• Title/Summary/Keyword: eligibility criteria

Search Result 140, Processing Time 0.021 seconds

Metformin Association with Lower Prostate Cancer Recurrence in Type 2 Diabetes: a Systematic Review and Meta-analysis

  • Hwang, In Cheol;Park, Sang Min;Shin, Doosup;Ahn, Hong Yup;Rieken, Malte;Shariat, Shahrokh F.
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.16 no.2
    • /
    • pp.595-600
    • /
    • 2015
  • Background: Accumulating evidence suggests that metformin possesses anticarcinogenic properties, and its use is associated with favorable outcomes in several cancers. However, it remains unclear whether metformin influences prognosis in prostate cancer (PCa) with concurrent type 2 diabetes (T2D). Materials and Methods: We searched PubMed, EMBASE, and the Cochrane Library from database inception to April 16, 2014 without language restrictions to identify studies investigating the effect of metformin treatment on outcomes of PCa with concurrent T2D. We conducted a meta-analysis to quantify the risk of recurrence, progression, cancer-specific mortality, and all-cause mortality. Summary relative risks (RRs) with corresponding 95% confidence intervals (CIs) were calculated. Publication bias was assessed by Begg's rank correlation test. Results: A total of eight studies fulfilled the eligibility criteria. We found that diabetic PCa patients who did not use metformin were at increased risk of cancer recurrence (RR, 1.20; 95%CI, 1.00-1.44), compared with those who used metformin. A similar trend was observed for other outcomes, but their relationships did not reach statistical significance. Funnel plot asymmetry was not observed among studies reporting recurrence (p=0.086). Conclusions: Our results suggest that metformin may improve outcomes in PCa patients with concurrent T2D. Well-designed large studies and collaborative basic research are warranted.

Research trend analysis of the introduction at the issue of private investigation institution (민간조사제도 도입시 쟁점에 대한 연구동향 분석)

  • Seo, Jin-Seok
    • Convergence Security Journal
    • /
    • v.15 no.3_2
    • /
    • pp.11-19
    • /
    • 2015
  • This paper, so far to analyze the research trends in the issue that has been discussed for the introduction of private investigation institutions, by projecting its suggestion, want the investigation purpose of presenting the desirable introduction direction. The analyzed issue was extracted for existing research material on the introduction of private investigation institutions. Investigators pointed out issue is the name, business scope, corporate, qualification system (eligibility criteria and test), education, association establishment, regulatory agencies, has been included in the eight categories such as legislation form. For the name, I think there is a need to unify under the name "detective". For the scope of work, the amendment is difficult law, place an overview of the general business rules, more specific and detailed investigation business content, to discipline through the ordinance it is possible to be rational. Private investigation institutions, I think the need for limited operations of the corporation. For education, the new education and re-education on a regular basis I do for the private investigation workers. You must be one of the National Police Agency to the management authority. Legislative form, not to be defined by its own law, the revision of the security law, but that is to complement the provisions for private sector research system is effective.

Relationships between Parenting Behavior, Parenting Efficacy, Adaptation Stress and Post Traumatic Stress Disorder among Mothers who Defected from North Korean (북한 이탈 어머니들의 자녀양육행동과 양육효능감, 적응스트레스 및 외상 후 스트레스 증상)

  • Lee, In-Sook;Park, Ho-Ran;Park, Hyun-Jeong;Park, Young-Hye
    • Child Health Nursing Research
    • /
    • v.16 no.4
    • /
    • pp.360-368
    • /
    • 2010
  • Purpose: The purpose of this study was to investigate the relationships between parenting behavior, parenting efficacy, adaptation stress and PTSD (Post Traumatic Stress Disorder) among mothers who have defected from North Korean. Methods: A descriptive study was conducted to illustrate the parenting behavior, parenting efficacy, adaptation stress and PTSD and report the relationships among them. Data were collected between August and November of 2009 in Hanawon and 105 mothers who met eligibility criteria participated in the study. Results: Ignorant/controlling parenting behavior of parenting showed the highest score in our study. The level of parenting efficacy was $2.72{\pm}0.36$ and adaptation stress level was $3.35{\pm}0.47$ showing perceived hostility the highest and homesickness the lowest. Participants with moderate to severe PTSD accounted for 79.5% of the mothers, and 75% of them reported symptoms for 3 months or more. Authoritative parenting behavior showed negative relationships with parenting efficacy, cultural crisis and fear, adaptation stress and PTSD. Conclusion: Mothers who have defected from showed negative parenting behaviors and high adaptation stress level and PTSD while parenting efficacy was high. These findings indicate that parenting intervention programs which can guide these mothers towards positive parenting behaviors need to be developed.

