• 제목/요약/키워드: randomized clinical trials

검색결과 984건 처리시간 0.023초

Long-term assessment of periodontal disease progression after surgical or non-surgical treatment: a systematic review

  • Sanz-Martin, Ignacio;Cha, Jae-Kook;Yoon, Sung-Wook;Sanz-Sanchez, Ignacio;Jung, Ui-Won
    • Journal of Periodontal and Implant Science
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    • 제49권2호
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    • pp.60-75
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    • 2019
  • The primary aim of this systematic review was to assess the evidence on periodontal disease progression after treatment in patients receiving supportive periodontal therapy (SPT) and to identify predictors of clinical attachment level (CAL) loss. A protocol was developed to answer the following focused question: In adult patients treated for periodontitis, what is the disease progression in terms of CAL loss after surgical or non-surgical treatment? Randomized controlled clinical trials, prospective cohort studies, and longitudinal observational human studies with a minimum of 5 years of follow-up after surgical or non-surgical treatment that reported CAL and probing depth changes were selected. Seventeen publications reporting data from 14 investigations were included. Data from 964 patients with a follow-up range of 5-15 years was evaluated. When the CAL at the latest follow-up was compared to the CAL after active periodontal therapy, 10 of the included studies reported an overall mean CAL loss of ${\leq}0.5mm$, 3 studies reported a mean CAL loss of 0.5-1 mm, and 4 studies reported a mean CAL loss of >1 mm. Based on 7 publications, the percentage of sites showing a CAL loss of ${\geq}2mm$ varied from 3% to 20%, and a high percentage of sites with CAL loss was associated with poor oral hygiene, smoking, and poor compliance with SPT. The outcomes after periodontal therapy remained stable over time. Disease progression occurred in a reduced number of sites and patients, mostly associated with poor oral hygiene, poor compliance with SPT, and smoking.

소아의 식욕부진에 대한 한약치료의 최신 임상연구 동향 - 중국 RCT 연구를 중심으로 - (Recent Trends in Clinical Research of Herbal Medicine Treatment for Anorexia in Children - Focused on Chinese Randomized Controlled Trials -)

  • 신혜진;박용석;이지홍;장규태
    • 대한한방소아과학회지
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    • 제33권4호
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    • pp.1-25
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    • 2019
  • Objectives The purpose of this study is to analyze the trends of Chinese clinical research in the last 5 years of Chinese herbal medicine treatment for anorexia in children, and to find ways to utilize the diagnostic criteria and herbal medicine treatment for children who have anorexia in Korea. Methods The authors searched literatures using China National Knowledge Infrastructure published from January 1, 2015 to June 18, 2019. Selected literatures were collected in order of recent publication year. And then, demographic data, duration of illness, intervention, treatment period, outcome, and adverse events were analyzed. In addition, the diagnostic criteria for anorexia in children are categorized and presented in chart. Results A total of 50 papers were included in the analysis of this study. In the selected studies, the most commonly used diagnostic criteria for anorexia in children were ${\ll}$Zhu Futang Practice of Pediatrics${\gg}$ in Western medicine and ${\ll}$Diagnostic and therapeutic criteria for TCM syndromes${\gg}$ in traditional Chinese medicine. As a result, in all the studies reporting total efficacy, the total effective rate of the treatment group treated with herbal medicine was significantly higher than that of the control group. Also, appetite recovery rate and weight gain were significantly higher, gastric emptying time and appetite recovery time were significantly shorter in the treatment group. Conclusions Herbal medicine treatment can help improve anorexia in children. In Korea, diagnostic criteria for anorexia in children should be established. In addition, criteria should be established to evaluate the effectiveness of herbal medicine treatment.

