• Title/Summary/Keyword: Evidence Based Diagnosis

검색결과 240건 처리시간 0.024초

Rapidly Progressive Small Bowel Necrosis in a Previously Healthy Child without Proven Mechanical Obstruction

  • Kim, Hyun Hee;Kang, Hyungoo;Park, Chul Hee;Kwon, Yu Jin;Jung, Euna;Lim, Misun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제22권3호
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    • pp.291-297
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    • 2019
  • Bowel ischemia is a life-threatening surgical emergency. We report a case of rapidly progressive bowel necrosis in a previously healthy child without proven mechanical small bowel obstruction. The definite diagnosis was established at the time of an exploratory operation. Of note, imaging studies and even a laparotomy did not reveal any evidence of acute appendicitis or mechanical obstruction such as intussusception or Meckel's diverticulum. During hospitalization, since we could not rule out surgical abdomen after inconclusive image findings, we closely followed the patient and repeated physical examinations carefully. Eventually surgical exploration was performed based on changes in clinical condition, which proved to be the right decision for the patient. We propose that in children with suspected strangulation of small bowel obstruction, especially when imaging findings do not provide a conclusive diagnosis, the timely exploratory surgical approach ought to be chosen based on carefully observed clinical findings and other evaluations.

Advantages of the single nucleotide polymorphism-based noninvasive prenatal test

  • Kim, Kunwoo
    • Journal of Genetic Medicine
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    • 제12권2호
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    • pp.66-71
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    • 2015
  • Down syndrome screening with cell-free DNA (cfDNA) in the maternal plasma has recently received much attention in the prenatal diagnostic field. Indeed, a large amount of evidence has already accumulated to show that screening tests with cfDNA are more sensitive and specific than conventional maternal serum and/or ultrasound screening. Globally, more than 1,000,000 of these noninvasive prenatal tests (NIPTs) have been performed to date. There are several different methods for NIPTs that are currently commercially available, including shotgun massively parallel sequencing, targeted massively parallel sequencing, and single nucleotide polymorphism (SNP)-based methods. All of these methods have their own advantages and disadvantages. In this review, I will focus specifically on the SNP-based NIPT.

한의사들이 원하는 한의학 지식체계에 대한 고찰 (A study of Korean medical knowledge system which Korean medical doctors want)

  • 손미주;김우영;정의민;박황진;한창현
    • 대한예방한의학회지
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    • 제16권3호
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    • pp.89-105
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    • 2012
  • Objectives : This study was carried out to know the status of clinical utilization of Korean medical knowledge and the Korean medical knowledge system which Korean medical doctors want. Methods : Questionnaires were distributed to Korean medical doctors registered for the Association of Korean medicine via the email and 249 answered questionnaires were analyzed. Results : 50.6 % of Korean medical doctors utilized the textbooks for Korean medicine when they treated their patients. The reason why they did not utilize the textbooks for Korean medicine was mostly that 'it could not be applied directly into clinical application with only contents of textbook because clinical approach (diagnosis and treatment methods) was not clearly described in the textbook'. 48.6 % of Korean medical doctors utilized the EBM materials when they treated their patients. EBM materials that they referred included domestic articles, other EBM materials excluding papers and international academic papers based on PubMed in order. The reasons why they did not utilize the EBM materials were mostly that 'it was difficult to find the evidence' and 'EBM materials were not actually helpful for the clinical practice.' It was found that Korean medical doctors approached the disease in aspects of Korean and Western Medicine concurrently upon the diagnosis of patients and performed the diagnosis and treatment of Korean medicine on the diseases which seemed to be effective with Korean medicine. It was also found that they thought that they needed to know the Western medical knowledge as much as general doctors who have a doctor's license or family medicine specialists who comprehensively treat the general diseases know. Korean medical doctors wanted to have the systematic summary of modern research performance in fields of acupoint, acupuncture, herbal drugs and formula. They thought that constitutional medicine and Sa-am acupuncture therapy were representative characteristics in Korean medicine differentiated from Traditional Chinese medicine and Kampo medicine. Conclusions : Korean medical doctors wanted to establish the Korean medical knowledge system based on evidence focusing on clinical and practical contents. New Korean medical knowledge system should be established based on these requirements in the future.

