• Title/Summary/Keyword: evidence based diagnosis

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Clinical practice recommendations for Bangpungtongseong-san (Bofutsusho-san) and Bangkihwangki-tang(Boiogito) in obesity (비만치료 및 체중 감량에서 방풍통성산과 방기황기탕 사용에 대한 임상 권고안)

  • Park, Jung-Hyun;Kim, Ho-Jun
    • Journal of Korean Medicine for Obesity Research
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    • v.12 no.1
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    • pp.48-58
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    • 2012
  • Objectives These prescribing recommendations have been written to guide clinicians on the appropriate use of Bangpungtongseong-san(BT) and Bangkihwangki-tang(BH) in the treatment of obesity. These recommendation are aimed at providing evidence based information concerning diagnosis and management of obesity. Methods We collected all relevant references about treatment effect of BT and BH on obesity in the forms of meta-analysis, systematic review, randomized controlled trial, case-control study, observational study and practice guideline from international and domestic databases and paper journals. We examined treatment effect, side effects, recommendations for dose, indication and contraindication of BT and BH. Results The treatment effect of BT and BH on obesity has been proved through clinical trial. BT is indicated for obese patients (Body mass index, $BMI{\geq}25$) with strong abdomen and a tendency to constipation, BH is indicated for obese patients ($BMI{\geq}25$) with a fair skinned, soft muscled, edematous and sweat easily. Conclusion We wish the information contained in theses recommendations will help clinicians reach a reasonable and beneficial decision with evidence-based results. Further studies are strongly needed to develop better treatment strategies for herbal medicines on obesity.

A study on the Development of Traditional Korean Medicine Clinical Practice Guideline for Atopic Dermatitis (아토피피부염의 한의학 진료 지침 개발을 위한 사전 연구)

  • Yun, Young-Hee;Choi, In-Hwa
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.25 no.2
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    • pp.38-48
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    • 2012
  • Background : The atopic dermatitis patient and their families are looking for safer herb-medicine treatments that possess therapeutic effects, but without the recurrence of symptoms and long-term harmful consequences that can result from other treatment. However, for many reasons, including methodological difficulties and lack of high quality study like randomized clinical study and systematic review, there are no consistent clinical guide line for atopic dermatitis in Traditional Korean Medicine. Objectives : Evidence-based clinical practice guidelines support clinical decision-making by making recommendations to guide clinical practice. The purpose of this study was to develop Traditional Korean Medicine clinical practice guideline for atopic dermatitis Result : The future guide should be based on scientific evidence and include the followings: (1) diagnosis of atopic dermatitis (2) the pattern identification of atopic dermatitis (3) classification of Sasang Constitution (4) efficacy assessment (5) treatment guideline (6) education for patients and care givers Conclusion : The development of Traditional Korean Medicine clinical practice guideline for atopic dermatitis is needed.

Current Trend of Mibyeong Health Policy and Service in China through Investigation Activity of Mibyeong Technology -Report of China Technology Research Group- (현지 기술 조사활동을 통한 중국의 미병 정책 및 의료서비스 최신 동향 보고)

  • Lee, Jae-Chul;Kim, Dong-Soo;Jang, Eun-Su
    • Journal of Society of Preventive Korean Medicine
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    • v.17 no.1
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    • pp.137-147
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    • 2013
  • Objectives : This study aims to report current trend of Mibyeong health policy and service in China from interview of China Technology Research Group. Methods : China Technology Research Group visited Guanganmen hospital, Yanhuang Dongfang Company, Xinjingzhen health center, and Shanghai Shuguang hospital. With an interpreter, We had interviews about Mibyeong health service and policy trend, medical instrument, and research issue. Results :Mibyeong health service was performed based on KY3H system and collaboration with traditional Chinese medicine hospital. Mibyeong health service consists of diagnosis with nine constitutional type, health guide and preventive treatment. Community health center also provide Mibyeong health service, with cooperative treatment of traditional Chinese medicine and western medicine. China's Mibyeong health policy is established by Top-down decision, even though there is not enough evidence for providing health service to consumer. Through constitutional diagnosis, examinations, and treatment, huge data have been stacked; however, assessment and research based on these data are not processed well. Cooperative treatment of traditional Chinese medicine and western medicine is widely provided to patients, and their works are relatively well classified. Conclusions : China plays leading role in Mibyeong service and it seems to be developed more than Korea's. Further study is necessary to establish Mibyeong policy and health service in Korea.

