• Title/Summary/Keyword: observational clinical study

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Analysis of the Result of Korean Medicine Treatment for Female Subfertility Using Herbal Medicine, Acupuncture and Moxibustion Treatment

  • Jeong, Jae-Cheol;Choi, Min-Sun;Yoon, Sang-Ho;Kim, Dong-Il
    • The Journal of Korean Medicine
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    • v.36 no.2
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    • pp.1-7
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    • 2015
  • Objectives: To report on the result of infertility treatment with Korean medicine in clinical settings. Methods: This study was single arm, retrospective observational study. Analysis of the medical records on thirty four infertile women who were treated by acupuncture, moxibustion, herbal medicine(Jokyungjongoktang-gagambang, Sutaehwan-gagambang). Pregnancy rate(PR) and Live birth rate(LBR) were analyzed as the primary outcomes. Changes of AMH, FSH, LH, $E_2$, $P_4$, endometrial thickness, fat mass, and BMI were also analyzed as the secondary outcomes. Results: A total of 34 patients were treated in the traditional Korean medical clinic. Nine patients were dropped, and 25 subjects completed the final examination at the end of this treatment schedule. Five of 25 subjects conceived during treatment, reaching 20% PR and LBR was also 20%. Except for FSH level, the results of the remaining outcome measures, including LFT, showed no significant changes. No serious adverse event has been reported. Conclusion: Although no significant changes in bio-markers were observed, complex treatment using Korean medicine has shown effectiveness on women's infertility. In addition, the safety of the treatment has been verified.

Usability Testing of a Prototype Personal Digital Assistant (PDA)-based Decision Support System for the Management of Obesity

  • Lee, Nam-Ju;Bakken, Suzanne
    • Perspectives in Nursing Science
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    • v.5 no.1
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    • pp.17-31
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    • 2008
  • Purpose: The purpose of this study was to evaluate the usability of a prototype personal digital assistant (PDA)-based decision support system for the management of obesity through usability testing with end-users (Advanced Practice Nurses [APNs]) prior to its implementation in clinical settings. Methods: This descriptive study used observational and think aloud techniques to address the research question: what usability problems are perceived by end-users? Five APNs were provided with the scenarios and the list of tasks to evaluate the application. Their verbalizations were recorded through Morae usabil ity software. Data analysis was based on the data captured through Morae, transcriptions, notes, and the end-user survey. Results: End-users completed all the required tasks without encountering a severe usability problem, and agreed that the system was easy to use. clear, concise, and useful. Usability issues that were unrecognized by the developer or usability experts were identified by APNs. The usability problems were categorized according to positive characteristics, negative characteristics, and recommendations. The usability issues were discussed with the project team members, and solutions were suggested to improve the user interface of the PDA-based decision support system before the final implementation. Conclusions: This approach had an important impact on making the system easier to use and more useful from the perspective of design and content. The results of this evaluation provided iterative feedback regarding the design and implementation of the PDA-based decision support system for the management of obesity.

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Effects of Herbal Prescriptions on the Immunological Parameter in Patients with Atopic & Allergic Diseases; Clinical Observational Study (아토피와 알러지에 대한 한의학적 약물치료의 혈액면역학적 개선효과)

  • Jo, Hyun-Ik;Shin, Byung-Cheul;Kim, Hyung-Il
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.6
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    • pp.1646-1654
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    • 2007
  • The aim of this study was to investigate the effects of several herbal prescriptions in patients with allergy or atopic disease, such as atopic dermatitis, asthma and allergy rhinitis and others, on the blood immunological parameters and to verify the safety of long-term use of herbal medicine. Eighty one patients with allergy or atopy disease who taken herbal medicine at least for 2 months were compared with patients who taken same medicine with no allergy & atopy disease (n=14) and normal healthy subjects (n=22). According to the comparison of immunological parameters change, the data showed that herbal medicine decreased IgE (P=0.003), Eosinophil ratio (P<0.001) and count (P<0.001) of White Blood Cell (WBC) and did not affect to the liver cell enzymes in blood. This results indicated that herbal medicine decreased immune hypersensitivity and improved chronic inflammation related to blood immunological parameters of allergy or atopy diseases. In addition, herbal medicine seemed to be safe to the liver function for long-term use.

