المؤلفون: Lee JH; Woorisaam Oriental Medicine Clinic, Goyang, South Korea., Kim MG; Department of Oriental Neuropsychiatry, Dongguk University Ilsan Korean Medicine Hospital, Goyang, South Korea.; Department of Oriental Neuropsychiatry, Graduate School of Dongguk University, Seoul, South Korea., Kim DY; Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, South Korea., Shin HW; UCI Memory Impairments and Neurological Disorders (UCI MIND), Irvine, CA, USA.; RIIID Medical Group of Irvine, Irvine, CA, USA., Kang H; Biostatistics and Center for Quantitative Sciences, Vanderbilt University, Nashville, TN, USA., Koo BS; Department of Oriental Neuropsychiatry, Dongguk University Ilsan Korean Medicine Hospital, Goyang, South Korea.; Department of Oriental Neuropsychiatry, Graduate School of Dongguk University, Seoul, South Korea., Kim KK; Department of Neurology, Dongguk University Ilsan Hospital, Goyang, South Korea.

المصدر: Medicine [Medicine (Baltimore)] 2022 Sep 23; Vol. 101 (38), pp. e30301.

نوع المنشور: Journal Article; Observational Study

بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 2985248R Publication Model: Print Cited Medium: Internet ISSN: 1536-5964 (Electronic) Linking ISSN: 00257974 NLM ISO Abbreviation: Medicine (Baltimore) Subsets: MEDLINE

مواضيع طبية MeSH: Cognitive Dysfunction*/diagnosis , Cognitive Dysfunction*/therapy , Dementia*/complications , Dementia*/diagnosis , Dementia*/therapy , Integrative Medicine*, Anticonvulsants ; Cognition ; Donepezil/therapeutic use ; Humans ; Neuropsychological Tests ; Retrospective Studies

مستخلص: Despite the urgent need to control dementia, an effective treatment has yet to be developed. Along with the Korean government's policy of cooperation between conventional medicine (CM) and Korean medicine (KM), integrative medical services for dementia patients are being provided. This study aimed to compare the integrative medical clinic (IMC) for dementia used by Dongguk University Hospitals (DUH) with other service models and to review the characteristics and treatment outcomes of patients who had visited DUH over the past 5 years. Patients' electronic medical records from May 2015 to June 2020 were searched and their data were analyzed to evaluate the IMC's service model. Patient demographic and clinical characteristics, diagnostic tests, and treatment patterns for CM and KM were collected. The proportion of patients who did not show worsening cognitive function was described in detail. A strength of the DUH integrative medicine clinic is its ability to manage both KM and CM patients in the same space at the same time. Among the 82 patients who visited the clinic during our study period, 56 remained for data analysis after we excluded patients who met the exclusion criteria; nineteen patients had diagnoses of mild cognitive impairment. Among collaboration patterns, the first visit to the IMC had the highest proportion (55.4%). Among diagnosed tests in CM, laboratory tests and neuropsychological tests were used the most. In KM, a heart rate variability test was frequently used. The most common CM treatment prescribed was anticonvulsants, with 22 patients (39.2%) receiving donepezil, whereas the most frequent KM treatments were acupuncture (82.1%) and herbal medicine (78.6%). Twelve patients were followed up with the Mini-Mental State Examination, and 8 demonstrated either no worsening or improved cognition (baseline Mini-Mental State Examination range: 21-26). All 8 patients had mild cognitive impairment including 6 with amnestic, multidomain impairment. This study searched for a way to improve cognitive dysfunction and dementia using an integrative approach, and it shows promising results for mild cognitive impairment. However, more precisely designed follow-up studies are needed to address the present work's limitations of a retrospective study design and a small sample size.
Competing Interests: The authors have no conflicts of interest to disclose.
(Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)

