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Analysis of the Effects on the Level of Pain and Functional Improvement After Integrated Korean Medicine in Patients with Shoulder Impingement Syndrome: A Retrospective Chart Review

  • Kim, Eun-song;Woo, Jae-hyuk;Lee, Hyo-eun;Lee, Hyun-seok;Lee, Soo-kyeong;Lee, Yoon-jung;Jin, So-ri
    • Journal of Acupuncture Research
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    • v.39 no.3
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    • pp.213-221
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    • 2022
  • Background: This study investigated the clinical effectiveness of Korean medicine (KM) treatment for shoulder impingement syndrome (SIS). Methods: There were 61 patients who were diagnosed with SIS in the Jaseng hospital network of KM (7 hospitals located in Korea: Gangnam, Daejeon, Bucheon, Haeundae, Bundang, Ulsan, and Gwangju) between January 1st, 2015 and December 31st, 2020 who were retrospectively reviewed. The patients were grouped according to complications, intake of analgesics, duration of illness preadmission, and treatment. Treatments consisted of herbal medicine, acupuncture, cupping, Chuna, pharmacopuncture, bee venom pharmacopuncture, medicinal steaming, Daoyin exercises, and physical therapy. By comparing the Numeric Rating Scale (NRS), Shoulder Pain and Disability Index, and European Quality of Life 5-Dimensions questionnaire scores, the effectiveness of integrated KM treatment was evaluated. Results: There were 14 males and 47 females. For inpatients diagnosed with SIS, the mean NRS score decreased from 5.78 ± 1.33 to 3.40 ± 1.43 (p < 0.001). The mean Shoulder Pain and Disability Index score decreased from 53.87 ± 14.76 to 38.56 ± 18.87 (p < 0.001), and the mean European Quality of Life 5-Dimensions questionnaire increased from 0.67 ± 0.13 to 0.76 ± 0.09 (p < 0.001) after KM treatment. Medicinal steaming (0.398; p < 0.001), acupuncture (0.290), cupping (0.288), bee venom pharmacopuncture (0.282), and Daoyin exercises (0.262; p < 0.05) had a positive correlation with improved changes in the NRS score. Conclusion: Conclusion: Treatment with integrated KM treatment improved the pain, range of motion, shoulder function, and quality of life of patients with SIS.

Clinical effectiveness of different types of bone-anchored maxillary protraction devices for skeletal Class III malocclusion: Systematic review and network meta-analysis

  • Wang, Jiangwei;Yang, Yingying;Wang, Yingxue;Zhang, Lu;Ji, Wei;Hong, Zheng;Zhang, Linkun
    • The korean journal of orthodontics
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    • v.52 no.5
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    • pp.313-323
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    • 2022
  • Objective: This study aimed to estimate the clinical effects of different types of bone-anchored maxillary protraction devices by using a network meta-analysis. Methods: We searched seven databases for randomized and controlled clinical trials that compared bone-anchored maxillary protraction with tooth-anchored maxillary protraction interventions or untreated groups up to May 2021. After literature selection, data extraction, and quality assessment, we calculated the mean differences, 95% confidence intervals, and surface under the cumulative ranking scores of eleven indicators. Statistical analysis was performed using R statistical software with the GeMTC package based on the Bayesian framework. Results: Six interventions and 667 patients were involved in 18 studies. In comparison with the tooth-anchored groups, the bone-anchored groups showed significantly more increases in Sella-Nasion-Subspinale (°), Subspinale-Nasion-Supramentale(°) and significantly fewer increases in mandibular plane angle and the labial proclination angle of upper incisors. In comparison with the control group, Sella-Nasion-Supramentale(°) decreased without any statistical significance in all treated groups. IMPA (angle of lower incisors and mandibular plane) decreased in groups with facemasks and increased in other groups. Conclusions: Bone-anchored maxillary protraction can promote greater maxillary forward movement and correct the Class III intermaxillary relationship better, in addition to showing less clockwise rotation of mandible and labial proclination of upper incisors. However, strengthening anchorage could not inhibit mandibular growth better and the lingual inclination of lower incisors caused by the treatment is related to the use of a facemask.

