• 제목/요약/키워드: Adverse outcomes

검색결과 523건 처리시간 0.028초

Pregabalin and gabapentin in neuropathic pain management after spinal cord injury: a systematic review and meta-analysis

  • Davari, Majid;Amani, Bahman;Amani, Behnam;Khanijahani, Ahmad;Akbarzadeh, Arash;Shabestan, Rouhollah
    • The Korean Journal of Pain
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    • 제33권1호
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    • pp.3-12
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    • 2020
  • Neuropathic pain after spinal cord injury (SCI) has a significant negative impact on the patients' quality of life. The objective of this systematic review is to examine the safety and efficacy of pregabalin (PGB) and gabapentin (GBP) in the treatment of neuropathic pain due to SCI. PubMed, the Cochrane Library, Embase, Scopus, and the Web of Science were searched up to December 2018. The reference lists of key and review studies were reviewed for additional citations. The quality of the studies was evaluated using the Cochrane Collaboration's tools for assessing the risk of bias. A meta-analysis was performed for primary and secondary outcomes. Eight studies were eligible for inclusion. Meta-analysis of PGB vs. placebo showed that PGB was effective for neuropathic pain (standardized mean difference [SMD] = -0.40; 95% confidence interval [CI]: -0.78, -0.01), anxiety (MD = -0.68; 95% CI: -0.77, -0.59), depression (mean difference [MD] = -0.99; 95% CI: -1.08, -0.89), and sleep interference (MD = -1.08; 95% CI: -1.13, -1.02). Also, GBP was more effective than a placebo for reducing pain. No significant difference was observed between the efficacy of the two drugs (MD = -0.37; 95% CI: -1.67, 0.93). There was no significant difference between the two drugs for discontinuation due to adverse events (risk ratio = 3.00; 95% CI: 0.81, 11.15). PGB and GBP were effective vs. placebos in decreasing neuropathic pain after SCI. Also, there was no significant difference between the two drugs for decreasing pain and adverse events.

췌장암 간전이 환자의 통합 암 치료에 대한 증례보고 (A Case Report of Pancreatic Cancer with Liver Metastasis Patient Treated with Integrative Cancer Treatment)

  • 고은주;명지수;김종희;박지혜;박소정;이연월;유화승
    • 대한암한의학회지
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    • 제26권1호
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    • pp.39-48
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    • 2021
  • Objective: The purpose of this study is to report effects and potential of Integrative Cancer Treatment (ICT) on metastatic pancreatic cancer patient. Methods: A 79-year-old pancreatic cancer patient diagnosed with metastasis on liver visited the Daejeon Korean medicine hospital of Daejeon university East West Cancer Center (EWCC) on May 2021. The patient has been received chemotherapy (gemcitabine plus abraxane) and concurrently treated with ICT since May 2021. The clinical outcomes were measured by computed tomography, laboratory findings including tumor markers (CEA, CA19-9) and numeric rating scales (NRS). Laboratory analysis and National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0 were used to evaluate the safety of ICT. Results: After treatment, constipation was relieved from NRS 5-6 to 2, both leg numbness was improved from NRS 9 to 2. Tumor size was generally decreased accompanying by reducing the levels of tumor markers. There were no severe adverse events induced by ICT based on NCI CTCAE version 5.0. Conclusion: This case study suggests that ICT in combination with chemotherapy may help in the treatment of patients with metastatic pancreatic cancer.

Aloe vera Is Effective and Safe in Short-term Treatment of Irritable Bowel Syndrome: A Systematic Review and Meta-analysis

  • Hong, Seung Wook;Chun, Jaeyoung;Park, Sunmin;Lee, Hyun Jung;Im, Jong Pil;Kim, Joo Sung
    • Journal of Neurogastroenterology and Motility
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    • 제24권4호
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    • pp.528-535
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    • 2018
  • Background/Aims To evaluate the efficacy and safety of Aloe vera (AV) in patients with irritable bowel syndrome (IBS). Methods We searched the MEDLINE, EMBASE, and Cochrane databases for studies dated between 1st January 1960 and 30th December 2017. Eligible randomized controlled trials (RCTs) compared AV to placebo in patients with IBS. The primary outcome was standardized mean difference of the change in severity of IBS symptoms as measured by patient-rated scales. Secondary outcomes included response rate of IBS symptoms and adverse events. Heterogeneity among studies was assessed using Cochrane's Q and $I^2$ statistics. Results Three RCTs with a total of 151 patients with IBS were included. The meta-analysis showed a significant difference for patients with AV compared to those with placebo regarding improvement in IBS symptom score (standardized mean difference, 0.41; 95% CI, 0.07-0.75; P = 0.020). Using intention-to-treat analysis, the AV patients showed significantly better response rates of IBS symptoms compared to placebo (pooled risk ratio, 1.69; 95% CI, 1.05-2.73; P = 0.030). No adverse events related with AV were found in included studies. There was no significant heterogeneity of effects across studies (P = 0.900; $I^2=0%$). Conclusion AV is effective and safe for the treatment of patients with IBS compared to placebo.

