• Title/Summary/Keyword: Randomized controlled trials

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Proper Understanding and Application of Gastric Lavage (위세척의 올바른 이해와 적용)

  • Oh, Bum Jin;Roh, Hyung-Keun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.11 no.1
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    • pp.1-8
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    • 2013
  • Gastric lavage is one of gastrointestinal decontamination methods which have been controversial in the clinical toxicology field for a long time. Expert groups of American and European clinical toxicologists have published the position papers regarding gastric lavage three times since 1997. They recommended that gastric lavage should not be used as a routine procedure in the management of acute intoxication, because they thought that there is no certain evidence of improving clinical outcome by its use. However, the studies they reviewed were not well-controlled randomized trials, which cannot be conducted in the clinical toxicology field due to variability of patients and ethical problems. Therefore, the results from these studies should be interpreted with caution. They also insisted that gastric lavage can be undertaken within 60 minutes of ingestion. The limitation of one hour after ingestion is too arbitrary and may cause a lot of misunderstanding. Formation of pharmacobezoar or gastric hypomotility after ingestion may significantly delay the gastric emptying time so that gastric lavage can be useful even after several hours or more in case of highly toxic substances or severe intoxication. Furthermore, as there are a number of serious intoxication by toxic pesticides with large amount in suicidal attempts in Korea, it seems that gastric lavage may be used more frequently in Korea than in Western countries. When deciding whether or not to use gastric lavage, all the indications, contraindications, and possible adverse effects should be taken into account on the basis of risk-benefit analysis. If the procedure is decided to be done, it should only be performed by well-trained experts.

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Intranasal Phototherapy for Allergic Rhinitis : a systematic review (알레르기 비염의 비강 내 광 치료 : 체계적 문헌고찰)

  • Kang, Jeong-In;Min, Kyung-Jin;Lee, Dong-Hyo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.33 no.4
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    • pp.55-73
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    • 2020
  • Objectives : We investigated the effectiveness and safety of intranasal phototherapy for allergic rhinitis (AR). Methods : We searched 8 electronic databases (PubMed, Cochrane Library, CNKI, CiNii Articles, OASIS, NDSL, KISS, KMbase) to identify randomized controlled trials (RCTs) that reported the use of intranasal phototherapy for AR from their inception until May 30, 2020. Two investigators independently searched, collected, and screened the RCTs. We performed data extraction and evaluation for risk of bias using the Cochrane risk-of-bias tool. Results : This study included 12 RCTs; six studies compared intranasal and sham phototherapy, of which four studies reported a significant inter group difference and two studies reported a significant difference partially. No significant changes in symptoms were observed between the phototherapy and conventional therapy groups. The phototherapy and concurrent acupuncture treatment group showed a significantly higher effectiveness rate compared with the group that received only acupuncture. Both the phototherapy and laser acupuncture group showed significant improvement in the symptom severity scale scores. Six studies reported mild adverse effects, such as dryness and nasal pain in the intranasal phototherapy group; however, no severe adverse effects were reported. Conclusions : This study confirmed the safety and effectiveness of intranasal phototherapy for symptom relief and improved quality of life in patients with AR. However, further studies are needed on this topic in order to demonstrate it clearly.

Effects of Korean Red Ginseng on Dry Mouth: A Randomized, Double-Blind, Placebo-Controlled Trial

  • Park, Jae-Woo;Lee, Beom-Joon;Bu, Young-Min;Yeo, In-Kwon;Kim, Jin-Sung;Ryu, Bong-Ha
    • Journal of Ginseng Research
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    • v.34 no.3
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    • pp.183-191
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    • 2010
  • Dry mouth is easily neglected if not associated with oral diseases. Consequently, xerostomatic patients often use unconventional therapies. In traditional Korean medicine, Korean red ginseng (KRG) has long been used to relieve dry mouth. However, no clinical trials have investigated whether KRG actually has an effect on dry mouth. This study was performed to evaluate the efficacy of KRG for dry mouth. We enrolled 100 volunteers with no obvious oral or salivary gland diseases and divided them into KRG and placebo groups. Each group was divided into six subgroups according to age and gender. The subjects received 6 g/day of KRG or placebo for 8 weeks. The dry mouth visual analog scale (VAS), salivary flow rate, and a dry mouth-related symptom questionnaire were evaluated at baseline and at 4 and 8 weeks. KRG treatment did not show any significant differences for any of the variables. However, KRG improved the dry mouth VAS at 4 weeks and dry mouthrelated symptoms at 8 weeks in women, but not in men. Subgroup analyses revealed that KRG markedly improved the dry mouth VAS in women of menopausal age (40 to 59 years) at 4 and 8 weeks. KRG may have beneficial effects for dry mouth in women, especially those of menopausal age, but not in men. Further investigation in post- and perimenopausal women is required to elaborate on these findings.

