• 제목/요약/키워드: Quality control guidelines

검색결과 248건 처리시간 0.025초

자하거 약침의 신경정신과 임상 응용에 관한 체계적 문헌 고찰 (A Systematic Review of Placenta Pharmacopuncture for Neuropsychiatric Diseases in Practice)

  • 신혜규;이재혁;강형원
    • 동의신경정신과학회지
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    • 제33권2호
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    • pp.157-180
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    • 2022
  • Objectives: To perform a systematic review of placenta pharmacopuncture for treating neuropsychiatric diseases, focusing on its efficacy and the safety so that evidence on its clinical use could be obtained, thus contributing to further studies. Methods: Through Korean, English, and Chinese databases (OASIS, Korean TK, KISS, RISS, ScienceON, Pubmed, Cochrane, EMBASE, CINAHL, AMED, CNKI, and Wanfang), combinations of keywords (placenta, pharmacopuncture, etc.) were used to select clinical studies published until January 2021 about placenta pharmacopuncture for neuropsychiatric diseases. Interventions included combined treatments. Study design included cases studies, series, and clinical trials. Cohort studies, literature reviews, in vitro and animal experiments were excluded. The primary outcomes involved measurements of symptoms, Visual Analogue Scale, or questionnaires. Data extracted from databases were imported to Endnote X7 to remove duplicates. The quality of the literature was assessed based on CAse REports Guidelines and Cochrane's Risk of Bias (ROB). Results: Twenty-one studies were selected, including ten case reports, three case series, two one-armed clinical trials, one non-randomized clinical trial, and five randomized clinical trials. There were six studies on sleep disorders, five studies on stroke sequela, two on mood disorders, two on enuresis, two on Guillain-Barré syndrome, two on multiple sclerosis, one on neurocognitive disorder, and one on vertigo. The most frequent combined treatment was acupuncture in both the experimental group (n=10) and the control group (n=3). Acupoints were ST36, SP6, BL23, CV4, GB20, GV20, N-HN54, and so on. All studies reported improvement of symptoms. The quality of case studies was relatively high. Assessment of ROBs resulted in low risks. Conclusions: Placenta pharmacopuncture is effective for neuropsychiatric diseases such as sleep disorders, mood disorders, enuresis, and neurocognitive disorders. Regarding insomnia, several studies have reported significant improvements with placenta pharmacopuncture. There was no adverse event associated with placenta pharmacopuncture.

Ten technical aspects of baseplate fixation in reverse total shoulder arthroplasty for patients without glenoid bone loss: a systematic review

  • Reinier W.A. Spek;Lotje A. Hoogervorst;Rob C. Brink;Jan W. Schoones;Derek F.P. van Deurzen;Michel P.J. van den Bekerom
    • Clinics in Shoulder and Elbow
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    • 제27권1호
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    • pp.88-107
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    • 2024
  • The aim of this systematic review was to collect evidence on the following 10 technical aspects of glenoid baseplate fixation in reverse total shoulder arthroplasty (rTSA): screw insertion angles; screw orientation; screw quantity; screw length; screw type; baseplate tilt; baseplate position; baseplate version and rotation; baseplate design; and anatomical safe zones. Five literature libraries were searched for eligible clinical, cadaver, biomechanical, virtual planning, and finite element analysis studies. Studies including patients >16 years old in which at least one of the ten abovementioned technical aspects was assessed were suitable for analysis. We excluded studies of patients with: glenoid bone loss; bony increased offset-reversed shoulder arthroplasty; rTSA with bone grafts; and augmented baseplates. Quality assessment was performed for each included study. Sixty-two studies were included, of which 41 were experimental studies (13 cadaver, 10 virtual planning, 11 biomechanical, and 7 finite element studies) and 21 were clinical studies (12 retrospective cohorts and 9 case-control studies). Overall, the quality of included studies was moderate or high. The majority of studies agreed upon the use of a divergent screw fixation pattern, fixation with four screws (to reduce micromotions), and inferior positioning in neutral or anteversion. A general consensus was not reached on the other technical aspects. Most surgical aspects of baseplate fixation can be decided without affecting fixation strength. There is not a single strategy that provides the best outcome. Therefore, guidelines should cover multiple surgical options that can achieve adequate baseplate fixation.

