• 제목/요약/키워드: clinical practice guidelines

검색결과 462건 처리시간 0.027초

Awareness and Prevalence of Mammography Screening and its Predictors - A Cross Sectional Study in a Primary Care Clinic in Malaysia

  • Yusof, Azianey;Chia, Yook Chin;Hasni, Yasmin Mohd
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권19호
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    • pp.8095-8099
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    • 2014
  • Background: Worldwide, over half a million women died of breast cancer in 2011 alone. Mammography screening is associated with a reduction of 20 to 35% in breast cancer mortality. The aim of this study was to determine the awareness and practice of mammography screening and predictors of its uptake in Malaysian women attending a primary care clinic. Materials and Methods: A cross-sectional study was carried out among women aged 40 to 74 years attending a primary care clinic in Selangor, Malaysia. An assisted structured questionnaire included questions on socio-demography, source of information and level of knowledge. An adapted version of the revised Champion Health Belief Model Scale plus other associated factors for mammography screening up-take were also included as part of the questionnaire. Predictors for mammography screening uptake were only determined in those who were aware about mammography screening. Significant predictors were determined by logistic regression. Results: 447 women were recruited for this study; 99.1% of them (n: 411) were aware about breast cancer. Only 50.1% (n: 206) had knowledge about mammography screening. Prevalence of clinical breast-examination (CBE) was 23.3% (n: 104) and mammography screening up-take was 13.2% (n: 59). The predictors for the latter were those who have had clinical breast-examination (aOR=17.58, 95%CI: 7.68-39.82) and those aged between 50 to 59 years (aOR=3.94, 95%CI: 1.61-9.66) as well as those aged 60 years and above (aOR=6.91, 95%CI: 2.28-20.94). Good knowledge and positive beliefs about mammography screening were not associated with mammography screening uptake. Conclusions: Half of our Malaysian women were aware about mammography screening. However, the uptake of mammography was low. Previous CBE and older age were significant predictors of mammography screening uptake. Increasing CBE services may increase compliance with guidelines.

안락사 (Euthanasia)

  • 홍영선;염창환;이경식
    • Journal of Hospice and Palliative Care
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    • 제2권1호
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    • pp.1-6
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    • 1999
  • 배경 : 안락사는 조절되지 않는 고통을 경감시킬 목적으로 한 사람의 생명을 끝낼 의도를 가지고 가해지는 중재를 말한다. 안락사를 합법화하고 규정을 만드는데 대한 논쟁이 의학 논문들을 통하여 계속되어 왔다. 방법 : 지난 수년간 발표된 안락사에 대한 논문들을 정리하였고 안락사를 시행하는 이유들을 알아보았다. 또한 네덜란드에서 안락사를 정책적으로 허용한 이후에 빚어진 결과를 문헌 고찰을 통하여 소개하였다. 결과 : 안락사가 아닌 행위가 종종 안락사로 불리어 왔으나 그 안에 내포된 윤리적 원칙들을 조사함으로써 구분이 가능하다. 네덜란드에서 안락사를 시행하는데 사용하였던 지침들은 부적절하였고 남용된 바가 컸는데도 렘멜링크 위원회의 보고서는 네덜란드에서는 안락사가 적절히 잘 이루어 졌다고 소개하였다. 결론 : 안락사를 합법화 해야할 임상상황은 어디에도 존재하지 않는다. 총괄적이고 여러 분야의 전문가가 협동하는 완화의학은 안락사를 시행해야 할 이유라고 불리는 말기환자들의 고통의 대부분을 효과적으로 조절해 줄 수 있다.

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Evaluation of Cancer Patients Admitted to the Emergency Department within One Month before Death in Turkey: What are the Problems Needing Attention?

