• Journal of Menopausal Medicine
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• v.24 no.3
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• pp.183-187
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• 2018

Objectives: The present mini review aimed to summarize the existing knowledge regarding the beneficial and adverse effects of raloxifene in menopausal women. Methods: This study is a review of relevant publications about the effects of raloxifene on sleep disorder, depression, venous thromboembolism, the plasma concentration of lipoprotein, breast cancer, and cognitive function among menopausal women. Results: Raloxifene showed no significant effect on depression and sleep disorder. Verbal memory improved with administration of 60 mg/day of raloxifene while a mild cognitive impairment risk reduction by 33% was observed with administration of 120 mg/day of raloxifene. Raloxifene was associated with a 50% decrease in the need for prolapse surgery. The result of a meta-analysis showed a significant decline in the plasma concentration of lipoprotein in the raloxifene group compared to placebo (standardized mean difference, -0.43; 10 trials). A network meta-analysis showed that raloxifene significantly decreased the risk of breast cancer (relative risk, 0.572; 95% confidence interval, 0.327-0.881; P = 0.01). In terms of adverse effects of raloxifene, the odds ratio (OR) was observed to be 1.54 (P = 0.006), indicating 54% increase in the risk of deep vein thrombosis (DVT) while the OR for pulmonary embolism (PE) was 1.05, suggesting a 91% increase in the risk of PE alone (P = 0.03). Conclusions: Raloxifene had no significant effect on depression and sleep disorder but decreased the concentration of lipoprotein. Raloxifene administration was associated with an increased risk of DVT and PE and a decreased risk of breast cancer and pelvic organ prolapse in postmenopausal women.

• Journal of Korean Critical Care Nursing
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• v.14 no.3
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• pp.141-156
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• 2021

Purpose : This study aimed to systematically review the preventive interventions for delirium in Korean intensive care unit (ICU) patients and evaluate their efficacy. Methods : For this systematic review and meta-analysis, we searched the literature and selected studies from data sources that included the RISS, KISS, National Central Library, National Assembly Library, DBpia, Science on, MEDLINE, and Cochrane Library. We used Cochrane's revised tool for risk of bias in randomized trials and non-randomized studies of intervention tools to assess the quality of the selected studies. The effect size of the intervention was calculated as odds ratio (OR) and standardized mean difference (SMD). Results : Preventive interventions reported in 23 studies with a total of 4,799 ICU patients were effective in reducing the occurrence of delirium (OR=0.64, 95% CI : 0.49~0.91, p=.011), but not the duration (SMD=-0.22, 95% CI : -0.51~0.08, p=.148). As a result of a subgroup analysis, non-pharmacological interventions were effective in reducing the occurrence of delirium (OR=0.66, 95% CI : 0.47~0.94, p=.020), while pharmacological interventions had no effect (OR=0.68, 95% CI : 0.33~1.40, p=.295). Among the non-pharmacological interventions, multi-component intervention had the largest effect size (OR=0.38, 95% CI : 0.26~0.55, p<.001). Conclusion : Non-pharmacological interventions were effective in reducing the occurrence of delirium. We recommend the development and application of multi-component interventions to prevent delirium in the Korean ICU patients.

• Tuberculosis and Respiratory Diseases
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• v.84 no.4
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• pp.299-316
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• 2021

Background: The lack of effective medications for coronavirus disease 2019 (COVID-19) has led to a trend of drug repurposing such as the case of azithromycin which shows immunomodulatory and anti-viral effect. Several clinical trials have shown conflicting results. It is currently unclear whether the available evidence is in favor or against the use of azithromycin in COVID-19 patients. Thus, the aim of this study was to investigate the efficacy and safety of azithromycin in COVID-19 patients. Methods: Four independent reviewers selected relevant studies from PubMed, ScienceDirect, EBSCO, and ProQuest published prior to March 2021. The protocol used in this study has been registered in PROSPERO (CRD42020224967). Results: We included 17 studies and found that the mortality rate (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.76-1.19), need of respiratory support (OR, 1.30; 95% CI, 0.98-1.73), hospitalization rate (standardized mean difference, 0.12; 95% CI, -0.02 to 0.27), and intensive care unit transfer (OR, 1.21; 95% CI, 0.79-1.86) of azithromycin-treated group did not differ significantly (p>0.05) from those of the control group. Azithromycin treatment did not significantly increase the risk of getting secondary infection (OR, 1.23; 95% CI, 0.83-1.82), hypoglycemia (OR, 0.73; 95% CI, 0.38-1.40), gastrointestinal problems (OR, 1.03; 95% CI, 0.73-1.45) or electrocardiogram abnormalities (OR, 1.16; 95% CI, 0.94-1.42). The overall quality of evidence ranged from low to very low. Conclusion: Azithromycin did not result in a superior clinical improvement in COVID-19 patients, although it was well-tolerated and safe to use.