소아 해수에 대한 추나요법의 효과: 체계적 문헌 고찰과 메타분석 (Chuna Manual Therapy for Pediatric Cough: A Systematic Review and Meta-analysis)

  • 박혜진;김현태;이상현;황만석;황의형;신병철;허인
    • 척추신경추나의학회지
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    • 제16권1호
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    • pp.25-34
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    • 2021
  • Objectives This review was conducted to evaluate the effectiveness and clinical significance of Chuna manual therapy (CMT) in the treatment of pediatric cough. Methods Ten electronic databases (PubMed, EMBASE, Cochrane, CNKI [CAJ], KMBASE, KISS, KISTI, NDSL, RISS, and Oasis) were searched. Only randomized controlled trials (RCTs) using CMT for pediatric cough treatment were included. The methodological quality of each RCT was evaluated using the Cochrane risk-of-bias tool (v1.0). Results Nine RCTs met the inclusion criteria. The meta-analysis revealed positive effects of CMT in the treatment of pediatric cough. Both CMT alone and CMT combined with Chinese medication or Chinese medicine acupoint application (CMAA) were effective in treating pediatric cough. Conclusions This systematic review shows the reliability, effectiveness, and clinical significance of CMT in the treatment of pediatric cough. However, the evidence is limited due to the defective design of the included RCTs. More well-designed RCTs are required to provide clearer evidence for this claim.

소아 식욕부진의 병인, 변증, 치료에 대한 고찰 -중의학 논문을 중심으로- (A Review of Etiology, Pattern Identification, Treatment of Traditional Chinese Medicine for Childhood Anorexia)

  • 서혜선;김혜연;박슬기;이선행;이진용;장규태
    • 대한한방소아과학회지
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    • 제36권1호
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    • pp.1-37
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    • 2022
  • Objectives This study aimed to provide a basis for applying Korean medical treatment for childhood anorexia in clinical practice by examining Korean medical etiology, pattern differentiation, and treatment, and focusing on research articles on Chinese medicine. Methods Articles on Chinese medicine related to childhood anorexia published before November 4, 2021, in the China National Knowledge Infrastructure (CNKI), were analyzed. The etiology, pattern differentiation, and Chinese medical treatment were summarized. Results Of a total of 73 studies, 13 were randomized controlled trials (RCT), 32 were case studies, and 28 were review papers. The most common Chinese medical etiology of childhood anorexia was emotional instability, and the western medical etiology was problems with diet and lifestyle. The most frequently reported pattern differentiations were spleen-stomach-qi deficiency (脾胃氣虛), stomach-yin deficiency (胃陰不足), and spleen failing in transportation syndrome (脾失健運). The most frequent prescriptions were modified Yangwijeungaektang (养胃增液湯加減), Samryongbakchulsan (蔘苓白术散加减), and Ekongsan (異功散加減). As frequntly used tuina acupoints, Naepalgwae (内八卦), Joksamli (足三里), and Bigyeong (脾經) were mentioned. Conclusions This study analyzed the etiology, pattern differentiation, and Korean medical treatment of anorexia in children. Based on this study, standardization and well-designed clinical studies on Korean medical treatments for childhood anorexia can be expected in the future.

과민성 대장증후군 환자를 대상으로 수행된 한약 및 침구치료의 객관적 효과와 기전 연구에 대한 문헌고찰 (Review on the Objective Effect and Mechanism Studies of Herbal Medicine, Acupuncture and Moxibustion Treatment for Irritable Bowel Syndrome Patients)

  • 노현덕;김민정;조임학;김소연
    • 동의생리병리학회지
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    • 제35권5호
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    • pp.199-209
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    • 2021
  • The purpose of this study was to explore objective indicators(outcomes) which are used to evaluate clinical efficacy and figure out the mechanisms of herbal medicine, acupuncture and moxibustion treatment for Irritable bowel syndrome(IBS). We searched randomized controlled trials(RCTs) that mediated with herbal medicine, acupuncture and moxibustion treatment for IBS and used objective indicators for outcome from November 1, 2020 to December 31, 2020. The RCTs that were published in Korean, English and Chinese were included in this study. The selected literatures were analyzed about methods of result measurement and assessed by Cochrane's risk of bias(RoB). Total 18 RCTs were included in this study. There were lots of objective indicators for result measurement; the concentration of hormones in blood and neurotransmitters, the sensitivity of rectum, the functional assessment of central nerve and autonomic nerve system, the change of intestinal flora, the concentration of serum cytokines. Various objective indicators can be used to evaluate the clinical efficacy of with herbal medicine, acupuncture and moxibustion treatment for IBS, but due to the limitations of the quality of the included studies, systematic review and meta-analysis will be needed.