  • Yildirim, Birdal;Tanriverdi, Ozgur
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권1호
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    • pp.349-353
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    • 2014
  • Background: Although previously studies have reported that most patients with malignancy prefer to die at home, this is not the real situation in clinical practice. Aim: In this study, we aimed to determine the characteristics of Turkish cancer patients admitted to the emergency department (ED) within one month before death. Materials and Method: This descriptive retrospective study focused on questions about how often and why patients with cancer visited the ED before death. A total of 107 individuals with cancer were divided into 2 groups: Group 1, patients with at least one visit in the final 4 weeks; and Group 2, patients with no visit to ED. Demographic and clinical features were compared between the two groups. Statistical analyses: Descriptive statistical methods, statistical analysis for correlation, Student's t-test, chi-square tests and logistic regression were used. Results: At least one visit to ED within one month before death was reported for 64 (60%) of the 107 cases. Of these 64 (Group 1), 38% (n=24) were discharged and 9% (n=6) died in the ED. The most common site of the primary tumor was the lung (n=24, 38%) and the most common symptom was dyspnea (92%). With the other 43 (40%) cancer patients not presenting to the ED within one month before death, they were more likely to be female with another type of cancer. Conclusions: Guidelines are needed for better management of cancer patients benefiting from visits to ED within the last month of life.

대한수혈학회 창립 30주년을 기념하며 (History of the Korean Society of Blood Transfusion and Blood Services in Korea)

  • 조한익;서동희;김현옥
    • 대한수혈학회지
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    • 제23권2호
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    • pp.97-106
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    • 2012
  • The Korean Society of Blood Transfusion (KSBT) was established in Seoul in 1982 by a group of physicians of clinical pathology (currently laboratory medicine), internal medicine, paediatrics, anaesthesiology, and surgery, who were members of the Korean Society of Hematology, in which they had been actively engaged as transfusion specialists. However, these physicians were dissatisfied with the lack of public recognition of blood transfusion and the unrealistic blood service system and therefore attempted to build an influential organization for improvement of blood services and transfusion medicine. The mission of the KSBT is to advance the science and practice of transfusion medicine. The KSBT advocates for education and research in the fields of transfusion medicine and for safe blood in blood services. The inaugural KSBT conference, with approximately 50 participants, was held in November, 1982; since then, annual conferences and educational workshops have been held regularly once or twice a year. Currently, the KSBT has approximately 800 members, who are practitioners of blood transfusion (holders of M.D.) or staff members of blood services (holders of other professional degrees). The Society also publishes the Korean Journal of Blood Transfusion (first issue published in 1990) and guidelines for blood services. A Society web site (http://www.transfusion.or.kr) was started in 2001, with the hope of increasingly providing information and feedback to members on a real-time basis. The KSBT has been an active participant in international activities. In 1995, the KSBT hosted the Sixth ISBT Western Pacific Regional Congress in Seoul and will host the $33^{rd}$ ISBT Congress in Seoul in 2014. Since its inauguration, the KSBT has had key roles not only in education and research in the fields of transfusion medicine but also in development of safe-blood services during the last 30 years.

MicroRNAs and periodontal disease: a qualitative systematic review of human studies

  • Mico-Martinez, Pablo;Alminana-Pastor, Pedro J.;Alpiste-Illueca, Francisco;Lopez-Roldan, Andres
    • Journal of Periodontal and Implant Science
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    • 제51권6호
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    • pp.386-397
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    • 2021
  • Purpose: MicroRNAs (miRNAs) are epigenetic post-transcriptional regulators that modulate gene expression and have been identified as biomarkers for several diseases, including cancer. This study aimed to systematically review the relationship between miRNAs and periodontal disease in humans, and to evaluate the potential of miRNAs as diagnostic and prognostic biomarkers of disease. Methods: The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines (reference number CRD42020180683). The MEDLINE, Scopus, Cochrane Library, Embase, Web of Science, and SciELO databases were searched for clinical studies conducted in humans investigating periodontal diseases and miRNAs. Expression levels of miRNAs across the different groups were analysed using the collected data. Results: A total of 1,299 references were identified in the initial literature search, and 23 articles were finally included in the review. The study designs were heterogeneous, which prevented a meta-analysis of the data. Most of the studies compared miRNA expression levels between patients with periodontitis and healthy controls. The most widely researched miRNA in periodontal diseases was miR-146a. Most studies reported higher expression levels of miR-146a in patients with periodontitis than in healthy controls. In addition, many studies also focused on identifying target genes of the differentially expressed miRNAs that were significantly related to periodontal inflammation. Conclusions: The results of the studies that we analysed are promising, but diagnostic tests are needed to confirm the use of miRNAs as biomarkers to monitor and aid in the early diagnosis of periodontitis in clinical practice.

