• Title/Summary/Keyword: Patient-controlled

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Analysis of Published Research in the Journal of Muscle and Joint Health from 2008 to 2020 (근관절건강학회지 게재 논문 분석: 2008년부터 2020년까지)

  • Park, Mi-Sung;Lee, Kyung-Sook;Shin, Gyeyoung;Woo, Soo-Hee;Lim, Kyung-Choon;Choi, Heejung;Jin, Soo-Ji;Park, Yeon-Hwan
    • Journal of muscle and joint health
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    • v.29 no.1
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    • pp.69-80
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    • 2022
  • Purpose: To identify research trends in the Journal of Muscle and Joint Health. Methods: In total, 315 studies published between 2008 and 2020 in the Journal of Muscle and Joint Health were reviewed using analysis criteria developed by the authors Results: Most participants were adults or older adults, they mostly had arthritis. The types of research design were descriptive research (46.4%), quasi-experimental design (21.9%), randomized controlled trial (1.9%), and qualitative research (4.1%). The occupation of most authors was professor in universities (61.0%). Data were collected mostly in hospitals (41.6%) or communities (24.4%) using a questionnaire (52.4%). Written consent was obtained at 75.6% and 47.9% of studies were approved by the Institutional Review Board (IRB). The instruments measuring physical concepts such as pain, flexibility, sense of balance and fatigue were mostly used. The most common interventions in experimental studies were physical interventions, with the main being exercise. Key words were categorized into four nursing meta-paradigms: human, health, environment and nursing. The most frequently reported key words were included in the health domain. The most frequently used key words were physical intervention, older patient, osteoarthritis, pain and depression. Conclusion: The results suggest that more research studies targeting various age groups related to muscle and joint health are required. Additionally there is a need to increase the number of qualitative studies, randomized experimental studies, and systematic review studies. It is necessary to pay attention to compliance with research ethics publication regulations.

Trends in Domestic and International Clinical Research of Craniosacral Therapy: Scoping Review (두개천골요법의 국내외 임상 연구 동향: 스코핑 리뷰)

  • Kwak, Min-Jae;Han, Yun-Hee;Geum, Ji-Hye;Park, Shin-Hyeok;Woo, Hyeon-Jun;Ha, Won-Bae;Lee, Jung-Han
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.3
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    • pp.13-27
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    • 2022
  • Objectives This study investigated the trends in domestic and international clinical research in craniosacral therapy, classified as a type of Chuna manual therapy, and suggested further directions in Korean medicine. Methods This scoping review was performed using the Arksey and O'Malley methodological framework and preferred reporting items as per the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews checklist. Eight electronic databases (PubMed, EMBASE, Cochrane Library, Koreanstudies Information Service System [KISS], KMBASE, Oriental Medicine Advanced Searching Integrated System [OASIS], Research Information Sharing Service [RISS], ScienceON) were searched to identify articles with the search terms "craniosacral therapy" and "cranial osteopathy" until December 2021. Results Forty-five studies were eligible as per our inclusion criteria. Most research studies (n=44) were conducted in the field of medicine and pharmacy, especially in rehabilitation medicine (n=16). As a result of the study design, randomized controlled trials (n=20) were the most common, and chronic pain (n=9) was the most frequently targeted disease, followed by headache (n=7). Thirty-two studies suggested interventions and 20 studies used Upledger's 10-step protocol. The average duration of craniosacral therapy was 41 min per session, administered 1.4 times per week. Outcome measurements were analyzed and categorized with the examination procedure for the patient. Conclusions This is the first scoping review of craniosacral therapy in Korea, and we believe that our findings could support its utility as Chuna. In the future, more studies should be conducted to establish the evidence of clinical efficacy of craniosacral therapy and develop standard techniques in Korean medicine.

