• 제목/요약/키워드: PubMed

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한의사들이 원하는 한의학 지식체계에 대한 고찰 (A study of Korean medical knowledge system which Korean medical doctors want)

  • 손미주;김우영;정의민;박황진;한창현
    • 대한예방한의학회지
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    • 제16권3호
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    • pp.89-105
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    • 2012
  • Objectives : This study was carried out to know the status of clinical utilization of Korean medical knowledge and the Korean medical knowledge system which Korean medical doctors want. Methods : Questionnaires were distributed to Korean medical doctors registered for the Association of Korean medicine via the email and 249 answered questionnaires were analyzed. Results : 50.6 % of Korean medical doctors utilized the textbooks for Korean medicine when they treated their patients. The reason why they did not utilize the textbooks for Korean medicine was mostly that 'it could not be applied directly into clinical application with only contents of textbook because clinical approach (diagnosis and treatment methods) was not clearly described in the textbook'. 48.6 % of Korean medical doctors utilized the EBM materials when they treated their patients. EBM materials that they referred included domestic articles, other EBM materials excluding papers and international academic papers based on PubMed in order. The reasons why they did not utilize the EBM materials were mostly that 'it was difficult to find the evidence' and 'EBM materials were not actually helpful for the clinical practice.' It was found that Korean medical doctors approached the disease in aspects of Korean and Western Medicine concurrently upon the diagnosis of patients and performed the diagnosis and treatment of Korean medicine on the diseases which seemed to be effective with Korean medicine. It was also found that they thought that they needed to know the Western medical knowledge as much as general doctors who have a doctor's license or family medicine specialists who comprehensively treat the general diseases know. Korean medical doctors wanted to have the systematic summary of modern research performance in fields of acupoint, acupuncture, herbal drugs and formula. They thought that constitutional medicine and Sa-am acupuncture therapy were representative characteristics in Korean medicine differentiated from Traditional Chinese medicine and Kampo medicine. Conclusions : Korean medical doctors wanted to establish the Korean medical knowledge system based on evidence focusing on clinical and practical contents. New Korean medical knowledge system should be established based on these requirements in the future.

DNMT3B -149 C>T and -579 G>T Polymorphisms and Risk of Gastric and Colorectal Cancer: a Meta-analysis

  • Khoram-Abadi, Khadijeh Mirzaee;Forat-Yazdi, Mohammad;Kheirandish, Shahnaz;Saeidi, Nasim;Zarezade, Zeinab;Mehrabi, Nahid;Neamatzadeh, Hossein
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권6호
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    • pp.3015-3020
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    • 2016
  • Background: Numerous studies have investigated associations of DNA methyltransferase (DNMT) -149 C>T and -579 G>T polymorphisms with gastric cancer (GC) and colorectal cancer (CRC) susceptibility; however, the findings are inconsistent prompting the present meta-analysis. Materials and Methods: Related studies were identified from PubMed, Google scholar, and SID until 10 October 2015. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were used to assess the strength of the associations. Results: Eleven studies were included based on the search criteria for CRC and GC related to the DNMT3B 149 C>T (3,353 cases and 4,936 controls) and DNMT3B 579 G>T (1,387 cases and 2,064 controls) polymorphisms. There was no significant association overall between DNMT3B -149 and 579 polymorphisms and the risk of cancer. In the stratified analysis by cancer type, DNMT3B 579G>T polymorphism was associated with the risk of CRC and GC. While the DNMT3B -149C/T polymorphism was related with a significantly increased risk of CRC in two tested models, dominant (GG+GT vs. TT: OR 0.51, 95 % CI 0.38-0.69; P = 0.00, Pheterogeneity=0.69, $I^2=0%$) and heterozygote (GT vs. TT: OR 0.50, 95 % CI 0.37-0.69; P=0.00, Pheterogeneity=0.41, $I^2=0%$), no evidence of any association with GC risk was observed as in the pooled analyses. Conclusions: More studies are needed to assess associations of DNMT3B -149C/T and DNMT3B 579G>T polymorphisms with cancer in different ethnicities with large population sizes to generate comprehensive conclusions.

