• Title/Summary/Keyword: exclusion criteria

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Efficacy of medications in adult patients with trigeminal neuralgia compared to placebo intervention: a systematic review with meta-analyses

  • Peterson-Houle, Georgia M.;AbdelFattah, Magda R.;Padilla, Mariela;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.5
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    • pp.379-396
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    • 2021
  • Background: Trigeminal neuralgia (TN) is characterized by brief, unilateral, sharp, stabbing, and shooting pain of the fifth cranial nerve. The objective of this systematic review with meta-analysis was to determine the effect of medications compared to placebo in adult patients with TN. Methods: Review authors identified randomized placebo-controlled trials (RCTs) from PubMed, Web of Science, Cochrane, and EMBASE up to February 2021. We assessed the inclusion and exclusion criteria as well as the risk of bias of the studies based on the Cochrane Handbook. A total of 324 unduplicated references were scanned independently and reduced to eight relevant RCTs, with 89 patients included. Medications investigated included oral carbamazepine, subcutaneous sumatriptan, lidocaine (intranasal, 8% spray on the oral mucosa or intravenous), buprenorphine (ganglionic local opioid analgesia), and oral Nav1.7, a selective sodium channel blocker. Results: Meta-analyses showed that overall patients receiving lidocaine reported a significantly lower post-treatment intensity of pain -3.8 points on a 0-10 scale (95% Cl = -4.653 to -2.873; P < 0.001). Patients who received lidocaine were 8.62 times more likely to have pain improvement than patients on placebo (P < 0.001). In one RCT, patients receiving oral carbamazepine showed a significant improvement in pain intensity of -32% compared to the placebo (P < 0.001). In one trial, patients receiving 3 mg subcutaneous sumatriptan had a significantly lower intensity of pain on average -6.1 points on a scale of 0-10 compared to placebo (P < 0.001) and a significant improvement in pain intensity of -75% compared to the improvement in the placebo group (P < 0.001). Patients who received subcutaneous sumatriptan were 10 times more likely to have pain improvement than those who received placebo (P = 0.001) in one study. Due to the unclear/high risk of bias and small sample size, the quality of the evidence for lidocaine in the treatment of TN was low. Conclusion: Further studies are needed for carbamazepine, sumatriptan, buprenorphine, and oral Nav1.7 sodium channel blockers, as only one study reported outcomes.

A Systematic Study of Computer-Based Driving Intervention Program for Elderly Drivers (노인 운전자에게 적용한 컴퓨터 기반 운전중재 프로그램에 관한 체계적 고찰)

  • Kim, Deok Ju
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.4
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    • pp.293-302
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    • 2019
  • This study systematically analyzed computer-based driving intervention programs for seniors, to provide the academic background for driving intervention for seniors. Articles published from January 2009 till December 2018 were researched and analyzed. 'PubMed, Google Scholar, and Science Direct' were used to search articles published overseas, and 'RISS, KERIS, and KISS' searched for articles published in Korea. Based on the inclusion and exclusion criteria, totally 359 papers were retrieved, and 10 articles were finally analyzed; 8 articles (80%) were evidence level I, and 2 articles (20%) were evidence level III. Amongst the computer-based interventions, driving simulators (70%) were the most common, followed by two video image training (20%) and one Nintendo Wii program (10%). In most studies, driving simulators trained the cognitive and visual abilities of seniors and enhanced their abilities to cope with risk situations under various simulated circumstances. Other interventions were also reported to have a positive effect. For evaluating elderly drivers, the driving performance evaluation using a driving simulator was the most common; in addition, evaluations of attention, space-time ability, cognitive function, risk perception, depression and anxiety were also commonly used. We believe that it is appropriate to employ computer-based driving intervention programs for seniors to train and evaluate various domains. We expect that these interventions can be used as an effective tool for safe driving.

Evaluation of Adherence to the CARE (CAse REport) Guidelines of Case Reports in the Journal of Korean Medicine Rehabilitation (한방재활의학과학회지에 게재된 증례보고의 CARE (CAse REport) 지침 준수에 대한 평가: 2016년 이후 발표된 논문들을 중심으로)

