• Title/Summary/Keyword: therapeutic evidence

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패혈증과 패혈쇼크의 치료 지침 (Treatment Guidelines of Sepsis and Septic Shock)

  • 이흥범;문희
    • Tuberculosis and Respiratory Diseases
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    • 제67권6호
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    • pp.491-498
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    • 2009
  • Severe sepsis and septic shock are major healthcare problems with high mortality, ranging from 20% to 60%, affecting millions of individuals around the world each year. The speed and appropriateness of therapy administered in the initial hours after severe sepsis develops have an important impact on the outcome. In 2004, an international guideline that the bedside clinician could use to improve the outcomes in severe cases of sepsis and septic shock was published. Several landmark studies recently demonstrated that therapeutic strategies may reduce mortality substantially. The "Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock: 2008", using a new evidence-based methodology system for assessing the quality of evidence and the strength of the recommendations, was updated. The revised version is based on an updated search into 2007. Evidenced-based recommendations regarding the acute management of sepsis and septic shock are the first step toward improving the outcomes of critically ill patients. We review the treatment guidelines of sepsis and septic shock.

Inhibition of Store-Operated Calcium Entry Protects Endothelial Progenitor Cells from H2O2-Induced Apoptosis

  • Wang, Yan-Wei;Zhang, Ji-Hang;Yu, Yang;Yu, Jie;Huang, Lan
    • Biomolecules & Therapeutics
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    • 제24권4호
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    • pp.371-379
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    • 2016
  • Store-operated calcium entry (SOCE), a major mode of extracellular calcium entry, plays roles in a variety of cell activities. Accumulating evidence indicates that the intracellular calcium ion concentration and calcium signaling are critical for the responses induced by oxidative stress. The present study was designed to investigate the potential effect of SOCE inhibition on $H_2O_2$-induced apoptosis in endothelial progenitor cells (EPCs), which are the predominant cells involved in endothelial repair. The results showed that $H_2O_2$-induced EPC apoptosis was reversed by SOCE inhibition induced either using the SOCE antagonist ML-9 or via silencing of stromal interaction molecule 1 (STIM1), a component of SOCE. Furthermore, SOCE inhibition repressed the increases in intracellular reactive oxygen species (ROS) levels and endoplasmic reticulum (ER) stress and ameliorated the mitochondrial dysfunction caused by $H_2O_2$. Our findings provide evidence that SOCE inhibition exerts a protective effect on EPCs in response to oxidative stress induced by $H_2O_2$ and may serve as a potential therapeutic strategy against vascular endothelial injury.

Cancer stem cell metabolism: target for cancer therapy

  • Chae, Young Chan;Kim, Jae Ho
    • BMB Reports
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    • 제51권7호
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    • pp.319-326
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    • 2018
  • Increasing evidence suggests that cancer stem cell (CSC) theory represents an important mechanism underlying the observed failure of existing therapeutic modalities to fully eradicate cancers. In addition to their more established role in maintaining minimal residual disease after treatment and forming the new bulk of the tumor, CSCs might also critically contribute to tumor recurrence and metastasis. For this reason, specific elimination of CSCs may thus represent one of the most important treatment strategies. Emerging evidence has shown that CSCs have a different metabolic phenotype to that of differentiated bulk tumor cells, and these specific metabolic activities directly participate in the process of CSC transformation or support the biological processes that enable tumor progression. Exploring the role of CSC metabolism and the mechanism of the metabolic plasticity of CSCs has become a major focus in current cancer research. The targeting of CSC metabolism may provide new effective therapies to reduce the risk of recurrence and metastasis. In this review, we summarize the most significant discoveries regarding the metabolism of CSCs and highlight recent approaches in targeting CSC metabolism.

