• Title/Summary/Keyword: Short-term trials

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Comparison of the Clinical Outcomes of Reconstruction Methods After Distal Gastrectomy: A Systematic Review and Meta-Analysis Based on Randomized Controlled Trials

  • Min, Jae-Seok;Kim, Rock Bum;Seo, Kyung Won;Jeong, Sang-Ho
    • Journal of Gastric Cancer
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    • v.22 no.2
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    • pp.83-93
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    • 2022
  • Background: To analyze the short- and long-term clinical outcomes of 2 reconstruction methods after distal gastrectomy for gastric cancer. Methods: Three keywords, "gastric neoplasm," "distal gastrectomy," and "reconstruction," were used to search PubMed. We selected only randomized controlled trial that compared the anastomosis methods. A total of 11 papers and 8 studies were included in this meta-analysis. All statistical analyses were performed using the R software. Results: Among short-term clinical outcomes, a shorter operation time, reduced morbidity, and shorter hospital stay were found for Billroth type I (B-I) than for Roux-en-Y (RNY) reconstruction in the meta-analysis (P<0.001, P=0.048, P<0.001, respectively). When comparing Billroth type II (B-II) to RNY, the operation time was shorter for B-II than for RNY (P<0.019), but there were no differences in morbidity or length of hospital stay (P=0.500, P=0.259, respectively).Regarding long-term clinical outcomes related to reflux, there were significantly fewer incidents of reflux esophagitis, reflux gastritis, and bile reflux (P=0.035, P<0.001, P=0.019, respectively) for RNY than for B-I in the meta-analysis, but there was no difference between the 2 methods in residual food (P=0.545). When comparing B-II to RNY, there were significantly fewer incidents of reflux gastritis (P<0.001) for RNY than for B-II, but the amount of residual food and patient weight gain showed no difference. Conclusion: B-I had the most favorable short-term outcomes, but RNY was more advantageous for long-term outcomes than for other methods. Surgeons should be aware of the advantages and disadvantages of each type of anastomosis and select the appropriate method.

Laparoscopic Versus Open Surgery for Rectal Cancer: A Systematic Review and Meta-analysis of Randomized Controlled Trials

  • Zhang, Feng-Wa;Zhou, Zhao-Yu;Wang, Hai-Lin;Zhang, Jv-Xia;Di, Bao-Shan;Huang, Wen-Hui;Yang, Ke-Hu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9985-9996
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    • 2014
  • Background and Aim: Laparoscopic and open rectum surgery for rectal cancer remains controversial. This systematic review compared the short-term and long-term efficiency and complications associated with laparoscopic and open resection for rectal cancer. Materials and Methods: We searched PubMed, Embase, Cochrane Library, ISI Web of Knowledge and the China Biology Medicine Database to identify potential randomized controlled trials from their inception to March 31, 2014 without language restriction. Additional articles were identified from searching bibliographies of retrieved articles. Two reviewers independently assessed the full-text articles according to the pre-specified inclusion and exclusion criteria as well as the methodological quality of included trials. The meta-analysis was performed using RevMan 5.2. Results: A total of 16 randomized controlled trials involving 3,045 participants (laparoscopic group, 1,804 cases; open group, 1,241 cases) were reviewed. Laparoscopic surgery was associated with significantly lower intraoperative blood loss, earlier return of bowel movement and reduced length of hospital stay as compared to open surgery, although with increased operative time. It also showed an obvious advantage for minimizing late complications of adhesion-related bowel obstruction. Importantly, there were no significant differences in other postoperative complications, oncological clearance, 3-year and 5-year or 10 year recurrence and survival rates between two procedures. Conclusions: On the basis of this meta-analysis we conclude that laparoscopic surgery has advantages of earlier postoperative recovery, less blood loss and lower rates of adhesion-related bowel obstruction. In addition, oncological outcome is comparable after laparoscopic and open resection for rectal cancer.

