• Title/Summary/Keyword: Non-clinical outcomes

Search Result 520, Processing Time 0.032 seconds

Clinical characteristics of heat stroke in bath facilities, and analysis of predictive factors of multiple major complications (목욕시설에서 발생한 열사병의 임상양상 및 열사병의 다발성 주요 합병증에 관한 예측인자 분석)

  • Park, Seok-Jin;Hyun, Sung-Youl;Lim, Yong-Su;Cho, Jin-Seong;Min, Kyoung-Jeen;Yang, Hyuk-Jun
    • Journal of The Korean Society of Emergency Medicine
    • /
    • v.29 no.5
    • /
    • pp.500-508
    • /
    • 2018
  • Objective: The aim of this study was to evaluate the clinical characteristics of heat stroke in a bath facility and investigate predictive factors of multiple major complications in heat stroke patients. Methods: This was a retrospective study on heat stroke patients who visited an urban emergency center from January 2010 to March 2018. We compared clinical characteristics, complication, and outcomes of heat stroke patients in bath and non-bath facilities. Multivariate logistic regression analysis were performed to identify independent predictors of multiple major complications in heat stroke patients. Results: A total of 67 heat stroke patients with heat stroke were enrolled, of which 42 (62.6%) were in a bath facility and 25 (37.3%) were in a non-bath facility. Patients with heat stroke in the bath facility were characterized by old age, past medical history of hypertension and diabetes mellitus, and high incidence of hypotension compared with those in the non-bath facility but also low incidence of acute renal failure, seizure, and multiple major complications. In the multivariate analysis, predictive factors of multiple major complications in heat stroke patients were non-bath facility (odds ratio [OR], 5.4; 95% confidence interval [CI], 1.2-29.9), Glasgow Coma Scale (GCS)${\leq}8$ (OR, 8.2; 95% CI, 1.3-49.4), and mean arterial pressure (MAP), body temperature above $40.5^{\circ}C$ (OR, 8.1; 95% CI, 1.1-58.8) <60 mmHg (OR, 14.8; 95% CI, 1.8-122.9). Conclusion: Heat stroke in the bath facility resulted in less major complications, and high body temperature, GCS ${\leq}8$, and MAP <60 mmHg were independent predictive factors of multiple major complications in heat stroke patients.

Clinical and Radiological Outcomes of 'Blocking Kirschner Wire Technique' in Displaced Intra-Articular Calcaneal Fractures via the Extended Sinus Tarsi Approach (전위된 관절 내 종골 골절에서 확장된 족근동 접근법을 통한 Kirschner Wire 강선 지지대 고정술의 임상 및 영상학적 결과)

  • Lee, Jeong-Kil;Kang, Chan;Kim, Sang-Bum;Lee, Gi-Soo;Hwang, Jung-Mo;An, Byung-Kuk
    • Journal of the Korean Orthopaedic Association
    • /
    • v.56 no.3
    • /
    • pp.224-233
    • /
    • 2021
  • Purpose: The purpose of this study was to retrospectively evaluate the effect of 'Blocking Kirschner Wire (K-Wire) Technique', which has been developed to reduce protrusion of the lateral wall, in maintaining the level of reduction through clinical and radiological outcomes. Materials and Methods: Twenty-two patients with displaced intra-articular calcaneal fractures who used the blocking K-wire to maintain reduction (group A) and 44 patients that did not use blocking K-wire and were paired in 1:2 ratio with those Group A patients (group B), between January 2015 and December 2017 were enrolled in the study. All surgical procedures were performed via the extended sinus tarsi approach, and internal fixation using cannulated screws, Steinmann pins and K-wires was performed. American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scale and postoperative recovery of exercise ability were compared for postoperative clinical outcomes. The radiological results were compared the Böhler angle, Gissane angle, calcaneal height and width, step off of posterior calcaneal joint, and the degree of protrusion of the lateral wall. Moreover, postoperative complications in both groups were compared. Results: There were no significant differences in the clinical outcomes of the two groups (p=0.924, p=0.961). The amount of Böhler angle, Gissane angle, calcaneal height and width, and step off of posterior calcaneal joint from the radiological results was not significantly different between the two groups (p=0.170, p=0.441, p=0.230, p=0.266, and p=0.400). However, the degree of protrusion of the lateral wall was 1.78 mm and 4.95 mm in group A and group B, respectively, and the difference between the two groups was significant (p=0.017). Although sural nerve entrapment and painful exostosis were more frequent in group B, they were occurred in a non-significant manner (p=0.293, p=0.655). Conclusion: Most of the clinical and radiological results as well as the complications were not significantly different between the two groups. However, the degree of protrusion of the calcaneus lateral wall in group A was promising. The 'Blocking K-Wires Technique' established by the authors may be an effective surgical option for maintaining the reduction of the lateral wall protrusion in displaced intraarticular calcaneal fractures.

