• Hip & pelvis
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• 제35권4호
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• pp.228-232
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• 2023

Purpose: Prosthetic joint infection (PJI) has an enormous physiological and psychological burden on patients. Surgeons rightly wish to minimise this risk. It has been shown that a standardised, evidence-based approach to perioperative care leads to better patient outcomes. A review of current practice was conducted using a cross-sectional survey among surgeons at multiple centers nationwide. Materials and Methods: An 11-question electronic survey was circulated to hip and knee arthroplasty consultants nationally via the BOA (British Orthopaedic Association) e-newsletter. Results: The respondents included 56 consultants working across 19 different trusts. Thirty-four (60.7%) screen patients for asymptomatic bacteriuria (ASB) preoperatively, with 19 (55.9%) would treating with antibiotics. Fifty-six (100%) screen for methicillin-resistant Staphylococcus aureus and treat if positive. Only 15 (26.8%) screen for methicillin-sensitive S. aureus (MSSA) or empirically eradicate. Zero (0%) routinely catheterize patients perioperatively. Forty-one (73.2%) would give intramuscular or intravenous gentamicin for a perioperative catheterisation. All surgeons use laminar flow theatres. Twenty-six (46.4%) use only an impervious gown, 6 (10.7%) exhaust pipes, and 24 (42.3%) surgical helmet system. Five different antimicrobial prophylaxis regimens are used 9 (16.1%) cefuroxime, 2 (3.6%) flucloxacillin, 19 (33.9%) flucloxacillin and gentamicin, 10 (17.9%) teicoplanin, 16 (28.6%) teicoplanin and gentamicin. Twenty-two (39.3%) routinely give further doses. Conclusion: ASB screening, treatment and intramuscular gentamicin for perioperative catheterisation is routinely practiced despite no supporting evidence base. MSSA screening and treatment is underutilised. Multiple antibiotic regimens exist despite little variation in organisms in PJI. Practice varies between surgeons and centers, we should all be practicing evidence-based medicine.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권1호
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• pp.1-27
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• 2019

The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in South Korea and worldwide, and new guidelines were established in each area with the strength of recommendations based on the levels of evidence: 1) definition and diagnosis of overweight and obesity in children and adolescents; 2) principles of treatment of pediatric obesity; 3) behavioral interventions for children and adolescents with obesity, including diet, exercise, lifestyle, and mental health; 4) pharmacotherapy; and 5) bariatric surgery.

• Clinical and Experimental Pediatrics
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• 제62권1호
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• pp.3-21
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• 2019

The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in South Korea and worldwide, and new guidelines were established in each area with the strength of recommendations based on the levels of evidence: (1) definition and diagnosis of overweight and obesity in children and adolescents; (2) principles of treatment of pediatric obesity; (3) behavioral interventions for children and adolescents with obesity, including diet, exercise, lifestyle, and mental health; (4) pharmacotherapy; and (5) bariatric surgery.

• 정신신체의학
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• 제30권2호
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• pp.80-98
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• 2022

외상후 스트레스 장애는 다양한 치료들에 대한 치료반응이 좋지 않아, 많은 임상가들에게 큰 도전이 되고 있다. 최근 발간된 여러 임상 진료지침들은 인지처리치료 및 지연노출치료를 포함한 트라우마 초점 정신치료들을 일차 치료로 공통적으로 권고하고 있다. 환자에게 근거에 기반한 치료적 선택지들에 대하여 정보를 제공함으로써 환자와 임상가가 함께 최선의 치료방법을 선택할 수 있도록 하는 것이 중요하며, 이를 위해 인지처리치료의 내용과 근거를 소개하는 것이 본 종설의 목적이다. 인지처리치료의 회기 구성과 내용을 요약하여 소개하고, 외상후 스트레스 장애에 대한 인지처리치료의 효과를 알아본 다양한 연구들을 민간인 집단과 재향군인/현역군인 집단으로 구분하여 제시하였다. 인지처리치료의 탈락율을 낮추고 치료성적을 올리며 치료접근도를 높일 수 있는 방법들 및 외상후 스트레스 장애에 대한 근거중심치료의 활성화를 위한 방안을 토의한다.