Meta-analysis of the Efficacy of Infliximab in Patients with Moderate-Severe Ulcerative Colitis (중등도-중증 궤양성 대장염 환자에서 infliximab의 치료효과에 대한 메타분석)

  • Kim, Jong Yoon;Lee, Sukhyang;Rhew, Ki Yon
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.3
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    • pp.251-259
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    • 2012
  • Ulcerative colitis (UC) is characterized by a life-long chronic course with remissions and exacerbations. Use of biological therapies may reduce or delay the surgical procedures in patients with UC. The aim of this study was to determine the impact of infliximab (IFX) use on the rate of remission, surgical interventions, and the effect on quality of life in patients with moderate to severe UC. Literature was searched for studies that investigated the efficacy of IFX on the rate of remission, colectomy and quality of life (QoL) between January 1990 and June 2012 at MEDLINE, January 1988 and June 2012 at EMbase and others. Eleven trials were included in the meta-analysis; divided into placebo controlled 8 trials and intravenous corticosteroid controlled group 3 trials. In comparison to placebo control groups, patients who received IFX had an odds ratio (OR) of 3.712 (95% CI: 2.714, 5.079) for the short-term clinical remission, and 3.053 (95% CI: 2.044, 4.559) for the rate of long-term remission. In colectomy rate and quality of life (QoL), odds ratio were 0.566(95% CI: 0.387, 0.827) and 0.658 (0.505, 0.811) respectively. Any adverse reactions including infections, infusion reaction, rash and arthralgia were equivalent in both groups. Compared with intravenous corticosteroid controlled group, patients who received IFX had lower remission rate with short-term odds ratio 0.227 (95% CI: 0.033, 1.556) and long-term odds ratio 1.054 (95% CI: 0.317, 3.502) respectively. However, statistical significance was not showed with both two analyses. The higher adverse drug reaction (ADR) rates were occurred in the corticosteroid controlled groups. 73.3% of patients treated corticosteroid reported Cushing-like syndrome with moon face. In conclusion, IFX does increase remission rate and decrease the rate of colectomy in patients with UC without elevating any adverse reactions significantly. IFX also improves QoL in moderate to severe UC patients. It would not exceed the efficacy of intravenous corticosteroid, whereas intravenous corticosteroid also reported high rate of adverse reactions.

Effectiveness of Shortwave Therapy in Management of Knee Osteoarthritis : A Systematic Review and Meta-analysis of Randomized Controlled Trials (무릎 뼈관절염의 단파치료 효과 : 무작위임상시험의 메타분석과 체계적 고찰)

  • Lee, Jae-Hyoung;Cho, Hyuk-Shin;Song, In-Yong
    • The Journal of Korean Physical Therapy
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    • v.26 no.5
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    • pp.331-343
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    • 2014
  • Purpose: The purpose of this study is to assess the effectiveness of short-wave therapy (SWT) for treatment of knee osteoarthritis (OA) as compared to placebo and control, and to assess the question of whether the effects are related to the mode, dosage, and application method. Methods: We searched randomized, placebo-controlled trials using electronic databases. We also manually reviewed sources in order to identify additional relevant studies. Results: Eight studies (597 participants) with OA were included in the meta-analysis. Pulse SWT had a significant effect on pain relief compared with control treatment, while did not favour compared with the placebo group. Pulse SWT had a significant effect on functional improvement compared with control and placebo treatment. Continuous SWT had no effect on pain relief and functional improvement. Capacitive SWT a significant effect on pain relief, functional improvement, and muscle strength. Continuous and capacitive SWT had increased muscle strength significantly. We found no clinical significance of all outcomes except pain and functional improvement in pulsed SWT with low dose. There was no difference in adverse events. None of the participants experienced any serious adverse events. Conclusion: Low dose pulsed SWT provided a short-term clinical benefit for pain relief and functional improvement. Pulsed SWD with low and high dose had effects on pain and function. There seems to be a placebo effect. We found significant effects on pain and function in capacitive SWT. Despite some positive findings, this analysis lacked data on how effectiveness is affected by mode, dosage, and application method of SWT. Further well-designed clinical studies are required in order to confirm the effectiveness of SWT.

Effectiveness of worksite-based dietary interventions on employees' obesity: a systematic review and meta-analysis