المؤلفون: Cheong MJ; Rare Diseases Integrative Treatment Research Institute, Wonkwang University Jangheung Integrative Medical Hospital, Jangheung-gun, Jeollanam-do, Republic of Korea., Lee DE; Rare Diseases Integrative Treatment Research Institute, Wonkwang University Jangheung Integrative Medical Hospital, Jangheung-gun, Jeollanam-do, Republic of Korea.; Department of Korean Neuropsychiatry Medicine, College of Korean Medicine, Wonkwang University, Iksan-si, Jeollabuk-do, Republic of Korea., Kim J; Rare Diseases Integrative Treatment Research Institute, Wonkwang University Jangheung Integrative Medical Hospital, Jangheung-gun, Jeollanam-do, Republic of Korea.; Department of Korean Neuropsychiatry Medicine, College of Korean Medicine, Wonkwang University, Iksan-si, Jeollabuk-do, Republic of Korea., Son IH; Department of Neurology, Wonkwang University Sanbon Hospital, Gunpo-si, Gyeonggi-do, Republic of Korea., Kim SC; Department of Acupuncture & Moxibustion Medicine, Gwangju Korean Medical Hospital of Wonkwang University, Nam-gu, Gwangju, Republic of Korea., Kang HW; Rare Diseases Integrative Treatment Research Institute, Wonkwang University Jangheung Integrative Medical Hospital, Jangheung-gun, Jeollanam-do, Republic of Korea.; Department of Korean Neuropsychiatry Medicine, College of Korean Medicine, Wonkwang University, Iksan-si, Jeollabuk-do, Republic of Korea.

المصدر: Medicine [Medicine (Baltimore)] 2022 Dec 23; Vol. 101 (51), pp. e32282.

نوع المنشور: Observational Study; Journal Article

بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 2985248R Publication Model: Print Cited Medium: Internet ISSN: 1536-5964 (Electronic) Linking ISSN: 00257974 NLM ISO Abbreviation: Medicine (Baltimore) Subsets: MEDLINE

مواضيع طبية MeSH: Quality of Life*/psychology , Dementia*/psychology, Humans ; Aged ; Caregivers/psychology ; Cognition

مستخلص: Background: Since 4 major diseases and geriatric diseases require consistent management, individuals with any of these diseases cannot live alone and need caregivers' assistance. Given these characteristics, an integrative medical service model for 4 major diseases and geriatric diseases was developed in Korea, currently. Dementia, one of the typical geriatric diseases, requires caregivers' assistance from the beginning because of its enormous burden. Thus, it is necessary to provide an integrative medical service that can improve the quality of life (QoL) for both patients and caregivers. Therefore, this study aims to collect various feedback by applying an integrative medical service, which was developed to improve the QoL in patients with dementia and their caregivers, to a single case, and to modify and improve the integrative medical service model based on the results.
Method/design: The integrative medical service program, which was developed to improve the QoL in patients with dementia and their caregivers in Korea, will be used for a patient-caregiver pair. This is an observational study with quantitative and qualitative feedback from various viewpoints. The program will be conducted in 8 sessions (twice a week, within 120 minutes). The patient will receive both Western and Korean medicine, and an integrative service will be provided to improve cognitive rehabilitation and QoL. Feedback collected at each session will be reflected on the program of the subsequent session.
Results: This study will then modify and improve the program with feedback and provide integrative medical services to a patient with dementia and caregiver.
Discussion: Patients with dementia need a program that would help them maintain cognitive function, and caregivers need a program that would improve their QoL by reducing the caregiving burden. This study is unique because the developed program is performed after modification based on feedback from the previous session. Accordingly, the patient and caregiver can check which program is the most satisfactory and helpful in improving their QoL. We expect that this study can modify the integrative medical service model to the optimized patient-based model. This study can also be used as basic data for a clinical pathway development study that applies the modified model to medical institutes.
Competing Interests: The authors have no conflicts of interest to disclose.
(Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)

المؤلفون: Tsai FJ; Department of Nursing, Fooyin University, Taiwan R.O.C., Shen SW; Department of Neurology, Pingtung Hospital, Ministry of Health and Welfare, Taiwan, R.O.C.