Comparisons of Bleeding Risks between Rivaroxaban and Dalteparin for Treatment of Venous Thromboembolism in Cancer Patients (암환자의 정맥혈전색전증 치료에서 rivaroxaban과 dalteparin의 출혈 부작용 비교)

  • Kim, Yoon Kyung;An, Sook Hee;Kim, Jae Yeon;Chung, Jee Eun;Gwak, Hye Sun
    • Korean Journal of Clinical Pharmacy
    • /
    • v.26 no.3
    • /
    • pp.195-200
    • /
    • 2016
  • Background: Venous thromboembolism (VTE) is a common and life-threating condition in cancer patients. Low molecular weight heparins (LMWH), such as dalteparin, are recommended in the treatment of VTE. Also, rivaroxaban, an orally administered direct factor Xa inhibitor, was approved for the treatment of VTE. It showed similar efficacy to standard therapy (LMWH or warfarin) and was associated with significantly lower rates of major bleedings. However, in the real world, bleeding has been reported to occur frequently in cancer patient receiving rivaroxaban. The goal of this research was to analyze bleeding risks between rivaroxaban and dalteparin for treatment of VTE in cancer patients. Methods: Medical records of oncology patients who were treated with rivaroxaban or dalteparin for VTE from July 2012 to June 2014 were retrospectively reviewed. Data collected were as follows: age, sex, weight, height, cancer types and stages, ECOG (eastern cooperative oncology group) PS (performance score), VTE types, concurrently used medications, study drug information (dose and duration of therapy), INR (international normalized ratio), PT (prothrombin time), and platelet counts. Bleeding was classified into major bleedings, clinically relevant non-major bleedings, and minor bleedings. Results: A total of 399 patients were included in the study. Of these patients, 246 were treated with rivaroxaban and 153 with dalteparin. Bleeding rates were significantly higher in the rivaroxaban group than in the dalteparin group (adjusted odds ratio (AOR) 2.09, 95% CI 1.22-3.60) after adjusting for confounders. In addition, rivaroxaban remained independently associated with 1.78-fold (95% CI 1.14-2.76) shorter time to bleeding compared to dalteparin after adjusting other factors known to be associated with poor outcomes. Conclusion: This study suggested that rivaroxaban was associated with an increased risk of bleedings in cancer patients.

Stem Cells in Plastic Surgery: A Review of Current Clinical and Translational Applications

