• The Korean Journal of Pain
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• v.37 no.1
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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.

• Journal of Preventive Medicine and Public Health
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• v.57 no.2
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• pp.96-107
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• 2024

Objectives: While several food assistance programs in the United States tackle food insecurity, a relatively new program, "Food is Medicine," (FIM) initiated in some cities not only addresses food insecurity but also targets chronic diseases by customizing the food delivered to its recipients. This review describes federal programs providing food assistance and evaluates the various sub-programs categorized under the FIM initiative. Methods: A literature search was conducted from July 7, 2023 to November 9, 2023 using the search term, "Food is Medicine", to identify articles indexed within three major electronic databases, PubMed, Medline, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Eligibility criteria for inclusion were: focus on any aspect of the FIM initiative within the United States, and publication as a peer-reviewed journal article in the English language. A total of 180 articles were retrieved; publications outside the eligibility criteria and duplicates were excluded for a final list of 72 publications. Supporting publications related to food insecurity, governmental and organizational websites related to FIM and other programs discussed in this review were also included. Results: The FIM program includes medically tailored meals, medically tailored groceries, and produce prescriptions. Data suggest that it has lowered food insecurity, promoted better management of health, improved health outcomes, and has, therefore, lowered healthcare costs. Conclusions: Overall, this umbrella program is having a positive impact on communities that have been offered and participate in this program. Limitations and challenges that need to be overcome to ensure its success are discussed.

• Clinics in Shoulder and Elbow
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• v.26 no.3
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• pp.296-301
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• 2023

Background: A supervised physiotherapy program (SPP) is a standard regimen after surgical rotator cuff repair (RCR); however, the effect of a home-based exercise program (HEP), as an alternative, on postoperative functional recovery remains unclear. Therefore, the purpose of this meta-analysis was to compare the functional effects of SPP and HEP after RCR. Methods: We searched electronic databases including Central, Medline, and Embase in April 2022. The primary outcomes included the Constant score, American Shoulder and Elbow Surgeons score, University of California Los Angeles shoulder score, and pain score. Secondary outcomes included range of motion, muscle strength, retear rate, and patient satisfaction rate. A meta-analysis using random-effects models was performed on the pooled results to determine the significance. Results: The initial database search yielded 848 records, five of which met our criteria. Variables at 3 months after surgery were successfully analyzed, including the Constant score (mean difference, -8.51 points; 95% confidence interval [CI], -32.72 to 15.69; P=0.49) and pain score (mean difference, 0.02 cm; 95% CI, -2.29 to 2.33; P=0.99). There were no significant differences between the SPP and HEP. Other variables were not analyzed owing to the lack of data. Conclusions: Our data showed no significant differences between SSP and HEP with regard to the Constant and pain scores at 3 months after RCR. These results suggest that HEP may be an alternative regimen after RCR. Level of evidence: I.

• Journal of Korean Medicine Rehabilitation
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• v.34 no.1
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• pp.83-95
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• 2024

Objectives This review was conducted to evaluate the therapeutic effects of manual acupuncture (MA) for shoulder impingement syndrome (SIS). Methods We searched 12 electronic databases (DBpia, Korean studies Information Service System [KISS], Oriental Medicine Advanced Searching Integrated System [OASIS], Research Information Sharing Service [RISS], China National Knowledge Infrastructure [CNKI], CINAHL, Clinical Key, Cochrane Library, Embase, JAMA, PubMed, Web of Science) to find randomized-controlled clinical trials (RCTs) investigating therapeutic effects of MA for treating SIS. Shoulder Pain and Disability Index scores and numeric pain rating scale or visual analogue scale were analyzed as the main evaluation criteria. Results Among 181 studies, 169 were screened and only 12 RCTs were eligible in our review. Finally, 11 RCTs could be statistically analyzed. MA was more effective than sham treatment and physical therapy in terms of reducing pain (p=0.003, p=0.0007 each). Electroacupuncture (EA) showed more significant effect than physical therapy (PT) for improving shoulder pain (p<0.00001) and shoulder functionality (p<0.00001). Conclusions These results suggest that MA and EA could be superior option for treating SIS than sham treatment or PT. However this review has its limitations due to the small sample size and lack of well-designed RCTs that were included in the study. Further well-designed RCTs are necessary to provide high-level evidence.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.27 no.5
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• pp.267-273
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• 2024