المصدر: Medicine [Medicine (Baltimore)] 2022 Dec 16; Vol. 101 (50), pp. e32172.

نوع المنشور: Review; Journal Article

بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 2985248R Publication Model: Print Cited Medium: Internet ISSN: 1536-5964 (Electronic) Linking ISSN: 00257974 NLM ISO Abbreviation: Medicine (Baltimore) Subsets: MEDLINE

مواضيع طبية MeSH: Yoga* , Dementia*/prevention & control , Dementia*/psychology, Humans ; Quality of Life ; Health Promotion ; Exercise

مستخلص: The number of older adults with dementia is predicted to markedly increase in the coming decades. A person suffers from dementia every 3 seconds globally, and one out of every 7 people suffers from dementia in Taiwan. The purpose of this narrative review is to integrate existing concepts of dementia prevention into health promotion and improve older adults' quality of life. This narrative review was performed using the PubMed database by searching for basic research and systematic reviews on dementia prevention and health promotion among older adults. We established a framework for dementia prevention and health promotion with regard to the physical, mental, spiritual, and social health aspects. We identified the following strategies related to older adults towards dementia prevention and health promotion in follows: Physical health promotion: cognitive activities, physical activities, body mass index, balanced diet, rainbow diet, Mediterranean diet, dietary approaches to stop hypertension diet, mind diet, no smoking and drinking, avoiding the "three highs" (i.e., hyperglycemia, hyperlipidemia, and hypertension), and head trauma; Mental health promotion: Positive thinking, Brief Symptom Rating Scale (BSRS-5), depression scale, and ascertained dementia 8 questionnaire (AD8) screening; Spiritual health promotion: religious beliefs, spiritual music, meditative activities, mindfulness, yoga, Qi-gong, Tai-chi, and Baduanjin; and Social health promotion: A supportive family system, socialization, social support, social networks, social interaction, and social participation. The conclusion of this narrative review was to integrate the concepts of dementia prevention and health promotion among older adults.
Competing Interests: The authors have no conflicts of interest to disclose.
(Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)

المؤلفون: Ho SY; Department of Emergency Medicine, Chi Mei Medical Center, Tainan, Taiwan.; Department of Geriatrics and Gerontology, Chi Mei Medical Center, Tainan, Taiwan., Chien TW; Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan., Lin ML; Department of Examination Room, Chi Mei Medical Center, Tainan, Taiwan., Tsai KT; Department of Geriatrics and Gerontology, Chi Mei Medical Center, Tainan, Taiwan.; Center for Integrative Medicine, Chi Mei Medical Center, Tainan, Taiwan.; Department of Nursing, Chung Hwa University of Medical Technology, Tainan, Taiwan.

المصدر: Medicine [Medicine (Baltimore)] 2023 Jan 27; Vol. 102 (4), pp. e32670.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 2985248R Publication Model: Print Cited Medium: Internet ISSN: 1536-5964 (Electronic) Linking ISSN: 00257974 NLM ISO Abbreviation: Medicine (Baltimore) Subsets: MEDLINE

مواضيع طبية MeSH: Mobile Applications* , Dementia*/diagnosis, Humans ; Neural Networks, Computer ; Taiwan

