• 제목/요약/키워드: exclusion criteria

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Soft-tissue Sarcomas in the Asia-Pacific Region: A Systematic Review

  • Ngan, Roger;Wang, Edward;Porter, David;Desai, Jayesh;Prayogo, Nugroho;Devi, Beena;Quek, Richard
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권11호
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    • pp.6821-6832
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    • 2013
  • Background: Soft-tissue sarcomas require tailored and multidisciplinary treatment and management. However, little is known about how sarcomas are treated and managed throughout the Asia-Pacific region. Materials and Methods: MEDLINE was systematically searched using prespecified criteria. Publications (previous 10 years) that reported tumour characteristics, treatment patterns, survival outcomes, and/or safety outcomes of patients with soft-tissue sarcoma were selected. Exclusion criteria were studies of patients <18 years of age; ${\leq}10$ patients; countries other than Australia, Hong Kong, Indonesia, Korea, Malaysia, New Zealand, Philippines, Singapore, Taiwan, or Thailand; >20% benign tumours; sarcomas located in bones or joints; gastrointestinal stromal tumour; Kaposi's sarcoma; or not reporting relevant outcomes. Results: Of the 1,822 publications retrieved, 35 (32 studies) were included. Nearly all patients (98%, 1,992/2,024; 31 studies) were treated with surgery, and more studies used adjuvant radiotherapy than chemotherapy (24 vs 17 studies). Survival outcomes and recurrence rates varied among the studies because of the different histotypes, sites, and disease stages assessed. Only 5 studies reported safety findings. Conclusions: These findings highlight the lack of specific data available about soft-tissue sarcomas in the Asia-Pacific region. Better efforts to understand how the sarcoma is managed and treated will help improve patient outcomes in the region.

The Clinical Effect of Bosingunyang-tang on Chronic Non-bacterial Prostatitis/Chronic Pelvic Pain Syndrome : Randomized Double-blind, Placebo-controlled Clinical Trial

  • ;;;;;;이병철
    • 대한한방내과학회지
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    • 제29권3호
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    • pp.800-809
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    • 2008
  • Objective : Although chronic prostatitis/chronic pelvic pain syndrcme(CP/CPPS) is a common disease, there is no consensus on the etiology or pathology and treatment. This was a double-blinded, placebo-controlled, randomized clinical trial, investigating the therapeutic effects of the traditional Korean medicine, Bosingunyang-tang(BSGYT). Method : Participants who met US National Institutes of Health (NIH) consensus criteria for CP/CPPS were entered after applying inclusion/exclusion criteria. They were randomized to the BSGYT or placebo group. and treated three times a day for 6 weeks. NIH-Chronic Prostatitis Symptom Index (NIH-CPSI) was used to estimate the clinical symptoms of CP/CPPS. Prostaglandin E2 and ${\beta}$-endorphin in prostatic fluid, collected by 2-glass pre-massage and post-massage test, were analyzed as factors associated with pain and inflammation. Result : The mean decrease in NIH-CPSI total score of the BSGYT group was 11.0 points, which is 5.7 points more than the placebo group. (Mann Whitney test P=0.038) Also the BSGYT group showed three times higher response rate than the placebo group in NIH-CPSI pain subscale score. (Fisher's exact test P=0.027) In those responders, prostaglandin E2 decreased significantly. (Wilcoxon's signed-ranks test P=0.037). No specific side effects were observed. Conclusion : After a 6-week treatment period, BSGYT improved clinical symptoms of CP/CPPS patients by decreasing PGE2 level in prostatic fluid.

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국내 전자저널에 수록된 월경통 평가지표 및 변증에 대한 한의학적 임상연구 고찰 (Systematic Review of Korean Medicine-related Study on Diagnostic Tools and Pattern Identification registered of Dysmenorrhea in the Korean Journal)