  • Ahn, Jonghyun;Ko, Junhyuk;Kim, Seyoon;Kim, Soojeon;Bae, Jun-hyeong;Yoon, Ye-ji;Lee, Hansol;Chang, Hokyung;Kim, Hyungsuk;Chung, Seok-hee;Lee, Jong-soo;Kim, Sung-soo;Chung, Won-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.29 no.3
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    • pp.75-85
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    • 2019
  • Objectives This study was perfomed to assess the adherance to CARE (CAse REport) guideline of case reports in the Journal of Korean Medicine Rehabilitation Methods We searched the case reports published in the Journal of Korean Medicine Rehabilitation from January 2016 to April 2019 in the database of oriental medicine advanced searching integrated system (OASIS). Then we evaluated the quality of the searched case reports based on the CARE guideline. Results Totally 31 papers were selected after the screening the case reports by the inclusion and exclusion criteria. The report rate of the sub-items of the CARE guideline was 78.26% at the maximum, 60.87% at the maximum, and 70.97% on the average. The following items were reported only in less than 50% of them; 'Timeline', 'Diagnostic challenges', 'Diagnostic reasoning including other diagnoses considered' 'Prognostic characteristics', 'Follow-up and Outcomes', 'Patient Perspective', 'Informed Consent' Conclusions This study is expected to contribute to the overall improvement of the level of case reports in the Journal of Korean Medicine Rehabilitation.

Current Research Trends on Prevalence, Correlates with Cognitive Function, and Intervention on Sarcopenia in Community-dwelling Older Adults: Systematic Review (지역사회 거주 노인의 근감소증 유병률, 인지기능과의 관계 및 중재연구 동향: 체계적 문헌고찰)

  • Ahn, Soojung;Chu, Sang Hui;Jung, Hyejeong
    • 한국노년학
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    • v.36 no.3
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    • pp.727-749
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    • 2016
  • This systematic review was performed to investigate relationship between sarcopenia and cognitive function among community-dwelling older adults. Studies which reported prevalence rates of sarcopenia in community-dwelling older adults, relationships between sarcopenia and cognitive dysfunction, or effective interventions in alleviated symptoms of sarcopenia were selected. Of 43 studies reviewed, prevalence rate of sarcopenia ranged from 2.5-42.4% in 25 studies, and 4 studies revealed a significantly positive correlation between sarcopenia and cognitive dysfunction. Among 12 randomized-control trials (RCTs), exercise intervention was used in 2 studies; nutrition intervention in 6; and 4 studies included both the exercise and nutrition interventions. All interventional studies reported positive effects on muscle mass, muscle strength, or physical function. However, only 6 studies met the high quality criteria of Risk of Bias, and there was no study which evaluated cognitive function as an outcome measure. Therefore, this study draws attention to the lack of high-quality RCTs and exclusion of cognitive function as an outcome measure in the research of sarcopenia. A comprehensive and sustained system including standardized sarcopenia screening, assessments of cognitive functioning, and evidence-based intervention programs is needed in order to prevent and manage sarcopenia amongst older adults in the community.

Efficacy of Ecabet Sodium for Helicobacter pylori Eradication with Sequential Therapy (순차치료에 병합 투여된 Ecabet Sodium이 Helicobacter pylori 제균에 미치는 효과)

  • So, Seol;Ahn, Ji Yong;Na, Hee Kyong;Jung, Kee Wook;Lee, Jeong Hoon;Kim, Do Hoon;Choi, Kee Don;Song, Ho June;Lee, Gin Hyug;Jung, Hwoon-Yong
    • The Korean journal of helicobacter and upper gastrointestinal research
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    • v.18 no.3
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    • pp.180-185
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    • 2018
  • Background/Aims: We aimed to compare the outcomes of Helicobacter pylori eradication in patients receiving sequential therapy (ST) depending on the use of ecabet sodium (ES). Materials and Methods: Between January to December 2015, 176 patients randomly received either ST alone (n=72) or 10-day ES therapy combined with ST (n=104). After applying the exclusion criteria, 56 patients were finally assigned to the ST-only group and 84 to the ST with ES group. We retrospectively reviewed and analyzed the H. pylori eradication rate and adverse events between the two groups. Results: Among the 140 patients, 121 (86.4%) achieved successful H. pylori eradication and 24 (17.1%) had adverse events. Eradication was achieved in 50 patients (89.3%) in the ST-only group and in 71 patients (84.5%) in the ST with ES group (P=0.420). No significant difference in the incidence of adverse events was found between the ST-only and ST with ES groups (12.5% vs. 20.2%, respectively; P=0.234). However, the ST with ES group tended to have a higher prevalence of nausea or vomiting than the ST-only group (11.9% vs. 1.8%; P=0.050). Conclusions: ST showed a good H. pylori eradication rate without deteriorating the adverse events regardless of adding ES.