알레르기성 비염에 대한 한약 및 양약 국소비강외용제의 효과 비교 : 체계적 문헌 고찰 (Comparison of the Effects of Topical Nasal Application on Allergic Rhinitis between Korean and Western Medicine : A Systematic Review of Randomized Controlled Trials)

  • 조효림;오세희;김선혜;성원석;홍승욱;김은정
    • 한방안이비인후피부과학회지
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    • 제32권4호
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    • pp.62-89
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    • 2019
  • Objectives : The purpose of this study is to evaluate the effectiveness and safety of topical nasal application of Herbal medicine compared with Western medicine in the treatment of Allergic Rhinitis(AR). Methods : Electronic databases including Cochrane library, PubMed, EMBASE, CNKI, KMBASE, KISS, NDSL, OASIS, KISS and KJTK(Korean Traditional Knowledge Portal) were searched by the keywords such as 'allergic rhinitis', 'nasal sprays', 'herbal medicine', 'plant extracts', and 'external application'. The quality of each RCTs was assessed by Cochrane Collaboration of 'Risk of bias(RoB) Tool'. Results : 19 RCTs were finally selected from 1419 references screened. 19 RCTs were compared with the effects of topical nasal application of Herbal medicine and Western medicine. Based on the symptom scores from 13 RCTs, topical nasal application of herbal medicine generally has a better effect on relief of AR. The two treatments have similar effects on improving the level of specific factors like IgE, IgG, IL-13, $uLTD_4$ in blood and urine. 8 RCTs showed adverse effects(AEs) in both groups and severe AEs were not reported. Conclusions : This study shows that topical nasal application of herbal medicine can improve symptoms and related factors of allergic rhinitis. Well-designed RCT studies with low risk of bias should be conducted to confirm these findings.

Efficacy of ketamine in the treatment of migraines and other unspecified primary headache disorders compared to placebo and other interventions: a systematic review

  • Chah, Neysan;Jones, Mike;Milord, Steve;Al-Eryani, Kamal;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제21권5호
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    • pp.413-429
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    • 2021
  • Background: Migraine headaches are the second leading cause of disability worldwide and are responsible for significant morbidity, reduction in the quality of life, and loss of productivity on a global scale. The purpose of this systematic review and meta-analysis was to evaluate the efficacy of ketamine on migraines and other primary headache disorders compared to placebo and other active interventions, such as midazolam, metoclopramide/diphenhydramine, and prochlorperazine/diphenhydramine. Methods: An electronic search of databases published up to February 2021, including Medline via PubMed, EMBASE, Web of Science, and Cochrane Library, a hand search of the bibliographies of the included studies, as well as literature and systematic reviews found through the search was conducted to identify randomized controlled trials (RCTs) investigating ketamine in the treatment of migraine/headache disorders compared to the placebo. The authors assessed the risk of bias according to the Cochrane Handbook guidelines. Results: The initial search strategy yielded 398 unduplicated references, which were independently assessed by three review authors. After evaluation, this number was reduced to five RCTs (two unclear risk of bias and three high risk of bias). The total number of patients in all the studies was 193. Due to the high risk of bias, small sample size, heterogeneity of the outcomes reported, and heterogeneity of the comparison groups, the quality of the evidence was very low. One RCT reported that intranasal ketamine was superior to intranasal midazolam in improving the aura attack severity, but not duration, while another reported that intranasal ketamine was not superior to metoclopramide and diphenhydramine in reducing the headache severity. In one trial, subcutaneous ketamine was superior to saline in migraine severity reduction; however, intravenous (I.V.) ketamine was inferior to I.V. prochlorperazine and diphenhydramine in another study. Conclusion: Further double-blind controlled studies are needed to assess the efficacy of ketamine in treating acute and chronic refractory migraines and other primary headaches using intranasal and subcutaneous routes. These studies should include a long-term follow-up and different ketamine dosages in diagnosed patients following international standards for diagnosing headache/migraine.