Clinical and autonomic characteristics in patients with postural tachycardia syndrome (기립빈맥증후군 환자의 임상적 및 자율신경 특성)

  • Kim, Duk Ju;Kang, Sa-Yoon;Kim, Joong Goo
    • Journal of Medicine and Life Science
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    • v.16 no.3
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    • pp.96-100
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    • 2019
  • Postural tachycardia syndrome (POTS) is common, although not so well-known variant of cardiovascular autonomic disorder characterized by an excessive heart rate increase on standing. POTS is probably underdiagnosed due to the heterogeneity in both presentation and etiology. This study aimed to evaluate the clinical and autonomic features in patients with POTS. We reviewed the medical records of patients with POTS. Medical records include onset age, sex, presenting symptoms, body mass index (BMI) and prognosis. All patients had an autonomic function and laboratory tests. Ninety-nine patients met the inclusion criteria for POTS (51.5% male; mean±SD age, 20.0±9.7 years; mean±SD, BMI 21.9±3.9). Common presenting symptoms were a brief loss of consciousness, dizziness, blurred vision and headache. Autonomic function tests showed abnormal quantitative sudomotor axon reflex testing in 20 patients of 99 POTS patients. The abnormal post-ganglionic sympathetic sudomotor function is generally considered to reflect a neuropathic form of POTS. In treatments, 83 patients were treated by non-pharmacological management including lifestyle changes and 16 patients required the initiation of pharmacological therapies. Most patients with POTS showed a relatively favorable prognosis. POTS is a chronic disease with a substantial subset of patients recovering within a few years after the initial presentation. Future efforts should focus on better understanding of POTS pathophysiology and designing randomized controlled trials for the selection of more effective therapy.

Trends in Research Studies Published in Journal of Korean Academy of Fundamentals of Nursing: 2009-2011 (최근 3년간 기본간호학회지 게재 논문 분석)

  • Kim, Kyung-Hee;Chang, Sung-Ok;Kang, Hyun-Sook;Kim, Keum-Soon;Kim, Jong-Im;Kim, Hwa-Soon;Park, Jin-Hee;Eom, Mi-Ran;Won, Jong-Soon;Youn, Mi-Sun;Lee, Og-Cheol
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.19 no.3
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    • pp.383-391
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    • 2012
  • Purpose: The purpose of this study was to identify the trends in research studies published in Journal of Korean Academy of Fundamentals of Nursing from 2009 to 2011. Methods: A total of 156 studies published between 2009 and 2011 were reviewed using analysis criteria developed by the researchers. Results: Quantitative studies accounted for 90.4% and qualitative studies, 8.3%. The research designs for the quantitative studies were experimental, 28.0% and survey, 63.8%. IRB approval was received for only 25.6% of the studies and 61.0% of studies presented participant criteria. Questionnaires were used for data collection in 90.8% of studies. Individual or group education was the most frequent intervention in the experimental studies. Conclusion: The results indicate that more randomized controlled trials with a low risk of bias are needed to support greater evidence-based nursing practice. Considering the low rate of ethical consideration, it is important that stricter application of research methods needs to be encouraged to improve the quality of Journal of Korean Academy of Fundamentals of Nursing.

