• Title/Summary/Keyword: Prospective randomized trial

검색결과 164건 처리시간 0.029초

국내 치매에 대한 한의치료 전향적 임상연구, 과제, 임상시험 프로토콜의 현황조사 (Scoping Review of Prospective Clinical Studies, Projects, and Clinical Study Protocol for Korean Medicine Treatment on Dementia)

  • 김제범;이동윤;하다정;권찬영
    • 대한한의학회지
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    • 제42권3호
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    • pp.99-118
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    • 2021
  • Objectives: The aim of this study is to review and analyze the trends in prospective clinical research (PCR), project, clinical study protocol of Korean medicine (KM) for dementia. Methods: We searched PCRs of KM on dementia in six electronical databases, up to January 28, 2021. Moreover, the clinical research protocol and projects of KM for dementia were searched. Results: Total eight PCRs, nine projects, and three clinical study protocols were included. In the PCRs, there were one randomized controlled trial, five before and after study, and two comparative group before-after studies. Four of them used herbal medicine, two used acupuncture, one study used both herbal medicine and acupuncture, and the other one used moxibustion. Jowiseungchung-tang was the most frequently used herbal medicine. BL62, KI6 were used in electro-acupuncture, auricular-Shenmen in auricular acupuncture, and GV20 in moxibustion. The most frequent outcome was Korean-Dementia Rating Scale (K-DRS). One reported significant increase in K-DRS score, one reported 60% improvement, and the other studies mostly reported no significant difference. In the projects including 20 clinical studies of dementia, herbal medicine, integrative medicine and acupuncture were mainly used. In the protocols, herbal medicine, complex KM intervention, and integrative medicine were used. Conclusions: Currently, the number of PCRs of KM for dementia is very scarce. Therefore, the researcher's interest in this field and national research support should be made more, and the quality of clinical research in the future can be further improved by supplementing the limitations of previously published clinical research.

Surgical Treatment of Gastroesophageal Junction Cancer

  • Hashimoto, Tadayoshi;Kurokawa, Yukinori;Mori, Masaki;Doki, Yuichiro
    • Journal of Gastric Cancer
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    • 제18권3호
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    • pp.209-217
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    • 2018
  • Although the incidence of gastroesophageal junction (GEJ) adenocarcinoma has been increasing worldwide, no standardized surgical strategy for its treatment has been established. This study aimed to provide an update on the surgical treatment of GEJ adenocarcinoma by reviewing previous reports and propose recommended surgical approaches. The Siewert classification is widely used for determining which surgical procedure is used, because previous studies have shown that the pattern of lymph node (LN) metastasis depends on tumor location. In terms of surgical approaches for GEJ adenocarcinoma, a consensus was reached based on two randomized controlled trials. Siewert types I and III are treated as esophageal cancer and gastric cancer, respectively. Although no consensus has been reached regarding the treatment of Siewert type II, several retrospective studies suggested that the optimal treatment strategy includes paraaortic LN dissection. Against this background, a Japanese nationwide prospective trial is being conducted to determine the proportion of LN metastasis in GEJ cancers and to identify the optimal extent of LN dissection in each type.

Optimal Dextrose Concentration for Pain Control in Healthy Newborns during Hepatitis B Vaccination

  • Oh, Seong Hee;Kim, In Ah;Jin, Hyunseung
    • Neonatal Medicine
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    • 제25권2호
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    • pp.72-77
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    • 2018
  • Purpose: Glucose has been recommended as an analgesic for mild to moderately painful procedures in neonates. The goal of this study was to assess the optimal dextrose concentration for pain control in newborns. Methods: This prospective, randomized, blinded clinical trial included 116 healthy full-term newborns. The neonates were randomly assigned to the following four groups by drawing straws: groups receiving sterile water or a 10%, 20%, or 40% dextrose solution orally. Each group was treated with the assigned solution prior to hepatitis B vaccination. The Neonatal Facial Coding System (NFCS) and the Neonatal Infant Pain Scale (NIPS) scores were evaluated before, immediately after, and 2 minutes after the injection in all neonates. Premature Infant Pain Profile (PIPP) scores were evaluated during the injection. All procedures were video-recorded, and pain scores were assessed by two independent observers who were not involved in the care of the newborns studied. The pain scores were compared among the four groups. Results: The 40% dextrose solution significantly reduced the NFCS (P=0.002) and the PIPP scores (P=0.001) compared with sterile water. No hyperglycemic events were noted in the study subjects 2 hours after the injection. Conclusion: The 40% dextrose solution effectively relieved pain due to intramuscular injection in full-term newborns without causing hyperglycemic events. However, the 10% and 20% dextrose solutions did not affect neonatal pain scores.

