• 제목/요약/키워드: Safety Library

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지역사회 거주 노인을 위한 약물사용검토 도구에 대한 체계적 문헌고찰 (Medication Use Review Tools for Community Dwelling Older Patients: A Systematic Review)

  • 박지영;전광희;백양서;박소영;이주연
    • 한국임상약학회지
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    • 제31권1호
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    • pp.61-78
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    • 2021
  • Background and Objective: The use of potentially inappropriate medications (PIMs) increases the risk of negative health outcomes, including drug-related admissions. Tools for structured medication review have been developed to ensure optimal medication use and safety. Here, we aimed to evaluate medication use review (MUR) tools for community-dwelling older patients. Methods: We performed a systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). We searched PubMed, Embase, and the Cochrane Library from 1991 to 2020, excluding tools that are specifically applied to hospitalized patients or nursing home residents. We identified the most common inappropriate medications, drug-disease interactions, drug-drug interactions and prescribing omissions presented among tools. Results: From among 9,788 identified reports screened, 60 met our inclusion criteria; finally, 27 were eligible for data analysis considering originality and up-to-dateness. Most tools presented explicit criteria (93%), and only one was specific to community-dwelling elderly. The most common PIM was tricyclic antidepressants. Use of diltiazem and verapamil in patients with heart failure and the combination of nonsteroidal anti-inflammatory analgesics and warfarin were the most frequent disease-specific PIM and drug-interaction, respectively. Conclusions: Although several medication review tools have been developed for older adults, specific guidelines for community-dwelling populations remain limited. Furthermore, the list of PIMs differed among available tools. In future, specific but integrating MUR tools need to be developed for clinical practice considering this population.

손목 터널 증후군에 대한 추나요법의 효과: 체계적 문헌 고찰 (Chuna Manual Therapy for Carpal Tunnel Syndrome: A Systematic Review)

  • 박선영;이상현;허인;황의형
    • 척추신경추나의학회지
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    • 제16권2호
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    • pp.9-19
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    • 2021
  • Objectives This systematic review aimed to provide evidence for the effectiveness and safety of Chuna manual therapy (CMT) for carpal tunnel syndrome (CTS). Methods We searched 12 electronic databases (PubMed, Ovid-MEDLINE, EMBASE, The Cochrane Library, CNKI, CiNii, ScienceON, KMbase, KISS, OASIS, KMTANK, and RISS) up to the end of October 2021. We only included randomized controlled trials (RCTs) investigating CMT for the treatment of CTS. The methodological quality of the included RCTs was evaluated using the Cochrane Risk of Bias Tool 1.0. Results Six RCTs were eligible for inclusion in our study. A meta-analysis of four studies demonstrated positive results for the use of CMT when used in conjunction with Korean medicine treatment compared to those for Western conservative treatment for CTS. Conjunction treatment significantly improved the total efficacy rate compared to conservative treatment alone (P=0.0007, n=4). Conclusions There is reliable evidence for the use of CMT in treating CTS based on a published meta-analysis. To measure only the effect of Chuna, an experimental group should be designed with Chuna alone to evaluate its effectiveness. However, it should be noted that the studies included in this systematic review were heterogeneous and of low quality, thus warranting further investigation using well-designed RCTs.

Efficacy of cannabis-based medications compared to placebo for the treatment of chronic neuropathic pain: a systematic review with meta-analysis

