• Title/Summary/Keyword: Randomized controlled trials

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Current situation of Translational research on Acupuncture, Moxibustion and Pharmacopuncture (침구와 약침에 대한 중개연구 현황)

  • Sin, Dae Chul;Song, Ho Sueb
    • Journal of Acupuncture Research
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    • v.33 no.2
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    • pp.109-116
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    • 2016
  • Objectives : Our primary objective lies in understanding the current landscape of translational research on acupuncture, moxibustion and pharmacopuncture. Methods : We searched our own selection of keywords of acupuncture, moxibustion and pharmacopuncture and translational research from three overseas databases (Pubmed, Scopus, Medicine) and four domestic databases (DBpia, KISS, Riss4u, Korea Med). Results : We have chosen 41 articles in total-40 articles on acupunture, 6 article on moxibustion(5 articles were duplicated in use in each category). Origin-wise, 48.8 %/24.8 %/17.0 % of our articles pool came from USA/China/Korea, respectively. UK, Austria, Thailand and Italy contributed the rest of our article pool. For those articles written in USA and China, review articles were the most common type. For the US articles, all 10 review articles were non-systematic reviews, while, for China's contribution, one out of 4 review articles were systematic review. Type-wise, our research pool's breakdown is as follows ; 17 review articles, 11 experimental research, 2 randomized controlled trials(RCT), 1 clinical trial, 4 conference reports, 1 letter, 1 study protocol and 4 uncategorized. Topic-wise, brain-neurology was most frequently referred with 8 articles, followed by parkinson's disease (3 articles) and epilepsy (2 articles). Conclusion : 1. In terms of research submission articles, Korea appears to be lacking translational research on acupuncture, moxibustion and pharmacopuncture, compared to USA and China, in our view. 2. Unlike the cases of USA and China, most of Korean translational research is limited to doing a T1 level of translational research. In order to bring bench-to-bedside to light. we believe, there should be more studies, and thereby a certain level of activation, to the T2 level of translational research in Korea. 3. Further, in our view there should be more efforts to improve article quality at the T1 level of translational research, which eventually becomes the fundamentals of the next level of research (i.e. T2 research), as well as to increase the number of research submissions, going forward.

Acupuncture for Lumbar Spinal Stenosis in Korean Literature: a Systematic Review (요추 척추관 협착증에 대한 침구치료의 국내 임상근거: 체계적 문헌고찰)

  • Kim, Kun-Hyung;Noh, Seung-Hee;Lee, Byung-Ryul;Kim, Jae-Kyu;Yang, Gi-Young
    • Journal of Acupuncture Research
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    • v.28 no.6
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    • pp.93-105
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    • 2011
  • Objectives : This study aims to evaluate currently available clinical evidence for the use of acupuncture in patients with lumbar spinal stenosis in the context of Republic of Korea. Methods : Five Korean databases were searched for all clinical studies employing acupuncture for patients with lumbar spinal stenosis. The exceptions were case reports and series involving less than 10 patients from their inception to September 2011. Only studies reported in Korean databases were searched. Results : Five retrospective audits among 22 initially identified studies were eligible for analysis in this review. There was no randomized controlled trial for this topic. The number of patients varied between 15 and 119 in each audit, and all the patients analyzed were inpatients. In all the included studies, acupuncture was conducted in combination with other concomitant treatments, including moxibustion, cupping, herbal remedies, acupoint injection, Chuna, and various physical therapies. All the included audits reported symptomatic and/or functional improvements compared to baseline. None of the included audits indicated whether any adverse events were reported. Conclusions : Current evidence for the use of acupuncture in patients with lumbar spinal stenosis in the context of South Korea is based solely on five retrospective audits that are very likely prone to a high risk of bias. Thus, further prospective and methodologically sound clinical trials to overcome this huge gap between clinical practice and the available evidence for the use of acupuncture in patients with lumbar spinal stenosis are needed.

A Meta-Analysis of the Effects of Exercise Programs on Glucose and Lipid Metabolism and Cardiac Function in Patients with Type II Diabetes Mellitus (제2형 환자를 위한 운동프로그램이 당대사, 지질대사 및 심폐기능에 미치는 효과에 대한 메타분석)

  • Yoo Ji Soo;Lee Suk Jeong
    • Journal of Korean Academy of Nursing
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    • v.35 no.3
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    • pp.546-554
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    • 2005
  • 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.

Stimulation-Oriented Interventions for Behavioral Problems among People with Dementia: A Systematic Review and Meta-Analysis (치매 환자의 문제행동을 위한 자극지향적 중재의 효과 연구: 체계적 고찰과 메타분석)

  • Kim, Eun Young;Hwang, Sung-Dong;Kim, Eun Joo
    • Journal of Korean Academy of Nursing
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    • v.46 no.4
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    • pp.475-489
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    • 2016
  • 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.

Role of Balloon Guide Catheter in Modern Endovascular Thrombectomy

  • 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.

A Meta-Analysis on the Effects of Mind-Body Therapy on Patients with Irritable Bowel Syndrome (심신요법이 과민성 장증후군 환자에 미치는 효과에 대한 메타분석)

  • Choi, Eun Hui;Kim, Moon Ja;Lee, Eun Nam
    • Journal of Korean Academy of Nursing
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    • v.50 no.3
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    • pp.385-400
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    • 2020
  • 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.

The Effect of Korean Medicine Treatments on Facial Asymmetry: A Case Report (안면 비대칭에 대한 한의학적 치료의 효과: 증례보고)

  • Kwon, Chan-Young;Lee, Hoon-Hui;Im, Yong-Seok
    • Korean Journal of Acupuncture
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    • v.34 no.3
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    • pp.179-184
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    • 2017
  • 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.

A Systematic Review of Interventions with Siblings of Pediatric Cancer Patients (소아암 환자의 형제자매 중재에 관한 연구논문의 체계적 문헌고찰)

  • Han, Soo-yeon;Hwang, Ji-Hye;Kim, Cho-hee;Jang, Hye-young;Bang, Kyung-Sook
    • Child Health Nursing Research
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    • v.23 no.3
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    • pp.394-404
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    • 2017
  • 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.

Review of Psychological Treatment for Post-Traumatic Stress Disorder : Focus on Survivors of Disaster (외상후 스트레스 장애에 대한 심리치료 효과 개관 : 재난 생존자를 중심으로)

  • Jang, Eun-Young;Lee, Hyunji;Kim, Daeho
    • Anxiety and mood
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    • v.12 no.2
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    • pp.69-78
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    • 2016
  • 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.

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Effectiveness of Active Warming Intervention for Women Undergoing Cesarean Section: A Systematic Review and Meta-analysis (제왕절개 환자에서 적극적 가온 요법의 효과: 체계적 문헌고찰 및 메타분석)

  • Choi, Jung Eun;Kim, Mee Sun;Song, Jin Ran
    • 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.