임신오조 한의표준임상진료지침 개발을 위한 한의사의 인식과 치료 실태에 관한 조사 (A Survey on Korean Medicine Doctors' Recognition and Treatment Method for Developing Clinical Practice Guideline of Nausea and Vomiting of Pregnancy)

  • 이흥숙;정효정;최수지;김동일
    • 대한한방부인과학회지
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    • 제36권2호
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    • pp.36-54
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    • 2023
  • Objectives: This study was aimed to develop a Korean Medicine (KM) clinical practice guideline (CPG) of Nausea and Vomiting of Pregnancy (NVP). Methods: We conducted a questionnaire survey targeting KM doctors belonging to the Association of Korean Medicine by e-mail. We received 1,023 responds, and analyzed the answers. Results: 1. 83.0% of respondents knew the concepts and contents of CPG, and 98.1% had practical use plan. 2. 82.1% of respondents used pattern identification diagnosis for NVP patients, and the most commonly diagnosed pattern was spleen-stomach weakness (脾胃虛弱) with 41.3%. 3. The most frequently used treatment for NVP patients was KM combined treatment (46.7%). Herbal medicine+acupuncture (46.8%) was most used among KM combined treatments, and herbal medicine (37.1%) was most used among KM single treatments. 4. Among the contents of CPG for NVP, the fields of interest were selected in the order of KM treatment, KM-Western medicine cooperative treatment, KM diagnosis, prevention and regimen management. In the 'diagnosis part', the use of the symptom evaluation scale questionnaire was 41.8%, higher than the KM pattern diagnosis (34.4%). In the 'treatment part', herbal medicine accounted for 33.8%, higher than that of acupuncture (including electro-acupuncture) at 23.7%. 5. As for the expected development effects, opinions on evidence-based, safety, clinical use, and standardization were the most common. Conclusions: We figured out KM doctors' recognition of KM clinical practice guideline, clinical diagnosis, treatment on NVP to make the contents of the CPG reflecting the clinical situation.

Evaluating LIMU System Quality with Interval Evidence and Input Uncertainty

  • Xiangyi Zhou;Zhijie Zhou;Xiaoxia Han;Zhichao Ming;Yanshan Bian
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • 제17권11호
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    • pp.2945-2965
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    • 2023
  • The laser inertial measurement unit is a precision device widely used in rocket navigation system and other equipment, and its quality is directly related to navigation accuracy. In the quality evaluation of laser inertial measurement unit, there is inevitably uncertainty in the index input information. First, the input numerical information is in interval form. Second, the index input grade and the quality evaluation result grade are given according to different national standards. So, it is a key step to transform the interval information input by the index into the data form consistent with the evaluation result grade. In the case of uncertain input, this paper puts forward a method based on probability distribution to solve the problem of asymmetry between the reference grade given by the index and the evaluation result grade when evaluating the quality of laser inertial measurement unit. By mapping the numerical relationship between the designated reference level and the evaluation reference level of the index information under different distributions, the index evidence symmetrical with the evaluation reference level is given. After the uncertain input information is transformed into evidence of interval degree distribution by this method, the information fusion of interval degree distribution evidence is carried out by interval evidential reasoning algorithm, and the evaluation result is obtained by projection covariance matrix adaptive evolution strategy optimization. Taking a five-meter redundant laser inertial measurement unit as an example, the applicability and effectiveness of this method are verified.

Middle East Consensus Statement on the Prevention, Diagnosis, and Management of Cow's Milk Protein Allergy

  • Vandenplas, Yvan;Abuabat, Ahmed;Al-Hammadi, Suleiman;Aly, Gamal Samy;Miqdady, Mohamad S.;Shaaban, Sanaa Youssef;Torbey, Paul-Henri
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제17권2호
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    • pp.61-73
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    • 2014
  • Presented are guidelines for the prevention, diagnosis, and treatment of cow's milk protein allergy (CMPA) which is the most common food allergy in infants. It manifests through a variety of symptoms that place a burden on both the infant and their caregivers. The guidelines were formulated by evaluation of existing evidence-based guidelines, literature evidence and expert clinical experience. The guidelines set out practical recommendations and include algorithms for the prevention and treatment of CMPA. For infants at risk of allergy, appropriate prevention diets are suggested. Breastfeeding is the best method for prevention; however, a partially hydrolyzed formula should be used in infants unable to be breastfed. In infants with suspected CMPA, guidelines are presented for the appropriate diagnostic workup and subsequent appropriate elimination diet for treatment. Exclusive breastfeeding and maternal dietary allergen avoidance are the best treatment. In infants not exclusively breastfed, an extensively hydrolyzed formula should be used with amino acid formula recommended if the symptoms are life-threatening or do not resolve after extensively hydrolyzed formula. Adherence to these guidelines should assist healthcare practitioners in optimizing their approach to the management of CMPA and decrease the burden on infants and their caregivers.