• PNF and Movement
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• v.17 no.1
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• pp.157-166
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• 2019

Purpose: This study compares and examines the effects of proprioceptive neuromuscular facilitation (PNF) on patients with chronic low back pain through systematic literature review and meta-analysis. Methods: Domestic literature was searched with combinations of keywords including "proprioceptive neuromuscular facilitation," "PNF," "back pain," and "low back pain" using the Research Information Sharing Service (RISS), Korean Studies Information Service System (KISS), and Korean Medical Database (KMbase). Six studies (n=148) were finally included in the analysis through a selection and exclusion process. The quality of the studies was evaluated using the PEDro scale. Results: According to the meta-analysis results, the low back pains of the PNF group and the contrast group showed a standardized mean difference (SMD) of 2.21 (95% CI: -3.35, -1.07, p=0.01, $I^2=83%$) after intervention. Thus, the PNF group showed a statistically significant decrease in low back pain compared with the control group. In addition, the SMDs of the Oswestry Disability Index (ODI), lung function, and the Roland and Morris Disability Questionnaire (RMDQ) were -1.34 (95% CI: -1.88, -0.79, p<0.01, $I^2=35%$), 1.14 (95% CI: 0.49, 1.79, p=0.01, $I^2=0%$), and -1.59 (95% CI: -2.56, -0.62, p=0.01, $I^2=46%$), respectively. Thus, the PNF group showed statistically significant differences from the control group. Conclusion: At present, there is some limit to obtaining definite results about effect sizes because there are relatively few randomized controlled experiments that analyze the effects of PNF exercise in patients with chronic low back pain. Therefore, continuous efforts should be made to conduct randomized clinical trials and long-term efficacy studies in the future.

• PNF and Movement
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• v.17 no.1
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• pp.93-101
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• 2019

Purpose: This study aimed to investigate lower extremity muscle activation to the variable weight shift on the affected side of patients with hemiplegia. Methods: Eighteen patients with chronic hemiplegia volunteered to participate in this study. All participants performed three types of weight shift (sideways, forward, and backward) in limits of stability on the affected side. Muscle activation in a paralyzed leg was measured with electromyography on the gluteus medius, tensor fasciae latae, rectus femoris, and biceps femoris; furthermore, the attached area was recommended by SENIAM projects. Each weight shift was performed three times, and then the mean value of the three measurements was analyzed. The data were analyzed by measuring the symmetrically standing position with the reference voluntary contraction (RVC) and was standardized with the percentage of RVC method. Results: No significant difference in lower extremity muscle activation occurred according to the three types of variable weight shift. However, significant differences in lower extremity muscle activation did occur with each weight shift position. In addition, activation increased at the rectus femoris and decreased at the gluteus medius and tensor fasciae latae. Conclusion: Hip abductor muscle strength training and variable weight shifts on the affected side must increase to improve patients'balance and limits of stability.

• The Korean Journal of Pain
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• v.35 no.1
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• pp.43-58
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• 2022

Background: Current therapies are quite unsuccessful in the management of neuropathic pain. Therefore, considering the inhibitory characteristics of GABA mediators, the present systematic review and meta-analysis aimed to determine the efficacy of GABAergic neural precursor cells on neuropathic pain management. Methods: Search was conducted on Medline, Embase, Scopus, and Web of Science databases. A search strategy was designed based on the keywords related to GABAergic cells combined with neuropathic pain. The outcomes were allodynia and hyperalgesia. The results were reported as a pooled standardized mean difference (SMD) with a 95% confidence interval (95% CI). Results: Data of 13 studies were analyzed in the present meta-analysis. The results showed that administration of GABAergic cells improved allodynia (SMD = 1.79; 95% CI: 0.87, 271; P < 0.001) and hyperalgesia (SMD = 1.29; 95% CI: 0.26, 2.32; P = 0.019). Moreover, the analyses demonstrated that the efficacy of GABAergic cells in the management of allodynia and hyperalgesia is only observed in rats. Also, only genetically modified cells are effective in improving both of allodynia, and hyperalgesia. Conclusions: A moderate level of pre-clinical evidence showed that transplantation of genetically-modified GABAergic cells is effective in the management of neuropathic pain. However, it seems that the transplantation efficacy of these cells is only statistically significant in improving pain symptoms in rats. Hence, caution should be exercised regarding the generalizability and the translation of the findings from rats and mice studies to large animal studies and clinical trials.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.26 no.12
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• pp.1777-1785
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• 2022

This study confirmed the validity of the health score(HS) calculation methodology and results. HS is an index that scores the degree of personal health by applying clinical standards and statistical function to health check-up items. It's calculated by the total size of the biomarker on the health change, the influence on the health change, the weight change rate according to the degree of outlier, and the standardized value. In order to confirm the validity of the results, several diseases were selected and HS was compared between the disease occurrence group and the disease absence group. And by segmenting the ranked HS, the disease incidence rate was compared. As a result, in all selected diseases, the difference in the mean of HS was significant according to the presence or absence of disease, and the incidence of selected diseases showed a tendency to increase as HS decreased.

