• Title/Summary/Keyword: Randomized Clinical Trials

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Lateral alveolar ridge augmentation procedure using subperiosteal tunneling technique: a pilot study

  • Kakar, Ashish;Kakar, Kanupriya;Sripathi Rao, Bappanadu H.;Lindner, Annette;Nagursky, Heiner;Jain, Gaurav;Patney, Aditya
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.3.1-3.8
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    • 2018
  • Background: In this research article, we evaluate the use of sub-periosteal tunneling (tunnel technique) combined with alloplastic in situ hardening biphasic calcium phosphate (BCP, a compound of β-tricalcium phosphate and hydroxyapatite) bone graft for lateral augmentation of a deficient alveolar ridge. Methods: A total of 9 patients with deficient mandibular alveolar ridges were included in the present pilot study. Ten lateral ridge augmentation were carried out using the sub-periosteal tunneling technique, including a bilateral procedure in one patient. The increase in ridge width was assessed using CBCT evaluation of the ridge preoperatively and at 4 months postoperatively. Histological assessment of the quality of bone formation was also carried out with bone cores obtained at the implant placement re-entry in one patient. Results: The mean bucco-lingual ridge width increased in average from 4.17 ± 0.99 mm to 8.56 ± 1.93 mm after lateral bone augmentation with easy-graft CRYSTAL using the tunneling technique. The gain in ridge width was statistically highly significant (p = 0.0019). Histomorphometric assessment of two bone cores obtained at the time of implant placement from one patient revealed 27.6% new bone and an overall mineralized fraction of 72.3% in the grafted area 4 months after the bone grafting was carried out. Conclusions: Within the limits of this pilot study, it can be concluded that sub-periosteal tunneling technique using in situ hardening biphasic calcium phosphate is a valuable option for lateral ridge augmentation to allow implant placement in deficient alveolar ridges. Further prospective randomized clinical trials will be necessary to assess its performance in comparison to conventional ridge augmentation procedures.

Efficacy of intralipid administration to improve in vitro fertilization outcomes: A systematic review and meta-analysis

  • Han, E Jung;Lee, Hye Nam;Kim, Min Kyoung;Lyu, Sang Woo;Lee, Woo Sik
    • Clinical and Experimental Reproductive Medicine
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    • v.48 no.3
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    • pp.203-210
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    • 2021
  • We performed a systematic review and meta-analysis to evaluate whether intralipid administration improved the outcomes of in vitro fertilization. Online databases (PubMed, Cochrane Library, Medline, and Embase) were searched until March 2020. Only randomized controlled trials (RCTs) that assessed the role of intralipid administration during in vitro fertilization were considered. We analyzed the rates of clinical pregnancy and live birth as primary outcomes. Secondary outcomes included the rates of chemical pregnancy, ongoing pregnancy, and missed abortion. We reviewed and assessed the eligibility of 180 studies. Five RCTs including 840 patients (3 RCTs: women with repeated implantation failure, 1 RCT: women with recurrent spontaneous abortion, 1 RCT: women who had experienced implantation failure more than once) met the selection criteria. When compared with the control group, intralipid administration significantly improved the clinical pregnancy rate (risk ratio [RR], 1.48; 95% confidence interval [CI], 1.23-1.79), ongoing pregnancy rate (RR, 1.82; 95% CI, 1.31-2.53), and live birth rate (RR, 1.85; 95% CI, 1.44-2.38). However, intralipid administration had no beneficial effect on the miscarriage rate (RR, 0.75; 95% CI, 0.48-1.17). A funnel plot analysis revealed no publication bias. Our findings suggest that intralipid administration may benefit women undergoing in vitro fertilization, especially those who have experienced repeated implantation failure or recurrent spontaneous abortion. However, larger, well-designed studies are needed to confirm these findings.

