• 제목/요약/키워드: evidence based diagnosis

검색결과 239건 처리시간 0.045초

만성 피로 증후군 (Overview of chronic fatigue syndrome)

  • 신호철
    • 한국건강관리협회지
    • /
    • 제3권1호
    • /
    • pp.97-109
    • /
    • 2005
  • Chronic fatigue syndrome(CFS) is a complex, debilitating disorder characterized by at least 6 months of severe persistent of relapsing fatigue and a group of characteristic but nonspecific symptoms. Many researchers have proposed that CFS has a specific cause. However currently no evidence exists that proves either a specific cause of CFS. And there is no diagnostic test for CFS. The diagnosis of chronic fatigue syndrome is based on the patient's history, excluding other illnesses In the absence of consistent biological markers, the diagnosis of CFS arises from operational criteria that do not afford validity. The prognosis is poor and often disability and impairment of daily function and performance are prolonged. A limited understanding of the CFS has complicated the management of this disorder. Therefore, treatment of CFS may be variable and should be tailored to each patient. Therapy should include exercise, diet, good sleep hygiene, antidepressants, and other medications, depending on the patient's presentation. Regular follow-up is key to continue to exclude other medical problems and provide support for patients. Chronic fatigue syndrome is a challenging illness to manage and requires a team approach of caring providers. For the majority of patients this is a chronic illness with the goals of therapy being to improve functional status and to prevent disability. Further understanding of the etiology and pathogenesis of this illness should lead to better specific therapy.

  • PDF

F-18 FDG Uptake in a Toxic Autonomous Thyroid Nodule

  • Lee, Myoung-Hoon;Park, Chan-H.;Kim, Hyun-Soo;Yoon, Seok-Nam;Hwang, Kyung-Hoon
    • 대한핵의학회지
    • /
    • 제35권4호
    • /
    • pp.286-287
    • /
    • 2001
  • A 44 year-old male patient was undergoing diagnosis and therapy for acute myelogenous leukemia (AML, M2). On physical examination a thyroid mass was palpated in the left lower lobe. He had palpitation and intolerance to heat. Thyroid function tests revealed hyperthyroidism; T3: 150ng/dl (N:60-90), fT4: 2.26 ng/dl (N:0.70-1.80), TSH: 0.01 ulU/ml (N:0.25-5.00). Ultrasonography demonstrated a hypoechoic mass with scattered calcifications measuring 2.55 2.03 3.64 cm in size. F-18 FDG camera-based PET scan performed as a follow-up study of AML revealed a focal increased uptake in the left neck, where an autonomous nodule was detected on Tc-99m thyroid scan. After the diagnosis of toxic autonomous nodule, Goetz disease, he underwent surgical nodulectomy. Microscopically, the nodule contained follicular proliferation with degenerative change but without evidence of thyroid carcinoma. Focal uptake in autonomous thyroid nodules is due to increased glycolysis within the nodules.

  • PDF

개에서 Ethylene glycol 중독에 의한 만성신부전증의 속발성 'Rubber jaw syndrome'의 방사선학적 진단례 (Radiographic Diagnosis of 'Rubber Jaw Syndrome' Secondary to Chronic Renal Failure Due to Ethylene Glycol Intoxication in a Dog)

  • 최호정;이영원;왕지환;정인조;연성찬;이효종;이희천
    • 한국임상수의학회지
    • /
    • 제24권2호
    • /
    • pp.260-263
    • /
    • 2007
  • A 9-month-old, intact female mixed dog was referred to Veterinary Medical Teaching Hospital of Gyeongsang National University with symmetrically enlarged and protruded upper jaw. The patient was diagnosed as acute renal failure due to ethylene glycol poisoning and was treated for 1 month in a local animal hospital. In spite of treatment, the patient proceeded to chronic renal failure. Also, the patient's upper jaw begun to enlarge continuously. To evaluate this upper jaw, radiographic examination was performed. Skull radiographs revealed thickening of maxilla, decreased bone opacity, cortical thinning, loss of lamina dura and periodontal space in the maxilla. Diagnosis of rubber jaw syndrome is based on clinicial signs, radiographic findings and laboratory evidence of chronic renal failure due to ethylene glycol poisoning.

A systematic review of treatment and outcomes in patients with mandibular coronoid process hyperplasia

  • Parmentier, Griet I.L.;Nys, Margaux;Verstraete, Laurence;Politis, Constantinus
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • 제48권3호
    • /
    • pp.133-148
    • /
    • 2022
  • Treatment of mandibular coronoid process hyperplasia (MCPH) has been described and explored in the literature. This systematic review aims to provide a comprehensive overview of the surgical and non-surgical treatment options for MCPH in pediatric and adult populations. Three databases were searched for treatment of MCPH patients (MEDLINE, Embase, and Web of Science). Two reviewers selected case reports and case series based on titles and abstracts. Finally, 55 studies reporting a total of 127 cases were included for qualitative synthesis and data extraction. The mean age at symptom onset was 15.6 years, while the mean age at diagnosis was 23.5 years. Of the included cases, 83.7% were male, and the condition was bilateral in more than 81% of the cases. Coronoidectomy was performed in 82.7% of the included cases, while coronoidotomy was performed in 3.9% of the cases. In 85.0% of the surgically treated cases, the approach was intraoral. The mean maximal intraoperative mouth opening was 38.1 mm compared with 16.5 mm at diagnosis. The mean maximal postoperative mouth opening was 35.3 mm, and the mean follow-up period was 16.3 months. Maximum mouth opening was achieved intraoperatively, and non-surgical treatment after surgery aims to reduce the risk of relapse. Additional research with a higher level of evidence is necessary to confirm these findings.

