• 제목/요약/키워드: Cognitive diagnosis

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The Iceberg Nature of Fibromyalgia Burden: The Clinical and Economic Aspects

  • Ghavidel-Parsa, Banafsheh;Bidari, Ali;Maafi, Alireza Amir;Ghalebaghi, Babak
    • The Korean Journal of Pain
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    • 제28권3호
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    • pp.169-176
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    • 2015
  • This review has focused on important but less visible aspects of fibromyalgia (FM) with respect to the high impact of this disorder on patients and societies. FM is a common but challengeable illness. It is characterized by chronic widespread pain, which can be accompanied by other symptoms including fatigue, sleep disturbances, cognitive dysfunction, anxiety and depressive episodes. While our understanding of this debilitating disorder is limited, diagnosis and treatment of this condition is very difficult, even in the hands of experts. Due to the nature of disease, where patients experience invalidation by medical services, their families and societies regarding the recognition and management of disease, direct, indirect and immeasurable costs are considerable. These clinical and economic costs are comparable with other common diseases, such as diabetes, hypertension and osteoarthritis, but the latter usually receives much more attention from healthcare and non-healthcare resources. Present alarming data shows the grave and "iceberg-like" burden of FM despite the benign appearance of this disorder and highlights the urgent need both for greater awareness of the disease among medical services and societies, as well as for more research focused on easily used diagnostic methods and target specific treatment.

위암환자의 피로와 영양상태와의 관계 (Relationship between Fatigue and Nutritional Status in Patients with Gastric Cancer)

  • 김경희;한영인;손수경
    • 종양간호연구
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    • 제5권2호
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    • pp.87-96
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    • 2005
  • Purpose: The purpose of this study was to identify the relationship between fatigue and nutritional status in gastric cancer Design. A correlational and crossectional study design was used. Method: Fatigue was measured using the Revised Piper Fatigue Scale. The parameters for nutritional status consisted of BMI, Hb, Hct, total protein, albumin and lymphocyte count. Result: The mean score of fatigue was $94.31{\pm}22.08(mean\;average\;4.48{\pm}1.00)$. The subdimensional scores of fatigue revealed $34.15{\pm}8.76$ for behavior/severity, $22.00{\pm}7.93$ for cognitive/mood, $21.67{\pm}5.56$ for sensory, and $20.81{\pm}6.69$ for affective. And the level of BMI, Hb, & Hct were under the normal ranges. In the ancillary analysis, there was a significant difference on the fatigue scores by the groups of present diet(F=3.343, P=.026). Age, types of treatments, period after diagnosis and weight change were related to nutritional status. There was a significant negative correlation between fatigue and nutritional status(r=-.371, P=.004). Conclusion: Considering the relationship between fatigue and nutritional status, nurses can identify the risk group most vulnerable to fatigue and malnourishment in order to provide appropriate interventions for them.

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급성 일산화탄소 중독 환자에서 발생한 양하지 말초 운동신경병증 1례 (Motor Peripheral Neuropathy Involved Bilateral Lower Extremities Following Acute Carbon Monoxide Poisoning: A Case Report)

  • 최재형;임훈
    • 대한임상독성학회지
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    • 제13권1호
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    • pp.46-49
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    • 2015
  • Carbon monoxide (CO) intoxication is a leading cause of severe neuropsychological impairments. Peripheral nerve injury has rarely been reported. Following are brief statements describing the motor peripheral neuropathy involved bilateral lower extremities of a patient who recovered following acute carbon monoxide poisoning. After inhalation of smoke from a fire, a 60-year-old woman experienced bilateral leg weakness without edema or injury. Neurological examination showed diplegia and deep tendon areflexia in lower limbs. There was no sensory deficit in lower extremities, and no cognitive disturbances were detected. Creatine kinase was normal. Electroneuromyogram patterns were compatible with the diagnosis of bilateral axonal injury. Clinical course after normobaric oxygen and rehabilitation therapy was marked by complete recovery of neurological disorders. Peripheral neuropathy is an unusual complication of CO intoxication. Motor peripheral neuropathy involvement of bilateral lower extremities is exceptional. Various mechanisms have been implicated, including nerve compression secondary to rhabdomyolysis, nerve ischemia due to hypoxia, and direct nerve toxicity of carbon monoxide. Prognosis is commonly excellent without sequelae. Emergency physicians should understand the possible-neurologic presentations of CO intoxication and make a proper decision regarding treatment.