Factors Affecting the Quality of Life of Patients With Dementia: A Systematic Review of Literature Focusing on the Subjects Admitted to an Overseas Long-term Care Facility (치매 환자의 삶의 질에 미치는 요인 분석: 국외 요양시설에 입소한 대상자를 중심으로 체계적 문헌고찰)

  • Kim, Sun-Il;Jung, Min-Ye
    • Therapeutic Science for Rehabilitation
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    • v.8 no.1
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    • pp.7-25
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    • 2019
  • Objective: The purpose of this study was to perform a systematic literature review focusing on international studies to identify various factors affecting the quality of life(QOL) of dementia patients admitted to long-term care facilities. Methods: From January 2000 to July 2018, the articles published in foreign journals were searched through CINAHL and MEDLINE databases. The main search terms were'dementia or Alzheimer's'. 'quality of life', 'long-term care', 'care home', 'nursing home', 'care institution', 'residential care', 'small- scale setting'. The first 1706 articles were searched, but 10 studies were selected using the selection and exclusion criteria. Results: Analysis of ten cross-sectional studies showed that factors such as physical functioning status, ability to perform activities of daily living, and cognition showed a positive correlation with QOL. Depression and anxiety, severity of dementia, and neuropsychiatric symptoms were found to be negatively correlated with QOL. In addition, two longitudinal studies have confirmed that factors affecting QOL are affected by individual functional status and social environmental factors rather than the size and form of care facilities. Conclusion: This study summarized 10 papers and analyzed them through a systematic review of literature. We found that factors such as individual characteristics and social environment determine QOL of patients with dementia. In this study, various intervention methods to improve QOL of patients with dementia should be developed and used in long-term care facilities by identifying the factors affecting QOL of dementia patients and using them.

A Comparative Analysis of Deficiency-Excess Pattern Identification with Sputum Cytokines and the Characteristics of Asthma Patients (천식환자 허실변증과 객담 cytokine 및 특성 비교분석)

  • Do, Ha-yoon;Yu, Chang-hwan;Kang, Sung-woo;Kim, Kwan-il;Lee, Beom-joon;Jung, Hee-jae
    • The Journal of Internal Korean Medicine
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    • v.40 no.4
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    • pp.582-596
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    • 2019
  • Objective: The aims of this study were to analyze the deficiency-excess pattern identification (虛實辨證) and compare it to the sputum cytokines of asthma patients. Method: 50 asthma patients who met the inclusion and exclusion criteria were included in this study. They were divided into two groups: deficiency and excess syndrome groups. Sputum examinations were performed including $TNF-{\alpha}$, Interleukin (IL)-4, IL-5, IL-10, and IL-13. The Quality of Life Questionnaire for Adult Korean Asthmatics (QLQAKA), the Visual Analog Scale(VAS), and heart rate variability (HRV) were also measured. We also conducted laboratory tests, including the hematological indexes. Results: Based on the pattern identification, 50 asthma patients can be divided into two categories of groups: the deficiency syndrome group (N=24) and the excess syndrome group (N=26). In the analysis of sputum cytokines, although the $TNF-{\alpha}$, IL-4 and IL-13 were at a higher level in the deficient pattern group than in the excess pattern group, it was insignificantly different. There was a negative correlation in the analysis of QLQAKA and VAS. In the analysis of HRV, although the mean value of VLF, LF, and HF in the deficiency syndrome group was higher than in the excess syndrome group, it was insignificantly different. There was no significant difference in the hematological tests between the deficiency and the excess syndrome group. The mean value of the IgE in the blood tests was five times greater than the reference value. Conclusion: The cytokines of sputum including $TNF-{\alpha}$, IL-4, IL-5, IL-10, and IL-13 were indifferent statistically. Reinforcing the healthy and eliminating the pathogenic factors should be considered.

Risk Factors and Preoperative Risk Scoring System for Shunt-Dependent Hydrocephalus Following Aneurysmal Subarachnoid Hemorrhage

