• Journal of Hospice and Palliative Care
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• v.18 no.2
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• pp.136-147
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• 2015

Purpose: This study was conducted to evaluate the effects of integrated palliative care intervention on quality of life in terminally ill patients. Methods: A comprehensive literature search was performed via PubMed, Cochrane Library CENTRAL, LWW (Ovid), CINAHL and several Korean databases. The main search strategy was to combine terms indicating palliative care intervention, presence of terminal illness and study design. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non-randomized studies. Data were analyzed by the Stata 10 program. Results: Eight clinical trials met the inclusion criteria with a total of 356 participants. Integrated palliative care interventions were administered for a mean of 6.5 weeks, 5.6 sessions and an average of 47.8 minutes per session. Effect sizes were heterogeneous, and subgroup analysis was done. Integrated palliative care interventions had a significant effect on quality of life (ES=1.83, P=0.018, $l^2=92%$), spiritual well-being (ES=0.78, P=0.040, $l^2=0$), depression (ES=0.86, P<0.001, $l^2=32$) and anxiety (ES=0.69, P=0.041, $l^2=71.1$). But integrated palliative care interventions had no significant effect on pain (ES=0.365, P=0.230, $l^2=69.8$). Conclusion: Results support findings that integrated palliative care interventions were helpful in lessening depression and anxiety and improving quality of life and spiritual well-being, however, the interventions did not assist pain management in terminal cancer patients. These findings suggest that various integrated palliative care interventions can assist terminal cancer patients with better quality of life in the socio-psycho-spiritual dimension.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.26 no.3
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• pp.135-145
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• 2023

Antibiotics are frequently administered during pregnancy. Although necessary to address acute infections, their use facilitates antibiotic resistance. Other associations have also been found with the use of antibiotics, such as perturbations of gut bacteria, delays in microbial maturation, and increased risks of allergic and inflammatory diseases. Little is known about how the prenatal and perinatal administration of antibiotics to mothers affects the clinical outcomes of their offspring. A literature search was conducted of the Cochrane, Embase, and PubMed engines. The retrieved articles were reviewed by two authors and verified for relevance. The primary outcome was the effect of pre- and perinatal maternal antibiotic use on clinical outcomes. Thirty-one relevant studies were included in the meta-analysis. Various aspects are discussed, including infections, allergies, obesity, and psychosocial factors. In animal studies, antibiotic intake during pregnancy has been suggested to cause long-term alterations in immune regulation. In humans, associations have been found between antibiotic intake during pregnancy and different types of infections and an increased risk of pediatric infection-related hospitalization. A dose-dependent positive association between pre- and perinatal antibiotic use and asthma severity has been reported in animal and human studies, while positive associations with atopic dermatitis and eczema were reported by human studies. Multiple associations were identified between antibiotic intake and psychological problems in animal studies; however, relevant data from human studies are limited. However, one study reported a positive association with autism spectrum disorders. Multiple animal and human studies reported a positive association between pre- and perinatal antibiotic use by mothers and diseases in their offspring. Our findings have potentially significant clinical relevance, particularly considering the implications for health during infancy and later in life as well as the related economic burden.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.16
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• pp.6643-6647
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• 2014

The breast and the thyroid are hormone responsive organs that are closely related with changes of endocrine function and glandular disease. An association between thyroid disorders and breast cancer (BC) risk has been suggested, although the results are inconclusive. The purpose of the present study was to summarize evidence supporting a relationship between BC and the level of thyroid hormones and antibodies. The MEDLINE and EMBASE electronic databases were searched for studies published between 2000 and 2014. The pooled effects were presented as weighted mean differences (WMD) with 95% confidence intervals (CI) using fixed or random effect models. We summarized the results of 8 cross-sectional studies with 4, 189 participants. The overall pooled results showed that the levels of $FT_3$ and $FT_4$ were significantly increased in patients with BC (WMD=1.592 pmol/l; 95% CI: 0.15-3.033 and WMD=0.461 ng/dl; 95% CI: 0.015-0.906; p=0.043). The TPOAb level in patients with BC was higher than that in the control group (WMD=81.4 IU/ml; 95% CI: 78.7-84.0; p=0.000). The overall pooled results of the TgAb with random effects analyses showed that the TgAb level was significantly increased in patients with BC (WMD=101.3 IU/ml; 95% CI: 48.7-153.9; p=0.000). The present results indicated that the serum levels of $FT_3$, TPOAb and TgAb are significantly higher in patients with breast cancer than in healthy controls.