Effectiveness and Safety Verification of Brinzolamide Combination Therapy on Primary Open-angle Glaucoma or Ocular Hypertension: A Systematic Review and Meta-analysis Study (브린졸라미드 복합제의 개방각 녹내장 또는 고안압증에 대한 효과 및 안전성 검증: 체계적 문헌 고찰 및 메타분석 연구)

  • Kim, Jin A;Lee, Heeyoung
    • Korean Journal of Clinical Pharmacy
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    • v.31 no.3
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    • pp.205-215
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    • 2021
  • Background: The treatment of primary open-angle glaucoma (POAG) or ocular hypertension (OHT) for intraocular pressure (IOP) reduction is recommended to proceed with the use of the compound. Therefore, this study aimed to evaluate the efficacy and safety of brinzolamide combination therapy on POAG and OHT following the subgroup analysis among types of brinzolamide combined medications. Methods: By June 2019, PubMed, EMBASE and Cochrane Library were searched to find a study that met our inclusion criteria. Based on randomized control trials (RCTs), we collected studies that tested the brinzolamide combination therapy in POAG and OHT patients, and analyzed the literature identified by the results of the study on IOP reduction and adverse reactions. Results: A total of 13 literature was collected to conduct an analysis including 2,197 patients. The intervention included brinzolamide combination therapies, combined with timolol, brimonidine, PGA or combined with both brimonidine and PGA. The analysis showed significant decreasing tendency for values at morning and end treatment per day in the use of brinzolamide combination therapy in the absolute IOP change (mean difference (MD) -1.41; 95% CI -1.92, -0.90; p<0.001 vs. MD -1.46; 95% CI -2.03, -0.89; p<0.00001, respectively). We could see higher adverse reactions in the brinzolamide combination group using intervention (odds ratio 1.43; 95% CI 1.20, 1.71; p<0.0001). Conclusion: Regarding IOP reduction in POAG and OHT patients, brinzolamide combination therapy is more effective but less safe than control treatment, which diverse among types of combined medications. Thus, more individualized therapy should be applied in real-world practice.

The effect of motor learning in children with cerebral palsy: A systemic review (뇌성마비 아동의 운동학습 효과 체계적 고찰)

  • Kim, Jung-Hyun
    • Journal of Korean Physical Therapy Science
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    • v.28 no.1
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    • pp.33-45
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    • 2021
  • Background: Children with cerebral palsy have difficulty acquiring motor skills through motor learning due to lack of motor planning of the central nervous system and musculoskeletal dysfunction. Motor learning is the acquisition or modification of movements with the aim of developing skilled movements and behaviors. Cerebral palsy improve motor function through motor learning, and effective motor learning mainly depends on practice parameters such as learning feedback. Therefore, we investigate the effect of motor learning in children with cerebral palsy and try to present the possibility of clinical application. Design: A systemic review. Methods: Research papers were published from Jan, 2010 to Dec, 2020 and were searched using PubMed and Medline. The search terms are 'task specific training' OR 'motor learning' OR 'feedback(Mesh term)' OR 'goal activity' AND 'cerebral palsy(Mesh term)'. A total of eight papers were analyzed in this study. The paper presented the quality level based on the research evidence, and also presented PEDro (Physiotherapy Evidence Database) scores to evaluate the quality of design studies in randomized clinical trials. Results: The results showed that motor learning coaching in children with cerebral palsy improved motor function in post and follow up tests. Also, self-control feedback of motor learning is more effective than external control feedback. 100% external control feedback of motor learning is effective in the acquisition phase and 50% external feedback of motor learning is effective in the retain phase. Conclusion: These results suggest that it will be an important data for establishing evidence on the effect of motor learning arbitration methods in children with cerebral palsy to develop clinical applicability and protocols.

A Review of Acupuncture Treatment Methods for Cold Hypersensitivity of Hands and Feet (수족냉증의 침 치료법에 대한 고찰)

  • Choi, Su-Ji;Choi, YunSeok;Lee, Yeon Sun;Noh, Eun-Ji;Kim, Dong-Il
    • Korean Journal of Acupuncture
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    • v.38 no.2
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    • pp.43-61
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    • 2021
  • Objectives : The purpose of this study is to review the acupuncture treatment for cold hypersensitivity of hands and feet. Methods : We searched articles in 7 search engines with keywords related to 'Cold hypersensitivity of hands and feet' and 'Raynaud disease' in March 2021. Clinical studies that used acupuncture for cold hypersensitivity of hands or feet were included. Animal studies and nonclinical data were excluded. Data on acupuncture treatment such as methods, site, duration, frequency, and period were analyzed. Also, network analysis between acupoints was conducted. Results : Of 41 selected articles, there were 32 case reports, 7 randomized controlled trials, and 2 uncontrolled clinical studies. Studies were conducted using manual acupuncture, electroacupuncture, warm needling, pharmacopuncture, fire needling, and auricular acupuncture. Most studies used more than one acupoint (n=40), and there were 111 acupoints selected for acupuncture treatment for cold hypersensitivity of hands and feet. The most commonly used acupoint was LI11 (n=27). In terms of the correlation of acupoints, LI11 had the highest value of degree centrality at 0.6989. The mean treatment time, number of treatments, and duration were 26.8±8.87 minutes, 15.51±15.75 times, and 77.69±132.80 days. Conclusions : The results of this study could be useful in establishing the evidence for performing standardized acupuncture treatment for cold hypersensitivity of hands and feet.

