Background: There is still a great deal of controversy with regard to the prognostic role of chemotherapy-induced amenorrhea (CIA) in breast cancer patients. To confirm whether CIA can serve as a useful factor in predicting clinical effects of systemic adjuvant chemotherapy, we performed this meta-analysis. Materials and Methods: Relevant studies were identified using PubMed, and Embase databases. Eligible study results were pooled and summary hazard ratios (HRs) with corresponding confidence intervals (CIs) were calculated. Subgroup analyses and an assessment of publication bias were also conducted. Results: A total of 8,333 patients from 11 published studies were identified through searching the databases. The pooled HRs for disease-free survival (DFS) suggested that CIA was associated with a significant reduction in the risk of recurrence, especially in patients with hormone receptor-positive lesions (overall HR=0.65, 95%CI 0.53-0.80, $I^2=41.3%$). When the five studies reporting the HR for overall survival (OS) were pooled (n=4193), a favorable trend was found (HR=0.69, 95%CI 0.52-0.91, $I^2=51.6%$). No publication bias was observed in this study. Conclusions: This meta-analysis suggests that CIA predicts a better outcome in premenopausal hormone receptor-positive breast cancer patients.
Objective: This review aims to analyze the effects of electromechanically assisted walking in patients with cerebral palsy(CP). Design: A systematic review and meta-analysis. Methods: We reviewed systematically using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist guidelines. The inclusion criteria for this study were all CP patients. The intervention was electromechanically assisted walking. The outcome measures included gait parameters, function, spasticity. Studies excluded from this review were excluded from the review if they were non-English languages and if the study was not published as a full report, and if they were not randomized controlled trials (RCTs) designs. The RevMan 5.4 program was used to evaluate and explain the results. The risk of bias was evaluated independently by two reviewers. The quantitative meta-analysis, including mean differences (MD) and associated standard deviations (SD) from baseline and follow-up assessments, were recorded. Results: A total of 634 articles were searched. Two hundred eighty-nine duplicate articles were excluded, and 345 of 634 originals were left for selection. Of these 74 papers, 44 were out of topic, and 19 reported no mean or standard deviation values. And one was a non-experimental study. Finally, ten studies were included. All 10 RCTs of electromechanically assisted walking were analyzed. The meta-analysis showed a significant improvement in gait cycle (95% CI (confidence intervals), 0.09 to 0.19, I2=0%), Gross Motor Function Measure (GMFM) D (95% CI, 3.27 to 13.17, I2=0%) and GMFM E (95% CI, 0.22 to 6.41, I2=0%). Conclusions: Electromechanically assisted training helps in walking in patients with CP.
Objectives: Despite the low cost and high accessibility of manual acupuncture (MA) treatments for the carpal tunnel syndrome (CTS), this intervention has not been uniformly evaluated in systematic reviews (SR), and no SR has evaluated MA monotherapy for CTS. This review was conducted to summarize the findings and undertake a quality assessment of randomized controlled trials (RCTs) of acupuncture treatment methods for mild-to-moderate CTS to identify clinical evidence for the use of MA in CTS. Methods: We searched five databases for articles on relevant RCTs that were published until June 2021 without imposing specific restrictions, such as age or sex, on CTS patients. RCTs that evaluated MA were included without any restriction on comparator interventions. Measurement tools for evaluating pain reduction and functional improvement or for evaluating efficacy using electrophysiological indicators were included as outcome measures. Results: We included seven RCTs, of which three studies reported both post-treatment improvement effects and statistical significance using p-values for all outcomes. Five studies reported statistically significant intergroup differences (p-values for all outcomes) in posttreatment improvement. None of the studies reported severe adverse effects of MA. In all of the RCTs, the reporting rates of the 2c, 2a, and 6a items of STRICTA 2010 were 14%, 29%, and 29%, respectively. PC7 (Daereung) was used to treat CTS in all of the included studies. Conclusion: MA can be used for CTS treatment without serious adverse effects. PC7 was the most commonly used acupoint. In order to ensure objective and reliable reporting, accurate standardization of acupuncture treatment methods acupoint terms should be undertaken in future RCTs.