Rapidly Progressive Small Bowel Necrosis in a Previously Healthy Child without Proven Mechanical Obstruction

  • Kim, Hyun Hee;Kang, Hyungoo;Park, Chul Hee;Kwon, Yu Jin;Jung, Euna;Lim, Misun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.3
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    • pp.291-297
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    • 2019
  • Bowel ischemia is a life-threatening surgical emergency. We report a case of rapidly progressive bowel necrosis in a previously healthy child without proven mechanical small bowel obstruction. The definite diagnosis was established at the time of an exploratory operation. Of note, imaging studies and even a laparotomy did not reveal any evidence of acute appendicitis or mechanical obstruction such as intussusception or Meckel's diverticulum. During hospitalization, since we could not rule out surgical abdomen after inconclusive image findings, we closely followed the patient and repeated physical examinations carefully. Eventually surgical exploration was performed based on changes in clinical condition, which proved to be the right decision for the patient. We propose that in children with suspected strangulation of small bowel obstruction, especially when imaging findings do not provide a conclusive diagnosis, the timely exploratory surgical approach ought to be chosen based on carefully observed clinical findings and other evaluations.

Advantages of the single nucleotide polymorphism-based noninvasive prenatal test

  • Kim, Kunwoo
    • Journal of Genetic Medicine
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    • v.12 no.2
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    • pp.66-71
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    • 2015
  • Down syndrome screening with cell-free DNA (cfDNA) in the maternal plasma has recently received much attention in the prenatal diagnostic field. Indeed, a large amount of evidence has already accumulated to show that screening tests with cfDNA are more sensitive and specific than conventional maternal serum and/or ultrasound screening. Globally, more than 1,000,000 of these noninvasive prenatal tests (NIPTs) have been performed to date. There are several different methods for NIPTs that are currently commercially available, including shotgun massively parallel sequencing, targeted massively parallel sequencing, and single nucleotide polymorphism (SNP)-based methods. All of these methods have their own advantages and disadvantages. In this review, I will focus specifically on the SNP-based NIPT.

A Survey on Korean Medicine Doctors' Recognition and Treatment Method for Developing Clinical Practice Guideline of Nausea and Vomiting of Pregnancy (임신오조 한의표준임상진료지침 개발을 위한 한의사의 인식과 치료 실태에 관한 조사)

  • Heung-Sook Lee;Hyo-Jeong Jung;Su-Ji Choi;Dong-Il Kim
    • The Journal of Korean Obstetrics and Gynecology
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    • v.36 no.2
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    • pp.36-54
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    • 2023
  • Objectives: This study was aimed to develop a Korean Medicine (KM) clinical practice guideline (CPG) of Nausea and Vomiting of Pregnancy (NVP). Methods: We conducted a questionnaire survey targeting KM doctors belonging to the Association of Korean Medicine by e-mail. We received 1,023 responds, and analyzed the answers. Results: 1. 83.0% of respondents knew the concepts and contents of CPG, and 98.1% had practical use plan. 2. 82.1% of respondents used pattern identification diagnosis for NVP patients, and the most commonly diagnosed pattern was spleen-stomach weakness (脾胃虛弱) with 41.3%. 3. The most frequently used treatment for NVP patients was KM combined treatment (46.7%). Herbal medicine+acupuncture (46.8%) was most used among KM combined treatments, and herbal medicine (37.1%) was most used among KM single treatments. 4. Among the contents of CPG for NVP, the fields of interest were selected in the order of KM treatment, KM-Western medicine cooperative treatment, KM diagnosis, prevention and regimen management. In the 'diagnosis part', the use of the symptom evaluation scale questionnaire was 41.8%, higher than the KM pattern diagnosis (34.4%). In the 'treatment part', herbal medicine accounted for 33.8%, higher than that of acupuncture (including electro-acupuncture) at 23.7%. 5. As for the expected development effects, opinions on evidence-based, safety, clinical use, and standardization were the most common. Conclusions: We figured out KM doctors' recognition of KM clinical practice guideline, clinical diagnosis, treatment on NVP to make the contents of the CPG reflecting the clinical situation.

A study of Korean medical knowledge system which Korean medical doctors want (한의사들이 원하는 한의학 지식체계에 대한 고찰)

  • Son, Mi-Ju;Kim, Wu-Young;Jerng, Ui-Min;Park, Hwang-Jin;Han, Chang-Hyun
    • Journal of Society of Preventive Korean Medicine
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    • v.16 no.3
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    • pp.89-105
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    • 2012
  • Objectives : This study was carried out to know the status of clinical utilization of Korean medical knowledge and the Korean medical knowledge system which Korean medical doctors want. Methods : Questionnaires were distributed to Korean medical doctors registered for the Association of Korean medicine via the email and 249 answered questionnaires were analyzed. Results : 50.6 % of Korean medical doctors utilized the textbooks for Korean medicine when they treated their patients. The reason why they did not utilize the textbooks for Korean medicine was mostly that 'it could not be applied directly into clinical application with only contents of textbook because clinical approach (diagnosis and treatment methods) was not clearly described in the textbook'. 48.6 % of Korean medical doctors utilized the EBM materials when they treated their patients. EBM materials that they referred included domestic articles, other EBM materials excluding papers and international academic papers based on PubMed in order. The reasons why they did not utilize the EBM materials were mostly that 'it was difficult to find the evidence' and 'EBM materials were not actually helpful for the clinical practice.' It was found that Korean medical doctors approached the disease in aspects of Korean and Western Medicine concurrently upon the diagnosis of patients and performed the diagnosis and treatment of Korean medicine on the diseases which seemed to be effective with Korean medicine. It was also found that they thought that they needed to know the Western medical knowledge as much as general doctors who have a doctor's license or family medicine specialists who comprehensively treat the general diseases know. Korean medical doctors wanted to have the systematic summary of modern research performance in fields of acupoint, acupuncture, herbal drugs and formula. They thought that constitutional medicine and Sa-am acupuncture therapy were representative characteristics in Korean medicine differentiated from Traditional Chinese medicine and Kampo medicine. Conclusions : Korean medical doctors wanted to establish the Korean medical knowledge system based on evidence focusing on clinical and practical contents. New Korean medical knowledge system should be established based on these requirements in the future.