Phylogenetic and Morphological Characterization of Cladosporium perangustum Associated with Flyspeck on Shine Muscat Grapes in South Korea

  • Hassan, Oliul;Lim, Yang-Sook;Chang, Taehyun
    • Mycobiology
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    • 제49권2호
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    • pp.183-187
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    • 2021
  • The Shine Muscat is a table grape, popular in South Korea for its unique mango-flavor taste. Flyspeck is a disease that is characterized by small, black, and circular specks on the grape cuticle was first observed in several commercial orchards in Sangju, South Korea, in August 2019. Here we identified the causal agent of flyspeck based on an advanced diagnosis approach, comprised of both morphological and molecular analyses. Morphological characteristics of the cultures isolated from grape flyspeck were identical to the fungus Cladosporium perangustum. The concatenated sequences of ITS, ACT, and EF1-α were used for molecular phylogenetic analysis, BLAST searches along with Bayesian inference-based phylogeny, confirmed that the causal agent of grape flyspeck is C. perangustum. The cultured fungal isolates also produced flyspeck symptoms on healthy fruits in pathogenicity tests. To the best of my knowledge, this is the first documented evidence of any Cladosporium sp. producing flyspeck symptoms on any plant.

미니 임플란트를 이용한 하악의 임플란트 지지 피개의치: 증례보고 (Mandibular Mini-Implants Supported Overdentures: A Case Report)

  • 박진홍;이정열;신상완
    • 대한구강악안면임플란트학회지
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    • 제19권3호
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    • pp.146-152
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    • 2015
  • Mini-dental implants for overdenture applications are increasingly popular due to their ease in placement with simplified, less traumatic surgical protocols in limited-width alveolar ridges. However, the clinical decisions including implant number, position, and loading protocol must be based on a thorough evaluation and evidence-based diagnosis. Herein, we reported a case treated with the current method of mandibular mini-implant supported overdenture.

Age of Diagnosis of Breast Cancer in China: Almost 10 Years Earlier than in the United States and the European Union

  • Song, Qing-Kun;Li, Jing;Huang, Rong;Fan, Jin-Hu;Zheng, Rong-Shou;Zhang, Bao-Ning;Zhang, Bin;Tang, Zhong-Hua;Xie, Xiao-Ming;Yang, Hong-Jian;He, Jian-Jun;Li, Hui;Li, Jia-Yuan;Qiao, You-Lin;Chen, Wan-Qing
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권22호
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    • pp.10021-10025
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    • 2014
  • Background: The study aimed to describe the age distribution of breast cancer diagnosis among Chinese females for comparison with the United States and the European Union, and provide evidence for the screening target population in China. Materials and Methods: Median age was estimated from hospital databases from 7 tertiary hospitals in China. Population-based data in China, United States and European Union was extracted from the National Central Cancer Registry, SEER program and GLOBOCAN 2008, respectively. Age-standardized distribution of breast cancer at diagnosis in the 3 areas was estimated based on the World Standard Population 2000. Results: The median age of breast cancer at diagnosis was around 50 in China, nearly 10 years earlier than United States and European Union. The diagnosis age in China did not vary between subgroups of calendar year, region and pathological characteristics. With adjustment for population structure, median age of breast cancer at diagnosis was 50~54 in China, but 55~59 in United States and European Union. Conclusions: The median diagnosis age of female breast cancer is much earlier in China than in the United States and the European Union pointing to racial differences in genetics and lifestyle. Screening programs should start at an earlier age for Chinese women and age disparities between Chinese and Western women warrant further studies.

Advances in Management of Hepatocellular Carcinoma

  • Intaraprasong, Pongphob;Siramolpiwat, Sith;Vilaichone, Ratha-korn
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권8호
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    • pp.3697-3703
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    • 2016
  • Hepatocellular carcinoma (HCC) is the most frequent type of malignant liver tumor and a high impact health problem worldwide. The prevalence of HCC is particularly high in many Asian and African countries. Some HCC patients have no symptoms prior to diagnosis and many of them therefore present at late stage and have a grave prognosis. The well-established causes of HCC are chronic hepatitis B virus (HBV) or chronic hepatitis C virus (HCV) infection or alcoholic cirrhosis and nonalcoholic steatohepatitis. The Barcelona Clinic Liver Cancer (BCLC) Staging System remains the most widely used for HCC management guidelines. To date, the treatments for HCC are still very challenging for physicians due to limited resources in many parts of the world, but many options of management have been proposed, including hepatic resection, liver transplantation, ablative therapy, chemoembolization, sorafnib and best supportive care. This review article describes the current evidence-based management of HCC with focus on early to advance stages that impact on patient overall survival.