Clinicopathological Significance and Diagnostic Accuracy of c-MET Expression by Immunohistochemistry in Gastric Cancer: A Meta-Analysis

  • Pyo, Jung-Soo;Kang, Guhyun;Cho, Hyunjin
    • Journal of Gastric Cancer
    • /
    • v.16 no.3
    • /
    • pp.141-151
    • /
    • 2016
  • Purpose: The aim of the present study was to elucidate the clinicopathological significance and diagnostic accuracy of immunohistochemistry (IHC) for determining the mesenchymal epidermal transition (c-MET) expression in patients with gastric cancer (GC). Materials and Methods: The present meta-analysis investigated the correlation between c-MET expression as determined by IHC and the clinicopathological parameters in 8,395 GC patients from 37 studies that satisfied the eligibility criteria. In addition, a concordance analysis was performed between c-MET expression as determined by IHC and c-MET amplification, and the diagnostic test accuracy was reviewed. Results: The estimated rate of c-MET overexpression was 0.403 (95% confidence interval [CI], 0.327~0.484) and it was significantly correlated with male patients, poor differentiation, lymph node metastasis, higher TNM stage, and human epidermal growth factor receptor 2 (HER2) positivity in IHC analysis. There was a significant correlation between c-MET expression and worse overall survival rate (hazard ratio, 1.588; 95% CI, 1.266~1.992). The concordance rates between c-MET expression and c-MET amplification were 0.967 (95% CI, 0.916~0.987) and 0.270 (95% CI, 0.173~0.395) for cases with non-overexpressed and overexpressed c-MET, respectively. In the diagnostic test accuracy review, the pooled sensitivity and specificity were 0.56 (95% CI, 0.50~0.63) and 0.79 (95% CI, 0.77~0.81), respectively. Conclusions: The c-MET overexpression as determined by IHC was significantly correlated with aggressive tumor behavior and positive IHC status for HER2 in patients with GC. In addition, the c-MET expression status could be useful in the screening of c-MET amplification in patients with GC.

New treatment method for pain and reduction of local anesthesia use in deep caries

  • Yun, Jihye;Shim, Youn-Soo;Park, So-Young;An, So-Youn
    • Journal of Dental Anesthesia and Pain Medicine
    • /
    • v.18 no.5
    • /
    • pp.277-285
    • /
    • 2018
  • Chemo-mechanical caries removal methods are known to be more effective compared with conventional methods in pain reduction. $Carie-care^{TM}$, a chemo-mechanical caries removal agent, was introduced in 2010 but a systematic review of its efficacy has not yet been performed. The purpose of this study was to investigate the effectiveness of $Carie-care^{TM}$ on the outcomes of treatment of caries in children and adolescents. The primary outcome was pain while the secondary outcomes included complete caries removal (CCR), time, need for local anesthesia and behavioral response changes. A Comprehensive literature search was performed in PubMed, EMBASE, and the Cochrane Library up to 30 September 2018. The following keywords were used in the search: 'chemo-mechanical caries removal agent', 'dental caries', 'Carie-care', 'chemo-mechanical caries removal', 'chemo-mechanical caries excavation', other related keywords, and their combinations. From 942 studies identified, 16 were analyzed. Finally, 4 studies met the eligibility criteria and 260 teeth in 120 children and adolescents were included in this review. This review showed that $Carie-care^{TM}$ reduces pain during caries treatment but requires a longer time for effective treatment than conventional methods. Local anesthesia was not required in the Chemo-mechanical caries removal (CMCR) group. In addition, dental anxiety decreased compared to the control group, and co-operation was more positive. Therefore, it may be a useful alternative to conventional methods in children and adolescents, but further verification through additional studies is needed.