A Systematic Review and Meta-Analysis on the Effect of Guibi-tang for Postpartum Depression (산후우울증에서 귀비탕(歸脾湯)의 임상효과에 대한 체계적 문헌 고찰 및 메타분석)

  • Eun-Sol Kang;Young-Tae Ahn;Hyo-Jeong Kim;Ji-Soo Hyun;Jin-Young Kang;Yoon-Jae Lee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.36 no.2
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    • pp.55-68
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    • 2023
  • Objectives: The purpose of this study is to analyze the effectiveness of Guibi-tang that are used for postpartum depression. Methods: We searched on five databases [Korean studies Information Service (KISS), Oriental medicine advanced searching integrated system (OASIS), The Cochrane Library, PubMed, and China national knowledge infrastructure (CNKI)] with keywords for Postpartum depression (English, Korean, and Chinese) and evaluated the risk of bias. Meta-analysis was performed on the selected studies. Results: 8 potentially relevant articles were retrieved for further evaluation. There was evidence that Guibi-tang compared with Western medicine was significantly higher rate in total effect rate (RR 1.20, 95% CI 1.04, 1.39, p=0.01). Also, the combined therapeutic effects of Guibi-tang and Psychological intervention compared with Psychological intervention were statistically significant in total effect rate (RR 1.14, 95% CI 1.05, 1.24, p=0.002). And they showed improvement on scores of HAMD (Hamilton depression scale, HAMD) and SF-36 (36-Item short form health survey, SF-36). Conclusion: Guibi-tang appears to be more effective compared to Western medicine in the treatment of postpartum depression. The combination Guibi-tang and Psychological intervention was more effective than psychological intervention alone treated for postpartum depression. However, since unclear risk of bias, the result of this study should be considered carefully. Further clinical trials should be carried out in order to academical clinical progress regarding treatment of Postpartum Depression.

Effect of Complex Korean Medical Treatment on Tic Disorder in Children Who Visited the Neuropsychiatric Clinic of Korean Medicine: A Retrospective Chart Review (한의원에 내원한 틱장애 아동 환자의 한의복합치료 후 개선 효과: 후향적 관찰 연구)

  • Dong-Hee Kim;Yu-Min Choi;Jong-Ho Yoo
    • Journal of Oriental Neuropsychiatry
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    • v.34 no.2
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    • pp.61-69
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    • 2023
  • Objectives: To examine the effect of complex Korean medical treatment on tic disorder in children who visited the neuropsychiatric clinic of Korean medicine. Methods: Medical records of 35 patients diagnosed with tic disorder based on DSM-V who received complex Korean medical treatment (herbal medicine, acupuncture and Korean psychotherapy) were reviewed. Tic disorder was then evaluated by Yale Global Tic Severity Scale (YGTSS) before and at 4, 8, and 12 weeks after treatment to determine whether their symptoms were improved. Results: 1) After the treatment, mean YGTSS was reduced from 35.54±14.77 to 23.20±12.65. There were statistically significant changes between scores according to the time of treatment (p< 0.05). 2) At the time of visit, symptoms of motor tics were in the order of eyes, neck and shoulders, mouth, head and arms & hands, nose, face, upper body and other parts, and legs and symptoms of vocal tics were in the order of sniffing, dry coughing and MMM, AA and whistling, and other sounds. 3) For 35 patients, herbal medicine was prescribed every two weeks. The frequency of prescriptions used was in the order of Shihogayonggolmoryo-tang, Gami-ondam-tang, and others. 4) The frequency of herbs used in 35 patients was in the order of Poria, Zingiberis Rhizoma Recens, Pinelliae Rhizoma and Scutellariae Radix, Bupleuri Radix, Ostreae Concha and Bovis Ossis Fossilia, and others. Conclusions: Complex Korean medical treatment including herbal medicine, acupuncture, and Korean psychotherapy is effective for reducing tic symptoms in children.

Usefulness of a 1,064 nm Microlens Array-type, Picosecond-dominant Laser for Pigmented Scars with Improvement of Vancouver Scar Scale

  • Ahn, Kwang Hyeon;Park, Eun Soo;Nam, Seung Min
    • Medical Lasers
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    • v.8 no.1
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    • pp.19-23
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    • 2019
  • Background and Objectives The picosecond 755 nm alexandrite laser was first approved by the US FDA in 2012. A previous study described the use of a 1,064 nm picosecond laser with a micro-lens array (MLA) in peri-areolar scarring from breast reconstruction surgery and reported significant improvement in the texture and aesthetic appearance of the scar without other wound complications. The purpose of this study was to evaluate the improvement of overall scarring, not just pigmentation, in the picosecond laser treatment of patients with pigmentations. Materials and Methods Sixteen patients who underwent 1,064 nm picosecond laser treatment from June 2016 to December 2018 were enrolled in this study. Patients received two to six sessions of picosecond laser treatment at intervals of 4 weeks. Before and after the laser treatment, the patients evaluated their own satisfaction score and a physician evaluated the Vancouver Scar Scale. To evaluate the satisfaction score and complication rate, a retrospective chart review was done. Results Seven were female and nine were male. The mean of the patients' satisfaction score before the treatment was 1.44 (interquartile range [IQR], 1-2) and 3.00 (IQR 2.25-3.75) six months after treatment. The mean of the Vancouver Scar Scale before the treatment was 9.69 (IQR 8-11), and 6.25 (IQR 5-7.75) six months after treatment. All the results were statistically significant (p<0.01). Conclusion This study provides evidence that the use of a 1,064 nm picosecond laser treatment for pigmented scars can be effective in improving the pigmentation and overall scar status, including vascularity, height, and pliability, with the results of a decrease in the VSS scores between treatments.

