• 제목/요약/키워드: Evidence Based Diagnosis

검색결과 240건 처리시간 0.026초

Approaches to the diagnosis and management of chronic urticaria in children

  • Choi, Sun Hee;Baek, Hey Sung
    • Clinical and Experimental Pediatrics
    • /
    • 제58권5호
    • /
    • pp.159-164
    • /
    • 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.

A Study on the Numerical Approach for Industrial Life Cycle: Empirical Evidence from Korea

  • LEE, Kangsun;CHOI, Kyujin;CHO, Daemyeong
    • The Journal of Asian Finance, Economics and Business
    • /
    • 제8권5호
    • /
    • pp.667-678
    • /
    • 2021
  • The industrial life cycle theory was extended to the product life cycle theory and the corporate life cycle theory, but a conceptual life cycle was presented, and quantitative empirical evidence for this was insufficient. It is intended to improve appropriate resource planning and resource allocation by quantitatively predicting the industrial cycle and its position (age) in the cycle. Human resources, tangible assets, and industrial output analysis were conducted based on 28 years of actual data of 39 industries in Korea by applying the Gompertz model, which is a population ecology prediction model. By predicting with the Gompertz model, the coefficient of determination R2 value was 97% or more, confirming the high suitability with the actual cumulative sales value of the industry. A numerical model for calculating the life cycle of each industry, calculating the saturation of input resources for each industry, and diagnosing the financial stability of the industry was presented. These results will contribute to the decision-making of industrial policy officers for budget planning appropriately for each stage of industry development. Future research will apply the numerical model of this study to foreign national industries, complete an inter-industry convergence diagnostic model (e.g. ease of convergence, suitability of convergence, etc.) for renewal of fading industries.

Imaging Features of Lung Lobe Torsion in Two Dogs with Typical or Atypical Initial Radiographic Signs

  • Jeong, Sulhwa;Seo, Jeongim;Lee, Jinmin;Chang, HwaSeok;Choi, Mincheol;Yoon, Junghee
    • 한국임상수의학회지
    • /
    • 제35권6호
    • /
    • pp.282-285
    • /
    • 2018
  • A 7 years old, male, Afghan hound (case 1) and a 10 years old, castrated male, Pekingese (case 2) were referred with dyspnea. In case 1, thoracic radiographs showed moderate amount of pleural effusion and lobar sign in the left cranial lung lobe. Following computed tomographic (CT) examination, lung lobe torsion in left cranial lung lobe was diagnosed. In case 2, thoracic radiographs showed increased cranial lobar opacity but there was no evidence of pleural effusion. CT examination revealed an abrupt ending bronchus in the left cranial lung lobe. Based on the imaging diagnosis, left cranial lung lobectomy was performed in both cases. Case 1 showed increased lobar opacity and pleural effusion, while case 2 just showed less concrete evidence of lung lobe torsion on thoracic radiographs and marked severe chronic suppurative pneumonia was histopathologically confirmed. In conclusion, CT could be an important modality when atypical lung disease is suspicious.

대구지역 소아청소년과 의사들의 요로감염 관리 실태분석 (Management of Urinary Tract Infections in Children: A Survey of Pediatricians in Daegu City)

  • 이상수;강석정;이재민;조민현;박용훈
    • Childhood Kidney Diseases
    • /
    • 제16권2호
    • /
    • pp.95-101
    • /
    • 2012
  • 목적: 소아의 요로감염은 적절히 관리 되지 않는 경우에 여러 문제를 일으킬 수 있어 다양한 관리 지침이 계속 개발되고 있고, 근래에는 근거 중심의 지침들이 만들어져서 진료에 적용되고 있다. 하지만 소아과 의사들의 요로감염 관리 실태에 대한 조사는 매우 드문 실정이다. 이 연구에서는 소아과 의사들의 요로감염에 대한 인식을 알아보고, 적절하게 관리가 이루어지는지를 평가하고 개선점을 찾고자 하였다. 방법: 대구시 지역의 78명의 소아청소년과 전문의들을 대상으로 요로감염의 진단, 영상검사 및 치료와 예방을 위한 환자교육을 어떻게 하는지를 설문조사로 알아보았다. 결과: 대부분의 응답자들은 발열의 원인을 찾을 수 없는 경우에 요로감염을 감별하기 위하여 소변검사를 하였다. 환자가 소변을 가릴 수 없는 경우 상당수의 응답자가 무균채뇨백을 사용하여 채뇨를 하였으며, 소변배양 검사를 하지 않는 경우도 많았다. 가장 많이 시행하는 영상검사는 초음파였다. 항생제는 입원한 경우에만 주사로 투여하고 외래 통원 시는 경구투여를 하였다. 요로감염의 중요성, 재발과 예방 등에 대한 환자 교육을 선택적으로 하고 있었다. 방광 요관역류의 관리 지침을 가지고 있는 경우는 28.6%로서 많지 않았다. 결론: 요로감염을 진단하기 위한 시도는 적절하게 이루어지고 있었으나, 무균채뇨백을 사용하여 소변배양을 하는 경우가 많아 위양성진단율이 높아져서 과잉치료가 우려되었다. 또한 영상검사를 하지 않는 경우가 많아 동반된 요로 기형의 진단이 조기에 되지 않을 수 있다는 것도 우려되었다. 근거-중심의 요로감염 관리 지침에 따른 보다 적절한 관리를 하기 위한 노력이 필요하다.

