• 제목/요약/키워드: Risk Reporting

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COVID-19 방역 지침의 규제 완화 이후 마스크 착용 행위에 대한 심리사회적 요인 (Mask-Wearing Behavior After Deregulation of COVID-19 Quarantine Guidelines)

  • 고준영;박태원;양종철;박종일;권주한;정상근
    • 대한불안의학회지
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    • 제19권2호
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    • pp.61-68
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    • 2023
  • Objective : The purpose of this study was to investigate the associations between psychosocial factors and the mask-wearing behavior after deregulation of COVID-19 quarantine guidelines among adults in Korea. Methods : We collected data (345 subjects) from online questionnaire survey. The questionnaire included the Korean version of the Patient Health Questionnaire-9, the Korean version of fear of COVID-19 Scale, the Korean version of the Patient Health Questionnaire-15, Korean versions of the Perceived Stress Scale, and measurement tools adapted from previous studies for COVID-19 risk perception, social stigma, and appearance interest of subjects. We analysed data using SPSS version 23.0 for descriptive statistics, chi-square test, and logistic regression analysis. Results : People with cohabitant or mask-wearing tendency before COVID-19 pandemic had a higher rate of mask-wearing than those who were not. Subjects reporting higher level of social stigma (OR=1.154, 95% CI 1.049-1.270) and COVID-19 anxiety (OR=1.072, 95% CI 1.007-1.141) were more likely to report maskwearing behavior. Conclusion : From the results, appropriate intervention to those who fear social stigma and are anxious to the infectious diseases will be needed. Additionally, providing policies and guidelines that consider cohabitants and offering continuous education with information of disease to the public are also expected to helpful for recovery of daily life from infectious diseases.

범불안장애의 한약 치료에 관한 체계적 문헌고찰 및 메타분석: 최근 5년 임상연구를 중심으로 (Systematic Review and Meta-Analysis on Herbal Medicine for Generalized Anxiety Disorder: Focusing on Clinical Studies over the Past 5 Years)

  • 김민재;박현섭;권찬영
    • 동의신경정신과학회지
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    • 제34권4호
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    • pp.403-420
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    • 2023
  • Objectives: This study investigated the effectiveness of herbal medicine for generalized anxiety disorder (GAD) based on recent clinical studies. Methods: Studies were searched through four databases. Clinical research studies on herbal medicine treatment for GAD patients were included. The studies were analyzed according to study design, diagnostic criteria, population, and intervention. A risk of bias assessment was performed to assess the quality of the included randomized controlled trials (RCT). If the intervention applied to the treatment and control groups was the same and two or more studies were reporting the same items as outcome indicators, a meta-analysis was performed. Results: A total of 19 studies, including 12 RCTs were selected. The most common pattern identification was 'Phlegm fire disturbing upward' (痰熱上擾), and the most used herb for therapeutic purposes was 'Rhizome of Poria cocos' (茯苓). Meta-analysis results of three studies showed that there were no significant differences in effectiveness between the herbal medicine intervention and the Western medicine intervention. Meta-analysis results of five studies showed that the Hamilton Anxiety Rating Scale was significantly reduced in the case of herbal medicine intervention compared to Western medicine intervention. Conclusions: The results of our study demonstrated that herbal medicine treatment for GAD is effective in alleviating anxiety symptoms and chief symptoms of GAD. However, this study has several limitations; there was a lack of placebo-controlled RCT and an absence of objective diagnostic criteria in case reports. Therefore, further well-designed clinical studies, conducted based on the results of this study, are recommended.

Concordance of Three International Guidelines for Thyroid Nodules Classified by Ultrasonography and Diagnostic Performance of Biopsy Criteria