Development of Competencies for New Nurses and Verification of Content Validity through a Delphi Survey (델파이조사를 통한 신규간호사 역량 도출 및 내용타당도 검증)

  • Hanna Jung;Yoonjung Lee;Jung Yeon Kim;Minjin Lee;Soo Young Han;Yumie Rhee;Shinki An;Phill Ja Kim
    • Korean Medical Education Review
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    • v.25 no.2
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    • pp.159-173
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    • 2023
  • The purpose of this study was to develop and validate a competency tool for new nurses and to pilot-test it with new nurses. A Delphi survey was conducted to develop a competency tool, and a self-evaluation was conducted among new nurses who pilot-tested the finally derived competencies. The Delphi survey panel consisted of 18 people, including adjunct professors at the College of Nursing, nursing managers, and nurses with master's degrees. The Delphi survey asked about the validity of the competencies constructed in two rounds. After analyzing the Delphi results with mean, standard deviation, content validity ratio, degrees of convergence, and degrees of consensus, 12 core competencies and 36 enabling competencies were finally derived. The competencies consisted of clinical judgment and management (nine items), task competence (four items), patient orientation (five items), moral value orientation (three items), cooperation (two items), supply management (two items), professional development (three items), confidence (one item), self-control (two items), flexibility (two items), influence (one item), and nurturing others (two items). The finally derived competencies were pilot-tested with 229 new nurses who had worked for 2-12 months. The self-evaluation scores of new nurses were distributed differently according to their working period. In this study, the competencies required for new nurses were identified and the corresponding enabling competencies were identified. In the future, it is expected that a competency-based education program will be prepared based on these findings, and furthermore, it will be possible to provide high-quality medical and nursing services that meet patients' needs by improving the competency of new nurses and lowering the turnover rate.

Effects of Employment Stress on Depression and Self-Esteem of Health Students (보건 계열 대학생의 취업 스트레스가 우울과 자아존중감에 미치는 영향)

  • Dae-Hee Lee;Cheul Jang
    • Journal of The Korean Society of Integrative Medicine
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    • v.12 no.1
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    • pp.41-48
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    • 2024
  • Purpose : This study aims to understand the effects of job-seeking stress on depression and self-esteem in college students majoring in health science. Methods : In this study, in order to measure college students' employment stress, depression, self-esteem, and social support, a measurement tool was used by modifying and supplementing the questionnaire to suit the purpose and method of this study. The subjects, 210 students (46 men and 164 women) enrolled in colleges located in Busan, had their scores on the Beck depression inventory (BDI), job-seeking stress scale, and self-esteem scale measured. Results : There was a positive correlation between all sub-variables of employment stress, and a negative correlation between employment stress and self-esteem. Additionally, a positive correlation was found between employment stress and depression, and a negative correlation was found between self-esteem and depression. The result taken from the job-stress scale showed that women experienced an overall higher level of stress than men while seeking jobs. Furthermore, in terms of the BDI, men exhibited a higher level of depression than women when subjected to job-seeking stress. Finally, the results from the self-esteem scale reveal that men exhibited less self-esteem than women. Conclusion : A comprehensive review of the study's findings suggested that women had greater job-seeking stress than men. Additionally, it found that, for men, job-seeking stress had a greater impact on depression levels and self-esteem. These results suggest that a higher level of job-seeking stress may lead to higher levels of depression and lower levels of self-esteem. It will be useful to conduct follow-up research by operating self-esteem and depression programs.

