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Therapeutic alternatives in painful diabetic neuropathy: a meta-analysis of randomized controlled trials

  • Vilar, Samuel;Castillo, Jose Manuel;Martinez, Pedro V. Munuera;Reina, Maria;Pabon, Manuel
    • The Korean Journal of Pain
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    • v.31 no.4
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    • pp.253-260
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    • 2018
  • Background: One of the most frequent problems caused by diabetes is the so called painful diabetic neuropathy. This condition can be treated through numerous types of therapy. The purpose of this study was to analyze, as a meta-analysis, different treatments used to alleviate painful diabetic neuropathy, with the aim of generating results that help making decisions when applying such treatments to tackle this pathology. Methods: A search was conducted in the main databases for Health Sciences, such as PUBMED, Web of Science (WOS), and IME biomedicina (Spanish Medical Reports in Biomedicine), to gather randomized controlled trials about treatments used for painful diabetic neuropathy. The analyzed studies were required to meet the inclusion criteria selected, especially those results related to pain intensity. Results: Nine randomized controlled trials were chosen. The meta-analysis shows significant positive effects for those treatments based on tapentadol [g: -1.333, 95% CI (-1.594; -1.072), P < 0.05], duloxetine [g: -1.622, 95 % CI (-1.650; -1.594), P < 0.05], pregabalin [g: -0.607, 95% CI (-0.980; -0.325), P < 0.05], and clonidine [g: -0.242, 95 % CI (-0.543; -0.058), P < 0.05]. Conclusions: This meta-analysis indicates the effectiveness of the treatments based on duloxetine, gabapentin and pregabalin, as well as other drugs, such as tapentadol and topic clonidine, whose use is better prescribed in more specific situations. The results provided can help increase the knowledge about the treatment of painful diabetic neuropathy and also in the making of clinical practice guidelines for healthcare professionals.

The Effect of Violent Experience on Burnout among Some Dental Hygienists

  • Jeon, Eun-Jeong;Han, Mi Ah;Park, Jong;Choi, Seong Woo
    • Journal of dental hygiene science
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    • v.17 no.5
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    • pp.413-422
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    • 2017
  • This study investigated the effect of violent experience on burnout among some dental hygienists. The study subjects were 242 dental hygienists working at dental clinics. Data were collected by self-administered questionnaire including information such as demographics, work-related characteristics, working environment, experience of violence, and burnout. The violence was classified as verbal violence, physical threat, or physical violence committed by dentists, patients, or caregivers. Descriptive analysis, t-test, ANOVA, correlation, and multiple linear regression analysis were performed to examine the factors associated with burnout. The levels of verbal violence, physical threat, and physical violence by dentists were $0.53{\pm}1.26$, $1.12{\pm}2.70$, and $0.04{\pm}0.42$, respectively. The levels of verbal violence, physical threat, and physical violence by patients and caregivers were $1.50{\pm}1.89$, $1.41{\pm}2.24$, and $0.24{\pm}1.38$, respectively. The score of burnout was $3.13{\pm}0.43$. Total violence, verbal violence, and physical violence by dentists were positively correlated with burnout. Total violence, verbal violence, and physical threat by patients and caregivers were positively correlated with burnout. In multiple linear regression analysis, the level of physical violence by dentists was positively associated with burnout of dental hygienists (${\beta}=0.95$, p=0.032). The levels of total physical violence (${\beta}=0.28$, p=0.002), verbal violence (${\beta}=0.15$, p<0.001), and physical threat (${\beta}=0.19$, p=0.009) by the patients or caregivers were positively associated with burnout of dental hygienists. This study examined the association between violence and burnout among dental hygienists. The level of violence showed positive correlation with burnout. Environment improvement to protect employees from violence and for management of employees who experienced workplace violence are needed to reduce the burnout.