냉증을 진단하고 치료하는 산소챔버 시스템의 설계 (Design of Oxygen Chamber System for Diagnosis and Treatment of Cold Hypersensitivity)

  • 조면균;최효선
    • 한국산학기술학회논문지
    • /
    • 제13권12호
    • /
    • pp.6013-6021
    • /
    • 2012
  • 냉감을 느끼지 않을만한 온도에서 신체부위에 차가움을 느껴 일상생활이 곤란함을 호소하는 냉증환자가 늘어남에도 불구하고, 정확한 진단기구와 뚜렷한 치료기기가 없는 것이 사실이다. 그러므로 본 논문에서는 다양한 센서를 통하여 냉증을 측정 및 진단하고 환자의 냉증정도에 맞게 적응적으로 산소압과 치료시간을 조정할 수 있는 산소챔버를 냉증치료용 의료기기로 제안 설계한다. 특히 의사의 진찰과 문진을 통해 경험에 의존하던 기존의 주관적인 냉증 진단 방법에서 벗어나, 첨단 복합 생체센서의 측정데이터를 임상실험에 근거한 임계치를 바탕으로 비교함으로써 냉증을 정확히 진단하는 방법을 소개한다. 최종적으로 냉증의 진단 단계에 따라 적응적으로 산소량을 제어함으로써 냉증을 효과적으로 치료하는 산소챔버를 구현하여 한의학 의료기기의 과학화와 대중화에 기여하고자 한다.

Surviving Covid-19 Diagnosis Among Registered Nurses: Reactions, Consequences, and Coping Mechanisms

  • Gladys Mbuthia;Doris Machaki;Sheila Shaibu;Rachel W. Kimani
    • Safety and Health at Work
    • /
    • 제14권4호
    • /
    • pp.467-475
    • /
    • 2023
  • Background: To mitigate the spread of Covid-19, nurses infected with the virus were required to isolate themselves from their families and community. Isolated patients were reported to have experienced mental distress, posttraumatic stress disorder symptoms, and suicide. Though studies have reported the psychological impact of the Covid-19 pandemic, less is known about the lived experiences of nurses who survived Covid-19 infection in sub-Saharan Africa. Methods: A descriptive phenomenological approach was used to study the lived experiences of registered nurses who survived Covid-19 disease. In-depth interviews were conducted among nurses diagnosed with Covid-19 from two hospitals in Kenya between March and May, 2021. Purposive and snowball sampling were used to recruit registered nurses. Data were analyzed using Giorgi's steps of analysis. Results: The study included ten nurses between 29 and 45 years of age. Nurses' experiences encompassed three themes: diagnosis reaction, consequences, and coping. Reactions to the diagnosis included fear, anxiety, and sadness. The consequence of the diagnosis and isolation was stigma, isolation, and loneliness. Nurses coping mechanisms included acceptance, creating routines, support, and spirituality. Conclusion: Our findings aid in understanding how nurses experienced Covid-19 infection as patients and will provide evidence-based content for supporting nurses in future pandemics. Moreover, as we acknowledge the heroic contribution of frontline healthcare workers during the Covid-19 pandemic, it is prudent to recognize the considerable occupational risk as they balance their duty to care, and the risk of infection to themselves and their families.

자폐스펙트럼장애 아동을 위한 상황이야기 중재의 효과 연구에 대한 체계적 고찰 (A Systematic Study on the Effect of Social StoryTM Intervention for Individual with Autism Spectrum Disorder)

  • 배원진;박주영
    • 대한통합의학회지
    • /
    • 제9권2호
    • /
    • pp.131-140
    • /
    • 2021
  • Purpose : The purpose of this study was to systematically review the studies on the effects of social story intervention on the individuals with autism spectrum disorders(ASD) to provide the basis for evidence-based practice. Methods : In order to find out the studies on the effect of social story intervention on individuals with ASD, studies published from 2011 to December 2020 were searched on Google Academic Search. The keywords used were "autism spectrum disorder AND social story". A total of 16,900 studies were searched, and from these, 12 studies were selected based on the application of the selection and exclusion criteria. The included studies comprised of 10 single subject design studies and 2 randomized controlled trials design studies. The included studies were analyzed in accordance to population, intervention, outcome measures and results. Results : As a result of analysing the subjects of the included studies, we found out that pre-school children and adolescents were the most common groups of individuals diagnozsed with ASD. In addition to ASD, the diagnosis of the subjects included intellectual disability, Asperger, and Prader-willi. We found out that there were more interventions that were mixed with other interventions, than just the pure social story interventions. In particular, video modeling was found to be the most frequent intervention. This was followed by photo-based social stories. For outcome measure, autism social skills profile was found to be the most often used standardized assessment. For a non-standardized assessment, social desired behavior was found to be the most frequently evaluated behavior, followed by personal problem behavior. Of all the dependent variables, the dependent variable reported as "effective" was the most, followed by "some effective". Conclusion : This study is organized to help the individuals with ASD, families, researchers, and therapists understand the effects of social story intervention on the individuals with ASD in an easy fashion. Further, therapists can use this study as the basic data for evidence-based practice.