• Imaging Science in Dentistry
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• v.52 no.2
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• pp.141-153
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• 2022

Purpose: This study aimed to identify the prevalence and extension of the anterior loop (AL) of the mental nerve in different populations and according to different cone-beam computed tomography (CBCT) imaging settings. Materials and Methods: Medline/PubMed, Embase, Scopus, Web of Science, and ProQuest were searched. The main inclusion criterion was ALs evaluated in CBCT images. The quality of studies was assessed with the Joanna Briggs Institute risk of bias checklist. Subgroup analyses were conducted for sex, side, continent, voxel size, field of view, and type of CBCT-reconstruction images with a random-effects model. Results: Sixty-three studies with 13,743 participants (27,075 hemimandibles) were included. An AL was found in 40.6% (95% CI: 32.8%-48.9%, P<0.05) of participants and 36.0% (95% CI: 27.5%-45.5%, P<0.05) of hemimandibles, in 34.9% (95% CI: 25.1%-46.2%, P<0.05) of males and 34.5% (95% CI: 23.5%-47.4%, P<0.05) of females. The average length of ALs was 2.39 mm (95% CI: 2.07-2.70 mm, P<0.05). Their extension was 2.13 mm (95% CI: 1.54-2.73 mm, P<0.05) in males and 1.85 mm (95% CI: 1.35-2.36 mm, P<0.05) in females. Significant differences were observed regarding the prevalence and length of ALs among continents and for its measured length on different CBCT-reconstruction images, but not between other subgroups. Conclusion: AL was a relatively common finding. The voxel size and fields of view of CBCT devices were adequate for assessing AL; however, a 2-mm safety margin from anatomical structures(such as the AL) could be recommended to be considered when using CBCT imaging.

• The Journal of Korean Medicine
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• v.38 no.3
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• pp.13-29
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• 2017

Objectives: The objective of this review is to investigate the use of conventional Western medicine (WM) and complementary and alternative medicine (CAM) on leg cramps. Leg cramps are the occurrence of muscular spasm in the leg muscles which occur frequently in the elderly and are frequently observed in the clinical field. Methods: Relevant clinical studies were searched from five medical databases including PubMed, KISS, RISS, OASIS, and J-STAGE. Systematic review, clinical studies, and clinical practice guideline were included in this review. Results: In total, 27 clinical studies, 9 systematic review and meta-analysis, and 1 clinical practice guideline met the inclusion criteria. Included studies were classified and analyzed according to the type of intervention. Studies on quinine and magnesium have been most studied in WM and CAM, respectively. Although quinine shows some clinical effects on leg cramps, however, the risk of side effects are suggested. In addition, magnesium failed to improve the clinically significant effects in most studies. Five case reports using Oriental herbal medicine (OHM) were included and OHMs were effective in improving leg cramps without side effects, however, the quality of evidence was low. Clinical studies on other interventions were lacking. Conclusions: The results of this study indicate that there is no definite treatment standard for leg cramps until now, and there are limitations such as low level of evidence and side effects for each treatment. OHM can be an effective alternative to conventional intervention on leg cramps, therefore, related clinical studies are needed.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.6
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• pp.527-545
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• 2021

The aim of this systematic review was to determine the success rate of nitrous oxide-oxygen procedural sedation (NOIS) in dentistry. A systematic digital search was conducted for publications or reports of randomized controlled trials evaluating the clinical performance of NOIS. Abstracts of research papers were screened for suitability, and full-text articles were obtained for those who met the inclusion and exclusion criteria accordingly. The quality of the studies was assessed using the revised Cochrane risk-of-bias tool (RoB 2). A total of 19 articles (eight randomized clinical trials with parallel intervention groups and 11 crossover trials), published between May 1988 and August 2019, were finally selected for this review. The studies followed 1293 patients reporting NOIS success rates, with a cumulative mean value of 94.9% (95% CI: 88.8-98.9%). Thirteen trials were conducted on pediatric populations (1098 patients), and the remaining six were conducted on adults (195 patients), with cumulative efficacy rates of 91.9% (95% CI: 82.5-98.1%) and 99.9% (95% CI: 97.7-100.0%), respectively. The difference was statistically significant (P = 0.002). Completion of treatment and Section IV of the Houpt scale were the most used efficacy criteria. Within the limitations of this systematic review, the present study provides important information on the efficacy rate of NOIS. However, further well-designed and well-documented clinical trials are required and there is a need to develop guidelines for standardization of criteria and definition of success in procedural sedation. Currently, completion of treatment is the most used parameter in clinical practice, though many others also do exist at the same time. To maximize NOIS efficacy, clinicians should strictly consider appropriate indications for the procedure.