The Characteristics of Groundwater quality in the Pusan Area (부산 지역 지하수의 수질오염 특성)

  • 정상용;강동환;심병완
    • Proceedings of the Korean Society of Soil and Groundwater Environment Conference
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    • 1998.11a
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    • pp.86-92
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    • 1998
  • 부산 지하수의 오염실태와 그 특성을 파악하기 위하여 1996년과 1997년에 분석된 지하수 수질자료 중에서 pH, TS, KMnO$_4$소비량, Cl, SO$_4$등을 통계분석 하였다. 각 성분의 평균치는 pH가 모두 7.3, TS는 216.0 mg/$\ell$와 242.3 mg/$\ell$, KMnO$_4$소비량은 2.6 mg/$\ell$와 6.3 mg/$\ell$, Cl은 35.7과 50.1mg/$\ell$, SO$_4$는 25.4와 33.9mg/$\ell$이다. 2년 동안 pH의 음용수 기준치 초과 비율은 0.55와 0.47%, TS는 1.89와 2.50%, KMnO$_4$소비량은 0.73과 1.17%, Cl은 1.41과 2.18%, 그리고 SO$_4$는 0.37과 0.86% 이다. 따라서 성분별로 비교해 볼 때, pH의 음용수 기준치 초과비율이 가장 적고, Cl의 초과비율이 가장 크다. Cl 및 SO$_4$이온의 음용수 기준치(각각 100 mg/$\ell$, 200mg/$\ell$) 초과지점과 이 이온들의 평균치보다는 훨씬 큰 100 mg/$\ell$이상되는 지점들의 분포를 분석한 결과, 해안가보다는 내륙에 더 많이 초과지점들이 분포한다. 따라서 부산지하수는 해수에 의한 영향보다는 내륙에서 생활하수나 기타원인(공장폐수, 오염된 하천수, 폐기물 매립 등)에 의한 오염이 훨씬 큰 것으로 보인다. 1996년에 5개 성분의 음용수 기준치 초과비율은 5.06%이고, 1997년의 초과비율은 6.87%로 전년도에 비하여 약간 증가하였다. 그러나 부산이 바다에 접하고 또한 인구과밀 지역임을 고려할 때, 부산의 지하수 수질은 양호한 편이다. 따라서 앞으로 부산 지하수의 보전 및 관리가 적절하게 진행된다면 부산에서 지하수는 시민의 생활용수로서의 역할을 증대해 나갈 수 있을 것이다.

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The effect of psychological Contract of Nurse on Voice Behavior (간호사의 심리적 계약이 발언행동에 미치는 영향)

  • Lee, Mi Hyang;Woo, Chung Hee;Bae, Young Hee
    • Journal of Digital Convergence
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    • v.16 no.2
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    • pp.235-242
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    • 2018
  • The purpose of this study is to provide basic data for human resource management and efficient hospital management of organization by checking the effect of psychological contract of nurses on voice behavior. It is a descriptive research study that survey nurses who consented responded to the research questions. As a result, nurse practitioners showed a low level of perceptions of organizational commitment, psychological contracts, transactional contract and relational contract. There was a positive correlation between transactional contract and constructive voice(p<.05), and there was a negative correlation between relational contract and destructive voice(p<.05). Therefore, it is necessary to establish a system in which internal and external compensation can be made according to changes in roles of nurses in order to carry out new polices and organizational changes. It is also necessary to improve the organizational culture so that nurses can actively participate in policy and organizational change.

The Dyeing Properties and The Functionality of Fabrics Dyed with Chelidonium Majus Extract (백굴채 추출물을 이용한 염색직물의 염색성 및 기능성)

  • Park, Young-Hee
    • Fashion & Textile Research Journal
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    • v.10 no.2
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    • pp.242-248
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    • 2008
  • This study was aimed to find whether the Chelidonium majus which grows naturally in Korean soil and has a various medical ingredient is valuable as a natural dyeing material and to examine the functionality of Chelidonium majus extract. As the test result of dyeing colorfastness, colorfastness to sunlight was 1st grade for all the dyed fabrics. The colorfastness to laundry for discoloration showed from 1st to 4th grade and that for discoloration showed from 4th to 5th grade through all the dyed fabrics. Colorfastness to perspiration, rubbing, and drycleaning showed from 4th to 5th grade through all the dyed fabrics. In the result of antibiosis test, the dyed cotton fabric showed the bacteria reduction rate of 99.0% for Staphylococcus aureus and Escherichia coli evenly when washed one, three, and five times, The dyed silk fabric, when washed one, three, and five times, showed the bacteria reduction rate of 99.0% for Staphylococcus aureus, but didn't showed the significant bacteria reduction. As the test result of sun protection test, in the case of the cotton fabric which was dyed but don't use mordant, after one-time washing, S.P.F.(Sun Protection Factor) showed 20.4, the interception rate of UV-A showed 94.3%, and that of UV-B showed 95.2%. After five-time washing, S.P.F. showed 14.3, the interception rate of UV-A showed 90.0%, and that of UV-B showed 93.2%. In the case of the silk fabric which was dyed but don't use mordant, after one time washing, S.P.F. showed 30.5, the interception rate of UV-A showed 95.9%, and that of UV-B showed 96.9%, after five-time washing, S.P.F. showed 31.0, the interception rate of UV-A showed 95.6%, and that of UV-B showed 96.7%.

