• 제목/요약/키워드: Systematic diagnosis

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The Association of Activity Limitation on Health-Related Quality of Life and Depression in Elderly Korean Stroke Patients

  • Do-Youn Lee
    • The Journal of Korean Physical Therapy
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    • 제35권6호
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    • pp.195-199
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    • 2023
  • Purpose: The purpose of this study was to help the numerous health care workers who participate in the rehabilitation of stroke patients by understanding how limitations on the activities of stroke patients affect the health-related quality of life and depression. Methods: We investigated 527 stroke patients from the Korean's National Health and Nutrition Examination Survey (KNHANES, 2013-2018). The subjects were divided into two categories: with and without activity limitation. A medical doctor's diagnosis of depression and the EQ-5D, which measures life satisfaction connected to health, were the study's factors. Based on their level of activity limitation, the individuals' depression and health-related quality of life were compared. The odds ratios relating to activity limitation's relationships with depression and stroke patients' quality of life were computed using logistic regression analysis. Results: The diagnosis of depression in subjects with activity limitation was 16.0%, while in those with no limitation on activity it was 5.6%, and the EQ-5D index was 0.67±0.02, 0.85±0.01. For every item on the EQ-5D, there existed a significant difference in the odds ratio. Furthermore, when comparing depression with activity limitation to non-activity limitation, the odds ratio was 4.09 (2.12-7.788). Conclusion: Limitation of activities of stroke patients significantly reduces the health-related quality of life and increase the probability of depression. Therefore, treatment of stroke patients should be approached taking into consideration their psychological condition. It is also deemed necessary to have a systematic and continuous rehabilitation program.

교정치료 후 비심미적인 상악 전치부 비율을 가진 환자에서 체계적인 진단 및 치료과정을 통해 심미성이 개선된 보철 수복 증례 (Esthetic improvements through systematic diagnosis and treatment procedures in patients with unesthetic maxillary anterior teeth proportion after orthodontic treatment: Case report)

  • 이성민;최유성
    • 대한치과보철학회지
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    • 제53권3호
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    • pp.262-275
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    • 2015
  • 상악 전치부와 같은 심미성이 요구되는 부위의 치료 시에는 건강하고, 주위조직과 조화를 이루며 매력적인 미소선의 형성을 염두에 두어야 한다. 이에 관하여 미소선, 연조직 및 경조직의 형태뿐 아니라 치아의 해부학적 형태와 비율 또한 고려하여야 한다. 상악 측절치의 왜소치(peg lateralis)로 인한 치간이개 및 부적절한 치은 형태로 인해 비심미적인 상악 전치부 비율을 가진 환자에서는 교정치료만으로 심미적 수복이 이루어지기 힘들 수 있다. 이런 경우, 교정치료가 끝난 이후 치아-치은-안면 구도에서의 진단 및 분석을 통한 치은절제술 및 보철적 수복을 통해 치아간의 근/원심, 폭/길이 비율을 개선시켜야 심미적으로 만족할 만한 결과를 얻어낼 수 있다. 또한, 상악 측절치의 왜소치(peg lateralis) 치아 비율 개선을 위한 보철물 제작 시 치질삭제가 적으며 인접치와 유사한 색조가 재현 가능하고 투명도가 높은 도재 라미네이트 비니어(Porcelain laminate veneer, PLV)가 선호되고 있다. 본 증례에서는 두 명의 20세 여자 환자로 교정치료 후 상악 측절치의 왜소치로 인한 치간이개 및 부적절한 치은 형태로 인해 비심미적인 상악 전치부 비율을 가진 환자에서의 체계적인 진단 및 치료과정을 통해 심미성이 개선된 보철 수복 증례를 보고하고자 한다.

Prevalence of HER-2-Positive Invasive Breast Cancer: A Systematic Review from Iran