• 대한안과학회지
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• 제59권11호
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• pp.1039-1048
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• 2018

목적: 연령관련황반변성 환자에 대해 항혈관내피성장인자의 가능한 치료 방법에 따라 건강보험 재정에 미치는 영향을 분석하였다. 대상과 방법: 여러 치료 방법에 따른 건강보험 재정의 변화를 향후 5년(2018-2022년) 동안 추정하였다. 새로운 급여기준 이외 바이오시밀러 등장, 허가초과 비급여약제 사용 등을 고려한 시나리오에 대해서도 재정 영향을 분석하였다. 국민건강보험공단 청구자료 및 의료기관 자료를 기준으로 각 시나리오별로 향후 5년 동안 예상 진료환자 수, 치료 횟수를 추정하였으며, 재정부담을 추계하였다. 결과: 연령관련황반변성에서 현행의 사용형태로 기존 급여기준(평생 14회)이 유지되는 경우(시나리오 1) 2018년 기준 향후 5년간 보험소요재정은 약 4,403억 원으로 추정되었다. 2017년 12월에 변경된 급여기준하에서 5년간 보험소요재정은 약 5,601억 원으로 추정되었다. 2020년 이후 바이오시밀러 급여(시나리오 3), 현재 허가초과 비급여약제인 베바시주맙(시나리오 4)을 급여전환하는 경우에 각각 5,210억 원, 4,197억 원으로 예상되었다. 결론: 본 평생 14회라는 급여기준 삭제로 인해 건강보험 재정이 크게 증가할 것이 예상되었으나 실제 0.1 이하 그리고 반흔화/위축성 병변일 경우 급여 중단 등의 새로운 기준으로 중간폭으로 증가하는 것으로 나타났다. 또한 고령화로 인한 연령관련황반변성 유병환자의 증가를 고려할 때 바이오시밀러 및 베바시주맙 도입 등의 정책적 대안도 고려할 수 있다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제18권1호
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• pp.26-30
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• 2007

This practice parameter for non-pharmacological treatment for attention-deficit hyperactivity disorder (ADHD) review the domestic and international literature on the psychosocial treatment of children and adolescents with ADHD. This parameter include the parental training & education, cognitive behavior therapy(group or individual), social skill training, family therapy, play therapy (individual psychotherapy) and non-traditional therapy (art therapy, herbal therapy et al). Among them, there is some proven evidence only in parental training & education and cognitive behavior therapy. So, this parameter describes some details only in the field of parental training & education and cognitive behavior therapy. The efficacy or effectiveness, especially, cost-effectiveness of specific psychosocial treatment method for ADHD cannot be fairly assessed due to the scarcity of controlled clinical data. Based on the clinical expert consensus and limited evidence, we cautiously suggest the practice recommendations about the non-pharmacological psychosocial treatment fur children and adolescents with ADHD.

• 대한치과의사협회지
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• 제52권8호
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• pp.472-477
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• 2014

The new paradigm of dentistry require the detection of caries in their earlier stages. To achieve this, a high technology detection device and systematic and organized caries management system are needed. Caries management by risk assessment (CAMBRA) model is representative caries management system that satisfied new paradigm. Dental caries prevention and treatment according to CAMBRA model is patient-centered, risk-based, evidence-based practice. Therefore, individual caries management such as CAMBRA should be performed through accurate assessment of caries disease indicators and comprehensive assessment of caries risk factors and protective factors. Based on the CAMBRA better effectiveness of comprehensive dental caries management including non-surgical treatment will be accomplished.

