• 제목/요약/키워드: Randomized Clinical Trials

검색결과 950건 처리시간 0.026초

Calcium hydroxide intracanal medication effects on pain and flare-up: a systematic review and meta-analysis

  • Ibrahim, Ahmed Mohamed;Zakhary, Siza Yacoub;Amin, Suzan Abdul Wanees
    • Restorative Dentistry and Endodontics
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    • 제45권3호
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    • pp.26.1-26.18
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    • 2020
  • Objectives: This study aimed to systematically review the pain and flare-up effects of calcium hydroxide (CH) as intracanal medication (ICM) in non-vital mature teeth. Materials and Methods: Electronic-databases searching for published and grey literature and manual searching were conducted. Only randomized clinical trials (RCTs) were included comparing CH to other ICMs in non-vital mature teeth. The risk of bias was assessed using the RoB 2.0 Cochrane tool. The main outcomes were pain and flare-up. Qualitative and quantitative analysis, wherever applicable, was performed. The certainty of evidence (CoE) was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: Sixteen articles were included in 6 comparisons at different time points for different outcomes. CH reduced pain risk than no ICM within the 1-14-days interval (p < 0.05) and than triple-antibiotic paste within the first day (p < 0.05) and was similar to corticosteroid/antibiotics combination (p > 0.05). Chlorhexidine (CHX) or CH/CHX, however, reduced pain levels than CH alone (p < 0.05). CH showed higher flare-up risk than CHX (p < 0.05). CoE, however, ranged from very low to moderate. Conclusion: Most comparisons for different outcomes are based on very few studies, mostly low-powered, with an overall low CoE. Thus, the available evidence is considered insufficient to either support or refute CH effectiveness or to recommend one ICM over another. Therefore, further well-designed, larger RCTs are required.

Surgical management of male genital lymphedema: A systematic review

  • Aulia, Indri;Yessica, Eva Chintia
    • Archives of Plastic Surgery
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    • 제47권1호
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    • pp.3-8
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    • 2020
  • Genital lymphedema (GL) is an uncommon and disabling disease that manifests as enlargement of the genital region resulting from the disturbance of lymphatic drainage. Although conservative treatment such as decompression is typically the first-line approach, surgical intervention has been shown to be effective in certain cases. This study aimed to systematically review studies evaluating available surgical alternatives for the treatment of male GL. A systematic search strategy using keyword and subject headings was applied to PubMed, Scopus, EMBASE, and Cochrane Library in May 2019. Studies investigating various surgical techniques to treat penile and scrotal lymphedema were included. The potential risk of bias of included trials was evaluated using the methodological index for non-randomized studies (MINORS). In total, 13 studies met the inclusion criteria, nine of which were determined to be high-quality. The average MINORS score was 12.45 for studies involving excision and 14 for studies involving lymphovenous anastomosis (LVA). The most common reason for a low score was a failure to describe the inclusion criteria. Recurrence of lymphedema during follow-up was reported in four studies involving excision and in no studies involving LVA. In general, the quality of the included literature was considered to be fair. Although surgical intervention might not always prevent the recurrence of lymphedema, all of the studies reported improved quality of life after the procedure. This study could be used as the basis for evidence-based guidelines to be applied in clinical practice for managing male GL.

흡연과 Carotenoid 함유 식품 섭취빈도에 따른 지질과산화 및 항산화능 비교 (Effect of Smoking and Carotenoid-rich Food Consumption on Lipid Peroxidation and Antioxidant Status)

