• Title/Summary/Keyword: Systemic literature review

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Systemic Literature Review Study on the Efficacy and Safety of Novel Alzheimer's Disease Treatments (새로운 알츠하이머 치료제의 안전성 유효성에 관한 체계적 문헌고찰)

  • Shinung Park;Harin Chang;HyunSoon Sohn;MiKyong Shim
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.4
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    • pp.290-304
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    • 2023
  • Background: Innovative Alzheimer's disease drugs received approval in the United States in 2021 and 2023. This study aims to assess the safety and efficacy of these novel treatments, elucidate their mechanisms of action, and compare their impact on cognitive function improvement with approved drugs. Methods: We conducted a comprehensive search of pivotal clinical studies related to Alzheimer's disease treatments in PubMed/Medline, Embase, and the Cochrane Library databases from January 1st, 2020 to December 31st, 2022. Meta-analysis was performed using RevMan 5.4 software. Results: A total of 14 studies were included in this systematic review. When compared to the placebo, the new drugs did not exhibit a statistically significant effect on MMSE (Mini-Mental State Examination) (mean difference= -0.04, 95% confidence intervals [CIs]: -0.31, 0.23, N=3662, I2=0%). However, they demonstrated a significant impact on ADAS-cog (Alzheimer's Disease Assessment Scale-Cognitive Subscale) (standardized mean difference= -0.15, 95% CIs: -0.2, -0.1, N=6710, I2=17%). When compared to the approved drugs, the new drugs showed a statistically significantly lower effect on MMSE (test for subgroup difference Chi2=23.13, N = 5870, p<0.00001) but showed only a trend of decreased efficacy on ADAS-cog (Chi2=1.16, N = 8670, p=0.28). Conclusion: New drugs yielded diverse clinical endpoint results compared to the placebo, and in comparison to existing approved drugs, they exhibited lower efficacy in improving cognitive function. The safety profile of these new drugs, as reported in clinical trials, was generally well-tolerated.

LITERATURE REVIEW OF ANTIBIOTICS PRESCRIPTION IN GENERAL DENTAL AND ORAL-MAXILLOFACIAL SURGICAL PRACTICE (치과분야 항생제 처방에 대한 국내외 문헌 분석)

  • Jo, Sae-Hyung;Alrashdan, Mohammad;Choung, Han-Ul;Pang, Kang-Mi;Park, Jong-Chul;Kim, Soung-Min;Kim, Myung-Jin;Lee, Jong-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.3
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    • pp.164-169
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    • 2009
  • Objectives : Administration methods of antibiotics implements a variety for indications and diseases. Therefore, it is impossible to produce a single guideline. Many antibiotics have been prescribed without specific index, by practicians for a long period of time. In general dental practice and oral and maxillofacial surgical practice, there is not a guidelines for antibiotics. Therefore, there is a dependency on pre-existent methods rather than following an exact guideline. Consequently, a controversy was issued that prescription of antibiotics tend to be misused or abused. And it is also direct relation to the tolerance of antibiotics as well. Moving forward, in this review we will be analyzing the exact usage and indication of antibiotics in dental treatment. Materials and Methods : 29 published articles of both domestic and international were researched through Pubmed and Kormed, and the review from these articles were performed accordingly. We examined the administration of antibiotics through the objective usage, that classified prophylactic and therapeutic. Results : For therapeutic usage, empirical prescription is mandatory for the first step. Next is to moderate the empirical prescription depending upon the result of its culture. Administration of antibiotics must be kept for 2days after the symptoms disappear. For a prophylactic use, we can generally pr escribe antibiotics to prevent local infection or systemic infection. Although the method of prescription and neccessity of antibiotics to prevent local in fection are controversial, exact guidelines of antibiotics to prevent systemic infection are established by AHA. Conclusion : Most crucial concept for prescript antibiotics is to determine if it is adequately suitable for all circumstances. In this decision making, a guideline for prescription of antibiotics in various dental surgical practice is necessary. This guideline can reduce the misusage and disusage of a ntibiotics in general dental practices and oral and maxillofacial surgical practices.

