• 한방재활의학과학회지
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• 제27권4호
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• pp.85-96
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• 2017

Objectives To summarize and evaluate the efficacy of traditional Chinese herbal medicine (TCHM) treatment for antibiotic associated diarrhea (AAD). Methods Eight electronic databases were searched from their inception to August 2017. Randomized controlled trials (RCTs) assessing the efficacy of TCHM treatment for AAD were included. The risk of bias was assessed using the Cochrane risk of bias assessment tool. Data analysis was performed using RevMan software version 5.3. Results Seventeen RCTs involving 1138 patients with AAD were included for qualitative synthesis. TCHM treatment improved total effective rate (TER). However, the results that TER in experimental group was significantly higher than in control group were different between the included studies. TCHM enema treatment improved TER, but not significantly higher than control group. The most frequently used herbal formulas were Gamiwekwanjeon, Gamiinsampaedoksan, and Samryungbaekchulsan. The most frequently used TCHMs were Atractylodes macrocephala (Bai Zhu), Dioscorea batatas (Shan Yao). Within the studies documenting the adverse events, no serious adverse events associated with TCHM treatment were observed. Conclusions Evidence of TCHM treatment efficacy for AAD is encouraging, but not conclusive, because of the low methodological qualities, diversity of TCHM treatment prescriptions. Further well-designed RCTs with rigorous randomization and blinding method are needed to confirm these results.

• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.3823-3827
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• 2016

Background: To investigate the association circumcision with prostate cancer. Materials and Methods: We searched PubMed, EMBASE, the Cochrane Library, and Chinese biomedicine literature database up to August 2015. All case-control studies were identified in which investigated the association circumcision with prostate cancer. Three authors independently assessed study quality and extracted data. All data were analyzed using RevMan 5.3 and STATA version 11.0. Results: Six case-control studies met the inclusion criteria. The pooled meta-analysis showed that there was a lower incidence of circumcision in prostate cancer patients compared with control (OR=0.90, 95% confidence interval [CI] 0.82-0.98, P=0.01). The results of meta-analysis also showed that no significant difference was found between circumcision and less aggressive prostate cancer (OR=0.93, 95% CI 0.83-1.04, P=0.19); however, there was a lower incidence of circumcision in more aggressive prostate cancer compared with control (OR =0.84, 95% CI 0.72-0.97, P=0.02). The Egger's results did not show any evidence of publication bias(P=0.798). Conclusions: In summary, within the limits of available data, male with circumcision appears to have a lower incidence of prostate cancer. In the future, high-quality multicenter studies are needed to thoroughly verify the outcome.

• 한국임상약학회지
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• 제20권3호
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• pp.183-192
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• 2010

While Self-monitoring of blood glucose (SMBG) has been recommended in some diabetes mellitus (DM) patients population according to the 2010 American Diabetes Association (ADA), 2007 Korean Diabetes Association (KDA), 2005 International Diabetes Federation guideline, it is excluded from a routine insurance coverage for outpatients in Korea. The objective of this study is to meta-analyze the impact of SMBG on HbA1c in non insulin-treated diabetes mellitus (NIT) DM patients. Published clinical literatures were identified through electronic database searches from inception and until May 2010. Studies were selected if they met the following inclusion criteria: 1) randomized controlled trials (RCTs), 2) comparing SMBG with non-SMBG in NIT type 2 diabetes, 3) measuring HbA1c as an outcome. Literature qualities were assessed by the Scottish Intercollegiate Guidelines Network Checklist. The mean difference of HbA1c between the 2 groups was pooled from non-heterogeneous 6 RCTs by meta-analysis using Review Manger (RevMan) Version 5.0 program. Pooled results demonstrated that SMBG is associated with a statistically significant improvement in glycemic control (mean HbA1c difference -0.23, 95%CI -0.32, -0.13). Sensitivity analysis showed that glycemic controls were significantly improved in patients with shorter study duration, more frequent self-monitoring, higher baseline HbA1c value, and without prior SMBG experiences. Conclusively SMBG is effective in improving glycemic control in NIT DM patients, but additional evidences from further researches in Korean patients and cost-effectiveness analysis would be necessary to make a suggestion for coverage expansion.

• 대한간호학회지
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• 제44권5호
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• pp.471-483
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• 2014

Purpose: This study was done to evaluate the effects of dignity interventions on depression, anxiety and meaning of life in terminally ill patients. Methods: PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL and several Korean databases were searched. The main search strategy combined terms indicating dignity intervention, presence of terminal illness and study design. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. Data were analyzed by the RevMan 5.2.11 program of Cochrane Library. Results: Twelve clinical trials met the inclusion criteria with a total of 878 participants. Dignity intervention was conducted for a mean of 2.2 weeks, 2.8 sessions and an average of 48.7 minutes per session. Effect sizes were heterogeneous and subgroup analysis was done. Dignity interventions had a significant effect on depression (ES= -1.05, p<.001, $I^2$=15%) and anxiety (ES= -1.01, p<.001, $I^2$=0). For meaning of life, dignity interventions were effective (ES= -1.64, p=.005) and effect sizes were still heterogeneous. Conclusion: Results support findings that dignity interventions can assist terminal ill patients in reducing emotional distress and improving meaning of life. Further well-designed dignity studies will lead to better understanding of the effects of treatments on spiritual well-being.

