• 제목/요약/키워드: Systematic diagnosis

검색결과 452건 처리시간 0.035초

Clinical Practice Guidelines on Pediatric Gastroesophageal Reflux Disease: A Systematic Quality Appraisal of International Guidelines

  • Harris, Jacob;Chorath, Kevin;Balar, Eesha;Xu, Katherine;Naik, Anusha;Moreira, Alvaro;Rajasekaran, Karthik
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • 제25권2호
    • /
    • pp.109-120
    • /
    • 2022
  • Purpose: While regurgitation is a common and often benign phenomenon in infants and younger children, it can also be a presenting symptom of gastroesophageal reflux disease (GERD). If untreated, GERD can lead to dangerous or lifelong complications. Clinical practice guidelines (CPGs) have been published to inform clinical diagnosis and management of pediatric GERD, but to date there has been no comprehensive review of guideline quality or methodological rigor. Methods: A systematic literature search was performed, and a total of eight CPGs pertaining to pediatric GERD were identified. These CPGs were evaluated using the Appraisal of Guidelines for Research and Evaluation instrument. Results: Three CPGs were found to be "high" quality, with 5 of 6 domains scoring >60%, one "average" quality, with 4 of 6 domains meeting that threshold, and the remaining four "low" quality. Conclusion: Areas of strength among the CPGs included "Scope and Purpose" and "Clarity and Presentation," as they tended to be well-written and easily understood. Areas in need of improvement were "Stakeholder Involvement," "Rigor of Development," and "Applicability," suggesting these CPGs may not be appropriate for all patients or providers. This analysis found that while strong CPGs pertaining to the diagnosis and treatment of pediatric GERD exist, many published guidelines lack methodological rigor and broad applicability.

A systematic review of treatment and outcomes in patients with mandibular coronoid process hyperplasia

  • Parmentier, Griet I.L.;Nys, Margaux;Verstraete, Laurence;Politis, Constantinus
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • 제48권3호
    • /
    • pp.133-148
    • /
    • 2022
  • Treatment of mandibular coronoid process hyperplasia (MCPH) has been described and explored in the literature. This systematic review aims to provide a comprehensive overview of the surgical and non-surgical treatment options for MCPH in pediatric and adult populations. Three databases were searched for treatment of MCPH patients (MEDLINE, Embase, and Web of Science). Two reviewers selected case reports and case series based on titles and abstracts. Finally, 55 studies reporting a total of 127 cases were included for qualitative synthesis and data extraction. The mean age at symptom onset was 15.6 years, while the mean age at diagnosis was 23.5 years. Of the included cases, 83.7% were male, and the condition was bilateral in more than 81% of the cases. Coronoidectomy was performed in 82.7% of the included cases, while coronoidotomy was performed in 3.9% of the cases. In 85.0% of the surgically treated cases, the approach was intraoral. The mean maximal intraoperative mouth opening was 38.1 mm compared with 16.5 mm at diagnosis. The mean maximal postoperative mouth opening was 35.3 mm, and the mean follow-up period was 16.3 months. Maximum mouth opening was achieved intraoperatively, and non-surgical treatment after surgery aims to reduce the risk of relapse. Additional research with a higher level of evidence is necessary to confirm these findings.

유전성대사이상질환의 진단의 체계적 접근 (Systematic Approach for the Diagnosis of IEM)