Helicobacter pylori infection is often acquired in early childhood. While most infected children remain asymptomatic, H. pylori can cause chronic gastritis, gastric ulceration, and, in the long term, gastric cancer. This article aimed to review different diagnostic and treatment options and discuss the challenges associated with applying the current guidelines in the real world. Relevant articles published from 2015 to August 2023 in the English language in PubMed and Medline electronic databases were extracted using subject headings and keywords of interest to the topic. References of interest in the selected articles were also considered. Invasive and noninvasive diagnostic tests have advantages but also disadvantages and limitations according to the clinical setting and age of the child. Guidelines recommend not performing diagnostic testing in children with long-lasting or recurrent abdominal complaints or cases of a family history of severe disease caused by H. pylori. However, parents regularly consult with the explicit demand to test for H. pylori because of them or a close family member experiencing severe gastric disease caused by H. pylori. In some situations, it may be challenging for the healthcare professional to stick to evidence-based guidelines and not consider "patient-centered care," with the risk of putting a trustful relationship in danger. Physicians may find it challenging not to perform diagnostic tests for H. pylori and prescribe eradication treatment in specific clinical settings when maintaining a trusting patientphysician relationship by applying this "patient-centered care" method when evidence-based guidelines recommend differently.

• The Journal of Korean Obstetrics and Gynecology
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• v.37 no.3
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• pp.49-62
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• 2024

Objects: This study was conducted to examine the effect of acupuncture on hot flashes symptoms that occurred after adjuvant endocrine therapy in breast cancer patients. Methods: A total of 7 electronic databases, including Pubmed, Cochrane Central, Embase, and CNKI, were used to search for randomized controlled trials studies on acupuncture treatment for hot flashes that occurred after adjuvant endocrine therapy in breast cancer patients. Studies published from January 2014 to March 2024 were targeted, and Breast Cancer, Hot Flashes, Acupuncture, and Electroacupuncture were used as search keywords. The intervention method, treatment period and follow-up period, results, side effects, and acupuncture points were analyzed. Results: According to the inclusion criteria, 7 studies were finally selected. Acupuncture, electroacupuncture, acupuncture and enhanced self-care were combined as intervention methods of the treatment group, and the most common control group was the use of sham acupuncture. The selected study was evaluated by the symptoms of hot flashes, quality of life, depression, and quality of sleep. In terms of hot flashes, quality of life, and depression, a significant number of treatment groups showed improvement results than control group. The most commonly used acupuncture points in the study were 百會 (GV20), 關元 (CV4), 氣海 (CV6) each of which was used twice. Conclusions: According to this study, the improvement of symptoms was confirmed when acupuncture and electroacupuncture treatment were used for hot flashes that occurred during breast cancer adjuvant endocrine therapy.

• The korean journal of orthodontics
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• v.54 no.5
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• pp.284-302
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• 2024

Objective: External apical root resorption (EARR) is characterized by permanent loss of dental structure at the root apex. This study aimed to systematically review gene polymorphisms associated with EARR in orthodontic patients. Methods: Electronic database searches were performed across several databases. Results: This systematic review included 21 studies. Outcome measures were based on tooth dimensions observed on radiographs obtained before and after treatment. Polymorphisms in the following genes were genotyped using polymerase chain reaction-restriction fragment length polymorphism analysis: purinergic-receptor-P2X, ligand-gated ion channel 7 (P2RX7), caspase-1/interleukin-converting enzyme (CASP1/ICE), caspase-5 (CASP5), IL-1beta (IL1B), IL-1alpha (IL1A), interleukin-1 receptor antagonist gene (IL1RN), tissue non-specific alkaline phosphatase (TNSALP), tumor necrosis factor-alpha (TNFα), tumor necrosis factor receptor superfamily gene member 11a (TNFRSF11A), secreted phosphoprotein 1 (SPP1), tumor necrosis factor receptor superfamily gene member 11b (TNFRSF11B), interleukin 17A (IL17), interleukin 6 (IL6), receptor activator of nuclear factor-kappa B (RANK), osteoprotegerin (OPG), stromal antigen 2 (STAG2), vitamin D receptor (VDR), cytochrome P450 family 24 subfamily A member 1 (CYP24A1), cytochrome P450 family 27 subfamily B (CYP27B1), group-specific component (GC), and interleukin-1 receptor-associated kinases 1 (IRAK1). Conclusions: Almost all studies suggested that IL1 gene is associated with EARR. Additionally, P2RX7 may be an important factor contributing to the etiopathogenesis of EARR. TNFRSF11A, SPP1, IL1RN, IL6, TNFRSF11B, STAG2, VDR, IRAK1, IL-17, CASP1/ICE and CASP5 have been identified in isolated studies. Further observational studies are needed to better explain the association between these genes and EARR.