Sensory Neural Hearing Loss after Concurrent Cisplatin and Radiation Therapy for Nasopharyngeal Carcinoma (비인강암 환자에서 Cisplatin과 방사선 병합치료시 발생하는 감각신경성 청력손실)

  • Oh Young-Taek;Koh Joong-Hwa;Choi Jin-Hyuk;Kang Seung-Hee;Chun Mi-Son
    • Korean Journal of Head & Neck Oncology
    • /
    • v.14 no.1
    • /
    • pp.15-19
    • /
    • 1998
  • Objectives: It is expected that the combined cisplatin and radiation therapy for nasopharyngeal carcinoma produces more sensory neural hearing losses compared to radiation therapy alone. The purpose of this study was to evaluate the incidence of sensory neural hearing losses after concurrent cisplatin and radiation therapy for nasopharyngeal carcinoma. Materials and Methods: From Jun. 1994 to Mar. 1997, 10 patients were available for this study with the following eligibility criteria: 1) The patients received concurrent cisplatin and radiation therapy for nasopharyngeal carcinoma. 2) There was no pre-existing auditory disease except serous otitis media due to nasopharyngeal carcinoma. 3) They had normal sensorineural hearing function on the pretreatment pure tone audiogram. 4) Pure tone audiograms were performed at least one time after treatment between 6months to 1 year follow-up without local recurrence. Results: At 1 year follow-up, 3 patients complained of decreased hearing capacity. Sensorineural hearing losses were developed in 15 ears out of 20(75%) and were more frequent and severe in high frequency area on pure tone audiogram. Conclusion: The concurrent cisplatin and radiation therapy for nasopharyngeal carcinoma may produce sensorineural hearing losses more frequently compared to historical data of radiation therapy alone and close evaluations with regular audiograms are necessary even in patients without symptoms and signs of hearing impairment.

  • PDF

Pharmacopuncture for Stroke: An Overview of Meta-Analyses (뇌졸중의 약침 치료에 대한 메타분석의 통합적 고찰)

  • Kim, Mikyung;Han, Chang-ho
    • The Journal of Internal Korean Medicine
    • /
    • v.40 no.6
    • /
    • pp.1081-1100
    • /
    • 2019
  • Objectives: This study is an overview of the meta-analysis and systematic review of randomized controlled trials investigating the clinical effectiveness and safety of pharmacopuncture for patients with stroke. Methods: Core electronic databases were searched from their inception to 21 May 2019. A measurement tool to assess systematic reviews (AMSTAR 2) was applied to screen high-quality studies. The results of these studies were summarized, and additional meta-analysis was conducted. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the certainty of evidence. Results: Sixteen studies met eligibility criteria. Four were excluded owing to insufficiency of AMSTAR 2 or low data reliability. The finally selected 12 studies were about pharmacopuncture using either a single herb extract, such as Dengzhan xixin, Sanch, Ginkgo biloba, or Acanthopanax, or a mixture of herbs, such as Compound danshen, Shenxiong, Xingnaojing, or Mailuoning. Most of the patients were from China, with acute ischemic stroke. All the studies using a pharmacopuncture versus a non-pharmacopuncture design reported the significant superiority of pharmacopuncture on every outcome measure. On the other hand, in a few studies, pharmacopuncture was inferior to active control in improving neurological deficit. Few studies reported adverse events. Conclusions: It is difficult to apply the results of this study directly to Korea, because the level of evidence is generally low and the clinical settings and social acceptance of pharmacopuncture therapy differ in Korea and China. Further studies are warranted to confirm the domestic applicability of evidence generated in China and to create evidence that supports the domestic situation.

Rivaroxaban in Patients Undergoing Hip Arthroplasty in Korean Patients: Implications in Clinical Practice (고관절치환술 후의 Rivaroxaban의 국내임상적용)

  • Liu, Yu Li;La, Hyen O;Rhie, Sandy Jeong
    • Korean Journal of Clinical Pharmacy
    • /
    • v.24 no.1
    • /
    • pp.1-8
    • /
    • 2014
  • Objective: Currently, rivaroxaban is widely used clinically for thromboprophylaxis after surgery. However, there are concerns on effectiveness and safety of rivaroxaban for its proper use. We aimed to evaluate the effectiveness and safety of rivaroxaban in orthopaedic patients after total hip replacement surgery in a large medical centre after the preferred formulary was switched from enoxaparin to rivaroxaban. Methods: The study was conducted on the patients who underwent hip arthroplasty surgery at the department of Orthopaedic Surgery at Seoul St. Mary's Hospital, South Korea. Electronic medical records were retrospectively reviewed to identify patients treated with rivaroxaban following total hip replacement between February 2011 and March 2012. Evaluation criteria included indications for use, dose, initiation and duration of therapy, drug interactions, adverse reactions, and status of health care reimbursement. The patients who were on enoxaparin were also reviewed as a reference. Results: We identified 57 patients who received rivaroxaban and 50 who received enoxaparin. All patients were prescribed the drugs for Korean Food and Drug Administration-approved indications. No thromboembolic or bleeding events were observed in either group. However, only 5.3% of rivaroxaban- treated patients had an appropriate length of prophylaxis and only 3.5% began rivaroxaban treatment at the recommended time. Surprisingly, 47.4% of rivaroxaban-treated patients received rivaroxaban despite being ineligible for reimbursement benefits. Conclusion: Rivaroxaban was generally well tolerated clinically. However, the duration of treatment, the time of initiation and patient eligibility for reimbursement require improvements, emphasising the need for education which indicates the area of pharmacists' involvement.

