• Title/Summary/Keyword: clinical diagnosis

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Current Diagnostic Methods for Periprosthetic Joint Infection

  • Lee, Jiyoung;Park, Heechul;Bae, Jinyoung;Hyun, Hyanglan;Kim, Sunghyun
    • Biomedical Science Letters
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    • v.28 no.1
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    • pp.1-8
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    • 2022
  • Total joint arthroplasty is a successful joint replacement treatment that improves joint function and overall quality of life and provides pain relief. However, the prevalence of periprosthetic joint infection (PJI) has become prevalent with the rise in the incidence of arthroplasty surgery. PJI occurs rarely following arthroplasty however presents with serious complications, including high morbidity. The identification of causative microorganisms is essential for the treatment of PJI. Managing PJI requires complex treatment strategies, including long-term antibacterial treatment, and significant medical costs can be incurred. The American Academy of Orthopedic Surgeons, the Centers for Disease Control and Prevention, and Surgical Care Improvement Project guidelines recommend that prophylactic antibiotics such as first-generation cephalosporins be infused completely 1 hour before surgical incision. However, these preventative antibiotics are very limited, therefore risk factors must be identified to diagnosis and treat patients effectively. Moreover, determining antimicrobial susceptibility during artificial joint surgery and choosing the most appropriate treatment strategy following an accurate diagnosis of microbial infections are essential. In the present review, we describe the management, including the etiology, diagnosis, and classification of PJI, and approaches to its diagnosis using the available novel molecular diagnostic methods.

Clinical Demands for Evidence-based Medical Interventions and Diagnostic Technology in Oriental Medicine (근거중심의학에 기반한 한의치료기술 및 한방진단기기 개발을 위한 임상수요조사)

  • Kim, Gyeong-Cheol;Park, Sang-Woog;Song, Kyung-Hoon;Park, Joo-Yeon;Hong, Sang-Min;Lee, Hai-Woong
    • Journal of Society of Preventive Korean Medicine
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    • v.14 no.2
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    • pp.121-133
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    • 2010
  • Objects : To establish directions to evidence-based medical interventions and diagnosis technology in oriental medicine, we did survey research among oriental medical doctors. Methods : Systematically-organized questionnaires were provided for survey. 105 Oriental medical doctors nationwide participated in the survey. We investigated diseases of their patients, differential diagnosis methods, frequently used medical interventions, needs for diagnosis devices, evidence-based clinical manuals, etc. Results : In oriental medical clinics, the most frequent patient class was patients with musculo-skeletal diseases. Oriental medical doctors assumed that the preparation of care solution for chronic life-style diseases was the most urgent. Dong-Eui-Bo-gam(東醫寶鑑) was the most frequently used reference for their herbal medication prescription. Fixed document for diagnosis and treatment were thought to be the most important in the developing evidence-based clinical manuals. Conclusions : Validity and reliability should be considered as very important in developing oriental diagnosis devices. Evidence-based clinical manuals are needed to build standardized document for diagnosis and treatment and to verify efficacy and safety of oriental medical diagnosis and treatment.

Integrated diagnostic approach of pediatric neuromuscular disorders

  • Lee, Ha Neul;Lee, Young-Mock
    • Journal of Genetic Medicine
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    • v.15 no.2
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    • pp.55-63
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    • 2018
  • Clinical and genetic heterogeneity in association with overlapping spectrum is characteristic in pediatric neuromuscular disorders, which makes confirmative diagnosis difficult and time consuming. Considering evolution of molecular genetic diagnosis and resultant upcoming genetically modifiable therapeutic options, rapid and cost-effective genetic testing should be applied in conjunction with existing diagnostic methods of clinical examinations, laboratory tests, electrophysiologic studies and pathologic studies. Earlier correct diagnosis would enable better clinical management for these patients in addition to new genetic drug options and genetic counseling.

Study on Clinical Establish Direction for Oriental Medicine Diagnosis Methods (한방진단방법에 대한 임상적 설정방향연구)

  • Kim Kwang-Joong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.20 no.1
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    • pp.245-256
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    • 2006
  • This research sought to survey oriental medicine diagnosis methods currently practiced, analyze their advantages and disadvantages, and work out clinical establish direction for oriental medicine diagnosis methods. Oriental medicine diagnosis methods currently practiced in the related circles are categorized into traditional Korean diagnosis methods and holistic auxiliary diagnosis methods. The traditional Korean diagnosis method focuses on treating diseases of traditional Korean health management methods which are based on the bodily self-viability capabilities according to the Orient's viewpoint of health. Under the diagnosis method, based on the cognition of maximizing the state of the bodily self-viability capabilities together with the characteristics of diseases, symptoms, pulse, first face-to-face patient observation, physical constitution, and life principle are managed according to form, color, pulse and symptom which divide the bodily viability capacities into inherent and acquired elements amid both elements interacting.