  • 김유경;천종희
    • Journal of Nutrition and Health
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    • 제38권10호
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    • pp.836-846
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    • 2005
  • This study was performed to determine the effect of carotenoid-rich food consumption and smoking on the lipid peroxidation and antioxidant status in human. The subjects consisted of the health 210 middle-aged adults who visited health care center in the Inha University hospital. The blood and urine samples of the subjects were taken to analyze serum lipid profiles, plasma TBARS, total antioxidant status (TAS) and urinary 8-isoprostanes concentration. The anthropometric indices of the subjects were measured. The nutritional intake and the frequency of carotenoid-rich food consumption was determined by semi-quantitative food frequency questionnaire survey. HDL-cholesterol level of the smoking subjects was significantly lower than that of the non-smoking subjects in men. In the analysis of the carotenoid-rich food consumption, the frequency of pepper and tomato consumption of the non-smoking subjects was significantly higher than that of the smoking subjects in men. In women, the Sequency of pear and peach consumption of the non-smoking subjects was significantly higher than that of the smoking subjects. HDL-cholesterol level of the high carotenoid rich food consumption group was significantly higher than that of medium and low group in women. TAS of the high carotenoid rich food consumption group was significantly higher than that of medium and low group. In conclusion, carotenoid intakes seemed to be effective to reduce lipid peroxidation and increase antioxidant status in the body. The frequency of the carotenoid-rich food consumption seemed to be lower in the smokers than in the non-smokers. However, further researches consisted of large-scaled and randomized clinical trials are required to determine whether carotenoids have any other beneficial effect in human. (Korean J Nutrition 38(10): 836$\sim$846,2005)

간호대학생 대상 시뮬레이션 기반 융합실습교육프로그램 개발 및 효과 (Development and Effects of a Simulation-Based Convergence Practicum Education Program for Nursing Seniors)

  • 안민정;조행난;;황윤영
    • 융합정보논문지
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    • 제9권10호
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    • pp.16-27
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    • 2019
  • 본 연구는 간호대학생 대상 시뮬레이션 기반 융합실습교육을 개발하고 그 효과를 파악하기 위하여 시도되었다. 본 연구는 단일군 반복측정 실험설계를 적용하여 수행되었다. G시 소재 대학에 재학중인 총 77명의 간호대학 4학년생에게 시뮬레이션 기반 실습교육 전, 교육 직후 및 교육 2개월 후에 자료를 수집하였고, repeated measure ANOVA 등을 통하여 분석하였다. 분석 결과, 간호술기 지식과 간호술기 수행자신감, 학습 자기효능감 및 임상실습 스트레스는 교육 전 대비 교육 직후와 교육 2개월 후에 유의하게 증진되었으나, 교육 직후와 교육 2개월 후 간에는 유의한 차이가 없었다. 본 연구결과는 시뮬레이션 기반 융합실습교육이 간호대학 4학년생들의 학습 효과를 증가시키고 임상실습 스트레스를 줄이는데 효과적인 전략임을 시사한다. 향후 무작위 대조군 실험연구를 통해 본 교육프로그램의 효과를 확인하는 연구가 필요하다.

Pharmacological and non-pharmacological strategies for preventing postherpetic neuralgia: a systematic review and network meta-analysis

  • Kim, Junhyeok;Kim, Min Kyoung;Choi, Geun Joo;Shin, Hwa Yong;Kim, Beom Gyu;Kang, Hyun
    • The Korean Journal of Pain
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    • 제34권4호
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    • pp.509-533
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    • 2021
  • Background: Postherpetic neuralgia (PHN) is a refractory complication of herpes zoster (HZ). To prevent PHN, various strategies have been aggressively adopted. However, the efficacy of these strategies remains controversial. Therefore, we aimed to estimate the relative efficacy of various strategies used in clinical practice for preventing PHN using a network meta-analysis (NMA). Methods: We performed a systematic and comprehensive search to identify all randomized controlled trials. The primary outcome was the incidence of PHN at 3 months after acute HZ. We performed both frequentist and Bayesian NMA and used the surface under the cumulative ranking curve (SUCRA) values to rank the interventions evaluated. Results: In total, 39 studies were included in the systematic review and NMA. According to the SUCRA value, the incidence of PHN was lower in the order of continuous epidural block with local anesthetics and steroids (EPI-LSE), antiviral agents with subcutaneous injection of local anesthetics and steroids (AV + sLS), antiviral agents with intracutaenous injection of local anesthetics and steroids (AV + iLS) at 3 months after acute HZ. EPI-LSE, AV + sLS and AV + iLS were also effective in preventing PHN at 1 month after acute HZ. And paravertebral block combined with antiviral and antiepileptic agents was effective in preventing PHN at 1, 3, and 6 months. Conclusions: The continuous epidural block with local anesthetics and steroid, antiviral agents with intracutaneous or subcutaneous injection of local anesthetics and a steroid, and paravertebral block combined with antiviral and antiepileptic agents are effective in preventing PHN.