Current Pharmacogenetic Approach for Oxaliplatin-induced Peripheral Neuropathy among Patients with Colorectal Cancer: A Systematic Review (대장암 환자의 옥살리플라틴(oxaliplatin) 유도 말초신경병증에 대한 약물유전학적 접근: 체계적 문헌고찰)

  • Ahn, Soojung;Choi, Soyoung;Jung, Hye Jeong;Chu, Sang Hui
    • Journal of Korean Biological Nursing Science
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    • v.20 no.2
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    • pp.55-66
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    • 2018
  • Purpose: Peripheral neuropathy is common among colorectal cancer (CRC) patients who undergo oxaliplatin-based (OXL) chemotherapy. A pharmacogenetic approach can be used to identify patients at high-risk of developing severe neuropathy. This type of approach can also help clinicians determine the best treatment option and prevent severe neurotoxicity. The purpose of this study is to investigate the evidence of pharmacogenetic markers for OXL-induced peripheral neuropathy (OXIPN) in patients with CRC. Methods: A systematic literature search was conducted using the following databases up to December 2017: Pubmed, EMBASE, and CINAHL. We reviewed the genetic risk factors for OXIPN in observational studies and randomized controlled clinical trials (RCTs). All processes were performed independently by two reviewers. Results: Sixteen studies published in English between 2006 and 2017 were included in this review. A genome-wide association approach was used in one study and various candidate genes were tested, based on their functions (e.g., DNA damage or repair, ion channels, anti-oxidants, and nerve growth etc.). The genes associated with incidence or severity of OXIPN were ABCG2, GSTP1, XRCC1, TAC1, and ERCC1. Conclusion: This study highlighted the need and the importance of conducting pharmacogenetic studies to generate evidence of personalized OXIPN symptoms management. Additional studies are warranted to accelerate the tailored interventions used for OXIPN in patients with CRC (NRF-2014R1A1A3054386).

Effect of Aerobic Exercise on Serum Lipids, Weight and Body Mass Index in Patients with Hypertension: A Systematic Review and Meta-analysis (유산소 운동이 고혈압 환자의 혈중지질, 체중 및 체질량지수에 미치는 효과: 체계적 문헌고찰 및 메타분석)

  • Chae, Young Ran;Lee, Sun Hee
    • Journal of Korean Biological Nursing Science
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    • v.22 no.1
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    • pp.11-22
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    • 2020
  • Purpose: The purpose of this study was to evaluate the effect of aerobic exercise on serum lipids, body weight, and body mass index in adults with hypertension using a systematic review and meta-analysis. Methods: Six electronic databases (PubMed, EMBASE, Co-chrane library, CINAHL, PsycINFO, SPORTDiscus) and five domestic databases were searched for randomized controlled trials studies. We used random effect models to derive weighted mean differences (WMD) and their 95% confidence intervals (CI) of aerobic exercise on serum lipids, body weight, and body mass index. Results: Nineteen studies met our inclusion criteria. In comparison with the control group, triglyceride level (TG) (-13.49 mg/dL, 95% CI: -26.74 to -0.24) and body weight (-0.62 kg, 95% CI: -1.08 to -0.16) difference between follow-up and baseline was significantly reduced in the aerobic exercise group. However, no difference was found in total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and body mass index (BMI). Conclusion: Aerobic exercise is effective in reducing the TG level and body weight in adults with hypertension. In order to improve levels of serum TC, LDL-C and HDL-C of hypertensive patients, it's needed to combine other intervention methods such as diet therapy.

A Systematic Review Focused on Health Behavior and Physiological Indicators of Diabetic Patients in Interventional Studies Based on Health Belief Model (건강신념모델 기반 중재연구가 당뇨환자의 건강행위와 생리적지표에 미치는 효과를 중심으로 한 체계적 문헌고찰)