Evaluating LIMU System Quality with Interval Evidence and Input Uncertainty

  • Xiangyi Zhou;Zhijie Zhou;Xiaoxia Han;Zhichao Ming;Yanshan Bian
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.17 no.11
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    • pp.2945-2965
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    • 2023
  • The laser inertial measurement unit is a precision device widely used in rocket navigation system and other equipment, and its quality is directly related to navigation accuracy. In the quality evaluation of laser inertial measurement unit, there is inevitably uncertainty in the index input information. First, the input numerical information is in interval form. Second, the index input grade and the quality evaluation result grade are given according to different national standards. So, it is a key step to transform the interval information input by the index into the data form consistent with the evaluation result grade. In the case of uncertain input, this paper puts forward a method based on probability distribution to solve the problem of asymmetry between the reference grade given by the index and the evaluation result grade when evaluating the quality of laser inertial measurement unit. By mapping the numerical relationship between the designated reference level and the evaluation reference level of the index information under different distributions, the index evidence symmetrical with the evaluation reference level is given. After the uncertain input information is transformed into evidence of interval degree distribution by this method, the information fusion of interval degree distribution evidence is carried out by interval evidential reasoning algorithm, and the evaluation result is obtained by projection covariance matrix adaptive evolution strategy optimization. Taking a five-meter redundant laser inertial measurement unit as an example, the applicability and effectiveness of this method are verified.

Middle East Consensus Statement on the Prevention, Diagnosis, and Management of Cow's Milk Protein Allergy

  • Vandenplas, Yvan;Abuabat, Ahmed;Al-Hammadi, Suleiman;Aly, Gamal Samy;Miqdady, Mohamad S.;Shaaban, Sanaa Youssef;Torbey, Paul-Henri
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.17 no.2
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    • pp.61-73
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    • 2014
  • Presented are guidelines for the prevention, diagnosis, and treatment of cow's milk protein allergy (CMPA) which is the most common food allergy in infants. It manifests through a variety of symptoms that place a burden on both the infant and their caregivers. The guidelines were formulated by evaluation of existing evidence-based guidelines, literature evidence and expert clinical experience. The guidelines set out practical recommendations and include algorithms for the prevention and treatment of CMPA. For infants at risk of allergy, appropriate prevention diets are suggested. Breastfeeding is the best method for prevention; however, a partially hydrolyzed formula should be used in infants unable to be breastfed. In infants with suspected CMPA, guidelines are presented for the appropriate diagnostic workup and subsequent appropriate elimination diet for treatment. Exclusive breastfeeding and maternal dietary allergen avoidance are the best treatment. In infants not exclusively breastfed, an extensively hydrolyzed formula should be used with amino acid formula recommended if the symptoms are life-threatening or do not resolve after extensively hydrolyzed formula. Adherence to these guidelines should assist healthcare practitioners in optimizing their approach to the management of CMPA and decrease the burden on infants and their caregivers.

Phylogenetic and Morphological Characterization of Cladosporium perangustum Associated with Flyspeck on Shine Muscat Grapes in South Korea

  • Hassan, Oliul;Lim, Yang-Sook;Chang, Taehyun
    • Mycobiology
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    • v.49 no.2
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    • pp.183-187
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    • 2021
  • The Shine Muscat is a table grape, popular in South Korea for its unique mango-flavor taste. Flyspeck is a disease that is characterized by small, black, and circular specks on the grape cuticle was first observed in several commercial orchards in Sangju, South Korea, in August 2019. Here we identified the causal agent of flyspeck based on an advanced diagnosis approach, comprised of both morphological and molecular analyses. Morphological characteristics of the cultures isolated from grape flyspeck were identical to the fungus Cladosporium perangustum. The concatenated sequences of ITS, ACT, and EF1-α were used for molecular phylogenetic analysis, BLAST searches along with Bayesian inference-based phylogeny, confirmed that the causal agent of grape flyspeck is C. perangustum. The cultured fungal isolates also produced flyspeck symptoms on healthy fruits in pathogenicity tests. To the best of my knowledge, this is the first documented evidence of any Cladosporium sp. producing flyspeck symptoms on any plant.