• 제목/요약/키워드: Evidence-Based Medicine

검색결과 1,232건 처리시간 0.033초

소아정신의학 역사 속의 진단기준 발전과 현상학적 기술정신의학 (Descriptive Psychiatry and the Development of Diagnostic Criteria in the History of Child Psychiatry and Phenomenological Descriptive Psychiatry)

  • 반건호;이연정;한주희
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제26권1호
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    • pp.1-11
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    • 2015
  • Phenomenology has been developed by philosophers like Kant and Husserl since the late 18th century. Jaspers, a German psychiatrist, adopted it into psychopathology studies and accumulated data by closely observing and recording the patients' symptoms and signs. Among descriptions done even before the psychopathology or diagnostic criteria of disorders in the field of child psychiatry was established, we can find exact and valuable descriptions matching the autism spectrum disorder or attention deficit/hyperactivity disorder. The diagnostic criteria of modern childhood psychiatric disorders were established based on these grounds. Phenomenological/descriptive methods in various psychiatric fields lead to medical study methods for social phenomenon such as oiettolie, hikikomori, and internet game addiction. Since Romanian orphans were adopted to the western world, descriptive studies along with neurobiological studies on the influence of stimulus deprivation on emotional and physical development are being conducted. While phenomenology, which was adopted by Jaspers to verify psychopathology, was developed mainly by observation and description, recent studies are explaining such descriptive phenomena even at the synapse level due to advances in neurobiology. Although phenomenological/descriptive psychiatry, describing precise and detailed experiences of patients, is less applied nowadays among modern study methods, we must remember that such descriptions may lead to biological studies and provide evidence to improve the accuracy of choosing and applying treatment methods.

Association of Common Vitamin D Receptor Gene Variations with Fracture Risk and Bone Mineral Density in Postmenopausal Korean Population

  • Hwang, Joo-Yeon;Lee, Seung Hun;Kim, Ghi-Su;Koh, Jung-Min;Go, Min-Jin;Kim, Tae-Ho;Hong, Jung-Min;Park, Eui-Kyun;Kim, Shin-Yoon;Lee, Jong-Young
    • Genomics & Informatics
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    • 제7권1호
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    • pp.13-19
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    • 2009
  • Osteoporosis is characterized by impaired osteogenesis. BMD is a major determinant of bone strength. The role of the VDR gene in predisposition to primary osteoporosis has been recognized. However, population-based case-control studies have been reported controversial results for known candidate genes in an ethnically distinct group. To determine the genetic effects of VDR variants on osteoporosis and BMD, we directly sequenced the VDR gene in 24 unrelated Korean individuals and identified eighteen sequence variants. We investigated the potential involvement of eight SNPs in osteoporosis in postmenopausal women (n = 729). Two SNPs (LD) in intron 2, -5294G>C (rs2238135) and -4817G>A (rs17882443) showed the evidence of association with enhanced BMD of the femoral neck ($p_{additive}$=0.031 for rs2238135; $p_{additive}$=0.017 and $p_{dominant}$= 0.019 for 17882443). Moreover, VDR -4817G>A was significantly associated with protective effect on all fracture risk ($p_{recessive}$=0.035, OR=0.2, 95% CI=$0.05{\sim}0.89$), and tended to be higher BMD values at various proximal femur sites. Therefore, we suggest that the -4817G>A may be useful genetic marker for vitamin D-related metabolism and may have an important role in the increased BMD of the proximal femur in postmenopausal Korean women.

도시 중년 남성의 건강식품 섭취 경험과 의도에 관한 연구 (The Experience and Intention of Health Food Use among Middle-aged Men in Urban Areas)