Which anchorage device is the best during retraction of anterior teeth? An overview of systematic reviews

  • Yassir, Yassir A.;Nabbat, Sarah A.;McIntyre, Grant T.;Bearn, David R.
    • 대한치과교정학회지
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    • 제52권3호
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    • pp.220-235
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    • 2022
  • Objective: To evaluate the available evidence regarding the clinical effectiveness of different types of anchorage devices. Methods: A comprehensive literature search of different electronic databases was conducted for systematic reviews investigating different anchorage methods published up to April 15, 2021. Any ongoing systematic reviews were searched using PROSPERO, and a grey literature search was undertaken using Google Scholar and OpenGrey. No language restriction was applied. Screening, quality assessment, and data extraction were performed independently by two authors. Information was categorized and narratively synthesized for the key findings from moderate- and high-quality reviews. Results: Fourteen systematic reviews were included (11 were of moderate/high quality). Skeletal anchorage with miniscrews was associated with less anchorage loss (and sometimes with anchorage gain). Similarly, skeletal anchorage was more effective in retracting anterior teeth and intruding incisors and molars, resulting in minor vertical skeletal changes and improvements in the soft tissue profile. However, insufficient evidence was obtained for the preference of any anchorage method in terms of the duration of treatment, number of appointments, quality of treatment, patient perception, or adverse effects. The effectiveness of skeletal anchorage can be enhanced when: directly loaded, used in the mandible rather than the maxilla, used buccally rather than palatally, using dual rather than single miniscrews, used for en-masse retraction, and in adults. Conclusions: The level of evidence regarding anchorage effectiveness is moderate. Nevertheless, compared to conventional anchorage, skeletal anchorage can be used with more anchorage preservation. Further high-quality randomized clinical trials are required to confirm these findings.

The Efficacy of Visual Activity Schedule Intervention in Reducing Problem Behaviors in Children With Attention-Deficit/Hyperactivity Disorder Between the Age of 5 and 12 Years: A Systematic Review

  • Thomas, Naveena;Karuppali, Sudhin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제33권1호
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    • pp.2-15
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    • 2022
  • Objectives: Children with attention-deficit/hyperactivity disorder (ADHD) tend to be noisy and violate rules with their disruptive behaviors, resulting in greater difficulties with off-task behaviors and being at risk for social refusal. The visual activity schedule (VAS) intervention program is a frequently used method to teach multiple skills involving on-task, use of schedules, transition behaviors, social initiation, independent play skills, classroom skills, and academic skills. The current systematic review aimed to examine the efficacy of using VAS intervention in reducing problem behaviors in children with ADHD between 5 and 12 years of age. Methods: Systematic searches were conducted using two electronic databases (PubMed and Scopus) to identify relevant studies published in English between 2010 and 2020. Four studies met the inclusion criteria: two studies examined the effect of schedule-based tasks and the use of an iPad on classroom skills, while the other two examined randomized clinical trials (RCTs) of psychosocial treatment for ADHD inattentive type and a cross-sectional study examined the impact of the group size on task behavior and work productivity in children with ADHD. Results: The findings indicate that the interventions used in all four studies could lead to increased satisfaction among participants and parents, as well as a reduction in problem behavior. In terms of the research indicators, the RCT had low quality, while the others were of high quality. Conclusion: A larger number of studies and the ADHD clinical population would help to increase the generalizability of future reviews of treatments in this context.