  • Kim, Joo Hyun;Kim, Jae Hoon;Kang, Hee In;Kim, Deok Ryeong;Moon, Byung Gwan;Kim, Joo Seung
    • Journal of Korean Neurosurgical Society
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    • v.62 no.6
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    • pp.643-648
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    • 2019
  • Objective : Shunt-dependent hydrocephalus (SdHCP) is a well-known complication of aneurysmal subarachnoid hemorrhage (SAH). The risk factors for SdHCP have been widely investigated, but few risk scoring systems have been established to predict SdHCP. This study was performed to investigate the risk factors for SdHCP and devise a risk scoring system for use before aneurysm obliteration. Methods : We reviewed the data of 301 consecutive patients who underwent aneurysm obliteration following SAH from September 2007 to December 2016. The exclusion criteria for this study were previous aneurysm obliteration, previous major cerebral infarction, the presence of a cavum septum pellucidum, a midline shift of >10 mm on initial computed tomography (CT), and in-hospital mortality. We finally recruited 254 patients and analyzed the following data according to the presence or absence of SdHCP : age, sex, history of hypertension and diabetes mellitus, Hunt-Hess grade, Fisher grade, aneurysm size and location, type of treatment, bicaudate index on initial CT, intraventricular hemorrhage, cerebrospinal fluid drainage, vasospasm, and modified Rankin scale score at discharge. Results : In the multivariate analysis, acute HCP (bicaudate index of ${\geq}0.2$) (odds ratio [OR], 6.749; 95% confidence interval [CI], 2.843-16.021; p=0.000), Fisher grade of 4 (OR, 4.108; 95% CI, 1.044-16.169; p=0.043), and an age of ${\geq}50years$ (OR, 3.938; 95% CI, 1.375-11.275; p=0.011) were significantly associated with the occurrence of SdHCP. The risk scoring system using above parameters of acute HCP, Fisher grade, and age (AFA score) assigned 1 point to each (total score of 0-3 points). SdHCP occurred in 4.3% of patients with a score of 0, 8.5% with a score of 1, 25.5% with a score of 2, and 61.7% with a score of 3 (p=0.000). In the receiver operating characteristic curve analysis, the area under the curve (AUC) for the risk scoring system was 0.820 (p=0.080; 95% CI, 0.750-0.890). In the internal validation of the risk scoring system, the score reliably predicted SdHCP (AUC, 0.895; p=0.000; 95% CI, 0.847-0.943). Conclusion : Our results suggest that the herein-described AFA score is a useful tool for predicting SdHCP before aneurysm obliteration. Prospective validation is needed.

A Systematic Review on Economic Evaluation of Rotavirus Vaccination (로타바이러스 백신 경제성평가 연구에 대한 체계적 문헌고찰)

  • Lee, Minjun;Lee, Hankil;Cho, Hyeonseok;Kang, Hye-Young
    • The Journal of Health Technology Assessment
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    • v.6 no.2
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    • pp.148-155
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    • 2018
  • Objectives: Rotavirus is one of the main causes of severe diarrhea in children under five. Two types of rotavirus vaccines [$Rotarix^{(R)}$ (RV1) and $Rotateq^{(R)}$ (RV5)] have been introduced and its administration was optional in South Korea. A systematic review (SR) on economic evaluation (EE) of RV was conducted to examine whether the introduction of rotavirus vaccine to national vaccine program (NIP) is cost-effective. Methods: Previous SR studies of EE for RV were searched in August 2017 through databases such as MEDLINE and EMBASE. Additional search was performed to include literatures published after or unincluded in the previous SR studies. Among the 11 SR studies identified, 2 studies were reviewed via inclusion/exclusion criteria. A previous SR study including 104 original articles was selected by A MeaSurement Tool to Assess systematic Reviews. Among the 36 original articles identified through additional search, 10 were selected, resulting in 114 studies included in our analysis. Results: RV1-only, RV5-only, and evaluating-both studies account for about 44%, 22%, and 33%, respectively. Among RV1-only, RV5-only, or evaluating-both studies, 90%, 64%, or 68% of the studies concluded RV as being cost-effective, respectively. RV5-only studies were usually executed in high-income countries (68%), whereas RV1-only studies were executed mostly in lower (32%) and upper (26%) middle-income countries. When classifying studies by their funding sources, RV1-only studies (82%; 28 of 34 studies specifying funding sources) were chiefly supported by non-profit organization, and 100% of these studies were concluded as being cost-effective. RV5-only studies were mostly supported by profit organization (68%; 13 of 19 studies specifying sources), and 92% of these studies concluded as being cost-effective. Conclusion: By reviewing global EE studies for RV, we have learned that about 70% of these studies was shown to be cost-effective and RV1 appeared to be more cost-effective than RV5.

Effect of tDCS on Cognitive Function of Patients With Stroke: A Systematic Review and Meta-Analysis (뇌졸중 후 인지장애에 대한 경두개 직류 자극: 체계적 고찰 및 메타분석)

  • Yang, Min Ah;Won, Kyung-A;Park, Hae Yean;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.10 no.2
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    • pp.7-22
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    • 2021
  • Objective : This study aimed to analyze the effect of transcranial direct current stimulation (tDCS) on cognitive function recovery in patients with stroke. Methods : Data published in Korean and foreign academic journals from 2009 to 2019 were searched using the NDSL, RISS, PubMed, and CINAHL databases. A total of 11 experimental research articles were selected based on the inclusion and exclusion criteria. A qualitative assessment was conducted, and a meta-analysis of nine results from seven of the stuides was performed using the Comprehensive Meta-Analysis 3.0 program. Results : Based on the results of the meta-analysis, the attention and memory effect sizes were 0.725 and 0.796, respectively, which were both considered a "medium effect size". Statistically significant changes were observed in both the areas (p<0.05). Conclusion : The results of this study confirmed that tDCS can be useful in the rehabilitation of patients with stroke with limited cognitive function. In addition, the application methods differed, indicating that a formalized tDCS protocol is required.