Clinical Practice Guidelines for the Medical and Surgical Management of Primary Intracerebral Hemorrhage in Korea

  • Kim, Jeong Eun;Ko, Sang-Bae;Kang, Hyun-Seung;Seo, Dae-Hee;Park, Sukh-Que;Sheen, Seung Hun;Park, Hyun Sun;Kang, Sung Don;Kim, Jae Min;Oh, Chang Wan;Hong, Keun-Sik;Yu, Kyung-Ho;Heo, Ji Hoe;Kwon, Sun-Uck;Bae, Hee-Joon;Lee, Byung-Chul;Yoon, Byung-Woo;Park, In Sung;Rha, Joung-Ho
    • Journal of Korean Neurosurgical Society
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    • 제56권3호
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    • pp.175-187
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    • 2014
  • The purpose of this clinical practice guideline (CPG) is to provide current and comprehensive recommendations for the medical and surgical management of primary intracerebral hemorrhage (ICH). Since the release of the first Korean CPGs for stroke, evidence has been accumulated in the management of ICH, such as intracranial pressure control and minimally invasive surgery, and it needs to be reflected in the updated version. The Quality Control Committee at the Korean Society of cerebrovascular Surgeons and the Writing Group at the Clinical Research Center for Stroke (CRCS) systematically reviewed relevant literature and major published guidelines between June 2007 and June 2013. Based on the published evidence, recommendations were synthesized, and the level of evidence and the grade of the recommendation were determined using the methods adapted from CRCS. A draft guideline was scrutinized by expert peer reviewers and also discussed at an expert consensus meeting until final agreement was achieved. CPGs based on scientific evidence are presented for the medical and surgical management of patients presenting with primary ICH. This CPG describes the current pertinent recommendations and suggests Korean recommendations for the medical and surgical management of a patient with primary ICH.

심혈관계 질환 합병증을 동반하지 않은 본태성 고혈압 환자의 안정시 심박수에 따른 대사증후군 세부 요인 변화에 대한 12개월 추적조사: 고혈압 초진과 재진 (The Components of Metabolic Syndrome according to the Resting Heart Rate in Hypertensive Patients without Cardiovascular Disease Complication after 12month Follow-up: First Visit and Revisit Hypertensive Patients)

  • 옥종선
    • 한국콘텐츠학회논문지
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    • 제20권10호
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    • pp.401-410
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    • 2020
  • 본 연구에서는 심혈관계 질환 합병증을 동반하지 않은 국내 본태성 고혈압 환자의 안정시 심박수에 따른 대사증후군 세부요인 변화에 대한 12개월 추적 조사 결과를 확인해 보고자 한다. 2013년부터 국내 25개 대학병원에서 진행되어 온 대규모 전향적 관찰 연구인 KorHR(Korean Hypertension Registry) 자료를 이용하였고 총 951명의 데이터를 R 통계 프로그램을 이용하여 분석하였다. 본 연구결과 초진과 재진 고혈압 환자의 안정시 심박수 그룹에 따라 대사증후군 세부요인의 변화 및 대사증후군 세부요인 증가 위험이 다른 것으로 나타났다. 따라서 초진과 재진 고혈압 환자에 따른 맞춤형 안정시 심박수 조절을 위한 지침 마련과 안정시 심박수 조절을 위한 다양한 중재방안 마련이 필요하다고 생각된다. 이를 통해 대표적인 만성질환인 고혈압에 따른 심혈관계 질환 발생을 예방하여 환자 및 가족의 삶의 질을 향상시킬 뿐만 아니라 보건 의료 분야에서의 효율성을 증대시키는데 기여하고자 한다.

노후된 알루미늄 압출기의 재제조 기술 개발 및 성능 개선 (Development and Performance Improvement of old Aluminum Extruder Remanufacturing Technology)

  • 윤상민;정항철;공만식
    • 한국산업융합학회 논문집
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    • 제26권1호
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    • pp.95-103
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    • 2023
  • The domestic remanufacturing industry is concentrated in auto parts, so it is necessary to expand into various industries. In the domestic aluminum industry, the extrusion process accounts for more than 40% of the total, but the old and management of the extrusion equipment is not done properly. In particular, the extruder has a structure in which equipment is not replaced until major parts are damaged or worn, so there are problems such as lower process precision, productivity and production efficiency compared to new equipment, and high maintenance costs. In this study, the old extruder was remanufactured for major high-risk parts through Failure Mode and Effect Analysis(FMEA), and the process level and performance of the extruder were evaluated before and after remanufacturing. Compared to the existing extruder, the standard deviation of the remanufacture extruder was reduced by 93.5%, 57.9%, and 70.0%, respectively, in major process control items such as container temperature, billet temperature, and ram speed, keeping performance constant. In addition, it was possible to produce products with complex shapes that could not be produced before due to problems such as dimensional deviation within tolerances. In this study, remanufacturing guidelines were presented by analyzing the effect of failure modes of the old extruder, and the performance improvement of the extruder was confirmed.

