• Title/Summary/Keyword: Meta-review

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Association Between Gestational Diabetes Mellitus and Subsequent Risk of Cancer: a Systematic Review of Epidemiological Studies

  • Tong, Gui-Xian;Cheng, Jing;Chai, Jing;Geng, Qing-Qing;Chen, Peng-Lai;Shen, Xin-Rong;Liang, Han;Wang, De-Bin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.10
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    • pp.4265-4269
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    • 2014
  • Purpose: This study aimed at summarizing epidemiological evidence of the association between gestational diabetes mellitus (GDM) and subsequent risk of cancer. Materials and Methods: We searched Medline, Embase, Cancer Lit and CINAHL for epidemiological studies published by February 1, 2014 examining the risk of cancer in patients with history of GDM using highly inclusive algorithms. Information about first author, year of publication, country of study, study design, cancer sites, sample sizes, attained age of subjects and methods used for determining GDM status were extracted by two researchers and Stata version 11.0 was used to perform the meta-analysis and estimate the pooled effects. Results: A total of 9 articles documented 5 cohort and 4 case-control studies containing 10,630 cancer cases and 14,608 women with a history of GDM were included in this review. Taken together, the pooled odds ratio (OR) between GDM and breast cancer risk was 1.01 (0.87-1.17); yet the same pooled ORs of case-control and cohort studies were 0.87 (0.71-1.06) and 1.25 (1.00-1.56) respectively. There are indications that GDM is strongly associated with higher risk of pancreatic cancer (HR=8.68) and hematologic malignancies (HR=4.53), but no relationships were detected between GDM and other types of cancer. Conclusions: Although GDM increases the risk of certain types of cancer, these results should be interpreted with caution becuase of some methodological flaws. The issue merits added investigation and coordinated efforts between researchers, antenatal clinics and cancer treatment and registration agencies to help attain better understanding.

A Systematic Review of Acupuncture for Chronic Fatigue Syndrome

  • Kim, Hong Guk;Ryoo, Dek Woo;Jeong, Seong Mok;Kim, Sung Jin;Baek, Seung Won;Lee, Chang Hee;Yoon, Jin Young;Goo, Bon Hyuk;Kim, Min Jeong;Park, Yeon Cheol;Seo, Byung Kwan;Baek, Yong Hyeon;Nam, Sang Soo;Kim, Yong Suk
    • Journal of Acupuncture Research
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    • v.34 no.2
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    • pp.93-112
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    • 2017
  • Objectives : To evaluate and summarize the efficacy and safety of acupuncture treatment (AT) in chronic fatigue syndrome (CFS). Methods : Fifteen databases (Pubmed, Cochrane, EMBASE, AMED, CINAHL, CNKI, Wanfang, and eight Korean databases) were searched up to September 2016. Only trials in which acupuncture was the sole treatment were included. Fatigue was used as the primary outcome measure, while the quality of life, pain, mood disorders, and adverse events were used as secondary outcome measures. We adopted three classifications: AT vs Sham AT, AT vs Wait-list, AT vs Western medication. The Cochrane risk of bias tool was used to assess the methodological quality. Results : A total of 11 randomized controlled trials involving 869 participants were identified. In comparison with Sham AT, AT significantly alleviated fatigue and pain, but no conclusions about the quality of life and mood disorders could be drawn. In the Wait-list group and Western medication groups, patients with CFS might feel less fatigued following acupuncture treatment, but the evidence was insufficient due to lack of study. Nine of 11 RCTs (81.8%) reported adverse events and there were two cases of mild subcutaneous hemorrhage, but no serious adverse cases. Conclusion : This review found evidence that patients with CFS may generally benefit from alleviation of symptoms by acupuncture treatment, and there is no evidence of worsening symptoms or causing of serious adverse events. A positive effect on fatigue and pain was observed, but no conclusion for improving quality of life and mood disorders.

The Effectiveness and Safety of Acupuncture for Recovery of Patients with Vertebral Compression Fractures: A Systematic Review and Meta-analysis (척추 압박 골절 환자의 회복에 대한 침 치료의 유효성 및 안전성 평가: 체계적 문헌 고찰과 메타분석)