Full-Endoscopic versus Minimally Invasive Lumbar Interbody Fusion for Lumbar Degenerative Diseases : A Systematic Review and Meta-Analysis

  • Son, Seong;Yoo, Byung Rhae;Lee, Sang Gu;Kim, Woo Kyung;Jung, Jong Myung
    • Journal of Korean Neurosurgical Society
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    • v.65 no.4
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    • pp.539-548
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    • 2022
  • Objective : Although full-endoscopic lumbar interbody fusion (Endo-LIF) has been tried as the latest alternative technique to minimally invasive transforaminal lumbar interobody fusion (MIS-TLIF) since mid-2010, the evidence is still lacking. We compared the clinical outcome and safety of Endo-LIF to MIS-TLIF for lumbar degenerative disease. Methods : We systematically searched electronic databases, including PubMed, EMBASE, and Cochrane Library to find literature comparing Endo-LIF to MIS-TLIF. The results retrieved were last updated on December 11, 2020. The perioperative outcome included the operation time, blood loss, complication, and hospital stay. The clinical outcomes included Visual analog scale (VAS) of low back pain and leg pain and Oswestry disability index (ODI), and the radiological outcome included pseudoarthosis rate with 12-month minimum follow-up. Results : Four retrospective observational studies and one prospective observational study comprising 423 patients (183 Endo-LIF and 241 MIS-TLIF) were included, and the pooled data analysis revealed low heterogeneity between studies in our review. Baseline characteristics including age and sex were not different between the two groups. Operation time was significantly longer in Endo-LIF (mean difference [MD], 23.220 minutes; 95% confidence interval [CI], 10.669-35.771; p=0.001). However, Endo-LIF resulted in less perioperative blood loss (MD, -144.710 mL; 95% CI, 247.941-41.478; p=0.023). Although VAS back pain at final (MD, -0.120; p=0.586), leg pain within 2 weeks (MD, 0.005; p=0.293), VAS leg pain at final (MD, 0.099; p=0.099), ODI at final (MD, 0.141; p=0.093) were not different, VAS back pain within 2 weeks was more favorable in the Endo-LIF (MD, -1.538; 95% CI, -2.044 to -1.032; p<0.001). On the other hand, no statistically significant group difference in complication rate (relative risk [RR], 0.709; p=0.774), hospital stay (MD, -2.399; p=0.151), and pseudoarthrosis rate (RR, 1.284; p=0.736) were found. Conclusion : Relative to MIS-TLIF, immediate outcomes were favorable in Endo-LIF in terms of blood loss and immediate VAS back pain, although complication rate, mid-term clinical outcomes, and fusion rate were not different. However, the challenges for Endo-LIF include longer operation time which means a difficult learning curve and limited surgical indication which means patient selection bias. Larger-scale, well-designed study with long-term follow-up and randomized controlled trials are needed to confirm and update the results of this systematic review.

Effect of Joint Mobilization and Insole on Pain, Pelvic Angle, and Foot Pressure in Patient with Sacroiliac Joint Pain : A Randomized Controlled Pilot Trial (관절가동술과 깔창적용이 엉치엉덩관절통증환자의 통증과 골반경사각, 족저압에 미치는 효과: 무작위배정예비임상시험)

  • Lim, Chae-Gil
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.3
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    • pp.383-392
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    • 2020
  • This study was to compare the effects of joint mobilization, treadmill with insole, and joint mobilization and treadmill with insole on pain, pelvic angle, and foot pressure in patients with sacroiliac joint pain. 24 patients randomly assigned to joint mobilization group(n=8), treadmill with insole group(n=8), or joint mobilization and treadmill with insole group(n=8). Each groups were conducted 30 minutes a day, two days a week for four weeks. Pain was evaluated using visual analogue scale and pelvic angle was measured using palpation meter and foot pressure(fore/rear ratio) was measured using Gateview AFA-50 before intervention and after 4 weeks. All groups were significant differences pain in intragroup(p<.01). In pelvic angle, the joint mobilization group was statistically significant in the anterior tilt only, the joint mobilization and treadmill with insole group showed statistically significant improvement in both anterior and posterior tilt(p<.01), and the treadmill with insole group did not show any statistically significant change(p>.05). Also the joint mobilization and treadmill with insole group were significant differences in foot pressure(p<.01). All the interventions reduce sacroiliac joint pain and joint mobilization and treadmill with insole training are most effective changes in pelvic angle and foot pressure. This study can be used as a basic data for prevention of injury, posture correction and gait training in patients with sacroiliac joint pain, as well as chronic low back pain and plantar pressure problem.

