• Title/Summary/Keyword: clinical treatment

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Systematic Review on Complementary and Alternative Medicine for Dysmenorrhea (월경통의 보완대체의학적 치료에 관한 논문 연구)

  • Ryu, Sung-Won;Youn, In-Hwan;Kim, Young-Eun;Lee, Seoung-Geun;Lee, Key-Sang;Cho, Han-Baek
    • The Journal of Korean Obstetrics and Gynecology
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    • v.22 no.1
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    • pp.279-302
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    • 2009
  • Purpose: The aim of this study was to review systemically clinical trials on the trends of studies for Complementary Alternative Medicine in the treatment of dysmenorrhea. Methods: Through medical websites, foreign clinical literatures about complementary and alternative medicines of dysmenorrhea were searched. And domestic clinical literatures about dysmenorrhea, complementary and alternative treatment and oriental medicine treatment were searched using internet websites or hand-searching in National digital library, National assembly library, KISS, RISS. And then they were assessed by the assessment standard of Jadad scale and Classifying Recommendations. Results: 1. 15 foreign literatures and 36 domestic literatures were selected. 2. 4 foreign and 4 domestic clinical literatures were enough to satisfy over 2 points in Jadad score and recommendation level in Classifying Recommendations. 3. Some clinical trials were rated low in Jadad score since it was not easy to set control groups and keep blinding in clinical trials. 4. Some clinical trials were rated low in Classifying Recommendations since they did not carry out enough study about stability, side effect and follow-ups. Conclusion: To put clinical trials to practical use of Complementary Alternative Medicine in the treatment of dysmenorrhea, scientific and objective-based studies should be needed.

The Effects of Clinical Practice in School on Clinical Competence in Nurse (재학시 주문선택 집중실습이 간호사의 임상수행능력에 미치는 효과)

  • Kim, Hye-Soon;Yang, In-Soon;Yi, Yeo-Jin
    • The Journal of Korean Academic Society of Nursing Education
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    • v.11 no.2
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    • pp.206-213
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    • 2005
  • Purpose: The purpose of this study was to test the effects of clinical practice in school on clinical competence in nurse. Method: This study used a quasi experimental post-test design. Data were collected after post-test from April 1, 2005 to May 30, 2005 and from 73 clinical nurses(53 experimental group, 20 control group) who work for 4 General hospitals. Data were analyzed using SPSSWIN 11.5 with $X^2$-test, t-test, Mann-Whitney U-test, and stepwise multiple regression. The experimental group participated in treatment : 4-week consecutive clinical nursing education with preceptor in schooling, and the control group participated in treatment : traditional clinical nursing education with preceptor in schooling. Results: Clinical competence were significantly different between experimental and control groups(t=3.221, p=.002). Clinical competence in nurse is effected by satisfaction of clinical practice in schooling in experimental group(F=14.781, p=.000). Conclusion: 4-week consecutive clinical nursing education with preceptor has an effect on clinical competence in nurse. Therefore we should spread and reinforce the 4-week consecutive clinical nursing education program for improving clinical competence of nurse.

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Survival Results and Prognostic Factors in T4 N0-3 Non-small Cell Lung Cancer Patients According to the AJCC 7th Edition Staging System