مستخلص: Background: Dementia is a progressive disease that worsens over time as cognitive abilities deteriorate. Effective preventive interventions require early detection. However, there are no reports in the literature concerning apps that have been developed and designed to predict patient dementia classes (DCs). This study aimed to develop an app that could predict DC automatically and accurately for patients responding to the clinical dementia rating (CDR) instrument.
Methods: A CDR was applied to 366 outpatients in a hospital in Taiwan, with assessments on 25 and 49 items endorsed by patients and family members, respectively. The 2 models of convolutional neural networks (CNN) and artificial neural networks (ANN) were applied to examine the prediction accuracy based on 5 classes (i.e., no cognitive decline, very mild, mild, moderate, and severe) in 4 scenarios, consisting of 74 (items) in total, 25 in patients, 49 in family, and a combination strategy to select the best in the aforementioned scenarios using the forest plot. Using CDR scores in patients and their families on both axes, patients were dispersed on a radar plot. An app was developed to predict patient DC.
Results: We found that ANN had higher accuracy rates than CNN with a ratio of 3:1 in the 4 scenarios. The highest accuracy rate (=93.72%) was shown in the combination scenario of ANN. A significant difference was observed between the CNN and ANN in terms of the accuracy rate. An available ANN-based app for predicting DC in patients was successfully developed and demonstrated in this study.
Conclusion: On the basis of a combination strategy and a decision rule, a 74-item ANN model with 285 estimated parameters was developed and included. The development of an app that will assist clinicians in predicting DC in clinical settings is required in the near future.
Competing Interests: The authors have no conflicts of interest to disclose.
(Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

لا يتم عرض هذه النتيجة على الضيوف.
تسجيل الدخول للوصول الكامل.

المؤلفون: Kwon CY; Department of Oriental Neuropsychiatry, Dong-eui University College of Korean Medicine, Busanjin-gu, Busan., Lee B; Clinical Medicine Division, Korea Institute of Oriental Medicine, Yuseong-gu, Daejeon, Republic of Korea.

المصدر: Medicine [Medicine (Baltimore)] 2021 Feb 12; Vol. 100 (6), pp. e24341.

نوع المنشور: Journal Article; Systematic Review

بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 2985248R Publication Model: Print Cited Medium: Internet ISSN: 1536-5964 (Electronic) Linking ISSN: 00257974 NLM ISO Abbreviation: Medicine (Baltimore) Subsets: MEDLINE

مواضيع طبية MeSH: Acupuncture Therapy*/methods, Dementia/*therapy, Aged ; Dementia/psychology ; Humans

مستخلص: Background: Dementia is a major mental health problem worldwide, and an optimal anti-dementia drug that could modify its core symptoms has not been developed yet. Behavioral and psychological symptoms of dementia (BPSD), an important clinical manifestation of dementia, is closely related to disease burden, caregiver burden, and consequent social burden. In general, many experts and international guidelines prefer non-pharmacological interventions, including psychosocial intervention, and complementary and integrative medicine in the management of BPSD. However, in clinical settings, psychotropic drugs are frequently used; therefore, the need to establish and actively use effective non-pharmacological interventions is emphasized. Therefore, in this systematic review, we will evaluate the effectiveness and safety of acupuncture, a promising non-pharmacological complementary and integrative medicine, for BPSD.
Methods and Analysis: A comprehensive search will be conducted in 13 electronic medical databases. Regardless of its design, original clinical studies, such as randomized controlled clinical trials, nonrandomized controlled clinical trials, and before-after studies, will be included to assess the beneficial effects and safety of acupuncture on BPSD. The severity of BPSD symptoms assessed by the validated tool will be considered as a primary outcome. The secondary outcome included the total effective rate, daily living activities and quality of life of patients, burden and quality of life of caregiver, placement in a long-term care facility from home, and safety data. The study selection, data extraction, and quality assessment process were performed by 2 independent researchers. The methodological quality of the included studies will be assessed using validated tools according to its design, such as the Cochrane Collaboration's risk of bias tool. RevMan version 5.3 will be used to perform the meta-analysis, with mean differences for continuous outcomes and risk ratio for binary outcomes, and 95% confidence intervals. A fixed- or random-effects model will be used according to the heterogeneity and number of included studies.
Ethics and Dissemination: As this protocol is for a systematic review, ethical approval is not required. The results of the systematic review will be disseminated by the publication of a manuscript in a peer-reviewed journal or presentation at a relevant conference.
Registration Number: OSF (URL: https://osf.io/hu5ac), PROSPERO (CRD42020211005) (URL: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020211005).
Competing Interests: The authors have no conflicts of interest to declare.
(Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

لا يتم عرض هذه النتيجة على الضيوف.
تسجيل الدخول للوصول الكامل.