  • Bae, Ji min;Lee, Myeong su;Choi, Ji won;Yang, Gi young;Kim, Kun hyung
    • Korean Journal of Acupuncture
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    • v.36 no.1
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    • pp.1-18
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    • 2019
  • Objectives : The purpose of this study was to evaluate the effectiveness and safety of acupuncture treatment for recovery of patients with vertebral compression fracture(VCF). Methods : We searched ten English and Chinese and seven Korean database up to April 2018. Randomised controlled trials(RCTs), quasi-RCTs, non-radomised Controlled Trials(CCTs) were eligible. Quasi-RCTs and CCTs were assessed only for safety assessment. Pain and adverse events were primary outcome of this review. Quality of life, dysfunction, patient satisfaction, incidence of new vertebral compression fracture were regarded as secondary outcomes. The risk of bias was assessed by two independent authors using the Cochrane risk of bias tool. Level of evidence was tabulated using the GRADE methods. Results : Of 1656 screened, 15 RCTs, 1 quasi-RCT and 3 CCTs were included. Number of participants per study ranged from 45 to 135. Most of the studies had unclear or high risk of bias and considerable heterogeneity in terms of type of intervention, comparison and time-points for outcome measurement. Compared to usual care alone, acupuncture combined with usual care showed short-term favorable results for pain relief in patients with VCF(5 studies, n=252, MD -1.05 point on a 0 to 10 point scale, 95% CI -1.45 to -0.65, $I^2=74%$). Four studies reported mild and temporary adverse events, and no serious adverse events were reported. One study descriptively reported that acupuncture was effective for improving quality of life without providing numerical outcomes. There were no reports of patient satisfaction and incidence of new VCF. Conclusions : Level of evidence is very low for the effectiveness and safety of acupuncture for pain, harms and other clinical outcomes in patients with VCF. Included studies suffered from incomplete reporting, high or unclear risk of bias and substantial heterogeneity between studies. Future high-quality RCTs are needed to assess whether acupuncture is beneficial for recovery of patients with VCF.

Efficacy and Safety of Combination Treatment of Traditional Korean Medicine after Gastric Cancer Surgery: A Systematic Review and Meta-analysis Protocol (위암 수술 후 항암치료를 병행한 한의치료의 유효성 및 안전성: 체계적 문헌고찰 및 메타분석 프로토콜)

  • Jong-hee Kim;Eunbin Kwag;So-jung Park;Donghyun Kim;Soodam Kim;Jihye Park;Hwa-seung Yoo
    • Herbal Formula Science
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    • v.31 no.4
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    • pp.361-371
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    • 2023
  • Objectives : Gastric cancer is a malignant tumor of the digestive tract that not only has a high mortality rate, but also affects quality of life. In Traditional Korean Medicine, acupuncture and herbal medicines can increase the survival rate for Gastric cancer and improve the quality of life. Traditional Korean Medicine treatment played an important role when used alone or in combination with chemotherapy. However, there is still insufficient evidence to support the efficacy and safety of Traditional Korean Medicine in patients undergoing chemotherapy after surgery. Therefore, the purpose of this study is to systematically evaluate the effect of oriental medicine treatment on patients as a complementary therapy for Gastric cancer. Methods : 2 researchers will search using EMBASE, Pubmed, CNKI, Cochrane Library, CiNii, KMBASE, KISS, OASIS, RISS, ScienceON. The search period of the database is from inception until June 2022. This study will include a randomized controlled trial of GC for acupuncture and herbal treatment. Primary outcomes include anti-cancer effects. Secondary outcomes evaluate survival rates and improvements in quality of life. The data uses Review Manager Software 5.4. Results : This study will provide a systematic evaluation by synthesizing the anti-cancer effect, survival rate and quality of life of Gastric cancer when Traditional Korean Medicine is combined with chemotherapy. Conclusion : The conclusion of this study will provide a basis for determining whether Traditional Korean Medicine treatment for Gastric cancer treatment is an effective and safe treatment method in clinical practice.

The Effect on Pulmonary Indices of Surfactant Therapy for Meconium Aspiration Syndrome: Systematic Review and Meta-analysis (태변흡인증후군에서 폐표면활성제 사용이 호흡기지표에 미치는 영향에 대한 체계적 문헌고찰과 메타분석)

  • Choi, Hyun-Jin;Hahn, Seo-Kyung;Lee, Soon-Min;Kim, Han-Suk;Bae, Chong-Woo
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.189-196
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    • 2011
  • Purpose: Surfactants have been used to improve oxygenation for infants with meconium aspiration syndrome (MAS). We evaluated the change of pulmonary indices after surfactant therapy for MAS through a systematic meta-analysis. Methods: Relevant randomized controlled studies (RCTs) were identified by database searches in MEDLINE, EMBASE, and CENTRAL, up to June 2011, and by additional hand searches. Data were extracted regarding pulmonary indices, such as the oxygen index and arterial alveolar oxygen gradient. Meta-analyses were separately conducted for the studies of surfactant lavage therapy and surfactant bolus therapy. The risk of bias was assessed, and clinical as well as statistical heterogeneities were also investigated. Results: Two RCTs for bolus surfactant therapy and two RCTs for surfactant lavage therapy were identified. The oxygenation index results were heterogeneous between the two studies in which bolus surfactant therapy was given, while a/A $PO_2$ showed significantly better results in the treatment group over time after use of surfactant (12 hours: WMD 0.08, 95% CI 0.04-0.12; 24 hours: WMD 0.17, 95% CI 0.06-0.28). For surfactant lavage therapy, both studies consistently suggested an interventional benefit in terms of the pulmonary indices although it did not reach statistical significance. Conclusion: Surfactant therapy appeared to improve oxygenation of infants with MAS. Since a limited number of RCTs are available in the current literature and those studies were also clinically heterogeneous in terms of illness severity and the method of surfactant use, further research is needed to gather evidence to support surfactant therapy in MAS.