  • 이홍진
    • 대한유전성대사질환학회지
    • /
    • 제14권2호
    • /
    • pp.123-134
    • /
    • 2014
  • 유전성대사장애질환의 진단과 치료는 최근들어 비약적인 발전을 하고 있으며, 치료가 불가능하여 대증적인 치료만이 가능하였던 많은 병들이 치료가 가능하 여지고 있다. 이러한 사실은 비가역적인 후유증이 생기기전의 조기진단의 중요성을 더 크게 한다. 유전성 대사장애질환은 현재 밝혀진 것만 하더라도 수백 가지의 질병에 이르며, 가까운 미래에 그 수는 수천에 이를 것으로 전망되고 있다. 이와 같은 질병의 다양성과 그 증상 및 임상적발현의 다양성은 임상의들이 정확한 진단에 이르는데 크나큰 장애요인이 되고 있다. 신생아기와 영아기 초기의 임상적인 발현은 비특이적이지만 나이가 들어가면서 다양한 특징적인 증상을 나타내게 된다. 같은 질병일지라도 잔류효소농도(residual enzyme activity)가 거의 없는 경우에는 신생아기 또는 영아기 등 이른시기에 증상이 나타나지만 잔류효소농도가 어느 정도 남아 있는 경우에는 늦게 소아기 또는 성인기에 증상을 나타내며, 유기산이나 지방산대사이상의 경우에는 이화작용이 증가되는 스트레스상태에서 갑작스런 악화를 보일 수도 있다. 본 논문에서는 이러한 다양한 증상과 검사소견들을 정리하여 보고, 그러한 증상을 일으키는 주된 질병들을 정리하여 감별진단과 검사를 체계적으로 접근할 수 있도록 하였다.

한방건강검진에서 한열허실 변증 진단의 타당성에 관한 연구 (Analytic Study of Diagnostic Validity by the Measure of Cold-Heat & Deficiency-Excess for Oriental Medical Examination)

  • 권오순;김정은;이재왕;서창운;한현영;홍상훈
    • 동의생리병리학회지
    • /
    • 제23권1호
    • /
    • pp.180-185
    • /
    • 2009
  • We are developing the methods for the objective and systematic diagnosis, but in actuality the relativity between a diagnosis of Korean medical doctor to a symptom of patients and the conformity to the expression of the Korean medical diagnostic mechanism is short of the statistical data. so, the questionnaire of Cold-Heat & Deficiency-Excess and a diagnosis of Korean medical doctor and a result of the Korean medical diagnostic mechanism, through the relationship of those, we have offered the objective data for diagnostic validity. The study group was 750 volunteers who diagnosed by Cold-Heat & Deficiency-Excess, out of 1475 volunteers who participated in Korean-Western medical examination. We compared the results of the questionnaires for Cold-Heat & Deficiency-Excess patternization through the questionnaire with a diagnosis of Korean medical doctor. we also studied the diagnostic validity for the item of the questionnaire by statistics analysis. It is proper that 9 questions of 16 questions for the Cold, 6 questions of 14 questions for the Heat, 13 questions of 14 questions for the Deficiency, 6 questions of 9 questions for the Excess, and there is close correlation between the questionnaire to the diagnosis. The difference between the questionnaire score is meaningful(p=0.000), this conforms to the diagnosis of the Korean medical doctor, so the questionnaire have the validity. The result of the questionnaire of Cold-Heat & Deficiency-Excess conform to a diagnosis of Korean medical doctor, it carries an important meaning by the measure of diagnosis, and it is necessary for further study for the significance of the medical diagnostic mechanism.

대형공정의 정성적 이상진단을 위한 공정분할전략 (A Process Decomposition Strategy for Qualitative Fault Diagnosis of Large-scale Processes)

  • 이기백
    • 한국가스학회지
    • /
    • 제4권4호
    • /
    • pp.42-49
    • /
    • 2000
  • 대부분의 화학공정은 매우 크고 복잡하기 때문에 전체 공정에 대한 진단시스템을 만드는 것은 매우 어렵다. 따라서, 대형공정을 몇 개의 부공정으로 분할하여 진단하는 체계적인 방법이 필요하다. 이 논문에서는 이상-결과 트리모델에 기반하여 정성적 이상진단을 위한 공정분할전략을 제안하였다. 분할기준으로 유연한 진단, 지식베이스의 크기축소, 및 복잡한 지식베이스의 일관된 구축을 사용하였다 부공정간의 인과관계를 연결하기 위해 통로변수를 도입한 다음 오프라인 분석을 통해 통로변수의 이상-결과 트리모델을 구축하였다 계분할이 없는 경우와 같은 진단결과를 얻을 수 있도록 온라인 진단전략을 수립하였다 제안된 방법의 유용성을 대형 보일러 공정에 대한 이상진단시스템을 통해 보였다.