Evolution of Process and Outcome Measures during an Enhanced Recovery after Thoracic Surgery Program

  • Lee, Alex;Seyednejad, Nazgol;Lawati, Yaseen Al;Mattice, Amanda;Anstee, Caitlin;Legacy, Mark;Gilbert, Sebastien;Maziak, Donna E.;Sundaresan, Ramanadhan S.;Villeneuve, Patrick J.;Thompson, Calvin;Seely, Andrew J.E.
    • Journal of Chest Surgery
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    • v.55 no.2
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    • pp.118-125
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    • 2022
  • Background: A time course analysis was undertaken to evaluate how perioperative process-of-care and outcome measures evolved after implementation of an enhanced recovery after thoracic surgery (ERATS) program. Methods: Outcome and process-of-care measures were compared between patients undergoing major elective thoracic surgery during a 9-month pre-ERATS implementation period to those at 1-3, 4-6, and 7-9 months post-ERATS implementation. Outcome measures included length of stay, the 30-day readmission rate, 30-day emergency department visits, and minor and major adverse events. Process measures included first time to activity, out-of-bed, ambulation, fluid diet, diet as tolerated, as well as removal of the first and last chest tube, epidural, patient-controlled analgesia, and Foley and intravenous catheters. Results: In total, 704 patients (352 pre-ERATS, 352 post-ERATS) were included. Mobilization-related process measures, including time to first activity (16.5 vs. 6.8 hours, p<0.001), out-of-bed (17.6 vs. 8.9 hours, p<0.001), and ambulation (32.4 vs. 25.4 hours, p=0.04) saw statistically significant improvements by 1-3 months post-ERATS implementation compared to pre-ERATS. Time to Foley removal improved by 4-6 months post-ERATS (19.5 vs. 18.2 hours, p=0.003). Outcome measures, including the 30-day readmission rate and emergency department visits, steadily decreased post-ERATS. By 7-9 months post-ERATS, both minor (18.2% vs. 7.9%, p=0.009) and major (13.6% vs. 4.4%, p=0.007) adverse events demonstrated statistically significant improvements. Length of stay trended towards improvement from 6.2 days pre-ERATS to 4.8 days by 7-9 months post-ERATS (p=0.06). Conclusion: The adoption of ERATS led to improvements in multiple process-of-care measures, which may collectively and gradually achieve optimization of clinical outcomes.

Comparison of the effectiveness of extensor muscle strengthening exercise by itself, exercise with polydeoxyribonucleotide injection, and exercise with extracorporeal shockwave therapy in lateral epicondylitis: a randomized controlled trial

  • Shim, Bum Jin;Seo, Eun-Min;Hwang, Jung-Taek;Kim, Do-Young;Yang, Jae-Shin;Seo, Su-Jung;Hong, Myung Sun
    • Clinics in Shoulder and Elbow
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    • v.24 no.4
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    • pp.231-238
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    • 2021
  • Background: Extensor muscle strengthening exercises with counterforce braces (EX) is a conventional conservative treatment for lateral epicondylitis (LE) of the elbow. In addition, polydeoxyribonucleotide (PDRN) or extracorporeal shockwave therapy (ESWT) has been recently used for LE. Methods: Sixty-three patients with chronic LE participated in this study and randomly allocated in three groups (G1: EX, G2: EX+PDRN injection, and G3: EX+ESWT). All of the three groups were taught to perform EX at the first out-patient department (OPD) visit. Group 2 was injected with 3 mL PDRN (5.625 mg/3 mL), while group 3 received ESWT at the first OPD visit. Visual analog scale pain score, Mayo elbow performance score (MEPS), and ultrasonographic examination were checked before, 6 weeks, and 12 weeks after the treatments. Results: Overall functional scores and ultrasonographic findings in all three groups improved after treatment. The mean MEPS in group 2 improved more than groups 1 and 3 at 6 weeks (G1, 56.9>62.4; G2, 54.3>65.0; G3, 55.7>62.6), and more than group 1 at 12 weeks (G1, 56.9>67.9; G2, 54.3>73.6). The mean common extensor tendon depth (CETD) on ultrasonography in group 2 increased more than groups 1 and 3 at 6 and 12 weeks (6 weeks: G1, 0.385>0.386; G2, 0.332>0.392; G3, 0.334>0.357; 12 weeks: G1, 0.385>0.409; G2, 0.332>0.438; G3, 0.334>0.405 [cm]). Conclusions: PDRN injections combined with EX exhibited a greater improvement in mean MEPS and mean CETD compared to EX only or EX combined with ESWT for LE within the 12 weeks follow-up.