  • Park, Seong-Hi;Kim, So-Young
    • Nutrition Research and Practice
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    • v.13 no.5
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    • pp.399-409
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    • 2019
  • BACKGROUND/OBJECTIVES: This study was designed to provide scientific evidence on the effectiveness of worksite-based dietary intervention to reduce obesity among overweight/obese employees. MATERIALS/METHODS: Electronic search was performed using Ovid Medline, Embase, Cochrane Library, and CINAHL databases. The keywords used were "obesity," "nutrition therapy," and "worksite." The internal validity of the randomized controlled trials (RCTs) was assessed using the Cochrane's Risk of Bias. Meta-analysis of selected studies was performed using Review Manager 5.3. RESULTS: A total of seven RCTs with 2,854 participants were identified. The effectiveness of dietary interventions was analyzed in terms of changes in weight, body mass index (BMI), total cholesterol, and blood pressure. The results showed that weight decreased with weighted mean difference (WMD) of -4.37 (95% confidence interval (CI): -6.54 to -2.20), but the effectiveness was statistically significant only in short-term programs < 6 months (P = 0.001). BMI also decreased with WMD of -1.26 (95% CI: -1.98 to -0.55), but the effectiveness was statistically significant only in short-term programs < 6 months (P = 0.001). Total cholesterol decreased with WMD of -5.57 (95% CI: -9.07 to -2.07) mg/dL, demonstrating significant effectiveness (P = 0.002). Both systolic (WMD: -4.90 mmHg) and diastolic (WMD: -2.88 mmHg) blood pressure decreased, demonstrating effectiveness, but with no statistical significance. CONCLUSIONS: The worksite-based dietary interventions for overweight/obese employees showed modest short-term effects. These interventions can be considered successful because weight loss was below approximately 5-10 kg of the initial body weight, which is the threshold for the management of obesity recommended by the Scottish Intercollegiate Guideline Network (SIGN).

Update of minimally invasive surfactant therapy

  • Shim, Gyu-Hong
    • Clinical and Experimental Pediatrics
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    • v.60 no.9
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    • pp.273-281
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    • 2017
  • To date, preterm infants with respiratory distress syndrome (RDS) after birth have been managed with a combination of endotracheal intubation, surfactant instillation, and mechanical ventilation. It is now recognized that noninvasive ventilation (NIV) such as nasal continuous positive airway pressure (CPAP) in preterm infants is a reasonable alternative to elective intubation after birth. Recently, a meta-analysis of large controlled trials comparing conventional methods and nasal CPAP suggested that CPAP decreased the risk of the combined outcome of bronchopulmonary dysplasia or death. Since then, the use of NIV as primary therapy for preterm infants has increased, but when and how to give exogenous surfactant remains unclear. Overcoming this problem, minimally invasive surfactant therapy (MIST) allows spontaneously breathing neonates to remain on CPAP in the first week after birth. MIST has included administration of exogenous surfactant by intrapharyngeal instillation, nebulization, a laryngeal mask, and a thin catheter. In recent clinical trials, surfactant delivery via a thin catheter was found to reduce the need for subsequent endotracheal intubation and mechanical ventilation, and improves short-term respiratory outcomes. There is also growing evidence for MIST as an alternative to the INSURE (intubation-surfactant-extubation) procedure in spontaneously breathing preterm infants with RDS. In conclusion, MIST is gentle, safe, feasible, and effective in preterm infants, and is widely used for surfactant administration with noninvasive respiratory support by neonatologists. However, further studies are needed to resolve uncertainties in the MIST method, including infant selection, optimal surfactant dosage and administration method, and need for sedation.

The Effectiveness of Smoking Cessation Program in Adults: Systematic Review of Randomized Controlled Trials (성인 흡연자의 금연 프로그램 효과: 무작위대조군 실험연구의 체계적 문헌고찰)

  • Park, Seong-Hi;Hwang, Jeong-Hae;Choi, Yun-Kyoung;Kang, Chang-Bum
    • Korean Journal of Health Education and Promotion
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    • v.29 no.3
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    • pp.1-14
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    • 2012
  • Objectives: The purpose of this study was to determine if smoking cessation programs (SCPs) are effective for adults through a systematic review of the results of such programs in large randomized controlled trials (RCTs). Methods: The PICO (Patient, Intervention, Comparator, Outcome) strategy was established, 1,160 literature from domestic and foreign electronic databases was reviewed, and 22 references were selected based on the inclusion and exclusion criteria. The quality of each reference was evaluated using the Scottish Intercollegiate Guidelines Network tool, and meta-analysis was carried out. Results: The SCPs were significantly effective for adult smokers. Smoking cessation counseling, education, and smoking cessation medications such as nicotine patch were more effective than the other interventions. However, the results showed short-term effects (within six months), and differences were observed among the SCPs. For the outcome measures for SCPs, the abstinence rate of seven days was mainly used, but differences were identified between the CO level and the cotinine-verified abstinence rate of smoking cessation. Conclusions: For a smoking cessation program for adult smokers, the strength of the evidence of the program's effectiveness in RCTs that provide the identified intervention strategies should be considered.