  • Younghee Yim;Dong Gyu Na;Eun Ju Ha;Jung Hwan Baek;Jin Yong Sung;Ji-hoon Kim;Won-Jin Moon
    • Korean Journal of Radiology
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    • 제21권1호
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    • pp.108-116
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    • 2020
  • Objective: To investigate the concordance of three international guidelines: the Korean Thyroid Association/Korean Society of Thyroid Radiology, American Thyroid Association, and American College of Radiology for thyroid nodules classified by ultrasonography (US) and the diagnostic performance of simulated size criteria for malignant biopsies. Materials and Methods: A total of 2586 thyroid nodules (≥ 1 cm) were collected from two multicenter study datasets. The classifications of the thyroid nodules were based on three different guidelines according to US categories for malignancy risk, and the concordance rate between the different guidelines was calculated for the classified nodules. In addition, the diagnostic performance of criteria related to four different simulated biopsy sizes was evaluated. Results: The concordance rate of nodules classified as high- or intermediate-suspicion was high (84.1-100%), but low-suspicion or mildly-suspicious nodules exhibited relatively low concordance (63.8-83.8%) between the three guidelines. The differences in sensitivity, specificity, and accuracy between the guidelines were 0.7-19.8%, 0-40.9%, and 0.1-30.5%, respectively, when the original biopsy criteria were applied. The differences decreased to 0-5.9%, 0-10.9%, and 0.1-8.2%, respectively, when simulated, similar biopsy size criteria were applied. The unnecessary biopsy rate calculated with the original criteria (0-33.8%), decreased with the simulated biopsy size criteria (0-8.7%). Conclusion: We found a high concordance between the three guidelines for high- or intermediate-suspicion nodules, and the diagnostic performance of the biopsy criteria was approximately equivalent for each simulated size criterion. The difference in diagnostic performance between the three guidelines is mostly influenced by the various size thresholds for biopsies.

성인 혈우병 환자와 운동: 체계적 문헌고찰과 메타분석 (Exercise and adults with hemophilia: a systematic review and meta-analysis)

  • 김두영;전미양;은영;정다인
    • Journal of Korean Biological Nursing Science
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    • 제26권1호
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    • pp.1-15
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    • 2024
  • Purpose: This study aimed to evaluate the effectiveness of exercise in patients with hemophilia. Methods: We carried out a systematic review and meta-analysis in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. A literature search was conducted of published randomized controlled trials for exercise interventions from January 1, 2014 to March 15, 2023. To estimate the size of the effects of exercise, a meta-analysis was performed using the R package "meta." Results: Five databases were searched to obtain articles published in Korean or English. Of 1,150 articles reviewed, 13 were included in the systematic review and 9 in the meta-analysis. The risk of bias was assessed using RoB 2.0. The overall effect sizes of exercise interventions, calculated as the standardized mean difference, were -0.11 (95% confidence interval [CI] = -1.41 to -1.20) for pain, -2.13 (95% CI = -3.33 to -0.93) for joint health, 9.96 (95% CI = 7.51 to 12.28) for physical activity, and 0.59 (95% CI = -0.39 to -1.56) for quality of life. Conclusion: These findings suggest that exercise is useful for improving the joint health and physical activity of patients with hemophilia. Thus, it is necessary to develop and apply exercise interventions for patients with hemophilia to reduce their pain and improve their quality of life.

Cardiovascular Magnetic Resonance Versus Histopathologic Study for Diagnosis of Benign and Malignant Cardiac Tumours: A Systematic Review and Meta-Analysis

  • Sandra Nobrega;Catarina Martins da Costa;Ana Filipa Amador;Sofia Justo;Elisabete Martins
    • Journal of Cardiovascular Imaging
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    • 제31권4호
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    • pp.159-168
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    • 2023
  • BACKGROUND: The gold standard for diagnosis of cardiac tumours is histopathological examination. Cardiovascular magnetic resonance (CMR) is a valuable non-invasive, radiation-free tool for identifying and characterizing cardiac tumours. Our aim is to understand CMR diagnosis of cardiac tumours by distinguishing benign vs. malignant tumours compared to the gold standard. METHODS: A systematic search was performed in the PubMed, Web of Science, and Scopus databases up to December 2022, and the results were reviewed by 2 independent investigators. Studies reporting CMR diagnosis were included in a meta-analysis, and pooled measures were obtained. The risk of bias was assessed using the Quality Assessment Tools from the National Institutes of Health. RESULTS: A total of 2,321 results was obtained; 10 studies were eligible, including one identified by citation search. Eight studies were included in the meta-analysis, which presented a pooled sensitivity of 93% and specificity of 94%, a diagnostic odds ratio of 185, and an area under the curve of 0.98 for CMR diagnosis of benign vs. malignant tumours. Additionally, 4 studies evaluated whether CMR diagnosis of cardiac tumours matched specific histopathological subtypes, with 73.6% achieving the correct diagnosis. CONCLUSIONS: To the best of our knowledge, this is the first published systematic review on CMR diagnosis of cardiac tumours. Compared to histopathological results, the ability to discriminate benign from malignant tumours was good but not outstanding. However, significant heterogeneity may have had an impact on our findings.