Subjective and Objective Caregiver Burden in Parkinson's Disease

  • Kim, Keum-Soon;Kim, Bog-Ja;Kim, Kyung-Hee;Choe, Myoung-Ae;Yi, Myung-Sun;Hah, Yang-Sook;Chung, Sun-Ju;Kwon, So-Hi
    • Journal of Korean Academy of Nursing
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    • v.37 no.2
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    • pp.242-248
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    • 2007
  • Purpose. Parkinson's disease (PD) is a common neurodegenerative disorder characterized by motor disabilities and increasing dependence on others for daily life activities with consequent impact on patients' and caregivers' quality of life. The aim of this study was to elucidate the burden on primary caregivers of patients with PD, and identify related factors. Methods. A cross-sectional descriptive study. Seventy-six primary caregivers of PD patients in a neurology out-patient clinic, Seoul, Korea completed structured questionnaires, of which 68 were analyzed. The structured self-report questionnaire included (1) demographic information on the caregivers, (2) information regarding the disease characteristics of the patients, and (3) the subjective and objective caregiver burdens as assessed on Montgomery, Gonyea, & Hooyman's scale. Results. The mean age of the caregivers was 54.56 years, and spouses represented the largest proportion (47.0%). Caregivers of PD patients experienced high levels of burden (mean scores on the subjective and objective burdens were 45.22 and 34.90, respectively), which were comparable to the caregiver burdens in stroke, and higher than the caregiver burdens in general chronic disease. Older caregivers and spousal caregivers experienced significantly higher burdens (p=.004 and p=.019, respectively). A greater motor disability and higher modified Hoehn and Yahr grade were related to higher caregiver burden (p=.001 and p=.018, respectively). Conclusion. Caring for PD patients is associated with a high level of caregiver burden. Therefore, healthcare professionals should identify the burden of caregivers who look after PD patients and develop comprehensive management strategies both for patients and their caregivers.

Platybasia in 22q11.2 Deletion Syndrome Is Not Correlated with Speech Resonance

  • Spruijt, Nicole E.;Kon, Moshe;Molen, Aebele B. Mink Van Der
    • Archives of Plastic Surgery
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    • v.41 no.4
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    • pp.344-349
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    • 2014
  • Background An abnormally obtuse cranial base angle, also known as platybasia, is a common finding in patients with 22q11.2 deletion syndrome (22q11DS). Platybasia increases the depth of the velopharynx and is therefore postulated to contribute to velopharyngeal dysfunction. Our objective was to determine the clinical significance of platybasia in 22q11DS by exploring the relationship between cranial base angles and speech resonance. Methods In this retrospective chart review at a tertiary hospital, 24 children (age, 4.0-13.1 years) with 22q11.2DS underwent speech assessments and lateral cephalograms, which allowed for the measurement of the cranial base angles. Results One patient (4%) had hyponasal resonance, 8 (33%) had normal resonance, 10 (42%) had hypernasal resonance on vowels only, and 5 (21%) had hypernasal resonance on both vowels and consonants. The mean cranial base angle was $136.5^{\circ}$ (standard deviation, $5.3^{\circ}$; range, $122.3-144.8^{\circ}$). The Kruskal-Wallis test showed no significant relationship between the resonance ratings and cranial base angles (P=0.242). Cranial base angles and speech ratings were not correlated (Spearman correlation=0.321, P=0.126). The group with hypernasal resonance had a significantly more obtuse mean cranial base angle ($138^{\circ}$ vs. $134^{\circ}$, P=0.049) but did not have a greater prevalence of platybasia (73% vs. 56%, P=0.412). Conclusions In this retrospective chart review of patients with 22q11DS, cranial base angles were not correlated with speech resonance. The clinical significance of platybasia remains unknown.