소아에서 말 언어장애 (Speech and language disorders in children)

  • 정희정
    • Clinical and Experimental Pediatrics
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    • 제51권9호
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    • pp.922-934
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    • 2008
  • Developmental language disorder is the most common developmental disability in childhood, occurring in 5-8% of preschool children. Children learn language in early childhood, and later they use language to learn. Children with language disorders are at increased risk for difficulties with reading and written language when they enter school. These problems often persist through adolescence or adulthood. Early intervention may prevent the more serious consequences of later academic problems, including learning disabilities. A child's performance in specific speech and language areas, such as phonological ability, vocabulary comprehension, and grammatical usage, is measured objectively using the most recently standardized, norm-referenced tests for a particular age group. Observation and qualitative analysis of a child's performance supplement objective test results are essential for making a diagnosis and devising a treatment plan. Emphasis on the team approach system in the evaluation of children with speech and language impairments has been increasing. Evidence-based therapeutic interventions with short-term, long-term, and functional outcome goals should be applied, because there are many examples of controversial practices that have not been validated in large, controlled trials. Following treatment intervention, periodic follow-up monitoring by a doctor is also important. In addition, a systematized national health policy for children with speech and language disorders should be provided.

The use of natural remedies to treat osteoarthritis

  • Tan, Boon Hooi;Ong, Chin Eng
    • 셀메드
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    • 제6권1호
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    • pp.1.1-1.9
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    • 2016
  • Osteoarthritis (OA) is the leading medical condition for which patients use alternative treatments including the natural remedies. The aim of this review is to describe the dietary supplements and herbal remedies most commonly used in patients with osteoarthritis with an emphasis on the efficacy and safety of these natural remedies. Glucosamine and chondroitin sulfate, two of the molecular building blocks found in articular cartilage, are the most commonly used remedies in OA treatment. Most clinical researches suggest that glucosamine and chondroitin show efficacy in reducing or improving symptoms and their ability to arrest progression of the disease or regenerate damaged cartilage. Patented formulations of both remedies are recommended by several therapeutic guidelines for use as first line background OA treatment. Reliable evidence that the combination is more effective than either agent alone is however still lacking. Several other herbs or remedies are promoted for treating osteoarthritis such as S-adenosylmethionine, methylsulfonylmethane, Harpagophytum procumbens (devil's claw), Curcuma longa (turmeric), Zingiber officinale (ginger), and capsaicin but there is no reliable evidence on long-term efficacy or safety. The clinical usefulness of these remedies is therefore rather limited currently.

Approaches to the diagnosis and management of chronic urticaria in children

  • Choi, Sun Hee;Baek, Hey Sung
    • Clinical and Experimental Pediatrics
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    • 제58권5호
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    • pp.159-164
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    • 2015
  • Most guidelines for chronic urticaria (CU) in infants and children are based on limited pediatric evidence. Current evidence used to guide treatment in children is extrapolated from data focusing on older age groups. CU in children is a different and complex condition than that in adults. Furthermore, there is little published information regarding urticaria in Korean children. The aim of the present article is to review recent research on chronic childhood urticaria and improve the current understanding of its pathogenesis and management. The classification and definition of urticaria in adults also applies to children. CU is defined as a daily occurrence of spontaneous wheals, angioedema, or both for >6 weeks. The precise pathophysiology of CU is unknown and the rates of successful identification of a cause in children with CU vary from 20%-50%. There is no established laboratory test to evaluate the presence of urticaria. The natural course of childhood CU is undetermined, with limited reports discussing long-term outcomes. Second-generation H1 antihistamines are the cornerstone of management, while limited therapeutic drugs are available for adults.

편마비 환자의 보행 특성과 기능적 보행지수 변화 (The Change of Gait Characteristics and FAP in Patients with Chronic Unilateral Stroke)

  • 김수민
    • PNF and Movement
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    • 제4권1호
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    • pp.37-44
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    • 2006
  • Purpose : Improved walking is a common goal after stroke. Although the neurodevelopmental intervention(PNF) is the most widely used approach in the walking training of hemiparetic subjects. There is little neurophysiological evidence for its presumed effects on gait symmetry and facilitation of paretic muscles during the therapeutic intervention. The study, therefore, investigated the immediate effects of gait entrainment by a PNF techniques. Methods : Included persons with stroke who were living in the community. Sixteen subjects were assigned to the experimental group participated in a measures design that evaluated the subjects with pre-treatment, post-treatment(8 weeks). Temporal-spatial parameter of gait were analysed for using the computerized GAITRite system. Intervention : Training for the experimental group was carried out 3 times a week for 8 weeks. The training sessions were comprised of 50 minutes of walking with pattern and techniques in PNF. Results : The experimental group had improvements in the functional walking ability after 8 weeks treatment and Post-treatment test scores were more significant than the pre-treatment score. The treatment group demonstrated significantly post-treatment test improvement in gait velocity, cadence and FAP. Post-treatment test scores were more significant than the pre-treatment score(p<0.05). Conclusion : The results of this study showed that the PNF exercise intervention can improve functional gait ability. This study provides evidence for the efficacy of PNF treatment at improving locomotor function in chronic stroke.

