• Title/Summary/Keyword: Risk Excluded

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Moxibustion Treatment for Knee Pain: A Systematic Review (슬통의 뜸치료에 대한 체계적 고찰)

  • Kim, Seok Hee;Lee, Kyung Jin;Choi, Yoo Min;Kim, Ju Yong;Yook, Tae Han;Lee, Sang Lyoung;Kim, Jong Uk
    • Journal of Acupuncture Research
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    • v.32 no.3
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    • pp.135-146
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    • 2015
  • Objectives : This study was designed to evaluate clinical evidence of moxibustion treatment for knee pain. Methods : All processes were independently carried out by three investigators. A literature search was performed in 3 databases from their inception to May 2015. Ten reports were found based on their title, abstract and text. Following this, data extraction and analysis were done using a risk of bias(ROB) and through an assessment of multiple systematic reviews(AMSTAR). Results : 10 studies(6RCT, 2SR, 2CR) were included. Generally, indirect moxibustion was used for knee pain, but only one study indicated the use of direct moxibustion. Moxibustion was shown to be effective in treating knee pain, and the number of required treatments was fourteen on average. In assessing risk of bias, indefinite and uncertain information made all included trials subject to a high risk of bias. On the other hand, SR showed all evaluation items in the assessment of multiple systematic reviews, with the exception of an included or excluded studies list. Conclusions : Because of deficient study design or limited research planning, there is not sufficient evidence to allow for any conclusion about the efficacy of moxibustion for knee pain. Therefore, well-designed high quality trials are needed from now on.

A Review of Chuna Manual Therapy for Tension Type Headache: Focusing on Pubmed and Korean Literature (긴장성 두통의 추나치료에 대한 임상 고찰: Pubmed와 국내문헌 중심으로)

  • Kim, Ju-Yong;Kim, Bo-Hyun;Kim, Hye-Bin;Yook, Tae-Han;Kim, Jong-Uk
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.11 no.1
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    • pp.1-10
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    • 2016
  • Objectives : The purpose of this study was to review the effectiveness of Chuna manual therapy for the treatment of tension type headache(TTH). Methods : All processes were independently carried out by three investigators. Literature search was performed in 3 databases(pubmed, OASIS, NDSL) from their inception to May 2016. Searched reports was twice excluded for title, abstract and body. And then, data extract and analysis was done before assessing risk of bias by Cochrane Handbook. Results : 11 RCT were included. Generally, Fascia Chuna therapy and Chuna spine & joint manipulation therapy were used for TTH. Except for 1 report, Chuna manual therapy was shown to be effective in treating TTH. In assessing risk of bias, because of the characteristic of intervention, blinding of participants was high risk of bias in most reports. Conclusions : Chuna manual therapy was shown to be effective in treating TTH. In korea, better designed trials with high quality is needed from now on.

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Asthma-COPD Overlap Syndrome: What We Know and What We Don't

  • Sin, Don D.
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.1
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    • pp.11-20
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    • 2017
  • Approximately one in four patients with chronic obstructive pulmonary disease (COPD) have asthmatic features consisting of wheezing, airway hyper-responsiveness or atopy. The Global initiative for Asthma/Globalinitiative for chronic Obstructive Lung Disease committee recently labelled these patients as having asthma-COPD overlap syndrome or ACOS. ACOS also encompasses patients with asthma, ${\geq}40$ years of age, who have been cigarette smokers (more than 5-10 pack years) or have had significant biomass exposure, and demonstrate persistent airflow limitation defined as a post-bronchodilator forced expiratory volume in 1 second ($FEV_1$)/forced vital capacity of <70%. Data over the past 30 years indicate that patients with ACOS have greater burden of symptoms including dyspnea and cough and show higher risk of COPD exacerbations and hospitalizations than those with pure COPD or pure asthma. Patients with ACOS also have increased risk of rapid $FEV_1$ decline and COPD mortality. Paradoxically, experimental evidence to support therapeutic decisions in ACOS patients is lacking because traditionally, patients with ACOS have been systematically excluded from therapeutic COPD and asthma trials to maintain homogeneity of the study population. In this study, we summarize the current understanding of ACOS, focusing on definitions, epidemiology and patient prognosis.

Clinical Analysis of Risk Factors in Pulmonary Complications after Curative Resection of Esophageal Cancer (식도암의 근치적 식도 절제술 후 폐합병증의 발생에 영향을 미치는 위험인자의 임상적 분석)