Nutritional Knowledge and Dietary Behavior of Middle School Students According to Their Mother's Employment Status (어머니의 취업유무에 따른 중학생의 영양지식과 식행동)

  • Kim, Seong Hee;Kim, Myung-Hee;Choi, Mi-Kyeong;Kim, Mi-Hyun
    • Journal of the Korean Society of Food Culture
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    • v.33 no.3
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    • pp.236-242
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    • 2018
  • The purpose of this study was to evaluate the nutritional knowledge and dietary behaviors of middle school students according to their mother's employment status. Of all 453 subjects, 52.1% were boys, and 67.5% of the mothers were employed. The total score of nutritional knowledge was 8.0 out of 10 for students with a non-working mom and 7.7 for those with a working mom, showing no significant difference. Among the 20 nutritional knowledge questions, correct answer rates for "lots of fruits may be eaten because of not gaining weight" (72.6% vs. 81.6%, p<0.05) and "eating raw carrots is better than eating fried ones with oil" (34.6% vs. 44.9%, p<0.05) were significantly higher in students with a working mom. The regularity of meals showed a significant difference according to the mother's employment, indicating that responses of "very regular" (62.4% vs. 72.1%) were high among students with a non-working mom and responses of "skipping breakfast" (31.4% vs. 19.7%) were higher in students with a working mom (p<0.05). The number of snacks a day was also significantly different according to the mother's employment, showing that 12.8% of the students with a working mom and only 3.4% of them with a non-working mom did not eat snacks at all (p<0.05). These results reveal no significant difference in middle school students' nutritional knowledge according to their mother's employment status; however, the students whose mother had a job were more likely to have more undesirable dietary behaviors such as irregular meals and snacking.

The Base of Understanding for Interdisciplinary Studies on Cyber Crimes - Centering on Regulations in Criminal Law - (사이버범죄의 학제간 연구를 위한 이해의 기초 - 형법상 규제를 중심으로 -)

  • Lim, Byoung-Rak
    • Journal of the Korea Society of Computer and Information
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    • v.13 no.3
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    • pp.237-242
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    • 2008
  • This study aims to provide theoretical base in criminal law for engineers in the viewpoint of jurists to encourage interdisciplinary studies on cyber crimes. Apart from seriousness of discussion on torrent cyber crimes, a good effect of the internet networks such as sharing of information has bee emphasized while the evil influence of its side effect has been neglected. Therefore, this study suggests that we need to consider reinforcement of cyber ethics, and legal mind of IT technicians, strict security by managers, active efforts to develop legitimate contents by managers of web hardware and P2P, and reinforcement of punishments against crimes by internet users. And this study approaches new norms on computer and cyber crimes in interpretational sense of criminal law, and provides the theoretical base of the criminal law focusing on traditional theories, assumptions, and precedents involved in regulations against computer virus distribution.

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Effects of Trauma Center Establishment on the Clinical Characteristics and Outcomes of Patients with Traumatic Brain Injury : A Retrospective Analysis from a Single Trauma Center in Korea

  • Kim, Jang Soo;Jeong, Sung Woo;Ahn, Hyo Jin;Hwang, Hyun Ju;Kyoung, Kyu-Hyouck;Kwon, Soon Chan;Kim, Min Soo
    • Journal of Korean Neurosurgical Society
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    • v.62 no.2
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    • pp.232-242
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    • 2019
  • Objective : To investigate the effects of trauma center establishment on the clinical characteristics and outcomes of trauma patients with traumatic brain injury (TBI). Methods : We enrolled 322 patients with severe trauma and TBI from January 2015 to December 2016. Clinical factors, indexes, and outcomes were compared before and after trauma center establishment (September 2015). The outcome was the Glasgow outcome scale classification at 3 months post-trauma. Results : Of the 322 patients, 120 (37.3%) and 202 (62.7%) were admitted before and after trauma center establishment, respectively. The two groups were significantly different in age (p=0.038), the trauma location within the city (p=0.010), the proportion of intensive care unit (ICU) admissions (p=0.001), and the emergency room stay time (p<0.001). Mortality occurred in 37 patients (11.5%). Although the preventable death rate decreased from before to after center establishment (23.1% vs. 12.5%), the difference was not significant. None of the clinical factors, indexes, or outcomes were different from before to after center establishment for patients with severe TBI (Glasgow coma scale score ${\leq}8$). However, the proportion of inter-hospital transfers increased and the time to emergency room arrival was longer in both the entire cohort and patients with severe TBI after versus before trauma center establishment. Conclusion : We confirmed that for patients with severe trauma and TBI, establishing a trauma center increased the proportion of ICU admissions and decreased the emergency room stay time and preventable death rate. However, management strategies for handling the high proportion of inter-hospital transfers and long times to emergency room arrival will be necessary.