• 대한한방부인과학회지
• /
• 제36권3호
• /
• pp.78-94
• /
• 2023

Objectives: The purpose of this study is to review the trends of clinical trials of traditional herbal medicine Gyejibongnyeong-hwan for chronic pelvic inflammatory disease in CNKI. Methods: We searched relevant studies using Chinese National Knowledge Infrastructure (CNKI). Data retrieval was carried out by December 20^th, 2021. We analyzed characteristics of study subjects, treatment period, composition of prescription, outcome and adverse event of selected studies and the risk of bias was assessed by using Cochrane's risk of bias tool. Results: Among the total 988 studies, 10 studies met the inclusion criteria. All of the studies were randomized controlled studies and written in Chinese. In all studies, Gyejibongnyeong-hwan was effective in improving chronic pelvic inflammatory disease. Conclusions: This study suggests that Gyejibongnyeong-hwan can be effective in treating chronic pelvic inflammatory disease compared to antibiotics treatment. Further large and well-established randomized placebo controlled trials will be needed.

• Clinical and Experimental Vaccine Research
• /
• 제12권4호
• /
• pp.313-318
• /
• 2023

Purpose: Globally, 25 million children were either unvaccinated or under-vaccinated in year 2021. Among them, India had the highest number of children unvaccinated. Studies have shown impact of coronavirus disease 2019 (COVID-19) pandemic on routine health-care services. Present study aimed to estimate the impact of COVID-19 on utilization of routine immunization services during years 2020 and 2021 in tertiary-care facility. Materials and Methods: Record based descriptive analytic study was conducted at pediatric tertiary-care hospital, Jaipur. Data of children vaccinated as per the National Immunization Schedule for the period January 2019 to December 2021 were retrieved from the immunization records. Doses administered were assessed as a proxy measure of vaccine coverage. The vaccination trends of 2020 and 2021 were compared assuming base year 2019. Unpaired t-test of significance and Pearson correlation was used for correlation analysis. Results: There was significant drop in the vaccine counts after emergence of COVID-19 pandemic. In year 2020 and 2021, mean monthly vaccine count was 2,190±715.1 and 2,305±393.2, respectively, in which maximum drop was in April 2020 (-79.12%) and May 2021 (-57.16%) when it was compared with matched month of base year. There was negative correlation between percent change in vaccine count and COVID-19 cases in 2020 (r=-0.057, p=0.861) and 2021 (r=-0.827, p=0.001) as compared to year 2019. Conclusion: Study concludes that there was a significant gap in utilization of routine immunization services during the COVID-19 pandemic. This necessitates planning and management of routine immunization services in-case of future pandemics to avoid resurgence of vaccine-preventable diseases in the Rajasthan.

• 한국간담췌외과학회지
• /
• 제26권1호
• /
• pp.17-30
• /
• 2022

Oncological scoring systems in surgery are used as evidence-based decision aids to best support management through assessing prognosis, effectiveness and recurrence. Currently, the use of scoring systems in the hepato-pancreato-biliary (HPB) field is limited as concerns over precision and applicability prevent their widespread clinical implementation. The aim of this review was to discuss clinically useful oncological scoring systems for surgical management of HPB patients. A narrative review was conducted to appraise oncological HPB scoring systems. Original research articles of established and novel scoring systems were searched using Google Scholar, PubMed, Cochrane, and Ovid Medline. Selected models were determined by authors. This review discusses nine scoring systems in cancers of the liver (CLIP, BCLC, ALBI Grade, RETREAT, Fong's score), pancreas (Genç's score, mGPS), and biliary tract (TMHSS, MEGNA). Eight models used exclusively objective measurements to compute their scores while one used a mixture of both subjective and objective inputs. Seven models evaluated their scoring performance in external populations, with reported discriminatory c-statistic ranging from 0.58 to 0.82. Selection of model variables was most frequently determined using a combination of univariate and multivariate analysis. Calibration, another determinant of model accuracy, was poorly reported amongst nine scoring systems. A diverse range of HPB surgical scoring systems may facilitate evidence-based decisions on patient management and treatment. Future scoring systems need to be developed using heterogenous patient cohorts with improved stratification, with future trends integrating machine learning and genetics to improve outcome prediction.