• Hip & pelvis
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• v.36 no.3
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• pp.168-178
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• 2024

The purpose of this meta-analysis is to compare the postoperative outcomes and complications of labral repair with those of labral reconstruction. An electronic search strategy was conducted from 1986 until August 2023 using the following databases: PubMed, Cochrane, and Google Scholar (pages 1-20). The primary objectives included the postoperative clinical outcomes determined by the number of patients who reached minimal clinical important difference (MCID) on the visual analog scale (VAS), modified Harris hip score (mHHS), Hip Outcome Score-Sports Subscale (HOS-SS), Hip Outcome Score-Activities of Daily Life (HOS-ADL), and International Hip Outcome Tool-12 (iHOT-12). In addition, analysis of the rate of revision arthroscopy, the rate of conversion to total hip arthroplasty (THA), the postoperative VAS, mHHS, HOS-SS, HOS-ADL, iHOT-12, nonarthritic hip score (NAHS), patient satisfaction, lower extremity function scale (LEFS), and the SF-12 (12-item shortform) was also performed. Any differences arising between the investigators were resolved by discussion. Seventeen studies were relevant to the inclusion criteria and were included in this meta-analysis. A higher rate of patients who reached MCID in the mHHS (P=0.02) as well as a higher rate of revision arthroscopy was observed for labral repair (P=0.03). The remaining studied outcomes were comparable. Despite the greater predictability of success in the reconstruction group, conduct of additional studies will be required for evaluation of the benefits of such findings. In addition, labral reconstruction is more technically demanding than a labral repair.

• Journal of The Korean Society of Integrative Medicine
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• v.12 no.3
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• pp.237-247
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• 2024

Purpose : This study aimed to systematically review the effectiveness of nursing interventions for patients receiving extracorporeal membrane oxygenation (ECMO). As the use of ECMO increases in critical care settings, it is important to understand how nursing interventions affect patient outcomes, survival, and complication rates. Methods : This systematic review followed the preferred reporting items for systematic reviews and meta-analysis guidelines. A literature search was performed using terms related to ECMO and nursing interventions in several international electronic databases including CINAHL, Embase, MEDLINE, and Web of Science. Studies were screened and selected according to predefined eligibility criteria, focusing on those that evaluated the impact of nursing interventions on adult. Data extraction and risk-of-bias assessment were independently performed by two researchers. Results : A total of 647 studies were identified, and seven met the inclusion criteria for qualitative analysis. The included studies demonstrated that high-quality nursing care significantly improves clinical outcomes and reduces complications in patients receiving ECMO. Effective nursing interventions included prone positioning combined with ECMO for patients with acute respiratory distress syndrome, meticulous infection control, comprehensive and continuous nursing protocols, skilled nursing, and multidisciplinary management. These interventions have been shown to improve oxygenation, reduce complications, such as bleeding, manage blood pressure, and enhance overall clinical outcomes. Conclusion : High-quality nursing interventions are critical to improve survival and reduce complications in patients receiving ECMO. Implementing a multidisciplinary approach and comprehensive nursing protocols, including infection control and psychological support, is essential for the effective management of these patients. The findings of this study provide a foundation for the development of practical guidelines and educational programs to improve the quality of care for patients undergoing ECMO, ultimately enhancing the effectiveness of ECMO treatment and patient outcomes.

• Anatomy and Cell Biology
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• v.55 no.1
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• pp.3-13
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• 2022

The Gantzer's muscle is often present in the flexor compartment of the forearm. It lies underneath flexor digitorum superficialis and compresses the anterior interosseous nerve. Furthermore, this muscle frequently bestows an accessory muscle of flexor pollicis longus or flexor digitorum profundus, or sometimes together. The current meta-analysis aims to compute the prevalence of subtypes of Gantzer's muscle. Major electronic databases (PubMed, Scopus, Google Scholar, etc.) were searched for title and abstract. After removing the duplicate citations, the titles/abstracts were shortlisted with the help of inclusion and exclusion criteria. The shortlisted titles/abstracts were downloaded or collected from the library. The data of all subtypes of Gantzer's muscle were pooled from shortlisted published manuscripts for meta-analysis. The pooled estimate of other anatomical characteristics was also observed. A total of 59 cadaveric studies of sample size 5,903 were evaluated for pooled prevalence of flexor pollicis longus (accessory head). Similarly, the authors evaluated 14 studies of 1,627 upper limbs for flexor digitorum profundus (accessory head). The unit of analysis was per 100 upper limbs. The Pooled prevalence of accessory muscle of flexor pollicis longus and flexor digitorum profundus were 48% (95% CI, 44%-52%) and 17% (95% CI, 13%-21%), respectively. The Gantzer's muscle is present in 2/3rd of the upper limbs. Accessory head of flexor pollicis longus is almost three times more common than the accessory head of flexor digitorum profundus. A classification of Gantzer's muscle is needed to reduce the ignorance of these variants.