Objectives: This study was performed to analyze the interventions of Oriental Medicine which had been commonly used for postpartum disease and postpartum care. Methods: We searched research on the interventions for postpartum disease and postpartum care in 4 domestic search engines. After that, we conducted eligibility screening based on inclusion and exclusion criteria. Results: 1. We selected total 50 studies. There were 2 randomized controlled trial (RCT), 5 non-RCT, 35 case reports, 8 case series within the 6~8 weeks after childbirth. 2. Of the 35 case reports, several interventions were used : acupuncture (22), moxibustion (11), cupping therapy (7), pharmacopuncture (5), chuna manipulation (4), herbal medicine (34). The most common symptoms were musculoskeletal symptoms (8), followed by postpartum depression (7). Various prescriptions and acupoints of oriental medicine were used depending on the diseases or symptoms. 3. Of the 8 case series, 382 subjects in 5 case series had taken Saenghwa-tang-gagam. And Acupuncture, moxibustion, cupping therapy (5), pharmacopuncture (1) were used as an intervention. 4. The most commonly used acupoint is 腎兪 (BL23) in the pain including postpartum back pain and 三陰交 (SP6), 關元 (CV4) in the postpartum care. 關元 (CV4) is the most commomly used moxibustion point not only the postpartum disease but also the postpartum care. Conclusions: In clinical studies of oriental medicine related to postpartum disease and postpartum care, pain-related clinical studies that belong to or progress to Sanhupung were the most common (30%), and among them, postpartum low back pain studies were the most common (20%). Based on this, we believe that large-scale clinical studies with high quality using oriental interventions including chuna and pharmacopuncture are needed to establish guidelines for the management of pain treatment including postpartum back pain.
Background: Innovative Alzheimer's disease drugs received approval in the United States in 2021 and 2023. This study aims to assess the safety and efficacy of these novel treatments, elucidate their mechanisms of action, and compare their impact on cognitive function improvement with approved drugs. Methods: We conducted a comprehensive search of pivotal clinical studies related to Alzheimer's disease treatments in PubMed/Medline, Embase, and the Cochrane Library databases from January 1st, 2020 to December 31st, 2022. Meta-analysis was performed using RevMan 5.4 software. Results: A total of 14 studies were included in this systematic review. When compared to the placebo, the new drugs did not exhibit a statistically significant effect on MMSE (Mini-Mental State Examination) (mean difference= -0.04, 95% confidence intervals [CIs]: -0.31, 0.23, N=3662, I2=0%). However, they demonstrated a significant impact on ADAS-cog (Alzheimer's Disease Assessment Scale-Cognitive Subscale) (standardized mean difference= -0.15, 95% CIs: -0.2, -0.1, N=6710, I2=17%). When compared to the approved drugs, the new drugs showed a statistically significantly lower effect on MMSE (test for subgroup difference Chi2=23.13, N = 5870, p<0.00001) but showed only a trend of decreased efficacy on ADAS-cog (Chi2=1.16, N = 8670, p=0.28). Conclusion: New drugs yielded diverse clinical endpoint results compared to the placebo, and in comparison to existing approved drugs, they exhibited lower efficacy in improving cognitive function. The safety profile of these new drugs, as reported in clinical trials, was generally well-tolerated.
Symptoms of fig mosaic disease have been noticed on leaves of fig (Ficus carica) for several decades, in Montenegro. In 2014, leaf samples were collected from trees of six fig cultivars in a plantation located in the main fig-producing area of Montenegro, to study the disease. After RNA isolation, samples were tested by RT-PCR for detection of nine fig viruses and three viroids. Four viruses were detected: fig leaf mottle-associated virus 1 (FLMaV-1), fig mosaic virus (FMV), fig mild mottle-associated-virus (FMMaV) and fig badnavirus 1 (FBV-1). Most of the viruses were present in mixed infections. The amplicons of the viruses were directly sequenced from both directions. A BLAST search of these sequences revealed sequence identities with their closest counterparts at GenBank of 92, 97, 92 and 100%, for FLMaV-1, FMV, FMMaV and FBV-1, respectively. Different responses in symptom expression due to the various virus combinations detected have been demonstrated. Variety $Su{\check{s}}ilica$ had the least symptom expression, with only one virus (FBV-1) found. Considering that the production of figs in Montenegro is increasing and has a substantial relevance in this geographic location, the results indicate that more attention should be given to improving the phytosanitary condition of fig trees in the country.
