• 제목/요약/키워드: Clinical Evaluation Tool

검색결과 395건 처리시간 0.031초

Usefulness of the Clock Drawing Test as a Cognitive Screening Instrument for Mild Cognitive Impairment and Mild Dementia: an Evaluation Using Three Scoring Systems

  • Kim, Sangsoon;Jahng, Seungmin;Yu, Kyung-Ho;Lee, Byung-Chul;Kang, Yeonwook
    • 대한치매학회지
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    • 제17권3호
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    • pp.100-109
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    • 2018
  • Background and Purpose: Although the clock drawing test (CDT) is a widely used cognitive screening instrument, there have been inconsistent findings regarding its utility with various scoring systems in patients with mild cognitive impairment (MCI) or dementia. The present study aimed to identify whether patients with MCI or dementia exhibited impairment on the CDT using three different scoring systems, and to determine which scoring system is more useful for detecting MCI and mild dementia. Methods: Patients with amnestic mild cognitive impairment (aMCI), vascular mild cognitive impairment (VaMCI), mild Alzheimer's disease (AD), mild vascular dementia (VaD), and cognitively normal older adults (CN) were included. All participants were administered the CDT, the Korean-Mini Mental State Examination (K-MMSE), and the Clinical Dementia Rating scale. The CDT was scored using the 3-, 5-, and 15-point scoring systems. Results: On all three scoring systems, all patient groups demonstrated significantly lower scores than the CN. However, while there were no significant differences among patients with aMCI, VaMCI, and AD, those with VaD exhibited the lowest scores. Area under the Receiver Operating Characteristic curves revealed that the three CDT scoring systems were comparable with the K-MMSE in differentiating aMCI, VaMCI, and VaD from CN. In differentiating AD from CN, however, the CDT using the 15-point scoring system demonstrated the most comparable discriminability with K-MMSE. Conclusions: The results demonstrated that the CDT is a useful cognitive screening tool that is comparable with the Mini-Mental State Examination, and that simple CDT scoring systems are sufficient for differentiating patients with MCI and mild dementia from CN.

Retrospective and Prospective Determination of the Cow's Milk-Related Symptom Score (CoMiSSTM) Values in Symptomatic Infants

  • Kozlowska-Jalowska, Anna;Horvath, Andrea;Vandenplas, Yvan;Szajewska, Hania
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제24권4호
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    • pp.384-391
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    • 2021
  • Purpose: The Cow's Milk-related Symptom Score (CoMiSSTM) was developed as an awareness tool for evaluating cow's milk-related symptoms in otherwise healthy children. Using a convenience sample of participants, this cross-sectional study aimed to determine CoMiSSTM values of symptomatic infants based on retrospectively or prospectively obtained information. Methods: CoMiSSTM values were determined in infants aged <12 months with symptoms suggestive of cow's milk protein allergy or functional gastrointestinal disorders. The exclusion criteria were previous diagnosis with acute or chronic disease, treatment with a therapeutic formula, and in case of breastfeeding, an elimination diet followed by the mother. Two CoMiSSTM values were assessed. A retrospective collection was defined as the collection of data after initial contact with the medical center but before the first medical consultation. A prospective collection was defined as the collection of data within 24 hours from the time of medical consultation but before starting any therapeutic intervention. The CoMiSSTM total and individual component scores obtained retrospectively or prospectively were compared between groups using the Wilcoxon signed-rank test. Results: This study was performed between August and November 2019. Data of 110 children (62 males and 48 females), with a mean±standard deviation age of 18.2±11.7 weeks, were obtained. The total CoMiSSTM value (p<0.001) and some individual component scores (crying, regurgitation, and stool) were significantly lower when collected prospectively than when collected retrospectively. Conclusion: CoMiSSTM values were retrospectively and prospectively determined. Lower CoMiSSTM values were obtained during prospective evaluation. Possible differences should be considered when using CoMiSSTM in clinical practice.