• Journal of Physiology & Pathology in Korean Medicine
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• v.35 no.5
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• pp.199-209
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• 2021

The purpose of this study was to explore objective indicators(outcomes) which are used to evaluate clinical efficacy and figure out the mechanisms of herbal medicine, acupuncture and moxibustion treatment for Irritable bowel syndrome(IBS). We searched randomized controlled trials(RCTs) that mediated with herbal medicine, acupuncture and moxibustion treatment for IBS and used objective indicators for outcome from November 1, 2020 to December 31, 2020. The RCTs that were published in Korean, English and Chinese were included in this study. The selected literatures were analyzed about methods of result measurement and assessed by Cochrane's risk of bias(RoB). Total 18 RCTs were included in this study. There were lots of objective indicators for result measurement; the concentration of hormones in blood and neurotransmitters, the sensitivity of rectum, the functional assessment of central nerve and autonomic nerve system, the change of intestinal flora, the concentration of serum cytokines. Various objective indicators can be used to evaluate the clinical efficacy of with herbal medicine, acupuncture and moxibustion treatment for IBS, but due to the limitations of the quality of the included studies, systematic review and meta-analysis will be needed.

• Structural Engineering and Mechanics
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• v.17 no.3_4
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• pp.527-537
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• 2004

Consequence-Based Engineering (CBE) is a new paradigm proposed by the Mid-America Earthquake Center (MAE) to guide evaluation and rehabilitation of building structures and networks in areas of low probability - high consequence earthquakes such as the central region of the U.S. The principal objective of CBE is to minimize consequences by prescribing appropriate intervention procedures for a broad range of structures and systems, in consultation with key decision makers. One possible intervention option for rehabilitating unreinforced masonry (URM) buildings, widely used for essential facilities in Mid-America, is passive energy dissipation (PED). After the CBE process is described, its application in the rehabilitation of vulnerable URM building construction in Mid-America is illustrated through the use of PED devices attached to flexible timber floor diaphragms. It is shown that PED's can be applied to URM buildings in situations where floor diaphragm flexibility can be controlled to reduce both out-of-plane and in-plane wall responses and damage. Reductions as high as 48% in roof displacement and acceleration can be achieved as demonstrated in studies reported below.

• Nutrition Research and Practice
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• v.5 no.5
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• pp.450-454
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• 2011

The beneficial effects of total parenteral nutrition (TPN) in improving the nutritional status of malnourished patients during hospital stays have been well established. However, recent randomized trials and meta-analyses have reported an increased rate of TPN-associated complications and mortality in critically ill patients. The increased risk of complications during TPN therapy has been linked to the development of hyperglycemia, especially during the first few days of TPN therapy. This retrospective study was conducted to determine whether the amount of dextrose from TPN in the 1st week in the intensive care unit (ICU) was related to the development of hyperglycemia and the clinical outcome. We included 88 non-diabetic critically ill patients who stayed in the medical ICU for more than two days. The subjects were 65 ${\pm}$ 16 years old, and the mean APACHE (Acute Physiology and Chronic Health Evaluation) II score upon admission was 20.9${\pm}$7.1. The subjects received 2.3${\pm}$1.4 g/kg/day of dextrose intravenously. We divided the subjects into two groups according to the mean blood glucose (BG) level during the 1st week of ICU stay: <140 mg/dl vs ${\geq}$ 140 mg/dl. Baseline BG and the amount of dextrose delivered via TPN were significantly higher in the hyperglycemia group than those in the normoglycemia group. Mortality was higher in the hyperglycemia group than in the normoglycemia group (42.4% vs 12.8%, P=0.008). The amount of dextrose from TPN was the only significant variable in the multiple linear regression analysis, which included age, APACHE II score, baseline blood glucose concentration and dextrose delivery via TPN as independent variables. We concluded that the amount of dextrose delivered via TPN might be associated with the development of hyperglycemia in critically ill patients without a history of diabetes mellitus. The amount of dextrose in TPN should be decided and adapted carefully to maintain blood glucose within the target range.

• Journal of Korean Medicine Rehabilitation
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• v.31 no.2
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• pp.41-48
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• 2021

Objectives To determine the evidence of effectiveness and safety of extracorporeal shock wave therapy (ESWT) with meridian and acupoint theory for knee osteoarthritis. Methods By March 3, 2021, five foreign electronic databases and six Korean medical electronic databases were reviewed with the key words 'extracorporeal shock wave' and '(acupoint OR acupuncture point)'. This key words was set up to increase the sensitivity of the search. After the search, knee osteoarthritis study was selected based on the title and abstract and then included after full-texts were read. Results Five randomized controlled trials were eligible in our inclusion criteria. The meta-analysis of three studies showed positive results for the using ESWT with meridian and acupoint theory for knee osteoarthritis compared with the control group on efficancy rate, visual analog scale and lysholm knee score. but there remains a conundrum regarding the safety of ESWT in the treatment of knee osteoarthritis. Conclusions Most of studies showed ESWT with meridian and acupoint theory were statistically effective to knee osteoarthritis. However there are limitations that the number of selected studies was small, risk of bias was unclear. So use of ESWT with meridian and acupoint theory for knee arthritis has limited evidence compared to usual care.