• 대한물리치료과학회지
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• 제30권4호
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• pp.92-110
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• 2023

Background: Digital therapeutics are software medical devices that provide evidence-based treatments to prevent, manage, and treat disease. Digital therapies have recently been shown to be effective in motivating children with cerebral palsy as a tool in neuropsychological therapy. Digital therapies improve postural control, balance and gait in children with cerebral palsy. Therefore, this study aims to investigate the effects of digital therapies on balance and gait in children with cerebral palsy and to provide guidelines for prescribing digital therapies for children with cerebral palsy. Design: A Systematic Review Methods: This study searched for English-language articles published in medical journals from January 2000 to July 2023 using PubMed and MEDLINE based on the year of initiation of the digital therapy. The search terms used in the study were 'digital technology' OR 'digital therapeutic' OR 'mobile application' OR 'mobile health' OR 'virtual reality' OR 'game' AND 'cerebral palsy', 'balance' 'gait' as the main keywords. The final article was assigned an evidence level and a Physiotherapy Evidence Database (PEDro) score to assess the quality of clinical trials studies. Results: The digital therapies applied to improve balance and gait in children with cerebral palsy are game-based virtual reality training and the Nintendo Wii Fit program. Both digital therapy interventions had a significant effect on improving balance in children with cerebral palsy, and virtual reality training significantly improved balance and gait. However, there were no significant improvements in balance and gait within two weeks of treatment, regardless of the type of digital intervention. Conclusion: The study suggests that this data will be important in building the evidence base for the effectiveness of digital therapies on balance and gait in children with cerebral palsy and in advancing clinical protocols.

• 대한한방소아과학회지
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• 제38권2호
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• pp.21-31
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• 2024

Objectives This study aimed to develop consensus-based recommendations for establishing standard clinical practice guidelines for pediatric anorexia through the utilization of a Delphi study. Methods We analyzed existing randomized controlled trials for pediatric anorexia treatment using the Delphi method-a structured process for achieving consensus among a panel of experts. A questionnaire was distributed among a select panel of nine specialists in the field. Results The initial Delphi round led to consensus on 30 distinct recommendations; however, consensus was not reached for 19 other recommendations, prompting a second Delphi round. In the subsequent round, adjustments were made based on feedback from the initial round, and deliberations were held on recommendations that previously lacked consensus. Following these adjustments, consensus was achieved on all recommendations. Additionally, a third Delphi iteration was conducted to address three specific queries that required amendment due to a reevaluation of the evidence levels of certain recommendations. In total, three Delphi rounds were carried out to produce informed recommendations related to the diagnosis, treatment, and general management of anorexia. Conclusions This investigation successfully generated evidence-based recommendations for the diagnosis and treatment of pediatric anorexia. The recommendations encompassed various practices, including herbal medicine, acupuncture, moxibustion, cupping, and Chuna manual therapy, which can be integrated into clinical settings.

• Asian Pacific Journal of Cancer Prevention
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• 제16권13호
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• pp.5521-5524
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• 2015

Purpose: This analysis was conducted to evaluate the efficacy and safety of icotinib based regimens in treating patients with non-small cell lung cancer (NSCLC). Methods: Clinical studies evaluating the efficacy and safety of icotinib-based regimens with regard to response and safety for patients with NSCLC were identified using a predefined search strategy. Pooled response rates of treatment were calculated. Results: With icotinib-based regimens, 7 clinical studies which including 5,985 Chinese patients with NSCLC were considered eligible for inclusion. The pooled analysis suggested that, in all patients, the positive reponse rate was 30.1% (1,803/5,985) with icotinib-based regimens. Mild skin itching, rashes and diarrhea were the main side effects. No grade III or IV renal or liver toxicity was observed. No treatment-related death occurred in patients treated with icotinib-based regimens. Conclusions: This evidence based analysis suggests that icotinib based regimens are associated with mild response rate and acceptable toxicity for treating Chinese patients with NSCLC.