개심술후 Desmopressin Acetate 가 출혈에 미치는 영향 (Effect of Treatment with Desmopressin Acetate to Reduce Blood Loss after Cardiac Surgery)

  • 유재현;이영
    • Journal of Chest Surgery
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    • 제23권2호
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    • pp.268-274
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    • 1990
  • Bleeding after cardiopulmonary bypass remains a cause for concern, requiring reexploration of the chest in approximately 3 percent of patients who have had operations on the heart. We examined the possibility that this problem might be alleviated by desmopressin acetate [DDAVP], synthetic vasopressin analogue that lacks vasoconstrictor activity. In a prospective, randomized trial, we studied the effect of intraoperative desmopressin acetate in 20 patients [the treated group 10 patients and the control group 10 patients] undergoing various cardiac operations requiring cardiopulmonary bypass. The result showed that the early postoperative [during first 24hrs] and mean postoperative blood loss [first 3 days] of the treated group were significantly reduced than the control group[447\ulcorner199ml in the treated group versus 746\ulcorner199ml in the treated group versus 746\ulcorner295 ml in the control group, p=0.014; mean\ulcornerstandard deviation and 675\ulcorner276 ml in the treated group versus 1006\ulcorner303 ml in control group, p=0.019]. The mean red-cell transfusion in first 3days were reduced in the treated group than the control group [3.3\ulcorner1.7 units vs 4.9\ulcorner1.7units, P=0.051]. There were no untoward side effects of desmopressin acetate. We conclude that the administration of desmopressin acetate can be recommended to reduce blood loss and blood conservation in patients undergoing cardiac operations.

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Intrathecal Meperidine Plus Lidocaine for Prevention of Shivering during Cesarean Section

  • Rastegarian, Ahmad;Ghobadifar, Mohamed Amin;Kargar, Hossein;Mosallanezhad, Zahra
    • The Korean Journal of Pain
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    • 제26권4호
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    • pp.379-386
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    • 2013
  • Background: Shivering related to spinal anesthesia may interfere with monitoring and is uncomfortable. The aim of the present study was to investigate low-dose intrathecal meperidine for the prevention of shivering after induction of spinal anesthesia in parturients with cesarean section. Methods: This was a prospective randomized, double-blind, placebo-controlled trial including 100 parturients, of American Society of Anesthesiologists (ASA) physical status I or II, scheduled for elective cesarean section under spinal anesthesia who were randomly assigned to a meperidine (0.2 mg/kg) plus hyperbaric lidocaine (5%, 75 mg, n = 50; group M) group or a placebo plus hyperbaric lidocaine (5%, 75 mg, n = 50; group L) group. Demographic and surgical data, adverse events, and the mean intensity for each parturient were assessed during the entire study period by a blinded observer. Results: There were no significant differences between the two study groups regarding the demographic and surgical data (P > 0.05). The incidence of shivering during the entire study period significantly decreased in the group of parturients who received intrathecal meperidine (P = 0.04). There were no significant differences in nausea and vomiting between the two groups. Conclusions: Low-dose intrathecal meperidine (10 mg) is safe and effective in reducing the incidence and severity of shivering associated with spinal anesthesia in parturients with cesarean section.

Multimodality Treatment for Patients with Node-Positive Prostate Cancer: the Role of Radiation Therapy

  • Ochiai, Satoru;Nomoto, Yoshihito;Kobayashi, Shigeki;Yamashita, Yasufumi;Watanabe, Yui;Toyomasu, Yutaka;Kawamura, Tomoko;Takada, Akinori;II, Noriko;Sakuma, Hajime
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권4호
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    • pp.1625-1630
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    • 2016
  • Prostate cancer is the secondary most frequently diagnosed cancer in the world. Although numerous prospective randomized trial have been conducted to guide the management of patients with localized or locally advanced prostate cancer, few clinical trials targeting node-positive prostate cancer have been reported. Therefore, there are still controversies in the optimal management of node-positive prostate cancer. Recently, efficacy of multimodality treatment, including radiation therapy (RT), for such patients has been reported in several articles. The results indicate potential benefit of RT both in adjuvant therapy after prostatectomy and in definitive therapy for node-positive prostate cancer. The aim in this article was to summarize the current evidence for RT and evaluate the role in multimodality treatment for patients with node-positive prostate cancer.