Efficacy of medications in adult patients with trigeminal neuralgia compared to placebo intervention: a systematic review with meta-analyses

  • Peterson-Houle, Georgia M.;AbdelFattah, Magda R.;Padilla, Mariela;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제21권5호
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    • pp.379-396
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    • 2021
  • Background: Trigeminal neuralgia (TN) is characterized by brief, unilateral, sharp, stabbing, and shooting pain of the fifth cranial nerve. The objective of this systematic review with meta-analysis was to determine the effect of medications compared to placebo in adult patients with TN. Methods: Review authors identified randomized placebo-controlled trials (RCTs) from PubMed, Web of Science, Cochrane, and EMBASE up to February 2021. We assessed the inclusion and exclusion criteria as well as the risk of bias of the studies based on the Cochrane Handbook. A total of 324 unduplicated references were scanned independently and reduced to eight relevant RCTs, with 89 patients included. Medications investigated included oral carbamazepine, subcutaneous sumatriptan, lidocaine (intranasal, 8% spray on the oral mucosa or intravenous), buprenorphine (ganglionic local opioid analgesia), and oral Nav1.7, a selective sodium channel blocker. Results: Meta-analyses showed that overall patients receiving lidocaine reported a significantly lower post-treatment intensity of pain -3.8 points on a 0-10 scale (95% Cl = -4.653 to -2.873; P < 0.001). Patients who received lidocaine were 8.62 times more likely to have pain improvement than patients on placebo (P < 0.001). In one RCT, patients receiving oral carbamazepine showed a significant improvement in pain intensity of -32% compared to the placebo (P < 0.001). In one trial, patients receiving 3 mg subcutaneous sumatriptan had a significantly lower intensity of pain on average -6.1 points on a scale of 0-10 compared to placebo (P < 0.001) and a significant improvement in pain intensity of -75% compared to the improvement in the placebo group (P < 0.001). Patients who received subcutaneous sumatriptan were 10 times more likely to have pain improvement than those who received placebo (P = 0.001) in one study. Due to the unclear/high risk of bias and small sample size, the quality of the evidence for lidocaine in the treatment of TN was low. Conclusion: Further studies are needed for carbamazepine, sumatriptan, buprenorphine, and oral Nav1.7 sodium channel blockers, as only one study reported outcomes.

Essential oils as growth-promoting additives on performance, nutrient digestibility, cecal microbes, and serum metabolites of broiler chickens: a meta-analysis

  • Irawan, Agung;Hidayat, Cecep;Jayanegara, Anuraga;Ratriyanto, Adi
    • Animal Bioscience
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    • 제34권9호
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    • pp.1499-1513
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    • 2021
  • Objective: The purpose of this meta-analysis was to evaluate the effect of dietary essential oils (EOs) on productive performance, nutrient digestibility, and serum metabolite profiles of broiler chickens and to compare their effectiveness as growth-promoting additives against antibiotics. Methods: Peer-reviewed articles were retrieved from Web of Science, Science Direct, PubMed, and Google scholar and selected based on pre-determined criteria. A total of 41 articles containing 55 experiments with 163 treatment units were eligible for analyses. Data were subjected to a meta-analysis based on mixed model methodology considering the doses of EOs as fixed effects and the different studies as random effects. Results: Results showed a linear increase (p<0.001) on body weight gain (BWG) where Antibiotics (FCR) and average daily feed intake decreased (p<0.001) linearly with an increasing dose of EOs. Positive effects were observed on the increased (p<0.01) digestibility of dry matter, crude protein, ether extract, and cecal Lactobacillus while Escherichia coli (E. coli) population in the cecum decreased (p<0.001) linearly. There was a quadratic effect on the weight of gizzard (p<0.01), spleen (p<0.05), bursa of fabricius (p<0.001), and liver (p<0.10) while carcass, abdominal fat, and pancreas increased (p<0.01) linearly. The dose of EOs linearly increased high density lipoprotein, glucose, protein, and globulin concentrations (p<0.01). In comparison to control and antibiotics, all type of EOs significantly reduced (p<0.001) FCR and tended to increase (p<0.1) BWG and final body weight. Cinnamaldehyde-compound was the only EOs type showing a tendency to increase (p<0.1) carcass weight, albumin, and protein of serum metabolites while this EOs together with EOs-Blend 1 decreased (p<0.01) E. coli population. Low density lipoprotein concentration decreased (p<0.05) with antibiotics and carvacrol-based compound when compared to the control group. Conclusion: This evidence confirms that EOs are suitable to be used as growth promoters and their economical benefit appears to be promising.

