• Title/Summary/Keyword: systematic reviews

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The Usefulness of 18F-FDG PET to Differentiate Subtypes of Dementia: The Systematic Review and Meta-Analysis

  • Seunghee Na;Dong Woo Kang;Geon Ha Kim;Ko Woon Kim;Yeshin Kim;Hee-Jin Kim;Kee Hyung Park;Young Ho Park;Gihwan Byeon;Jeewon Suh;Joon Hyun Shin;YongSoo Shim;YoungSoon Yang;Yoo Hyun Um;Seong-il Oh;Sheng-Min Wang;Bora Yoon;Hai-Jeon Yoon;Sun Min Lee;Juyoun Lee;Jin San Lee;Hak Young Rhee;Jae-Sung Lim;Young Hee Jung;Juhee Chin;Yun Jeong Hong;Hyemin Jang;Hongyoon Choi;Miyoung Choi;Jae-Won Jang;Korean Dementia Association
    • Dementia and Neurocognitive Disorders
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    • v.23 no.1
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    • pp.54-66
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    • 2024
  • Background and Purpose: Dementia subtypes, including Alzheimer's dementia (AD), dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD), pose diagnostic challenges. This review examines the effectiveness of 18F-Fluorodeoxyglucose Positron Emission Tomography (18F-FDG PET) in differentiating these subtypes for precise treatment and management. Methods: A systematic review following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines was conducted using databases like PubMed and Embase to identify studies on the diagnostic utility of 18F-FDG PET in dementia. The search included studies up to November 16, 2022, focusing on peer-reviewed journals and applying the goldstandard clinical diagnosis for dementia subtypes. Results: From 12,815 articles, 14 were selected for final analysis. For AD versus FTD, the sensitivity was 0.96 (95% confidence interval [CI], 0.88-0.98) and specificity was 0.84 (95% CI, 0.70-0.92). In the case of AD versus DLB, 18F-FDG PET showed a sensitivity of 0.93 (95% CI 0.88-0.98) and specificity of 0.92 (95% CI, 0.70-0.92). Lastly, when differentiating AD from non-AD dementias, the sensitivity was 0.86 (95% CI, 0.80-0.91) and the specificity was 0.88 (95% CI, 0.80-0.91). The studies mostly used case-control designs with visual and quantitative assessments. Conclusions: 18F-FDG PET exhibits high sensitivity and specificity in differentiating dementia subtypes, particularly AD, FTD, and DLB. This method, while not a standalone diagnostic tool, significantly enhances diagnostic accuracy in uncertain cases, complementing clinical assessments and structural imaging.

NEW ANTIDEPRESSANTS IN CHILD AND ADOLESCENT PSYCHIATRY (소아청소년정신과영역의 새로운 항우울제)

  • Lee, Soo-Jung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.12-25
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    • 2003
  • Objectives:As increasing number of new antidepressants have been being introduced in clinical practice, pharmacological understanding has been broadened. These changes mandate new information and theories to be incorporated into the treatment process of children with depressive disorders. In light of newly coming knowledge, this review intended to recapitulate the characteristics of new antidepressants and to consider the pivotal issues to develope guidelines for the treatment of depression in childhood and adolescence. Methods:Searching the Pub-Med online database for the articles with the key words of 'new', 'antidepressants' and 'children' ninety-seven headings of review articles were obtained. The author selected the articles of pertinent subjects in terms of either treatment guideline or psychopharmacology of new antidepressants. When required, articles about the clinical effectiveness of individual antidepressants were separatedly searched. In addition, the safety information of new antidepressants was acquired by browsing the official sites of the United States Food and Drugs Administration and Department of Health and Human Services. Results:1) For the clinical course, treatment phase, and treatment outcome, the reviews or treatment guidelines adopted the information from adult treatment guidelines. 2) Systematic and critical reviews unambiguously concluded that selective serotonin reuptake inhibitors(SSRIs) excelled tricyclic antidepressants( TCAs) for both efficacy and side effect profiles, and were recommend for the first-line choice for the treatment of children with depressive disorders. 3) New antidepressants generally lacked treatment experiences and randomized controlled clinical trials. 4) SSRIs and other new antidepressants, when used together, might result in pharmacokinetic and/or pharmacodynamic drug-to-drug interaction. 5) The difference of the clinical effectiveness of antidepressants between children and adults should be addressed from developmental aspects, which required further evidence. Conclusion:Treatment guidelines for the pharmacological treatment of childhood and adolescence depression could be constructed on the basis of clinical trial findings and practical experiences. Treatment guidelines are to best serve as the frame of reference for a clinician to make reasonable decisions for a particular therapeutic situation. In order to fulfill this role, guidelines should be updated as soon as new research data become available.