Evaluation of ultrasonography as a diagnostic tool in the management of periapical cysts and granulomas: A clinical study

  • Avci, Fatma;Etoz, Meryem;Ustun, Yakup;Arslan, Tugrul
    • Imaging Science in Dentistry
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    • 제52권2호
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    • pp.209-217
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    • 2022
  • Purpose: The aim of this study was, firstly, to determine the concordance of ultrasonographic and histopathological diagnoses in patients in whom apical resection was already indicated. Secondly, this study aimed to determine whether lesions were periapical granulomas or cysts, and to compare them after root canal treatment using ultrasonography and periapical radiographs. Materials and Methods: In the first stage of the study, ultrasonographic and histopathologic diagnoses of 10 lesions were compared. Secondly, the periapical radiographs and ultrasonographic images of 44 lesions were measured. The presence of internal vascularity was determined by ultrasonographic color and power Doppler modes. Follow-up examinations of healing after root canal treatment were performed using ultrasonography and periapical radiographs, and these modalities were compared. Results: In the periapical granuloma and cyst groups, the measurement values decreased for all variables. There was no significant difference in the dimensional changes of lesions between the 2 groups, and ultrasonography and periapical radiographs were compatible. The pre-diagnoses were compared with histopathological diagnoses and were found to be compatible. Conclusion: The ultrasonographic color and power Doppler techniques could be an effective method for diagnosing periapical lesions as cysts or granulomas. After root canal treatment of granulomas and cysts, the dimensional shrinkage and healing patterns appear to be similar. Ultrasonography and periapical radiographs were consistent in terms of dimensional comparisons, and ultrasonography may be an alternative method for follow-up of the healing of periapical lesions.

노인의 삶의 질을 위한 지역사회 프로그램에 관한 체계적 고찰 (A Systemic Review of Community-Based Programs for the Quality of Life of the Elderly)

  • 주은솔;방요순
    • 대한통합의학회지
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    • 제9권2호
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    • pp.173-181
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    • 2021
  • Purpose : The purpose of this study was to identify the clinical effect, assessment, method, and recent trend of the programs by systematically reviewed community-based programs for the elderly's quality of life conducted in the last ten years, and to present comprehensive basic data for occupational therapists who want to apply community-based programs improving quality of life. Methods : This study identified 811 studies from among those registered in the RISS, KISS, DBpia, NDSL, and KCI databases from January to September 2020, using "elderly," "community elderly," "65 aged," "quality of life," "occupational therapy," "occupational therapy program," "intervention," and "intervention program" as keywords. From these results, 11 documents were selected. Results : It was found that studies of occupational therapy programs for the quality of life of the elderly have been continuously conducted since 2010, and most of them were non-random control studies. The quality of life evaluation tool used most frequently was SF-36, and WHOQOL-BREF and SF-8 were also used. The selected programs were classified as were exercise programs and complex programs. For most of the exercise programs, interventions were carried out for 12 weeks, three times a week for 30~60 minutes. In the case of the complex programs, the duration of interventions was nine weeks, and the frequency and time per session varied. All of the exercise programs showed significant effects. Among the complex programs, two studies showed significant effects, but the remaining one study did not. Conclusion : Through this study, the types and effects of occupational therapy programs for the quality of life of the elderly were examined. Hereafter, studies of the development and to verify the effects of these programs should be actively carried out.

Periodontal parameters in orthodontically tractioned teeth: A systematic review and meta-analysis

  • de Mattos, Paola Marques;Goncalves, Flavio Magno;Basso, Isabela Bittencourt;Ferraz, Aline Xavier;Zeigelboim, Bianca Simone;Stechman-Neto, Jose;Santos, Rosane Sampaio;de Araujo, Cristiano Miranda;Guariza-Filho, Odilon
    • 대한치과교정학회지
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    • 제52권6호
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    • pp.420-431
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    • 2022
  • Objective: This systematic review aimed to evaluate periodontal parameters in orthodontically tractioned teeth compared with the respective non-tractioned contralateral teeth. Methods: Search strategies were developed for six electronic databases and gray literature. Random-effects meta-analyses were performed for the outcomes of interest. Furthermore, the certainty of the evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) tool. Results: Overall, 2,082 articles were identified, of which 24 were selected for the qualitative synthesis. A significant difference was observed between the impacted and contralateral teeth (mean difference [MD] = 0.25; 95% confidence interval [CI] = 0.10-0.40; I2 = 0%) when the gingival index was evaluated. Additionally, impacted teeth showed a greater probing depth, with a significant mean difference between the groups (MD = 0.14; 95% CI = 0.07-0.20; I2 = 6%). Most studies had a low risk of bias; however, the certainty of the evidence was very low owing to the design of existing studies. Conclusions: The evidence in the literature indicated that tractioned teeth might show worsening of periodontal parameters related to the gingival index and probing depth; however, the evidence remains uncertain about this outcome. Furthermore, probing depth should be considered regarding its clinical significance because of the small effect size observed.