푸드 리터러시에 대한 개념 정립과 적용 방안 모색: 주제범위 문헌고찰을 통하여 (Defining Food Literacy and Its Application to Nutrition Interventions: A scoping Review)

  • 유혜림;조은빈;김기랑;박소현
    • 대한지역사회영양학회지
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    • 제26권2호
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    • pp.77-92
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    • 2021
  • Objectives: Food literacy (FL) can be an important concept that embodies the nutritional capabilities of individuals. The purpose of this study was to introduce the definition and core elements of FL from previous literature, to summarize measurement tools and intervention programs with FL, and to suggest the direction of future research and programs to integrate the concept of FL. Methods: The literature review was conducted through PubMed and Google Scholar databases by combining the search term 'food literacy' with 'definition', 'measurement', 'questionnaire', 'intervention', and 'program'. Among the 94 papers primarily reviewed 31 manuscripts that suited the purpose of the study were used for analyses. Results: There is no consensus on the definition of FL that encompasses the multidimensional aspects of the concept. The definitions of FL were slightly different depending on the authors, and the interpretation of the core elements also varied. Based on the review, we propose a framework of FL that is in line with the current discussion among international researchers. This focuses on the core elements adapted from health literacy, namely functional, interactive, and critical FL. Specifically, we suggest some detailed elements for interactive and critical FL, which were often the subject of divergent views among researchers in previous literature. We found that most of the tools in the reviewed literature provided information on validity and reliability and were developed for a specific target population. Also, most of the tools were focused on functional FL. Similarly, most of the interventions targeted functional FL. Conclusions: This study reviewed the definition and core elements of FL, available measurement tools, and intervention programs using validated tools. We propose the development of tools with sound reliability and validity that encompass the three core elements of FL for different age groups. This will help to understand whether improving food literacy can translate into better nutritional intake and health status among individuals and communities.

노인 운전자에게 적용한 컴퓨터 기반 운전중재 프로그램에 관한 체계적 고찰 (A Systematic Study of Computer-Based Driving Intervention Program for Elderly Drivers)

  • 김덕주
    • 한국산학기술학회논문지
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    • 제20권4호
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    • pp.293-302
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    • 2019
  • 본 연구는 노인 운전자를 대상으로 한 컴퓨터 기반 운전중재 프로그램에 대해 체계적으로 분석함으로써, 노인을 위한 운전중재에 대한 근거를 제시하고자 하였다. 연구 분석을 위해 2009년 1월부터 2018년 10월까지 출판된 문헌들을 대상으로 하였으며, 국외 문헌은 'Pubmed, Goggle Scholar, Science Direct'에서 검색하였고, 국내 문헌은 'RISS, Keris, KISS'를 통하여 검색하였다. 총 359편의 논문이 검색되었고, 포함기준과 배제기준을 바탕으로 분석하여 최종 10편의 논문이 분석에 사용되었으며, 근거수준 I이 8편(80%), III가 2편(20%)이었다. 분석결과 노인에게 적용한 컴퓨터 기반 중재 방법에는 운전 시뮬레이터가 7편(70%)으로 가장 많았으며, 비디오 영상훈련 2편(20%), 닌텐도 Wii 프로그램이 1편(10%)을 차지하였다. 대부분의 연구에서 운전 시뮬레이터는 노인들의 인지영역과 시지각 능력을 훈련하고, 다양한 모의 상황에서 위험 상황에 대처하는 능력을 향상시켜 주었으며, 다른 중재방법들도 노인들에게 긍정적인 영향을 미쳤다. 노인 운전자를 평가한 평가 항목에서는 운전 시뮬레이터를 사용한 운전수행능력 평가가 가장 많았으며, 그 외 주의력, 시공간 능력, 인지기능, 위험인지 평가, 우울 및 불안평가 등이 시행되었다. 노인 운전자를 대상으로 한 컴퓨터 기반 운전중재 프로그램은 다양한 영역들을 훈련하고 평가하기에 적절하며, 안전운전을 위한 중재도구로 효과적으로 활용될 수 있을 것으로 기대한다.