간호진단-간호결과-간호중재 연계를 이용한 내외과계 간호단위 간호정보시스템 구축 및 적용 (Construction and Application of Nursing Information System Using NANDA-NOC-NIC Linkage in Medical-Surgical Nursing Units)

  • 고은;소향숙
    • 성인간호학회지
    • /
    • 제25권4호
    • /
    • pp.365-376
    • /
    • 2013
  • Purpose: The purpose of this study was to construct, develop, and apply a nursing information system (NIS) using NANDA-NOC-NIC linkage in medical-surgical nursing units. Methods: This study consisted of three phases which were the construction of the database, development of the NIS, and application of the NIS. To construct the database, a questionnaire and nursing record review by an expert group were used. Collected data were analyzed by the SPSS/WIN 13.0 program. Results: In first phase, the database was made up of 50 nursing diagnoses, 127 nursing outcomes and 300 nursing interventions. In the second phase, NIS was developed according to its flow diagram and then tested. In the third phase, the developed NIS was applied to 130 inpatients. Nursing diagnoses frequently used were acute pain, delayed surgical recovery, and deficient knowledge (specify). Nursing outcomes for a nursing diagnosis of 'acute pain' were identified as pain control, pain level and comfort level. Nursing interventions for the nursing outcome 'pain control' were pain management, patient controlled analgesia assistance and medication management. Conclusion: The results of this study will facilitate the use of the newly proposed NIS in nursing practice and provide a guideline for evidence-based nursing.

Metabolic evaluation of children with global developmental delay

  • Eun, So-Hee;Hahn, Si Houn
    • Clinical and Experimental Pediatrics
    • /
    • 제58권4호
    • /
    • pp.117-122
    • /
    • 2015
  • Global developmental delay (GDD) is a relatively common early-onset chronic neurological condition, which may have prenatal, perinatal, postnatal, or undetermined causes. Family history, physical and neurological examinations, and detailed history of environmental risk factors might suggest a specific disease. However, diagnostic laboratory tests, brain imaging, and other evidence-based evaluations are necessary in most cases to elucidate the causes. Diagnosis of GDD has recently improved because of remarkable advances in genetic technology, but this is an exhaustive and expensive evaluation that may not lead to therapeutic benefits in the majority of GDD patients. Inborn metabolic errors are one of the main targets for the treatment of GDD, although only a small proportion of GDD patients have this type of error. Nevertheless, diagnosis is often challenging because the phenotypes of many genetic or metabolic diseases often overlap, and their clinical spectra are much broader than currently known. Appropriate and cost-effective strategies including up-to-date information for the early identification of the "treatable" causes of GDD are needed for the development of well-timed therapeutic applications with the potential to improve neurodevelopmental outcomes.

유방암에서 PET의 응용 (Application of PET in Breast Cancer)

  • 노동영
    • 대한핵의학회지
    • /
    • 제36권1호
    • /
    • pp.34-38
    • /
    • 2002
  • Positron emission tomography(PET) is an imaging method that employs radionuclide and tomography techniques. Since 1995, we applied PET not only to the diagnosis of breast cancer but also to the detection of abnormalities in the augmented breast and to the detection of metastasis. Until 2001, we evaluated 242 breast cases by PET at PET center of Seoul National University Hospital. Our group has reported serially at the international journals. In the first report, PET showed high sensitivity for detecting breast cancer, both the primary and axillary node metastasis. A total of 27 patients underwent breast operations based on PET results at Seoul National University Hospital from 1995 to 1996. The diagnostic accuracy of PET were 97% for the primary tumor mass and 96% for axillary lymph node metastasis. In case of the breast augmented, PET also showed excellent diagnostic results for primary breast cancer and axillary lymph node metastasis where mammography and ultrasound could not diagnose properly. PET also had outstanding results in the detection of recurrent or metastatic breast cancer(sensitivity 94%, specificity 80%, accuracy 89%). In addition, our study gave some evidence that PET could be applied further to evaluate the growth rate of tumors by measuring SUV, and finally to prognosticated the disease. PET could also be applied to evaluate the response after chemotherapy to measure its metabolic rate and size. In conclsion, PET is a highly sensitive, accurate diagnostic tool for breast cancer of primary lesion in various conditions including metastasis.