Hematuria in children: causes and evaluation

  • Eujin Park;Sang Woon Kim;Su Jin Kim;Minki Baek;Yo Han Ahn;Myung Hyun Cho;Hyun Kyung Lee;Kyoung Hee Han;Yae Lim Kim;Miyoung Choi;Hee Gyung Kang;Jin-Soon Suh;Eun Mi Yang
    • Childhood Kidney Diseases
    • /
    • 제28권2호
    • /
    • pp.66-73
    • /
    • 2024
  • Hematuria is the presence of blood in the urine and is classified as either gross hematuria or microscopic hematuria. There are many causes of hematuria, and the differential diagnosis depends on the presence or absence of comorbidities and whether it is glomerular or non-glomerular. When hematuria in children is symptomatic or persistent, an evaluation of the cause is essential. The causes of hematuria and basic approaches to its diagnosis are discussed in this review.

DRG(Diagnosis-Related Group)를 이용한 포괄진료비 지불제도의 선택 참여에 따른 재원일수 변화 (Variation in hospital length of stay according to the DRG-based prospective payment system in the voluntarily participating providers)

  • 최숙자;권순만;강길원;문상준;이진석
    • 보건행정학회지
    • /
    • 제20권2호
    • /
    • pp.17-39
    • /
    • 2010
  • This study explored the impact on the DRG(Diagnosis-Related Groups)-based prospective payment system(PPS) operated by voluntarily participation providers. We analyzed whether the provides in the DRG-based PPS and in traditional fee-for-service(FFS) systems showed different the degree of variation in length of stay(LOS), and the providers' behaviors depending on the differences according to the varied participation periods. The study sample included all data 2,061 institutions participated in DRG-PPS in 2007 and all cases 473 FFS institutions which reported fee-for-service claims were reviewed same diagnosized diseases at least 10cases claims during three months We compared the differences of the LOS among health care institutions according to their type, region, and size. For DRGs showing significant differences in LOS, multiple regression analyses were performed to find out factors associated with LOS and interaction effect participation and hospital types or participation periods. The result provide the evidence that the DRG payment system operated by volunteering health care institutions had impact on resources use, which can reduce the institutions' the length of stay. While some DRGs had no correlation between participation periods and LOS, other DRGs, DRG participation period reversely linear relationship with LOS. That is to say, the longer participation year, the less reducing the LOS. These results support the future expansion of the DRG-based PPS plan to all health care services in Korea.

수생태계 현황 조사 및 건강성 평가결과를 활용한 수생태계 훼손원인 진단체계 구축 (Establishing Diagnosis Systems for Impaired Stream Ecosystem using Stream/River Ecosystem Survey and Health Assessment)

  • 이종원;이상우;황순진;장민호;원두희;안경진;박혜진;이정아
    • 생태와환경
    • /
    • 제53권1호
    • /
    • pp.1-10
    • /
    • 2020
  • 본 연구는 훼손된 하천 수생태계의 훼손원인을 식별하고 그 전이 과정을 규명하기 위해 수생태계 훼손원인 진단체계를 구축하고 정책적 활용 가능성을 보고자 하였다. 수생태계 현황 조사 및 건강성 평가결과는 하천의 훼손에 대한 전반적인 상황을 알 수 있어 하천 복원 및 관리의 판단 근거로 사용된다. 그러나 하천이 훼손된 원인이나 훼손이 발생하게 된 전이 과정을 고려하지 못한다는 한계를 가진다. 따라서 본 연구에서는 과학적이고 체계적인 진단체계를 제안하여 훼손원인과 그 전이 과정을 규명하였다. 미국, 호주, 유럽의 사례를 분석하여 우리나라에 맞는 진단체계를 제안하였다. 총 8단계로 구성되며, 기초자료 조사, 하천 수생태계 훼손 판단, 훼손 구간 설정, 훼손 유형화 및 잠재적 훼손원인 도출, 본 조사, 주훼손원인 진단 및 최적 훼손 모델 도출, 종합분석 및 하천 복원방안으로 이루어져 있다. 이러한 진단체계는 하천 생태계의 복잡하고 다양한 특성을 고려하여 훼손원인을 파악할 수 있으며 하천 복원 및 관리 방안을 제시하여 효율적인 의사결정을 지원할 수 있다.