  • Salibian, Ara A.;Widgerow, Alan D.;Abrouk, Michael;Evans, Gregory R.D.
    • Archives of Plastic Surgery
    • /
    • v.40 no.6
    • /
    • pp.666-675
    • /
    • 2013
  • Background Stem cells are a unique cell population characterized by self-renewal and cellular differentiation capabilities. These characteristics, among other traits, make them an attractive option for regenerative treatments of tissues defects and for aesthetic procedures in plastic surgery. As research regarding the isolation, culture and behavior of stem cells has progressed, stem cells, particularly adult stem cells, have shown promising results in both translational and clinical applications. Methods The purpose of this review is to evaluate the applications of stem cells in the plastic surgery literature, with particular focus on the advances and limitations of current stem cell therapies. Different key areas amenable to stem cell therapy are addressed in the literature review; these include regeneration of soft tissue, bone, cartilage, and peripheral nerves, as well as wound healing and skin aging. Results The reviewed studies demonstrate promising results, with favorable outcomes and minimal complications in the cited cases. In particular, adipose tissue derived stem cell (ADSC) transplants appear to provide effective treatment options for bony and soft tissue defects, and non-healing wounds. ADSCs have also been shown to be useful in aesthetic surgery. Conclusions Further studies involving both the basic and clinical science aspects of stem cell therapies are warranted. In particular, the mechanism of action of stem cells, their interactions with the surrounding microenvironment and their long-term fate require further elucidation. Larger randomized trials are also necessary to demonstrate the continued safety of transplanted stem cells as well as the efficacy of cellular therapies in comparison to the current standards of care.

Therapeutic effect of the traditional herbal formula, Hwanglyeonhaedok-tang, on rhinitis: A Review of the experimental study (황련해독탕이 비염 개선에 미치는 효과: 기초실험 연구 문헌 분석)

  • Son, Mi-Ju;Jerng, Ui-Min;Kim, Yun-Hee;Lee, Dong-Hyo;Kim, Sung-Ha
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
    • /
    • v.30 no.1
    • /
    • pp.74-86
    • /
    • 2017
  • Objectives : This study aimed to assess the scientific evidence for the use of Hwanglyeonhaedok-tang, a traditional herbal formula, in the treatment of rhinitis, and prepare the basis for the investigational new drug application by analyzing the experimental studies. Methods : Ten electronic databases were searched up to December, 2016 without language limitation. Experimental studies on the anti-inflammatory and anti-allergic effects of Hwanglyeonhaedok-tang against rhinitis were included. We extracted data about study design, characteristics of intervention, outcomes, and pharmacological effects from the included studies and summarized them. Results : Eight hundred and thirty-three potentially relevant studies were identified, of which 18 experimental studies met our inclusion criteria. Of 18 included studies, 5 had conducted cell viability test, and all studies had reported that Hwanglyeonhaedok-tang was non-cytotoxic. Hwanglyeonhaedok-tang exhibits anti-inflammatory effect by regulating the inflammation-related cytokines including nitric oxide(NO), prostaglandin $E_2(PGE_2)$, interleukin-6(IL-6), and tumor necrosis $factor-{\alpha}(TNF-{\alpha})$ in vitro and in vivo. Hwanglyeonhaedok-tang exhibits anti-allergic effect by suppressing eosinophil, and histamine levels. Hwanglyeonhaedok-tang helps in the recovery of nasal mucous membrane by supressing goblet cells, heat shock protein 70, and substance P. Conclusions : This study suggests that Hwanglyeonhaedok-tang has the potential to be developed as therapeutic agent for rhinitis. Further experimental and clinical studies needed to be performed to prove the safety and efficacy.

A Review of the Korean Traditional Medicine for Cervical Spondylotic Myelopathy (경추증성 척수증의 한의학적 치료에 대한 국내외 연구 동향)

  • Byun, Da-young;Lee, Gi-eon;Roh, Ji-ae;Kim, Hyo-jun;Huh, Suk-won;Han, Si-hoon
    • Journal of Korean Medicine Rehabilitation
    • /
    • v.29 no.2
    • /
    • pp.149-158
    • /
    • 2019
  • Objectives This study was performed to research the trends of Korean traditional medicine treatment for cervical spondylotic myelopathy (CSM). Methods Clinical studies about Korean traditional medicine of CSM were searched in 7 online databases. We extracted the characteristics of selected studies according to author, publication year, country, research design, treatment methods, evaluation tools, and adverse events. Results Nineteen studies were selected in online databases. The included studies consist of 8 uncontrolled trial, 7 case reports, 3 randomized controlled trials and 1 non-randomized controlled trials. In these studies, various Korean traditional medicine treatments were performed, and herbal medicine was the most common. The most commonly used outcomes was effective rate. Conclusions This study showed that Korean traditional medicine could be an effective treatment for CSM. It was suggested that various studies should be conducted to provide objective evidence of the therapeutic effects of Korean traditional medicine treatment for CSM.