Lee, Jiwon M.;Ahn, Yo Han;Lim, Seon Hee;Kang, Hee Gyung
Childhood Kidney Diseases
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제25권2호
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pp.92-111
/
2021
Purpose: Nephrotic syndrome (NS) is the most common form of glomerulopathy in children. Most pediatric patients respond to glucocorticosteroid treatment (steroid-sensitive NS, SSNS), while approximately 10-15% will remain unresponsive or later become steroid-resistant. There has been a long-standing effort to find biomarkers that may predict steroid responsiveness. Methods: We systematically reviewed current studies which investigated clinically relevant biomarkers for predicting steroid responsiveness in pediatric NS. We performed a PubMed and EMBASE search to identify eligible articles. We collected data on urinary markers, blood/serum markers (including cellular phenotypes and mRNA expression), genotypes and HLA allele frequency. Results: A total of 659 articles were identified following electronic and manual searches. After reviewing the titles, abstracts, and full texts, 72 eligible articles were finally included. Vitamin D-binding protein (VDBP) seemed to be significantly elevated in SRNS than in SSNS, in both serum and urine specimen, although further validation is required. Conclusions: The present paper narratively illustrates current understandings of potential biomarkers that may help predict steroid responsiveness. Further investigation and collaboration involving a larger number of patients are necessary.
Objectives The purpose of this study is to help find the future prospects by analyzing the trends of scalp acupuncture treatment for Parkinson's disease (PD) by searching the China National Knowledge Infrastructure (CNKI) and PubMed. Methods We searched clinical studies adopting scalp acupuncture treatment as a main intervention for PD through the searching the database of CNKI and PubMed. We analyzed the characteristics of selected studies especially according to study design, publication year, sample size, treatment period, treatment methods, outcomes criteria and adverse events. Results Twelve randomized controlled trials studies published from January 1, 2012 to July 1, 2023 were selected. In these studies, two types of scalp acupuncture treatments were performed and the most common treatment was Jiao shunfa's scalp acupuncture with fine needles. The most commonly used acupoints were "Chorea tremor control area", 風池 (GB20), 四神聰 (EX-HN1) and 百會 (GV20). The most commonly used outcome measures were effective rate, unified Parkinson disease rating scale (UPDRS) and UPDRS-III. Conclusions Through these results, we found that the Chinese review literature positively reported the effects of scalp acupuncture on PD. However, more high-quality evaluation using the well-designed studies including more objective outcomes should be required.
Giorgia Burrelli Scotti;Roberto Lorenzetti;Annalisa Aratari;Antonietta Lamazza;Enrico Fiori;Claudio Papi;Stefano Festa
Clinical Endoscopy
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제56권6호
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pp.726-734
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2023
Background/Aims: Endoscopic stenting for stricturing Crohn's disease (CD) is an emerging treatment that achieves more persistent dilatation of the stricture over time than endoscopic balloon dilatation (EBD). We aimed to explore the efficacy and safety of stenting for the treatment of CD strictures. Methods: A systematic electronic literature search was performed (PROSPERO; no. CRD42022308033). The primary outcomes were technical success, efficacy, complication rate, and the need for further interventions due to reobstruction. The outcomes of partially covered self-expanding metal stents (PCSEMS) with scheduled retrieval after seven days were also analyzed. Results: Eleven eligible studies were included in the review. Overall, 173 patients with CD were included in this study. Mean percentage of technical success was 95% (range, 80%-100%), short-term efficacy was 100% in all studies, and long-term efficacy was 56% (range, 25%-90%). In patients with a scheduled PCSEMS retrieval, the long-term efficacy was 76% (range, 59%-90%), the mean complication rate was 35% (range, 15%-57%), and the major complication rate was 11% (range, 0%-29%). Conclusions: Endoscopic stenting with scheduled PCSEMS retrieval may be considered a feasible second-line treatment for short CD strictures to postpone surgery. However, larger head-to-head prospective studies are needed to understand the role of stenting as an alternative or additional treatment to EBD in CD.