  • 김지혜;김종열;전영주
    • 동의생리병리학회지
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    • 제29권5호
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    • pp.434-442
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    • 2015
  • The purpose of this review was to survey the Korean Medicine related papers about women with primary dysmenorrhea in order to develop the clinical protocol of the diagnostic medical device. We searched the literature from 2000 through April 2015 using 5 online databases including Oriental Medicine Advanced Searching Integrated Sysptem (OASIS), Research Information Sharing Service (RISS), DataBase Periodical Information Academic (DBpia) and Korean Medical Database (KMBase). We selected papers to meet the following inclusion criteria: the papers involved dysmenorrhea (excluding secondary dysmenorrhea), published papers (excluding textbook, educational materials, conferences, etc.) and the papers matched search keywords or scope, but excluded papers to meet the following exclusion criteria: the duplicative papers, get out of the keywords and scope and not in english or korean language. Finally we found 17 papers and classified the papers according to the three search purposes which were diagnostic tools for evaluating the menstrual pain, dysmenorrhea' pattern identification and menstrual phase. Out of the 16 studies, 4 studies were focused on the diagnostic tools including Visual Analogue Scale (VAS), Measurement of Menstrual Pain (MMP) and etc. Other 5 studies were aimed at menstrual phase, and the other 7 studies were studied for pattern identification. The VAS has been widely used in research and in clinical practice for the detection of the menstrual pain. Treatments for patients with primary dysmenorrhea can be prescribed in consideration of their patterns of sasang constitution or body constitution as following: Qi stagnation-Blood deficiency, cold dampness, Qi deficiency-blood deficiency and liver-kidney deficiency etc. This results of research will be used as a useful material during plan a clinical study of primary dysmenorrhea and acquisition of good clinical data.

Effects of Intensive Neuro Rehabilitation Intervention on the Motor Function Recovery and Balance in Stroke Patients

  • Lee, Je-Hyeok;Choi, Jong-Duk
    • 대한물리의학회지
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    • 제11권4호
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    • pp.41-47
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    • 2016
  • PURPOSE: The purpose of this study was to investigate the effects of differences in exercise time arrangement on the functional recovery of the lower limbs and balance of stroke patients. METHODS: The subjects of this study were 100 patients who were hospitalized in two hospitals located in Gyeonggi-do. Before the experiment, 60 of these patients who met the inclusion criteria and did not meet the exclusion criteria were randomly divided into an experimental group (n = 30), whose exercise time was concentrated, and a control group (n = 30), whose exercise time was diffuse. The two groups underwent six weeks of physical and occupational therapy four times a day for five days a week. One session of therapy took 30 minutes, including three sets of physical therapy and one set of occupational therapy. The rest time between the sessions was different for each group. The experimental group had five minutes of rest between each therapy session, and the control group had two hours of rest time between each session. The Fugl-Meyer assessment (FMA), an assessment of each patient's limit of stability (LOS), and a timed up and go test (TUG) were used as test tools. RESULTS: Both groups showed statistically significant increases in their FMA results, LOS measurements, and TUG results. The FMA results of the experimental group were significantly higher than those of the control group. CONCLUSION: Thus, concentrated exercise time was more effective than diffuse exercise time for the recovery of motor function.

Sleep Quality and Associated Risk Factors in Leukemia Patients Undergoing Chemotherapy in Iran

  • Bagheri-Nesami, Masoumeh;Goudarzian, Amir Hossein;Babaei, Ghasem Jan;Badiee, Milad;Mousavi, Mostafa;Sharifi, Mohammad Sadegh
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권sup3호
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    • pp.107-111
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    • 2016
  • This study aimed to determine sleep disorders and associated risk factors in leukemia patients undergoing chemotherapy in Imam Khomeini Hospital of Sari, Iran. This cross-sectional study was conducted in 2015 with 100 patients selected. Inclusion criteria included complete mental and psychological health and being over 18 years old, and exclusion criteria included suffering other cancers, other chronic diseases, concurrent radiotherapy, and chemotherapy. The Pittsburgh Sleep Quality standard questionnaire was used to collect data. The questionnaire consisted of mental sleep quality, sleep latency, sleep duration, sleep quality, sleep disturbances, use of sleeping drugs, and impaired daily functioning. Data were analyzed by software SPSS 18 and by using descriptive and inferential tests (Pearson, Spearman, T-test and chi-square). Totals of 47 men (47%) and 53 women (53%) with a mean age of $44.1{\pm}1.7$, participated in the study. The mean overall score of sleep quality was $9.3{\pm}3.9$, which represents the average sleep quality in most participants. T-test shows that males have better sleep quality than females (t=2.1; 95%CI:0.004-0.25; P<0.01). Also the sleep quality increased with age (r=0.22, P=0.03). Results show that the amount of sleep quality was only moderate in most patients, so it is necessary to take coping strategies to improve their quality of sleep.