• Korean Circulation Journal
• /
• 제54권1호
• /
• pp.1-12
• /
• 2024

Background and Objectives: The objective of this study was to estimate the supply and demand for cardiologists in Korea and provide evidence for healthcare policy to ensure a stable and adequate workforce for optimal cardiovascular disease management. Methods: Past trends of inflow and outflow of cardiologists were used to make crude projections, which were then adjusted based on demands of services to obtain final projections. Inflow of cardiologists was estimated using second-order polynomial regression and demand for cardiology care was estimated using linear regression. Results: There were 1,139 active cardiologists who were under the age of 65 in clinical practice in Korea. The estimated number of cardiologists from 2022 to 2040 showed that the number of cardiologists would peak at 1,344 in 2032 and gradually decrease thereafter. We also estimated an increase of 947,811 cases of heart-related procedures annually from 2023 to 2032. The number of heart-related procedures per cardiologist would increase 1.4 times from 12,964 in 2023 to 17,862 in 2032. The estimated number of emergency patients per cardiologist under 50 years old would almost double from 544 in 2022 to 987 in 2032. Conclusions: We expect significant shortage of cardiologists in Korea within the next 10 years. The number of emergency patients per cardiologist will increase by nearly 50%, leading to high individual workload for cardiologists. To prevent this imbalance between supply and demand, an organized and collective approach by the specialty of cardiology is imperative to produce a balanced workforce.

• Restorative Dentistry and Endodontics
• /
• 제49권3호
• /
• pp.29.1-29.11
• /
• 2024

This study aimed to identify and analyze articles on enamel microabrasion for the treatment of white spot lesions. A search was conducted on the Web of Science. The following parameters were recorded and analyzed: number of citations, year, journal, impact factor, study design, theme, country and continent, institution, authors, and keywords. Data was analyzed using VOSviewer software. The initial search resulted in 1,126 documents, of which 94 articles were included. The highest number of citations an article received was 65. The oldest article was published in 1975, and the most recent in 2023. The most frequent study design was case report (n = 42). Regarding the themes, it was observed that the main objective of the studies was to evaluate the clinical performance of enamel microabrasion (n = 75), primarily using Opalustre (Ultradent Products Inc., South Jordan, UT, USA) (n = 37) for treating white stains caused by dental fluorosis (n = 41). Most articles originated from Latin America (n = 31), mainly from Brazil (n = 26). The most frequent author was Sundfeld RH (n = 10). This study reveals research trends in the field of enamel microabrasion. The publications were mainly case reports/series using Opalustre for the removal of fluorosis stains.

• Journal of Dental Anesthesia and Pain Medicine
• /
• 제24권5호
• /
• pp.329-340
• /
• 2024

Dental treatment is challenging for children experiencing pain and anxiety. Effective administration of local anesthesia (LA) is crucial for most pediatric dentistry treatments. Eye Movement Desensitization and Reprocessing (EMDR) therapy has emerged primarily to manage post-traumatic stress disorder (PTSD) and a wide variety of anxiety- and pain-related conditions. However, the use of this therapy to manage pain in pediatric dentistry has not yet been reported. This study aimed to assess the trends in pain in pediatric dental patients with and without EMDR therapy during LA and extraction. The need for analgesic consumption within 24 h post extraction and the overall dental experience were also evaluated. Methods: Sixty children aged 8-12 years participated in a randomized controlled clinical trial with the goal of extracting the primary mandibular first or second molar on the right or left side and were stratified into: group I: EMDR therapy; group II: Tender Love and Care. Pain was measured at three different time intervals. An unpaired t-test was performed for intergroup comparison of continuous data, and the repeated measures ANOVA was applied for intergroup comparison between the groups. Results: Pain was significantly lower in group I (pain after topical LA gel application, P = 0.229; pain after LA administration, P = 0.036; pain after extraction, P < 0.001). The need for analgesic consumption was lower in this group (P = 0.072), and the overall dental experience was rated better (P < 0.0001). Conclusion: Research has shown that EMDR therapy effectively reduces pain in children, making it a recommended practice for pediatric dentists trained in this technique.