두드러기의 한약 치료에 대한 최근 국내외 임상 연구 동향 (Research Trend of Herbal Medicine Treatments for Urticaria)

  • 남혜진;박재은;김현진;안재영;신나영;전명규;이영진;채고은;고아라;조혜정;김현우
    • 한방안이비인후피부과학회지
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    • 제35권2호
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    • pp.49-60
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    • 2022
  • Objectives : The purpose of this review is to overview the research trend of herbal medicine for urticaria. Methods : We searched for studies of urticaria treated with herbal medicine published from 2010 until March 2022, through 5 web databases. After searching studies, we analyzed selected studies. Results : As a result, 7 studies have been found and analyzed. Three studies were randomized controlled trials, and four studies were before & after clinical research. All of research which selected have reported that herbal medicine treatment was effective for urticaria. Conclusion : According to the results, herbal medicine treatments can be effective treatment for urticaria. Further clinical studies are expected using evaluation methods to analyze the results and to establish high level of evidence.

비알코올 지방간질환에 대한 한의학 연구 동향 보고: 국내 논문을 중심으로 (A Review of Research Trends in Traditional Korean Medicine for Nonalcoholic Fatty Liver Disease)

  • 김나연;윤미정;최홍식;김승모;김상찬;김경순
    • 대한한방내과학회지
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    • 제43권4호
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    • pp.680-719
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    • 2022
  • Objectives: The aim of this study was to investigate the trends in research on non-alcoholic fatty liver disease (NAFLD) using Korean traditional medicine. Methods: This review included studies related to the treatment of NAFLD, irrespective of the year of publication. The search terms were "nonalcoholic fatty liver disease", "non-alcoholic fatty liver", "nonalcoholic hepatitis", "herb", "herbal medicine", "acupuncture", and "traditional medicine". The studies were analyzed according to the type of research. Results: After screening, 179 studies were selected from the 592 identified by the search. The types of studies were 151 in vivo or in vitro studies, 5 randomized controlled trials, 12 case reports, 2 unspecified clinical studies, 8 review articles, and 1 article that was difficult to classify. Conclusion: Analysis of the trends in Korean traditional medicine treatment by reviewing the studies on NAFLD revealed a focus on experimental studies rather than clinical studies. Therefore, multifaceted and well-designed studies are needed.

Resuscitation Fluids for Patients at High Risk of Multiple Organ Dysfunction Syndromes: A Systematic Review and Meta-analysis

  • Nam, Jae Hyun;Kwack, Hee Jin;Ha, Woo Seob;Chung, Jee-Eun
    • 한국임상약학회지
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    • 제32권3호
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    • pp.251-259
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    • 2022
  • Background: Intravenous fluid therapy is one of the most common interventions in critically ill patients. Normal saline is frequently used, but there have been some concerns about hyperchloremia. Due to closer to plasma composition, crystalloids have been used as alternatives to normal saline. However, the optimal choice of resuscitative fluids remains controversial. Methods: MEDLINE, EMBASE, and CENTRAL were comprehensively searched until July 2021 to compare balanced crystalloids with normal saline in critically ill patients with the risk factors for multiple organ dysfunction syndromes (MODS).The primary endpoint was composite mortality. Secondary outcomes were acute kidney injury (AKI)/acute renal failure (ARF), and new receipt of renal replacement therapy (RRT). Results: A total of 1,240 studies were searched, and finally, 8 randomized controlled trials and 5 cohort studies were included. In the meta-analysis of composite mortality of 30,710 patients, balanced crystalloids compared to normal saline were significantly associated with reduced mortality (OR 0.80, 95% CI 0.68-0.95). In AKI/ARF, balanced crystalloids had a lower risk than normal saline (OR 0.91, 95% CI 0.84-0.99). There was no difference between balanced crystalloids and normal saline in risk of new receipt of RRT (OR 0.91, 95% CI 0.80-1.04). Conclusion: In fluid resuscitation for patients at high risk of MODS, the use of balanced crystalloids showed a significantly lower incidence of mortality compared to normal saline.