  • Sainsbury, Bradley;Bloxham, Jared;Pour, Masoumeh Hassan;Padilla, Mariela;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제21권6호
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    • pp.479-506
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    • 2021
  • Background: Chronic neuropathic pain (NP) presents therapeutic challenges. Interest in the use of cannabis-based medications has outpaced the knowledge of its efficacy and safety in treating NP. The objective of this review was to evaluate the effectiveness of cannabis-based medications in individuals with chronic NP. Methods: Randomized placebo-controlled trials using tetrahydrocannabinol (THC), cannabidiol (CBD), cannabidivarin (CBDV), or synthetic cannabinoids for NP treatment were included. The MEDLINE, Cochrane Library, EMBASE, and Web of Science databases were examined. The primary outcome was the NP intensity. The risk of bias analysis was based on the Cochrane handbook. Results: The search of databases up to 2/1/2021 yielded 379 records with 17 RCTs included (861 patients with NP). Meta-analysis showed that there was a significant reduction in pain intensity for THC/CBD by -6.624 units (P < .001), THC by -8.681 units (P < .001), and dronabinol by -6.0 units (P = .008) compared to placebo on a 0-100 scale. CBD, CBDV, and CT-3 showed no significant differences. Patients taking THC/CBD were 1.756 times more likely to achieve a 30% reduction in pain (P = .008) and 1.422 times more likely to achieve a 50% reduction (P = .37) than placebo. Patients receiving THC had a 21% higher improvement in pain intensity (P = .005) and were 1.855 times more likely to achieve a 30% reduction in pain than placebo (P < .001). Conclusion: Although THC and THC/CBD interventions provided a significant improvement in pain intensity and were more likely to provide a 30% reduction in pain, the evidence was of moderate-to-low quality. Further research is needed for CBD, dronabinol, CT-3, and CBDV.

한약이 류마티스 관절염 환자의 골다공증에 미치는 영향: 체계적 문헌 고찰 및 메타분석을 위한 프로토콜 (Effects of Herbal Medicines on Osteoporosis in Rheumatoid Arthritis: Study Protocol for a Systematic Review and Meta-Analysis)

  • 권도영;구지향;이은정
    • 한방재활의학과학회지
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    • 제32권3호
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    • pp.77-84
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    • 2022
  • Objectives This study is designed to identify the effectiveness of herbal medicine for osteoporosis in rheumatoid arthritis. Methods We will investigate 10 databases, 4 Korean databases (KoreaMed, KMBASE, Koreanstudies Information Service System [KISS], ScienceOn) and 6 of abroad (PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure [CNKI], WanFang, Citation Information by NII [CiNii]) without publication date, language limitation for clinical study of herbal medicine for osteoporosis in rheumatoid arthritis. Type, dose, duration, frequency of herb medicine will be analyzed. Results Randomized controlled trials about herbal medicine or herb extract for osteoporosis in rheumatoid arthritis should be included in the study. Cochrane's risk of bias tools will be used to assess quality of the study. Mean differences or standardized mean differences of 95% confidence intervals will calculated and data synthesis will be conducted using Review Manager (RevMan, ver.5.3; The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). Conclusions It is expected to provide basic data for the active use of herb medicine by systematically synthesizing and analyzing the actual situation, effectiveness, and safety of herb medicine for osteoporosis in rheumatoid arthritis.

소아·청소년 천식에 대한 수기요법의 효과: 체계적 문헌 고찰 (Effectiveness of Manual Therapy for Asthma in Children and Adolescents: A Systematic Review)

  • 박선영;허인;신병철
    • 척추신경추나의학회지
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    • 제17권1호
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    • pp.11-19
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    • 2022
  • Objectives This systematic review aimed to provide evidence of the effectiveness and safety of manual therapy for asthma in children and adolescents. Methods We queried eight electronic databases (PubMed, Ovid-MEDLINE, EMBASE, The Cochrane Library, CNKI, ScienceON, KISS, and RISS) up to the end of April 2022. We included only randomized controlled trials (RCTs) investigating manual therapy for the treatment of asthma in children and adolescents. The methodological quality of the included RCTs was evaluated using the Cochrane risk-of-bias tool 1.0. Results Four RCTs were eligible for inclusion. Meta-analysis could not be performed due to the heterogeneity of the studies. One study showed the statistical significance of SMD 0.41 (95% CI: 0.06, 0.76, p<0.05) in the comparison with the osteopathic therapy group and the sham control group before and after treatment on the same day of peak expiratory flow. Conclusions This possibility was observed in a non-pharmacological approach to manual therapy. Manual therapy can be considered as an adjunct therapy for asthma treatment in children and adolescents who have difficulty with drug therapy.