  • PDF

만성피로증후군에 대한 소요산(逍遙散)과 그 변방(變方)의 효과 : 메타분석을 통한 체계적인 문헌고찰 (Effectiveness of Soyo-san (Xiaoyao-san) and its Modifications on Chronic Fatigue Syndrome: a Systematic Review and Meta-analysis)

  • 김준열;송정윤;남동현
    • 동의생리병리학회지
    • /
    • 제34권3호
    • /
    • pp.117-125
    • /
    • 2020
  • The purpose of this review is to confirm whether Soyo-san (Xiaoyao-san) and its modifications is effective on alleviating clinical symptoms in chronic fatigue syndrome (CFS) patients. We collected clinical trials (randomized controlled trial, quasi-randomized controlled trial, controlled clinical trial) to investigate the effects of Soyo-san and its modifications on general symptoms, fatigue, depression and anxiety in CFS patients. The databases used for data retrieval were Pubmed, Central Cochrane, Embase, CNKI, CQVIP, Wanfang, CiNii, OASIS, RISS, and Koreamed. We performed selection/exclusion process from the found studies to conform with prespecified criteria, and assessed the final included trials according to the Cochrane risk of bias tool. The included studies were classified based on the interventions in experimental and control group. Eight randomized controlled trials and one controlled clinical trial (total 921 participants) were eligible and their results were synthesized in the meta analysis. The synthesis showed a considerable effect of Soyo-san and its modifications on improvement of general symptoms (relative risk 0.27 [95% CI 0.19 to 0.39], Z=7.03, P<0.00001; I2=0%) and fatigue severity (SMD -1.20 [95% CI -1.46 to -0.93], Z=8.78, P<0.00001; I2=52%) in CFS patients, while Effect on depression and anxiety were inconclusive. We found that Soyo-san and its modifications were effective for improvement of general symptoms and fatigue severity in CFS post-treatment.

Deep learning convolutional neural network algorithms for the early detection and diagnosis of dental caries on periapical radiographs: A systematic review

  • Musri, Nabilla;Christie, Brenda;Ichwan, Solachuddin Jauhari Arief;Cahyanto, Arief
    • Imaging Science in Dentistry
    • /
    • 제51권3호
    • /
    • pp.237-242
    • /
    • 2021
  • Purpose: The aim of this study was to analyse and review deep learning convolutional neural networks for detecting and diagnosing early-stage dental caries on periapical radiographs. Materials and Methods: In order to conduct this review, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA) guidelines were followed. Studies published from 2015 to 2021 under the keywords(deep convolutional neural network) AND (caries), (deep learning caries) AND (convolutional neural network) AND (caries) were systematically reviewed. Results: When dental caries is improperly diagnosed, the lesion may eventually invade the enamel, dentin, and pulp tissue, leading to loss of tooth function. Rapid and precise detection and diagnosis are vital for implementing appropriate prevention and treatment of dental caries. Radiography and intraoral images are considered to play a vital role in detecting dental caries; nevertheless, studies have shown that 20% of suspicious areas are mistakenly diagnosed as dental caries using this technique; hence, diagnosis via radiography alone without an objective assessment is inaccurate. Identifying caries with a deep convolutional neural network-based detector enables the operator to distinguish changes in the location and morphological features of dental caries lesions. Deep learning algorithms have broader and more profound layers and are continually being developed, remarkably enhancing their precision in detecting and segmenting objects. Conclusion: Clinical applications of deep learning convolutional neural networks in the dental field have shown significant accuracy in detecting and diagnosing dental caries, and these models hold promise in supporting dental practitioners to improve patient outcomes.