Disinfectant effectiveness of chlorhexidine gel compared to sodium hypochlorite: a systematic review with meta-analysis

  • Theodoro Weissheimer;Karem Paula Pinto;Emmanuel Joao Nogueira Leal da Silva;Lina Naomi Hashizume;Ricardo Abreu da Rosa;Marcus Vinicius Reis So
    • Restorative Dentistry and Endodontics
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    • 제48권4호
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    • pp.37.1-37.17
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    • 2023
  • This study aimed to compare the disinfectant ability of chlorhexidine (CHX) gel and sodium hypochlorite (NaOCl). Systematic searches were conducted from inception until December 8th, 2022 (MEDLINE/PubMed, Cochrane Library, Web of Science, Scopus, Embase, and Grey Literature databases). Only randomized clinical trials were included. The revised Cochrane risk of bias tools for randomized trials were used to assess the quality of studies. Meta-analyses were performed. The overall quality of evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation tool. Six studies were included. Five had a low risk of bias and 1 had some concerns. Three studies assessed bacterial reduction. Two were included in the meta-analysis for bacterial reduction (mean difference, 75.03 [confidence interval, CI, -271.15, 421.22], p = 0.67; I2 = 74%); and 3 in the meta-analysis for cultivable bacteria after chemomechanical preparation (odds ratio, 1.03 [CI, 0.20, 5.31], P = 0.98; I2 = 49%). Five studies assessed endotoxin reduction. Three were included in a meta-analysis (mean difference, 20.59 [CI, -36.41, 77.59], p = 0.48; I2 = 74%). There seems to be no difference in the disinfectant ability of CHX gel and NaOCl, but further research is necessary.

산란계에서 Chlorhexidine-inactivated Salmonella Enteritidis, S. Typhimurium 및 S. Gallinarum 3가 백신의 효능평가 (Evaluation of the protective efficacy of trivalent Salmonella inactivated vaccine including Chlorhexidine-inactivated Salmonella Enteritidis, S. Typhimurium and S. Gallinarum in poultry)

  • 유영주;유정희;허진
    • 한국동물위생학회지
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    • 제46권4호
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    • pp.303-314
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    • 2023
  • Protective efficacy of trivalent Salmonella inactivated vaccine containing Chlorhexidine-inactivated S. Enterltidis (SE), S. Typhimurium (ST), and S. Gallinarum (SG) strains, was evaluated in this study. A total of 70 brown nick layers were divided into 7 groups, A to G, containing 10 hens per group. All hens in groups B to D were intramuscularly immunized with approximately 7×108 cells (3×108 cells of SE+1×108 SE+1×108 cells of ST+3×108 cells of SG) of the trivalent vaccine in 0.5 mL of PBS. All chickens in groups E to G were injected with sterile PBS. All hens of groups B and E, groups C and F, and groups D and G were orally challenged with approximately 2 ×109 CFU of wild-type SE, ST, and SG, respectively. Serum IgG titers and CD3+CD4+ T-cells, and CD3+CD8+ T-cells levels of groups B to D significantly higher than those of group A. In addition, all animals in groups A to C, E and F showed no clinical symptoms and survived after the virulent challenges, whereas one chicken in group D died and all chickens in group G died following the challenge. The protection against wild-type SE and ST in liver, spleen, cecum, and cloaca of groups B and C chickens was significant effective as compared with those in groups E and F. These indicate that the trivalent inactivated vaccine can be an effective tool for prevention of Salmonella infections by inducing robustly protective immune responses and cellular immune response in chickens.

안정형 협심증 환자들에서 관상동맥 전산화단층촬영을 이용한 심근허혈의 평가 (Evaluation of Myocardial Ischemia Using Coronary Computed Tomography Angiography in Patients with Stable Angina)

  • 고성민
    • 대한영상의학회지
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    • 제81권2호
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    • pp.250-271
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    • 2020
  • 안정형 협심증 환자에서 관상동맥질환의 치료 여부를 결정하고 임상 결과를 예측하기 위해서는 심근허혈의 평가가 중요하다. 현재 심근허혈 진단의 표준검사법으로 분획혈류예비력 검사법이 인정되나 침습적 검사라는 제한점이 있다. 또한, 관상동맥 전산화단층촬영은 형태적인 관상동맥질환 진단에 유용한 방법으로 정립되었지만, 혈역학적으로 유의한 협착에 의한 심근허혈 진단에는 한계가 있다. 최근 이러한 문제를 해결하고자 관상동맥 전산화단층촬영 영상을 기반으로 측정한 관상동맥 죽상경화판의 정량화, 심근관류, 그리고 심근 분획혈류 예비력을 이용한 연구들이 진행되어 왔고, 그 진단적 가치를 점차 인정받고 있다. 본 종설에서는 심근허혈진단과 관련된 관상동맥 전산화단층촬영 혈관조영술의 여러 영상기법들에 대해서 알아보고자 한다.

