• 제목/요약/키워드: Treatment guideline

검색결과 704건 처리시간 0.029초

Imaging follow-up strategy after endovascular treatment of Intracranial aneurysms: A literature review and guideline recommendations

  • Yong-Hwan Cho;Jaehyung Choi;Chae-Wook Huh;Chang Hyeun Kim;Chul Hoon Chang;Soon Chan KWON;Young Woo Kim;Seung Hun Sheen;Sukh Que Park;Jun Kyeung Ko;Sung-kon Ha;Hae Woong Jeong;Hyen Seung Kang;Clinical Practice Guideline Committee of the Korean Neuroendovascular Society
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • 제26권1호
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    • pp.1-10
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    • 2024
  • Objective: Endovascular coil embolization is the primary treatment modality for intracranial aneurysms. However, its long-term durability remains of concern, with a considerable proportion of cases requiring aneurysm reopening and retreatment. Therefore, establishing optimal follow-up imaging protocols is necessary to ensure a durable occlusion. This study aimed to develop guidelines for follow-up imaging strategies after endovascular treatment of intracranial aneurysms. Methods: A committee comprising members of the Korean Neuroendovascular Society and other relevant societies was formed. A literature review and analyses of the major published guidelines were conducted to gather evidence. A panel of 40 experts convened to achieve a consensus on the recommendations using the modified Delphi method. Results: The panel members reached the following consensus: 1. Schedule the initial follow-up imaging within 3-6 months of treatment. 2. Noninvasive imaging modalities, such as three-dimensional time-of-flight magnetic resonance angiography (MRA) or contrast-enhanced MRA, are alternatives to digital subtraction angiography (DSA) during the first follow-up. 3. Schedule mid-term follow-up imaging at 1, 2, 4, and 6 years after the initial treatment. 4. If noninvasive imaging reveals unstable changes in the treated aneurysms, DSA should be considered. 5. Consider late-term follow-up imaging every 3-5 years for lifelong monitoring of patients with unstable changes or at high risk of recurrence. Conclusions: The guidelines aim to provide physicians with the information to make informed decisions and provide patients with high-quality care. However, owing to a lack of specific recommendations and scientific data, these guidelines are based on expert consensus and should be considered in conjunction with individual patient characteristics and circumstances.

성장기 부정교합환자의 근신경계 부조화를 해소한 증례: 교정치료 과정과 결과를 모니터링하기 위한 근전도검사(EMG)의 임상적 응용 (Clinical Application of Electromyography for Monitoring Procedure and Result of Orthodontic Treatment ; A of Three Cases)

  • 차봉근;이남기;최동순;김상호
    • 구강회복응용과학지
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    • 제22권1호
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    • pp.89-100
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    • 2006
  • Traditionally, goals of orthodontic treatment fall into four categories: good tooth alignment, improvement of skeletal profile and good soft tissue, and rehabilitation of the normal function. Electromyography (EMG) has proven as useful tool in evaluating masticatory function among the maxillomandibular relationship and could be useful in accompanying orthodontic treatment objectives. But in pursuit of clinical application, it is necceassry to systemize clinical guideline for diagnosis by EMG records in evaluating the effects of orthodontic, orthopedic, or surgical treatment. This study present 3 orthodontic cases, which treatment results, ie neuromuscular balances of masticatory muscle, could be moitered by EMG procedure.

급성기 양극성우울증 약물치료 전략 (Pharmacological Treatment Strategies for Acute Bipolar Depression)

  • 김세주
    • 신경정신의학
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    • 제57권4호
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    • pp.287-300
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    • 2018
  • Of the different phases of bipolar disorder, bipolar depression is more prevailing and is more difficult to treat. However, there is a deficit in systemic research on the pharmacological treatment of acute bipolar depression. Therefore, consensuses on the pharmacological treatment strategies of acute bipolar depression has yet to be made. Currently, there are only three drugs approved by the Food and Drug Administration for acute bipolar depression : quetiapine, olanzapine-fluoxetine complex, and lurasidone. In clinical practice, other drugs such as mood stabilizers (lamotrigine, lithium, valproate) and/or the other atypical antipsychotics (aripiprazole, risperidone, ziprasidone) are frequently prescribed. There remains controversy on the use of antidepressants in bipolar depression. Here, we summarized the evidence of current pharmacological treatment options and reviewed treatment guidelines of acute bipolar depression from recently published studies.