암 환자의 삶의 질, 식욕 부진과 악액질에 대한 복합 한의 치료 프로그램의 효과: 후향적 차트 리뷰 (Effectiveness of comprehensive traditional Korean Medicine treatment on quality of life, anorexia and cachexia of cancer patients : Retrospective chart review)

  • 한원주;이은지;한가진;윤상훈;한가진;임정태
    • 대한한의학회지
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    • 제40권2호
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    • pp.119-132
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    • 2019
  • Purpose: This study was conducted to collect and analyze real world data to evaluate the effectiveness and safety of comprehensive traditional Korean Medicine treatment on quality of life, anorexia and cachexia of cancer patients. Methods: We analyzed medical records of 62 cancer patients admitted to O-I Dang Korean Medicine Hospital from February 2018 to February 2019. The primary outcome was a change score in the Anorexia/Cachexia Subscale of Functional Assessment of Anorexia/Cachexia Therapy (FAACT). The secondary outcomes were Functional Assessment of Cancer Therapy-General (FACT-G), Trial Outcome Index(TOI) of FAACT, 11 point Pain Intensity Numeric Rating Score (11 PI-NRS) and Patient Global Impression of Change (PGIC) and adverse event. Results: Cachexia and quality of life in cancer patients assessed by FAACT, increased by $5.59{\pm}14.83$ (p=0.004) after treatment. PI-NRS was reduced by $2.10{\pm}1.81$ (p<0.001) and TOI and FACT-G total scores were increased by $5.17{\pm}11.70$ (p=0.001) and $3.59{\pm}10.94$ (p=0.012), respectively. These results were also clinically meaningful assessed via minimal clinically important difference (MCID). There was no severe adverse event. Conclusion: These findings suggest that comprehensive traditional Korean Medicine treatment might be effective and safe strategy for improving quality of life, anorexia, cachexia and pain of cancer patients. Further advanced studies with controlled group and more participants with rigorous design are needed to ensure these findings.

교정시설에 수용된 소년범의 교정 처우에서 '용서하기'의 가능성에 대한 고찰 (The Possibility of Forgiving Among Serious Juvenile Offenders in Correctional Facilities)

  • 지원근
    • 한국심리학회지:법
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    • 제13권1호
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    • pp.53-74
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    • 2022
  • 본 연구는 현행 교정 처우의 보완적 방안으로서 소년 교정시설 내에서의 '용서하기'의 가능성을 고찰하는 데 그 목적이 있다. 문헌 고찰을 통해 지난 30여 년간 심리학자들을 중심으로 논의되어 온 용서의 개념과 용서 프로그램이 기반하고 있는 주요 용서 모델을 개관하였다. 그리고 최근 형사사법에서 주목받고 있는 회복적 사법에서 통용되는 용서와의 차이점을 살펴보았다. 또한, 교정시설에 수용된 소수의 고위험군 소년범은 상대적으로 심각성과 위험도가 낮은 소년범보다 아동기 부정적 생애경험을 비롯한 피해 사건을 더 많이 겪는다고 보고한 선행연구와 다양한 배경에서 시행된 용서 프로그램 결과를 토대로 소년 교정 현장에서의 '용서하기'의 가능성을 논증하였다. 이러한 논의 결과를 바탕으로 가해자인 소년범들도 이전에 경험한 피해 사실의 범주 내에서 제한적으로 '용서하기'가 가능하며, '용서하기'를 통한 심리적 어려움의 경감과 타인에 대한 부정적 태도의 개선이 교정 처우의 효과 제고에 기여할 수 있다는 점이 결론으로 제시되었다. 마지막에서는 본 연구의 제한점과 후속 연구에 대해 논의하였다.