Making Strategic Choice for Sustainable Social Enterprise: The Application of Holon Dynamics Approach (지속 가능한 사회적 기업을 위한 전략적 방향 제시: 홀론 다이내믹스의 적용)

  • Yu, Jae-Eon
    • Korean System Dynamics Review
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    • v.13 no.1
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    • pp.133-157
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    • 2012
  • This paper aims to propose the strategy making in social enterprise for ensuring organizational sustainability and governance of social enterprise from systems thinking's perspective. Based on previous reviews on organizational sustainability and theories of governance currently advocated in the social enterprise literature, we use 'Holon Dynamics' approach, which is a synthesis of System Dynamics and Soft Systems Methodology (SSM), offers the problem-solving method for dealing with social contexts and "ill-defined" situations. To do so, a researcher carried out the interpretive action research using 'Holon Dynamics' approach from September, 2009 to August, 2010. The outcomes of research are summarized as follows. Firstly, systems methodologies are useful to offer a strategic choice that makes to achieve an organizational sustainability in the case of Korean social enterprise; 'the Rediscovery of Korea'. Secondly, systems thinking offers an alternative concept of system, which is known as an 'appreciative system' that is evolved from the mental constructs amongst participants in given situations. Lastly, the paper delineates the usefulness of systems thinking and the process of inquiry, which deal with social contexts (including cultural and political factors), are contributed to making the necessary conditions for organizational legitimacy and the appropriate strategic choice for social enterprise within combined functioning of the two roles of social and commercial activities from systemic perspectives.

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Bilateral Sequential Single Lung Transplantation for Eisenmenger's Syndrome (Eisenmenger's 증후군이 동반된 동맥관 개존증환자에서의 순차적 양측 폐이식술 - 1례 보고 -)

  • 이교준;정은규;함석진;이두연;백효채;김해균;조현민
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.64-67
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    • 2002
  • Eisenmenger's syndrome is the disease of right to left shunt developing from the increased pulmonary vascular resistance caused by excessive pulmonary blood flow in patients with abnormal connections of systemic to pulmonary blood passage. The heart-lung transplantation was the only curative method in early transplantation period, but good results after bilateral lung transplantation have been reported as the fact that right heart function improved by only lung transplantation. We successfully carried out bilateral sequential single lung transplantation in a 34-year-old female patient with Eisenmenger's syndrome with large PDA. We report this case with a brief review of the literature.

Climate Change and Health - A Systemic Review of Low and High Temperature Effects on Mortality (기후변화와 건강 - 저온과 고온이 사망에 미치는 영향에 관한 체계적 고찰)

  • Lim, Youn-Hee;Kim, Ho
    • Journal of Environmental Health Sciences
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    • v.37 no.6
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    • pp.397-405
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    • 2011
  • Objectives: The impact of climate change on the health has been of increasing concern due to a recent temperature increase and weather abnormality, and the research results of the impact varied depending on regions. We synthesized risk estimates of the overall health effects of low and high temperature taking account of the heterogeneity. Methods: A comprehensive literature search was conducted using PUBMED to identify journal articles of low and/or high temperature effects on mortality. The search was limited to the English language and epidemiological studies using time-series analysis and/or case-crossover design. Random-effect models in meta analysis were used to estimate the percent increase in mortality with $1^{\circ}C$ temperature decrease or increase with 95% confidence intervals (CI) in cold or hot days. Results: Twenty three studies were presented in two tables: 1) low temperature effects; 2) high temperature effects on mortality. The combined effects of low and high temperatures on total mortality were 2% (95% CI, 1-4%) per $1^{\circ}C$ decrease and 4% (95% CI, 2-5%) per $1^{\circ}C$ increase of temperature, respectively. Conclusions: This meta analysis found that both low and high temperatures affected mortality, and the magnitude of high temperature appeared to be stronger than that of low temperature.

Epstein-Barr Virus Infection with Acute Acalculous Cholecystitis

  • Kim, Ahlee;Yang, Hye Ran;Moon, Jin Soo;Chang, Ju Young;Ko, Jae Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.17 no.1
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    • pp.57-60
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    • 2014
  • Acute acalculous cholecystitis (AAC) is an inflammation of the gallbladder in the absence of demonstrated stones. AAC is frequently associated with severe systemic inflammation. However, the exact etiology and pathogenesis of AAC still remain unclear. Acute infection with Epstein Barr virus (EBV) in childhood is usually aymptomatic, whereas it often presents as typical infectious mononucleosis symptoms such as fever, cervical lymphadenopathy, and hepatosplenomegaly. AAC may occur during the course of acute EBV infection, which is rarely encountered in the pediatric population. AAC complicating the course of a primary EBV infection is usually associated with a favorable outcome. Most of the patients recover without any surgical treatment. Therefore, the detection of EBV in AAC would be important for prediction of better prognosis. We describe the case of a 10-year-old child who presented with AAC during the course of primary EBV infection, the first in Korea, and review the relevant literature.