APPLICATION OF MONITORING, DIAGNOSIS, AND PROGNOSIS IN THERMAL PERFORMANCE ANALYSIS FOR NUCLEAR POWER PLANTS

  • Kim, Hyeonmin;Na, Man Gyun;Heo, Gyunyoung
    • Nuclear Engineering and Technology
    • /
    • 제46권6호
    • /
    • pp.737-752
    • /
    • 2014
  • As condition-based maintenance (CBM) has risen as a new trend, there has been an active movement to apply information technology for effective implementation of CBM in power plants. This motivation is widespread in operations and maintenance, including monitoring, diagnosis, prognosis, and decision-making on asset management. Thermal efficiency analysis in nuclear power plants (NPPs) is a longstanding concern being updated with new methodologies in an advanced IT environment. It is also a prominent way to differentiate competitiveness in terms of operations and maintenance costs. Although thermal performance tests implemented using industrial codes and standards can provide officially trustworthy results, they are essentially resource-consuming and maybe even a hind-sighted technique rather than a foresighted one, considering their periodicity. Therefore, if more accurate performance monitoring can be achieved using advanced data analysis techniques, we can expect more optimized operations and maintenance. This paper proposes a framework and describes associated methodologies for in-situ thermal performance analysis, which differs from conventional performance monitoring. The methodologies are effective for monitoring, diagnosis, and prognosis in pursuit of CBM. Our enabling techniques cover the intelligent removal of random and systematic errors, deviation detection between a best condition and a currently measured condition, degradation diagnosis using a structured knowledge base, and prognosis for decision-making about maintenance tasks. We also discuss how our new methods can be incorporated with existing performance tests. We provide guidance and directions for developers and end-users interested in in-situ thermal performance management, particularly in NPPs with large steam turbines.

맥진 객관화를 위한 디지탈 맥진기의 진단 파라메터 연구 (A Study of Digital EPG Diagnosis Parameter for EPG Standardization)

  • 이준영;김정훈;서현우;이정환;이병채;이명호
    • 대한전기학회:학술대회논문집
    • /
    • 대한전기학회 2000년도 하계학술대회 논문집 D
    • /
    • pp.3243-3244
    • /
    • 2000
  • From ancient times, the diagnosis method of the oriental medicine has been performed by curing diseases by means of rectifying and adjusting the unbalance in the physiological function of the five viscera and the six bowels of a human body. Diseases have been diagnosed by the condition of blood circulation that cycles a human body through blood vessels by dint of the vitality of the heart. Based on such a systematic pulse diagnosis method, the article presents parameters that will be beneficial to clinical application on the basis of its analysis of the filtering for eliminating noises from pulse signals inputted from sensor group, the digital hardware dealing with signals necessary for recognition algorithm, and the structure of diagnosis algorithm and components of pulse waveform.

  • PDF

Chronic non-bacterial osteomyelitis in the jaw

  • Kim, Soung Min;Lee, Suk Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • 제45권2호
    • /
    • pp.68-75
    • /
    • 2019
  • Chronic recurrent multifocal osteomyelitis (CRMO) is one of the most severe form of chronic non-bacterial osteomyelitis (CNO), which could result in bone and related tissue damage. This autoinflammatory bone disorder (ABD) is very difficult for its clinical diagnosis because of no diagnostic criteria or biomarkers. CRMO in the jaw must be suspected in the differential diagnosis of chronic and recurrent bone pain in the jaw, and a bone biopsy should be considered in chronic and relapsing bone pain with swelling that is unresponsive to treatment. The early diagnosis of CRMO in the jaw will prevent unnecessary and prolonged antibiotic usage or unnecessary surgical intervention. The updated researches for the identification of genetic and molecular alterations in CNO/CRMO should be studied more for its correct pathophysiological causes and proper treatment guidelines. Although our trial consisted of reporting items from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), there are very few articles of randomized controlled trials. This article was summarized based on the author's diverse clinical experiences. This paper reviews the clinical presentation of CNO/CRMO with its own pathogenesis, epidemiology, recent research studies, and general medications. Treatment and monitoring of the jaw are essential for the clear diagnosis and management of CNO/CRMO patients in the field of dentistry and maxillofacial surgery.