Treatment Strategies of Improving Quality of Care in Patients With Heart Failure

  • Se-Eun Kim;Byung-Su Yoo
    • Korean Circulation Journal
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    • 제53권5호
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    • pp.294-312
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    • 2023
  • Heart failure (HF) is a global health problem closely related to morbidity and mortality. As the burden of HF increases, it is necessary to manage and treat this condition well. However, there are differences between real-world practice and guidelines for the optimal treatment for HF. Patient-related, healthcare provider-related, and health system-related factors contribute to poor adherence to optimal care. This review article aims to examine HF treatment patterns and treatment adherence in real-world practice, identify clinical gaps to suggest ways to improve the quality of care for HF and clinical outcomes for patients with HF. Although it is important to optimize treatment based on evidence-based guidelines to the greatest extent, it is known that there is still poor treatment adherence, and many patients do not receive guideline-directed medical therapy, especially at the early stages. To improve medication adherence, qualitative evaluation through performance measurement, as well as education of patients, caregivers and medical staff through a multidisciplinary approach are important.

기계가공 공정에서 금속가공유 관리에 대한 평가지침 -수용성 금속가공유를 중심으로- (Assessment guideline for the safe use of metalworking fluids - Focused on water-soluble metalworking fluids)

  • 박동욱
    • 한국산업보건학회지
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    • 제20권2호
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    • pp.131-138
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    • 2010
  • This technical report was developed to suggest the guideline to assess the safe use and handling metalworking fluids (MWFs) in machining operation. The basis of this method developed in this study was based on self assessment procedure recommended by Organization Resources Counselors (ORC) of the United States (US). In addition, various MWF management elements obtained from the review on various articles, reports and author's experience regarding MWF were newly added to the evaluation guideline. A total of four areas were finally selected in order to control exposure to MWF used in machining operations. They are all related to the presence and efficiency of the control measures, exposure assessment, management on tank and sump, and safe treatment of chips and metal fines generated during machining operations. Each area is consisted of several related elements. Several evaluation areas and elements used in this study could be revised, replaced, added and deleted according to the process environment, evaluation objectives and evaluator's (manager) criteria etc. This evaluation guide manual could be used for safe management of MWF in metalworking operation. In addition, industrial hygienists can use this evaluation method for auditing and evaluating the management status on MWF.

미국 FAA 신체검사 기준 및 AME 보수교육 변화동향: 한국과의 비교 (US FAA Physical Examination Standards and Amendment of AME Conservation Education: Comparison with Korea)

  • 김영효
    • 항공우주의학회지
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    • 제28권3호
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    • pp.52-55
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    • 2018
  • The purpose of the aviation physical examination guideline is not only to determine the physical fitness of the aviation workers but also to treat the underlying diseases of the aviation employees effectively and to carry out the optimal aviation duties. As medical science advances, treatment guidelines for various diseases are rapidly changing, and aviation physical examination guidelines need to be revised accordingly. Therefore, it is necessary to analyze the change trends of the AME guideline around the world and appropriately reflect it according to the situation of Korea. It is also necessary to continue the training of AME who are required to carry out examinations and certificates by these revision guidelines. Therefore, it would be desirable to analyze the education system of the advanced countries including the US and introduce the advantages of these systems into Korean AME education curriculum. Primarily, with the development of the Internet, various online lectures have been developed recently. Therefore, we first aimed to look at the changes in the current AME guideline of the Federal Aviation Administration. Next, we aimed to discuss changes in the course of the AME refresher course. Finally, we would like to suggest some points to be improved by comparing these AME guidelines and educational programs with those of Korea.

패혈증과 패혈쇼크의 치료 지침 (Treatment Guidelines of Sepsis and Septic Shock)

  • 이흥범;문희
    • Tuberculosis and Respiratory Diseases
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    • 제67권6호
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    • pp.491-498
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    • 2009
  • Severe sepsis and septic shock are major healthcare problems with high mortality, ranging from 20% to 60%, affecting millions of individuals around the world each year. The speed and appropriateness of therapy administered in the initial hours after severe sepsis develops have an important impact on the outcome. In 2004, an international guideline that the bedside clinician could use to improve the outcomes in severe cases of sepsis and septic shock was published. Several landmark studies recently demonstrated that therapeutic strategies may reduce mortality substantially. The "Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock: 2008", using a new evidence-based methodology system for assessing the quality of evidence and the strength of the recommendations, was updated. The revised version is based on an updated search into 2007. Evidenced-based recommendations regarding the acute management of sepsis and septic shock are the first step toward improving the outcomes of critically ill patients. We review the treatment guidelines of sepsis and septic shock.