Clinical effects of different prescriptions on the inclination of maxillary and mandibular incisors by using passive self-ligating brackets

  • Savoldi, Fabio;Sangalli, Linda;Ghislanzoni, Luis T. Huanca;Dalessandri, Domenico;Gu, Min;Mandelli, Gualtiero;Paganelli, Corrado
    • The korean journal of orthodontics
    • /
    • v.52 no.6
    • /
    • pp.387-398
    • /
    • 2022
  • Objective: Controlling the incisal inclination is fundamental in orthodontics. However, the relationship between the inclination prescription and its clinical outcome is not obvious, and the incisal inclination changes generated by different bracket prescriptions were investigated. Methods: Twenty-eight non-extraction dental Class II patients (15 females, 13 males; mean age = 12.9) were retrospectively analyzed. Patients were treated using passive self-ligating fixed appliances with three inclination prescriptions for maxillary incisors (high, standard, low), and two for mandibular incisors (standard, low). Clinical outcomes were compared among different prescriptions, and regression analysis was used to explain the effects of bracket prescriptions and to understand the prescription selection criteria (α = 0.05). Results: For maxillary central incisors, low and high prescriptions were related to linguoversion (p = 0.046) and labioversion (p = 0.005), respectively, while standard prescription maintained the initial dental inclination. Maxillary lateral incisors did not show significant changes. For mandibular incisors, low prescription led to linguoversion (p = 0.005 for central incisors, p = 0.010 for lateral incisors), while standard prescription led to labioversion (p = 0.045 for central incisors, p = 0.005 for lateral incisors). The factors affecting inclination changes were the imposed change and selected prescription, while prescription selection was influenced by the initial dental inclination and initial intercanine distance. Conclusions: The direction of correction of incisal inclination can be controlled by choosing a certain prescription, but the final inclination may show limited consistency with it. The amount of imposed inclination change was the most relevant predictor of the clinical outcome.

Extent of Contrast Enhancement on Non-Enhanced Computed Tomography after Intra-Arterial Thrombectomy for Acute Infarction on Anterior Circulation : As a Predictive Value for Malignant Brain Edema

  • Song, Seung Yoon;Ahn, Seong Yeol;Rhee, Jong Ju;Lee, Jong Won;Hur, Jin Woo;Lee, Hyun Koo
    • Journal of Korean Neurosurgical Society
    • /
    • v.58 no.4
    • /
    • pp.321-327
    • /
    • 2015
  • Objective : To determine whether the use of contrast enhancement (especially its extent) predicts malignant brain edema after intra-arterial thrombectomy (IAT) in patients with acute ischemic stroke. Methods : We reviewed the records of patients with acute ischemic stroke who underwent IAT for occlusion of the internal carotid artery or the middle cerebral artery between January 2012 and March 2015. To estimate the extent of contrast enhancement (CE), we used the contrast enhancement area ratio (CEAR)-i.e., the ratio of the CE to the area of the hemisphere, as noted on immediate non-enhanced brain computed tomography (NECT) post-IAT. Patients were categorized into two groups based on the CEAR values being either greater than or less than 0.2. Results : A total of 39 patients were included. Contrast enhancement was found in 26 patients (66.7%). In this subgroup, the CEAR was greater than 0.2 in 7 patients (18%) and less than 0.2 in the other 19 patients (48.7%). On univariate analysis, both CEAR ${\geq}0.2$ and the presence of subarachnoid hemorrhage were significantly associated with progression to malignant brain edema (p<0.001 and p=0.004), but on multivariate analysis, only CEAR ${\geq}0.2$ showed a statistically significant association (p=0.019). In the group with CEAR ${\geq}0.2$, the time to malignant brain edema was shorter (p=0.039) than in the group with CEAR <0.2. Clinical functional outcomes, based on the modified Rankin scale, were also significantly worse in patients with CEAR ${\geq}0.2$ (p=0.003) Conclusion : The extent of contrast enhancement as noted on NECT scans obtained immediately after IAT could be predictive of malignant brain edema and a poor clinical outcome.