Comparison of radiographic and computed tomographic acetabular index in small-breed dogs: a preliminary study using Maltese and Shih Tzu

  • Kanthavichit, Kanokporn;Klaengkaew, Auraiwan;Thanaboonnipat, Chutimon;Darawiroj, Damri;Soontornvipart, Kumpanart;Choisunirachon, Nan
    • Journal of Veterinary Science
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    • 제22권4호
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    • pp.58.1-58.13
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    • 2021
  • Background: The morphometry of the acetabulum is one source of information that assists in the clinical diagnosis of the hip and influences the proper selection of a prosthesis, reducing post-operative complications such as those seen in total hip replacement (THR). However, acetabular parameters in small-breed dogs are rarely reported. Objectives: To investigate acetabular parameters using radiography and computed tomography (CT) in small-breed dogs with Maltese and Shih Tzu dogs used as model breeds. Methods: Standard calibrated, extended hip radiographs and CT images were obtained. Subsequently, acetabular width (AW) in various directions was measured using radiography and CT, whereas acetabular depth (AD) was obtained by CT. Acetabular index (AI) is a ratio calculated from AD and AW. Results: The values of AW and AD were much higher in Shih Tzu than in Maltese dogs. Male Shih Tzus showed higher values of these parameters than females, while sex-based differences in most of the parameters could not be detected in Maltese. Body weight, but not age, influenced AWs and ADs. While AWs and ADs were influenced by several factors, AI was comparable among the assessed factors and between Maltese and Shih Tzu dogs (p = 0.172; 31.42 ± 1.35 and 32.60 ± 1.80, respectively). Also, AI did not vary with breed, sex, or body size. Conclusions: The obtained radiographic and CT acetabular parameters could be useful as guidelines for evaluating the acetabulum of small-breed dogs in clinical practice.

Clinical practice guideline for the diagnosis and treatment of pediatric obesity: recommendations from the Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology Hepatology and Nutrition

  • Yi, Dae Yong;Kim, Soon Chul;Lee, Ji Hyuk;Lee, Eun Hye;Kim, Jae Young;Kim, Yong Joo;Kang, Ki Soo;Hong, Jeana;Shim, Jung Ok;Lee, Yoon;Kang, Ben;Lee, Yeoun Joo;Kim, Mi Jin;Moon, Jin Soo;Koh, Hong;You, JeongAe;Kwak, Young-Sook;Lim, Hyunjung;Yang, Hye Ran
    • Clinical and Experimental Pediatrics
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    • 제62권1호
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    • pp.3-21
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    • 2019
  • The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in South Korea and worldwide, and new guidelines were established in each area with the strength of recommendations based on the levels of evidence: (1) definition and diagnosis of overweight and obesity in children and adolescents; (2) principles of treatment of pediatric obesity; (3) behavioral interventions for children and adolescents with obesity, including diet, exercise, lifestyle, and mental health; (4) pharmacotherapy; and (5) bariatric surgery.