Analysis of Influencing Factors on the Outpatient Prescription of Antipsychotic Drugs in the Elderly Patients (노인환자의 항정신병 약물 원외처방 내역에 미친 영향 요인 분석)

  • Dong, Jae Yong;Lee, Hyun Ji;Lee, Tae Hoon;Kim, Yujeong
    • Korean Journal of Clinical Pharmacy
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    • v.31 no.4
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    • pp.268-277
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    • 2021
  • Background: Most antipsychotic drugs studies have been mainly conducted on side effects, randomized clinical trials, utilization rates, and trends. But there have been few studies on the influencing factors in elderly patients. The purpose of this study was to analyze the influencing factors on the outpatient prescription of antipsychotic drugs in the elderly patients. Methods: Active ingredients of antipsychotic drugs in Korea were selected according to the Korean Pharmaceutical Information Center (KPIC)'s classification. Data source was Korean Health Insurance Review and Assessment Service (HIRA) claims data in 2020 and target patient group was the elderly patient group. We extracted patients who have been prescribed one or more antipsychotic drugs and visited only one medical institution. Data were analyzed using descriptive statistics, chi-square, t-test, negative binomial regression. Results: A number of outpatients were 245,197 and prescriptions were 1,379,092. Most characteristics of patients were 75-85 year's old, female, health insurance type, no disease (dementia, schizophrenia), atypical drugs, cci score (>2) and characteristics of medical institution were neurology in specialty, rural region, general hospitals. Results of regression showed that patient's characteristics and medical center characteristics had significant effect on the outpatient prescription of antipsychotic drugs in the elderly patients. Conclusion: This study suggests that national policy of antipsychotic drugs in the elderly patients, with the consideration of the patients' and medical institutions' characteristics, is needed.

Effectiveness of Manual Therapy for Asthma in Children and Adolescents: A Systematic Review (소아·청소년 천식에 대한 수기요법의 효과: 체계적 문헌 고찰)

  • Park, Sun-Young;Heo, In;Shin, Byung-Cheul
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.17 no.1
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    • pp.11-19
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    • 2022
  • Objectives This systematic review aimed to provide evidence of the effectiveness and safety of manual therapy for asthma in children and adolescents. Methods We queried eight electronic databases (PubMed, Ovid-MEDLINE, EMBASE, The Cochrane Library, CNKI, ScienceON, KISS, and RISS) up to the end of April 2022. We included only randomized controlled trials (RCTs) investigating manual therapy for the treatment of asthma in children and adolescents. The methodological quality of the included RCTs was evaluated using the Cochrane risk-of-bias tool 1.0. Results Four RCTs were eligible for inclusion. Meta-analysis could not be performed due to the heterogeneity of the studies. One study showed the statistical significance of SMD 0.41 (95% CI: 0.06, 0.76, p<0.05) in the comparison with the osteopathic therapy group and the sham control group before and after treatment on the same day of peak expiratory flow. Conclusions This possibility was observed in a non-pharmacological approach to manual therapy. Manual therapy can be considered as an adjunct therapy for asthma treatment in children and adolescents who have difficulty with drug therapy.