Predictive Validity of Pressure Ulcer Risk Assessment Scales among Patients in a Trauma Intensive Care Unit (외상중환자의 욕창 위험사정 도구의 타당도 비교)

  • Choi, Ja Eun;Hwang, Sun-Kyung
    • Journal of Korean Critical Care Nursing
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    • v.12 no.2
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    • pp.26-38
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    • 2019
  • Purpose : The aims of this study were to identify the incidence of pressure ulcers and to compare the predictive validities of pressure ulcer risk assessment scales among trauma patients. Methods : This was a prospective observational study. A total of 155 patients admitted to a trauma intensive care unit in a university hospital were enrolled. The predictive validity of the Braden, Cubbin & Jackson, and Waterlow scales were assessed based on the sensitivity, specificity, positive and negative predictive values, and area under the receiver operating characteristic curve (AUC). Results : Of the patients, 14 (9.0%) subsequently developed pressure ulcers. The sensitivity, specificity, positive predictive values, and negative predictive values were 78.6%, 75.9%, 24.4%, and 97.3%, respectively, for the Braden scale (cut-off point of 12); 85.7%, 68.8%, 21.4%, and 98.0%, respectively, for the Cubbin & Jackson scale (cut-off point of 26); and 71.4%, 87.2%, 35.7%, and 96.9%, respectively, for the Waterlow scale (cut-off point of 18). The AUCs were 0.88 (Waterlow), 0.86 (Braden), and 0.85 (Cubbin & Jackson). Conclusion : The findings indicate that the predictive validity values of the Waterlow, Braden, and Cubbin & Jackson scales were similarly high. However, further studies need to also consider clinical usefulness of the scales.

Sternal Retraction and Subclavian Vein Catheter Occlusion during Cardiac Surgery

  • Tarbiat, Masoud;Bakhshaei, Mohammad Hossein;Derakhshanfar, Amir;Rezaei, Mahmoud;Ghorbanpoor, Manoochehr;Zolhavarieh, Seyed Mohammad
    • Journal of Chest Surgery
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    • v.54 no.5
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    • pp.377-382
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    • 2021
  • Background: Subclavian vein (SV) catheterization is a method for the delivery of fluids, drugs, and blood products, venous blood sampling, and central vein pressure monitoring in cardiac surgery. Catheter occlusion is a serious complication of SV catheterization during cardiac surgery, especially after sternal retractor expansion. Methods: In this observational study, 303 patients who had successful right infraclavicular SV catheterization from September 2019 to April 2020 were enrolled to determine the incidence of catheter occlusion. After catheterization, the lumens of all catheters were checked for the ability to infuse and withdraw blood from the catheter before and after sternal retractor expansion. The patients' characteristics, cannulation approach, on-pump or off-pump technique, occlusion of the catheter and its lumens, and any associated complications were recorded. The data were analyzed using IBM SPSS ver. 22.0 (IBM Corp., Armonk, NY, USA). Results: Of the 303 patients studied, 205 were male (67.7%) and 98 were female (32.3%). Catheter occlusion occurred in 11 patients with on-pump cardiopulmonary bypass (CPB) (227 patients) and 4 patients with off-pump CPB (76 patients) (p=0.863). The incidence of catheter occlusion was 4.95% (15 of 303 patients) with no cases of simultaneous 3-lumen occlusion in a catheter. The most commonly occluded lumen was the distal lumen (57.92%). Simultaneous 2-lumen occlusion occurred in 4 patients. Catheter occlusion was found in 3 of 13 malpositioned catheters (23.07%). Conclusion: The current study showed that malpositioning of the catheter tip was a risk factor for catheter occlusion and that the distal lumen of a triple-lumen catheter was the most commonly occluded lumen.