Effects of oral caffeine and capsaicin administration on energy expenditure and energy substrates utilization in resting rats

  • Kim, Jisu;Jeon, Yerim;Hwang, Hyejung;Suh, Heajung;Lim, Kiwon
    • Korean Journal of Exercise Nutrition
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    • v.15 no.4
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    • pp.183-189
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    • 2011
  • Caffeine and capsaicin increase resting energy metabolism. However, most measurements have been conducted in short-term studies. Therefore, we investigated the effects of caffeine and capsaicin on energy expenditure and energy substrate utilization in resting rats for 6 h. The caffeine (Experiment 1) experiment included four male rats aged 5 weeks and measured the effects of oral administration of caffeine (10 or 50 mg/kg) on respiratory gas, energy expenditure, and energy substrate oxidation for 6 h. Experiment 2 included four male rats aged 6 weeks to measure the effects of capsaicin (10 mg/kg) using the same method as in Experiment 1. The results of Experiment 1 indicated that O2 uptake and carbohydrate oxidation after caffeine administration for 2 h was higher in the 10 mg trial than that in the 50 mg or placebo trials (P < 0.05). However fat oxidation was not significantly different. In contrast, capsaicin (Experiment 2) observed no differences between the placebo and the capsaicin trials. In conclusion, caffeine initially increased the resting energy consumption for 2 h, and this energy expenditure was due to carbohydrate oxidation. Capsaicin did not change oxygen uptake, respiratory exchange ratio, fat oxidation, or carbohydrate oxidation.

The Effect of Dual-task Training on a Serial Reaction Time Task for Motor Learning

  • Choi, Jin-Ho;Park, So Hyun
    • The Journal of Korean Physical Therapy
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    • v.24 no.6
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    • pp.405-408
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    • 2012
  • Purpose: We examined the effect of dual-task and single-task training on serial reaction time (SRT) task performance to determine whether SRT is based more on motor or perception in a dual-task. Methods: Forty healthy adults were divided into two groups: the dual-task group (mean age, $21.8{\pm}1.6$ years) and the single-task group (mean age, $21.7{\pm}1.6$ years). SRT task was conducted total 480 trial. The four figures were presented randomly 16 times. A unit was set as 1 block that would repeat 10 times. Thus, there were a total of 160 trials for each of the three color conditions. The dual-task group performed an SRT task while detecting the color of a specific shape. The end of the task, subjects answered the specific shape number; the single-task group only performed the SRT task. The study consisted of three parts: pre-measurement, task performance, and post-measurement. Results: Differences of pre and post reaction time between two group was higher for the dual-task group as compared to the single task group and there was a significant interaction between time and group (p<0.05). Conclusion: Our results indicate that. short term period SRT is not quiet effective under dual-task conditions, individuals need additional cognitive processes to successfully navigate a task This suggests that dual-task training might not be appropriate for motor learning enhancement, at least when the training is over a short period.

Tainting and Depuration in Fish by Petroleum Hydrocarbon (유류오염이 어체에 미치는 영향과 유성분 제거에 관한 연구)

  • 강석중;최병대
    • Journal of Aquaculture
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    • v.10 no.2
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    • pp.189-197
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    • 1997
  • A series of short (8 hours) and long term (96 hours) exposure studies was conducted on a laboratory scale to evaluation (1) the threshold concentrations of petroleum hydrocarbon in seawater which can lead to tainting problems in yellow tail (Seriola quinqueradiata) and (2) the time to recover (depuration period) once the tainting has occurred. The water-soluble fraction (WSF) of crude oil was prepared by stirring the oil with cold seawater. The main component of the WSF were low-boiling aromatics, although these were only al small proportion of the starting oil. From the sencory evaluation it was concluded that the threshold hydrocarbon levels in seawater which will impart a taint in yellow tail fillets within a 8-hour exposure period (short exposure period) are in the range of 0.4 to 1.0 ppm and within a 96-hour exposure period (long exposure period) are in the range of 0.2 to 0.5 ppm. Depuration trials were carried out with WSF from crude oil. The fish were exposed for 48 hours to concentration of 2.5 ppm hydrocarbons. After 48-hour exposure period, the fish were allowed to depurate in fresh, uncontaminated seawater. Depuration time for these fish was 10 days. The taste panelists were able to detect the contaminated fillets very easily while the depurated fish could not be distiguished from the control.

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