  • Keyhani, Elahe;Muhammadnejad, Ahad;Karimlou, Masoud
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권11호
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    • pp.5477-5482
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    • 2012
  • Background: The HER-2/neu gene is altered in 15-20% of breast cancer patients. Immunohistochemistry (IHC) is considered to be the most cost-effective method for HER-2 detection in many countries. Approximately 8,000 new cases of breast cancer are observed annually in Iran. The aims of this study were to conduct a systematic review of the literature on the rate of HER-2-positive breast cancer diagnosed by IHC in Iran. Methods: A systematic search of the medical literature using the Medline/PubMed, ISI and SID databases revealed articles published in the English and Persian languages evaluating HER-2-positive breast cancer in Iran. Results: From 22 studies, 3,033 patients were evaluated, of whom 1,350 were diagnosed as HER-2-positive by IHC HER-2 testing. The mean percentage of HER-2-positive patients was 44.5%, which is higher than that recorded in international statistics. Results of this meta-analysis showed a significant heterogeneity between ratios. There was a statistically significant difference between the results of pre- and post implementation of 2007 American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) guideline. IHC HER-2 testing has been performed in Iran for over 10 years. Similar to many other countries, before establishment of an infrastructure for IHC diagnostic tests, HER-2 testing was routinely performed in Iran. Our study showed that the statistics reported from Iran varied widely; for instance, the rate of HER-2-positive cases varied from 23.3% to 81.0%. Conclusions: Our results demonstrate that the lack of standardization and harmonization of this test have led to marked variations in breast cancer diagnosis in Iran.

Use of magnetic resonance imaging for evaluation of therapeutic response in breast cancer-related lymphedema: A systematic review

  • Forte, Antonio Jorge;Boczar, Daniel;Kassis, Salam;Huayllani, Maria T.;McLaughlin, Sarah A.
    • Archives of Plastic Surgery
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    • 제47권4호
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    • pp.305-309
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    • 2020
  • Breast cancer treatment-related lymphedema (BCRL) is a common comorbidity in breast cancer survivors. Although magnetic resonance imaging (MRI) is widely used to evaluate therapeutic response of patients with various medical conditions, it is not routinely used to evaluate lymphedema patients. We conducted a systematic review of the literature to identify studies on the use of MRI to evaluate therapy for BCRL. We hypothesized that MRI could provide information otherwise not possible through other examinations. On October 21, 2019, we conducted a systematic review on the PubMed/MEDLINE and Scopus databases, without time frame or language limitations, to identify studies on the use of MRI to evaluate therapy for BCRL. We excluded studies that investigated other applications of MRI, such as lymphedema diagnosis and surgical planning. Of 63 potential articles identified with the search, three case series fulfilled the eligibility criteria. In total, 53 patients with BCRL were included and quantitatively evaluated with MRI before and after manual lymphatic drainage. Authors used MRI or MR lymphagiography to investigate factors such as lymphatic vessel cross-sectional area, tissue water relaxation time (T2), and chemical exchange saturation transfer. The only study that compared MRI measurement with standard examinations reported that MRI added information to the therapy evaluation. MRI seems to be a promising tool for quantitative measurement of therapeutic response in patients with BCRL. However, the identified studies focused on only manual lymphatic drainage and were limited by the small numbers of patients. More studies are necessary to shed light on the topic.

귀비탕과 그 변방의 만성피로증후군 증상완화에 대한 효용성: 체계적인 문헌고찰 (Is Gwibitang and its modification beneficial for alleviating symptoms in chronic fatigue syndrome: A systematic review and meta-analysis)

  • 남동현
    • 대한한의학방제학회지
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    • 제28권2호
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    • pp.199-209
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    • 2020
  • Objectives : The purpose of this systematic review is to confirm whether Gwibitang is beneficial in chronic fatigue syndrome (CFS). Methods : Clinical trials were searched from databases including Pubmed, Embase, Central Cochrane, CNKI, Wanfang, CQVIP, CiNii, OASIS, Koreamed, and NDSL. The eligible study design was limited into randomized controlled trial, quasi-randomized controlled trial and controlled clinical trial. The outcomes included general effectiveness as nominal scale, and fatigue severity, insomnia severity and quality of life as interval or ratio scale. The meta-analysis and assessment of risk of bias was performed based on the data extracted from the selected trials. Results : The results of eight randomized controlled trials (n=596) were included in the meta-analysis. The results of the synthesis showed Gwibitang is beneficial substantially for relieving and managing the general symptoms, and its heterogeneity was not in important level (RR 0.26 [95% CI 0.17, 0.39], Z=6.47, P<0.00001, I2=0%). Gwibitang was beneficial for alleviating fatigue (SMD -0.78 [95% CI -1.27, -0.30], Z=3.17, P=0.002), but its certainty was low. In case of insomnia, too few trials had been found and their risk of bias was substantial, so no conclusions had been brought to. Conclusions : We found an evidence that Gwibitang could be beneficial for managing and alleviating main symptoms in CFS patients.