  • Choi, Phil Jo;Jeong, Sang Seok
    • Korean Journal of Bronchoesophagology
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    • v.17 no.2
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    • pp.98-103
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    • 2011
  • Purpose Pulmonary complications continue to be the major cause of morbidity and mortality after esophageal resection. The aim of this study was to compare and analyze retrospectively the factors which effect for postoperative pulmonary complications in patients who underwent curative resection for esophageal cancer. Material and Method A total of 118 patients were enrolled in the study from January 1994 to March 2009, and patients with previous neoadjuvant chemotherapy or radiotherapy were excluded. Of the total 118 patients, 27 patients developed pulmonary complications within 30 days of their operation. the factors which effect for postoperative pulmonary complications were compared and analyzed. Results There were 7 patients in-hospital deaths. 51 patients (43.2%) developed complications, and of them, the most common complication was pulmonary complication and occurred in 27 patients (22.9%). In univariate analysis, diabetes mellitus, cervical anastomosis through the retrosternal route, old age and poor lung function were risk factors contributing to postoperative pulmonary complications (p<0.05). In multivariate analysis, statistically significant factor was old age (65 years or older). Conclusion Clinical factor for the pulmonary complications after esophagectomy of esophageal cancer was significantly associated with diabetes mellitus, cervical anastomosis through the retrosternal route, old age (65 years or older) and poor lung function (FEV1<80%). Of these, old age was the most significant factor.

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Spatial and Temporal Analysis of Thunderstorm Wind Gust (뇌우 동반 돌풍의 시공간분포 분석)

  • Lee, Sung Su;Kim, Jun Yeong
    • Spatial Information Research
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    • v.21 no.4
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    • pp.1-6
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    • 2013
  • This study presents the analysis of temporal and spatial distribution of occurrences of wind gust over Korea from 2002 to 2009. The events during typhoons are excluded and the topographical effects on the wind speed are also corrected using KBC (2005). As the results, the frequency of the occurrences is as high as 286 and the higher occurrences appear mainly along the coastal area. This study also shows that the uncertainty of the appearance of wind gust during thunderstorm is much higher than in synoptic wind by comparing wind speed records for both events. This study also found that the spatial distribution of cumulative cloud quotient is closely correlated to that of occurrences of thunderstorm wind gust, which suggests the possible utilization of the cloud quotient as weighting factors in assessing wind gust risk.

Effect of premedication on postoperative pain after root canal therapy in patients with irreversible pulpitis: a systematic review and meta-analysis

  • Kumar, Gaurav;Sangwan, Pankaj;Tewari, Sanjay
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.5
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    • pp.397-411
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    • 2021
  • This systematic review aimed to assess the effect of premedication on postoperative pain after root canal treatment in vital teeth. Five electronic databases were searched for randomized clinical trials, and two independent reviewers selected eligible studies, extracted data, and assessed the quality of studies using the Cochrane Risk of Bias tool. Meta-analysis was conducted using the random-effects model, and the pooled effect estimate of the standardized mean difference (SMD) between premedication and placebo was calculated. Subgroup analysis was conducted based on the class and route of the drug. Studies with a high risk of bias were excluded from the sensitivity analysis. Ten trials satisfied the inclusion criteria, of which eight were included in the meta-analysis. Premedication was more effective in reducing postoperative pain than placebo at 6 hours (SMD = -1.00; 95% confidence interval [CI] = -1.33 to -0.66), 12 hours (SMD = -0.80; 95% CI = -1.05 to -0.56), and 24 hours (SMD = -0.72; 95% CI = -1.02 to -0.43). The results of the sensitivity analysis confirmed the findings of the primary analysis. Based on these results, it can be concluded that premedication is effective in reducing postoperative pain in teeth with irreversible pulpitis. However, additional quality studies are required for further validation.

The Effects of Job Stress, Fatigue, and Health and Safety Services on Health Issues of Male Manufacturing Workers (남자 제조업 근로자의 직무스트레스, 피로도, 안전보건서비스의 경험이 건강문제에 미치는 영향)

  • Choi, Eun-Hi;Jung, Hye-Sun
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.29 no.2
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    • pp.226-235
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    • 2019
  • Objectives: The purpose of this study was to investigate whether there were differences in manufacturing industry worker's health issues depending on job stress, fatigue, and health and safety services. Methods: The purpose of the questionnaire survey and its contents were explained to manufacturing industry health personnel, and the questionnaires were collected from 666 workers from 17 manufacturing workplaces. Questionnaires with missing data were excluded from the analysis so a total of 632 questionnaires were included. Results: Overall, 74.1% of the respondents had experienced health issues during the preceding month. The factors affecting worker health were number of workers(OR=1.000034, p=.013), job demand(OR=1.82, p=.009), MFS(OR=1.85, p=.003), provision of safety & health information(OR=1.85, p=.048), wearing protector(OR=2.58, p=.021). Conclusion: It is necessary to strengthen the safety and health education to mitigate hazardous and risk factors. Employers should provide health managers in charge of safety and health education to control workplace risk factors. In case of small businesses, it may be necessary to strengthen safety and health education in existing worker health centers and government support projects.

