• Title/Summary/Keyword: Meta-analyses

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Primary Hyperoxaluria in Korean Pediatric Patients

  • Choe, Yunsoo;Lee, Jiwon M.;Kim, Ji Hyun;Cho, Myung Hyun;Kim, Seong Heon;Lee, Joo Hoon;Park, Young Seo;Kang, Hee Gyung;Ha, Il Soo;Cheong, Hae Il
    • Childhood Kidney Diseases
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    • v.23 no.2
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    • pp.59-66
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    • 2019
  • Background: Primary hyperoxaluria (PH), a rare inborn error of glyoxylate meta bolism causing overproduction of oxalate, is classified into three genetic subgroups: type 1-3 (PH1-PH3) caused by AGXT, GRHPR, and HOGA1 gene mutations, respectively. We performed a retrospective case series study of Korean pediatric patients with PH. Methods: In total, 11 unrelated pediatric patients were recruited and their phenotypes and genotypes were analyzed by a retrospective review of their medical records. Results: Mutational analyses revealed biallelic AGXT mutations (PH1) in nine patients and a single heterozygous GRHPR and HOGA1 mutation in one patient each. The c.33dupC was the most common AGXT mutation with an allelic frequency of 44%. The median age of onset was 3 months (range, 2 months-3 years), and eight patients with PH1 presented with end stage renal disease (ESRD). Patients with two truncating mutations showed an earlier age of onset and more frequent retinal involvement than patients with one truncating mutation. Among eight PH1 patients presenting with ESRD, five patients were treated with intensive dialysis followed by liver transplantation (n=5) with/without subsequent kidney transplantation (n=3). Conclusion: Most patients presented with severe infantile forms of PH. Patients with two truncating mutations displayed more severe phenotypes than those of patients with one truncating mutation. Sequential liver and kidney transplantation was adopted for PH1 patients presenting with ESRD. A larger nation-wide multicenter study is needed to confirm the genotype-phenotype correlations and outcomes of organ transplantation.

Cancer Health Literacy and Cancer Screening Behaviors: A Systematic Review (암 건강정보문해력과 암 조기진단행위: 체계적 문헌고찰)

  • Guo, Lingru;Kim, Hyunli
    • Journal of the Korea Convergence Society
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    • v.12 no.9
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    • pp.373-385
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    • 2021
  • The purpose of this paper is to systematically evaluate the relationship between cancer health literacy and cancer screening behaviors using global data. Following the preferred reporting items for systematic reviews and meta-analyses review guidelines, full-text articles published on PubMed, CINAHL, Embase, and Cochrane Library were reviewed until 31 January 2021. The reference lists of all selected studies have been also included. The cancer health literacy and cancer-screening behaviors of the participants aged ≥18 years were assessed. Seventeen studies that met the inclusion criteria were included. The cancer screening behaviors included mammograms, clinical breast cancer examination, Papanicolaou test, colonoscopy, and PSA screening. Eleven studies revealed a statistically meaningful relationship between the cancer health literacy and cancer screening behaviors. Further research should focus on developing effective interventions and guidelines on cancer health knowledge. The research scope of all areas of cancer health literacy and cancer screening behaviors should be extended to improve the cancer screening rates and public health.

Deep learning convolutional neural network algorithms for the early detection and diagnosis of dental caries on periapical radiographs: A systematic review

  • Musri, Nabilla;Christie, Brenda;Ichwan, Solachuddin Jauhari Arief;Cahyanto, Arief
    • Imaging Science in Dentistry
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    • v.51 no.3
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    • pp.237-242
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    • 2021
  • Purpose: The aim of this study was to analyse and review deep learning convolutional neural networks for detecting and diagnosing early-stage dental caries on periapical radiographs. Materials and Methods: In order to conduct this review, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA) guidelines were followed. Studies published from 2015 to 2021 under the keywords(deep convolutional neural network) AND (caries), (deep learning caries) AND (convolutional neural network) AND (caries) were systematically reviewed. Results: When dental caries is improperly diagnosed, the lesion may eventually invade the enamel, dentin, and pulp tissue, leading to loss of tooth function. Rapid and precise detection and diagnosis are vital for implementing appropriate prevention and treatment of dental caries. Radiography and intraoral images are considered to play a vital role in detecting dental caries; nevertheless, studies have shown that 20% of suspicious areas are mistakenly diagnosed as dental caries using this technique; hence, diagnosis via radiography alone without an objective assessment is inaccurate. Identifying caries with a deep convolutional neural network-based detector enables the operator to distinguish changes in the location and morphological features of dental caries lesions. Deep learning algorithms have broader and more profound layers and are continually being developed, remarkably enhancing their precision in detecting and segmenting objects. Conclusion: Clinical applications of deep learning convolutional neural networks in the dental field have shown significant accuracy in detecting and diagnosing dental caries, and these models hold promise in supporting dental practitioners to improve patient outcomes.

