Purpose: This study was a systematic review and meta-analysis of the effects of exercise programs in patients with type II diabetes mellitus. Method: Two investigators systematically searched and reviewed English articles from PUBMED from 1988 to 2004, selecting randomized controlled trials on structured exercise programs for DM patients. Out of 87 studies identified, a meta analysis was done for eleven studies which satisfied inclusion criteria and focused on glycemic indices, lipid indices, and cardiac function indices. Results: The means and standard deviations were compared for experimental groups that received exercise-only or exercise and diet programs and control groups that received no intervention or only diet education. The groups were considered homogeneous as the p value of the Q score in each variable group was over 0.05. The experimental groups demonstrated a moderate positive effect on HbA,c and $VO_{2max}$ (d=0.55 & 0.5), and a small positive effect on fasting blood glucose and cholesterol (d=0.38 & 0.27) compared to the control groups. HDL and LDL cholesterol levels, however, showed a very low positive effect (d=0.11 & 0.12) in the experimental groups. Aerobic exercise was more beneficial than resistance exercise on $HbA_1c$ (d=0.59 vs 0.28) in the groups. Conclusions: Regular exercise has a positive effect on $HbA_1c$, fasting blood glucose, total cholesterol, HDL cholesterol, LDL cholesterol, and $VO_{2max}$ in Type 2 diabetic patients.
Purpose: This study was a systematic review and meta-analysis designed to investigate the effects of stimulation-oriented interventions for behavioral problems among people with dementia. Methods: Based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), a literature search was conducted using seven electronic databases, gray literature, and other sources. Methodological quality was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) for randomized controlled trials (RCTs). Data were analyzed using R with the 'meta' package and the Comprehensive Meta-Analysis (CMA 2.0) program. Results: Sixteen studies were included for meta-analysis to investigate the effect of stimulation-oriented interventions. The quality of individual studies was rated as '++' for eight studies and '+' for the rest. The effect sizes were analyzed according to three subgroups of interventions (light, music, and others); Hedges' g=0.04 (95% CI: -0.38~0.46), -0.23 (95% CI: -0.56~0.10), -0.34 (95% CI: -0.34~0.00), respectively. To explore the possible causes of heterogeneity ($I^2=62.8%$), meta-regression was conducted with covariates of sample size, number of sessions, and length of session (time). No moderating effects were found for sample size or number of sessions, but session time showed a significant effect (Z=1.96, 95% CI: 0.00~0.01). Finally, a funnel plot along with Egger's regression test was performed to check for publication bias, but no significant bias was detected. Conclusion: Based on these findings, stimulation-oriented interventions seem to have a small effect for behavioral problems among people with dementia. Further research is needed to identify optimum time of the interventions for behavioral problems among dementia pateints.
Chueh, Ju-Yu;Kang, Dong-Hun;Kim, Byung Moon;Gounis, Matthew J.
Journal of Korean Neurosurgical Society
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v.63
no.1
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pp.14-25
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2020
Proximal flow control achieved with a balloon guide catheter (BGC) during endovascular treatment of acute ischemic stroke is reviewed in this article. In clinical practice, BGCs offer a multi-faceted approach for clot retrieval by creating proximal flow arrest, reducing embolic burden, and shortening procedure time. Evaluation of frontline thrombectomy procedures with BGCs revealed advantages of combined use over the conventional guide catheter (CGC), notably in the significant reduction of distal emboli to both the affected and previously unaffected territories. Recently, new measures of early and complete reperfusion at first thrombectomy pass have been identified as independent predictors of improved outcomes, which were consistently demonstrated with use of BGC as a safe and effective option to minimize number of passes during intervention. Prior randomized controlled trials reported the positive correlation between BGC-treated patients and a lower risk of mortality as well as shortened procedure time. While BGC use is more common in stent retriever-mediated mechanical thrombectomy, preliminary data has shown the potential benefit of device application during contact aspiration thrombectomy to achieve successful recanalization. However, the question of which major endovascular strategy reigns superior as a frontline remains to be answered. Along with clinical case assessments, BGC performance during in-vitro simulation was analyzed to further understand mechanisms for optimization of thrombectomy technique.