외전신경마비의 한의학 치료에 대한 체계적 문헌 고찰 (Systematic Review of Korean Medicine for the Treatment of Sixth Cranial Nerve Palsy)

  • 원서영;김민지;차지윤;정은선;조현경;유호룡;설인찬;김윤식
    • 대한한방내과학회지
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    • 제40권3호
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    • pp.409-424
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    • 2019
  • Objectives: This research aimed to confirm the efficacy of oriental medicine in sixth cranial nerve palsy and to evaluate the quality of the studies. Methods: Using the medical subject heading (MeSH) keywords "abducens nerve palsy", "abducens nerve paralysis", "sixth nerve palsy", "herbal medicine", "Chinese medicine", "oriental medicine" and "acupuncture", we collected the research papers through an electronic database search in Oriental Medicine Advanced Searching Integrated System (OASIS), National Discovery for Science Leaders (NDSL), PubMed, Cochran Library, and China National Knowledge Infrastructure (CNKI). Results: A total of 136 papers were searched from the databases. Among these, 15 case reports and 8 randomized controlled trials (RCTs) met our criteria. 17 articles were found on the use of acupuncture as the main intervention, 11 on the use of herbal medicine as the main intervention, and 9 on the use of electroacupuncture as the main intervention. The frequently used acupoints were LI4, EX-HN5, GB1, BL2, TE23, LR3, BL1, ST2, GB20, and ST36. All 23 studies confirmed the efficacy of Korean medicine. According to the assessment using the risk of bias, the overall quality of the RCTs was low. Conclusions: Twenty-three papers suggested that Korean medicine treatment for abducens nerve palsy was effective in many cases. Analyzing the potential bias was difficult.

다감각환경중재에 관한 국외 연구의 경향: 체계적 고찰 (The Trend of Overseas Studies on the Intervention of Multisensory Environment: Systemic Review)

  • 조은희;송현은;유두한
    • 대한감각통합치료학회지
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    • 제17권1호
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    • pp.54-64
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    • 2019
  • 목적 : 다감각환경 중재에 관한 효과를 연구한 국외 논문들을 체계적으로 분석하여 임상적용 시 정보를 제공하고, 국내 다감각환경 연구에 도움이 되고자 한다. 연구방법 : 전자 데이터 베이스인 Pubmed, Cochrane, Google scholar을 이용하여 2008년부터 2018년까지의 논문을 검색하였다. 주요 검색어는 'multi-sensory environment', 'snoezelen'을 사용하였다. 최종적으로 10편의 국외논문을 선정하였으며, PICO(Patient, Intervention, Comparison, Outcome)에 따라 정리하였다. 연구결과 : 선정된 10편의 논문 중 치매환자를 대상으로 한 연구가 6편으로 가장 많았고, 그 외에 지적장애, 정신분열증, 임산부를 대상자로 하였다. 연구기간은 3주에서 10개월로, 주 2~3회기의 중재가 대부분이였고, 회기별 중재시간은 30~60분으로 나타났다. 종속변인으로는 불안과 우울과 같은 심리적인 요인과 삶의 질과 같은 사회적 요인, 인지적, 신체적인 영역에서 효과를 알아보고자 하였다. 연구에서 중재로 사용된 다감각환경은 시각, 청각, 촉각으로 구성되었으며, 그 외의 후각과 미각, 전정감각 등이 추가적으로 제공되었다. 결론 : 앞으로 국내에서는 다감각환경 중재에 대해 관심을 가지고, 다양한 대상군 특히, 아동에게 적용해 보는 연구가 이루어져야 할 것이다.