A Methodological and Reporting Quality Assessment of the Systematic Reviews in the Journal of Korean Obstetrics and Gynecology (대한한방부인과학회지에 게재된 체계적 문헌고찰의 방법론 및 보고의 질 평가)

  • Seo, Ji-Hye;Kang, So-Hyeon;Hur, Da-Hee;Lee, Dong-Nyung;Kim, Hyeong-Jun
    • The Journal of Korean Obstetrics and Gynecology
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    • v.34 no.2
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    • pp.108-123
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    • 2021
  • Objectives: The purpose of this study is to assess the methodological and reporting quality of the systematic reviews in the Journal of Korean obstetrics and gynecology. Methods: Systematic reviews in the Journal of Korean obstetrics and gynecology were selected from January 1987 to February 2021, by searching Koreanstudies Information Service System (KISS) and the search system of the Society of Korean medicine obstetrics and gynecology. The methodological and reporting quality was assessed using A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR 2) tool and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Results: Total of 19 systematic reviews were finally included for this study. The levels of methodological quality were low in 63.2% and very low in 36.8%. As a result of evaluating the reporting quality, 22 to 15 (average 18.6) items out of 27 items (81.5 to 55.6%) were reported. Conclusions: The results of a systematic review are helpful in giving a high level of evidence. In order to improve the quality of systematic reviews published in the Journal of Korean Obstetrics and Gynecology, it is necessary to perform and report according to the the PRISMA checklist and AMSTAR 2.

Korean Domestic Trends in Clinical Research on Rheumatoid Arthritis since 2008 (류마티스 관절염의 임상 연구 동향: 2008년 이후 국내 학술 문헌을 중심으로)

  • Han, Yun-Hee;Woo, Hyeon-Jun;Park, Soo-Yeon;Lee, Chang-Hoon;Chung, Chong-Hyuk;Lee, Myeung-Su;Lee, Jung-Han
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.3
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    • pp.19-29
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    • 2021
  • Objectives To investigate the trends in clinical study on rheumatoid arthritis in all academic fields in Korea. Methods We searched seven Korean web databases for clinical studies published from 2008 to 2021. All identified studies were reviewed and classified by the year of publication, academic field, and study design. Results A total of 347 clinical studies were selected. An average of 26.7 studies were published each year. Regarding the distribution of studies by academic fields, 309 studies were published in the medical field and 17 studies were published during the same period in Korean medicine, and 21 studies were published in other fields. The distribution of studies by study design was as follows: 8 studies, meta-analyses; 5 studies, systematic reviews; 16 studies, experimental studies; and 318 studies, observational studies. Conclusions Multidisciplinary access and management are required for the early diagnosis of rheumatoid arthritis, effective management of disease progression, and prevention of rheumatoid joint deformities. Additionally, study design with high-level of evidence on the intervention of rheumatoid arthritis are warranted.

Update on Current Role of Perioperative Chemotherapy in Upper Tract Urothelial Carcinoma (상부 요로상피암에서 신보조 항암요법 및 보조 항암요법의 최신 지견)

  • Jeon, Byeong Jo;Tae, Bum Sik;Park, Jae Young
    • The Korean Journal of Urological Oncology
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    • v.16 no.3
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    • pp.89-96
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    • 2018
  • Upper tract urothelial carcinoma (UTUC) has a relatively low prevalence rate of about 1.8 per 100,000 people. According to the recent literature, the development of diagnostic techniques has gradually increased the prevalence and diagnosis rate. In the past, when UTUC was diagnosed, more than 60% of the patients were diagnosed as locally advanced or metastatic cancer. However, since 2010, approximately 70% of the patients have been diagnosed as operable stage. Although radical nephroureterectomy is known as the basis of treatment for UTUC, overall survival is poor in patients with lymph node invasion. Especially, the finding that a localized UTUC is associated with a high risk of cancer metastasis in approximately 50% of patients suggests that these patients may not have sufficient treatment through surgery alone. The European Association of Urology and the National Comprehensive Cancer Network guideline 2017 suggested that postoperative adjuvant chemotherapy may be considered in patients with advanced UTUC beyond pT2. Also, recent meta-analyses have reported that cisplatin-based adjuvant chemotherapy can be expected to have a synergistic effect of overall survival and disease-free survival. However, many patients with UTUC undergo postoperative renal failure, which may result in failure to perform cisplatin-based adjuvant chemotherapy with adequate dose. For this reason, several researchers have suggested that it is beneficial to apply neoadjuvant chemotherapy when the preoperative renal function is maintained to a certain extent. But, neoadjuvant chemotherapy has not been used by many clinicians because of the lack of studies and the rarity of the disease. We are currently discussing the outcomes and prospects of perioperative chemotherapy.