Background: Head and neck cancer (HNC) is the ninth most common cancer worldwide, and has a poor 5-year survival rate averaging 50%, which has not changed for decades. A high prevalence of HNC has been reported in the southwestern region of Saudi Arabia, as compared to other areas of the country. However, data in regards to HNC are scattered and not well documented. Thus, the aim of this systematic review was to gather all available and updated important information regarding HNC in Saudi Arabia, and highlight the gaps of knowledge in our country with regard to this disease. In addition, suggestions of solutions to overcome the current status and improve our future standard of care to fight HNC are also highlighted. Materials and Methods: The electronic databases PubMed and Google Scholar using English-language literature were used for this systematic review, using specific inclusion and exclusion criteria and keywords. The search was performed in April 2016 and updated in June 2016. Results: Our search revealed twenty-one studies that fulfilled our inclusion and exclusion criteria and that were conducted in Saudi Arabia. These studies investigated different aspects of HNC, including prevalence, risk factors, biomarkers, and assessed knowledge and awareness of both public and practitioners with regard to HNC. Conclusions: This review uncovered a big gap in our epidemiological data in cancer information in general, and head and neck cancer in particular. In addition, a lack of knowledge and awareness of both the public and health care practitioners hinders the early diagnosis of disease and negatively impact the prognosis, treatment and outcome. The Ministry of Health in Saudi Arabia should develop a more systematic way and adapt policies to gather cancer information in general, and head and neck cancer in particular, from all governmental and private sectors from all over the kingdom, and develop educational programs to raise the knowledge and awareness of HNC in the country.
Purpose: The purpose of this study was to review systematically the effects of home based pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD) patients using qualitative synthesis. Methods: Studies designed randomized controlled trials were identified to extract data and to assess the quality of studies in 8 domestic and 3 foreign search engines, and hand search reference reviews. Results: A total of 9 studies met the inclusion criteria. Overall, the methodological quality of the studies ranged from average to poor. Home based pulmonary rehabilitation consisted of exercise, education, and psychosocial interventions. Several exercises such as aerobic, strength, respiratory muscle training, and flexibility were used in home based pulmonary rehabilitation for COPD patients. Upper muscle exercise and walking were the most frequently used exercises. The most common topics for education were 'knowledge of the illness' and 'drug management'. Walking distance test (WDT) and quality of life (QoL) were the most frequently measured as the dependent variables to evaluate rehabilitation outcomes, followed by pulmonary function test (PFT) and dyspnea. WDT was the most effective outcome, followed by dyspnea, QoL and PFT. Conclusion: This study informed about the details of scientific and effective home based rehabilitation programs in COPD patients for future researchers and clinicians. These findings can help expand the recognition and accessibility of home based rehabilitation in COPD patients.
Purpose: This study aimed to utilize concept analysis to obtain a better understanding of the concept of "continuity of care" in chronic diseases. Methods: The concept of continuity of care was analyzed using the Walker and Avant method. Covering literature in English from 1930 to 2018, the data sources included CINAHL Complete, Academic Search Complete, MEDLINE, PsyARTICLES, Health Source: Nursing/Academic Edition, Google Scholar, Science Direct, and the Cochrane Library. Results: A comprehensive definition of concept of continuity of care was developed based on a systematic search and synthesis. The key defining attributes were identified as (a) care over time, (b) the relationship between an individual patient and a care team, (c) information transfer, (d) coordination, and (e) meeting changing needs. The antecedents of continuity of care were having a chronic disease, inexperienced with disease management, a poorly coordinated healthcare system, and medical care limitations. The consequences of continuity of care were decreasing hospital admissions, reducing costs, reducing emergency room visits, improving the quality of life, improving patient satisfaction, and delivering good healthcare. Conclusion: The thorough concept analysis provides insight into the nature of "continuity of care" in chronic diseases and also helps ground the concept in healthcare.
BACKGROUND/OBJECTIVES: The long-term health impacts of dietary sugar have begun to be reported. The committee on the 2020 Dietary Reference Intakes for Koreans for sugar intended to update the scientific evidence on the association of added sugar intake with health outcomes, including mortality. This study evaluated the evidence on the association of dietary sugar with the all-cause and cardiovascular disease mortality from cohort studies. SUBJECTS/METHODS: The PubMed and ScienceDirect databases were searched until July 2021. The search terms were based on multiple combinations of keywords, such as added sugar, beverage, and mortality, included in the title or abstract. Two authors independently assessed the eligibility criteria of study selection and extracted the information from each selected article for this systematic review. RESULTS: The literature search identified 276 articles. Seventeen cohort studies met the inclusion criteria and were included in this systematic review. This study extracted information on the cohort and participants, dietary assessment methods, exposure and its comparison groups, health outcomes, and risk measures. Five articles reported added sugar intake, and 15 articles reported the food sources of the added sugar in the association with mortality. Increased mortality was observed in higher added sugar intake and a lower intake of less than 5% of energy, while higher discrepancies between gender, age groups, and countries were noted. In addition, nutritious sugary foods and beverages did not increase mortality. CONCLUSIONS: A 'U' or 'J' shaped relationship between the added sugar intake and mortality was estimated. The observed discrepancy indicated the need for more evidence to establish the dose-response relationship for Koreans.
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