Motor imagery on upper extremity function for persons with stroke: a systematic review and meta-analysis

  • Lee, Dongsu;Hwang, Sujin
    • Physical Therapy Rehabilitation Science
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    • 제8권1호
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    • pp.52-59
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    • 2019
  • Objective: The purpose of this review was to investigate whether motor imagery training has an effect on the recovery of upper extremity function in individuals with hemiparetic stroke or not. Design: A systematic review and meta-analysis. Methods: PubMed and three other databases were searched up to December 18th, 2018 and randomized controlled trials (RCTs) evaluating motor imagery training on upper extremity function in persons with a diagnosis of hemiparetic stroke were included. This review selected the following information from each study: surname of the first author, published year, nation, population, intervention, therapeutic intensity of intervention, therapeutic comparison, outcome measures, additional therapy, summary of results, and descriptive statistics of outcome measures. Results: This review selected seventeen RCTs with 487 stroke survivors and the following intervention methods: six motor imagery training with additional therapeutic technology, two motor imagery training with additional modified constraint-induced therapy, four mirror therapy, and five motor imagery training. Ten RCTs were eligible for meta-analysis after systematic review. The motor imagery group were more effective than the control group based on the Fugl-Meyer assessment (3.43; 95% confidence interval [CI], 1.65 to 5.22; heterogeneity [$chi^2=8.03$, df=8, $I^2=0%$], test of overall effect Z=3.76; test for subgroup differences [$chi^2=2.56$, df=2, $I^2=21.8%$]) and the Action Research Arm Test (1.32; 95% CI, -8.12 to 10.76; heterogeneity [$Tau^2=70.74$, $chi^2=15.22$, df=3, $I^2=80%$], test of overall effect Z=3.76). Conclusions: The results of this review suggests that motor imagery shows positive effectiveness on improving upper extremity function in persons with hemiparetic stroke.

The Kernohan-Woltman Notch Phenomenon : A Systematic Review of Clinical and Radiologic Presentation, Surgical Management, and Functional Prognosis

  • Beucler, Nathan;Cungi, Pierre-Julien;Baucher, Guillaume;Coze, Stephanie;Dagain, Arnaud;Roche, Pierre-Hugues
    • Journal of Korean Neurosurgical Society
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    • 제65권5호
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    • pp.652-664
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    • 2022
  • The Kernohan-Woltman notch phenomenon (KWNP) refers to an intracranial lesion causing massive side-to-side mass effect which leads to compression of the contralateral cerebral peduncle against the free edge of the cerebellar tentorium. Diagnosis is based on "paradoxical" motor deficit ipsilateral to the lesion associated with radiologic evidence of damage to the contralateral cerebral peduncle. To date, there is scarce evidence regarding KWNP associated neuroimaging patterns and motor function prognostic factors. A systematic review was conducted on Medline database from inception to July 2021 looking for English-language articles concerning KWNP, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The research yielded 45 articles for a total of 51 patients. The mean age was 40.7 years-old and the male/female sex ratio was 2/1. 63% of the patients (32/51) suffered from head trauma with a majority of acute subdural hematomas (57%, 29/51). 57% (29/51) of the patients were in the coma upon admission and 47% (24/51) presented pupil anomalies. KWNP presented the neuroimaging features of compression ischemic stroke located in the contralateral cerebral peduncle, with edema in the surrounding structures and sometimes compression stroke of the cerebral arteries passing nearby. 45% of the patients (23/51) presented a good motor functional outcome; nevertheless, no predisposing factor was identified. A Glasgow coma scale (GCS) of more than 3 showed a trend (p=0.1065) toward a better motor functional outcome. The KWNP is a regional compression syndrome oftentimes caused by sudden and massive uncal herniation and leading to contralateral cerebral peduncle ischemia. Even though patients suffering from KWNP usually present a good overall recovery, patients with a GCS of 3 may present a worse motor functional outcome. In order to better understand this syndrome, future studies will have to focus on more personalized criteria such as individual variation of tentorial notch width.