  • 송화숙;오세영
    • 대한지역사회영양학회지
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    • 제5권2호
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    • pp.193-200
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    • 2000
  • This study examined the experience and intention of health food use regarding the different type of health foods among 201 middle-aged Korean men form urban areas. Based upon the results of a prestudy, health foods were classified into 4 groups including Chinese medicine(CM), toner foods(TF), vitamin or mineral supplements(VMS), and other manufactured heath food supplements(MHFS). compared with the4 case of health food experience, the similar proportion of the subjects were intended to use CM( 70%) and MHFS( 40%), yet the smaller proportion of them had the intention for TF(46%) and VMS(52%). Our subjects mainly obtained information on CM and TF from social networks, such as families, relatives, friends and neighbors and VMS and MHFS from mass media. Expected effects of health food consumption were different by the type of health food. The most positive expected effects were found in CM, followed by VMS. However, there was weak evidence for the positive effects of the TF and MHFS. Upon the consumption of health foods, our subject appeared to expect to their body energy to increased and body functions to be improved in general. Multivariate analyses indicated the importance of expected effects of health food consumption and aging symptoms as determinants of future health food use. Experience was rarely associated with intention in health food use. This study suggests that educated middle-aged Korean men may have a rational attitude toward health food use. Regarding different attitudes and behavior toward the different type of health foods, further research should consider the nature of each type of health foods. The limitations of this study are also discussed.

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새 신체활동기준의 동향과 함의 (Features and implication of new physical activity guidelines)

  • 고광욱
    • 보건교육건강증진학회지
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    • 제35권5호
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    • pp.17-24
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    • 2018
  • Objectives: After many national physical activity guidelines have established, recent changes are deep and rapid. So the major features and implication to reverse worsening Korean physical activity indicator is desprate but related knowledge and informations are few. So review of recent features and implications of new physical activity guidelines have made. Methods: National physical activity guidelines of advanced countries were searched through snowballing methods. Major features were described according to the nation. Implication were drew through discussion for Korean realitiy. Results: New Australian physical activity and sedentary behaviour guideline explicitly included sedentary behaviour. The age in the guideline expanded to early years. Canada also presented 24-hour movement guidelines to early years. The second generation of the physical activity guidelines reflects the extensive amount of new knowledge. New aspects include discussions of additional health benefits related to brain health, additional cancer sites, and fall-related injuries; immediate and longer term benefits for how people feel, function, and sleep; further benefits among older adults and people with additional chronic conditions; risks of sedentary behavior and their relationship with physical activity; elimination of the requirement for physical activity benefits to occur in bouts of at least 10 minutes; and tested strategies that can be used to get the population more active. Conclusions: The most important message from the new guidelines is that the greatest health benefits accrue by moving from no, to even small amounts of, physical activity. Multiple studies demonstrate that the steepest reduction in disease risk occurs at the lowest levels of physical activity. People need to understand that even small amounts of physical activity are beneficial and that reductions in the risk of disease and disability occur by simply getting moving. So various evidence based proven strstegies are needed in Korea including workforce training.

Prevalence and extension of the anterior loop of the mental nerve in different populations and CBCT imaging settings: A systematic review and meta-analysis

  • Hadilou, Mahdi;Gholami, Leila;Ghojazadeh, Morteza;Emadi, Naghmeh
    • Imaging Science in Dentistry
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    • 제52권2호
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    • pp.141-153
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    • 2022
  • Purpose: This study aimed to identify the prevalence and extension of the anterior loop (AL) of the mental nerve in different populations and according to different cone-beam computed tomography (CBCT) imaging settings. Materials and Methods: Medline/PubMed, Embase, Scopus, Web of Science, and ProQuest were searched. The main inclusion criterion was ALs evaluated in CBCT images. The quality of studies was assessed with the Joanna Briggs Institute risk of bias checklist. Subgroup analyses were conducted for sex, side, continent, voxel size, field of view, and type of CBCT-reconstruction images with a random-effects model. Results: Sixty-three studies with 13,743 participants (27,075 hemimandibles) were included. An AL was found in 40.6% (95% CI: 32.8%-48.9%, P<0.05) of participants and 36.0% (95% CI: 27.5%-45.5%, P<0.05) of hemimandibles, in 34.9% (95% CI: 25.1%-46.2%, P<0.05) of males and 34.5% (95% CI: 23.5%-47.4%, P<0.05) of females. The average length of ALs was 2.39 mm (95% CI: 2.07-2.70 mm, P<0.05). Their extension was 2.13 mm (95% CI: 1.54-2.73 mm, P<0.05) in males and 1.85 mm (95% CI: 1.35-2.36 mm, P<0.05) in females. Significant differences were observed regarding the prevalence and length of ALs among continents and for its measured length on different CBCT-reconstruction images, but not between other subgroups. Conclusion: AL was a relatively common finding. The voxel size and fields of view of CBCT devices were adequate for assessing AL; however, a 2-mm safety margin from anatomical structures(such as the AL) could be recommended to be considered when using CBCT imaging.