A Field Efficacy Trial of Inactivated Hantaan Virus Vaccine ($Hantavax^{TM}$) Against Hemorrhagic Fever with Renal Syndrome (HFRS) in the Endemic Areas of Yugoslavia from 1996 to 1998 ($1996{\sim}1998$년 유고슬라비아에서 실시한 한탄바이러스 불활화 백신($Hantavax^{TM}$)의 면역효과에 대한 야외시험)

  • Chu, Yong-Kyu;Gligic, Anna;Tomanovic, Snezana;Bozovjc, Boyana;Obradovic, Mirceta;Woo, Young-Dae;An, Chang-Nam;Kim, Hun;Jiang, Yang-Seok;Park, Seung-Chul;Kim, Min-Ja;Lee, Eun-Il;Lee, Ho-Wang
    • The Journal of Korean Society of Virology
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    • v.29 no.2
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    • pp.55-64
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    • 1999
  • In Yugoslavia, hemorrhagic fever with renal syndrome (HFRS) is one of the important national health problem, but no vaccine has been used to prevent HFRS. Since first HFRS case in 1952, sporadic cases of HFRS occurred every year and over 4,000 registered cases with $1{\sim}16%$ mortality so far. We performed a prospective, randomized double-blind placebo-controlled trial to evaluate the effectiveness of $Hantavax^{TM}$ against HFRS in 3,900 healthy adults living in the endemic areas of Yugoslavia. 1,900 people were given 0.5 ml of Hantavax subcutaneously twice at one month interval and a booster shot at one year after. For controls other 2,000 healthy people were given 0.5 ml of physiolosical saline as a placebo. We investigated HFRS cases in both the vaccinated and nonvaccinated groups by monitoring the program for patient registration in the areas from 1996 to 1998, and the effect of vaccine was analyzed epidemiologically. No confirmed case of HFRS was observed among 1,900 Hantavax vaccinees, while 20 confirmed cases were observed among 2,000 nonvaccinated control group. There were no remarkable side effects among the vaccinees either locally or in general after inoculation of the vaccine. The Hantavax vaccine showed statistically significant protective efficacy against HFRS among Yugoslavian people.

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A Study on Information System for Safe Transportation of Emergency Patients in the Era of Pandemic Infectious Disease (팬데믹 감염병 시대에 안전이송을 위한 정보시스템 연구)

  • Seungyong Kim;Incheol Hwang;Dongsik Kim
    • Journal of the Society of Disaster Information
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    • v.18 no.4
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    • pp.839-846
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    • 2022
  • Purpose: To secure the safety of firefighters who are dispatched to emergency activities for patients with suspected infectious diseases during an epidemic, and to identify the current status of suspected infectious disease patients by region based on the information collected at the site, and manage firefighting infectious diseases that can be controlled and supported I want to develop a system. Method: Develop a smartphone app that can classify suspected infectious disease patients to check whether an infectious disease is suspected, and develop a disposable NFC tag for patient identification to prevent infection from suspected infectious disease patients. Develop a management system that collects and analyzes data related to emergency patients with suspected infectious disease input from the field and provides them to relevant business personnel to evaluate whether the transport of emergency patients with suspected infectious disease is improved. Result: As a result of the experiment, it was possible to determine whether an infectious disease was suspected through the algorithm implemented in the smartphone app, and the retransfer rate was significantly reduced by transferring to an appropriate hospital. Conclusion: Through this study, the possibility of improving emergency medical services by applying ICT technology to emergency medical services was confirmed. It is expected that the safety of paramedics will be actively secured.