Combined Effects Methylation of FHIT, RASSF1A and RARβ Genes on Non-Small Cell Lung Cancer in the Chinese Population

  • Li, Wen;Deng, Jing;Tang, Jian-Xin
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.15 no.13
    • /
    • pp.5233-5237
    • /
    • 2014
  • Epigenetic modifications of tumour suppressor genes are involved in all kinds of human cancer. Aberrant promoter methylation is also considered to play an essential role in development of lung cancer, but the pathogenesis remains unclear.We collected the data of 112 subjects, including 56 diagnosed patients with lung cancer and 56 controls without cancer. Methylation of the FHIT, RASSF1A and RAR-${\beta}$ genes in DNA from all samples and the corresponding gene methylation status were assessed using the methylation-specific polymerase chain reaction (PCR, MSP). The results showed that the total frequency of separate gene methylation was significantly higher in lung cancer compared with controls (33.9-85.7 vs 0 %) (p<0.01).Similar outcomes were obtained from the aberrant methylation of combinations of any two or three genes (p<0.01). There was a tendency that the frequency of combinations of any two or three genes was higher in stage I+II than that in stage III+IV with lung cancer. However, no significant difference was found across various clinical stages and clinic pathological gradings of lung cancer (p>0.05).These observations suggest that there is a significant association of promoter methylation of individual genes with lung cancer risk, and that aberrant methylation of combination of any two or three genes may be associated with clinical stage in lung cancer patients and involved in the initiation of lung cancer tumorigenesis. Methylation of FHIT, RASSF1A and $RAR{\beta}$ genes may be related to progression of lung oncogenesis.

Efficacy of electrical neuromuscular stimulation in the treatment of chronic periodontitis

  • Puhar, Ivan;Kapudija, Amalija;Kasaj, Adrian;Willershausen, Brita;Zafiropoulos, Gregory-George;Bosnjak, Andrija;Plancak, Darije
    • Journal of Periodontal and Implant Science
    • /
    • v.41 no.3
    • /
    • pp.117-122
    • /
    • 2011
  • Purpose: The purpose of the present randomized controlled clinical study was to evaluate the short-term outcomes of micro-current electrical neuromuscular stimulation (MENS) as an adjunct method to nonsurgical periodontal therapy. Methods: Twenty patients with moderate to severe chronic periodontitis were recruited into the study and randomly treated with either nonsurgical periodontal therapy followed by 5 MENS treatments with a micro current device or by nonsurgical periodontal therapy alone. Periodontal parameters were measured at baseline and 6 weeks following therapy, and included the plaque index, bleeding on probing, probing depth, and clinical attachment level (CAL). Results: All measured values were reduced at the time of re-evaluation. The amount of inflammation was significantly reduced in both the test (P=0.002) and control group (P=0.015). The test group demonstrated a significant CAL gain at 6 weeks following therapy, including non-molar (P=0.009) and molar teeth (P=0.028). In comparison with the control group, the test group showed statistically significant differences in the CAL on both molar (P=0.027) and non-molar teeth (P=0.031). Conclusions: In conclusion, the short-term results of the study indicate that MENS could be a suitable adjunctive method in the treatment of chronic periodontitis.