AirQ+와 BenMAP을 이용한 초미세먼지 개선의 건강편익 산정 (Assessing the Health Benefits of PM2.5 Reduction Using AirQ+ and BenMAP)

  • 간순영;배현주
    • 한국환경보건학회지
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    • 제49권1호
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    • pp.30-36
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    • 2023
  • Background: Among various pollutants, fine particle (PM2.5, defined as particle less than 2.5 nm in aerodynamic diameter) shows the most consistent association with adverse health effects. There is scientific evidence documenting a variety of adverse health outcomes due to exposure to PM2.5. Objectives: This study aims to assess the health benefits of that would be achieved by meeting the World Health Organization's air quality guidelines for PM2.5 using AirQ+ and BenMAP. Methods: We estimated PM2.5 related health benefits in Korea from implementing the World Health Organization's air quality guidelines (annual average 5 ㎍/m3 and 10 ㎍/m3) and Korea's National Ambient Air Quality Standard (annual average 15 ㎍/m3). We used World Health Organization's AirQ+ and U.S. Environmental Protection Agency's Environmental Benefits Mapping and Analysis Program. Results: The annual number of avoided PM2.5 related premature deaths exceeding WHO guideline levels was assessed using both AirQ+ and BenMAP. We estimated that the health benefits of attaining the World Health Organization's air quality guidelines for PM2.5 (annual average 5 ㎍/m3) would suggest an annual reduction of 26,128 (95% confidence interval [CI]: 17,363~34,024) and 26,853 (95% CI: 18,527~34,944) premature deaths. Conclusions: Our study provided useful information to policy makers and confirms that the reduction of PM2.5 concentration would result in significant health benefits in Korea.

Mitochondrial oxidative damage by co-exposure to bisphenol A and acetaminophen in rat testes and its amelioration by melatonin

  • Hina Rashid;Mohammad Suhail Akhter;Saeed Alshahrani;Marwa Qadri;Yousra Nomier;Maryam Sageer;Andleeb Khan;Mohammad F. Alam;Tarique Anwer;Razan Ayoub;Rana J. H. Bahkali
    • Clinical and Experimental Reproductive Medicine
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    • 제50권1호
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    • pp.26-33
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    • 2023
  • Objective: Human exposure to multiple xenobiotics, over various developmental windows, results in adverse health effects arising from these concomitant exposures. Humans are widely exposed to bisphenol A, and acetaminophen is the most commonly used over-the-counter drug worldwide. Bisphenol A is a well-recognized male reproductive toxicant, and increasing evidence suggests that acetaminophen is also detrimental to the male reproductive system. The recent recognition of male reproductive system dysfunction in conditions of suboptimal reproductive outcomes makes it crucial to investigate the contributions of toxicant exposures to infertility and sub-fertility. We aimed to identify toxicity in the male reproductive system at the mitochondrial level in response to co-exposure to bisphenol A and acetaminophen, and we investigated whether melatonin ameliorated this toxicity. Methods: Male Wistar rats were divided into six groups (n=10 each): a control group and groups that received melatonin, bisphenol A, acetaminophen, bisphenol A and acetaminophen, and bisphenol A and acetaminophen with melatonin treatment. Results: Significantly higher lipid peroxidation was observed in the testicular mitochondria and sperm in the treatment groups than in the control group. Levels of glutathione and the activities of catalase, glutathione peroxidase, glutathione reductase, and manganese superoxide dismutase decreased significantly in response to the toxicant treatments. Likewise, the toxicant treatments significantly decreased the sperm count and motility, while significantly increasing sperm mortality. Melatonin mitigated the adverse effects of bisphenol A and acetaminophen. Conclusion: Co-exposure to bisphenol A and acetaminophen elevated oxidative stress in the testicular mitochondria, and this effect was alleviated by melatonin.

Efficacy and Safety of ClearCutTM Knife H-type in Endoscopic Submucosal Dissection for Gastric Neoplasms: A Multicenter, Randomized Trial

  • Eun Jeong Gong;Hyun Lim;Sang Jin Lee;Do Hoon Kim
    • Journal of Gastric Cancer
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    • 제23권3호
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    • pp.451-461
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    • 2023
  • Purpose: Endoscopic submucosal dissection (ESD) is an effective treatment for early gastrointestinal neoplasms. However, this is a time-consuming procedure requiring various devices. This study aimed to evaluate the efficacy and safety of the ClearCutTM Knife H-type, which is an integrated needle-tipped and insulated-tipped (IT) knife. Materials and Methods: Between July 2020 and September 2021, 99 patients with gastric epithelial neoplasms scheduled for ESD at three tertiary care hospitals were randomly assigned to H-knife (ClearCutTM Knife H-type) or IT-knife (conventional IT knife) groups. Procedure times, therapeutic outcomes, and adverse events were analyzed. Results: A total of 98 patients (50 in the H-knife group and 48 in the IT-knife group) were analyzed. The median total procedure time was 11.9 minutes (range, 4.4-47.2 minutes) in the H-knife group and 12.7 minutes (range, 5.2-137.7 minutes) in the IT-knife group (P=0.209). Unlike the IT-knife group, which required additional devices in all cases, no additional devices were used in the H-knife group (P<0.001). En-bloc resection was performed for all lesions in both groups. The incidence of adverse events was not significantly different between groups (4.0% in the H-knife group vs. 8.3% in the IT-knife group; P=0.431). Conclusions: The newly developed hybrid device, the ClearCutTM Knife H-type, had comparable efficacy to the conventional IT knife for gastric ESD.