Concurrent Use of Sulfonylureas and Antimicrobials of the Elderly in Korea: A Potential Risk of Hypoglycemia (고령자에서 Sulfonylureas와 항균제의 병용투여 현황)

  • Lee, Sera;Ock, Miyoung;Kim, Hyunah
    • Korean Journal of Clinical Pharmacy
    • /
    • v.28 no.3
    • /
    • pp.188-193
    • /
    • 2018
  • Background: Previous studies have noted that the simultaneous use of sulfonylureas and antimicrobials, which is common, could increase the risk of hypoglycemia. In particular, an age of 65 years or older is a known risk factor for sulfonylurea-related hypoglycemia in hospitalized patients. Therefore, we performed this study to determine the potential risk of hypoglycemia from the concurrent use of antimicrobials and sulfonylureas. Methods: We performed a cross-sectional study on the National Health Insurance Service-National Sample Cohort from 2013. The eligibility criteria included patients of 65 years of age or older taking a sulfonylurea with 25 different antimicrobials. Different risk ratings of severity in drug-drug interactions (potential DDIs), level X, D, or C in Lexi-$Interact^{TM}$ online, and contraindicated, major, or moderate severity level in $Micromedex^{(R)}$ were included. SAS version 9.4 was used for data analysis. Results: A total of 6,006 elderly patients with 25,613 prescriptions were included. The largest age group was 70 to 74 (32.7%), and 39.7% of patients were men. The mean number of prescriptions was 4.3 per patient. The most frequently used antimicrobials were levofloxacin (6,583, 25.7%), ofloxacin (6,549, 25.6%), fluconazole (4,678, 18.0%), and ciprofloxacin (2,551, 9.8%). Among sulfonylureas, glimepiride was prescribed most frequently, followed by gliclazide, glibenclamide, and glipizide. Conclusion: Of the antimicrobials with a high potential of hypoglycemia, levofloxacin, ofloxacin, fluconazole, and ciprofloxacin were used frequently. Thus, the monitoring of clinically relevant interactions is required for patients concurrently administered sulfonylureas and antimicrobials.

Effectiveness of Deep Breathing Exercise for Postoperative Pulmonary Complications Prevention: A Systematic Review (수술 후 폐 합병증 예방을 위한 심호흡 운동의 효과에 대한 체계적 고찰)

  • Lee, Worlsook;Yang, You Lee;Oh, Eui Geum
    • Journal of Korean Academy of Fundamentals of Nursing
    • /
    • v.21 no.4
    • /
    • pp.423-432
    • /
    • 2014
  • Purpose: This study was done to evaluate effectiveness of deep breathing exercise as a postoperative intervention to prevent pulmonary complications. Methods: A search of databases from 1990 to 2012 was done including MEDLINE, EMBASE, CINAHL, Cochrane Library and eight Korean databases. Ten studies met eligibility criteria. Researchers trained in systematic review, independently assessed the methodological quality of selected studies using the Cochrane's risk of bias tool. Data were analyzed using RevMan 5.2 program. Results: Among ten RCTs in four studies, deep breathing exercise was compared with an instrument using interventions such as incentive spirometry, in the other four studies deep breathing exercise was compared with non-intervention, and in last two studies bundles of interventions including coughing and early ambulation were assessed. A significant difference was found between deep breathing exercise group and non-intervention group. The odds ratio (OR) of occurrence of pulmonary complications for deep breathing exercise versus non-intervention was 0.30. However, there was no significant difference between deep breathing exercise group and incentive spirometry group (OR=1.22). Conclusion: Deep breathing exercise is vital to improving cost-effectiveness and efficiency of patient care in preventing postoperative pulmonary complications. For evidence-based nursing, standardized guidelines for deep breathing in postoperative care should be further studied.