Trends of conscious sedation in the Department of Pediatric Dentistry at the Dankook University Dental Hospital for 11 Years

  • Sohyun Park;Jongbin Kim;Jongsoo Kim;Joonhaeng Lee;Miran Han;Jisun Shin
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제23권5호
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    • pp.265-271
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    • 2023
  • Background: Anxiety and fear in children's dental care are major impediments to successful dental care. High-quality dental treatment can be achieved using various behavioral control methods; however, conscious sedation using drugs can be used if behavioral control is difficult, owing to excessive fear and anxiety. This study aimed to examine the trends in conscious sedation implemented in pediatric dentistry at the Dankook University Dental Hospital over the past 11 years. Methods: This study included 6,438 cases of dental treatment under conscious sedation conducted over 11 years between January 2011 and December 2021 in the Department of Pediatric Dentistry at Dankook University Dental Hospital. Results: Over the past 11 years, the number of dental treatments under sedation has increased. In the case of inhalation sedation using nitrous oxide, the rate of increase was approximately twice every year, and the use of midazolam gradually decreased. The average age of children who underwent sedation was 5.11 years, and the rate of sedation treatment in children aged <4 years tended to decrease, while that of children aged >5 years tended to increase. This is related to the trend of changes in drugs used. In a sex-based survey, sedation treatment rate was higher in males than that in females. Conclusion: Appropriate selection of sedatives can reduce the frequency of general anesthesia and minimize complications through efficient and safe dental treatments. Trend analysis of sedation by year will help provide guidelines for the appropriate selection of sedation for dental treatment of children and patients with disability.

부인과 암 생존자와 정상 대조군의 영양소 섭취와 식사의 질(Diet Quality Index-International) 비교 - 2013~2016년 국민건강영양조사 자료이용 - (A Comparisons of Nutritional Intake and Diet Quality Index-International in Gynecological Cancer Survivors and Normal Women - Using the Korea National Health and Nutrition Examination Survey 2013~2016 -)

  • 서보영;허은실
    • 대한지역사회영양학회지
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    • 제25권5호
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    • pp.406-415
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    • 2020
  • Objectives: The aim of this study was to compare the nutritional intake and Diet Quality Index-International (DQI-I) of gynecological cancer survivors and normal women. Methods: This study compared the anthropometric indices, dietary behavior, nutritional intake, and DQI-I in women with previous history of breast or uterine cancer [Gynecological cancer survivors group (GCSG, n=126)] and normal women [Normal control group (NCG, n=7,011)] using the 2013~2016 Korea National Health and Nutrition Examination Survey data. Results: Body mass index and waist circumference were lower in the GCSG compared the NCG. The frequency of skipping breakfast and eating out was higher in the NCG compared to GCSG. Energy and fat intake were significantly higher in the NCG than in the GCSG, whereas intake of all minerals and vitamins (excluding thiamine), and dietary fiber intake were higher in GCSG. It was observed that the fatty acid intake of the GCSG was significantly lower than that of the NCG. The diet quality evaluation using DQI-I results showed that GCSG was higher in the "within-group" diet variety and adequacy of vegetable group than the NCG, whereas the intake level of the fruit group was higher in NCG. Besides, protein, calcium, and vitamin C intake were higher in the GCSG than in the NCG. The GCSG showed higher levels of total fat and saturated fat moderation than the NCG, whereas cholesterol moderation showed the opposite results. The results of DQI-I comparison according to the cancer survival years showed that the overall score and scores related to diet adequacy and balance were higher in the below 5-year group, whereas the over 5-year group scored higher in terms of moderation of diet. Conclusions: The results of this study suggest that a chronic disease based management approach is needed in cancer survivors. The study provides important data which can help in the preparation of guidelines for long-term lifestyle and diet management, in these patients.

Chinese Patients with Gastric Cancer Need Targeted Adjuvant Chemotherapy Schemes

  • Shi, Wen-Tao;Wei, Lei;Xiang, Jin;Su, Ke;Ding, Qiong;Tang, Meng-Jie;Li, Ji-Qiang;Guo, Yi;Wang, Pu;Zhang, Jing-Wei
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권10호
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    • pp.5263-5272
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    • 2012
  • Background: Gastric cancer (GC) is one of the most common cancers in China. Adjuvant chemotherapy (AC) is a routine auxiliary treatment for GC recommended by the guidelines issued in 2011 by the Ministry of Health of the People's Republic of China, but the relevant credible consequences in China have been insufficient because of China's late start and ethical concerns. Methods: A series of databases, including Cochrane Library, MEDLINE, EMBASE, the Chinese database of the National Knowledge Infrastructure and the VIP database, were searched by 2 reviewers independently for studies investigating AC for GC through March 2012. The retrieved literature was screened according to the eligibility criteria. Results: A total of 35 randomized control trials (RCTs) were subjected to the final analysis, including 4,043 patients in treatment group and 3,884 in the control group, as well as 4 clinical-control trials (CCTs), which accessed the final analysis with 238 and 252 patients, respectively. AC reduced the risk of death as a protective treatment with statistical significance (HR=0.91, 95%CI: [0.85, 0.97], P=0.002), and it seemed more effective for Asian than non-Asian patients. The effects of AC were not influenced by the starting time (P>0.05). D2 lymphadenectomy-based chemotherapy was effective (HR=0.89, 95%CI: [0.80, 0.99], P=0.04). Oral S-1 40 mg/m2 after D2 lymphadenectomy might be a better choice for Asians with advanced GC and might result in a greater reduction of adverse events than in non-Asian patients. GRADE quality assessment determined that the strength of the evidence from foreign studies from Europe, the United States and Asian countries other than China was high, while it was moderate for Chinese studies. Conclusion: AC was effective or even curative in Chinese patients in general, although it is still necessary to optimize a targeted AC scheme for Chinese patients with GC.