• 한국임상약학회지
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• 제27권3호
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• pp.150-160
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• 2017

Background: Recently, a fixed combination of grazoprevir and elbasvir (GE) has been introduced to the arsenal of chemotherapeutics to fight against this virus. The study aimed to provide information on the efficacy and safety of GE for the treatment of HCV infection by performing a meta-analysis of literature data. Methods: PubMed and EMBASE database searches were conducted. Among the literature retrieved, pivotal Phase III clinical studies were analyzed. Statistical analysis of the data was performed by RevMan. Results: Four pivotal Phase III clinical studies compared the efficacy and safety of GE. When HCV patients were treated with GE for 12 weeks, the sustained virologic response, defined as the viral RNA level below the lower limit of quantification at 12 weeks after the cessation of therapy (SVR12), was 94.7%. The clinical advantage of GE involves its use by patients with cirrhosis and/or renal failure without dose adjustment. If the genotype (GT) of the causative virus was GT1a with NS5A polymorphism or GT4 with resistance to peginterferon/ribavirin, treatment with GE plus ribavirin for 16 weeks resulted in a better outcome compared to treatment with GE alone for 12 weeks. Adverse events reported during the four clinical studies were 71.09% in the GE arms and it was 76.61% in the non-GE arms, with the most frequent events being mild central nervous system symptoms. Conclusion: GE was generally safe and effective for the treatment of HCV infection. However, since HCV mutates very rapidly and becomes resistant to antiviral agents, long-term monitoring should be mandatory.

• Asian Pacific Journal of Cancer Prevention
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• 제16권9호
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• pp.3871-3874
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• 2015

Objective: To investigate any association of the miRNA146a rs2910164 C>G polymorphism with head and neck cancer risk. Materials and Methods: The Medline, PubMed, PUBMED, EMBASE, Web of Science, WanFang and CNKI databases were searched and a meta-analysis was conducted using RevMan 5.2 software. Results: After searching and evaluating the literature, a total seven papers involving 2,766 patients with head and neck cancer and 6,603 healthy controls were included into this meta analysis. The results showed that there were no significant differences between patients and healthy controls overall for the miRNA rs2910164 C>G gene polymorphism (dominant model:OR=0.78, 95%CI:0.58-1.04, P=0.09; recessive model:OR=0.86, 95%CI:0.67-1.12, P=0.27;GG:CC:OR=0.75, 95%CI:0.52-1.08, P=0.12;GC:CC:OR=0.79, 95%CI:0.60-1.04, P=0.10). However, a significant association of miRNA rs2910164 C>G gene polymorphism with Chinese head and neck cancer risk was noted, limited to the dominant model (OR=0.68, 95%CI:0.50-0.95, P=0.02;GG:CC:OR=0.62, 95%CI:0.42-0.92, P=0.02;GC:CC:OR=0.72, 95%CI:0.520.99, P=0.04). Conclusions: miRNA146a rs2910164 C>G polymorphism is not associated with head and neck cancer risk in general, but tehre may be link in Chinese.

• 한국임상약학회지
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• 제28권1호
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• pp.10-16
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• 2018

Background: Vitamin D has been associated with sepsis in pediatric and adult patients. The association with neonates is unclear. This systematic review and meta-analysis examined the effect of neonatal and maternal vitamin D levels on neonatal early-onset sepsis. Methods: We searched studies published up to November 2017 in PubMed/Medline, Embase, and the Cochrane Library databases. All studies that reported 25-hydroxyvitamin D levels in neonates with or without early-onset sepsis were included. Meta-analysis was performed using RevMan 5.3 software. Results: Four studies were eligible. The weighted mean difference of 25-hydroxyvitamin D levels in neonates with early-onset sepsis and controls was -7.27 ng/mL (95% confidence interval = -7.62, -6.92). Maternal vitamin D levels in neonates with early-onset sepsis were significantly lower than those in controls (weighted mean difference -7.24 ng/mL, 95% confidence interval -8.45, -6.03). All neonates with early onset sepsis had vitamin D deficiency (25-hydroxyvitamin D <20 ng/mL). Conclusion: Lower neonatal and maternal 25-hydroxyvitamin D levels were associated with neonatal early-onset sepsis. Vitamin D supplementation during pregnancy may be helpful to prevent neonatal early-onset sepsis. The effects of vitamin D supplementation on early-onset sepsis in neonates warrant further study.