저강도 초음파 치료기기의 안전성 및 성능평가 가이드라인 수립을 위한 연구 (A Study on the Safety and Performance Test Guideline of Low Intensity Therapeutic Ultrasound Device)

  • 김주영;김재영;노시철;최흥호
    • 대한의용생체공학회:의공학회지
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    • 제36권5호
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    • pp.162-168
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    • 2015
  • In this study, we suggested the performance and safety testing guideline for low intensity pulsed ultrasound (LIPUS) represented by the ultrasound fracture treatment device and cartilage treatment device and low intensity focused ultrasound (LIFU) represented by ultrasonic face lifting device. For these study, the international standards and management regulations of Korea, Japan and United State were analyzed. And the usefulness and applicability were evaluated by testing with commercial equipment and reflecting the views of the industry and experts. As a result of this study, the safety and performance test guidelines for low intensity therapeutic ultrasound device were proposed by presenting the 10 items for LIPUS and 12 items for LIFU. The suggested guidelines are considered a high utilization in the domestic testing and approval authorities. And they are also thought to be useful to new technology development.

Change Pattern of Species and Antimicrobial Susceptibility of Microorganisms Isolated from Blood Culture during 5 Years: 2008-2012

  • Shin, Kyung-A;Shin, Kyeong Seob;Hong, Seung Bok
    • 대한의생명과학회지
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    • 제19권3호
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    • pp.245-253
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    • 2013
  • To provide reference data or guideline for empirical treatment of bloodstream infection, we studied a change pattern in causative microorganisms and antimicrobial susceptibility in a general hospital at Gyeonggi province during five years. We retrospectively reviewed the frequency of causative microorganisms and antimicrobial susceptibility results of 5,782 microorganisms isolated from blood culture in a general hospital during the period from January 2008 to December 2012. The most common pathogens were Escherichia coli (14.7%), Staphylococcus aureus (7.5%), Streptococcus viridans group (4.9%), and Klebsiella pneumoniae (4.1%). The multiple microorganisms were isolated in 4.3% of bloodstream infection patients. The average contamination rate of blood culture during five years was 3.0%. Methicillin-resistant S. aureus (MRSA), vancomycin-resistant Enterococcus faecium (VRE), and penicillin-resistant Streptococcus pneumoniae were isolated at 62%, 27% and 11%, respectively. Cefotaxime-resistant E. coli and K. pneumoniae was 20% and 18%, respectively. Imipenem-resistant Pseudomonas aeruginosa (IRPA) and Acinetobacter baumannii (IRAB) was 25% and 66%, respectively. E. coli and S. aureus were most common pathogens isolated from blood culture for five years. The increase of multidrug-resistant microorganisms, such as MRSA, VRE, ESBL, IRPA and IRAB, requires more strict control of antibiotics and causes the need of the more updated guideline for the treatment of blood stream infection.

화병 임상진료지침 II. (화병의 실태) (Clinical Guidelines for Hwabyung II. (Research on the Status of Hwabyung in Korea))

  • 정선용;송승연;김종우
    • 동의신경정신과학회지
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    • 제24권spc1호
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    • pp.15-22
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    • 2013
  • Objectives : The Hwabyung Research Center of The Korean Society Of Oriental Neuropsychiatry attempted to produce clinical guidelines for doctors of Korean medicine for the treatment of Hwabyung. Methods : A standard guideline development process was followed. Relevant literature was identified by a review of bibliographies. The operational criteria were used to rate the quality of scientific evidence, and the line of treatment recommendations included a consensus clinical opinion. This section of "the status of Hwabyung in Korea" is 2 out of 5 articles drafted and reviewed by clinicians. Results : Hwabyung is changed depending on the time and have a risk of relapse. Like the previous studies, Female and lower socio-economic and educational level people suffers Hwabyung frequently. But recently number of Male Hwabyung patients increases. Recovery of Hwabyung is involved in depression, anxiety, stress. Hwabyung is related to Major depressive disorder, generalized anxiety disorder, somatoform disorder and diseases of the digestive system. Conclusions : This study was observed for the progression of Hwabyung. Hwabyung is a long-term disease associated with depression, anxiety and stress. Hwabyung is accompanied by physical and psychological symptoms and degrades the quality of life.