심폐소생술 수행자의 엉덩관절 각도가 심폐소생술 결과에 미치는 영향 (Effect of Chest Compression Position Depending on the Rescuer's Hip Joint Angle During Basic CPR)

  • 이재민;윤형완
    • 한국화재소방학회논문지
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    • 제34권2호
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    • pp.103-109
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    • 2020
  • 이 연구는 기본심폐소생술 교과목을 이수한 응급구조과 학생을 대상으로 수행자 엉덩관절 각도에 따라 기본심폐소생술의 질이 향상되는지 알아보고자 하였다. 기본심폐소생술 중 엉덩관절 각도에 따른 기본심폐소생술 질(가슴압박 깊이, 완전한 이완, 압박속도 등)을 측정하기 위해 SimPad SkillReporter와 Resusci Anne® QCPR®을 이용하여 비교 분석하였고, 2015 AHA Guideline 따랐으며, 가슴압박과 인공호흡의 비율은 30:2로 5주기 시행하였다. 실험군과 대조군의 일반적인 자세에서는 엉덩관절 각도, 인공호흡정도, 가슴압박 깊이, 가슴압박 속도, 가슴압박 이완, 가슴압박 정확도, 가슴압박 중단시간(Hands off time), 가슴압박 적용시간 비율은 큰 차이를 보이지 않았다(p > 0.05). 엉덩관절 각도를 90도로 유지하는 기본심폐소생술은 유지하지 않았을 때와 큰 차이는 없었으나, 적정깊이와 100% 이완에서는 좋은 결과를 보여 주어 보다 더 나은 심폐소생술 질 향상을 기대할 수 있을 것이다.

Surveillance Evaluation of the National Cancer Registry in Sabah, Malaysia

  • Jeffree, Saffree Mohammad;Mihat, Omar;Lukman, Khamisah Awang;Ibrahim, Mohd Yusof;Kamaludin, Fadzilah;Hassan, Mohd Rohaizat;Kaur, Nirmal;Myint, Than
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권7호
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    • pp.3123-3129
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    • 2016
  • Background: Cancer is the fourth leading cause of death in Sabah Malaysia with a reported age-standardized incidence rate was 104.9 per 100,000 in 2007. The incidence rate depends on non-mandatory notification in the registry. Under-reporting will provide the false picture of cancer control program effectiveness. The present study was to evaluate the performance of the cancer registry system in terms of representativeness, data quality, simplicity, acceptability and timeliness and provision of recommendations for improvement. Materials and Methods: The evaluation was conducted among key informants in the National Cancer Registry (NCR) and reporting facilities from Feb-May 2012 and was based on US CDC guidelines. Representativeness was assessed by matching cancer case in the Health Information System (HIS) and state pathology records with those in NCR. Data quality was measured through case finding and re-abstracting of medical records by independent auditors. The re-abstracting portion comprised 15 data items. Self-administered questionnaires were used to assess simplicity and acceptability. Timeliness was measured from date of diagnosis to date of notification received and data dissemination. Results: Of 4613 cancer cases reported in HIS, 83.3% were matched with cancer registry. In the state pathology centre, 99.8% was notified to registry. Duplication of notification was 3%. Data completeness calculated for 104 samples was 63.4%. Registrars perceived simplicity in coding diagnosis as moderate. Notification process was moderately acceptable. Median duration of interval 1 was 5.7 months. Conclusions: The performances of registry's attributes are fairly positive in terms of simplicity, case reporting sensitivity, and predictive value positive. It is moderately acceptable, data completeness and inflexible. The usefulness of registry is the area of concern to achieve registry objectives. Timeliness of reporting is within international standard, whereas timeliness to data dissemination was longer up to 4 years. Integration between existing HIS and national registration department will improve data quality.