불면 장애에 대한 족욕 치료법의 체계적 문헌고찰과 메타분석 연구 (A Systematic Review and Meta-Analysis of Foot Bath Therapy for Insomnia Disorder)

  • 김동현;조준희;임정화;김보경
    • 동의신경정신과학회지
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    • 제34권3호
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    • pp.163-179
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    • 2023
  • Objectives: The purpose of this study was to provide evidence for the clinical effects of foot bath therapy for insomnia disorder through a systematic review and meta-analysis. Methods: Studies were selected from seven domestic and international literature databases. Data on diagnostic tools, pattern identification, sample size, intervention methods, outcome measurements, results, and adverse events were extracted. The quality of the selected literature was assessed using Cochrane's risk of bias (RoB) assessment tool. Results: A total of 11 studies were included in this study. The primary diagnostic tool for insomnia dis- order was the criteria for the diagnosis and therapeutic effect of diseases and syndromes in traditional Chinese medicine (CDTDSTCM), along with the Chinese classification of mental disorders-3 (CCMD-3). Treatment effects were mainly evaluated by the effective rate and the Pittsburgh Sleep Quality Index (PSQI). The meta-analysis results showed statistically higher effectiveness rates for treating insomnia disorder in the experimental groups receiving herbal medicine foot bath therapy with sleeping or herbal medication compared to the control group. The PSQI was lower in the treatment group receiving herbal medicine foot bath therapy with sleeping medication. The herbal materials used in herbal medicine foot bath therapy mainly included Radix Angelicae Sinensis, Polygonum Multiflorum, Ziziphi Spinosae Semen, Rhizoma Coptidis, Radix Salviae Miltiorrhizae, and Cortex Albizziae. The quality of the included studies was generally poor. Conclusions: This study found that foot bath therapy had clinical efficacy for treating insomnia disorder. The research findings could provide foundational evidence for establishing the clinical basis of foot bath therapy in the treatment of insomnia.

치과위생사의 치주병환자 구강보건교육 실태 및 전략 수립에 관한 연구 (The status and strategy of oral health education of dental hygienist on periodontal patients)

  • 문애은;문하영
    • 한국치위생학회지
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    • 제11권2호
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    • pp.149-158
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    • 2011
  • Objectives : The objective of this study was to analyze cognition and status of oral health education of dental hygienists who manage the patients visiting dental clinics and to utilize the findings as continuous study data required for development of systematic oral health education program for management of peridontal disease of adults. Methods : Survey was carried out for 261 dental hygienists working in dental clinics who are performing oral health education of patients with peridontal disease living. Results : 1. In the socio-dynamic diagnosis, it was analyzed that, the younger the age is and the lower the career is, the more the work is centered around assisting medical treatment job and, the older the age is and the higher the career is, the work is centered around oral health education job. 2. In the behavioral diagnosis, it was analyzed that, as to source of knowledge acquisition, guide of dentists and senior dental hygienists was the highest and, as to education media, visual education and demonstration education were mainly used. 3. In educational diagnosis, as to the degree of knowledge about oral health education and the degree of practice, it showed that the degree of knowledge was lower than the degree of practice in peridontal disease process and oral prophylaxis as well as scaling part. 4. In both the cases of independent practice and group practice, it showed that the most frequent obstacle was insufficient educational materials and tools and it was analyzed that acquisition of new knowledge and technology is required as a matter to be improved. Conclusions : It seems to be required for the dental hygienists to develop detailed knowledge and professional technology in order to induce actions and motive of patients during oral health education of peridontal patients and to develop and produce data for efficient education of peridontal patients.

두통의 분류와 진단의 동서의학적 고찰 (The Study about the Comparison of Oriental-Western Medicine on the Classification and Diagnosis of Headache)

  • 정찬영;김은정;장민기;윤은혜;남동우;강중원;이승덕;이재동;김갑성
    • Journal of Acupuncture Research
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    • 제26권6호
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    • pp.225-239
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    • 2009
  • Objectives : To establish a well organized and systematic oriental medicine classification of headache, the western and oriental medicine diagnosis and treatment systems of headache were reviewed. Methods : The history and development process of western medicine classification of headache were studied. A literature review of oriental medicine classification of headache was done. The characters of each classification systems were assessed. Results : In western medicine, many international societies concerning headache have been established. Through these societies, a classification of headache which can be used by both researchers and practitioners has been suggested. And the suggested classification system is highly recommended to be used in studies in order to increase utilization. As data is accumulated, new versions of the classification system were updated. But in the case of oriental medicine, various classification systems of headache are presented in numerous literatures. But the effort to unify and systemize the oriental medicine headache classification has been in lack. Conclusions : Establishment and utilization of a standardized oriental medicine headache classification system, based on various classifications and detailed descriptions is needed.

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