The Oncological Safety of Nipple-Sparing Mastectomy: A Systematic Review of the Literature with a Pooled Analysis of 12,358 Procedures

  • Headon, Hannah Louise;Kasem, Abdul;Mokbel, Kefah
    • Archives of Plastic Surgery
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    • 제43권4호
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    • pp.328-338
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    • 2016
  • Nipple-sparing mastectomy (NSM) is increasingly popular as a procedure for the treatment of breast cancer and as a prophylactic procedure for those at high risk of developing the disease. However, it remains a controversial option due to questions regarding its oncological safety and concerns regarding locoregional recurrence. This systematic review with a pooled analysis examines the current literature regarding NSM, including locoregional recurrence and complication rates. Systematic electronic searches were conducted using the PubMed database and the Ovid database for studies reporting the indications for NSM and the subsequent outcomes. Studies between January 1970 and January 2015 (inclusive) were analysed if they met the inclusion criteria. Pooled descriptive statistics were performed. Seventy-three studies that met the inclusion criteria were included in the analysis, yielding 12,358 procedures. After a mean follow up of 38 months (range, 7.4-156 months), the overall pooled locoregional recurrence rate was 2.38%, the overall complication rate was 22.3%, and the overall incidence of nipple necrosis, either partial or total, was 5.9%. Significant heterogeneity was found among the published studies and patient selection was affected by tumour characteristics. We concluded that NSM appears to be an oncologically safe option for appropriately selected patients, with low rates of locoregional recurrence. For NSM to be performed, tumours should be peripherally located, smaller than 5 cm in diameter, located more than 2 cm away from the nipple margin, and human epidermal growth factor 2-negative. A separate histopathological examination of the subareolar tissue and exclusion of malignancy at this site is essential for safe oncological practice. Long-term follow-up studies and prospective cohort studies are required in order to determine the best reconstructive methods.

무릎 골관절염 환자에게 적용된 운동 프로그램이 통증 및 삶의 질에 미치는 영향: 체계적 문헌고찰과 메타분석 (The Effect of Exercise Program on Pain and Quality of Life for Patients with Knee Osteoarthritis: A Systematic Review and Meta-Analysis)

  • 윤청구;안창식
    • 근관절건강학회지
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    • 제21권3호
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    • pp.173-183
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    • 2014
  • Purpose: This study examined the effects of exercise programs on the pain and quality of life in patients with knee osteoarthritis. Methods: Electronic bibliographic databases of KiSTi, KoreaMed, KISS and KERIS were searched to identify studies of randomized controlled trials and non-randomized controlled trials. As a result, 1213 publications identified and 16 studies met inclusion and exclusion criteria. All studies examined for quality assessment of studies using Cochrane's risk of bias. Results: The 16 studies were eligible for inclusion criteria, then the meta-analysis was conducted to examine effectiveness of exercise programs on pain and quality of life in patients with knee osteoarthritis. The meta- analysis based on the random effect model showed that the exercise program was beneficial in decreasing pain (effect size .69; 95% confidence interval 0.45~0.91). Also, the exercise programs have been shown to be effective in significantly improving the quality of life. However, it was not statistically significant due to severe deviations of studies (effect size 1.06; 95% confidence interval -0.34~2.46). Conclusion: Exercise programs had positive effects on pain relief and improvement of the quality of life in patients with knee osteoarthritis, although the quality of life was not statistically significant due to severe deviations of studies.

Magnetic resonance imaging analysis of rotator cuff tear after shoulder dislocation in a patient older than 40 years

