• 제목/요약/키워드: Systematic diagnosis

검색결과 467건 처리시간 0.022초

Evidence-based management of isolated dentoalveolar fractures: a systematic review

  • Samriddhi Burman;Babu Lal;Ragavi Alagarsamy;Jitendra Kumar;Ankush Ankush;Anshul J. Rai;Md Yunus
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • 제50권3호
    • /
    • pp.123-133
    • /
    • 2024
  • Dentoalveolar (DA) trauma, which can involve tooth, alveolar bone, and surrounding soft tissues, is a significant dentofacial emergency. In emergency settings, physicians might lack comprehensive knowledge of timely procedures, causing delays for specialist referral. This systematic review assesses the literature on isolated DA fractures, emphasizing intervention timing and splinting techniques and duration in both children and adults. This systematic review adhered to PRISMA guidelines and involved a thorough search across PubMed, Google Scholar, Semantic Scholar, and the Cochrane Library from January 1980 to December 2022. Inclusion and exclusion criteria guided study selection, with data extraction and analysis centered on demographics, etiology, injury site, diagnostics, treatment timelines, and outcomes in pediatric (2-12 years) and adult (>12 years) populations. This review analyzed 26 studies, categorized by age into pediatrics (2-12 years) and adults (>12 years). Falls were a common etiology, primarily affecting the anterior maxilla. Immediate management involved replantation, repositioning, and splinting within 24 hours (pediatric) or 48 hours (adult). Composite resin-bonded splints were common. Endodontic treatment was done within a timeframe of 3 days to 12 weeks for children and 2-12 weeks for adults. Tailored management based on patient age, tooth development stage, time elapsed, and resource availability is essential.

체계적인 방위산업기술보호를 위한 보호체계 우선순위 분석 연구 (Analysis of Security System Priority for the Systematic Defense Technology Security)

  • 박흥순;김세용;김용환
    • 융합보안논문지
    • /
    • 제19권4호
    • /
    • pp.3-12
    • /
    • 2019
  • 방위산업기술의 유출은 해당 기업의 영업 손실뿐만 아니라 국가안보 및 국익 차원에서도 심각한 피해를 야기할 수 있다. 최근 정부는 방위산업기술의 중요성을 인식하여 방위산업기술보호법을 제정하였고, 그에 따른 방위산업기술 보호지침을 마련하였다. 법규에 따르면 방위산업기술을 보유한 기관 및 업체는 방위산업기술 보호체계를 구축해야 하며, 정부는 이들의 기술보호 수준 향상을 위해 다양한 기술보호 정책을 수립하고 추진해야 한다. 본 연구에서는 기존의 기술보호지침에 대한 비교를 통해 시사점을 도출하고 방위산업기술 보호지침의 자가진단 항목을 대상으로 AHP 기법을 통해 보호체계 세부항목에 대한 우선순위 분석을 하였다. 이를 통해 대상기관에 대한 보호수준의 효율적 진단과 보호체계의 체계적인 구축을 위한 정책 지원이 가능할 것으로 기대된다.

Are p53 Antibodies a Diagnostic Indicator for Patients with Oral Squamous Cell Carcinoma? Systematic Review and Meta-Analysis

  • Yang, Zhi-Cheng;Ling, Li;Xu, Zhi-Wei;Sui, Xiao-Dong;Feng, Shuang;Zhang, Jun
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제17권1호
    • /
    • pp.109-115
    • /
    • 2016
  • Background: P53 has been reported to be involved with tumorigenesis and has also been implicated as a significant biomarker in oral squamous cell carcinoma(OSCC). However, the diagnostic value of p53 antibodies remains controversial; hence, we comprehensively and quantitatively assessed the potential in the present systematic review. Materials and Methods: A comprehensive search was performed using PubMed and Embase, up to October 31, 2014, without language restriction. Studies were assessed for quality using QUADAS (quality assessment of studies of diagnostic accuracy). The positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were pooled separately and compared with overall accuracy measures using diagnostic odds ratios (DORs) and symmetric summary receiver operating characteristic (SROC) curves. Results: Of 150 studies initially identified, 7 eligible regarding serum p53 antibodies met the inclusion criteria. Some 85.7% (6/7) were of relatively high quality (QUADAS $score{\geq}7$). The summary estimates for quantitative analysis of serum p53 antibody in the diagnosis of squamous cell carcinoma were: PLR 2.06 [95% confidence interval (CI) : 1.35-3.15], NLR 0.85 (95%CI: 0.80-0.90) and DOR 2.47 (95%CI: 1.49-4.12). Conclusions: This meta-analysis suggests that the use of s-p53-antibodies has potential diagnostic value with relatively high sensitivity and specificity for OSCC particularly with serum specimens for discrimination of OSCCs from healthy controls. However, its discrimination power is not perfect because of low sensitivity.