양성 돌발성 두위 현훈에 대한 반하백출천마탕(半夏白朮天麻湯)의 효과 : 체계적 문헌고찰 - CNKI 검색을 중심으로 (The Effect of Banhabaekchulcheonma-tang on Benign Paroxysmal Positional Vertigo: A Systematic Review Using the CNKI Database)

  • 권기현;오서혜;박은수;김미현;홍승효;송금주;박은영
    • 대한한방내과학회지
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    • 제42권4호
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    • pp.572-589
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    • 2021
  • Objectives: This study examines the effect of Banhabaekchulcheonma-tang on Benign Paroxysmal Positional Vertigo (BPPV) through a systematic review of randomized controlled trials (RCTs) in the Chinese National Knowledge Infrastructure Database (CNKI). Methods: RCTs were included that tested the effect of Banhabaekchulcheonma-tang on BPPV. A study of the literature in the CNKI was performed for papers published from January 1, 2011 to June 30, 2021. Results: A total of eight RCTs met the inclusion criteria. All studies identified the effect of Banhabaekchulcheonma-tang in the treatment of BPPV. The effectiveness of treatment was higher in the intervention group than in the control group, as shown through evaluation indicators, including the total effective rate, dizziness handicap inventory (DHI), and blood lipids. Conclusion: Treatment with Banhabaakchulcheonma-tang was found to be effective in treating BPPV. However, due to the low quality of available studies, the significance of this conclusion is somewhat limited. Further clinical studies are needed on the development of diagnosis and treatment methods for BPPV based on Korean medicine.

방아쇠 수지에 대한 한의학적 치료 연구 동향 분석 (An Analysis of the Trends of Korean Medicine Treatments for Trigger Finger)

  • 최재용;이상건;김호;유상준;강동협;이도훈;최기원;이유진
    • 한방재활의학과학회지
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    • 제31권4호
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    • pp.65-74
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    • 2021
  • Objectives The purpose of this review is to analyze the trends of Korean medicine treatment for trigger finger. Methods Clinical papers using Korean medicine to treat trigger finger were searched in five online databases-Koreanstudies Information Service System, Oriental Medicine Advanced Searching Integrated System, ScienceON, Research Information Sharing Service, and PubMed. Nine studies were selected, and we analyzed their characteristics according to the author, year, number/gender/age of patients, duration of disease, duration of treatment, intervention method, measurement methods, and results. Results Seven case report studies, one prospective observational study, and one randomized controlled trials (RCTs) were selected in online databases, and there were no review studies. The most frequently used therapies were pharmacopuncture and acupuncture treatment. visual analogue scale, Quinnell's classification of triggering, was frequently used for measurement methods. All nine studies had therapeutic effects. Conclusions We reviewed studies of Korean medicine treatments for trigger finger, in this study. However, there are limitations that seven of the nine selected papers were case papers, and the number of papers was small. This paper suggests that a higher level of research and more studies on Korean medicine treatments of trigger finger need to be conducted.

Helicobacter pylori infection에 대한 한약과 합성의약품 병용투여 효과에 대한 메타분석 및 체계적 문헌고찰 : PubMED를 중심으로 (Meta-analysis and Systematic Review on the Effects of Herbal Medicine and Synthetic Drugs in Helicobacter pylori Infection: Focusing on PubMED)