Procedural outcomes of laparoscopic caudate lobe resection: A systematic review and meta-analysis

  • Shahab Hajibandeh;Ahmed Kotb;Louis Evans;Emily Sams;Andrew Naguib;Shahin Hajibandeh;Thomas Satyadas
    • 한국간담췌외과학회지
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    • 제27권1호
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    • pp.6-19
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    • 2023
  • A systematic review was conducted in compliance with PRISMA statement standards to identify all studies reporting outcomes of laparoscopic resection of benign or malignant lesions located in caudate lobe of liver. Pooled outcome data were calculated using random-effects models. A total of 196 patients from 12 studies were included. Mean operative time, volume of intraoperative blood loss, and length of hospital stay were 225 minutes (95% confidence interval [CI], 181-269 minutes), 134 mL (95% CI, 85-184 mL), and 7 days (95% CI, 5-9 days), respectively. The pooled risk of need for intraoperative transfusion was 2% (95% CI, 0%-5%). It was 3% (95% CI, 1%-6%) for conversion to open surgery, 6% (95% CI, 0%-19%) for need for intra-abdominal drain, 1% (95% CI, 0%-3%) for postoperative mortality, 2% (95% CI, 0%-4%) for biliary leakage, 2% (95% CI, 0%-4%) for intra-abdominal abscess, 1% (95% CI, 0%-4%) for biliary stenosis, 1% (95% CI, 0%-3%) for postoperative bleeding, 1% (95% CI, 0%-4%) for pancreatic fistula, 2% (95% CI, 1%-5%) for pulmonary complications, 1% (95% CI, 0%-4%) for paralytic ileus, and 1% (95% CI, 0%-4%) for need for reoperation. Although the available evidence is limited, the findings of the current study might be utilized for hypothesis synthesis in future studies. They can be used to inform surgeons and patients about estimated risks of perioperative complications until a higher level of evidence is available.

Neoadjuvant chemoradiotherapy versus immediate surgery for resectable and borderline resectable pancreatic cancer: Meta-analysis and trial sequential analysis of randomized controlled trials

  • Shahab Hajibandeh;Shahin Hajibandeh;Christina Intrator;Karim Hassan;Mantej Sehmbhi;Jigar Shah;Eshan Mazumdar;Ambareen Kausar;Thomas Satyadas
    • 한국간담췌외과학회지
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    • 제27권1호
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    • pp.28-39
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    • 2023
  • We aimed to compare resection and survival outcomes of neoadjuvant chemoradiotherapy (CRT) and immediate surgery in patients with resectable pancreatic cancer (RPC) or borderline resectable pancreatic cancer (BRPC). In compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards, a systematic review of randomized controlled trials (RCTs) was conducted. Random effects modeling was applied to calculate pooled outcome data. Likelihood of type 1 or 2 errors in the meta-analysis model was assessed by trial sequential analysis. A total of 400 patients from four RCTs were included. When RPC and BRPC were analyzed together, neoadjuvant CRT resulted in a higher R0 resection rate (risk ratio [RR]: 1.55, p = 0.004), longer overall survival (mean difference [MD]: 3.75 years, p = 0.009) but lower overall resection rate (RR: 0.83, p = 0.008) compared with immediate surgery. When RPC and BRPC were analyzed separately, neoadjuvant CRT improved R0 resection rate (RR: 3.72, p = 0.004) and overall survival (MD: 6.64, p = 0.004) of patients with BRPC. However, it did not improve R0 resection rate (RR: 1.18, p = 0.13) or overall survival (MD: 0.94, p = 0.57) of patients with RPC. Neoadjuvant CRT might be beneficial for patients with BRPC, but not for patients with RPC. Nevertheless, the best available evidence does not include contemporary chemotherapy regimens. Patients with RPC and those with BRPC should not be combined in the same cohort in future studies.