Comparison of Interferon-γ Release Assays and the Tuberculin Skin Test for Diagnosis of Tuberculosis in Human Immunodeficiency Virus: A Systematic Review

  • Overton, Kristen;Varma, Rick;Post, Jeffrey J.
    • Tuberculosis and Respiratory Diseases
    • /
    • 제81권1호
    • /
    • pp.59-72
    • /
    • 2018
  • Background: It remains uncertain if $interferon-{\gamma}$ release assays (IGRAs) are superior to the tuberculin skin test (TST) for the diagnosis of active tuberculosis (TB) or latent tuberculosis infection (LTBI) in immunosuppressed populations including people with human immunodeficiency virus (HIV) infection. The purpose of this study was to systematically review the performance of IGRAs and the TST in people with HIV with active TB or LTBI in low and high prevalence TB countries. Methods: We searched the MEDLINE database from 1966 through to January 2017 for studies that compared results of the TST with either the commercial QuantiFERON-TB Gold in Tube (QFTGT) assay or previous assay versions, the T-SPOT.TB assay or in-house IGRAs. Data were summarized by TB prevalence. Tests for concordance and differences in proportions were undertaken as appropriate. The variation in study methodology was appraised. Results: Thirty-two studies including 4,856 HIV subjects met the search criteria. Fourteen studies compared the tests in subjects with LTBI in low TB prevalence settings. The QFTGT had a similar rate of reactivity to the TST, although the first-generation version of that assay was reactive more commonly. IGRAs were more frequently positive than the TST in HIV infected subjects with active TB. There was considerable study methodology and population heterogeneity, and generally low concordance between tests. Both the TST and IGRAs were affected by CD4 T-cell immunodeficiency. Conclusion: Our review of comparative data does not provide robust evidence to support the assertion that the IGRAs are superior to the TST when used in HIV infected subjects to diagnose either active TB or LTBI.

Head and neck radiotherapy-induced changes in dentomaxillofacial structures detected on panoramic radiographs: A systematic review

  • Munhoz, Luciana;Nishimura, Danielle Ayumi;Iida, Christyan Hiroshi;Watanabe, Plauto Christopher Aranha;Arita, Emiko Saito
    • Imaging Science in Dentistry
    • /
    • 제51권3호
    • /
    • pp.223-235
    • /
    • 2021
  • Purpose: This study aimed to summarize the impact of neck and head radiation treatment on maxillofacial structures detected on panoramic radiographs. Materials and Methods: In this systematic review, the authors searched PubMed Central, Embase, Scopus, Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar for original research studies up to February 2020 that included the following Medical Subject Headings keywords: words related to "radiotherapy" and synonyms combined with keywords related to "panoramic radiography" and "oral diagnosis" and synonyms. Only original studies in English that investigated the maxillofacial effects of radiotherapy via panoramic radiographs were included. The quality of the selected manuscripts was evaluated by assessing the risk of bias using Cochrane's ROBINS-I tool for non-randomized studies. Results: Thirty-three studies were eligible and included in this review. The main objectives pertained to the assessment of the effects of radiation on maxillofacial structures, including bone architecture alterations, periodontal space widening, teeth development abnormalities, osteoradionecrosis, and implant bone loss. The number of participants evaluated ranged from 8 to 176. Conclusion: The interaction between ionizing radiation and maxillofacial structures results in hazard to the tissues involved, particularly the bone tissue, periosteum, connective tissue of the mucosa, and endothelium. Hard tissue changes due to radiation therapy can be detected on panoramic radiographs.