Analysis on Construction Clients' Role for Safety and Health Management in Plan, Design, and Construction Stage (건설공사 발주자의 계획, 설계, 공사단계 안전보건관리 역할 분석)

  • Lim, Se Jong;Jeong, Seong-choon;Na, Ye Ji;Won, Jeong-Hun
    • Journal of the Korean Society of Safety
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    • v.35 no.3
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    • pp.24-31
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    • 2020
  • The duty of construction clients in WSH (Workplace Safety and Health) system was included in the amendment of Occupational Safety and Health Act (enforced on 16 January 2020), which was estimated the shift of paradigm in the prevention of construction accidents. The purpose of this paper is to introduce the analysis results of construction clients' role in the construction project, which were performed by authors over the recent years in order to impose the duty on construction clients, and to suggest their role according the plan, design, and construction stage. Utilizing the systematic literature review process based on Meta analysis, the related papers were selected. For the selected papers, related domestic and foreign regulations, and other prominent report, the construction clients' role was analyzed by reflecting the experts' advice. Results show that the construction clients should control the designer and contractor for implementing the WHS system during the whole process of the construction project. They should supply sufficient source and time to ensure the workers' safety. In the plan stage, the key role of construction clients is to identify intensively controlled hazard and risk reduction plan and to transfer the results. In the design stage, their key role is to select the designer with the capacity in WSH and to assist the designer for the safety design. The main key role of construction clients in the costruction stage is to select the contractor with specialty in WSH including a contract reflecting the WSH requirement and to check implementation of WSH plan, WSH cost, WSH education, and accident report. In addition, it is thought that the construction clients' participations in the site WSH activity and adjustment of safety and health problem among contractors can be effect in the prevention of construction accidents.

Tumor hypoxia and reoxygenation: the yin and yang for radiotherapy

  • Hong, Beom-Ju;Kim, Jeongwoo;Jeong, Hoibin;Bok, Seoyeon;Kim, Young-Eun;Ahn, G-One
    • Radiation Oncology Journal
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    • v.34 no.4
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    • pp.239-249
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    • 2016
  • Tumor hypoxia, a common feature occurring in nearly all human solid tumors is a major contributing factor for failures of anticancer therapies. Because ionizing radiation depends heavily on the presence of molecular oxygen to produce cytotoxic effect, the negative impact of tumor hypoxia had long been recognized. In this review, we will highlight some of the past attempts to overcome tumor hypoxia including hypoxic radiosensitizers and hypoxia-selective cytotoxin. Although they were (still are) a very clever idea, they lacked clinical efficacy largely because of 'reoxygenation' phenomenon occurring in the conventional low dose hyperfractionation radiotherapy prevented proper activation of these compounds. Recent meta-analysis and imaging studies do however indicate that there may be a significant clinical benefit in lowering the locoregional failures by using these compounds. Latest technological advancement in radiotherapy has allowed to deliver high doses of radiation conformally to the tumor volume. Although this technology has brought superb clinical responses for many types of cancer, recent modeling studies have predicted that tumor hypoxia is even more serious because 'reoxygenation' is low thereby leaving a large portion of hypoxic tumor cells behind. Wouldn't it be then reasonable to combine hypoxic radiosensitizers and/or hypoxia-selective cytotoxin with the latest radiotherapy? We will provide some preclinical and clinical evidence to support this idea hoping to revamp an enthusiasm for hypoxic radiosensitizers or hypoxia-selective cytotoxins as an adjunct therapy for radiotherapy.