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수근관 증후군의 한의학적 치료에 대한 논문 고찰 -국내 학술지를 중심으로- (Korean Medicine for Carpal Tunnel Syndrome: a Systematic Review of Literature Published in Korea)

  • 이종호
    • 동의생리병리학회지
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    • 제29권1호
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    • pp.79-84
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    • 2015
  • The aim of this review is to investigate studies of Korean medical treatment of carpal tunnel syndrome published in Korea and the evidence of it's effects in order to suggest a better research method in the future. Four Korean web databases were searched by using key words such as 'carpal', and checked relevant Korean journals. The papers were classified into the field of study, publish date, diagnostic methods, evaluation methods and analysed the study tendency. There are 9 case studies, 4 controlled studies. The paper was published almost every year more than once. Acupucture, pharmacopuncture, acupotomy, warm needle acupuncture, taping, etc. were used as treatment tools. The two most commonly used diagnostic method for carpal tunnel syndrome are Phalen's test and Tinel's sign. The two most commonly used evaluation method are VAS(Visual Analog Scale) and subjective symptoms. Korean medical treatment of carpal tunnel syndrome was effective in all studies. Korean medical treatment of carpal tunnel syndrome was effective in all studies. So it is possible that Korean medical treatment of carpal tunnel syndrome is useful as therapeutic medicine, but there are not sufficient evidence based papers, so there should be further studies.

아토피피부염의 한의학 진료 지침 개발을 위한 사전 연구 (A study on the Development of Traditional Korean Medicine Clinical Practice Guideline for Atopic Dermatitis)

  • 윤영희;최인화
    • 한방안이비인후피부과학회지
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    • 제25권2호
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    • pp.38-48
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    • 2012
  • Background : The atopic dermatitis patient and their families are looking for safer herb-medicine treatments that possess therapeutic effects, but without the recurrence of symptoms and long-term harmful consequences that can result from other treatment. However, for many reasons, including methodological difficulties and lack of high quality study like randomized clinical study and systematic review, there are no consistent clinical guide line for atopic dermatitis in Traditional Korean Medicine. Objectives : Evidence-based clinical practice guidelines support clinical decision-making by making recommendations to guide clinical practice. The purpose of this study was to develop Traditional Korean Medicine clinical practice guideline for atopic dermatitis Result : The future guide should be based on scientific evidence and include the followings: (1) diagnosis of atopic dermatitis (2) the pattern identification of atopic dermatitis (3) classification of Sasang Constitution (4) efficacy assessment (5) treatment guideline (6) education for patients and care givers Conclusion : The development of Traditional Korean Medicine clinical practice guideline for atopic dermatitis is needed.

한포진 치료의 중의학 임상연구 동향 - 무작위 대조군 임상연구를 중심으로 - (An Overview of Clinical Studies for Pompholyx in Traditional Chinese Medicine - Literature Review based on Randomized Controlled Trials -)

  • 우정아;박범찬;최일신;김기봉;천진홍
    • 대한한방소아과학회지
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    • 제35권4호
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    • pp.82-95
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    • 2021
  • Objectives The purpose of this study is to analyze clinical studies on the effectiveness of TCM (traditional Chinese medicine) for pompholyx treatment and provide evidence for Korean medicine use. Methods Randomized controlled trials (RCT) which used TCM as a treatment for pompholyx were searched in China National Infrastructure (CNKI) platform. The risk of bias of studies was assessed by using Cochrane risk of bias (RoB) 2.0 tool. Results The selected 10 RCTs showed that the experimental group treated with either TCM alone or with a combination of TCM and Western medicine showed more significant therapeutic effect compared to the control group which Western medicine alone. Conclusions Based on the studies from China, TCM may be an effective treatment for pompholyx. This provides evidence for Korean medicine use, and its possible effectiveness in treating pompholyx