A systematic review of therapeutic outcomes following treatment of squamous cell carcinoma of the retromolar trigone

  • Kim, Hye-Won;Kim, Moon-Young;Kim, Chul-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • 제47권4호
    • /
    • pp.291-314
    • /
    • 2021
  • Squamous cell carcinoma (SCC) of the retromolar trigone (RMT) is a rare but potentially fatal disease that carries a poor prognosis due to its unique anatomic position. RMT SCCs tend to spread to vital nearby structures, including the tonsillar pillar, masticatory muscles, and underlying mandibular bone, even in their early stages, and aggressive treatment is often warranted. This systematic review appraises and qualitatively analyzes all available literature regarding the survival outcomes and prognosis of RMT SCC. Four databases were searched to identify all eligible articles published since January 1980. Of the 1,248 studies, a total of 15 studies representing 4,838 cases met the inclusion criteria. The evaluated patients had a high rate of advanced tumor stage (T3 or T4: 61.4%), lymph node metastasis (38.8%), and mandibular bone invasion (24%) at the time of diagnosis. Aggressive surgical treatments such as lip-splitting (92%), segmental mandibulectomy (61.1%), radical neck dissection (44.1%), and reconstruction using free flaps (49.5%) was undertaken for 92% of the pooled patient population. The mean rates for local, regional, and systemic recurrence were 23.40%, 8.40%, and 8.50%, respectively. The mean 5-year overall survival rate was 38.90%. Osteonecrosis was noted in 11.6% of the 328 patients who received radiotherapy. In conclusion, RMT SCC is generally associated with high recurrence, low survival, and high postoperative complication rates. Early diagnosis and aggressive treatment are thus warranted. However, significant methodological problems hamper current knowledge. Future studies of this topic that use randomized or cohort designs are thus needed.

Incidence and management of condylar resorption after orthognathic surgery: An overview

  • Barone, Selene;Cosentini, Giorgio;Bennardo, Francesco;Antonelli, Alessandro;Giudice, Amerigo
    • 대한치과교정학회지
    • /
    • 제52권1호
    • /
    • pp.29-41
    • /
    • 2022
  • Objective: Condylar resorption (CR) is one of the major post-surgical complications of orthognathic surgery. This systematic review (SR) aimed to evaluate epidemiological data, risk factors, and therapeutical management of CR. Methods: Six databases were screened by two investigators until September 2020 to obtain all SRs. After reading the titles and abstracts, eligible SRs were determined and data extraction was performed. Using the latest version of A Measurement Tool to Assess Systematic Reviews, the methodological quality of the included SRs was determined. Results: Ten SRs with low or critically-low methodological quality were included in this review. Mandibular hypoplasia on the sagittal plane and hyperdivergent growth pattern on the vertical plane were the most common skeletal alterations in which CR could occur after orthognathic surgery. Post-operative condylar changes were analyzed both on two-dimensional and three-dimensional (3D) radiographic examinations. The incidence of CR was not related to the fixation method. Based on the severity of the pathological conditions, management of CR can include conservative or surgical therapy. Conclusions: Despite the limited evidence in literature, CR is considered a consequence of orthognathic surgery. However, an accurate diagnosis of CR and a better orthognathic surgical planning must include 3D radiographic examinations to improve pre- and post-surgical comparison. Well-designed studies with long-term follow-up and 3D data are needed to clarify the findings of this analysis..

허로에 대한 국내 연구동향 분석 및 연구방향 제안 (Review of Research Topics on Consumptive Disease and Chronic Fatigue)