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Meta-analysis of Intravitreal Injection of Anti-vascular Endothelial Growth Factors for Diabetic Macular Edema (당뇨황반부종에서 항혈관성장인자의 유효성과 안전성: 네트워크 메타분석)

  • Tchoe, Hajin;Shin, Sang Jin;Suh, Jae Kyung;Cho, Songhee;Yang, Jangmi;Kang, Min Joo;Jee, Donghyun
    • Journal of The Korean Ophthalmological Society
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    • v.60 no.2
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    • pp.144-151
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    • 2019
  • Purpose: Intravitreal aflibercept, ranibizumab, bevacizumab, and dexamethasone are the most widely used drugs in the treatment of diabetic macular edema (DME). The aim of this study was to compare the efficacy and safety of anti-vascular endothelial growth factors and dexamethasone for the treatment of DME. Methods: There were nine previous systematic reviews on this topic; we updated these high-quality reviews. Seven studies were added to two studies following a literature search. Efficacy outcomes were 1) average improvement in visual acuity, 2) proportion of patients who experienced an improvement in vision (an increase in best-corrected visual acuity (BCVA) of ${\geq}15$ in the Early Treatment Diabetic Retinopathy Study [ETDRS]), and 3) proportion of patients who experienced worsening vision (a decrease in BCVA of ${\geq}15$ in the ETDRS). Safety outcomes included systemic adverse events and ocular-related adverse events. Results: The mean difference in the BCVA for ranibizumab versus bevacizumab treatment was 0.16 (95% confidence interval [CI]: -0.02, 0.34), and that for ranibizumab versus aflibercept was -0.08 (95% CI: -0.26, 0.10). The mean difference in the change of BCVA for aflibercept versus ranibizumab was -0.20 (95% CI: -0.40, -0.01), and that for aflibercept versus bevacizumab was -0.34 (95% CI: -0.53, -0.14). Other efficacy outcomes showed similar trends, and there was no significant difference between treatments. There was also no significant difference in both systemic and ocular adverse events rates between the treatments. Conclusions: In DME patients, the efficacy of aflibercept was found to be higher with respect to BCVA changes compared with ranibizumab or bevacizumab. However, there were no significant difference in terms of visual acuity improvement or visual acuity of more than 15 letters, nor in terms of anti-vascular endothelial growth factors (as a safety outcome).

Development of nutrition quotient for elementary school children to evaluate dietary quality and eating behaviors (학령기 아동 대상 영양지수 개발과 타당도 검증)

  • Lee, Jung-Sug;Hwang, Ji-Yun;Kwon, Sehyug;Chung, Hae-Rang;Kwak, Tong-Kyung;Kang, Myung-Hee;Choi, Young-Sun;Kim, Hye-Young
    • Journal of Nutrition and Health
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    • v.53 no.6
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    • pp.629-647
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    • 2020
  • Purpose: This study was undertaken to develop a nutrition quotient for elementary school children (NQ-C) for evaluating the overall dietary quality and eating behaviors. Methods: The NQ-C was developed by implementing 3 stages: item generation, item reduction, and validation. Candidate food behavior checklist (FBC) items of the NQ-C were derived from systematic literature reviews, expert in-depth interviews, statistical analyses of the fifth Korean National Health and Nutrition Examination Survey data, and national nutrition policies and recommendations. For the pilot survey, 260 elementary school students (128 second graders and 132 fifth graders) completed self-administered questionnaires as well as 24-hour dietary intakes, with the help of their parents and survey team staff, if required. Based on the pilot survey results, expert reviews, and priorities of national nutrition policy and recommendations, checklist items were reduced from 41 to 24. A total of 20 items for NQ-C were finally selected from results generated from 1,144 nationwide samples surveyed. Construct validity of the NQ-C was assessed using the confirmatory factor analysis, LInear Structural RELations. Results: Analyses of the exploratory factors of NQ-C identified that 5 dimensions of diet (balance, diversity, moderation, practice and environment) accounted for 46.2% of the total variance. Standardized path coefficients were used as weights of the items. The NQ-C and 5-factor scores of the subjects were calculated using the obtained weights of the FBC items. Conclusion: Our data indicates that NQ-C is a useful and suitable instrument for assessing nutrition adequacy, dietary quality, and eating behaviors of Korean elementary school children.