A case of Behcet's Disease with CNS Manifestations (중추 신경계 증상이 동반된 Behcet,씨 병 1예)

  • Shin, Dong-Gu;Ko, Myung-Ku;Yoon, Kyung-Woo;Kim, Chong-Suhl
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.307-311
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    • 1986
  • Beh,cet's disease was originally described as a triple symptom complex of oral aphthous ulceration, genital ulceration, and hypopyon iritis. It is now known to have a wide systemic manifestations. Among them, the central nervous system involvement should be diagnosed earlier because of it's lethal potential. Recently the authors experienced a case of Behcet's disease with CNS involvement. A 51-year-old female patient was admitted due to deterioration of mentality and generalized ache since 2 years prior to admission. The findings on physical examination were compatible with Behcet's disease, but without cerebrospinal pleocytosis. The manifestations were improved with medications of prednisolone, chlorambucil, colchicine, but relapsed 2 months later during subsequent tapering of prednisolone and chlorambucil. The patient is now on medication again. A case of Beh,cet's disease with CNS manifestations is reported with review of literature.

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Subependymal Giant Cell Astrocytoma in the Tuberous Sclerosis (결정성 경화증에서의 상의하 거대 성상세포종)

  • Park, Jin-Han;Kim, Seong-Ho;Han, Dong-Ro;Bae, Jang-Ho;Ko, Sam-Kyu;Kim, Oh-Lyung;Chok, Byung-Yeam;Cho, Soo-He
    • Journal of Yeungnam Medical Science
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    • v.11 no.2
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    • pp.221-229
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    • 1994
  • Tuberous sclerosis is reported rarely and is associated with systemic lesions including central nervous system, skin, heart, eye and kidney. Approximately 5-15% of individuals with tuberous sclerosis will develope brain neoplasia, almost invariably subependymal giant-cell astrocytoma (SGCA). We experienced a case of SGCA with tuberous sclerosis operated by the transcallosal approach and report with literature review.

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Primary Cutaneous Mucinous Carcinoma Treated with Narrow Surgical Margin

  • Choi, Jin-Hee;Kim, Seung Chan;Kim, Jiye;Chung, Yoon Kyu
    • Archives of Craniofacial Surgery
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    • v.17 no.3
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    • pp.158-161
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    • 2016
  • Primary cutaneous mucinous carcinoma (PCMC) is a rare malignant tumor of eccrine origin. Clinically, the carcinoma presents as a solitary, slow growing, and painless nodule. For this reason, this tumor is often considered to be a benign mass in the preoperative setting. The lesion is, however, malignant in nature and has a tendency for local recurrence and infrequent metastasis. Wide local excision is the treatment of choice. However, few reports exist with information regarding surgical margins and clinical outcomes. Herein, we report a case of PCMC excised with a narrow surgical margin and review the relevant literature. A 49-year-old man presented with a small cutaneous nodule of the right cheek. The mass was excised without any margin, but pathologic examination revealed histology of mucinous carcinoma. Because of this, the operative site was re-excised with a 5-mm margin, and the wound was closed using a V-Y advancement flap. Systemic work-up did not reveal other potential metastatic primary, for a final diagnosis of PCMC. We report this case of PCMC, treated with relatively narrow margin in a patient with good prognostic factors.

TWO CASES REPORT OF MAXILLARY SINUS ASPERGILLOSIS (상악동에 발생한 국균증의 치험2례)

  • Kim, Soo-Min;Yeo, Hwan-Ho;Kim, Young-Kyun;Kim, Su-Gwan;Cho, Jeo-O
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.726-733
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    • 1996
  • Aspergillosis of the maxillary sinus was rare disease, but it was increasing tendency with overuse antibiotics, streoid hormones, and anticanncerous agents. The clinical features and X-ray findings are similar to chronic suppurative paranasal sinusitis. Aspergillosis of the maxillary siuses may occur as a chronic diseae in an otherwise healthy person. This infection is usually confined to a single paranasal sinus, the maxillary antrum, though it can involve the orbit and may initiate with findings of proptosis and decreased vision. The disease is characterized by a wide range of initial symptoms, and should be considered as a possible diagnosis in sinusitis refractory to antibiotics and antral lavage. The choice of treatment of this disease is radical surgery and adjunctive systemic antifungal therapy. We experienced a case of right maxillary sinus aspergillosis in a 34 years old male who has dull pain on Rt. zygoma area, and a case of left maxillary sinus aspergillosis in a 30 years old male who had been suffered from nasal stiffness and frontal headache for 3-4 years. We reported two cases with review of literature.

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