Diagnostic Hierarchy of Tic Disorders in Real-World Clinical Practice

  • Yeeji Sung;Soon-Beom Hong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.34 no.4
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    • pp.236-241
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    • 2023
  • Objectives: According to the 10th revision of the International Classification of Diseases, the main categories of tic disorders (F95.0, F95.1, and F95.2) follow a diagnostic hierarchy based on the duration and diversity of tic symptoms. The present study investigated the use of this diagnostic hierarchy in real-world clinical practice. Methods: Based on the National Health Insurance Service-National Health Information Database, the diagnosis of transient tic disorder (F95.0) made after a diagnosis of chronic motor or vocal tic disorder (F95.1) or Tourette's syndrome (F95.2) and diagnosis of chronic motor or vocal tic disorder (F95.1) made after a diagnosis of Tourette's syndrome (F95.2) were referred to as type A errors. The diagnosis of transient tic disorder (F95.0) repeated after a period of >12 months was referred to as type B error. Demographic and clinical differences according to the diagnostic error types were analyzed using analysis of variance, Student's t-tests, and chi-squared tests. Results: Most participants (96.5%) were without errors in the diagnosis of tic disorders. Higher proportions of males (p=0.005) and antipsychotic prescriptions (p<0.001) were observed in patients with type A or B diagnostic errors. A higher proportion of health insurance holders was observed among those with type A errors (p=0.027). Conclusion: Errors were absent in majority of the tic diagnoses in real-world clinical practice in terms of the diagnostic hierarchy.

The Clinical Characteristic and Management of Patients with Nocardiosis in a Tertiary Hospital in China

  • Peilin Liu;Zhiqian Wang;Zijuan Jian;Xuan Liu;Yanming Li;Qun Yan;Baiyun Zhong;Mengting Liao;Xianghui Liang;Wenen Liu
    • Journal of Microbiology and Biotechnology
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    • v.33 no.5
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    • pp.574-581
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    • 2023
  • Nocardiosis is an uncommon opportunistic bacterial infection which becomes a significant health problem due to its increasing incidence and high mortality rate. However, many nocardiosis patients are underdiagnosed by physicians. To summarize the clinical characteristics and management of nocardiosis would help with better diagnosis and prognosis of nocardiosis. This retrospective study was conducted based on the medical records of nocardiosis patients between January 2015 and December 2021 in a tertiary hospital in China. Overall, 44 nocardiosis patients with 54 specimens were included. The patients consisted of 26 males and 18 females with a mean age of 50.4 ± 13.2 years. Among 44 patients, 26 (59.1%) were previously given immunosuppressive therapy. Connective tissue diseases (CTDs) were the most common underlying disease (16/44). The most frequent infection sites were the lungs (17/44) and skin or soft tissues (8/44). Common symptoms included cough (23/44), expectoration (18/44), fever (15/44), and subcutaneous abscesses (15/44). Forty-five out of 54 specimens (83.3%) required over 48 hours of culture time for nocardiosis detection. Thirty-six patients were cured or improved, 5 patients were discharged from the hospital due to poor prognosis, and 1 patient died. The average diagnosis time of poor prognosis cases was 19.7 days, which was significantly longer than those of improved or cured patients (7.3 days). Immunosuppressed patients comprise a large part of nocardiosis cases, which is worth attention in clinical practice. Early diagnosis, specifically through prolonged cultivation time of specimen, could help achieve better prognosis of nocardiosis patients.

Analysis of Corneal Topography in Keratoconus (원추각막의 각막지형도 분석)

  • Kim, Douk-Hoon
    • Journal of Korean Clinical Health Science
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    • v.4 no.3
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    • pp.652-661
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    • 2016
  • The analysis of cornea morphology using corneal topographers is a clinical practice for the diagnosis of keratoconus in contact lens fitting. The recently technique has developed with the possibility of achieving a great number of measuring points of both anterior and posterior corneal surfaces in cornea. Also these data are used to extract a series of topographic valuation indices that permit to offer the most exact clinical diagnosis of keratoconus in contact lens fitting. This study describes the technologies in which current corneal topographers are based on the morphological characteristics that the keratoconus status observe on corneal surface. Therefore, this paper can provide that the analysis of corneal topographers applied for the diagnosis of keratoconus in contact lens fitting.