Effectiveness of home-based therapy on gross motor function in children with cerebral palsy: A systematic review (뇌성마비 아동의 대동작 기능에 대한 가정중심치료 효과 : 체계적 고찰)

  • Jung-Hyun, Kim
    • Journal of Korean Physical Therapy Science
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    • v.29 no.4
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    • pp.27-42
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    • 2022
  • Background: Although children with cerebral palsy (CP) are able to walk independently, gait imbalance occurs due to abnormal muscle tone, musculoskeletal deformity, loss of balance, and selective motor control impairment. Gait restriction in the community and school is a major problem of rehabilitation in CP. Home-based therapy (HBT) provides a variety of interventions in which the therapist and the parent work together to resolve the activities and problems caused by the child's body structure. Therefore, we investigate the effectiveness of home-centered therapy on gross motor function in CP and try to present the possibility of clinical application. Design: A Systematic Review Methods: Research papers were published from Jan, 2012 to Jan, 2022 and were searched using Medline and PubMed. The search terms are 'family-centered' OR 'home-based' AND 'cerebral palsy'. A total of nine papers were analyzed in this study. The paper presented the quality level based on Physiotherapy Evidence Database (PEDro) scores to assess the quality of randomized clinical trials studies. Results: The results showed that HBT for strengthening exercise in lower extremity has a positive effect on the isokinetic torque and gross motor function. home-based treadmill therapy in CP is effective to perform at least 12 sessions of treadmill HBP in which the therapist determines the treadmill speed every week and the child's own gait pattern is modified. Conclusion: These results suggest that it will be important data for founding evidence on the effectiveness of home-centered therapy on gross motor function in children with cerebral palsy to advance clinical protocols.

A narrative review of clinical studies on thread embedding acupuncture treatment for spasticity after stroke

  • Sooran Cho;Eunseok Kim
    • The Journal of Korean Medicine
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    • v.43 no.4
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    • pp.131-144
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    • 2022
  • Objectives: This study aimed to review clinical studies on thread embedding acupuncture (TEA) for the treatment of patients with post-stroke spasticity (PSS) Methods: Clinical studies related to TEA treatment for PSS were searched for in several electronic databases, including PubMed, Cochrane Library, MEDLINE, OASIS, and CNKI. After the selection/exclusion process, information on study design, disease, experimental/control group, intervention, outcome measurement, between-group differences, and adverse events was extracted. Results: A total of 13 randomized controlled trials were included in this review. The usual frequency of TEA treatment was once every 1-2 weeks, and the treatment most commonly included 4 sessions. In the dorsal area, EX-B2 and the acupoints in governing vessel meridian were commonly used. Acupoints in the meridian of the large intestine were most frequently used in the treatment of upper limb spasticity. Except for HT1, PC6, and PC8, all TEA points for treating PSS of the upper limb were on the Yang meridians. For the lower limb spasticity, the most frequently used acupoints were ST36, GB34, GB30, BL60, and BL57 on Yang meridians, and LR3, SP6, SP9, and SP10 on Yin meridians. TEA treatment showed better effects than conventional treatment for PSS in terms of spasticity, motor dysfunction, and activities of daily livings. Nevertheless, the absence of the follow-up observation, lack of sham TEA treatment, and low quality of the included studies necessitated caution in interpreting the results. Conclusions: The results of this review are expected to provide basic data on the modalities of TEA treatment for PSS and provide insights to facilitate well-designed studies in the future.

Review of Studies on Domestic and International Clinical Trends for Korean Medicine Treatment of Rotator Cuff Calcific Tendinitis (회전근개 석회화 건염의 한의 치료에 대한 국내외 임상 동향 분석)

  • Jeong-Hyun Park;Hyeon-Jun Woo;Su-Hyeon Jeong
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.18 no.2
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    • pp.43-52
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    • 2023
  • Objectives This study aimed to investigate trends in domestic and international clinical approaches to the Korean medicine treatment of rotator cuff calcific tendinitis and to suggest future research directions. Methods We utilized nine electronic databases to identify domestic and international studies on Korean medicine treatment for rotator cuff calcific tendinitis. By analyzing the title, abstract, and main text, studies concerning Korean medicine treatment of rotator cuff tendinitis were included. Results Among the searched for studies, fourteen studies met our criteria. Eight of these were case reports and six were randomized controlled trials (RCTs). Across the studies, five treatment methods were employed, including acupuncture, herbal medicine, physical therapy, cupping therapy, and moxibustion. Acupuncture, used in all fourteen studies, was the most frequently utilized intervention. Thirteen evaluation tools were used to measure the effectiveness of Korean medicine treatment, and all studies reported positive outcomes. Conclusions We identified current trends in clinical approaches of Korean medicine treatment for rotator cuff calcific tendinitis and assessed the effectiveness of such treatment. However, further studies are warranted to establish a basis for Korean medicine treatment for rotator cuff calcific tendinitis.