  • Noh, Eun-Young;Cho, Yoonjeong;Lee, Yewon;Yun, Sunyoung
    • Journal of Korean Biological Nursing Science
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    • v.22 no.1
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    • pp.1-10
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    • 2020
  • Purpose: Diabetes Mellitus (DM) is a leading cause of death with a prevalence rate of 12.4% in South Korea. Self-management is crucial for patients with DM, because many studies have reported that self-management intervention based on the Health Belief Model (HBM) is effective. The purpose of this study was to investigate the current state of HBM based intervention studies and the components and effects of the theories used in the study for diabetes patients. Methods: A systematic review was conducted using the Pubmed, Cochrane Library and Embase databases from January 2009 to May 2019. We reviewed characteristics of intervention based on the HBM in randomized controlled clinical trials (RCTs), quasi-experimental study intervention. Results: Eight studies published in English between 2009 and 2019 were included in this review. The key components of the health behavior promotion program applied to the DM patients were perceived susceptibility, perceived severity, perceived benefits, perceived barriers and self-efficacy. The intervention based on these components has reported to significantly increase the health behavior change, likelihood of taking health action and improve physiological indicators (HbA1c, and fasting blood sugar etc.). Conclusion: This study highlighted the importance of intervention programs based on the HBM for DM patients.

The Influence of Contract-Relax Exercise of PNF on Equilibrium Ability (PNF의 수축-이완 운동이 균형능력에 미치는 영향)

  • Gong, Won-Tae;Seo, Hyun-Kyu;Kim, Tae-Ho
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.13 no.1
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    • pp.1-9
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    • 2007
  • Purpose: The purpose of this study was to evaluate the The Influence of contract-relax exercise of PNF on Equilibrium Ability. Methods: The subjects were consisted of thirty patients (14 females and 16 males). They were from 20 to 42 years old and the mean age was 25.03. All subjects were randomly assigned to two groups: contract-relax exercise of proprioceptive neuromuscular facilitation(PNF) group (n=15), control group (n=15). Contract-relax exercise group received contract-relax exercise for about 10 minutes along with therapeutic massage for about 15 minutes, 3 times per week during 4 weeks period. However, control group did not receive intervention during the same 4 weeks. The Balance performance monitor(BPM) was used to measure equilibrium ability. All measurements of each subjects were measured at pre-experiment, after 2 weeks, and post-experiment. Results: The results of this study were summarized below : 1. The sway area of contract-relax exercise group was significantly reduced according to within treatment period(p<.05), most significantly reduced between pre-test and post-test(p<.05). Contract-relax exercise group significantly more reduced than control group(p<.05). 2. The sway path length of contract-relax exercise group was significantly reduced according to within treatment period(p<.05), most significantly reduced between pre-test and post-test(p<.05). Contract-relax exercise group significantly more reduced than control group(p<.05). Conclusion : Contract-relax exercise applied with therapeutic massage can increased equilibrium ability. Additional randomized controlled trials to more fully investigate treatment effects and factors that may mediate these effects are needed.

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Literature Review of Catgut-embedding Therapy for Lumbar Disk Herniation (요추 추간판 탈출증의 매선치료에 대한 문헌적 고찰)

  • Park, Sang-Hun;Jeon, Yong-Tae;Han, Kuk-In;Kim, Min-Ji;Lee, Ha-Il;Lee, Jung-Han;Ko, Youn-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.25 no.4
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    • pp.29-40
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    • 2015
  • Objectives We have attempted to provide the basis of treatment effects by considering foreign & domestic randomized controlled trials (RCTs), being implemented with catgut-embedding therapy for lumbar disc herniation. Methods We found the literatures prepared in Korean, English, and Chinese by December 2014 in electronic databases (Pubmed, Science Direct, Proquest, OASIS, KMbase, NDSL, RISS, National Assembly Library). We choosed RCTs by selection criteria through abstracts & articles, extracted and analyzed data. Cochrane's Risk of Bias Tool was used & implemented for the risk of bias. Results The total of 17 studies were included in the review. 88.2% of studies were accomplished within the last decade. The experimental group has shown more significant effects in 70.6% of studies, and the long-term & partial significant results were obtained in 29.4% of studies. Affected lumbar area and pelvic limb area with radiating pain were mostly selected for acupoint. Conclusions Overall and partial significant results were obtained from 17 foreign & domestic comparative RCTs which substantiates the treatment effects of catgut-embedding therapy for lumbar disc herniation. Since all studies, however, were exposed to the risk of bias, so future research of higher quality shall be necessary.