Bae, Ji min;Lee, Myeong su;Choi, Ji won;Yang, Gi young;Kim, Kun hyung
Korean Journal of Acupuncture
/
v.36
no.1
/
pp.1-18
/
2019
Objectives : The purpose of this study was to evaluate the effectiveness and safety of acupuncture treatment for recovery of patients with vertebral compression fracture(VCF). Methods : We searched ten English and Chinese and seven Korean database up to April 2018. Randomised controlled trials(RCTs), quasi-RCTs, non-radomised Controlled Trials(CCTs) were eligible. Quasi-RCTs and CCTs were assessed only for safety assessment. Pain and adverse events were primary outcome of this review. Quality of life, dysfunction, patient satisfaction, incidence of new vertebral compression fracture were regarded as secondary outcomes. The risk of bias was assessed by two independent authors using the Cochrane risk of bias tool. Level of evidence was tabulated using the GRADE methods. Results : Of 1656 screened, 15 RCTs, 1 quasi-RCT and 3 CCTs were included. Number of participants per study ranged from 45 to 135. Most of the studies had unclear or high risk of bias and considerable heterogeneity in terms of type of intervention, comparison and time-points for outcome measurement. Compared to usual care alone, acupuncture combined with usual care showed short-term favorable results for pain relief in patients with VCF(5 studies, n=252, MD -1.05 point on a 0 to 10 point scale, 95% CI -1.45 to -0.65, $I^2=74%$). Four studies reported mild and temporary adverse events, and no serious adverse events were reported. One study descriptively reported that acupuncture was effective for improving quality of life without providing numerical outcomes. There were no reports of patient satisfaction and incidence of new VCF. Conclusions : Level of evidence is very low for the effectiveness and safety of acupuncture for pain, harms and other clinical outcomes in patients with VCF. Included studies suffered from incomplete reporting, high or unclear risk of bias and substantial heterogeneity between studies. Future high-quality RCTs are needed to assess whether acupuncture is beneficial for recovery of patients with VCF.
Background : The nationwide tuberculosis registry system in Korea has been operated with the dual reporting system - public health center (PHC) and private medical services (PMS) - since 2000. While three-fifths of the registered cases in 2002 was reported by PMS, it was reported that the success rate of patients at PMS was lower than that at PHC. To identify the problems of the patients' management at the PMS as well as the PHC in a community is the aim of this paper. Methods : The subject was selected from the registered cases of the pulmonary tuberculosis in Jejudo, 2002. The needed items for this study were gathered by the reviewing the medical charts directly. Results : Of the 262 patients included in the subject, 92 cases (35%) were treated initially at PMS. The sputum smear as an essentially diagnostic test was carried out with 69.2% at private clinics compared with 98.2% at PHC. The success rate of the treatment at PMS was 59.8% so that it had a statistically significant difference from that at PHC (80.0%; p<0.01). Conclusion : These results showed that there were several problems in diagnosis and treatment for the patient of pulmonary tuberculosis at PMS. To improve the success rate of the treatment at PMS, the nationwide clinical guideline for control of pulmonary tuberculosis should be systematically disseminated and strongly recommended at PMS by the government.
Kim, Kyung-Suk;Kim, Sme-Hyun;Eo, Wan-Kyu;Cheon, Seong-Ha;Eom, Seok-Ki;Jo, Hak-Jun
Journal of Korean Medical classics
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v.23
no.4
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pp.39-62
/
2010
Background : I investigated clinical research methodology of Traditional Korean Medicine(TKM) for treatment of lung cancer with Evidence Based Medicine(EBM) approach. Methods : I conducted the internet search of National Central Library, the National Assembly Library, Korea Education & Research Information Service, Korea Institute of Science and Technology Information for Korean theses and papers, and MEDLINE for the outside articles. Conclusion : In addition to outcomes of clinical trial, abundant clinician's experience and patients' preference are also considered. Pragmatic trials and quasi-experimental trials are better than clinical trials to plan clinical design of TKM for lung cancer and appropriate endpoints includes overall survival, disease-free survival, patient reporting outcome.