• 기본간호학회지
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• 제21권4호
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• pp.423-432
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• 2014

Purpose: This study was done to evaluate effectiveness of deep breathing exercise as a postoperative intervention to prevent pulmonary complications. Methods: A search of databases from 1990 to 2012 was done including MEDLINE, EMBASE, CINAHL, Cochrane Library and eight Korean databases. Ten studies met eligibility criteria. Researchers trained in systematic review, independently assessed the methodological quality of selected studies using the Cochrane's risk of bias tool. Data were analyzed using RevMan 5.2 program. Results: Among ten RCTs in four studies, deep breathing exercise was compared with an instrument using interventions such as incentive spirometry, in the other four studies deep breathing exercise was compared with non-intervention, and in last two studies bundles of interventions including coughing and early ambulation were assessed. A significant difference was found between deep breathing exercise group and non-intervention group. The odds ratio (OR) of occurrence of pulmonary complications for deep breathing exercise versus non-intervention was 0.30. However, there was no significant difference between deep breathing exercise group and incentive spirometry group (OR=1.22). Conclusion: Deep breathing exercise is vital to improving cost-effectiveness and efficiency of patient care in preventing postoperative pulmonary complications. For evidence-based nursing, standardized guidelines for deep breathing in postoperative care should be further studied.

• Asian Pacific Journal of Cancer Prevention
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• 제13권7호
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• pp.3253-3258
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• 2012

Objective: To evaluate the efficacy and safety of whole brain radiotherapy (WBRT) plus chemotherapy versus WBRT alone for treating brain metastases (BM) from lung cancer by performing a meta-analysis based on randomized controlled trials (RCTs). Methods: The PubMed, Embase, CENTRAL, ASCO, ESMO, CBM, CNKI, and VIP databases were searched for relevant RCTs performed between January 2000 and March 2012. After quality assessment and data extraction, the meta-analysis was performed using the RevMan 5.1 software, with funnel plot evaluation of publication bias. Results: 19 RCTs involving 1,343 patients were included. The meta-analyses demonstrated that compared to WBRT alone, WBRT plus chemotherapy was more effective with regard to the objective response rate (OR = 2.30, 95% CI = 1.79 - 2.98; P < 0.001); however, the incidences of gastrointestinal reactions (RR = 3.82, 95% CI = 2.33 - 6.28, P <0.001), bone marrow suppression (RR = 5.49, 95% CI = 3.65 - 8.25, P < 0.001), thrombocytopenia (RR = 5.83, 95% CI = 0.39 - 86.59; P = 0.20), leukopenia (RR = 3.13, 95% CI = 1.77 - 5.51; P < 0.001), and neutropenia (RR = 2.75, 95% CI = 1.61 - 4.68; P < 0.001) in patients treated with WBRT plus chemotherapy were higher than with WBRT alone. There was no obvious publication bias detected. Conclusion: WBRT plus chemotherapy can obviously improve total efficacy rate, butalso increases the incidence of adverse reactions compared to WBRT alone. From the limitations of this study, more large-scale, high-quality RCTs are suggested for further verification.

• Asian Pacific Journal of Cancer Prevention
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• 제13권7호
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• pp.3431-3436
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• 2012

Objective: X-ray cross-complementing group 4 (XRCC4) is a major repair gene for DNA double-strand breaks (DSB) in the non-homologous end-joining (NHEJ) pathway. Several potentially functional polymorphisms of the XRCC4 gene have been implicated in breast cancer risk, but individually published studies showed inconclusive results. The aim of this meta-analysis was to investigate the association between XRCC4 polymorphisms and the risk of breast cancer. Methods: The MEDLINE, EMBASE, Web of science and CBM databases were searched for all relevant articles published up to June 20, 2012. Potential associations were assessed with comparisons of the total mutation rate (TMR), complete mutation rate (CMR) and partial mutation rate (PMR) in cases and controls. Statistical analyses were performed using RevMan 5.1.6 and STATA 12.0 software. Results: Five studies were included with a total of 5,165 breast cancer cases and 4,839 healthy controls. Meta-analysis results showed that mutations of rs2075686 (C>T) and rs6869366 (G>T) in the XRCC4 gene were associated with increased risk of breast cancer, while rs2075685 (G>T) and rs10057194 (A>G) might decrease the risk of breast cancer. However, rs1805377 (A>G), rs1056503 (G>T), rs28360317 (ins>del) and rs3734091 (A>G) polymorphisms of XRCC4 gene did not appear to have an influence on breast cancer susceptibility. Conclusion: Results from the current meta-analysis suggest that the rs2075685 (G>T) and rs6869366 (G>T) polymorphisms of the XRCC4 gene might increase the risk of breast cancer, whereas rs2075685 (G>T) and rs10057194 (A>G) might be protective factors.