One Case of Meniere's Disease (메니에르병 치험 1례)

  • Lee, Seung-Yeop;Kim, Mi-Young;Kim, Young-Jee;Choi, Won-Woo;Min, In-Kyu;Park, Joo-Young;Jung, Woo-Sang;Moon, Sang-Kwan;Cho, Ki-Ho;Kim, Young-Suk
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.9 no.1
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    • pp.40-45
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    • 2008
  • Meniere's disease is characterized by intermittent episodes of vertigo lasting from minutes to hours, with fluctuating hearing loss, tinnitus, and aural pressure. The primary histopathological correlate is endolymphatic hydrops, but its etiology is still disputed. Several medical therapies have been offered to patients with this disease since 1961 that the first report had been given by Prosper Meniere. Some will be helpful for relieving the symptoms but there is still no absolutely effective treatment to cure the disease. One male patient with Meniere's disease was hospitalized in Kyung-Hee medical center, and we treated him with oriental medical therapies. The treatment was effective to relieve his symptoms, and they had been successfully controlled until he was discharged from hospital. The result suggests that the oriental medical therapy is safe and helpful to patients with Meniere's disease, so we reported this case.

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Conventional Versus Artificial Intelligence-Assisted Interpretation of Chest Radiographs in Patients With Acute Respiratory Symptoms in Emergency Department: A Pragmatic Randomized Clinical Trial

  • Eui Jin Hwang;Jin Mo Goo;Ju Gang Nam;Chang Min Park;Ki Jeong Hong;Ki Hong Kim
    • Korean Journal of Radiology
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    • v.24 no.3
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    • pp.259-270
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    • 2023
  • Objective: It is unknown whether artificial intelligence-based computer-aided detection (AI-CAD) can enhance the accuracy of chest radiograph (CR) interpretation in real-world clinical practice. We aimed to compare the accuracy of CR interpretation assisted by AI-CAD to that of conventional interpretation in patients who presented to the emergency department (ED) with acute respiratory symptoms using a pragmatic randomized controlled trial. Materials and Methods: Patients who underwent CRs for acute respiratory symptoms at the ED of a tertiary referral institution were randomly assigned to intervention group (with assistance from an AI-CAD for CR interpretation) or control group (without AI assistance). Using a commercial AI-CAD system (Lunit INSIGHT CXR, version 2.0.2.0; Lunit Inc.). Other clinical practices were consistent with standard procedures. Sensitivity and false-positive rates of CR interpretation by duty trainee radiologists for identifying acute thoracic diseases were the primary and secondary outcomes, respectively. The reference standards for acute thoracic disease were established based on a review of the patient's medical record at least 30 days after the ED visit. Results: We randomly assigned 3576 participants to either the intervention group (1761 participants; mean age ± standard deviation, 65 ± 17 years; 978 males; acute thoracic disease in 472 participants) or the control group (1815 participants; 64 ± 17 years; 988 males; acute thoracic disease in 491 participants). The sensitivity (67.2% [317/472] in the intervention group vs. 66.0% [324/491] in the control group; odds ratio, 1.02 [95% confidence interval, 0.70-1.49]; P = 0.917) and false-positive rate (19.3% [249/1289] vs. 18.5% [245/1324]; odds ratio, 1.00 [95% confidence interval, 0.79-1.26]; P = 0.985) of CR interpretation by duty radiologists were not associated with the use of AI-CAD. Conclusion: AI-CAD did not improve the sensitivity and false-positive rate of CR interpretation for diagnosing acute thoracic disease in patients with acute respiratory symptoms who presented to the ED.