Sarfaraz, Ifrah;Pascoal, Selma;Macedo, Jose Paulo;Salgado, Abel;Rasheed, Dil;Pereira, Jorge
Journal of Dental Anesthesia and Pain Medicine
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v.21
no.4
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pp.269-282
/
2021
This review aimed to assess and compare the outcomes of the anesthetic efficacy of inferior alveolar nerve block (IANB) and Gow-Gates mandibular nerve block (GGMNB) in patients with symptomatic irreversible pulpitis. A descriptive systematic review of quantitative research was conducted wherein the "Preferred Reporting Items for Systematic Reviews (PRISMA)" was adopted, and the Problem/Patient/Population, Intervention/Indicator, Comparison, Outcome (PICO) criteria were used to structure the research question. A literature search was performed using PubMed/Medline, Cochrane Library, Google Scholar, and Ovid. Selection criteria were applied for populations over nine years of age, of either sex, with irreversible pulpitis, and articles published in English regarding conventional IANB or IANB and Gow-Gates techniques between 2009 and 2019. Prospective randomized clinical trials or randomized controlled trials were included in the review, in which anesthetic efficacy or success was measured. After screening, four articles were included. Three studies were randomized clinical trials, and two were randomized controlled trials. The validity and reliability of the individual studies were examined. There was evidence of the higher efficacy of the GGMNB technique than that of the IANB technique. However, both techniques can be mastered through training.
Purpose: A meta-analysis was performed to assess the outcomes following surgical intervention for medial knee plica. Materials and Methods: A literature search of Medline, EMBASE, CINAHL and Cochrane CENTRAL was performed using relevant key words. The primary outcome was patient-reported postoperative scores of "good" and "excellent". Meta-analyses were performed using a random effects model. Results: The literature search identified 731 articles. After removing duplicates and those not meeting the inclusion criteria, 12 articles reporting on a total of 643 knees were included for analysis, and of these, 7 articles including 235 knees were used for meta-analysis. The overall rate of good and excellent outcomes following surgery was estimated at 84.2% (95% confidence interval [CI], 72.8-91.4). In those cases that had non-surgical therapy prior to surgery, the rate of good and excellent outcomes of surgery was estimated at 76.1% (95% CI, 60.1-87). Conclusions: Arthroscopic surgical management of symptomatic medial knee plica results in favourable outcomes. Our results suggest that arthroscopic surgical excision should be considered as a treatment modality in patients with pathological medial plica disease of the knee either as a first-line treatment or when symptoms have not responded to non-surgical interventions. Level of Evidence: IV.
The Journal of Churna Manual Medicine for Spine and Nerves
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v.15
no.2
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pp.75-81
/
2020
Objectives The purpose of this study was to report the effect of Korean medicine treatment, including the application of joint mobilizing chuna, by reporting two cases after tibial plateau fracture surgery. Methods Two patients with tibial plateau fractures were treated using joint mobilizing chuna, myofascial chuna, acupuncture, and herbal medication. The effect of the treatments was evaluated using the range of motion, manual muscle test, numeric rating scale, and Korean Knee Injury and Osteoarthritis Outcome Score. Results In both cases, the range of motion, muscle strength, and pain were significantly improved. In particular, the range of motion for knee joint flexion increased by 47° in case 1 and 30° (right) and 42° (left) in case 2. Conclusions Korean medicine treatment, especially joint mobilizing chuna, may be an effective intervention for rehabilitation after tibial plateau fracture surgery.
Purpose: Fire response education is critical for healthcare providers working in hospitals to ensure a safe environment for patients and staff. However, a comprehensive review that thoroughly examines the contents, methodologies, and outcomes of fire response education in hospitals is currently lacking. Methods: We conducted a scoping review by adhering to the framework proposed by Arksey and O'Malley. We searched five electronic databases for literature published after 1990, using the key categories of "hospitals," "fires," and "education." As a result, we identified 15 relevant articles that met our inclusion criteria for the review. Results: Of the 15 articles, 12 had adopted a quasi-experimental design and the remaining 3 had employed a true experimental design. The majority of these studies (11 out of 15) were conducted in the United States, with 4 studies forming committees or teams dedicated to education. Simulation methods were used in 13 studies, while 2 studies had employed a combination of methods. All studies focused on first-response procedures based on RACE (Rescue, Alarm, Contain, Extinguish/Evacuation). Outcome measures included the learners' overall experience, performance in the educational settings, and performance in the field, with all studies reporting positive results following the educational interventions. Conclusion: Our review highlights the importance of multi-professional and multi-departmental educational strategies based on institutional-level initiatives for healthcare providers to create a safe hospital environment.
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