Toosendan Fructus ameliorates the pancreatic damage through the anti-inflammatory activity in non-obese diabetic mice

  • Roh, Seong-Soo;Kim, Yong-Ung
    • 대한본초학회지
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    • 제30권2호
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    • pp.1-9
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    • 2015
  • Objectives : The present study was conducted to examine whether Toosendan Fructus has an ameliorative effect on diabetes-induced alterations such as oxidative stress and inflammation in the pancreas of non-obese diabetic (NOD) mice, a model of human type I diabetes. Methods : Extracts of Toosendan Fructus (ETF) were administered to NOD mice at three doses (50 mg/kg, 100 mg/kg and 200 mg/kg). Mice at 18 weeks of age were measured glucose tolerance using intraperitoneal glucose tolerance test. After 28 weeks of ETF treatment, glucose, total cholesterol (TC), triglyceride (TG), and proinflammatory cytokines in serum, western blot analyses and a histopathological examination in pancreas tissue, and on the onset of diabetes were investigated. Results : The results showed that levels of glucose, glucose tolerance, TC, TG, interferon-${\gamma}$, interleukin (IL)-1 ${\beta}$, IL-6, and IL-12 in serum were down-regulated, while IL-4, IL-10, SOD, and catalase significantly increased. In addition, ETF improved protein expression of proinflammatory mediaters (such as cyclooxygenase-2, and inducible nitric oxide synthase) and a proapoptotic protein (caspase-3) in the pancreatic tissue. Also, in the groups treated with ETF (100 mg/kg or 200 mg/kg), insulitis and infiltration of granulocytes were alleviated. Conclusions : Based on these results, the anti-diabetic effect of ETF may be due to its anti-inflammatory and antioxidant effect. Our findings support the therapeutic evidence for Toosendan Fructus ameliorating the development of diabetic pancreatic damage via regulating inflammation and apoptosis. Our future studies will be focused on the search for active compounds in these extracts.

Anatomic evaluation of the posterior superior alveolar artery using cone-beam computed tomography: A systematic review and meta-analysis

  • Faraz Radmand ;Tahmineh Razi ;Milad Baseri ;Leili Faraji Gavgani;Fatemeh Salehnia ;Masoumeh Faramarzi
    • Imaging Science in Dentistry
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    • 제53권3호
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    • pp.177-191
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    • 2023
  • Purpose: This systematic review examined the detection of the posterior superior alveolar artery, along with various anatomic characteristics, on cone-beam computed tomography images. Materials and Methods: Studies were identified electronically through the Web of Science, MEDLINE, Scopus, and Embase databases. The quality of the included studies was evaluated using a 5-item binary scale. The detection rate, location, and classified diameter of the posterior superior alveolar artery were estimated as prevalence values. The diameter of this artery, as well as the distances from the artery to the alveolar crest and sinus floor, were estimated as means with associated 95% confidence intervals. Results: Thirty-seven studies were enrolled, with 34 of these included in the meta-analysis. The mean detection rate was 79% (range: 72%-84%), and the mean diameter was 1.06±0.05 mm (range: 0.96-1.16 mm). The posterior superior alveolar artery was located intraosseously in 64% of cases. The mean distance of the artery from the alveolar crest was 16.71±0.49 mm (range: 15.75-17.68 mm), while the mean distance from the artery to the sinus floor was 8.85±0.4 mm (range: 8.05-9.64 mm). Conclusion: According to the findings of this meta-analysis regarding various anatomic characteristics of the posterior superior alveolar artery, severe hemorrhage after damage to this artery during sinus augmentation procedures is not a substantial clinical problem.