Pre-exposure Prophylaxis Adherence Among Men Who Have Sex With Men: A Systematic Review and Meta-analysis

  • Suchitra Hudrudchai;Charin Suwanwong;Pitchada Prasittichok;Kanu Priya Mohan;Nopphadol Janeaim
    • Journal of Preventive Medicine and Public Health
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    • 제57권1호
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    • pp.8-17
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    • 2024
  • Objectives: The effectiveness and efficiency of pre-exposure prophylaxis (PrEP) in reducing the transmission of human immunodeficiency virus (HIV) among men who have sex with men (MSM) relies on how widely it is adopted and adhered to, particularly among high-risk groups of MSM. The meta-analysis aimed to collect and analyze existing evidence on various factors related to PrEP adherence in MSM, including demographic characteristics, sexual behaviors, substance use, and psychosocial factors. Methods: The meta-analysis followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search included articles published between January 2018 and December 2022, obtained from the PubMed, ScienceDirect, and Scopus databases. The studies that were included in the analysis reported the proportion of MSM who demonstrated adherence to PrEP and underwent quality appraisal using the Newcastle-Ottawa Scale. Results: Of the 268 studies initially identified, only 12 met the inclusion criteria and were included in the final meta-analysis. The findings indicated that education (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.12 to 2.40), number of sexual partners (OR, 1.16; 95% CI, 1.02 to 1.31), engaging in sexual activities with an human immunodeficiency virus-positive partner (OR, 1.59; 95% CI, 1.16 to 2.26), substance use (OR, 0.83; 95% CI, 0.70 to 0.99), and lower levels of depression (OR, 0.55; 95% CI, 0.37 to 0.82) were associated with higher rates of PrEP adherence among MSM. Conclusions: Despite these findings, further research is necessary to investigate PrEP adherence more comprehensively. The findings of this meta-analysis can be utilized to inform interventions aimed at improving PrEP adherence among MSM and provide directions for future research in this area.

Impact of COVID-19 Infection on Work Functioning in Japanese Workers: A Prospective Cohort Study

  • Makoto Okawara;Keiki Hirashima;Yu Igarashi ;Kosuke Mafune ;Keiji Muramatsu ;Tomohisa Nagata ;Mayumi Tsuji ;Akira Ogami ;Yoshihisa Fujino
    • Safety and Health at Work
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    • 제14권4호
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    • pp.445-450
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    • 2023
  • Background: The impact of COVID-19 infection on workers' work function persists even after the acute phase of the infection. We studied this phenomenon in Japanese workers. Methods: We conducted a one-year prospective cohort study online, starting with a baseline survey in December 2020. We tracked workers without baseline work functioning impairment and incorporated data from 14,421 eligible individuals into the analysis. We estimated the incidence rate ratio for new onset of work functioning impairment due to COVID-19 infection during follow-up, using mixed-effects Poisson regression analysis with robust variance. Results: Participants reporting infection between January and December 2021 showed a significantly higher incidence of new work functioning impairment (adjusted incidence rate ratio: 2.18, 95% confidence interval: 1.75-2.71, p < 0.001). The formality of the recuperation environment correlated with a higher risk of work functioning deterioration in infected individuals (p for trend <0.001). Conclusion: COVID-19-infected workers may continue to experience work difficulties due to persistent, post-acute infection symptoms. Companies and society must urgently provide rehabilitation and social support for people with persistent symptoms, recognizing that COVID-19 is not just a transient acute infection.

적혈구 증가증으로 인한 급성 뇌경색에서 경동맥 혈관벽 자기공명영상 소견: 증례 보고 (Carotid Vessel Wall MRI Findings in Acute Cerebral Infarction Caused by Polycythemia Vera: A Case Report)

  • 박준경;이은자;김동억;이현정
    • 대한영상의학회지
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    • 제83권1호
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    • pp.178-183
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    • 2022
  • 진성적혈구증가증은 드문 골수 증식성 질환이며 제어되지 않은 적혈구 생산으로 인해 절대 적혈구 질량이 증가한다. 진성적혈구증가증은 큰 혈관의 협착 또는 폐색과 함께 허혈성 뇌졸중의 위험이 높다. 진성적혈구증가증 환자에서 뇌경색에 대한 많은 증례 보고가 있다. 그러나 합병증으로 뇌졸중이 발생한 진성적혈구증가증 환자의 좁아진 혈관에서 혈관벽 자기공명영상 소견은 보고되지 않았다. 저자들은 뇌졸중으로 인해 입원한 후 PV로 진단된 30세 남성의 경동맥 VW-MRI 소견에 관해 보고하고자 하며, 이는 우리가 아는 한 영어로 된 첫 번째 보고이다.