Donor-Site Morbidity Analysis of Thenar and Hypothenar Flap

  • Dong Chul Lee;Ho Hyung Lee;Sung Hoon Koh;Jin Soo Kim;Si Young Roh;Kyung Jin Lee
    • Archives of Plastic Surgery
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    • v.51 no.1
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    • pp.94-101
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    • 2024
  • Background For the small glabrous skin defect, Thenar and Hypothenar skin are useful donors and they have been used as a free flap. Because of similar skin characteristics, both flaps have same indications. We will conduct comparative study for the donor morbidity of the Free thenar flap and Hypothenar free flap. Methods From January 2011 to December 2021, demographic data, characteristics of each flap, and complications using retrospective chart review were obtained. Donor outcomes of the patient, who had been followed up for more than 6 months, were measured using photographic analysis and physical examination. General pain was assessed by Numeric Rating Scale (NRS) score, neuropathic pain was assessed by Douleur Neuropathique 4 Questions (DN4) score, scar appearance was assessed by modified Vancouver Scar Scale (mVSS), and patient satisfaction was assessed on a 3-point scale. Statistical analysis was performed on the outcomes. Results Out of the 39 survey respondents, 17 patients received Free thenar flaps, and 22 patients received Hypothenar free flaps. Thenar group had higher NRS, DN4, and mVSS (p < 0.05). The average scores for the Thenar and Hypothenar groups were 1.35 and 0.27 for NRS, 2.41 and 0.55 for DN4, and 3.12 and 1.59 for mVSS, respectively. Despite the Hypothenar group showing greater satisfaction on the 3-point scale (1.82) compared with the Thenar group (1.47), the difference was not significant (p = 0.085). Linear regression analysis indicated that flap width did not have a notable impact on the outcome measures, and multiple linear regression analysis revealed no significant interaction between flap width and each of the outcome measures. Conclusion Despite the limited number of participants, higher donor morbidity in general pain, neuropathic pain, and scar formation was noted in the Thenar free flap compared with the Hypothenar free flap. However, no difference in overall patient satisfaction was found between the two groups.

Midterm outcomes of suture anchor fixation for displaced olecranon fractures

  • Michael J. Gutman;Jacob M. Kirsch;Jonathan Koa;Mohamad Y. Fares;Joseph A. Abboud
    • Clinics in Shoulder and Elbow
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    • v.27 no.1
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    • pp.39-44
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    • 2024
  • Background: Displaced olecranon fractures constitute a challenging problem for elbow surgeons. The purpose of this study is to evaluate the role of suture anchor fixation for treating patients with displaced olecranon fractures. Methods: A retrospective review was performed for all consecutive patients with displaced olecranon fractures treated with suture anchor fixation with at least 2 years of clinical follow-up. Surgical repair was performed acutely in all cases with nonmetallic suture anchors in a double-row configuration utilizing suture augmentation via the triceps tendon. Osseous union and perioperative complications were uniformly assessed. Results: Suture anchor fixation was performed on 17 patients with displaced olecranon fractures. Functional outcome scores were collected from 12 patients (70.6%). The mean age at the time of surgery was 65.6 years, and the mean follow-up was 5.6 years. Sixteen of 17 patients (94%) achieved osseous union in an acceptable position. No hardware-related complications or fixation failure occurred. Mean postoperative shortened disabilities of the arm, shoulder, and hand (QuickDASH) score was 3.8±6.9, and mean Oxford Elbow Score was 47.5±1.0, with nine patients (75%) achieving a perfect score. Conclusions: Suture anchor fixation of displaced olecranon fractures resulted in excellent midterm functional outcomes. Additionally, this technique resulted in high rates of osseous union without any hardware-related complications or fixation failures.

Anatomic total shoulder arthroplasty with a nonspherical humeral head and inlay glenoid: 90-day complication profile in the inpatient versus outpatient setting

  • Andrew D. Posner;Michael C. Kuna;Jeremy D. Carroll;Eric M. Perloff;Matthew J. Anderson;Ian D. Hutchinson;Joseph P. Zimmerman
    • Clinics in Shoulder and Elbow
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    • v.26 no.4
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    • pp.380-389
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    • 2023
  • Background: Total shoulder arthroplasty (TSA) with a nonspherical humeral head component and inlay glenoid is a successful bone-preserving treatment for glenohumeral arthritis. This study aimed to describe the 90-day complication profile of TSA with this prosthesis and compare major and minor complication and readmission rates between inpatient- and outpatient-procedure patients. Methods: A retrospective review was performed of a consecutive cohort of patients undergoing TSA with a nonspherical humeral head and inlay glenoid in the inpatient and outpatient settings by a single surgeon between 2017 and 2022. Age, sex, body mass index, American Society of Anesthesiologists (ASA) score, Charlson Comorbidity Index (CCI), and 90-day complication and readmission rates were compared between inpatient and outpatient groups. Results: One hundred eighteen TSAs in 111 patients were identified. Mean age was 64.9 years (range, 39-90) and 65% of patients were male. Ninety-four (80%) and 24 (20%) patients underwent outpatient and inpatient procedures, respectively. Four complications (3.4%) were recorded: axillary nerve stretch injury, isolated ipsilateral arm deep venous thrombosis (DVT), ipsilateral arm DVT with pulmonary embolism requiring readmission, and gastrointestinal bleed requiring readmission. There were no reoperations or other complications. Outpatients were younger with lower ASA and CCI scores than inpatients; however, there was no difference in complications (1/24 vs. 3/94, P=1.00) or readmissions (1/24 vs. 1/94, P=0.37) between these two groups. Conclusions: TSA with a nonspherical humeral head and inlay glenoid can be performed safely in both inpatient and outpatient settings. Rates of early complications and readmissions were low with no difference according to surgical setting. Level of evidence: IV.