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사상의학적으로 치료하여 호전된 주요 신경인지장애 치험 2례 (Two Case Reports on Major Neurocognitive Disorder Patients Treated in Sasang Constitutional Medicine)

  • 박정환;곽진영;고영미;윤지원;안택원
    • 혜화의학회지
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    • 제26권1호
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    • pp.58-67
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    • 2017
  • Objectives:This study was designed to report treatment by Sasang Constitutional Medicine to the patients with Major Neurocognitive Disorder(Dementia) from various causes. Methods:These two patients were diagnosed as Taeeumin and Soyangin according to the result of Sasang constitutional diagnosis, and treated by Sasang constitutional medications. The progress was evaluated with the Korean version of Mini-Mentel State Exam(KMMSE) and Global Disorientation Scale(GDS). Result:The symptoms like wandering, insomnia, cognitive disorder was improved in these patients. Also, KMMSE and GDS score were highly improved. the one patient was cured with Cheongsimyeonja-tang and and the other was cured with Jihwangbaekho-tang and Yanggyuksanhwa-tang. Conclusion:This cases show that Sasang constitutional herbal medications are an effective treatment for the patients with Major Neurocognitive Disorder.

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Dentatorubropallidoluysian Atrophy 일가족 (A Family of Dentatorubropallidoluysian Atrophy)

  • 정지윤;박미영;이준;윤준필;박현정
    • Journal of Yeungnam Medical Science
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    • 제23권1호
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    • pp.118-123
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    • 2006
  • Dentatorubropallidoluysian atrophy (DRPLA) is a rare neurodegenerative disorder usually inherited in an autosomal dominant pattern. DRPLA has been shown to be associated with expansion of an unstable cytosine-adenine-guanine (CAG) trinucleotide repeat in a gene on chromosome 12p. We evaluated a family with DRPLA that affected three members; A 35-year-old female presented with seven year history of gait ataxia, dysarthria and mild cognitive impairment. The MRI of the brain revealed diffuse cerebellar atrophy with an incidental lipoma in the midbrain. Her 30-year-old brother presented with progressive cerebellar ataxia that developed at the age of 20. Her grandmother and mother were reported to have developed ataxia during the late period of their life, and died at the age of 60 and 55, respectively. The demonstration of an expanded CAG repeat in the gene for DRPLA was used to confirm the diagnosis.

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요양시설 노인을 위한 구강건강 평가 도구의 타당도와 신뢰도 (Validity and Reliability of an Oral Health Assessment Tool for Elderly in Long-Term Care Facilities)

  • 김나연;배현숙
    • 대한치위생과학회지
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    • 제4권1호
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    • pp.53-64
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    • 2021
  • Background: The elderly in long-term care facilities tend to have a diminished oral health status, with a high prevalence of dental caries and periodontal disease, as reduced cognitive function, joint mobility, and gait ability hinder the performance of oral hygiene. To improve the oral health of the elderly at long-term care facilities, it is necessary to have precise guidelines for oral health care and assessment; however, such guidelines are not readily available. Therefore, the present study aimed to develop an oral care assessment tool with verified reliability and validity. Methods: The participants in this study were 100 elderly patients at a care facilities and 10 clinical dental hygienists. Collected data were analyzed using the descriptive statistics, content validity index, and inter-rater reliability, as well as the analyses of intra-class correlation coefficient. Results: After a review of relevant literature, a preliminary questionnaire comprised of seven questions related to the evaluation of oral health was formed. After revising and supplementing the questions through a content validity test, a total of nine questions were selected. Conclusion: The novel assessment tool developed for the present study is anticipated to allow analyses of the level of problems related to oral health care before routine and professional care. Moreover, regular oral health status check-ups will enable the early diagnosis and treatment of diseases.

A Review on the Correlation between the Pathology of Alzheimer's Disease and microRNA

  • Kim, Soo-Jung;Cho, Hyun-Jeong
    • 대한의생명과학회지
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    • 제27권4호
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    • pp.208-215
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    • 2021
  • The purpose of this study was to explain the pathology of Alzheimer's disease (AD) and to investigate the correlation between AD and microRNA. AD is the most common type of dementia, accounting for about 80% of all types of dementia, causing dysfunction in various daily activities such as memory loss, cognitive impairment, and behavioral impairment. The typical pathology of AD is explained by the accumulation of beta-amyloid peptide plaques and neurofibrillary tangles containing hyperphosphorylated tau protein. On the other hand, microRNA is small non-coding RNA 22~23 nucleotides in length that binds to the 3' untranslated region of messenger RNA to inhibit gene expression. Many reports explain that microRNAs found in circulating biofluids are abundant in the central nervous system, are involved in the pathogenic mechanism of AD, and act as important factors for early diagnosis and therapeutic agents of AD. Therefore, this paper aims to clarify the correlation between AD and microRNA. In this review, the basic mechanism of miRNAs is described, and the regulation of miRNAs in the pathological processes of AD are highlighted. Furthermore, we suggest that miRNA-based system in development of therapeutic and diagnostic agents of AD can be a promising tool.

