yong Sun;Lee, In
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.30 no.5
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    • pp.327-337
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    • 2016
  • The objective of this study was to review the current clinical studies about the effect of herbal medicine for Parkinson's disease in China over the last 5 years and then to suggest the foundation for treatment and further studies. We had searched for studies in China National Knowledge Infrastructure(CNKI, http://www.cnki.net) and PubMed from January 2010 to December 2014. Key words were the various combinations of '帕金森', '湯', '丸', '散', '中醫藥', 'Parkinson's disease', and 'herbal medicine'. Total 53 clinical studies were selected and analyzed. The most frequently used diagnostic criteria of Parkinson's disease was the Unified Parkinson's Disease Rating Scale(UPDRS). The most frequently used medical herb was Paeoniae Radix alba(白芍藥) more 30 times and the highest amount was Astragali radix(黃芪) 100g per day. The most frequent syndrome differentiation was liver kidney yin deficiency(肝腎陰 虛). We found out there are many clinical studies of herbal medicine for Parkinson's disease in China. These studies would be able to provide the basis of clinical research on Parkinson's disease, and also applied to the treatment of Parkinson's disease in Korea.

The Effect of Exercise Program on Pain and Quality of Life for Patients with Knee Osteoarthritis: A Systematic Review and Meta-Analysis (무릎 골관절염 환자에게 적용된 운동 프로그램이 통증 및 삶의 질에 미치는 영향: 체계적 문헌고찰과 메타분석)

  • Yun, Cheonggu;An, Changsik
    • Journal of muscle and joint health
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    • v.21 no.3
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    • pp.173-183
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    • 2014
  • Purpose: This study examined the effects of exercise programs on the pain and quality of life in patients with knee osteoarthritis. Methods: Electronic bibliographic databases of KiSTi, KoreaMed, KISS and KERIS were searched to identify studies of randomized controlled trials and non-randomized controlled trials. As a result, 1213 publications identified and 16 studies met inclusion and exclusion criteria. All studies examined for quality assessment of studies using Cochrane's risk of bias. Results: The 16 studies were eligible for inclusion criteria, then the meta-analysis was conducted to examine effectiveness of exercise programs on pain and quality of life in patients with knee osteoarthritis. The meta- analysis based on the random effect model showed that the exercise program was beneficial in decreasing pain (effect size .69; 95% confidence interval 0.45~0.91). Also, the exercise programs have been shown to be effective in significantly improving the quality of life. However, it was not statistically significant due to severe deviations of studies (effect size 1.06; 95% confidence interval -0.34~2.46). Conclusion: Exercise programs had positive effects on pain relief and improvement of the quality of life in patients with knee osteoarthritis, although the quality of life was not statistically significant due to severe deviations of studies.

Relationship between Ferric Reducing Antioxidant Power and Metabolic Risk Factors in Korean Women Living in Seoul (서울지역 일부 성인 여성에서 혈청 Ferric Reducing Antioxidant Power와 대사 위험요인간의 상관성에 대한 연구)

  • Kwak, Ho-Kyung;Lee, Mee-Sook;Lim, So-Young;Yoon, Sun
    • Korean Journal of Community Nutrition
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    • v.13 no.1
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    • pp.91-99
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    • 2008
  • The present study was conducted to examine metabolic risk factors and total antioxidant capacity (TAC) of Korean females living in Seoul and to investigate the relationship between the metabolic risk factors and serum TAC. A total of 353 females aged between 20 and 64 participated in the study. Obesity indicators, blood pressure, serum lipid profile and fasting blood glucose were measured as metabolic risk factors. Ferric reducing antioxidant power (FRAP) assay was employed to determine serum TAC of subjects. Obesity indicators such as body mass index, waist circumference and waist-hip ratio were significantly higher in the participants aged $\geq$ 50 y (older group) than in the participants aged 20-49 y (younger group) (p < 0.001). Blood pressure, serum total cholesterol (TC), triglyceride (TG) and fasting blood glucose were also significantly higher in the older group than in the younger group (p < 0.001), demonstrating significant positive correlations between age and MS risk factors. The association between FRAP and MS risk factors were also investigated. FRAP values showed significant positive correlations with age (p = 0.001), serum TG (p = 0.002) and TC (p = 0.03). A tendency of positive association between FRAP and waist circumference was observed without any significant difference (p = 0.06). Increased serum FRAP with central obesity and serum lipids may be interpreted as results of activation of antioxidant defense system against oxidative stress induced by metabolic syndrome (MS) constituent factors. However, to verify the function of FRAP as a potential biomarker of susceptibility to MS various contributors to the plasma antioxidant capacity and their biological relevance related to MS should be elucidated further.