경막외 Morphie 투여시 생기는 소양증에 대한 Propofol과 Naloxone의 효과 비교 (Treatment of Epidural-Morphine-Induced Pruritus: Propofol Versus Naloxone)

  • 박정현;정현정
    • The Korean Journal of Pain
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    • 제10권2호
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    • pp.208-213
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    • 1997
  • Background: Pruritus is the most frequent undesirable symptom associated with epidural morphine. It is unpleasant and often difficult to treat. Naloxone is presently the drug of first choice for treating this symptom. Naloxone however decrease the pain threshold in some cases. Recently it was reported subhypnotic doses of propofol were efficient in relieving epidural-morphine-induced pruritus(EMIP). In a prospective. randomized, double-blinded clinical trial, we compared the efficacy of propofol and naloxone for treatment of EMIP. Methods: Forty patients with EMIP were allocated to receive either 20 mg propofol, or 1.5 ${\mu}g/kg$ naloxone intravenously. Pruritus and level of postoperative pain were assessed after 5 min, using pruritus rating scale and visual analogue scale. Results: The overall success rate in treating pruritus was similar in both groups (propofol 70% vs naloxone 65%). Twenty-five percent of the patients in the naloxone group had an increase in the level of postoperative pain versus none in the propofol group(P=0.018). Conclusions: These results suggest propofol and naloxone are equally effective in treating EMIP. However, the level of postoperative pain is significantly reduced when treated with propofol.

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Effect of relative head position on the anesthetic efficacy of inferior alveolar nerve block during endodontic treatment of patients with irreversible pulpitis

  • Aggarwal, Vivek;Singla, Mamta;Miglani, Sanjay
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제18권1호
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    • pp.41-46
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    • 2018
  • Background: The purpose of this prospective randomized single-blind clinical trial was to evaluate the effect of tilting the head on the anesthetic efficacy of inferior alveolar nerve block (IANB) in patients with symptomatic irreversible pulpitis. Methods: Ninety-two patients were divided into two groups: the first group received IANB and the head was tilted in the direction of the block for 15 min, whereas the second group received IANB and the head was tilted to the opposite side. Access cavity preparation was initiated after 15 min. Success was defined as no pain or faint/weak/mild pain during endodontic access preparation and instrumentation. The anesthetic success rates were analyzed by Pearson chi-square test at 5% significance levels. Results: The same side position and opposite side position yielded 41% and 30% anesthetic success rates, respectively; there was no significant difference between the two sides. Conclusions: Relative head position has no effect on the anesthetic success rate of IANB.

급성 비천공성 충수염 수술시 예방적 항균제의 사용기간 (Appropriate Duration of Prophylactic Antibiotics in Acute Nonperforated Appendicitis)

  • 서옥경;강성희;양대현;신완균
    • 한국임상약학회지
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    • 제12권2호
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    • pp.65-70
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    • 2002
  • Prophylactic antibiotics in acute nonperforated appendicitis have been used for preventing infection after appendectomy. However, duration of antibiotic administration for surgical prophylaxis in Korea has been noted to be longer than those recommended in other countries. The objective of this study was to identify appropriate duration of prophylactic antibiotics in acute nonperforated appendicitis by comparing two different antibiotic regimens for their wound infection rates. Eighty-four acute nonperforated appendicitis patients were enrolled in this prospective, randomized, open trial and were assigned to one of two antibiotic regimens: cefoxitin 1 g every 8 hours given intravenously for 24hours or cefoxitin 1 g every 8 hours given intravenously plus sisomicin 75 mg every 12 hours given jntramuscularly for 72 hours. First doses were given just prior to the induction of anesthesia. Postoperative wound infections were detected in $4.8\%$ of the 72-hour-treated group (n=42), whereas none occurred in the 24-hour-treated group (n=42). However, the difference in the rates of wound infections between two groups was not statistically significant. The most frequently isolated microorganism from appendiceal tissues was E coli. In conclusion, administration of cefoxitin alone for 24 hours is sufficient as surgical prophylaxis in nonperforated appendicitis.

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Survival rates against fracture of endodontically treated posterior teeth restored with full-coverage crowns or resin composite restorations: a systematic review

  • Suksaphar, Warattama;Banomyong, Danuchit;Jirathanyanatt, Titalee;Ngoenwiwatkul, Yaowaluk
    • Restorative Dentistry and Endodontics
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    • 제42권3호
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    • pp.157-167
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    • 2017
  • This systematic review aims to summarize the current clinical studies that investigated survival rates against fracture of endodontically treated posterior teeth restored with crowns or resin composite restorations. Literature search were performed using keywords. Publications from 1980 to 2016 were searched in PubMed, ScienceDirect, ISI Web of SCIENCE, MEDLINE, and SCOPUS. Included studies were selected based on inclusion and exclusion criteria. Three clinical studies were included: 1 randomized controlled trial and 1 prospective and 1 retrospective cohort studies. Pooled survival rates ranged from 94%-100% and 91.9%-100% for crowns and resin composite, respectively. The majority of teeth had no more than 3 surface loss of tooth structure. The studies included were heterogeneous, and were not appropriate for further meta-analysis. Current evidence suggested that the survival rates against the fracture of endodontically treated posterior teeth restored with crowns or resin composites were not significantly different in the teeth with minimum to moderate loss of tooth structure.