The Construction of Job Exposure Matrix (직무 - 노출매트릭스의 설계)

  • Yim, Hyeon Woo;Roh, Youngman;Lee, Won Chul
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.11 no.2
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    • pp.161-168
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    • 2001
  • The types of exposure data needed in an industry-based study depend on the diseases of interest and the study design to be used. The best situation occurs when we have quantified personal exposure estimates for the agents of interest, the least informative case occurs when we have only knowledge of the fact of employment in a plant, industry, or trade where exposure probability is high. Exposure information for most industry-based studies falls somewhere between these tow extremes. Job exposure matrices(JEM) are designed to link information on occupation with information on exposure to specific workplace hazards. Some forms of systematic error of bias may be less likely to occur in studies that utilize job-exposure matrices to indirectly infer exposures from job titles than in studies that assess exposures by asking subjects about their past exposure. JEM can be used effectively in industry-based studies for historic cohort studies, case-control study to assist with the retrospective assessment of occupational exposures among workers whose individual exposure histories are unavailable. JEM generally consist of a computerized database that links information about job categories and likely exposures. These two major axes may be stratified by calendar time. This article reviews the design of JEM in support of industry-based studies. Specific matrices may find broader applicability along with the increasing availability of detailed hygienic data.

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Analysis of Food Intake and Physical Activity in Randomized Controlled Trials on Herbal Medicine for Treatment of Human Obesity (비만 치료 한약 무작위 대조 임상시험에서의 음식 섭취량과 운동량 실태분석)

  • Kim, Doo-Hee;Shin, Woo-Suk;Park, Won-Hyung;Cha, Yun-Yeop;Song, Yun-Kyung;Ahn, Min-Youn;Ko, Seong-Gyu
    • Journal of Korean Medicine for Obesity Research
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    • v.13 no.2
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    • pp.58-65
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    • 2013
  • Objectives: The objective of this study was to analyse the methods being used to control food intake and physical activity in RCTs of human obesity. Methods: A total of 21 randomized controlled trials (RCTs) were investigated. Nine of which were domestic studies from "http://oasis.kiom.re.kr" and the other of which were foreign studies from systematic reviews of RCTs on herbal medicine for treatment of human obesity. Results: According to domestic studies, "low calorie diet" were recommended in five cases of the domestic studies, "maintain current dietary habit" were recommended in two and no information on diet was two. Considering the seven cases where the information on diet was available, patients' food intake were checked at every visit in six cases. Only two cases among the six had been dropped owing to the violation of dietary habit by patients. Exercises were prohibited in two cases, "maintain current level of phisical activity" were recommended in three cases and, from the rest, no information was available. The level of physical activity were not strictly controlled by any means hence no drop out. According to foreign studies, "low calorie diet" were recommended in two cases, "very low calorie diet (less than 700 kcal/day)" in one case, "maintain current dietary habit" in two cases, "do not eat fat" in two cases and no information was available in the rest five cases. Exercises which concerns spending about 300 kcal/day was recommended in one case, "moderate exercise" were recommended in three cases, "maintain current level of physical activity" were recommended in three cases and no information available in the rest five cases. Conclusions: In order to improve the accuracy of RCT, for the dietary side, researchers should record patient food intake at every visit by means of 24-hour dietary recall methods. This can be supplemented by multiple choice survey that are designed to help patients to diagnose themselves more accurately leading to less bias. For the exercise side, it is highly recommended to confine the exercises to walking only so as to quantify the amount of physical activity more easily by using pedometer.

Analyses of Studies on Exercise Therapy for Middle-Age Women with Chronic Low Back Pain in Korea (만성요통을 가진 중년 여성의 운동요법에 대한 국내 연구논문 분석)

  • Kwak, Hyeweon;Kim, Nahyun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.6
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    • pp.389-399
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    • 2016
  • This study examined the status of studies on exercise interventions for middle-aged women with chronic low back pain that had been conducted over the past 10 years (2005-2014) in Korea. The existing reports were searched electronically using the database of RISS, National Assembly Library, KISS, and DBpia with the key words of middle-aged women, chronic low back pain, exercise, and exercise program. Finally, 12 articles were included in the review. One article was from nursing science, and 11 were from other disciplines. In a qualitative evaluation on the papers, 1 study scored 8 out of 10 points, 8 studies scored between 5-6 points, and 3 studies scored 3-4 points. Intervention sessions were conducted for 55 minutes, on average, each at a frequency of 3.1 sessions per week, for a total of 29.7 sessions. This study found that lumbar neuromuscular exercise, yoga exercise, and aquatic exercise were effective in rehabilitation in middle-aged women with chronic low back pain. In the future, these findings are expected to be used in nursing intervention for the establishment of the basis for evidence-based nursing practice.