  • Arslan, Deniz;Bozcuk, Hakan;Gunduz, Seyda;Tural, Deniz;Tattli, Ali Murat;Uysal, Mukremin;Goksu, Sema Sezgin;Bassorgun, Cumhur Ibrahim;Koral, Lokman;Coskun, Hasan Senol;Ozdogan, Mustafa;Savas, Burhan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2465-2472
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    • 2014
  • Background: The American Joint Committee on Cancer (AJCC) published a new staging system ($7^{th}$ edition) in 2009. In our study, we evaluated the survival results and prognostic factors among T4 local advanced non-small cell lung cancer (LA-NSCLC) patients in a large heterogeneous group, in accordance with this new system. Materials and Methods: We retrospectively evaluated the files of 122 T4 N0-3 M0 LA-NSCLC patients, identified according to the new staging system, treated at two centers between November 2003 and June 2012. Variables correlating with univariate survival at p<0.20 were later included in multivariate Cox regression analysis. Here, selection of relevant predictors of survival was carried out in accordance with the likelihood ratio formula with p<0.05 regarded as significant. Results: The median age was 60 and the median follow-up period was 17.4 months. Median overall survival (OS) was 18.3 months, the 1 year overall survival (OS) rate was 72%, and the 5 year OS rate was 28%. Statistically significant predictors of survival were (p<0.20) ECOG-PS (Eastern Cooperative Oncology Group Performance Status), age, T4 factor subgroup, stage and primary treatment in OS univariate analysis. On multivariate analysis for OS ECOG-PS (p=0.001), diagnostic stage (p=0.021), and primary treatment (p=0.004) were significant. In the group receiving non-curative treatment, the median OS was 11.0 months, while it was 19.0 months in the definitive RT group and 26.6 months in the curative treatment group. There was a significant difference between the non-curative group and the groups which had definitive RT and curative operations (respectively p<0.001 and p=0.001) in terms of OS, but not between the groups which had definitive RT and curative operations. The median event free survival (EFS) rate was 9.9 months, with rates of 46% and 19% at 3 and 5 years, respectively. On univariate analysis of EFS rate with ECOG-PS, weight loss and staging, statistical significance was found only for thorax computerized tomography (CT)+18F-fluorodeoxy-glucose positron emission tomography-CT (PET-CT) use, stage and primary treatment (p<0.20). In multivariate analysis with EFS, only the primary treatment was statistically significant (p=0.001). In the group receiving non-curative treatment, the median EFS was 10.5 months while in the curative operation group it was 14.7 months. When all the primary treatment groups were taken into consideration, grade III/IV side effect swas observed in 57 patients (46.6%). Esophagitis was most prominent among those that received definitive radiotherapy. Conclusions: Independent prognostic factors among these 122 heterogeneous LA-NSCLC T4 N0-3 M0 patients were age at diagnosis, ECOG-PS, stage and primary treatment, the last also being a significant prognostic indicator of EFS. Our findings point to the importance of appropriate staging and a multidisciplinary approach with modern imaging methods in this patient group. In those with T4 lesions, treatment selection and the effective use of curative potential should be the most important goal of clinical care.

Outcomes of comprehensive fixed appliance orthodontic treatment: A systematic review with meta-analysis and methodological overview

  • Papageorgiou, Spyridon N.;Hochli, Damian;Eliades, Theodore
    • The korean journal of orthodontics
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    • v.47 no.6
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    • pp.401-413
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    • 2017
  • Objective: The aim of this systematic review was to assess the occlusal outcome and duration of fixed orthodontic therapy from clinical trials in humans with the Objective Grading System (OGS) proposed by the American Board of Orthodontics. Methods: Nine databases were searched up to October 2016 for prospective/retrospective clinical trials assessing the outcomes of orthodontic therapy with fixed appliances. After duplicate study selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of the mean OGS score and treatment duration were performed and 95% confidence intervals (CIs) were calculated. Results: A total of 34 relevant clinical trials including 6,207 patients (40% male, 60% female; average age, 18.4 years) were identified. The average OGS score after treatment was 27.9 points (95% CI, 25.3-30.6 points), while the average treatment duration was 24.9 months (95% CI, 24.6-25.1 months). There was no significant association between occlusal outcome and treatment duration, while considerable heterogeneity was identified. In addition, orthodontic treatment involving extraction of four premolars appeared to have an important effect on both outcomes and duration of treatment. Finally, only 10 (39%) of the identified studies matched compared groups by initial malocclusion severity, although meta-epidemiological evidence suggested that matching may have significantly influenced their results. Conclusions: The findings from this systematic review suggest that the occlusal outcomes of fixed appliance treatment vary considerably, with no significant association between treatment outcomes and duration. Prospective matched clinical studies that use the OGS tool are needed to compare the effectiveness of orthodontic appliances.