Purpose: Previous randomized controlled trials (RCT) found that mind-body therapy can improve the health outcomes of patients with irritable bowel syndrome (IBS). The purpose of this meta-analysis was to identify the combined effects of mind-body therapy on patients' IBS symptoms, quality of life, anxiety, and depression. Methods: A systematic literature search was conducted using various databases such as PubMed, EMBASE, CINAHL CENTRAL, DBpia, RISS, and KISS. The primary outcome variables were IBS symptoms and quality of life; the secondary outcome variables were anxiety and depression. Comprehensive Meta-Analysis version 3.0 was used to analyze the extracted data. The effect size was calculated using standardized mean difference (SMD) and 95% confidence interval (CI). Results: Eleven final RCTs were used for this meta-analysis. Mind-body therapy was found to have a significant effect on the IBS patients' symptoms (SMD, -0.63; 95% CI, -0.77 to -0.48), quality of life (SMD, 1.03; 95% CI, 0.40 to 1.66), anxiety (SMD, -0.28; 95% CI, -0.47 to -0.09), and depression (SMD, -0.31; 95% CI, -0.06 to -0.12). Conclusion: This meta-analysis reveals that mind-body therapy significantly improves IBS patients' symptoms, quality of life, anxiety, and depression. The results suggest that, in the future, appropriate mind-body therapy should be applied to Koreans suffering from IBS. Moreover, the therapy's long-term effects should be assessed.
Objectives : Despite the applicability of Korean Medicine(KM) treatments for facial asymmetry, no relevant study has been reported. In this case report, we report the effect and safety of KM treatments on facial asymmetry by mandibular lateral displacement. Methods : Three patients suffering from facial asymmetry received twelve KM treatment sessions composed of Motion Style Treatment(MST), Yinyang Balance Appliance(YBA) of Functional Cerebrospinal Therapy(FCST), and Instrument Assisted Soft Tissue Mobilization(IASTM). The photos of each patient were taken before and after the treatment. And four primary reference lines were assessed before and after the treatment. Results : All subjects were improved after KM treatments on photos. However, no statistical significance was observed. Conclusions : This case report is the first to introduce the effect of KM treatments on facial asymmetry. Further well-designed, randomized, placebo-controlled trials are needed to verify these results.
Purpose: The purpose of this study was to review interventions available to nurses caring for siblings of children with cancer. Methods: Searches of CINAHL, MEDLINE, PubMed, EMBASE, and RISS identified ten intervention studies published from January, 2000 to November, 2016. Results: Ten studies on interventions for siblings of pediatric cancer patients were identified as follows: 4 included camps, 4 included support groups, and 2 provided individual interventions. Theoretical frameworks were mainly cognitive behavioral theory and most studies were led by psychologists and multidisciplinary teams. The purpose of the interventions was primarily enhancing psychosocial adjustment. Siblings' fear of disease, self-esteem, and social support were improved significantly after the interventions. Findings were inconsistent with regard to depression, anxiety, behavioral problems, post-traumatic stress, health-related quality of life, and siblings' perceptions of the illness. Conclusion: Study findings showed the potential for enhancing emotional and behavioral outcomes in siblings of children with cancer. However, the number of studies was very small, and several methodological limitations were identified. In the future, more randomized controlled trials with larger samples are needed to extend the evidence base. Moreover, future research should identify sibling's characteristics and circumstances most likely to bring benefits to the siblings.
Objective : Disaster causes psychological distress to a large number of people in a short period of time, by both direct and indirect exposure to traumatic events embedded in various realms of disaster experience. Optimal, well-planned treatment interventions should follow from the early acute period to recovery phase, extending up to several months later. In this context, there is an increasing need for systemic review to gain comprehensive insights for disaster interventions. These need to be added to public policy, and for the prevention and treatment of disaster-related psychopathology. Here, we review the published studies on psychological interventions for disaster-related posttraumatic stress disorder. Methods : Specific psychological interventions regarded as effective treatments for have been selected for this review, such as CBT (Cognitive-Behavior Therapy), Exposure Therapy, EMDR (Eye Movement Desensitization & Reprocessing), SIT (Stress Inoculation Therapy) and Psychoeducation. In addition, natural disasters, industrial disasters, and accidents involving aircraft and ships were also categorized as disasters, along with war and combat trauma. Results : Cognitive behavior therapy and exposure therapy had the strongest research support for effectiveness, and could be considered as the first-choice treatment for disaster-related PTSD. The second line of treatment is EMDR, although this treatment modality has the advantage of reaching certain treatment improvements in fewer sessions. However, the effects of SIT and psychoeducation to the survivors of disasters, remains unclear at this point. Additionally, we propose the possibilities of using virtual reality component and imagery rescripting as modified forms of traditional cognitive behavior therapy and exposure therapy. Conclusion : Cognitive behavior therapy and exposure therapy, deemed effective treatments for various trauma, are considered to be effective for survivors from disasters. However, the efficacy of other interventions has not yet been examined methodologically in well-designed studies, such as randomized controlled trials. In particular, future empirical studies are needed, since it is difficult to conclude that psychological interventions have similar effects on different types of disasters.