The Impact of Senior Mobility Funding on Hearing Aid Acquisition and Compliance to Hearing Aid Use in a Singapore Hospital

  • Chua Wei De, Kenneth
    • Journal of Audiology & Otology
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    • 제25권1호
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    • pp.8-13
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    • 2021
  • Background and Objectives: In 2013, the Singapore government reviewed and expanded the Senior Mobility Fund (SMF) to provide subsidy for assistive devices, including hearing aids (HA). While SMF has improved accessibility to HA, its impact on HA acquisition has not been determined. The study aims to elucidate the influence of SMF on HA acquisition and the relationship between financial funding and compliance to HA use. Subjects and Methods: Retrospective review of 643 patients seen between January 2017 to January 2018 at the earnose and throat specialist outpatient clinic, who were referred for a hearing aid evaluation. Of the 643 patients, 109 patients with baseline hearing handicap (HH) scores recorded, and no formal diagnosis of cognitive impairment were included. The patients were grouped according to SMF eligibility and clinical data were obtained. Results: The odds ratio for acquiring HA was significantly higher with SMF, regardless of HH scores. When looking at actual degree of hearing loss (DHL), HA uptake was significantly higher in the least severe of DHL categories. There is no relationship between SMF and compliance to HA use. However, HH score is positively correlated with data log in regression analyses. Conclusions: SMF appears to influence HA acquisition. Especially in financially funded patients with low self-perceived HH, the benefits of HA may be underappreciated given the few hours of HA use. Further studies are warranted to investigate the impact of financial funding on outcomes of HA users to help policy planners and clinicians be prudent in the utilization of SMF.

The Impact of Senior Mobility Funding on Hearing Aid Acquisition and Compliance to Hearing Aid Use in a Singapore Hospital

  • De, Kenneth Chua Wei
    • 대한청각학회지
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    • 제25권1호
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    • pp.8-13
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    • 2021
  • Background and Objectives: In 2013, the Singapore government reviewed and expanded the Senior Mobility Fund (SMF) to provide subsidy for assistive devices, including hearing aids (HA). While SMF has improved accessibility to HA, its impact on HA acquisition has not been determined. The study aims to elucidate the influence of SMF on HA acquisition and the relationship between financial funding and compliance to HA use. Subjects and Methods: Retrospective review of 643 patients seen between January 2017 to January 2018 at the earnose and throat specialist outpatient clinic, who were referred for a hearing aid evaluation. Of the 643 patients, 109 patients with baseline hearing handicap (HH) scores recorded, and no formal diagnosis of cognitive impairment were included. The patients were grouped according to SMF eligibility and clinical data were obtained. Results: The odds ratio for acquiring HA was significantly higher with SMF, regardless of HH scores. When looking at actual degree of hearing loss (DHL), HA uptake was significantly higher in the least severe of DHL categories. There is no relationship between SMF and compliance to HA use. However, HH score is positively correlated with data log in regression analyses. Conclusions: SMF appears to influence HA acquisition. Especially in financially funded patients with low self-perceived HH, the benefits of HA may be underappreciated given the few hours of HA use. Further studies are warranted to investigate the impact of financial funding on outcomes of HA users to help policy planners and clinicians be prudent in the utilization of SMF.

Multi-biomarkers-Base Alzheimer's Disease Classification

  • Khatri, Uttam;Kwon, Goo-Rak
    • Journal of Multimedia Information System
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    • 제8권4호
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    • pp.233-242
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    • 2021
  • Various anatomical MRI imaging biomarkers for Alzheimer's Disease (AD) identification have been recognized so far. Cortical and subcortical volume, hippocampal, amygdala volume, and genetics patterns have been utilized successfully to diagnose AD patients from healthy. These fundamental sMRI bio-measures have been utilized frequently and independently. The entire possibility of anatomical MRI imaging measures for AD diagnosis might thus still to analyze fully. Thus, in this paper, we merge different structural MRI imaging biomarkers to intensify diagnostic classification and analysis of Alzheimer's. For 54 clinically pronounce Alzheimer's patients, 58 cognitively healthy controls, and 99 Mild Cognitive Impairment (MCI); we calculated 1. Cortical and subcortical features, 2. The hippocampal subfield, amygdala nuclei volume using Freesurfer (6.0.0) and 3. Genetics (APoE ε4) biomarkers were obtained from the ADNI database. These three measures were first applied separately and then combined to predict the AD. After feature combination, we utilize the sequential feature selection [SFS (wrapper)] method to select the top-ranked features vectors and feed them into the Multi-Kernel SVM for classification. This diagnostic classification algorithm yields 94.33% of accuracy, 95.40% of sensitivity, 96.50% of specificity with 94.30% of AUC for AD/HC; for AD/MCI propose method obtained 85.58% of accuracy, 95.73% of sensitivity, and 87.30% of specificity along with 91.48% of AUC. Similarly, for HC/MCI, we obtained 89.77% of accuracy, 96.15% of sensitivity, and 87.35% of specificity with 92.55% of AUC. We also presented the performance comparison of the proposed method with KNN classifiers.