A Case of Korean Medical Treatment on Parkinson's Disease Patient with Postural Instability, Presenting as Camptocormia (몸통굽힘증을 주소로 하는 파킨슨병 환자의 자세 이상에 대한 한의 치료 증례 1례)

  • Kim, Ha-ri;Jeong, Hye-seon;Shin, Hee-yeon;Choi, Jeong-woo;Yang, Seung-bo;Cho, Seung-yeon;Park, Jung-mi;Ko, Chang-nam;Park, Seong-uk
    • The Journal of Internal Korean Medicine
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    • v.40 no.2
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    • pp.220-227
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    • 2019
  • Objectives: Parkinson's disease is the neurodegenerative disease that affects both motor and non-motor function, including postural instability. Camptocormia is an abnormal condition in which the thoracolumbar spine bends forward during walking or standing. However, the treatment options are limited and often not effective. The purpose of this study was to report on the Korean medical treatment of a Parkinson's disease patient with postural instability who presented with camptocormia. Methods: We used Korean medical treatment including herbal medicine (Jemageopung-tang), acupuncture and pharmacopuncture therapy to the patient who was admitted to the hospital for 21 days. The clinical symptoms were assessed with the Unified Parkinson's Disease Rating Scale (UPDRS) and walking time without assistance. Results: After treatment, the UPDRS Parts 2 and 3 scores were decreased from 5 to 3 and 20 to 9, respectively. Also, the walking time without assistance was improved. Conclusion: This study suggested that Korean medical treatment could be an effective option for treating Parkinson's disease with postural instability.

Current Status of Clinical Practice for Gout in Korean Medicine - On-line (Web-Based) Survey (통풍의 한의임상진료현황 - 온라인(웹기반) 설문조사)

  • Hwang, Ji Hye;Lee, Kwang Ho;Nam, Dong Woo;Yook, Tae-han;Song, Ho Sueb
    • Korean Journal of Acupuncture
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    • v.38 no.1
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    • pp.16-31
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    • 2021
  • Objectives : The purpose of this study was to investigate the current status of clinical practice for gout in Korean Medicine (KM). Methods : On-line survey was adopted for this study, targeted at KM Doctors who were registered in the Association of Korean Medicine. The questionnaire included the general status of treatment, pattern identification and treatment method according to three stages given: acute, chronic and asymptomatic hyperuricemia stage. Results : Data from a total of 384 respondents was analyzed. Participants who responded most were in their 40s, working in KM clinics located in Seoul. Acupuncture and herbal medicines were the top priority treatments in preparing recommendations in clinical practice guidelines for gout, and where clinical trials were considered essential. As of the past year, the average number of first visits per month was 86.7%, and the average treatment duration was less than 1 month, accounting for 72.9%. As for the diagnostic method used for gout patients, the "diagnosed by clinical pattern" response was the highest, and the "blood and urine test" response was the highest as the diagnostic equipment used. As for the evaluation scale being used, the "VAS/NRS" response was the highest. Regardless of the gout stage, acupuncture was the most commonly used treatment method for gout patients, and bee venom pharmacopuncture was the highest for the pharmacopuncture used. In the case of herbal medicine, it was found that a wider variety of herbal medication uninsured in health insurance and herbal prescription were used for the staged treatment of gout than herbal medication in national health insurance coverage. In clinical practice, "acupuncture treatment three times a week" was the most common, and the "acupoints in the limb" were the most frequently used; LR3 and SP3 were the most frequently used acupoints. Conclusions : It is suggested that this survey should be helpful to develop clinical practice guideline for gout that reflects actual clinical practice.

A Case Study of Dysgeusia in a Patient with an Acute Thalamic Infarction Treated with Korean Medicine (급성 시상 경색으로 인한 미각 장애 치험 1례)

  • Lee, Mi-rim;Park, Min-jeong;Kim, Gyeong-muk;Cho, Ki-ho;Moon, Sang-kwan;Kwon, Seung-won;Jung, Woo-sang
    • The Journal of Internal Korean Medicine
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    • v.38 no.2
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    • pp.226-234
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    • 2017
  • The case of a 73-year-old Korean female with dysgeusia due to an acute left thalamic infarction is presented. The patient was treated with the herbal medicine Yanggyuksanhwa-tang, in addition to acupuncture and electronic acupuncture treatment. The filter-paper test and Oral Health Impact Profile-14, (OHIP-14) test were administered to evaluate dysgeusia. Post-treatment, the patient's dysgeusia improved. Korean medicine may be an effective treatment for dysgeusia caused by a thalamic infarction.