• 재활치료과학
• /
• 제10권1호
• /
• pp.7-17
• /
• 2021

목적 : 본 연구는 텍스트마이닝을 활용하여 국외 노인 작업치료의 양적 변화와 현황 파악을 정량적으로 분석하고자 하였다. 연구 방법 : 2009~2019년까지 PubMed를 활용하여 Elderly, Health, Occupational therapy가 들어간 제목과 초록이 존재하는 연구논문을 분석대상으로 선정하여 초록의 단어들을 수집하였다. 수집된 정보를 통해 연도별 발생 논문 편수, 핵심어 분석, 연도별 핵심어 분석, 단어들 간의 관계성을 분석하였다. 결과 : 2009-2019년에 발표된 논문은 9,941편이며, 2009년부터 점차적으로 증가하여 2017년 또는 2018년에 최다 빈도를 보인 후 2019년에 감소하는 추이를 보였다. 최근 5년간 빈도수가 많은 단어는 Care, Group, Intervention, Pain, Treatment, Work이었다. 최근 11년간 평균적인 빈도수를 기준으로 단어 간의 관계성을 파악한 결과, Function, Health, Intervention, Participation이 단어들 간의 높은 관계성을 보였다. 결론 : 본 연구는 텍스트마이닝이라는 새로운 연구방법을 적용하여 작업치료의 동향을 실증적, 체계적으로 분석하여 거시적이고 종합적인 결과를 제시했다는 점에 의의가 있다. 이를 토대로 노인과 관련된 작업치료 임상 및 연구 현장에서 새로운 연구방향을 설정하는데 도움이 될 것으로 기대한다.

• Pediatric Infection and Vaccine
• /
• 제24권2호
• /
• pp.95-101
• /
• 2017

목적: 소아 급성 세균성 위장염은 흔히 급성 바이러스성 위장염에 비해 더 심각한 증상을 일으킬 수 있다. 본 연구는 소아 급성 세균성 위장염 환자의 원인을 조사하고, 임상 양상을 알아보고자 하였다. 방법: 2011년 1월부터 2014년 12월까지 서울에 위치한 1개 이차 병원에서 급성 위장염 증상으로 진료 받은 소아 환자들의 대변을 서울시 보건환경연구원으로 보내어 원인균 검사를 시행하였다. 결과에 따른 임상적인 특성은 소아 환자들의 의무기록을 통해 후향적으로 조사하였다. 결과: 총 664 대변 샘플 중 183개(27.6%)에서 원인균이 분리되었다. 2012년부터 검사가 시행되었음에도 불구하고, 황색포도알균이 가장 흔한 원인균이었다(39.3%). 월별 검출률은 8월이 24.6%로 가장 높았다. 캄필로박터균의 연령군에 따른 검출률은 12-19세 군에서 가장 높았다(16.7%, P=0.04). 혈변을 보인 환자들 중에서 캄필로박터균이 가장 흔하게 분리되었다(31.0%, P=0.04). C-반응단백질을 비교 시 살모넬라속균 또는 캄필로박터균이 분리된 군이 황색포도알균 또는 병원성 대장균이 분리된 군에 비해서 더 높았다($5.7{\pm}0.6mg/dL$ vs. $2.1{\pm}0.3mg/dL$, P<0.01). 결론: 황색포도알균, 병원성 대장균, 캄필로박터균, 살모넬라속균이 소아 세균성 위장염의 중요한 원인균이었다. 연령에 따른 원인균 차이, 임상 증상, 염증 지표를 고려하는 것이 원인균을 추정하는 데 도움이 될 수 있겠다.