How to design in situ studies: an evaluation of experimental protocols

  • Sung, Young-Hye;Kim, Hae-Young;Son, Ho-Hyun;Chang, Juhea
    • Restorative Dentistry and Endodontics
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    • v.39 no.3
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    • pp.164-171
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    • 2014
  • Objectives: Designing in situ models for caries research is a demanding procedure, as both clinical and laboratory parameters need to be incorporated in a single study. This study aimed to construct an informative guideline for planning in situ models relevant to preexisting caries studies. Materials and Methods: An electronic literature search of the PubMed database was performed. A total 191 of full articles written in English were included and data were extracted from materials and methods. Multiple variables were analyzed in relation to the publication types, participant characteristics, specimen and appliance factors, and other conditions. Frequencies and percentages were displayed to summarize the data and the Pearson's chi-square test was used to assess a statistical significance (p < 0.05). Results: There were many parameters commonly included in the majority of in situ models such as inclusion criteria, sample sizes, sample allocation methods, tooth types, intraoral appliance types, sterilization methods, study periods, outcome measures, experimental interventions, etc. Interrelationships existed between the main research topics and some parameters (outcome measures and sample allocation methods) among the evaluated articles. Conclusions: It will be possible to establish standardized in situ protocols according to the research topics. Furthermore, data collaboration from comparable studies would be enhanced by homogeneous study designs.

Positional change of the condylar heads after wearing complete denture on dental cone beam CT (치과용 콘빔 CT영상에서 총의치 장착 후 하악과두의 위치변화)

  • Lee, Bong-Ho;Kim, Jae-Duk;Chung, Chae-Heon
    • Imaging Science in Dentistry
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    • v.38 no.1
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    • pp.23-27
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    • 2008
  • Purpose: The aim of this study was to evaluate the change in the position of the mandibular condyle within articular fossa by a CBCT after wearing complete denture (CD). Materials and Methods: CBCT of 34 temporomandibular joints were taken from 9 male and 8 female patients with CB $Mercuray^{TM}$ (Hitachi, Japan) before and after wearing a CD for rehabilitation. Position of mandibular condyle within articular fossa at centric occlusion was evaluated with $Vimplant2.0^{TM}$ (CyberMed, Korea) on the central parasagittal view and curved panoramic coronal view of the condylar head. A statistical evaluation was done with SPSS. Results: The range of anteroposterior positional rate (AP) of condylar head within articular fossa was -16-5 and -10-12 respectively on the right and left sides. Before wearing CD, the AP rate showed discrepancy between right and left sides (p<0.05). After wearing CD, both condyles showed a tendency to decrease in posterior condylar position (right side; p<0.05). The average discrepancy between right and left side in mediolateral positional rate (MD) was 15.5 and 4.5 respectively before and after wearing CD. The improvement was observed in mediolateral relationship of both condylar heads after wearing CD (p< 0.01). Before wearing CD, the average horizontal angle of long axis of condylar head was $79.6{\pm}2.7^{\circ}\;and\;80.1{\pm}5.7^{\circ}$ respectively on the right and left sides. After wearing CD, both condyles were rotated in the same direction in average on axial plane. Conclusion: We observed with CBCT the significant clinical evidence in case of positional change of mandibular condyle after wearing complete denture.

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