Resistance to sliding in orthodontics: misconception or method error? A systematic review and a proposal of a test protocol

  • Savoldi, Fabio;Papoutsi, Aggeliki;Dianiskova, Simona;Dalessandri, Domenico;Bonetti, Stefano;Tsoi, James K.H.;Matinlinna, Jukka P.;Paganelli, Corrado
    • The korean journal of orthodontics
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    • v.48 no.4
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    • pp.268-280
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    • 2018
  • Resistance to sliding (RS) between the bracket, wire, and ligature has been largely debated in orthodontics. Despite the extensive number of published studies, the lack of discussion of the methods used has led to little understanding of this phenomenon. The aim of this study was to discuss variables affecting RS in orthodontics and to suggest an operative protocol. The search included $PubMed^{(c)}$, $Medline^{(c)}$, and the Cochrane $Library^{(c)}$. References of full-text articles were manually analyzed. English-language articles published between January 2007 and January 2017 that performed an in vitro analysis of RS between the bracket, wire, and ligature were included. Study methods were analyzed based on the study design, description of materials, and experimental setup, and a protocol to standardize the testing methods was proposed. From 404 articles identified from the database search and 242 records selected from published references, 101 were eligible for the qualitative analysis, and six for the quantitative synthesis. One or more experimental parameters were incompatible and a meta-analysis was not performed. Major factors regarding the study design, materials, and experimental setup were not clearly described by most studies. The normal force, that is the force perpendicular to the sliding of the wire and one of the most relevant variable in RS, was not considered by most studies. Different variables were introduced, often acting as confounding factors. A protocol was suggested to standardize testing procedures and enhance the understanding of in vitro findings.

Analysis of Recent Trends in Clinical Research Publications on Acupuncture and Moxibustion Studies (침구 임상연구 논문동향 분석)

  • Park, Ji-Eun;Oh, Dal-Seok;Shin, Seon-Hwa;Choi, Jun-Yong;Koo, Chang-Mo;Kim, Ae-Ran;Jung, So-Young;Han, Kyung-Ju;Choi, Sun-Mi
    • Korean Journal of Oriental Medicine
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    • v.13 no.2 s.20
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    • pp.101-112
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    • 2007
  • Objective : This study was aimed to review the trend of clinical research articles of acupuncture and moxibustion from the year of 1995 to 2006. Methods : The retrieving and analyzing period were from January 1995 to July 2006. Articles were collected by retrieving Pubmed database. Search terms were as follows; 'Acupuncture', 'Acupuncture & Meridian', 'Moxibustion'. After reviewing articles by our pre-defined criteria, Correlation was assessed qualitatively between contents of the final selected articles and those of Korea Institute of Oriental Medicine. Results : The number of acupuncture research articles have increased with higher rate since the year of 2000. In the field of medical devices, the articles were sparsely existed. The percentage of clinical acupuncture research articles was 75%. However, in the category of Korean investigators' researches, it was 46%. Publications by Korean investigators were concentrated to several specific journals of which their impact factor were below 1 point. Conclusion : There needs more qualifying studies in acupuncture studies which are represented by impact factor in Journal Citation Reports. It is necessary to research and develop the medical devices quantatively rating the outcome of acupuncture trials. The secondary research, such as, systematic reviews, meta-analysis, would be a key approach to evaluate the effectiveness and safety of acupuncture treatments. Moxibustion research would be noticeable in regard to its historical effectiveness and its variable indications.

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Endovascular Treatment with Intravenous Thrombolysis versus Endovascular Treatment Alone for Acute Anterior Circulation Stroke : A Meta-Analysis of Observational Studies

  • Kim, Chul Ho;Jeon, Jin Pyeong;Kim, Sung-Eun;Choi, Hyuk Jai;Cho, Yong Jun
    • Journal of Korean Neurosurgical Society
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    • v.61 no.4
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    • pp.467-473
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    • 2018
  • Objective : The aim of this study was to determine outcome of ischemic stroke patients in the anterior circulation treated with endovascular treatment (EVT) with intravenous thrombolysis (IVT) versus EVT alone group. Methods : A systemic literature review was performed using online database from January 2004 to January 2017. Primary outcomes were successful recanalization seen on finial angiography and good outcome at three months. Secondary outcomes were mortality and the development of symptomatic intracranial hemorrhage (S-ICH) after the procedure. A fixed effect model was used when heterogeneity was less than 50%. Egger's regression test was used to assess publication bias. Results : Five studies were included for final analysis. Between EVT with IVT and EVT alone group, successful recanalization (odds ratio [OR] 1.467, p=0.216), good clinical outcome at three months (OR 1.199, p=0.385), mortality (OR 0.776, p=0.371), and S-ICH (OR 1.820, p=0.280) did not differ significantly. Egger's regression intercept with 95% confidence interval (CI) was 1.99 (95% CI -2.91 to 6.89) in successful recanalization and -0.27 (95% CI -6.35 to 5.80) in good clinical outcome, respectively. Conclusion : The two treatment modalities, EVT with IVT and EVT alone, could be comparable in treating acute anterior circulation stroke. Studies to find specific beneficiary group for EVT alone, without primary IVT, are needed further.