Study of the structural damage identification method based on multi-mode information fusion

  • Liu, Tao;Li, AiQun;Ding, YouLiang;Zhao, DaLiang
    • Structural Engineering and Mechanics
    • /
    • 제31권3호
    • /
    • pp.333-347
    • /
    • 2009
  • Due to structural complicacy, structural health monitoring for civil engineering needs more accurate and effectual methods of damage identification. This study aims to import multi-source information fusion (MSIF) into structural damage diagnosis to improve the validity of damage detection. Firstly, the essential theory and applied mathematic methods of MSIF are introduced. And then, the structural damage identification method based on multi-mode information fusion is put forward. Later, on the basis of a numerical simulation of a concrete continuous box beam bridge, it is obviously indicated that the improved modal strain energy method based on multi-mode information fusion has nicer sensitivity to structural initial damage and favorable robusticity to noise. Compared with the classical modal strain energy method, this damage identification method needs much less modal information to detect structural initial damage. When the noise intensity is less than or equal to 10%, this method can identify structural initial damage well and truly. In a word, this structural damage identification method based on multi-mode information fusion has better effects of structural damage identification and good practicability to actual structures.

최근 5개년 (2013~2017)간 기관지확장증(J47) 환자에게 처방한 급여한약제제 현황 분석 - 건강보험청구자료 중심으로 (Herbal medicine prescription analyses of bronchiectasis patients with claim data during 5 years (2013~2017))

  • 강소현;김진희;장수빈;이미영;이주아;박선주
    • 대한예방한의학회지
    • /
    • 제23권3호
    • /
    • pp.1-12
    • /
    • 2019
  • Objectives : Korean national health insurance data is a useful real-world data representing whole medical bills submitted to Health Insurance Review Agency. This study aims to understand recent benefit trend of insurance herbal preparations for treating bronchiectasis(disease code J47) utilizing insurance data. Methods : We reviewed national health insurance claims data from 2013 to 2017 which have main diagnosis or sub diagnosis code of J47 and with the record of prescribing insurance herbal medication. Frequency analysis was performed to analyze the most frequently prescribed prescription. Results & Conclusions : Both the number of claims statement(770 to 1,746cases) and patients(266 to 484) of insurance herbal preparations increased considerably from 2013 to 2017. Top 10 preparations based on the number of claims statement were 'Samso-eum', 'Yeonkyopaedok-san', 'Socheongryong-tang', 'Bojungikgi-tang', 'Hyangsapyungwi-san', 'Yijin-tang', 'Saengmaek-san', 'Jaeumganghwa-tang', 'Ojeok-san' and 'Gungha-tang'. Top 10 preparations based on the number of patients were 'Samso-eum', 'Socheongryong-Tang', 'Saengmaek-san', 'Yeonkyopaedok-san', 'Haengso-tang', 'Hyangsapyungwi-san', Yijin-tang', 'Jaeumganghwa-tang', 'Bojungikgi-tang' and 'Hyeonggaeyeongyo-tang' in respectiv order. Claims of top 10 frequent preparations occupied more than 60% of total claims. We hope this finding to be utilized as basic data for future research of evidence-based bronchiectasis treatment utilizing Korean traditional medicine.

Efficiency and accuracy of artificial intelligence in the radiographic detection of periodontal bone loss: A systematic review

  • Asmhan Tariq;Fatmah Bin Nakhi;Fatema Salah;Gabass Eltayeb;Ghada Jassem Abdulla;Noor Najim;Salma Ahmed Khedr;Sara Elkerdasy;Natheer Al-Rawi;Sausan Alkawas;Marwan Mohammed;Shishir Ram Shetty
    • Imaging Science in Dentistry
    • /
    • 제53권3호
    • /
    • pp.193-198
    • /
    • 2023
  • Purpose: Artificial intelligence (AI) is poised to play a major role in medical diagnostics. Periodontal disease is one of the most common oral diseases. The early diagnosis of periodontal disease is essential for effective treatment and a favorable prognosis. This study aimed to assess the effectiveness of AI in diagnosing periodontal bone loss through radiographic analysis. Materials and Methods: A literature search involving 5 databases (PubMed, ScienceDirect, Scopus, Health and Medical Collection, Dentistry and Oral Sciences) was carried out. A specific combination of keywords was used to obtain the articles. The PRISMA guidelines were used to filter eligible articles. The study design, sample size, type of AI software, and the results of each eligible study were analyzed. The CASP diagnostic study checklist was used to evaluate the evidence strength score. Results: Seven articles were eligible for review according to the PRISMA guidelines. Out of the 7 eligible studies, 4 had strong CASP evidence strength scores (7-8/9). The remaining studies had intermediate CASP evidence strength scores (3.5-6.5/9). The highest area under the curve among the reported studies was 94%, the highest F1 score was 91%, and the highest specificity and sensitivity were 98.1% and 94%, respectively. Conclusion: AI-based detection of periodontal bone loss using radiographs is an efficient method. However, more clinical studies need to be conducted before this method is introduced into routine dental practice.