Herbal Medicine for Pediatric Epilepsy: Clinical Research Trends in Traditional Chinese Medicine

  • Kim, Sang-Ho;Kim, Da-Woon
    • Journal of Oriental Neuropsychiatry
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    • v.33 no.2
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    • pp.181-214
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    • 2022
  • Pediatric epilepsy, a chronic, recurrent brain disorder, is the most common neurological disorder in children. Its prevalence is increasing. Early management is very important since 30~40% of cases persist into adulthood. To provide basic data for future clinical research on pediatric epilepsy using Korean medicine treatment and cooperation between Western medicine doctors and Korean medicine doctors, we reviewed recent clinical research in traditional Chinese medicine (TCM) using herbal medicine for pediatric epilepsy. A total of 23 articles (1 clinical practice guideline, 3 systematic reviews, 15 randomized controlled trials (RCTs), and 4 non-RCTs) were reviewed in this study. The authors summarized characteristics of included studies regarding study subjects, diagnostic tools, pattern identification tools, treatment period, evaluation tools, detail of herbal medicines, treatment effects, and adverse events. Combination therapy using both herbal medicine (HM) and anti-epileptic drugs (AEDs) was performed more frequently than herbal medicine alone. Liver-pacifying medicinal, water-draining medicine, and orifice-opening medicine were frequently used. The main single HMs were Cheonma, Boglyeong, Jogudeung, and Seogchangpo. Combined therapy using HM and AEDs had significant benefits in improving total effective rate. It also appeared to be safer than AEDs. However, since the quality of clinical trials was poor and only studies in the last 10 years were included, the clinical evidence was uncertain. Finally, the authors provided limitations of this study and several suggestions for future research based on our analysis results.

Recent Research Trends of Acupuncture Treatment for Recurrent Implantation Failure (RIF) Patients in In Vitro Fertilization (체외수정에서 반복 착상 실패(RIF) 환자 침치료 최근 연구 동향)

  • Se-Yeon Cho;Seung-Kyu Kim;Deok-Sang Hwang;Jin-Moo Lee;Jun-Bock Jang;Chang-Hoon Lee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.37 no.2
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    • pp.120-134
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    • 2024
  • Objectives: This research aimed at investigating the trends of acupuncture treatment for Recurrent Implantation Failure (RIF) patients in IVF. Methods: Studies were searched from PubMed, Cochrane Library, EMBASE, CNKI up to April 2024. Terms as 'Implantation failure', 'Recurrent implantation failure', 'Repeated implantation failure', 'RIF' and 'Acupuncture', 'Electroacupuncture', 'Needling' were used. Results: Of 136 screened, 10 studies are selected and analyzed. Studies were conducted using manual acupuncture and electroacupuncture. The results showed that acupuncture (electroacupuncture) treatment for RIF patients is effective in improving clinical pregnancy rate, endometrial blood flow, uterus morphology, endometrium thickness. The most frequently used acupoints were 三陰交 (SP6) and 子宮 (EX-CA1). Conclusions: Included studies showed that acupuncture (electroacupuncture) might have effect on RIF. Further research and meta-analysis should be conducted to verify its therapeutic mechanisms and safety.

Endoscopic clipping in non-variceal upper gastrointestinal bleeding treatment

  • Giuseppe Galloro;Angelo Zullo;Gaetano Luglio;Alessia Chini;Donato Alessandro Telesca;Rosa Maione;Matteo Pollastro;Giovanni Domenico De Palma;Raffaele Manta
    • Clinical Endoscopy
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    • v.55 no.3
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    • pp.339-346
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    • 2022
  • Since the earliest reports, advanced clipping systems have been developed, and it is possible to choose among many models with different structural and technical features. The main drawback of through-the-scope clips is their small size, which allows the compression of limited amounts of tissue needed for large-size vessel treatment. Therefore, the over-the-scope clip system was realized, allowing a larger and stronger mechanical compression of large tissue areas, with excellent results in achieving a definitive hemostasis in difficult cases. Many studies have analyzed the indications and efficacy of two-pronged endoclips and have shown good results for initial and permanent hemostasis. The aim of this review was to provide updated information on indications, positioning techniques, and results of clip application for endoscopic treatment of upper gastrointestinal non-variceal bleeding lesions.