Biometry of width between labial transitional line angles in anterior teeth: an observational study

  • Wen, Chao;Ye, Hongqiang;Chen, Hu;Zhou, Yongsheng;Huang, Mingming;Sun, Yuchun
    • The Journal of Advanced Prosthodontics
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    • v.14 no.1
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    • pp.1-11
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    • 2022
  • PURPOSE. The maximum width between the mesial and distal labial transitional line angles, described as "esthetic width" herein, could significantly influence the visual perception of the teeth and smile. This study aimed to conduct biometric research on esthetic width and to explore whether regular distribution exists in the esthetic width of human teeth. MATERIALS AND METHODS. A total of 4,264 maxillary and mandibular anterior teeth were measured using the Geomagic studio software program. The proportions of maxillary to mandibular homonymous teeth and proportions between the adjacent teeth were calculated. Bilateral symmetry and the correlation between the esthetic and mesiodistal widths were both accounted for during the measurement procedures. RESULTS. The mean esthetic widths were 6.773 ± 0.518 mm and 4.329 ± 0.331 mm for maxillary and mandibular central incisors, respectively, 5.451 ± 0.487 mm and 5.008 ± 0.351 mm for maxillary and mandibular lateral incisors, respectively, and 3.340 ± 0.353 mm and 5.958 ± 0.415 mm for maxillary and mandibular canines, respectively. Except for the mandibular canines, no significant difference in esthetic width was found among homonymous teeth from the same jaw. A high linear correlation was found between the esthetic and mesiodistal widths of the same tooth, except for the maxillary canines. Esthetic width proportions among different tooth categories showed some regular patterns, which were similar to those of the mesiodistal width. CONCLUSION. Esthetic width is regularly distributed among the teeth in the Chinese population. This could provide an important reference for anterior dental restorations and dimension recovery in esthetic reconstruction of anterior teeth.

Clinical Outcomes of Multidisciplinary Team Care on the Regulation of Chronic Kidney Disease - Mineral and Bone Disorder (CKD-MBD) in Patients Undergoing Dialysis (미네랄 골질환 합병증을 가진 투석환자에서 다학제 팀 서비스의 임상적 성과)

  • Han, Nayoung;Lee, Sang-Min;Hong, Jin Yi;Noh, Hye Jin;Ji, Eunhee;Song, Yun-Kyoung;Song, Jeeyoun;Kim, In-Wha;Kim, Yon Su;Oh, Jung Mi
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.4
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    • pp.318-323
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    • 2016
  • Background: Multidisciplinary team care (MTC) is a collaborative approach to treatment plan and ongoing care. We aimed to evaluate the clinical effect of MTC on the regulation of chronic kidney disease-mineral and bone disorder (CKD-MBD) complications in dialysis patients. Methods: This retrospective observational study was approved by the institutional review board. Among patients who have undergone dialysis at admission, the patients admitted to the nephrology ward were allocated to MTC group, and the others to usual care (UC) group. The MTC group had collaborative care by nephrologists, nurses, pharmacists, and nutritionists. The endpoints were the regulation of corrected calcium (cCa) and phosphate (P), the percent of patients in target level of cCa-P product ($cCa{\times}P$), and the prescription rate of non-calcium based P-binders. Results: A total of 163 patients were included from January to December 2009. A significant difference was shown in the percentage of patients in target $cCa{\times}P$ level at admission (MTC vs. UC, 81.40% vs. 91.67%; P = 0.038), but there was no significant difference at discharge. During admission, the cCa and P levels of patients in only UC group were significantly changed. In addition, compared with UC group, patients in MTC group were more likely prescribed appropriate P-binders, when they had higher $cCa{\times}P$ levels than $55mg^2/dL^2$ (P <0.001). Conclusion: It was found that MTC had beneficial effect on improving the regulation of CKD-MBD and the appropriate phosphate binder uses. Therefore, application of the MTC is anticipated to enhance quality of clinical care in chronic diseases.

Neonatal Total Nutritional Pharmacy Service at Intensive Care Unit at a University Hospital in Korea (신생아 중환자실 영양요법치료에서 약사의 역할과 영향)