A Pilot Clinical Study of the Efficacy and Safety of Phellinus Linteus (Sanghuang) Extract Treatment for Knee Osteoarthritis

  • Ryu, Hwa yeon;Lee, Hyun;Kang, Jae Hui
    • Journal of Acupuncture Research
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    • 제39권2호
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    • pp.115-121
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    • 2022
  • Background: To evaluate the efficacy and safety of Phellinus linteus (PL) extract for the treatment of knee osteoarthritis (KOA) a pilot clinical study was performed. Methods: There were 24 patients with KOA who enrolled in this double-blind, randomized, controlled, clinical trial. There were 3 groups: PL 1,000 mg/day (PL 1,000), PL 1,500 mg/day (PL 1,500), and dextrin 3,000 mg/day (placebo). Patients took capsules twice a day, 3 capsules at a time, over 8 weeks. Patients were monitored prior to treatment (Visit 1: Week 0), and followed up every 4 weeks (Visit 2: Week 4 and Visit 3: Week 8) where outcome measurements were taken. The primary outcome measure was the score from the Korean version of the Western Ontario and McMasters Universities from baseline to Week 8. The secondary outcomes were measurements from the visual analog scale, quality of life scale, erythrocyte sedimentation, and c-reactive protein. Adverse events were recorded at every visit. Results: The Korean version of the Western Ontario and McMasters Universities score showed the greatest improvement in symptoms of KOA in the PL 1,500 group compared with the placebo group. The erythrocyte sedimentation tended to decrease in the PL 1,500 group compared with the placebo group (which was within the normal range). The visual analog scale score decreased in all groups, with no significant differences between groups. No adverse events related to PL were reported. There were no abnormal hematological or physical findings. Conclusion: This pilot clinical trial was the first step to assess the efficacy and safety of PL used in the treatment of patients with KOA.

Postoperative analgesic effects of the quadratus lumborum block in pediatric patients: a systematic review and meta-analysis

  • Insun Park;Jae Hyon Park;Hyun-Jung Shin;Hyo-Seok Na;Bon-Wook Koo;Jung-Hee Ryu;Ah-Young Oh
    • The Korean Journal of Pain
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    • 제37권1호
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    • pp.59-72
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    • 2024
  • Background: This study assessed the postoperative analgesic efficacy and safety of the quadratus lumborum block (QLB) in pediatric patients. Methods: Electronic databases were searched for studies comparing the QLB to conventional analgesic techniques in pediatric patients. The primary outcome was the need for rescue analgesia 12 and 24 hours after surgery. Secondary outcomes covered the Face-Legs-Activity-Cry-Consolability Scale (FLACC) scores at various time points; parental satisfaction; time to the first rescue analgesia; hospitalization time; block execution time; block failure rates, and adverse events. Results: Sixteen randomized controlled trials were analyzed involving 1,061 patients. The QLB significantly reduced the need for rescue analgesia both at 12 and 24 hours after surgery (12 hours, relative risk [RR]: 0.45; 95% confidence interval [CI]: 0.01, 0.88; 24 hours, RR: 0.51; 95% CI: 0.31, 0.70). In case of 24 hours after surgery, type 1 QLB significantly reduced the need for rescue analgesia (RR: 0.56; 95% CI: 0.36, 0.76). The QLB also exhibited lower FLACC scores at 1 hour (standardized mean difference [SMD]: -0.87; 95% CI: -1.56, -0.18) and 6 hours (SMD: -1.27; 95% CI: -2.33, -0.21) following surgery when compared to non-QLB. Among QLBs, type 2 QLB significantly extended the time until the first rescue analgesia (SMD: 1.25; 95% CI: 0.84, 1.67). No significant differences were observed in terms of parental satisfaction, hospitalization time, block execution time, block failure, or adverse events between QLB and non-QLB groups. Conclusions: The QLB provides non-inferior analgesic efficacy and safety to conventional methods in pediatric patients.