• 생물정신의학
• /
• 제24권3호
• /
• pp.95-109
• /
• 2017

본 종설에서는 우울증에서의 rTMS 임상연구를 임상특성과 TMS 적용방법을 고려하여 체계적으로 고찰하였으며 새로운 TMS 치료기법에 대해 살펴보았다. rTMS는 항우울제에 반응이 적은 단극성 우울증 환자의 치료에 병용 혹은 단독요법으로 사용될 수 있는 안전하고 비침습적인 뇌조절술이다. rTMS는 고빈도 좌측 DLPFC, 저빈도 우측 DLPFC, 그리고 양측성 DLPFC 적용방법이 비슷한 수준으로 허위자극에 비해 유의하게 항우울효과를 가지고 있다. 그러나 치료저항성 단극성 우울증에 대한 항우울효과 크기는 작았다. 또한 정신병적 증상이 동반된 우울증의 치료와 양극성 장애의 우울삽화에 대해서는 치료효과가 불분명하다. 기존 rTMS의 항우울효과 크기는 작은 정도로 그 효과를 증진시키기 위해 고용량의 자극, 보다 깊이 자극할 수 있는 코일을 이용한 rTMS 치료, 표적영역에 보다 정확하게 코일을 위치시키는 신경항법 등을 이용한 TMS 적용 등의 새로운 시도들이 진행되고 있다. 또한 세타돌발자극과 자기경련치료와 같은 새로운 치료기법을 이용한 시도가 우울증 치료의 새로운 장을 열고 있다. 비록 현재까지 rTMS의 항우울효과가 만족할 만한 수준은 아니지만 임상양상을 세분화한 치료적용과 개선된 치료기법의 적용 등을 통해 더 많은 후속 연구가 이루어질 필요가 있다. 또한 여러 형태의 TMS 기법에 대해 잘 설계된 허위자극에 대한 통제연구뿐만 아니라 서로의 비교연구를 통해 우울증 치료에서의 근거수준을 높일 수 있을 것으로 기대한다.

• 한국콘텐츠학회논문지
• /
• 제18권4호
• /
• pp.480-494
• /
• 2018

본 연구는 이현희(2017)의 연구에서 개발한 병동 간호활동원가계산 프로그램의 실무 적용 확대를 위하여 자료의 저장 및 그래프 변환 출력 기능을 보완하여 수정 개발한 후속 연구이다. 전체 프로그램 개발과정은 프로그램 요구사항 분석과 프로그램 설계 및 개발, 프로그램 타당성 검토의 3단계로 이루어졌다. 본 프로그램은 단순히 원가계산에서 그치는 것이 아니라 원가효율성 및 원가분석 추세 비교까지 결과를 산출하여 간호관리자가 병동 간호단위 관리에 필요한 원가정보를 얻을 수 있고 이를 기반으로 원가관리전략을 수립할 수 있도록 하여 그 활용도를 확장한 점에서 의의가 있다. 또한 향후 이를 기반으로 병동 단위 뿐 아니라 수술실, 중환자실과 같은 특수부서 그리고 외래와 같이 간호활동의 구성과 범위가 다른 부서별 간호활동원가계산을 수행하는 원가분석 프로그램 개발할 수 있는 토대를 마련한 점에서도 의의가 있다. 이에 본 연구를 기반으로 이를 다양한 실제 임상 간호관리 실무에 적용함으로써 임상 간호사의 원가관리 역량을 강화하고 나아가 간호단위 간호활동의 수익과 이익 분석을 통해 계량화된 간호의 기여도를 측정, 제시함으로써 간호성과 측정 연구를 확대해 나갈 것을 제안한다. 아울러 본 TD-ABC 간호활동원가계산 프로그램의 적용과 활용을 학부 수준의 간호관리학 교과과정과 접목하고, 임상간호사의 보수교육 프로그램으로도 활용하여 간호원가관리 역량 강화를 위한 교육매체로도 활용할 것을 제안한다.