A model to secure storage space for CCTV video files using YOLO v3

  • Seong-Ik, Kim
    • 한국컴퓨터정보학회논문지
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    • 제28권1호
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    • pp.65-70
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    • 2023
  • 본 논문에서는 YOLO v3를 이용한 CCTV 저장공간 확보 모델을 제안한다. CCTV는 방범, 화재예방, 감시 등 재난·재해 및 안전을 위해 사회 곳곳에 설치·운영되며, 개수의 증가와 화질의 개선이 함께 이뤄지고 있다. 이로 인해 영상파일의 개수와 크기가 증가하면서 기존의 저장공간으로는 이를 감당하기 어려움을 느끼고 있다. 이를 해소하기 위해 CCTV 영상 속의 특정 객체를 YOLO v3를 이용하여 탐지하여 해당 프레임만을 저장하여 불필요한 프레임을 삭제하는 모델을 제안하여 영상파일의 크기를 줄임으로써 저장공간을 확보하고, 그로 인해 더 오랜 기간 영상을 저장·관리할 수 있도록 하였다. 제안 모델 적용 후 평균 94.9% 영상파일의 크기가 절감됨을 확인하였으며, 제안 모델을 적용하기 전보다 약 20배의 보관 기간이 증가했음을 확인할 수 있었다.

백선피(白鮮皮)의 피부과적 효능과 약인성 간손상에 대한 문헌 연구 (A literature study on dermatological efficacy and drug induced liver injury of Dictamnus dasycarpus Turcz)

  • 이유정;김서영;김형우
    • 대한본초학회지
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    • 제33권1호
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    • pp.9-15
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    • 2018
  • Objectives : The root bark of Dictamnus dasycarpus has been frequently used to treat patients with skin diseases in Korea. Recently, wild root of D. dasycarpus are reported to induce liver injury. Methods : Traditional uses of D. dasycarpus for skin diseases were analysed bibliographically. In addition, reported cases were collected and analysed using pubmed and national digital library. Results : In taiwan, D. dasycarpus revealed to be one of major herbs for skin diseases and many researchers in worldwide had reported its dermatological efficacies. Reported cases related in liver injury described that hepatocellular or cholestatic liver injury were seen in patients eating wild root of D. dasycarpus. In addition, 6 cases in worldwide and 1 case in Korea showed that patients with drug induced liver injury (DILI) ingested not root bark of D. dasycarpus but prescriptions containing root bark of D. dasycarpus. These mean that wild root of D. dasycarpus (Bongsam or Bongwhangsam) was estimated to be closely related in DILI. Whereas, it was difficult to confirm direct correlation between root bark of D. dasycarpus used as herbal medicine by doctor of Korean medicine and DILI. Conclusions : these results imply that wild root of D. dasycarpus is closely related in DILI and strong recommendation not to take it without consultation by experts is needed. In addition, although there are no evidences of direct correlation between root bark of D. dasycarpus and DILI, doctor of Korean medicines should pay attention to use root bark of D. dasycarpus in their clinics.

월경전증후군에 대한 침 치료의 효과 : 체계적 문헌고찰과 메타분석 (Acupuncture for Premenstrual Syndrome: A Systematic Review and Meta-analysis)