• Research in Community and Public Health Nursing
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• v.33 no.3
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• pp.340-355
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• 2022

Purpose: This study aimed to examine the effects of non-pharmacological sleep intervention programs in improving sleep quality among older adults in long-term care facilities. Methods: A literature search and selection was performed on nine different databases using the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Overall, 14 studies met the inclusion criteria and were systematically reviewed. For the meta-analysis, the effect size was estimated using the random-effects model in Review Manager (RevMan) desktop version 5.4 of the Cochrane Library. Results: The meta-analysis of overall non-pharmacological interventions obtained a total effect size of 1.0 (standardized mean difference [SMD]=1.0, 95% confidence interval [CI]: 0.64~1.35), which was statistically significant (Z=5.55, p<.001). The most frequently studied non-pharmacological intervention was aroma therapy, with an effect size of 0.61 (SMD=0.61, 95% CI: 0.14~1.08), which was statistically significant (Z=2.55, p=.010). In the subgroup analysis, group-based interventions, interventions for >4 weeks, and untreated control studies were more effective. Conclusion: This study confirms that non-pharmacological interventions are effective in improving sleep quality among older adults in long-term care facilities. However, the sample size was small and the risk of bias in assessing the interventions of individual studies was unclear or high, thereby limiting the generalizability of the results. Further reviews that evaluate randomized control trials, evidence-based interventions that consider older adult participants' physical activity levels, different intervention methods and durations, and different control group intervention types are needed to obtain more conclusive evidence.

• Clinical and Experimental Pediatrics
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• v.65 no.2
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• pp.98-107
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• 2022

Background: Various interventions have been tested to prevent or treat childhood obesity in South Korea. However, the overall effect of those interventions is unclear, as very few reviews and meta-analyses were specific to Korean children and adolescents. Purpose: We aimed to examine the overall effect of obesity interventions among Korean children and adolescents, while also examining differences by sex, age group, baseline weight category, intervention duration, number of intervention components, and type of intervention components. Methods: A meta-analysis was conducted for all intervention studies sampling Korean children and adolescents, with at least one control group and one month of follow-up, published between January 2000 and August 2020. Cohen d was calculated as an effect size for treatment effect, using the standardized difference between intervention group's body mass index (BMI) change and control group's BMI change. Results: The final sample included 19 intervention studies with 2,140 Korean children (mean age, 12.2 years). Overall, interventions were strongly favored over their controls (d=1.61; 95% confidence interval [CI], 1.12-2.09). The subgroup analysis showed that interventions with at least one physical activity component (d=2.43; 95% CI, 1.63-3.24) were significantly better than those that did not include physical activity (d=0.02; 95% CI, -0.26 to 0.31). Conclusion: Type of intervention component appeared important, though no differential association was observed by sex, age, baseline weight category, intervention duration, and number of intervention components. Korean and non-Korean interventions may be substantively different. Additional studies are needed to understand why and how Korean interventions differ from non-Korean interventions.

• Animal Bioscience
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• v.35 no.12
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• pp.1881-1891
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• 2022

Objective: The present study aimed to quantify the effects of fermented soybean meal (FSBM) on broiler chickens' performance by employing a meta-analysis approach. Methods: A total of 16 studies were included in the database after being systematically selected using a PRISMA protocol. Hedges' g effect size was used to quantify pooled standardized mean difference (SMD) using random-effects models at 95% confidence intervals (95% CI). Publication bias among studies was computed with Egger's test and visualized using funnel plots. Results: Results indicated that dietary FSBM inclusion increased final body weight (BW) (SMD = 0.586, 95% CI: 0.221 to 0.951, p = 0.002) of broiler chickens, particularly in starter period (SMD = 0.691, 95% CL: 0.149 to 1.233, p = 0.013) while in the finisher period, the effect was weaker (SMD = 0.509, 95% CI: 0.015 to 1.004, p = 0.043). Average daily gain (ADG), feed intake (FI), and feed conversion ratio (FCR) were not affected with FSBM inclusion when compared to control. Subgroup analysis revealed that FI increased in starter period (SMD = 0.582, 95% CI: 0.037 to 1.128, p = 0.036). When considering types of microorganism as moderating variables in the subgroup analysis, we found that Aspergillus oryzae, mixed probiotics+bromelain protease, Bacillus subtilis, and Lactobacillus bacteria significantly increased ADG and FI (p<0.01). Additionally, either Bacillus subtilis+protease or Bacillus subtilis alone decreased FCR (p<0.001). However, meta-regression analysis showed that levels of FSBM inclusion had no effects on final BW (p = 0.502), ADG (p = 0.588), FI (p = 0.861), and FCR (p = 0.462). Conclusion: Substituting SBM in broiler chickens' diet with FSBM improved BW of broiler chickens, especially in the starter period whereas the effects on ADG, FI, and FCR were mostly dependent on microbial strains used for fermentation.