미숙아의 장관영양 시 위 잔류 확인의 유용성 평가 (The Usefulness of the Evaluation of Gastric Residuals in Premature Infants)

  • 이경민;최수정
    • 중환자간호학회지
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    • 제12권3호
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    • pp.74-83
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    • 2019
  • Purpose : The routine evaluation of gastric residuals (RGR) is considered standard care for premature infants. This study evaluated the usefulness of RGR in premature infants. Methods : The study retrospectively investigated 208 premature infants (gestational aged under 34 weeks) who underwent gavage feeding in a neonatal intensive care unit at a tertiary hospital. The patients were divided into two groups: RGR (n=104) and no-RGR (n=104). Those in the no-RGR group had their gastric residuals checked only if signs of feeding intolerance were present. Clinical outcomes, including the time to reach full enteral feeding (FEF) and the incidences of gastrointestinal disorders such as feeding intolerance (FI) and necrotizing enterocolitis (NEC), were compared. Data were analyzed with SPSS ver. 21, using a Mann-Whitney U test, chi-squared test, and Fisher's exact test. Results : There was no statistically significant difference for the time to FEF (z=-0.61, p=.541), incidence of FI ($X^2=0.38$, p=.540), and NEC ($X^2=1.42$, p=.234) between the two groups. Conclusion : No-RGR did not increase the risk for FI or NEC. These results suggest that RGR evaluation may not improve nutritional outcomes in premature infants. Recommendations for further research and practice guidelines will be provided.

일반 방사선검사의 소요 시간 실태조사 (Investigation of the Time Required for General Radiography)

  • 임우택;주영철;김연민
    • 대한방사선기술학회지:방사선기술과학
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    • 제45권3호
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    • pp.255-262
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    • 2022
  • In this study, by analyzing the examination time for each procedure, the appropriate workload of radiologic technologist is analyzed based on the actual examination time in the current clinical setting by comparing with the examination time in the radiology field setting of the health insurance review and assessment service. In addition, this result is introduced into the calculation of relate value units; it was attempted to provide accurate and objective evidence in the field of radiology. From May 2020 to December 2021, the study retrospectively investigated the examination times recorded in the electronic medical record and picture archiving and communication system at 5 tertiary general hospitals and 1 general hospital. The total of 16 examination parts are applied in this study, including the head, sinuses, chest, ribs, abdomen, pelvis, cervical, thoracic, lumbar, shoulder, elbow, wrist, hip, femur, knee, and ankle. The minimum number of images that could be obtained per radiation generator was 3.6 images for one hour, and the maximum was 6.4 images. When 50% median of procedure time is calculated, the minimum number of images that could be obtained was 16.7 images and maximum was 35.3 images; in addition, minimum examination time is 1.7 minutes, and maximum time is 3.6 minutes. In conclusion, it is judged that there will be insufficient explanation time for basic infection instructions such as hand hygiene during the examinations in current clinical practice. It is believed that radiologic technologists will contribute to providing higher-quality of radiation examination services to the public by complying with guidelines for work and setting appropriate workload on their own.

기관내관을 적용중인 국내 중환자실 성인 입원환자의 구강간호에 대한 주제범위 문헌고찰 (Oral Hygiene Care of Endotracheal Intubated Patients in Korean Intensive Care Units : A Scoping Review)

  • 임정은;정덕유;유리호
    • 중환자간호학회지
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    • 제17권1호
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    • pp.68-82
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    • 2024
  • Purpose : This scoping review was designed to identify gaps in knowledge and guide future directions for clinical nursing practices and research on oral hygiene care for endotracheally intubated patients in Korean intensive care units. Methods : We conducted a scoping review using the methodological framework proposed by Arksey and O'Malley. PubMed, CINAHL, RISS, Science On, and DBpia databases were searched. Two reviewers independently selected the studies and extracted data. A total of 445 studies were identified, of which 17 were included in the final analysis. Results : No research has been conducted from 2021 to the present. A total of 12 instruments were utilized in 13 studies to assess the effectiveness of oral hygiene care. All studies investigating the effectiveness of oral hygiene care have consistently documented that chlorhexidine has the most significant effect. The frequency and time of oral hygiene care were each examined in one study. Conclusion : A research study is necessary to develop a measurement tool for assessing the effectiveness of oral hygiene care suitable for endotracheal intubated patients in intensive care units. Interventional studies should be conducted to determine the effects of chlorhexidine and the appropriate frequency and time of oral hygiene care. Thereafter, revision of domestic evidence-based clinical practice guidelines by integrating these results will be necessary.