  • 김지혜;김재욱;김근호
    • 동의생리병리학회지
    • /
    • 제27권5호
    • /
    • pp.587-593
    • /
    • 2013
  • Exhaustion syndrome(虛勞) became broadly experienced symptoms in Korean population. In this work, we carried out a systematic literature review on exhaustion syndrome(ES) and chronic fatigue. We searched through the databases Koreanstudies Information Service System, Oriental Medicine Advanced Searching Integrated System, DataBase Periodical Information Academic for the articles published between 1994 and 2013, with the keywords 'exhaustion syndrome(虛勞)', 'consumption(虛損)', 'overexertion syndrome(勞倦)', 'fatigue', 'chronic fatigue' and 'degree of fatigue'. Among the first-run rough-searched 602 articles, we narrowed down the scope within the field of Oriental medicine (126 articles), and finally selected 28 articles appropriate to the intended research field; the selected articles were categorized by literature study(7 papers), clinical treatment (7), clinical diagnosis (5), treatment effects of herbal medicine (2), diagnosis in Sasang medicine and treatment effect of dry cupping therapy (2), and questionnaire-based diagnosis (5). We found that the overall research level on ES remained in the preliminary stages, and more efforts are needed in the field of terminology definition and standardization of diagnosis, and treatment efficacy validation beyond muscle fatigue. Finally, to develop reliable diagnostic devices on ES, we proposed a study design that included the development of objective ES diagnostic indicators and a clinical validation procedure.

Systematic Review on Epstein-Barr Virus (EBV) DNA in Diagnosis of Nasopharyngeal Carcinoma in Asian Populations

  • Han, Bao-Lin;Xu, Xiang-Ying;Zhang, Chun-Zhi;Wu, Jian-Juan;Han, Chun-Feng;Wang, Hui;Wang, Xuan;Wang, Guang-Shun;Yang, Shu-Juan;Xie, Yao
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제13권6호
    • /
    • pp.2577-2581
    • /
    • 2012
  • Objective: To conduct a meta-analysis to investigate the value of EBV DNA in diagnosis of nasopharyngeal cancer (NPC) in Asian populations, and provide important evidence for screening. Methods: Prospective or respective case-control or cohort studies regarding the detection role of EBV DNA for NPC were included in our study. We conducted a comprehensive literature search in PubMed, EMBASE, and the Chinese Biomedical Database (CBM database between January 1980 and March 2012. Results: A total of 18 studies with 1492 NPC cases and 2641 health controls were included. Almost of the included studies were conducted in China, and only one other conducted in Thailand. The overall results demonstrated that the pooled sensitivity, specificity, positive likelihood (+LR) and negative likelihood (-LR) were 0.73 (0.71-0.75), 0.89 (0.88-0.90), 8.84 (5.65-13.84) and 0.19(0.11-0.32), respectively. The overall EBV DNA detection showed the largest area of 0.932 under the summary receiver operator curve (SROC). The accuracy of detection by plasma for NPC (0.86) was higher than in serum (0.81), with largest areas under the SROC of 0.97 and 0.91, respectively. Conclusion: Our results demonstrated the EBV DNA detection in plasma or serum has high sensitivity and specificity in diagnosis of NPC, especially in Chinese populations with a high risk of cancer.

Post-traumatic Stress Disorder and Post-traumatic Growth in Breast Cancer Patients - a Systematic Review

  • Parikh, Darshit;Ieso, Paolo De;Garvey, Gail;Thachil, Thanuja;Ramamoorthi, Ramya;Penniment, Michael;Jayaraj, Rama
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제16권2호
    • /
    • pp.641-646
    • /
    • 2015
  • Breast cancer (BC) is potentially a traumatic stressor which may be associated with negative outcomes, such as post-traumatic stress disorder (PTSD) or positive changes, such as post-traumatic growth (PTG). This study aims to identify the core issues of BC related PTSD, PTG and psychological distress by interrogating the literature in BC survivors. We have also highlighted issues related to the assessment, diagnosis and clinical management of PTSD and PTG. The authors systematically reviewed studies published from 1985 to 2014 pertaining to PTSD, psychological distress and PTG in BC survivors with particular attention paid to incidence rates and causative factors. Multiple studies intimated that women with BC have evidence of PTSD at the initial stages of diagnosis, whereas PTG develops once patients undergo treatment. Early diagnosis and treatment of PTSD/PTG is paramount from literature review but the previously mentioned relationship between PTSD and PTG in BC patients could not be verified. It is evident from the literature that a small percentage of BC patients experience PTSD, while the majority experience PTG after BC diagnosis and treatment. Future research should include prospective studies focusing on high-risk patients, causative factors and the development of psychological interventions.