암환자에게 제공된 다빈도 간호중재 분석 - 5개 종합병원을 중심으로 - (Analysis of Nursing Interventions Frequently Used with Cancer Patients)

  • 문경희;안미정;김필자;박정연;김명애;박인숙;배수현;이소정;권인각;김소선
    • 임상간호연구
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    • 제15권1호
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    • pp.107-122
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    • 2009
  • Purpose: The purpose of this study was to identify nursing interventions frequently used with cancer patients. Nursing records from 5 general hospitals for patients with stomach, liver, lung or colon cancer were analyzed. Method: A descriptive study methodology was used and nursing records for 15 patients in each disease category at each hospital, who were admitted and discharged during June 2007 were analyzed. Results: Five domains of NIC were found and the physiological(basic) domain was most frequent (31.52%). Twenty two classes of NIC were identified with risk management for safety being most frequent (22.49%). For the 119 nursing interventions identified, the most frequent was pain management with 7,827 (12.31%), followed by prevention of falls (11.76%), surveillance (6.79%) and wound care (5.12%). Nursing activities of pain management and prevention of falls were comparable to activities listed in literature on guidelines for evidence based and best practices in nursing care. Eight of the 17 nursing activities for pain management, and 9 of 14 for fall prevention were consistent with these guidelines. Conclusion: In this study, nursing interventions were found to be focused on physical care, monitoring patients' condition and education. We have to develop diverse nursing interventions and a convenient recording process.

경기도 일개 종합병원에서 혈액제제 출고 현황 (Status of Blood Products Release at a General Hospital in Gyeonggi-Do)

  • 최호근;최경숙
    • 대한임상검사과학회지
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    • 제54권1호
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    • pp.73-77
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    • 2022
  • 혈액제제(BPs)는 한정적인 자원이다. 혈액제제는 가장 적절하게 사용되어야 하지만 근거 기반 없이 무분별하게 사용되고 있는 것이 사실이다. 본 연구는 헤모글로빈 수치를 기준으로 혈액제제의 사용 적절성을 평가하는 것을 목적으로 하였다. 2020년 11월 1일부터 2021년 10월 31일까지 병원에서 수행된 혈액 공급 데이터는 병원의 디지털 종합의료정보시스템을 활용하였다. 총 제공 건수는 21,303건이었고, 진료과별로 사용하는 농축적혈구제제의 공급 중 헤모글로빈 수치(>7.0 g/dL)의 경우는 1,173건으로 나타났다. 수혈의 오남용은 사회적 비용을 증가시키고, 수혈의 적절성은 더욱 중요해지고 있어, 각 의료기관은 수혈지침 평가지표를 검토하고, 수혈지침의 혈액제제 방출 현황 및 수혈지침의 교육프로그램을 점검하여 적절성을 평가해야 할 것으로 사료된다.

Association between diet quality and untreated dental caries: results from the Korea National Health and Nutrition Examination Survey

  • Seon-Ju Sim;Ja-Young Moon;Hye-Sun Shin
    • Nutrition Research and Practice
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    • 제17권5호
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    • pp.959-968
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    • 2023
  • BACKGROUND/OBJECTIVES: Few studies have provided evidence of the association between diet quality and dental caries. This study aimed to examine the association between diet quality and untreated dental caries in a Korean representative population. SUBJECTS/METHODS: The study population included a sample of 13,815 participants, aged ≥ 19 from the Korea National Health and Nutrition Examination Survey during 2013-2015. The explanatory variable was diet quality and the outcome variable was untreated dental caries. Untreated dental caries were defined by the number of decayed teeth recorded according to the criteria established by the World Health Organization. Diet quality was defined by using the Korean Healthy Eating Index (KHEI) through the 24-h recall methods. We assessed the association between diet quality and untreated dental caries while adjusting for age, sex, education, income, smoking status, dental visits, toothbrushing frequencies, obesity, and diabetes mellitus. RESULTS: The mean overall KHEI scores in the untreated dental caries group were significantly lower than those in the group without untreated dental caries. Significant differences were observed in the untreated dental caries group based on the KHEI quartiles (P < 0.001). After adjusting for potential confounders, the quartiles of KHEI scores showed an association with untreated dental caries, demonstrating a dose-effect trend (odds ratio [OR], 1.57; 95% confidence interval [CI], 1.35-1.84 for 1st quartile; OR, 1.38; 95% CI, 1.19-1.59 for 2nd quartile; OR, 1.32; 95% CI, 1.14-1.53 for 3rd quartile; reference quartile highest]). CONCLUSIONS: The findings indicated an inverse association between diet quality and untreated dental caries in Korean adults. Healthcare providers should take into account the significant role of diet quality in preventing and managing oral health.