Review of Randomized Controlled Trials on Ideal Acupuncture Treatment for Degenerative Knee Osteoarthtritis (RCT논문을 중심으로 한 퇴행성 슬관절염 침구 치료 방법에 대한 고찰)

  • Kim, Eun-Jung;Lee, Seung-Deok;Jung, Chan-Yung;Yoon, Eun-Hye;Jang, Min-Gee;Nam, Dong-Woo;Kim, Hyun-Wook;Lee, Eun-Yong;Kim, Kyung-Ho;Lee, Geon-Mok;Lee, Jae-Dong;Kim, Kap-Sung
    • Journal of Acupuncture Research
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    • v.26 no.2
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    • pp.125-145
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    • 2009
  • Objectives : To analyze the inclusion criteria of participants, control group interventions, and the results of prior studies of acupuncture for OA. Also to identify aspects of the procedure that are associated with positive outcomes in order to establish ideal acupuncture treatment model. And to assess the methodological quality of the trials with modified Jadad score and FEAS in order to evaluate the quality of prior studies and find out whether or not acupuncture has a positive effect in treating OA. Methods : Articles up to the date of November 2008 were searched via computerized databases of PubMed, Journal of Korean Oriental Medicine, The Journal of Korean Acupuncture & Moxibustion Society and Journal of Oriental Rehabilitation Medicine. Bibliographies of reviewed papers were also searched and reviewed. Only randomized controlled trials (RCTs) and systematic reviews concerning the effects of acupuncture or electroacupuncture (EA) on symptoms of osteoarthritis of the human knee, published in English and Korean were included. The acupuncture treatment methods of the reviewed trials were assessed based on STRICTA. And the methodological quality of the trials was assessed by modified Jadad score and FEAS. Results : Twenty one trials of acupuncture for OA were analyzed. Based on the results of this review the following factors might contribute to optimal results from acupuncture treatment. 1) Usage of $ST_{35}$, $GB_{34$, $EX_{32}$, $ST_{36}$ and $SP_9$ acupuncture points. 2) More than four acupuncture points should be used. 3) More than 15 minutes of needle retention time. 4) Needle length-40mm and diameter-0.30mm 5) Usage of EA 6) more than 10 times treatment 7) Treatment frequency of more than once a week, 8) Treatment duration longer than 6 to 8 weeks. Conclusions : High quality clinical trials of Acupuncture for OA is still in lack. Future investigators must concentrate their attentions on the quality of acupuncture treatment itself used in the trials as well as the methodological quality of trials.

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Effect of Image Making Education on Self-Esteem and Education Satisfaction (이미지메이킹 교육이 자아존중감과 교육만족도에 미치는 영향)

  • Cho, Ju-Eun;Ko, Seon-Hee
    • The Journal of the Korea Contents Association
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    • v.14 no.11
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    • pp.1030-1040
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    • 2014
  • The purpose of this study is to examine the relationship among image making education, self-esteem and education satisfaction using airline service department in the university. In this study, 2 hypotheses based on literature reviews were employed. Questionnaire was also developed based on previous studies. A convenience sample of 240 students was surveyed and 218 usable questionnaires were analyzed. According to the exploratory factor analysis, image making education was divided into 'external image education', 'basic character education' and 'manner education'. Self-esteem, on the other hand, was categorized into the following variables: 'sense of value' and 'esteem' accordingly. Then the data and hypotheses were examined using structural equation modeling (SEM) by AMOS. The results are as follows. Firstly, 'external image' and 'manner education' have positive effect on 'sense of value' while manner education has effect on 'esteem'. Secondly, 'sense of value' and 'esteem' factor have positive effects on education satisfaction. Hence continuous and systematic education should be conducted to administer 'image making curriculum'. Self-esteem should also be taught in schools to encourage student's satisfaction on education. The contribution and limitations of this research were discussed and the future possible researches were mentioned.

Effect of Emotional Labor on Service Commitment and Customer Orientation among Hotel Employees -moderating effect of supervisor's emotional intelligence- (호텔종사자의 감성노동이 서비스몰입 및 고객지향성에 미치는 영향 -상사의 감성지능의 조절효과-)

  • Ko, Seon-Hee;Park, Eun-Suk
    • The Journal of the Korea Contents Association
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    • v.13 no.12
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    • pp.470-483
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    • 2013
  • The purpose of this study is to examine the relationship among the emotional labor, service commitment and customer orientation in hotel service context. Moreover, this study was designed to test the moderating effect of supervisor's emotional intelligence to provide fundamental and practical data for hotel industry. In this study, 4 hypotheses based on literature reviews were employed. A questionnaire was also developed based on previous studies. A convenience sample of 318 hotel employees was surveyed and a total of 297 usable questionnaires were analyzed. Then the data and hypotheses were examined using multiple regression analysis using SPSS 18.0. The results are as follows. Firstly, emotional labor was divided into 'emotional dissonance', 'emotional frequency', 'emotional diversity' and 'emotional intensity' according to the literature review. Analysis showed that emotional labor has partial effects on service commitment accordingly. Secondly, service commitment has positive effect on customer orientation. Thirdly, emotional labor has partial effects on customer orientation. Lastly, supervisor's emotional intelligence has partial moderating effects between emotional labor and customer orientation. Continuous and systematic training should be conducted to administer 'emotional labor'.