  • 정설;곽승연;조은지;정의민
    • 대한본초학회지
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    • 제36권5호
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    • pp.69-79
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    • 2021
  • Objectives : In clinical practice, there are many cases of co-administration of herbal medicine and synthetic drugs. This study tried to identify whether the combined administration of herbal medicine and synthetic drugs including amoxicillin increases Helcicobacter pylori eradication rate compared to the single administration of synthetic drugs or the combined administration of synthetic drugs and placebo herbal medicine through systematic review. Methods : Relevant randomized controlled trials were searched in PubMED database. The risk of biases was assessed through the Cochrane Risk of Bias criteria. Three reviewers were extracted the characteristics and outcomes of each study. Meta-analysis of eradication rate and adverse event was conducted. Results : Four RCTs were selected. In meta-analysis, the combination of herbal medicine and synthetic drugs showed eradication effect, but it was not statistically significant (Odds Ratio [OR] 0.46; 95% confidence interval [CI] 0.17 to 1.24; p=0.13; I2=56%) than administration of synthetic medicine alone. Combination of herbal medicine and synthetic medicine did not increased the incidence of adverse event(OR 1.07; 95% CI 0.72 to 1.59; p=0.68, I2=0%) compared to single administration of synthetic medicine. Conclusion : Although no significant difference was observed between the two groups in the eradication rate and the incidence rate of adverse events, it was difficult to draw a clear conclusion due to the heterogeneity between studies and the low quality of reporting. A number of studies that have overcome these limitations in the future will lead to definite conclusions.

Comparative Efficacy and Safety of Long-acting Injectable and Oral Second-generation Antipsychotics for the Treatment of Schizophrenia: A Systematic Review and Meta-analysis

  • Park, Seon-Cheol;Choi, Mi Young;Choi, Jina;Park, Eunjung;Tchoe, Ha Jin;Suh, Jae Kyung;Kim, Young Hoon;Won, Seung Hee;Chung, Young-Chul;Bae, Kyung-Yeol;Lee, Sang-Kyu;Park, Chan Mi;Lee, Seung-Hwan
    • Clinical Psychopharmacology and Neuroscience
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    • 제16권4호
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    • pp.361-375
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    • 2018
  • We aimed to compare the efficacy and safety of long-acting injectable (LAI) and oral second-generation antipsychotics (SGAs) in treating schizophrenia by performing a systematic review and meta-analysis. MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Library, as well as five Korean databases, were systemically searched to identify studies published from 2000 to 16 April 2015, which compared the efficacy and safety of LAI and oral SGAs. Using data from randomized controlled trials (RCTs), meta-analyses were conducted. In addition, the GRADE (the Grading of Recommendations, Assessment, Development and Evaluation) approach was applied to explicitly assess the quality of the evidence. A total of 30 studies including 17 RCTs and 13 observational studies were selected. The group treated with LAI SGAs was characterized by significantly lower relapse rates, longer times to relapse and fewer hospital days, but also by a higher occurrence of extrapyramidal syndrome and prolactin-related symptoms than that in the group treated with oral SGAs. Our findings demonstrate that there is moderate to high level of evidence suggesting that in the treatment of schizophrenia, LAI SGAs have higher efficacy and are associated with higher rates of extrapyramidal syndrome and prolactin-related symptoms. Additionally, the use of LAI SGAs should be combined with appropriate measures to reduce dopamine $D_2$ antagonism-related symptoms.

유방암 환자의 림프부종에 대한 한의학적 치료 : 체계적 문헌 고찰 (The Effect of Traditional Medicine for Lymphedema in Breast Cancer Patients: A Systematic Review)

  • 박찬란;이가영;손창규;조정효;이남헌
    • 대한한방내과학회지
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    • 제40권3호
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    • pp.343-355
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    • 2019
  • Objectives: Traditional oriental medicine is used in treating breast cancer-related lymphedema to alleviate symptoms. Upper limb lymphedema is a symptom that is frequently observed in patients with breast cancer, and it impairs their quality of life. This systematic review aimed to summarize the current available evidence to evaluate the effect of traditional oriental medicine on upper limb lymphedema in breast cancer patients. Methods: The review evaluated randomized controlled trials (RCTs) measuring the effect of herbal medicine, acupuncture, and moxibustion on upper limb lymphedema in breast cancer patients within four electronic databases. The Cochrane risk of bias (ROB) tool was used to assess the quality of the RCTs. Results: In total, 23 RCTs met the inclusion criteria. Among them, 22 studies reported that the rate of severity of lymphedema improved after treatment in the traditional treatment group using herbal medicine, acupuncture, or moxibustion better than in the conventional medicine group. The methodological quality of the RCTs was insufficient with an unclear and high ROB. Conclusions: Traditional oriental medicine may have a potential to improve lymphedema in patients with breast cancer. To confirm the clinical recommendation, further research with a rigorous study design is required to support the effects of traditional oriental medicine.