  • Oh, Yun Kyoung;Lee, Gwang Sup;Rhie, Sandy
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.2
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    • pp.167-174
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    • 2013
  • Objective: The study evaluated the impact of pharmacist inventions with the implementation of pharmacistinvolved nutritional support service at neonate intensive care unit in a tertiary teaching hospital. Method: A retrospective and observational study was carried out. The total of 58 infants in neonate intensive care unit was enrolled between January 2011 and October 2012. The pharmacist-involved total parenteral nutritional program was initiated in June of 2012. During the program, pharmacist actively participated in the multidisciplinary round with performing the interventions from reviewing the amount of combined total parenteral nutrition and enteral fluid intakes, the amount of total calories, the glucose infusion rate, and the amounts of proteins per weight in kilogram. The outcome was compared with the results from the control group which reflected the prior period of the program initiation. Result: The number of days of regaining birth weight was significantly shorter (14.5 vs. 19 days, p=0.049) and the percentage of total calorie days with >90 kcal/kg/day was increased significantly (40 vs. 13%, p=0.008) in intervention group compared to the values in control group. In addition, the total mean daily caloric intakes ($84.78{\pm}13.8$ vs. $74.86{\pm}15.36$ kcal/kg/day, p=0.018) was significantly higher in intervention group than those results in control group. There were no significant differences in safety parameters between two groups related to nutritional services of necrotizing enterocolitis, intraventricular hemorrhage, proven sepsis, and also parenteral nutrition-induced hepatotoxicity. Conclusion: Pharmacist-involved total parenteral nutrition managed program was successfully implemented. The outcome showed the improved effectiveness of total parenteral nutrition with pharmacist interventions and no differences in adverse reactions. This could prove the positive effects of pharmacist involvement on nutritional therapy for neonate population.

Clinical, Histopathological and Molecular Characteristics of Metastatic Breast Cancer in North-Eastern Kazakhstan: a 10 Year Retrospective Study

  • Abiltayeva, Aizhan;Moore, Malcolm A;Myssayev, Ayan;Adylkhanov, Tasbolat;Baissalbayeva, Ainur;Zhabagin, Kuantkan;Beysebayev, Eldar
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.10
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    • pp.4797-4802
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    • 2016
  • Background: Breast cancer (BC) is the top cancer among women worldwide and has been the most frequent malignancy among Kazakhstan women over the past few decades. Information on clinical and histopathological features of metastatic breast cancer (MBC), as well as the distribution of molecular subtypes is limited for Kazakh people. Materials and Methods: The present observational retrospective study was carried out at Regional Oncologic Dispensaries in the North-East Region of Kazakhstan (in Semey and Pavlodar cities). Сlinical and histopathological data were obtained for a total of 570 MBC patients in the 10 year period from 2004-2013, for whom data on molecular subtype were available for 253. Data from hospital charts were entered into SPSS 20 for analysis by one-way ANOVA analysis of associations of different variables with 1-5 year survival. Pearson correlation and linear regression models were used to examine the relation between parameters with a p-value < 0.05 considered statistically significant. Results: No significant relationships were evident between molecular subtype and survival, site of metastases, stage or ethnicity. Young females below the age of 44 were slightly more likely to have triple negative lesions. While the ductal type greatly predomonated, luminal A and B cases had a higher percentage with lobular morphology. Conclusions: In this select group of metastatice brease cancer, no links were noted for survival with molecular subtype, in contrast to much of the literature.

Glucose Variations in the First Day of Life of Newborns under Observational Surveillance (관찰감시를 요하는 저위험신생아의 생후 초기 혈당변이 탐색)

  • Cho, Jung Ae;Son, Kyoung Hee;Eom, Hyun Young;Lim, Seo Hae;Jun, Yong Hoon;Ahn, Young Mee
    • Child Health Nursing Research
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    • v.26 no.2
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    • pp.212-221
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    • 2020
  • Purpose: Nursing protocols for glucose management are well known for both healthy term newborns and high-risk newborns. However, for less risky newborns who are under only observation surveillance, hypoglycemia could be overlooked unless clinical symptoms develop. Methods: A retrospective study was performed to explore factors influencing variations in glucose levels in 91 newborns who did not require any interventions, but were under nursing surveillance, at a level II neonatal intensive care unit. Data were retrieved from electrical medical records on glucose levels, demographic characteristics, and other clinical characteristics of newborns in their first day of life from January 2016 to May 2019. Results: Glucose levels tended to stabilize within the normal range (60~80 mg/dL) as time passed during the first day of life. Cesarean section, multiple gestation, abnormal growth, and later preterm birth were associated with low glucose levels in the first 2 hours of life. Thirty-one newborns experienced a hypoglycemic episode (< 45 mg/dL) during the first 24 hours of life. Conclusion: The findings of this study support the active encouragement of early feeding within 2 hours of birth and urgent adoption of a structural protocol for glucose surveillance in newborns with potential health problems immediately after birth.