Outcomes of Gastrectomy for Gastric Cancer in Patients Aged >80 Years: A Systematic Literature Review and Meta-Analysis

  • Zelalem Chimdesa Merga ;Ji Sung Lee ;Chung-Sik Gong
    • Journal of Gastric Cancer
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    • v.23 no.3
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    • pp.428-450
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    • 2023
  • This meta-analysis examined the surgical management of older patients (>80 years) with gastric cancer, who were often excluded from randomized controlled trials. We analyzed 23 retrospective cohort studies involving 18,372 patients and found that older patients had a higher in-hospital mortality rate (relative risk [RR], 3.23; 95% confidence interval [CI], 1.46-7.17; P<0.01) and more post-operative complications (RR, 1.36; 95% CI, 1.19-1.56; P<0.01) than did younger patients. However, the surgical complications were similar between the two groups. Older patients were more likely to undergo less extensive lymph node dissection and longer hospital stays. Although older patients had statistically significant post-operative medical complications, they were not deprived of surgery for gastric cancer. The comorbidities and potential risks of post-operative complications should be carefully evaluated in older patients, highlighting the importance of careful patient selection. Overall, this meta-analysis provides recommendations for the surgical management of older patients with gastric cancer. Careful patient selection and evaluation of comorbidities should be performed to minimize the risk of post-operative complications in older patients, while recognizing that they should not be deprived of surgery for gastric cancer.

A Study on the Improvement for Port Placement of Response Vessel (방제선 배치 항만의 개선 방안)

  • Jang, Duck-Jong;Kim, Dae-Jin;Kim, Woo-Young
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.23 no.7
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    • pp.810-819
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    • 2017
  • The purpose of this study is to evaluate port use and the distribution of risk factors in 15 major ports in Korea, delineating the risk of each port after classifying the ports into four risk groups based on estimated risks. The placement of response vessels is then analyzed accordingly. Based on the results, danger was estimated to be especially high in ports where large-scale petrochemical facilities are located, such as Yeosu Gwangyang ports (1.85), Ulsan port (1.33) and Daesan port (1.25). The ports showing the next highest degree of danger were Pusan (0.95) and Incheon (0.83), which have significant vessel traffic, followed by Mokpo (0.71) and Jeju (0.49), which expanded their port facilities recently and saw an increase in large vessel traffic. Next is Masan (0.44), for which many fishing permits in the vicinity. When the relative ratios of each port were graded based on the Yeosu Gwangyang Ports, which showed the highest risk values, and risk groups were classified into four levels, the highest risk groups were Yeosu Gwangyang, Ulsan, Daesan and Pusan, with Incheon, Mokpo, Jeju, and Masan following. Pyeongtaek Dangjin, Pohang, Gunsan, and Donghae Mukho were in the mid-range danger group, and the low risk groups were Samcheonpo, Okgye, and Changsungpo. Among these, all response vessel placement ports specified by current law were above the mid-range risk groups. However, we can see that ports newly included in mid-range risk group, such as Mokpo, Jeju, and Donghae Mukho, were excluded from the pollution response vessel placement system. Therefore, to prepare for marine pollution accidents these three ports should be designated as additional response vessel placement ports.

A retrospective analysis of risk factors of oromaxillofacial infection in patients presenting to a hospital emergency ward

  • Park, Jinyoung;Lee, Jae-Yeol;Hwang, Dae-Seok;Kim, Yong-Deok;Shin, Sang-Hun;Kim, Uk-Kyu;Song, Jae-Min
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.49.1-49.8
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    • 2019
  • Background: The purpose of this study was to review the clinical features of oromaxillofacial infections in patients presenting to a hospital emergency ward, to identify the key factors affecting the requirement for hospitalization, and the potential risk factors predisposing to a prolonged length of hospital stay. Methods: A retrospective medical record review of the 598 patients treated for oromaxillofacial infection from 2013 to 2017 at the oral and maxillofacial surgery department, Yangsan Pusan National University Hospital, was conducted. The following information was collected from each patient: sex, age, past medical history, site of infection, etiology, admission or outpatient care, level of C-reactive protein (mg/dL), fascial spaces involved, treatment method, and duration of hospitalization. Chi-squared tests were used to identify risk factors, which were further analyzed using multivariable logistic regression. Results: A total of 606 patients were eligible for inclusion in the study, of which eight were excluded due to having incomplete charts; thus, 598 patients were included: 55% were male, mean patient age was 47.1 ± 19.9 years, and 12.9% of patients were diabetic. Furthermore, 71.2% of patients had infection originating in the mandible; the most common tooth of origin was lower posterior, and 29.8% of patients were hospitalized. Risk factors for hospital admission were elderly patients with concurrent disease, elevated C-reactive protein level, and multiple-space infection in the oromaxillofacial area. The duration of hospitalization was correlated with both diabetes and age. Conclusions: The requirement for hospital admission is determined by the severity of the infection; even severe infections, once treated with appropriate surgery, have no relation to the length of hospital stay. The important risk factors for increased duration of hospitalization are diabetes mellitus and older age. The understanding of risk factors associated with a prolonged hospital stay during the treatment of oromaxillofacial infection will aid in treatment planning as well as highlight the importance of adequate diabetes control in patients at risk of such infection.