  • Kim, Jung-Han;Park, Jin-Woo;Heo, Si-Young;Noh, Young-Min
    • Clinics in Shoulder and Elbow
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    • 제23권3호
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    • pp.144-151
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    • 2020
  • Background: This study was designed to evaluate characters of the rotator cuff tear (RCT) recognized after primary shoulder dislocation in patients older than 40. Methods: From 2008 to 2019, patients who visited two hospitals after dislocation were retrospectively reviewed. Inclusion criteria were patients over 40 who had dislocation, with magnetic resonance imaging (MRI) undergone. Exclusion criteria were patients who lost to follow-up, combined with any proximal humerus fracture, brachial plexus injury, and previous operation or dislocation history in the ipsilateral shoulder. Also patients who had only bankart or bony bakart lesion in MRI were excluded. We evaluated RCTs that were recognized by MRI after the primary shoulder dislocation with regard to tear size, degree, involved tendons, fatty degeneration, the age when the first dislocation occurred, and the duration until the MRI was evaluated after the dislocation. Results: Fifty-five RCTs were included. According to age groups, the tear size was increased in coronal and sagittal direction, the number of involved tendons was increased, and the degree of fatty degeneration was advanced in infraspinatus muscle. Thirty-two cases (58.2%) conducted MRI after 3 weeks from the first shoulder dislocation event. This group showed that the retraction size of the coronal plane was increased significantly and the fatty accumulation of the supraspinatus muscle had progressed significantly. Conclusions: Age is also a strong factor to affect the feature of RCT after the shoulder dislocation in patients over 40. And the delay of the MRI may deteriorate the degree of tear size and fatty degeneration.

Are There Standardized Cutoff Values for Neutrophil-Lymphocyte Ratios in Bacteremia or Sepsis?

  • Gurol, Gonul;Ciftci, Ihsan Hakki;Terzi, Huseyin Agah;Atasoy, Ali Riza;Ozbek, Ahmet;Koroglu, Mehmet
    • Journal of Microbiology and Biotechnology
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    • 제25권4호
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    • pp.521-525
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    • 2015
  • Bacteremia and sepsis are common causes of morbidity and mortality worldwide, with incorrect or delayed diagnoses being associated with increased mortality. New tests or markers that allow a more rapid and less costly detection of bacteremia and sepsis have been investigated. The aim of this study was to clarify the cutoff value of the neutrophillymphocyte ratio (NLR) according to procalcitonin (PCT) level in the decision-making processes for bacteremia and sepsis. In addition, other white blood cell subgroup parameters, which are assessed in all hospitals, for bacteremia and sepsis were explored. This retrospective study included 1,468 patients with suspected bacteremia and sepsis. Patients were grouped according to the following PCT criteria: levels <0.05 ng/ml (healthy group), 0.05-0.5 ng/ml (local infection group), 0.5-2 ng/ml (systemic infection group), 2-10 ng/ml (sepsis group), and >10 ng/ml (sepsis shock group). One important finding of this study, which will serve as a baseline to measure future progress, is the presence of many gaps in the information on pathogens that constitute a major health risk. In addition, clinical decisions are generally not coordinated, compromising the ability to assess and monitor a situation. This report represents the first study to determine the limits of the use of NLR in the diagnosis of infection or sepsis using a cutoff value of <5 when sufficient exclusion criteria are used.

Efficacy of methotrexate therapy in patients with tubal pregnancy and a serum human chorionic gonadotropin level above 10,000 IU/L

  • Kim, Kidong;Suh, Dong Hoon;Cheong, Hyun Hoon;Yoon, Sang Ho;Lee, Taek-Sang;No, Jae Hong;Kim, Yong-Beom
    • Clinical and Experimental Reproductive Medicine
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    • 제41권1호
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    • pp.33-36
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    • 2014
  • Objective: To estimate the failure rate of medical treatment and to identify variables associated with treatment failure in patients with tubal pregnancy and an initial serum level of human chorionic gonadotropin (HCG) over 10,000 IU/L. Methods: The inclusion criteria were tubal pregnancy diagnosed using ultrasonography, primary treatment of intramuscular methotrexate injection at one of the four institutions between January 2003 and December 2011, a serum HCG level within two days before treatment >10,000 IU/L, and follow-up data to determine treatment success or failure. Exclusion criteria were other primary treatments besides intramuscular methotrexate injection. The clinicopathologic data of 36 patients were collected and analyzed. Results: Medical treatment failed and surgery was performed in 19 (53%) patients. In univariable analysis, age, parity, and size of the gestational sac were associated with treatment failure, but none of the variables were associated with treatment failure in multivariable analysis. The failure rate in the subgroup with age<33 years and size of gestational sac ${\geq}1.1cm$ was significantly higher than those of the other subgroups (82% vs. 41% [mean of the other subgroups], respectively). Conclusion: Patients with a serum HCG level >10,000 IU/L who received medical treatment had a high failure rate. Among them, patients aged<33 year and with a gestational sac ${\geq}1.1cm$ had an extremely high failure rate.