자궁내막암의 치료 후 루틴 추적검사 방법으로서 FDG-PET/CT의 유용성 (Usefulness of FDG-PET/CT as a Diagnostic Tool for Routine Post Therapy Evaluation in Endometrial Cancer)

  • 이신재;전태주;김승조;김희진;안희정
    • Nuclear Medicine and Molecular Imaging
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    • 제43권4호
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    • pp.301-308
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    • 2009
  • 목적: 자궁내막암의 치료 후 루틴 추적관찰로써의 FDG-PET/ET의 유용성에 대해 알아보고자 하였다. 대상 및 방법: 자궁내막암으로 치료 받은 환자 중 2004년 1월 1일부터 2008년 1월 31일 사이에 FDG-PET/CT를 시행한 101명의 환자(25-79세, 평균 50.6세)를 대상으로 하였다. 모든 환자에서 종양표지 자와 다른 영상의학적 검사(CT, MR)에 대해서도 함께 검토하였다. FDG-PET/CT상 국소 FDG 섭취를 보인 병변을 benign, equivocal, malignant로 분류하였고, equivocal과 maliganat 병변에 대하여 조직학적 혹은 임상적으로 재발유무를 판정하였다. 결과: FDG-PET/CT상 강한 섭취를 보인 경우는 19명의 30개의 병변이었다. Malignant 섭취를 보인 환자는 14명이었고, 이중 11예가 재발로 확인되었다. Equivocal 병변을 보인 환자는 5명 이었고, 이중 1예가 재발로 확인되었다. 위음성을 보인 경우는 2예가 있었고, 모두 복강내 암종증 환자로 진단되었다. 이상의 결과를 종합하였을 때, 자궁내막암의 치료 후 재발의 평가에 대한 전반적인 결과는 예민도 86 %,특이도 92 %, 양성 예측도 63 %, 음성예측도 98 %, 그리고 정확도는 91 %였다. 결론: 자궁내막암의 치료 후 루틴 추적관찰로써 FDG-PET/ET를 시행할 경우 높은 예민도, 특이도로 재발의 진단에 도움이 될 뿐만 아니라 높은 음성 예측도로 인하여 FDG-PET/CT상 음성인 경우 불필요한 추가 검사를 피할 수 있을 것으로 기대된다.

만성 뇌졸중 환자들의 지역사회 보행 수준 구별을 위한 일어나 걸어가기 검사, 8자 모양 경로 보행 검사, 네 막대 스텝 검사, 스텝 검사의 변별력과 예측 타당도 (Discriminant and predictive validity of TUG, F8WT, FSST, ST for community walking levels in chronic stroke survivors)

  • 이동건;안승헌;이규창
    • 대한물리치료과학회지
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    • 제27권2호
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    • pp.25-35
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    • 2020
  • Background: There are many situations where walking in an actual community needs to change direction along with walking on a straight path, and this situation needs to be reflected in assessing walking ability of the community. Therefore, in this study, we tried to determine whether the assessments can distinguish the level of walking in the community. Design: Retrospective cohort study. Methods: Fifty-two survivors with chronic stroke have participated in the study. According to the evaluation result of 10mWT, the subjects of 0.8m/s and above were classified as the group who could walk in the community (n=22), and the subjects of 0.4m/s~0.8m/s were classified into the group who could not walk in the community (n=30). Modified Rivermead Mobility Index, Postural Assessment Scale for Stroke, Fugl-Meyer Assessment, Berg Balance Scale, 10-meter Walk Test (10mWT) were used to evaluate the motor skills. Furthermore, Activities-specific Balance Confidence Scale was used to evaluate psychological factors, and Timed Up & Go Test (TUG), Figure-of-Eight Walk Test (F8WT), Four Square Step Test (FSST), Step Test (ST) were applied to evaluate dynamic balance and mobility. Results: As a result for distinguishing walking levels in the community, TUG was 14.25 seconds, F8WT was 13.34 seconds, FST was 19.43 seconds, and ST of affected side and non-affected side were 6.5 points and 7.5 points, respectively. TUG (AUC=0.923), F8WT (AUC=0.905), and FST (AUC=0.941) were highly accurate, but the ST of affected side and non-affected side (AUC=0.806, 0.705) showed the accuracy of the median degree, respectively. Conclusion: To distinguish walking levels in the community of survivors with chronic stroke, TUG and FSST have been found to be the best assessment tool, and in particular, FSST could be very valuable in clinical use as the most important assessment tool to distinguish walking levels in the community.