  • 김안나;김영은;이은희;손미주
    • 대한한방부인과학회지
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    • 제36권3호
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    • pp.154-172
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    • 2023
  • Objectives: This study aimed to assess the clinical evidence supporting the use of acupuncture (AC) for premenstrual syndrome (PMS). Methods: We searched randomized controlled trials (RCTs) that used AC for PMS in 9 databases (PubMed, EMBASE, Cochrane Library, CINAHL, CNKI, CiNii, SCIENCE ON, KoreaMed, OASIS) from their inception to July 2022. Results: We identified 1,168 studies, of which 15 RCTs met the inclusion criteria. The risk of bias in the included studies was relatively unclear or high. Meta-analysis of 3 RCTs showed that the AC group had a significantly higher effective rate than the Medroxyprogesterone group (RR 1.48, 95% CI (1.23, 1.78), p<0.0001). Meta-analysis of 2 RCTs showed that there was no statistically significant difference between the AC group and the Sham AC group in the effective rate (RR 4.72, 95% CI (0.88, 25.36), p=0.07). In a review of individual studies, the AC group was more effective than the control group in terms of the effective rate, symptom scale, quality of life, adverse events, and recurrence rate. Conclusions: The AC group was more effective than general treatments groups such as sham AC, western medicine, and dietary supplements, and there were no serious adverse events. However, the evidence on the effectiveness and safety of acupuncture for PMS was inconclusive due to the small number of included studies and low quality. Therefore, systematic reviews based on more rigorously designed randomized clinical trials are needed in the future to properly evaluate the effect of AC on PMS.

시각장애인을 위한 보행 안내 스마트 안경 플랫폼 설계 (Design of Smart Glasses Platform walking guide for the visually impaired)

  • 이재범;장종욱;장성진
    • 한국정보통신학회:학술대회논문집
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    • 한국정보통신학회 2021년도 추계학술대회
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    • pp.320-322
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    • 2021
  • 세계적으로 고령 인구가 증가함에 따라 시각장애인의 비율 역시 증가하고 있으며, 여전히 안전상에 문제, 안내정보 부족 등 시각장애인이 외부 활동을 하는 데에 있어서 많은 제약이 존재한다. 이를 해결하기 위해 광학 문자 인식(OCR) 기능이 탑재된 스마트 안경 등 스마트 기기에 관한 연구가 활발히 진행되고 있다. 본 논문에서는 전방에 장애물을 인식해 음성으로 정보를 알려주고, 목적지까지 길을 안내해주는 시스템을 제안한다. 딥러닝 객체 인식 모델인 Yolo를 이용하여 계단, 라바 콘과 같은 위험요소를 장애물로 인식하고 음성으로 정보를 전달해주며, 길 찾기 API와 음성인식, TTS 라이브러리를 사용하여 입력한 목적지까지 음성으로 길 안내를 해줌으로써 시각장애인의 외부 활동 범위가 확대되는 효과를 기대할 수 있다.

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회전근개 질환의 전침 치료에 대한 체계적 문헌고찰 및 메타분석 (Electroacupuncture for Rotator Cuff Disorder: A Systematic Review and Meta-Analysis)

  • 나복연;이상훈;우창훈;김영준
    • 한방재활의학과학회지
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    • 제34권3호
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    • pp.27-41
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    • 2024
  • Objectives This study aims to evaluate the efficacy and safety of electroacupuncture for rotator cuff disorder. Methods We searched nine online databases (PubMed, Embase, Cochrane Library, Chinese Academic Journals, Korean studies Information Service System, Rsearch Information Sharing Service, ScienceON, KMbase, Oriental Medicine Advanced Searching Integrated System) and two related journals up to April 2024 to identify randomized controlled trials that applied electroacupuncture to rotator cuff disorder. Selected studies were analyzed for risk of bias using the Cochrane risk of bias tool, and a meta-analysis was performed with RevMan version 5.4.1. Results Out of 175 studies, eleven randomized controlled trials were selected for final analysis. Most studies showed that electroacupuncture had effect on rotator cuff disorder. In the meta-analysis, electroacupuncture combined with rehabilitation treatment was significantly more effective than rehabilitation treatment alone in improving visual analog scale (p<0.00001). Almost studies did not report any side effects or adverse reactions to electroacupuncture treatment. Conclusions This systematic review suggests that electroacupuncture is an effective treatment for pain management in rotator cuff disorder. However, the lack of adverse effect reporting and a high risk of bias indicate the need for high-quality randomized controlled trials from various countries.