Journal of Korean Academy of Fundamentals of Nursing
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v.24
no.3
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pp.167-180
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2017
Purpose: The aim of this study was to synthesize the best available evidence for active warming interventions during cesarean section. Methods: A database search was done for randomized controlled trials utilizing active warming interventions. Maternal temperature, shivering and neonatal temperature were evaluated as outcome variables. Data were analyzed using Cochrane Review Manager software Version 5.3. Results: Thirteen studies including 1306 patients were reviewed. The degree of lowering of maternal temperature decreased in the warmed fluids (MD 0.51; p=.004) and warming mattress interventions (MD 0.22; p<.001) compared with control groups. Incidence of shivering was also lower in the active warming group (OR 0.55; p=.003). There was no statistically significant difference in maternal temperature with a forced air warming intervention (MD 0.64; p=.15) or in neonatal temperature (MD 0.12; p=.26). Conclusion: Findings show that with warmed fluids and warming mattresses applied during cesarean sections maternal temperature decline was reduced and also the incidence of shivering declined, but no significant effect was observed for forced air warming interventions. These findings provide a basis for developing a warming guideline for women having a cesarean section and will help to improve the quality of care for cesarean section patients.
Objectives: The purpose of this study was to examine clinical studies on the treatment of dysmenorrhea treatments and analyze the results to provide sufficient evidence to provide adequate evidence of the efficacy of the ear-acupuncture treatment on dysmenorrhea patients. Methods: The search for foreign papers used 'Pubmed', a research engine in the America National Library of Medicine. Used searching terms were 'dysmenorrhea' and 'menstrual pain' in all cases. And among these studies, we searched by using key word 'auricular acupuncture' or 'ear acupuncture' or 'auricular acupressure' or 'ear acupressure'. Results: Overall 53 studies, 7 studies were finally selected to this study. There was 1 controlled study, 3 clinical trials, and 3 randomized-control studies. About acupoints in study, the endocrine was used in all 7 papers. Internal genitals, shenmen, sympathesis, kidney, liver were used in 4 papers, central rim, hypo-cortex, uterus were used in 2 papers, central of cymba auriculae was used in 2 paper. In 4 papers, the effect of ear acupuncture treatment was effective in relieving menstrual pain. Moreover, we can see that ear acupuncture therapy was effective in reducing menstrual pain than in oriental herb medicine. Conclusions: As a result of the 7 papers, we found that patients with menstrual pain decreased after ear acupuncture therapy. However, there was little research and it was limited to achieving the results of the analysis. A vigorous clinical study should be conducted to demonstrate the efficacy of ear acupuncture therapy and standardize treatment methods.
Objectives: The purpose of this study was to evaluate the clinical effect of Korean medical treatments such as herbal medicine, acupuncture, and electroacupuncture by using the portable gas chromatograph OralChroma$^{TM}$ (Abimedical, Japan) in halitosis patients. Methods: We surveyed 30 halitosis patients who had visited the Oral Diseases Clinic in the Korean Medical Hospital of Kyunghee University from October, 2013 to November, 2014. Before starting Korean medical treatment, the subjects were evaluated on sociodemographic characteristics, severity of discomfort using visual analogue scale (VAS), unstimulated salivary flow rate (USFR), and halitosis associated life-quality test (HALT) score. To evaluate the therapeutic effect, we measured the volatile sulfur compounds (VSCs) in breath by using OralChroma$^{TM}$ before and after 3 weeks treatment. Results: The concentration of total VSCs measured by OralChroma$^{TM}$ significantly decreased (p=0.001). Furthermore, the level of hydrogen sulfide and methyl mercaptan also significantly decreased (p<0.05). However, although the level of dimethyl sulfide decreased as well, there was no significance(p>0.05). Conclusions: Korean medical treatment was effective in treating halitosis by decreasing VSCs. Further study, with well-designed randomized controlled trials with larger number of cases will be needed in the future.
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