Medication Use Review Tools for Community Dwelling Older Patients: A Systematic Review (지역사회 거주 노인을 위한 약물사용검토 도구에 대한 체계적 문헌고찰)

  • Park, Ji-Young;Jun, Kwanghee;Baek, Yang-Seo;Park, So-Young;Lee, Ju-Yeun
    • Korean Journal of Clinical Pharmacy
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    • v.31 no.1
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    • pp.61-78
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    • 2021
  • Background and Objective: The use of potentially inappropriate medications (PIMs) increases the risk of negative health outcomes, including drug-related admissions. Tools for structured medication review have been developed to ensure optimal medication use and safety. Here, we aimed to evaluate medication use review (MUR) tools for community-dwelling older patients. Methods: We performed a systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). We searched PubMed, Embase, and the Cochrane Library from 1991 to 2020, excluding tools that are specifically applied to hospitalized patients or nursing home residents. We identified the most common inappropriate medications, drug-disease interactions, drug-drug interactions and prescribing omissions presented among tools. Results: From among 9,788 identified reports screened, 60 met our inclusion criteria; finally, 27 were eligible for data analysis considering originality and up-to-dateness. Most tools presented explicit criteria (93%), and only one was specific to community-dwelling elderly. The most common PIM was tricyclic antidepressants. Use of diltiazem and verapamil in patients with heart failure and the combination of nonsteroidal anti-inflammatory analgesics and warfarin were the most frequent disease-specific PIM and drug-interaction, respectively. Conclusions: Although several medication review tools have been developed for older adults, specific guidelines for community-dwelling populations remain limited. Furthermore, the list of PIMs differed among available tools. In future, specific but integrating MUR tools need to be developed for clinical practice considering this population.

Prevalence and extension of the anterior loop of the mental nerve in different populations and CBCT imaging settings: A systematic review and meta-analysis

  • Hadilou, Mahdi;Gholami, Leila;Ghojazadeh, Morteza;Emadi, Naghmeh
    • Imaging Science in Dentistry
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    • v.52 no.2
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    • pp.141-153
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    • 2022
  • Purpose: This study aimed to identify the prevalence and extension of the anterior loop (AL) of the mental nerve in different populations and according to different cone-beam computed tomography (CBCT) imaging settings. Materials and Methods: Medline/PubMed, Embase, Scopus, Web of Science, and ProQuest were searched. The main inclusion criterion was ALs evaluated in CBCT images. The quality of studies was assessed with the Joanna Briggs Institute risk of bias checklist. Subgroup analyses were conducted for sex, side, continent, voxel size, field of view, and type of CBCT-reconstruction images with a random-effects model. Results: Sixty-three studies with 13,743 participants (27,075 hemimandibles) were included. An AL was found in 40.6% (95% CI: 32.8%-48.9%, P<0.05) of participants and 36.0% (95% CI: 27.5%-45.5%, P<0.05) of hemimandibles, in 34.9% (95% CI: 25.1%-46.2%, P<0.05) of males and 34.5% (95% CI: 23.5%-47.4%, P<0.05) of females. The average length of ALs was 2.39 mm (95% CI: 2.07-2.70 mm, P<0.05). Their extension was 2.13 mm (95% CI: 1.54-2.73 mm, P<0.05) in males and 1.85 mm (95% CI: 1.35-2.36 mm, P<0.05) in females. Significant differences were observed regarding the prevalence and length of ALs among continents and for its measured length on different CBCT-reconstruction images, but not between other subgroups. Conclusion: AL was a relatively common finding. The voxel size and fields of view of CBCT devices were adequate for assessing AL; however, a 2-mm safety margin from anatomical structures(such as the AL) could be recommended to be considered when using CBCT imaging.

The Impact of Abdominal Liposuction on Abdominally Based Autologous Breast Reconstruction: A Systematic Review

  • Bond, Evalina S.;Soteropulos, Carol E.;Poore, Samuel O.
    • Archives of Plastic Surgery
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    • v.49 no.3
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    • pp.324-331
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    • 2022
  • Prior abdominal liposuction can be viewed as a relative or absolute contraindication to abdominally based autologous breast reconstruction given concerns for damaged perforators and scarring complicating intraoperative dissection. This systematic review aims to explore the outcomes of abdominally based breast reconstruction in patients with a history of abdominal liposuction. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guided literature search was conducted using PubMed, Scopus, and Web of Science from the earliest available date through June 2020. Deep inferior epigastric perforator, muscle-sparing transverse rectus abdominis musculocutaneous (TRAM), superficial inferior epigastric artery, and pedicled TRAM flaps were included for evaluation. Complications included total or partial flap loss, fat necrosis, seroma, delayed wound healing, and donor site complications. After inclusion criteria were applied, 336 non-duplicate articles were screened, yielding 11 for final review, representing 55 flaps in 43 patients. There was no instance of total flap loss, eight (14.5%) flaps developed partial loss or fat necrosis, three (5.4%) flaps had delayed wound healing, and two (4.6%) patients had donor site complications. Most authors (8/11) utilized some type of preoperative imaging. Doppler ultrasonography was the most used modality, and these patients had the lowest rate of partial flap loss or flap fat necrosis (8%), followed by those without any preoperative imaging (10%). In conclusion, this review supports that patients undergoing abdominally based autologous breast reconstruction with a history of abdominal liposuction are not at an increased risk of flap or donor site complications. Although preoperative imaging was common, it did not reliably decrease complications. Further prospective studies are needed to address the role of imaging in improving outcomes.

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

  • Oh, Hyunjoo;Lee, Jeongyun;Lee, Hyeri;Lee, Junhee
    • Journal of Sasang Constitutional Medicine
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    • v.34 no.2
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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.