Recent Advances in the Clinical Application of Next-Generation Sequencing

  • Ki, Chang-Seok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.1
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    • pp.1-6
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    • 2021
  • Next-generation sequencing (NGS) technologies have changed the process of genetic diagnosis from a gene-by-gene approach to syndrome-based diagnostic gene panel sequencing (DPS), diagnostic exome sequencing (DES), and diagnostic genome sequencing (DGS). A priori information on the causative genes that might underlie a genetic condition is a prerequisite for genetic diagnosis before conducting clinical NGS tests. Theoretically, DPS, DES, and DGS do not require any information on specific candidate genes. Therefore, clinical NGS tests sometimes detect disease-related pathogenic variants in genes underlying different conditions from the initial diagnosis. These clinical NGS tests are expensive, but they can be a cost-effective approach for the rapid diagnosis of rare disorders with genetic heterogeneity, such as the glycogen storage disease, familial intrahepatic cholestasis, lysosomal storage disease, and primary immunodeficiency. In addition, DES or DGS may find novel genes that that were previously not linked to human diseases.

A Study on the meaning and clinical treatment of Chukbu(尺膚) diagnostic method in Huangdineijing(黃帝內經) -Focusing on Neijing(內經) and later medical books- (『황제내경(黃帝內經)』 척부진단법(尺膚診斷法)의 의미와 임상 활용에 대한 고찰 - 『내경(內經)』 및 후대 의서를 중심으로 -)

  • Yun, Ki-ryoung;Kim, Jong-hyun;Kim, Hye-il;Kim, Sang-hyun;Park, Cheol-han;Jeong, Chang-hyun
    • Journal of Korean Medical classics
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    • v.29 no.2
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    • pp.13-29
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    • 2016
  • Objectives : The purpose of this study is to investigate the concept of the Chukbu(尺膚) diagnosis in Huangdineijing(黃帝內經) and explain the characteristic of Chukbu(尺膚) diagnosis and causes of its clinical applicational decline. It will help the application of the Chukbu(尺膚) diagnosis to clinical treatment. Methods : The Sikuquanshu(四庫全書) database and Traditional Chinese Medical(TCM) books web database were used. The related contents of the Chukbu(尺膚) diagnosis in Huangdineijing (黃帝內經) and its annotation books were analyzed. The mentions on the Chukbu(尺膚) diagnosis in other medical books were examined. Results & Conclusions : The Chukbu(尺膚) diagnosis is important in the diagnostic system of the Huangdineijing(黃帝內經). The Chukbu(尺膚) diagnosis is composed of inspection and palpation. Its characteristic is something different compared to that of the Chongumaek(寸口脈) diagnosis; it relatively diagnoses condition of exterior disease(表病). The causes of its clinical applicational decline are relative inconvenience, limits of feudal society, and development of Zangfubianzheng(臟腑辨證) in that era.

Clinical Practice Guideline for Soeumin Disease of Sasang Constitutional Medicine: Diagnosis and Algorithm (소음인체질병증 임상진료지침: 진단 및 알고리즘)

  • Lee, Jun-Hee;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.26 no.1
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    • pp.11-26
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    • 2014
  • Objectives This research was proposed to present Clinical Practice Guideline(CPG) for Soeumin Disease of Sasang Constitutional Medicine(SCM): Diagnosis and Algorithm. This CPG was developed by the national-wide experts committee consisting of SCM professors. Methods We searched the literature and articles related to Soeumin Symptomatology diagnosis and algorithm. For developin diagnosis and algorithm, we searched the classification, ordinary symptom, present symptom of the Soeumin Symptomatology Results & Conclusions We classified the Soeumin Symptomatology by 4 steps: Exterior-Interior disease, favorable-unfavorable pattern, mild-moderate-severe-critical pattern, initial-intermediate-advanced pattern. And at the unfavorable pattern, ordinary symptom is very important. So Doctors focuss on the symptom of unfavorable's ordinary symptom such as temperament inclined symptom, excessive sweating, diarrhea, and vexation.